Drinking and parenting practices as predictors of impaired driving behaviors among U.S. adolescents

The Role of Parenting Behaviors and Their Influence on Adolescent Drunk and Drugged Driving: 2016-2019, USA

Drugged driving, the act of driving a vehicle under the influence of illicit drugs, by adolescents is a serious public health concern. Many factors contribute to this risk behavior, but much less is known regarding the role of parenting behaviors in this phenomenon. The purpose of this study was to examine specific parenting behaviors and their influence among a nationally representative sample of adolescents. Pooled data from the 2016-2019 National Survey on Drug Use and Health (NSDUH) among 17,520 adolescents ages 16-17 years old were analyzed. Differences were found in specific parenting behaviors and adolescent drugged/drunk driving, with parents not checking homework and not telling their children they are proud of them being the most influential. Findings from the present study may inform drugged driving prevention programs for parents and adolescents and enhance road safety interventions.

The association between single and dual use of cannabis and alcohol and driving under the influence and riding with an impaired driver in a large sample of Canadian adolescents

OBJECTIVE

Dual use of cannabis and alcohol has increased in adolescents, but limited research has examined how it relates to impaired driving or riding with an impaired driver (IDR) compared to single substance use. This study aimed to examine the odds of alcohol- and/or cannabis-IDR among adolescents based on their use of alcohol and/or cannabis, and whether associations differed by gender and age.

METHODS

Cross-sectional survey data were used from a sample of 69,621 students attending 182 Canadian secondary schools in the 2021/22 school year. Multilevel logistic regression estimated the odds of exclusive alcohol-IDR, exclusive cannabis-IDR, and both alcohol and cannabis IDR (alcohol-cannabis-IDR). Substance use interactions with gender and age were tested.

RESULTS

Overall, 14.7% of participants reported IDR; 7.5% reported exclusive alcohol-IDR, 3.2% reported exclusive cannabis-IDR, 4.0% reported alcohol-cannabis-IDR, and 7.4% were unsure if they had experienced IDR. The prevalence of IDR varied across substance use groups, 8.0% among nonuse, 21.9% among alcohol-only use, 35.9% among cannabis-only use, and 49.6% among dual use groups. Gender diverse, older, and students with lower socioeconomic status exhibited a higher likelihood of reporting alcohol-cannabis-IDR. Dual use was significantly associated with 9.5 times higher odds of alcohol-cannabis-IDR compared to alcohol-only use, and 3.0 times higher odds compared to cannabis-only use. Dual use was also associated with an increased likelihood of either alcohol- or cannabis-IDR.

CONCLUSIONS

This study highlights that all students, regardless of substance use, are at risk of IDR, but students engaged in dual use of alcohol and cannabis face an elevated risk compared to both peers who do not use substances and those who use only a single substance. These findings emphasize the importance of targeted interventions that address the risks associated with IDR.

Shared and distinct parental influences on teen impaired driving in rural and suburban contexts: A mixed methods study of young drivers

OBJECTIVE

To explore shared and distinct parental influences on rural and suburban adolescents' riding with an impaired driver (RWI) and driving while impaired (DWI) behaviors during high school.

METHODS

Participants in the NEXT Generation Health Study (NEXT) were classified into four RWI/DWI trajectory classes (i.e., Abstainer, Escalator, Decliner, Persister) which described patterns of RWI/DWI from high school to emerging adulthood. A follow-up, in-depth, qualitative interview was conducted with a purposeful selection of participants from each trajectory class between March and September 2020. Guided by Ecodevelopmental Theory, the interview included questions which explored parent-teen influences on driving and RWI/DWI.

RESULTS

Imposition of a curfew was a shared parental influence in rural and suburban contexts. Unique to the rural context, parent modeling of RWI/DWI was described as normative and occurring since childhood.

CONCLUSIONS

Prevention interventions targeting parent RWI/DWI may reduce their children's risk for RWI/DWI among rural adolescents.

Impact of the external school food environment on the associations of internal school food environment with high schoolers’ diet and body mass index

Objective:

To examine associations of school food availability with student intake frequency and BMI, and whether the number of neighborhood food outlets modifies these associations.

Design:

Baseline assessment of a nationally representative cohort study of U.S. 10th graders. Students reported intake frequency of fruits and vegetables (FV), snacks, and soda. BMI was calculated from measured height and weight. Administrators of 72 high schools reported the frequency of school availability of FV, snacks, and soda. The number of food outlets within 1 km and 5 km were linked with geocoded school addresses. Data were analyzed using adjusted linear and logistic mixed models with multiple imputation for missing data.

Setting:

U.S. 2009-2010.

Participants:

2,263 U.S. 10th graders from the Next Generation Health Study (NEXT).

