Khanna Aditya S, Rousell Noah, Davis Tori, Zhang Yurui, Sheeler Daniel, Cioe Patricia, Martin Rosemarie, Kahler Christopher W
Brown University School of Public Health, Providence, RI, USA.
The University of Chicago, Chicago, IL, USA.
Int J Alcohol Drug Res. 2024 Dec 12;12(2):54-67. doi: 10.7895/ijadr.507. Epub 2024 Oct 1.
Tobacco smoking and alcohol use contribute to a synergy of epidemics (a "syndemic") that disproportionately affects persons involved with the criminal legal system (PCLS) and their social networks. An improved understanding of the complex interrelationships among the factors of the incarceration-tobacco-alcohol syndemic is essential to develop effective reform policies and interventions. However, collecting empirical data on these interrelationships is often hampered due to logistical and ethical challenges.
We developed an agent-based network model (ABNM) to simulate the effects of the incarceration-tobacco-alcohol syndemic in the state of Rhode Island, USA. The model was validated and calibrated using empirical survey and demographic data. Outcomes included current smoking and heavy alcohol use rates in the first year after release among previously incarcerated agents and in their social networks.
The model successfully replicated demographic, substance use, and incarceration-related parameters. Simulation results suggest high rates of smoking (approximately 80% currently smoking persons in the first few weeks after release) and heavy alcohol use (approximately 40% current heavy alcohol use rate in the first few weeks after release) among PCLS, especially persons with multiple incarceration events. The model also estimated elevated rates of current smoking and current heavy alcohol use in the direct social contacts of PCLS.
This ABNM integrates biobehavioral health processes relating to incarceration and substance use. This model can be used as a platform to evaluate the potential impacts of interventions provided to PCLS and their networks.
吸烟和饮酒促成了多种流行病的协同作用（一种“综合征”），这种协同作用对涉及刑事法律系统的人员（PCLS）及其社交网络产生了不成比例的影响。更好地理解监禁 - 烟草 - 酒精综合征各因素之间的复杂相互关系对于制定有效的改革政策和干预措施至关重要。然而，由于后勤和伦理方面的挑战，收集这些相互关系的实证数据往往受到阻碍。
我们开发了一种基于主体的网络模型（ABNM）来模拟美国罗德岛州监禁 - 烟草 - 酒精综合征的影响。该模型使用实证调查和人口统计数据进行了验证和校准。结果包括先前被监禁人员及其社交网络中释放后第一年的当前吸烟率和重度饮酒率。
该模型成功复制了人口统计学、物质使用和与监禁相关的参数。模拟结果表明，PCLS中吸烟率很高（释放后的头几周约80%的人目前吸烟），重度饮酒率也很高（释放后的头几周约40%的人目前重度饮酒），尤其是有多次监禁经历的人。该模型还估计PCLS的直接社会接触者中当前吸烟率和当前重度饮酒率有所上升。
这个ABNM整合了与监禁和物质使用相关的生物行为健康过程。该模型可作为一个平台，用于评估向PCLS及其网络提供的干预措施的潜在影响。
