Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, MA (LEW, KMM, ERW); Department of Pediatrics, Harvard Medical School, MA (LEW, SL, ERW); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California Los Angeles, CA (LEW); Division of Developmental Medicine, Boston Children's Hospital, MA (SL); Computational Health Informatics Program, Boston Children's Hospital, MA (ERW).
J Addict Med. 2020 Jul/Aug;14(4):311-318. doi: 10.1097/ADM.0000000000000603.
Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, we sought to identify clusters of RALD and test associations with use behaviors.
Eligible YCMC (ages 9-18) recruited from outpatient clinics reported their use behaviors and importance of potential RALD. Cluster analysis was used to discern RALD patterns, which were examined as predictors of alcohol use using multivariate regression.
Among 398 participants, 30.9% reported past year alcohol use. Concerns about impacts on medications, school, and disease status were the most frequently endorsed RALD; prior negative experiences with alcohol and family history were the least frequently endorsed. Five RALD clusters were identified for all YCMC and 2 for recent drinkers. Compared to the cluster with high endorsement of multiple general and health-related RALD, those predominantly citing concerns about addiction and those not strongly endorsing any RALD consistently reported greater alcohol use. Among recent drinkers, the cluster characterized by low concern across multiple RALD also consistently reported greater alcohol use compared to their counterparts expressing moderate concern.
For YCMC, RALD are complex but endorsement of multiple general and health-related RALD is associated with less use, and health concerns are especially prevalent. More research is needed to understand how salient RALD can inform tailored interventions that aim to delay and reduce substance use and improve health outcomes for YCMC.
患有慢性疾病的年轻人（YCMC）的饮酒水平与健康同龄人相似，但面临更高的不良健康后果风险。由于 YCMC 避免或限制饮酒的重要原因（RALD）尚不清楚，我们试图确定 RALD 的聚类，并测试其与使用行为的关联。
从门诊诊所招募的合格 YCMC（9-18 岁）报告了他们的使用行为和潜在 RALD 的重要性。聚类分析用于辨别 RALD 模式，并用多元回归检验这些模式与饮酒行为的关联。
在 398 名参与者中，30.9%报告了过去一年的饮酒情况。对药物、学业和疾病状况影响的担忧是最常被提及的 RALD；之前与酒精有关的负面经历和家族史是最不常被提及的。为所有 YCMC 确定了 5 个 RALD 聚类，为最近饮酒者确定了 2 个。与高度认可多种一般和与健康相关的 RALD 的聚类相比，那些主要关注成瘾问题的聚类和那些不强烈认可任何 RALD 的聚类报告的饮酒量始终更大。在最近饮酒者中，那些对多个 RALD 关注度较低的聚类也始终报告的饮酒量比表达中度关注的聚类更大。
对于 YCMC，RALD 很复杂，但认可多种一般和与健康相关的 RALD 与使用量较少相关，而健康问题尤其普遍。需要进一步研究如何了解重要的 RALD 可以为针对 YCMC 的延迟和减少物质使用以及改善健康结果的量身定制的干预措施提供信息。