Results:

Greater school FV availability was positively associated with student FV intake. Food outlets within 5 km of schools (but not 1 km) attenuated the association of school FV availability with student intake; this was no longer significant at schools with >58 food outlets within 5 km. School food availability was not associated with student BMI or student snack or soda intake.

Conclusions:

School food availability was associated with student intake of FV, but not with snacks, soda, or BMI. Attenuation of the observed associations by the school neighborhood food environment indicates a need to find ways to support healthy student eating behaviors in neighborhoods with higher food outlet density.

Trajectories and Outcomes of Adolescents that Ride With an Impaired Driver/Drive While Impaired

INTRODUCTION

For young drivers, independent transportation has been noted to offer them opportunities that can be beneficial as they enter early adulthood. However, those that choose to engage in riding with an impaired driver (RWI) and drive while impaired (DWI) over time can face negative consequences reducing such opportunities. This study examined the prospective association of identified longitudinal trajectory classes among adolescents that RWI and DWI with their later health, education, and employment in emerging adulthood.

METHODS

We analyzed all seven annual assessments (Waves, W1-W7) of the NEXT Generation Health Study, a nationally representative longitudinal study starting with 10^th grade (2009-2010 school year). Using all seven waves, trajectory classes were identified by latent class analysis with RWI (last 12 months) and DWI (last 30 days) dichotomized as ≥once = 1 vs. none = 0.

RESULTS

Four RWI trajectories and four DWI trajectories were identified: abstainer, escalator, decliner, and persister. For RWI and DWI trajectories respectively, 45.0% (N=647) and 76.2% (N=1,657) were abstainers, 15.6% (N=226) and 14.2% (N=337) were escalators, 25.0% (N=352) and 5.4% (N=99) were decliners, and 14.4% (N=197) and 3.8% (N=83) persisters. RWI trajectories were associated with W7 health status (χ²=13,20, p<.01) and education attainment (χ²=18.37, p<.01). Adolescent RWI abstainers reported better later health status than RWI escalators, decliners, and persisters; and decliners reported less favorable later education attainment than abstainers, escalators, and persisters. DWI trajectories showed no association with health status, education attainment, or employment.

CONCLUSIONS

Our findings suggest the importance of later health outcomes of adolescent RWI. The mixed findings point to the need for more detailed understanding of contextual and time-dependent trajectory outcomes among adolescents engaging in RWI and DWI.

Mapping the complex causal mechanisms of drinking and driving behaviors among adolescents and young adults

BACKGROUND

The proportion of motor vehicle crash fatalities involving alcohol-impaired drivers declined substantially between 1982 and 1997, but progress stopped after 1997. The systemic complexity of alcohol-impaired driving contributes to the persistence of this problem. This study aims to identify and map key feedback mechanisms that affect alcohol-impaired driving among adolescents and young adults in the U.S.

METHODS

We apply the system dynamics approach to the problem of alcohol-impaired driving and bring a feedback perspective for understanding drivers and inhibitors of the problem. The causal loop diagram (i.e., map of dynamic hypotheses about the structure of the system producing observed behaviors over time) developed in this study is based on the output of two group model building sessions conducted with multidisciplinary subject-matter experts bolstered with extensive literature review.

RESULTS

The causal loop diagram depicts diverse influences on youth impaired driving including parents, peers, policies, law enforcement, and the alcohol industry. Embedded in these feedback loops are the physical flow of youth between the categories of abstainers, drinkers who do not drive after drinking, and drinkers who drive after drinking. We identify key inertial factors, discuss how delay and feedback processes affect observed behaviors over time, and suggest strategies to reduce youth impaired driving.

CONCLUSION

This review presents the first causal loop diagram of alcohol-impaired driving among adolescents and it is a vital first step toward quantitative simulation modeling of the problem. Through continued research, this model could provide a powerful tool for understanding the systemic complexity of impaired driving among adolescents, and identifying effective prevention practices and policies to reduce youth impaired driving.

The association of motivation and perceived social norms with eating behaviors in emerging adults

Objective

This study examines the associations of eating-related motivation, perceived norms, and their interaction with eating behaviors in emerging adults.

Design

Data are from the NEXT Generation Health Study, a nationally representative sample of US emerging adults. Binominal logistic regression analyses estimated associations of eating behaviors with self-determined motivation, non-self-determined motivation, and perceived social norms. Multiplicative interaction terms between each motivation construct and perceived social norms were tested in the models.

Results

Self-determined motivation was positively associated with intake frequency of whole grains, low-fat dairy, and fruit and vegetables. Soda intake frequency was inversely associated with greater non-self-determined motivation, but not self-determined motivation or perceived social norms. Perceived social norms were positively associated with the intake of whole grains, low-fat dairy, and fruit and vegetables. Perceived social norms did not moderate the association of motivation constructs with eating behaviors.

