Epidemiology and Prevention in Alcohol Research

Mike Hilton, Ph.D.

Reissuance of PA-18-390, PA-18-391, and PA-18-413

Purpose

The purpose of this announcement is to replace a series of recently expired Program Announcements in order to communicate the broad scope of research topics of interest to the Division of Epidemiology and Prevention Research at the National Institute on Alcohol Abuse and Alcoholism.

Advancing knowledge about the epidemiology of alcohol use is fundamental to improving public health. One prominent objective is to better understand the developmental trajectories of alcohol use, misuse, and alcohol use disorder. Studies have established that people who initiate alcohol use at younger ages are more likely to develop alcohol use disorders; however, much remains to be learned about factors that either accelerate or inhibit the progression from early initiation to frequent heavy drinking, and to the development of an alcohol use disorder. Research to elucidate the interplay between risk factors in this progression is of interest including identifying the ways in which epigenetic changes in gene expression are produced by interactions with environmental influences. Similarly, of interest, is research that identifies correlates of "maturing out" of heavy drinking, and provides a better understanding of how to support this phenomenon which happens in most individuals, but not all.

The ultimate goal is to identify and understand interactions of risk and protective factors that vary in salience over the life course, as well as by gender, ethnicity, and socioeconomic status, and to develop prevention strategies that can be tailored to optimize effectiveness for a particular subgroup or age category.

The outcomes targeted by prevention interventions can vary. For example, they may seek to reduce early onset, binge drinking, high-intensity drinking, and/or alcohol use disorders. Others may target health conditions including hepatic disease, cardiovascular disease, and cancer. Others target injuries or deaths attributed to traffic crashes, interpersonal violence, or suicide. The whole matrix of risk and protective factors by alcohol-related outcomes describes a rich set of potential interventions that can be developed and targeted.

Scope

Given these considerations, NIAAA encourages applications in, but not limited to, the following areas:

• Understand the interaction of alcohol use and other risk factors during gestation, childhood, adolescence, young adulthood, and midlife, and across generations, that lead or contribute to chronic diseases and health conditions.
• Build a better understanding of alcohol misuse among women and identify and evaluate effective strategies to reduce alcohol misuse among females across the lifespan, with particular emphasis on adolescent girls, pregnant women, and breastfeeding women.
• Examine the impact of simultaneous alcohol and drug use on unintentional and intentional injuries and how to prevent simultaneous use.
• Identify the factors driving high-intensity drinking and evaluate strategies to reduce its prevalence.
• Use ecological momentary assessment techniques to study the influence of mood states, environmental cues, and social contexts on the occurrence of heavy drinking occasions.
• Develop and evaluate novel tools for screening and brief intervention for both alcohol and drug misuse.
• Develop and evaluate interventions to prevent and reduce alcohol misuse by older adults.
• Develop and evaluate strategies to prevent and reduce alcohol misuse among young adults, especially those in the military and the civilian work force.
• Evaluate strategies to reduce harmful alcohol use in college and non-college populations.
• Develop and evaluate strategies to prevent underage drinking.
• Develop and evaluate culturally appropriate and effective interventions to reduce alcohol misuse in in NIH-defined minority health and health disparities populations.
• Develop and evaluate prevention strategies tailored for specific populations and developmental periods when universal approaches are less effective.
• Study the effect of public policy on alcohol use, other substance use, and alcohol related harms.
• Support epidemiologic and systems science research to elucidate how biological, environmental, and behavioral determinants interact to impact alcohol misuse and related consequences.
• Understand the nature and extent of harms that misuse of alcohol imposes on others and evaluate interventions to prevent or reduce such harms.
• Examine the linkages between alcohol misuse and various health conditions, both mental and somatic, and develop and evaluate interventions for persons with such co-occurring disorders.
• Develop interventions to prevent untoward effects of advertising, social media, and cultural influences on underage drinking.

Outcomes

• Improved understanding of the developmental trajectories of alcohol misuse and alcohol use disorders.
• Clarification of how those trajectories may differ by age, gender, race, and ethnicity.
• Better understanding of the drivers of the maturing out process, which could be the targets of prevention efforts.
• Improved understanding of “in the moment” cognitions and motivations that influence drinking episodes, as revealed by ecological momentary assessment research.
• Monitoring to determine whether public policy choices reduce or increase problems associated with alcohol consumption.

Grant Mechanisms

We will use the R01 Research Project Grant, R21 Exploratory/Developmental Research Grant, and R03 Small Grant mechanisms.