Vaca Federico E, Li Kaigang, Hingson Ralph, Simons-Morton Bruce G
Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut.
Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado.
J Stud Alcohol Drugs. 2016 Jan;77(1):77-85. doi: 10.15288/jsad.2016.77.77.
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.
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).
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.
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.
本研究旨在调查从十年级到高中毕业后第一年与酒精/药物影响下的驾驶员同乘(RWI)情况的变化及其变化的预测因素。
在“下一代健康研究”中,采用转换模型来估计RWI的四个阶段(W1 - W4)与W4环境状况变量以及随时间变化的协变量之间的关联。该研究是一个具有全国代表性的美国十年级学生队列(N = 2,785)。
总体而言,在W1中,33%(加权)的青少年报告在过去12个月中有过RWI,在W2(24%)、W3(27%)和W4(26%)中略有下降。随着时间推移,采用广义估计方程的转换模型显示,之前报告有过RWI的人(比值比从3.62到3.66,p <.001)、使用药物的人(比值比从1.81到1.82,p <.001)以及大量饮酒的人(比值比从1.85到1.86,p <.001)更有可能出现RWI。与住在家中的人相比,住在大学校园里的人参与RWI的可能性略高(比值比 = 1.38,.05 < p <.10)。当考虑到个人药物使用和大量饮酒情况时,父母监督知识和同伴酒精/药物使用对RWI的影响会受到抑制。
前几个阶段的药物使用、大量饮酒以及RWI历史是RWI动态模式中的持续因素。新兴成年人在高中毕业后第一年的生活环境可能会影响他们参与RWI的情况。研究结果表明,减少伤害策略应侧重于识别早期RWI,并减少药物使用和大量饮酒。