Conclusion

Self-determined motivation and perceived social norms may be considered in intervention targeting healthful eating behaviors in emerging adults.

Intoxicated driving and riding with impaired drivers: Comparing days with alcohol, marijuana, and simultaneous use

BACKGROUND

Young adults who engage in simultaneous alcohol and marijuana (SAM) use may be more likely to engage in unsafe behaviors including riding with impaired drivers and driving after alcohol and/or marijuana use.

METHODS

Young adult SAM users (N = 408) self-reported their behavior for five 14-day bursts, yielding daily-level responses on a total of 14,675 substance use days. Adjusted odds ratios (AOR) estimated the likelihood of riding with an impaired driver and of driving after use on SAM use days compared to alcohol- or marijuana-only use days.

RESULTS

More frequent SAM users were more likely to ride with an impaired driver and to drive after use than less frequent SAM users (between-persons). On SAM use days, there were greater odds of riding with an impaired driver, compared to alcohol-only days (AOR = 1.28) and marijuana-only days (AOR = 2.22), and of driving after use, compared to marijuana-only days (AOR = 1.25). Driving after use was more likely on days with non-simultaneous alcohol and marijuana use compared to SAM use (AOR = 1.59).

CONCLUSIONS

Riding with an impaired driver is common among young adult substance users, and more likely following simultaneous use of alcohol and marijuana compared to other types of alcohol and marijuana use. Driving after use is more likely after SAM use than marijuana-only use days, but most likely on days when both alcohol and marijuana were used but not simultaneously. Future research on situation-level predictors of riding and driving-related risks among young adults is warranted.

An open trial investigation of Treatnet Family among adolescents with substance use problems

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Treatnet Family (TF) had a positive significant impact in reducing alcohol use.

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After participating in the TF, the adolescents were engaged with significantly fewer friends who consumed substances and participated in antisocial behaviours.

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The two most reported life events (i.e., “got in a lot of arguments or fights” and “had problems with drugs or alcohol”) before the intervention were significantly decreased at the follow-up assessment.

•

Based on parent’s/family member’s reports, there was a significant decrease in mental health problems across time.

Introduction

Studies that used evidence-based family therapies have demonstrated significant effects in reducing adolescent drug use and delinquent behaviours, and in reducing comorbid mental health problems. However, almost all these studies were conducted in high-income countries. The overall aim of the present study was to explore the effect of United Nations Office on Drugs and Crime’s (UNODC) Treatnet Family (TF) in reducing substance consumption, drug-related activities, reducing mental health problems, and in improving family interaction among adolescents with substance-use problems.

Method

Nineteen adolescents who had been referred to a community counselling clinic because of substance-use problems and their parents/family members participated in TF. They completed a set of questionnaires to measure substance use, family functioning, mental health problems, and life events at pre-, post-intervention as well as at a one month-follow-up assessment.

Results

TF had a positive significant impact in reducing alcohol use among adolescents with substance-use problems. The number of adolescents who smoked cigarettes and marijuana, and used amphetamines reduced across time. After participating in TF, the adolescents were involved with significantly fewer friends who consumed substances and participated in antisocial behaviours. Furthermore, parent/family member reported a significant decrease in mental health problems, and positive changes in adolescent’s behaviours.

Conclusion

The TF had a positive impact in reducing alcohol consumption and problems related to substance consumption among adolescents with substance-use problems when delivered by practitioners in routine community settings.

Riding with an impaired driver and driving while impaired among adolescents: Longitudinal trajectories and their characteristics

PURPOSE

The purpose of this study was to identify and characterize trajectory classes of adolescents who ride with an impaired driver (RWI) and drive while impaired (DWI).

METHODS

We analyzed all 7 annual assessments (Waves W1-W7) of the NEXT Generation Health Study, a nationally representative longitudinal study starting with 10th grade (2009-2010 school year). Using all 7 waves, latent class analysis was used to identify trajectory classes with dichotomized RWI (last 12 months) and DWI (last 30 days; once or more = 1 vs. none = 0). Covariates were race/ethnicity, sex, parent education, urbanicity, and family affluence.

