Administrative Data Research Wales, Swansea University Medical School, Wales SA2 8PP, UK.
National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Wales, SA2 8PP, UK.
Int J Popul Data Sci. 2022 Jul 7;7(1):1717. doi: 10.23889/ijpds.v7i1.1717. eCollection 2022.
Early alcohol use has significant association with poor health outcomes. Individual risk factors around early alcohol use have been identified, but a holistic, data-driven investigation into health and household environmental factors on early alcohol use is yet to be undertaken.
This study aims to investigate the relationship between preceding health events, household exposures and early alcohol use during adolescence using a two-stage data-driven approach.
In stage one, a study population (N = 1,072) were derived from the Millennium Cohort Study (MCS) Wales (born between 2000-2002). MCS data were first linked with electronic-health records. Factors associated with early (<=eleven years old) alcohol use were identified using feature selection and stepwise logistic regression. In stage two, analogous risk factors from MCS were recreated for whole population (N = 59,231) of children (born between 1998-2002 in the Welsh Demographic Service Dataset) using routine data to predict the alcohol-related health events in hospital or GP records.
Significant risk factors from stage two included poor maternal mental (adjusted odds ratio [aOR] = 1.31) and physical health (aOR = 1.25), living with someone with alcohol-related problem (aOR = 2.16), single-adult household (aOR = 1.45), ever in deprivation (aOR = 1.66), child's high hyperactivity (aOR = 3.57), and conduct disorder (aOR = 3.26). Children with health events, whose health needs are supported (e.g., are taken to the doctor), are at lower risk of early alcohol use.
Health events of the family members and the child can act as modifiable exposures and may therefore inform the development of prevention initiatives. Families with known alcohol problems, living in deprivation, experiencing child behavioural problems and those who are not taken to the doctor are at higher risk of early drinking behaviour and should be prioritised for early years support and interventions to target problem drinking in young people.
早期饮酒与健康不良结局密切相关。已经确定了与早期饮酒有关的个体风险因素，但尚未进行全面的数据驱动研究，以调查健康和家庭环境因素对早期饮酒的影响。
本研究旨在使用两阶段数据驱动方法调查青少年时期之前的健康事件、家庭暴露与早期饮酒之间的关系。
在第一阶段，从千禧年队列研究（MCS）威尔士（2000-2002 年出生）中获得研究人群（N=1072）。首先将 MCS 数据与电子健康记录链接。使用特征选择和逐步逻辑回归确定与早期（<=11 岁）饮酒相关的因素。在第二阶段，使用常规数据为 MCS 中的类似风险因素创建整个人群（1998-2002 年出生于威尔士人口服务数据集的 59231 名儿童），以预测医院或全科医生记录中的与酒精相关的健康事件。
第二阶段的显著风险因素包括母亲心理健康不佳（调整后的优势比[aOR]=1.31）和身体健康不佳（aOR=1.25）、与有酒精相关问题的人同住（aOR=2.16）、单亲家庭（aOR=1.45）、曾经贫困（aOR=1.66）、儿童高度多动（aOR=3.57）和品行障碍（aOR=3.26）。有健康事件的儿童，如果其健康需求得到支持（例如，去看医生），则不太可能早期饮酒。
家庭成员和儿童的健康事件可以作为可改变的暴露因素，因此可以为预防措施的制定提供信息。已知有酗酒问题、生活贫困、有儿童行为问题且未就医的家庭，以及那些未就医的家庭，更有可能出现早期饮酒行为，应优先为其提供早期支持和干预措施，以针对年轻人的问题饮酒行为进行干预。
