Project Recognize: Improving Measurement of Alcohol Use and Demographic Factors through Community Engagement

Researchers and health practitioners use data from federal health surveys, electronic health records (EHRs), and research studies to monitor health in the United States. Within the U.S. population, there are stark health differences, particularly for alcohol use, substance use, and mental illness by demographic factors. The ability to accurately identify potential causal pathways and how they differ by demographic factors is vital to ensure that public health and health care research, policy, and practice are appropriately equipped to address health needs in the U.S. population. This is particularly true in the case of alcohol, which remains one of the most commonly used and abused drugs nationwide, in both adolescent and adult individuals. However, measurement of demographic characteristics remains poorly defined and inconsistently used across health research and practice settings. For example, most research studies, electronic health records platforms, and national epidemiologic surveys contain demographic questions that have not been rigorously validated across all demographic groups, and limitations in question wording and response options are evident. Current approaches fail to capture accurate and consistent demographic data relevant to the full U.S. population, leading to difficulties in comparing the magnitude of disease across systems. Furthermore, current measures often are not comprehensive, lack the ability to select multiple response options, and fail to account for changes over time. Without comprehensive, validated measures to assess demographics, the ability to understand the magnitude of disease impact across different communities, as well as the best approaches to intervene, is limited. Therefore, it is vital to develop standardized, flexible demographic measures for use across all populations and regions. This project will address these gaps through iterative, community-engaged development of new demographic measures, and will assess the effectiveness of new vs. prior measures to characterize differences in alcohol use, substance use, and mental health in the US population.