RESULTS

Four RWI trajectories and 4 DWI trajectories were identified: abstainer, escalator, decliner, and persister. For RWI and DWI trajectories respectively, 45.0% (n = 647) and 76.2% (n = 1,657) were abstainers, 15.6% (n = 226) and 14.2% (n = 337) were escalators, 25.0% (n = 352) and 5.4% (n = 99) were decliners, and 14.4% (n = 197) and 3.8% (n = 83) persisters. Race/ethnicity (χ² = 23.93, P = .004) was significantly associated with the RWI trajectory classes. Race/ethnicity (χ² = 20.55, P = .02), sex (χ² = 13.89, P = .003), parent highest education (χ² = 12.49, P = .05), urbanicity (χ² = 9.66, P = .02), and family affluence (χ² = 12.88, P = .05) were significantly associated with DWI trajectory classes.

CONCLUSIONS

Among adolescents transitioning into emerging adulthood, race/ethnicity is a common factor associated with RWI and DWI longitudinal trajectories. Our results suggest that adolescent RWI and DWI are complex behaviors warranting further detailed investigation of the respective trajectory classes. Our study findings can inform the tailoring of prevention and intervention efforts aimed at preventing illness/injury and preserving future opportunities for adolescents to thrive in emerging adulthood.

Factors Contributing to Delay in Driving Licensure Among U.S. High School Students and Young Adults

PURPOSE

More teens delay in driving licensure (DDL). It is conceivable they miss Graduated Driver Licensing (GDL) safety benefits. We assessed prevalence, disparities, and factors associated with DDL among emerging adults.

METHODS

Data used were from all seven waves (W1-7) of the NEXT Generation Health Study (W1 in 10th grade [2009-2010]). The outcome variable was DDL (long-DDL [delayed >2 years], intermediate-DDL [delayed 1-2 years] versus no-DDL), defined as participants receiving driver licensure ≥1 year after initial eligibility. Independent variables included sex, urbanicity, race/ethnicity, family structure, parental education, family affluence, parental monitoring knowledge, parent perceived importance of alcohol nonuse, and social media use. Logistic regressions were conducted.

RESULTS

Of 2,525 participants eligible for licensure, 887 (38.9%) reported intermediate-DDL and 1,078 (30.1%) long-DDL. Latinos (adjusted odds ratio [AOR] = 2.5 vs. whites) and those with lower affluence (AOR = 2.5 vs. high) had higher odds of intermediate-DDL. Latinos (AOR = 4.5 vs. whites), blacks (AOR = 2.3 vs. whites), those with single parent (AOR = 1.7 vs. both biological parents), whose parents' education was high school or less (AOR = 3.7 vs. bachelor+) and some college (AOR = 2.0 vs. bachelor+) levels, and those with lower affluence (AOR = 4.4 vs. high) had higher odds of long-DDL. Higher mother's monitoring knowledge (AOR = .6) was associated with lower odds of long-DDL, but not intermediate-DDL.

CONCLUSIONS

Some teens that DDL "age out" of protections afforded to them by GDL driver restrictions. Minority race/ethnicity, socioeconomic status, urbanicity, and parenting factors contribute to DDL. Further study of these factors and their individual/collective contributions to DDL is needed to understand potential unintended consequences of GDL, particularly in more vulnerable youth.

Longitudinal Associations of 12th-Grade Binge Drinking With Risky Driving and High-Risk Drinking

OBJECTIVE

To study the longitudinal associations of 12th-grade binge drinking with driving while impaired (DWI), riding with an impaired driver (RWI), blackouts, extreme binge drinking, and risky driving (self-reported Checkpoints Risky Driving Scale) among emerging adults up to 4 years after leaving high school.

METHODS

The data were all 7 waves (W 1 to W 7 of the NEXT Generation Health Study; a US nationally representative study (N = 2785) with a probability cohort of 10th-graders (mean age = 16.2 years; SE = 0.03) starting in the 2009-2010 year. Binary and ordinal logistic regressions were used for the analysis.

RESULTS

Binge drinking prevalence in W1 to W3 was 27.2%, 23.8%, and 26.8%, respectively. Twelfth-grade binge drinking was associated with a higher likelihood of DWI, RWI, blackouts, and risky driving in W4 to W7 and extreme binge drinking in W7. Adolescents who binged ≥3 times in high school were more likely to DWI, RWI, blackout (W4 to W7), be involved in extreme binge drinking (W7), and report riskier driving several years after high school. In some waves, parental practices appeared to have enduring effects in protecting against DWI, RWI, and blackouts.

CONCLUSIONS

Twelfth-grade binge drinking is a robust predictor of early adulthood DWI, RWI, blackout, extreme binge drinking, and risky driving. Our study suggests that ongoing parental practices could be protective against DWI, RWI, and blackouts once adolescents transition from high school into early adulthood. Prevention programs that incorporate binge drinking-focused screening and bolster parental practices may reduce the likelihood of later major alcohol-related health-risk behaviors and consequences in emerging adults.

Driving/riding after alcohol and marijuana use among young adults: Is residing with family protective?

Objective: Driving while impaired by alcohol or drugs increases the risk of motor vehicle fatalities, the leading cause of death among young adults. The current study documented the prevalence of driving after alcohol and marijuana use in the past 2 weeks as well as the prevalence of riding with a driver who had used each substance during that time frame. We tested whether young adults who lived with family members (i.e., their parents or their children) were less likely to engage in these behaviors. Methods: Participants aged 18-25 who resided in nonmetropolitan areas in the United States (N = 1,131; 55% female, M_age = 22.6) completed an online survey. Multivariate logistic regressions examined alcohol- and marijuana-related driving and riding behaviors adjusting for demographic factors. Interactions tested whether associations varied by gender. Results: In the 2 weeks prior to the survey, 17% of participants drove after drinking alcohol and 21% had ridden with a driver who had been drinking. The prevalence of driving after marijuana use was 11%, and 16% of the sample had ridden with a driver who had been using marijuana. Participants who lived with their parents were less likely to ride with a driver who had been using alcohol or marijuana (adjusted odds ratios [AORs] = 0.71 and 0.55, respectively). Living with parents was also associated negatively with driving after both substances, but these associations were no longer significant when controlling for substance use frequency and driving frequency. Surprisingly, the odds of driving after marijuana use were over 2 times larger for young adults who lived with their children. For women, but not men, residing with children decreased the odds of driving and riding after alcohol use. Conclusions: Living with parents protects against riding after substance use among young adults. Prevention programs should target young adults who live independently or those transitioning away from the parental home. Furthermore, given the higher rates of driving after marijuana use among young adult parents, this group should be educated about the risks associated with this behavior.

Factors Associated with Parents' Belief in the Appropriateness of Providing Alcohol to their Child

BACKGROUND

Parental provision of alcohol to their underage child has been associated with risky adolescent drinking. While parents' belief in the appropriateness of providing their child with alcohol may influence their provision behaviors, research into the factors associated with this belief is lacking.

OBJECTIVES

This study sought to identify the factors associated with parents' belief in the appropriateness of providing alcohol to their underage child.

METHODS

Western Australian parents of 12-17 year olds (n = 443) completed an online survey assessing their drinking habits, alcohol provision behaviors, alcohol-related beliefs and attitudes, their child's alcohol consumption, and demographics.

RESULTS

Nearly half (44%) the parents surveyed reported providing their underage child with alcohol. Parents of older children and parents who (i) did not believe in the harms and recommendations associated with alcohol use in youth, (ii) agreed with youth-related drinking myths, and (iii) reported more occasions of alcohol consumption by their child were more likely to believe that it was appropriate to provide alcohol to their underage child. Those who believed providing alcohol to their underage child was appropriate were in turn more likely to provide alcohol.

CONCLUSIONS

Interventions aiming to reduce parental provision of alcohol to children should focus on changing parents' beliefs that this is an appropriate harm minimization behavior. Belief change may be facilitated by the implementation of public education campaigns that increase parents' belief in the alcohol-related harms associated with youth drinking and debunk youth-related drinking myths.

Context and culture: Reasons young adults drink and drive in rural America

Montana, a large and rural U.S. state, has a motor vehicle fatality rate almost double the national average. For young adults, the alcohol-related motor vehicle fatality rate in the state is almost three times the national average. Yet little research has explored the underlying reasons that young people in rural areas drink and drive. Drawing from the theory of triadic influence (TTI) and a series of qualitative focus group discussions, the current study examined how aspects of the landscape and culture of rural America promote and hinder drinking and driving among young people. In 2015 and 2016, 72 young adults (36 females) aged 18-25 years old (mean age = 20.2) participated in 11 semi-structured focus groups in 8 rural counties in Montana. Discussions were transcribed, and two reviewers independently coded text segments. Themes were identified and an inductive explanatory model was created. The results demonstrated that aspects of the social context (e.g., peer pressure and parental modeling), rural cultural values (e.g., independence, stoicism, and social cohesion), and the legal and physical environment (e.g., minimal police presence, sparse population, and no alternative transportation) promoted drinking and driving. The results also identified salient protective factors in each of these domains. Our findings demonstrate the importance of examining underlying distal determinants of drinking and driving. Furthermore, they suggest that future research and interventions should consider the complex ways in which cultural values and environmental factors intersect to shape the risky health behaviors of rural populations.

Physical activity and sedentary behavior of US immigrant versus non-immigrant adolescents: findings from the NEXT Generation Health Study data

OBJECTIVE

This study examined associations of physical activity (PA) and sedentary behavior (SB) with adolescents' immigration status and language spoken at home and with friends.

METHODS

Participants (N = 2475) were included from Wave 1 of the NEXT Generation Health Study, a nationally representative 10th-grade cohort study starting in 2009. PA included recommended moderate-to-vigorous PA (MVPA) and vigorous PA (VPA); SB included screen viewing and social-media use. Linear and logistic regressions were conducted controlling for complex survey variables.

RESULTS

Adolescents with non US-born compared with US-born parents were less likely to engage in VPA (odds ratio = 0.60, p ≤ .05, 95% CI = 0.38-0.96). Parent country of origin and language spoken were not significantly associated with recommended MVPA engagement. None of screen viewing and social-media use was significantly associated with immigration status.

CONCLUSIONS

Recent immigration status was negatively associated with adolescents' PA documenting an important health disparity.

Emerging Adults Riding With Marijuana-, Alcohol-, or Illicit Drug-Impaired Peer and Older Drivers

OBJECTIVE

The purpose of this study was to examine the prevalence and covariates among emerging adults of riding with an impaired peer or older adult driver (RWI) because of marijuana (MJ), alcohol (ALC), or illicit drugs (ID).

METHOD

Data were from Waves 4 (W4, N = 2,085) and 5 (W5, N = 2,116) of the NEXT Generation Health Study, collected in 2013-2014, 1 and 2 years after high school. W5 RWI was specified for substance-specific impaired peer and older adult (peer/older adult) drivers. Multinomial logistic regressions estimated W5 association of substance-specific RWI with W4 RWI, and W5 heavy episodic drinking, MJ use, and school/residence/work status.

RESULTS

At W5, 33% of the participants reported RWI in the past year, including riding with ALC- (21%), MJ- (17%), and ID- (5%) impaired peer drivers and ALC- (2%), MJ- (4%), and ID- (0.7%) impaired older adult drivers. W4 RWI was associated with W5 RWI with impaired peer/older adult drivers for ALC- (adjusted odds ratio [AOR] = 4.28, 2.69) and MJ-RWI (AOR = 2.34, 3.56). W5 heavy episodic drinking was positively associated with W5 peer ALC-related RWI (AOR = 2.16) and peer/older adult MJ-related RWI (AOR = 2.38, 5.45). W5 MJ use was positively associated with W5 peer ALC-related RWI (AOR = 2.23), peer/older adult MJ-related (AOR = 10.89, 2.98), and peer/older adult ID-related (AOR = 9.34, 4.26) RWI. ID-related RWI was higher among those not attending 4-year college (AOR = 3.38), attending technology school (AOR = 16.23), living on their own (AOR = 6.85), or living on campus (AOR = 11.50).

CONCLUSIONS

The high prevalence of RWI among emerging adults occurred mostly with ALC- or MJ-impaired peer drivers. The findings support the need for precisely tailored programs to prevent impaired driving according to substance use and age.

Marijuana-, alcohol-, and drug-impaired driving among emerging adults: Changes from high school to one-year post-high school

INTRODUCTION

Driving while impaired (DWI) increases the risk of a motor vehicle crash by impairing performance. Few studies have examined the prevalence and predictors of marijuana, alcohol, and drug-specific DWI among emerging adults.

METHODS

The data from wave 3 (W3, high school seniors, 2012, N=2407) and wave 4 (W4, one year after high school, N=2178) of the NEXT Generation Health Study with a nationally representative cohort. W4 DWI (≥1day of past 30days) was specified for alcohol-specific, marijuana-specific, alcohol/marijuana-combined, illicit drug-related DWI. Multinomial logistic regression models estimated the association of W4 DWI with W3 covariates (perceived peer/parent influence, drinking/binge drinking, marijuana/illicit drug use), and W4 environmental status variables (work/school/residence) adjusting for W3 overall DWI, demographic, and complex survey variables.

RESULTS

Overall DWI prevalence from W3 to W4 changed slightly (14% to 15%). W4 DWI consisted of 4.34% drinking-specific, 5.02% marijuana-specific, 2.41% drinking/marijuana combined, and 3.37% illicit drug-related DWI. W3 DWI was significantly associated with W4 alcohol-related and alcohol/marijuana-combined DWI, but not other DWI. W3 marijuana use, binge drinking, and illicit drug use were positively associated with W4 marijuana-specific, alcohol/marijuana-combined, and illicit drug-related DWI, respectively. W3 friend drunkenness and marijuana use were positively associated with W4 alcohol-specific and marijuana-related DWI, respectively. W3 peer marijuana use was negatively associated with W4 alcohol-specific DWI.

CONCLUSIONS

Driving under the influence of alcohol, marijuana, and illicit drugs is a persistent, threatening public health concern among emerging U.S. adults. High school seniors' binge drinking as well as regular alcohol drinking and marijuana/illicit drug use were independently associated with respective DWI one year after high school. Peer drunkenness and marijuana use in high school may be related to subsequent DWI of emerging adults.

PRACTICAL APPLICATIONS

The results support the use of injunctive peer norms about getting drunk and smoking marijuana in guiding the development of prevention programs to reduce youth DWI.

Transitions in Riding With an Alcohol/Drug-Impaired Driver From Adolescence to Emerging Adulthood in the United States

OBJECTIVE

The purpose of this study was to examine changes and predictors of changes in riding with an alcohol/drug-impaired driver (RWI) from 10th grade through the first post-high school year.

METHOD

Transition models were used to estimate the association of four waves (W1-W4) of RWI with W4 environmental-status variables and time-varying covariates in the NEXT Generation Health Study, a nationally representative cohort of U.S. 10th graders (N = 2,785).

RESULTS

Overall, 33% (weighted) of adolescents reported RWI in the past 12 months in W1, and slightly declined in W2 (24%), W3 (27%), and W4 (26%). Across time, transition models with generalized estimating equations showed that RWI was more likely among those who previously reported RWI (ORs from 3.62 to 3.66, p < .001), substance use (ORs from 1.81 to 1.82, p < .001), and heavy episodic drinking (ORs from 1.85 to 1.86, p < .001). Those living on college campuses were somewhat more likely to engage in RWI (OR = 1.38, .05 < p <.10) than those living at home. The effects of parental monitoring knowledge and peer alcohol/substance use on RWI were suppressed when individual substance use and heavy episodic drinking were taken into consideration.

CONCLUSIONS

Substance use and heavy episodic drinking in previous waves and the history of RWI were persistent factors of RWI in a dynamic pattern. The setting in which emerging adults live during their first post-high school year could affect their engagement in RWI. The findings suggest that harm-reduction strategies should focus on the identification of early RWI coupled with reduction of substance use and heavy episodic drinking.

Covariability in three dimensions of teenage driving risk behavior: impaired driving, risky and unsafe driving behavior, and secondary task engagement

OBJECTIVE

This research examined the extent to which teenagers who engaged in one form of risky driving also engaged in other forms and whether risky driving measures were reciprocally associated over time.

METHODS

The data were from waves 1, 2, and 3 (W1, W2, and W3) of the NEXT Generation study, with longitudinal assessment of a nationally representative sample starting with 10th graders starting in 2009-2010. Three measures of risky driving were assessed in autoregressive and cross-lagged analyses: driving while alcohol/drug impaired (DWI), Checkpoints Risky Driving Scale (risky and unsafe driving), and secondary task engagement while driving.

RESULTS

In adjusted autoregression models, the risk variables demonstrated high levels of stability, with significant associations observed across the 3 waves. However, associations between variables were inconsistent. DWI at W2 was associated with risky and unsafe driving at W3 (β = 0.21, P < .01); risky and unsafe driving at W1 was associated with DWI at W2 (β = 0.20, P < .01); and risky and unsafe driving at W2 is associated with secondary task engagement at W3 (β = 0.19, P < .01). Over time, associations between DWI and secondary task engagement were not significant.

CONCLUSIONS

Our findings provide modest evidence for the covariability of risky driving, with prospective associations between the Risky Driving Scale and the other measures and reciprocal associations between all 3 variables at some time points. Secondary task engagement, however, appears largely to be an independent measure of risky driving. The findings suggest the importance of implementing interventions that addresses each of these driving risks.

The Predictive Influence of Youth Assets on Drinking and Driving Behaviors in Adolescence and Young Adulthood

Drinking and driving among adolescents and young adults remains a significant public health burden. Etiological research is needed to inform the development and selection of preventive interventions that might reduce alcohol-involved crashes and their tragic consequences. Youth assets-that is, skills, competencies, relationships, and opportunities-can help youth overcome challenges, successfully transition into adulthood, and reduce problem behavior. We examined the predictive influence of individual, relationship, and community assets on drinking and driving (DD) and riding with a drinking driver (RDD). We assessed prospective relationships through analysis of data from the Youth Assets Study, a community-based longitudinal study of socio-demographically diverse youth. Results from calculation of marginal models using a Generalized Estimating Equation approach revealed that parent and peer relationship and school connectedness assets reduced the likelihood of both drinking and driving and riding with a drinking driver approximately 1 year later. The most important and consistent asset that influenced DD and RDD over time was parental monitoring, highlighting the role of parental influence extending beyond the immediate teen driving context into young adulthood. Parenting-focused interventions could influence factors that place youth at risk for injury from DD to RDD, complementing other evidence-based strategies such as school-based instructional programs and zero tolerance Blood Alcohol Concentration laws for young and inexperienced drivers.

Examination of a dual-process model predicting riding with drinking drivers

BACKGROUND

Nearly 1 in 5 of the fatalities in alcohol-related crashes are passengers. Few studies have utilized theory to examine modifiable psychosocial predictors of individuals' tendencies to be a passenger in a vehicle operated by a driver who has consumed alcohol. This study used a prospective design to test a dual-process model featuring reasoned and reactive psychological influences and psychosocial constructs as predictors of riding with drinking drivers (RWDD) in a sample of individuals aged 18 to 21.

METHODS

College students (N = 508) completed web-based questionnaires assessing RWDD, psychosocial constructs (attitudes, expectancies, and norms), and reasoned and reactive influences (intentions and willingness) at baseline (the middle of the spring semester) and again 1 and 6 months later. Regression was used to analyze reasoned and reactive influences as proximal predictors of RWDD at the 6-month follow-up. Subsequent analyses examined the relationship between the psychosocial constructs as distal predictors of RWDD and the mediation effects of reasoned and reactive influences.

RESULTS

Both reasoned and reactive influences predicted RWDD, while only the reactive influence had a significant unique effect. Reactive influences significantly mediated the effects of peer norms, attitudes, and drinking influences on RWDD. Nearly all effects were constant across gender except parental norms (significant for females).

CONCLUSIONS

Findings highlight that the important precursors of RWDD were reactive influences, attitudes, and peer and parent norms. These findings suggest several intervention methods, specifically normative feedback interventions, parent-based interventions, and brief motivational interviewing, may be particularly beneficial in reducing RWDD.

Reciprocal Associations Between Parental Monitoring Knowledge and Impaired Driving in Adolescent Novice Drivers

OBJECTIVE

Adolescent driving while alcohol/drug impaired (DWI) and parental monitoring knowledge may have notable interplay. However, the magnitude and direction of causality are unclear. This study examined possible reciprocal associations among adolescents between DWI and parental monitoring knowledge.

METHODS

The data were from waves 1, 2, and 3 (W1, W2, and W3) of the NEXT Generation Health Study, with longitudinal assessment of a nationally representative sample of 10th graders starting in 2009-2010 (n = 2,525 at W1) and analyzed in 2014. Those who had obtained an independent/unsupervised driving license were included for the analysis. Autoregressive cross-lagged path analysis was used to examine potential reciprocal associations between DWI and parental monitoring knowledge of both mothers and fathers, controlling for potential confounders.

RESULTS

Stability of fathers' and mothers' monitoring knowledge across 3 consecutive interview waves was identified. W1 monitoring knowledge of both fathers and mothers was prospectively associated with DWI at W2 but not for W2 with W3. A significant negative association between adolescent DWI at W2 and mothers' monitoring knowledge at W3 was found but not between W1 and W2. None of the associations between DWI and fathers' monitoring knowledge from W1 to W2 or from W2 to W3 were significant.

CONCLUSIONS

Early (10th grade) parental monitoring knowledge may predict lower adolescent self-reported DWI in 11th grade. More notably, adolescent DWI did not seem to increase parental monitoring knowledge. Future interventions are needed to improve parental monitoring knowledge and enhance awareness of the DWI risk in their adolescent novice drivers.

Association between riding with an impaired driver and driving while impaired

OBJECTIVE

To examine the association between driving while alcohol/drug impaired (DWI) and the timing and amount of exposure to others' alcohol/drug-impaired driving (riding while impaired [RWI]) and driving licensure timing among teenage drivers.

METHODS

The data were from waves 1, 2, and 3 (W1, W2, and W3, respectively) of the NEXT Generation Study, with longitudinal assessment of a nationally representative sample of 10th graders starting in 2009-2010. Multivariate logistic regression was used for the analyses.

RESULTS

Teenagers exposed to RWI at W1 (adjusted odds ratio [AOR] = 21.12, P < .001), W2 (AOR = 19.97, P < .001), and W3 (AOR = 30.52, P < .001) were substantially more likely to DWI compared with those reporting never RWI. Those who reported RWI at 1 wave (AOR = 10.89, P < .001), 2 waves (AOR = 34.34, P < .001), and all 3 waves (AOR = 127.43, P < .001) were more likely to DWI compared with those who never RWI. Teenagers who reported driving licensure at W1 were more likely to DWI compared with those who were licensed at W3 (AOR = 1.83, P < .05).

CONCLUSIONS

The experience of riding in a vehicle with an impaired driver increased the likelihood of future DWI among teenagers after licensure. There was a strong, positive dose-response association between RWI and DWI. Early licensure was an independent risk factor for DWI. The findings suggest that RWI and early licensure could be important prevention targets.