Department of Community Medicine, Mercer University School of Medicine, Macon, Georgia.
Department of Psychiatry, Mercer University School of Medicine, Macon, Georgia.
J Rural Health. 2019 Jun;35(3):354-361. doi: 10.1111/jrh.12321. Epub 2018 Aug 30.
The purpose of this study was to examine the importance of rural location in the likelihood of adolescent drunk driving and riding in a vehicle with a driver under the influence while controlling for a variety of student-, school-, and county-level factors.
Data from the 2013 Georgia Student Health Survey (GSHS) II (a statewide assessment of student health in public school students in Georgia) were analyzed using multilevel binary regressions to examine rural-urban differences in prevalence of driving under the influence (11 and 12 graders only; n = 114,907) and riding with a driver under the influence (9 -12 graders; n = 258,610), controlling for school-level race, gender, and income, in addition to county-level education level, unemployment, alcohol use, and smoking.
Across geographies, students were twice as likely to report riding with a driver under the influence (10.32%) as driving under the influence (4.16%). While both outcomes were more likely among rural adolescents in unadjusted analyses, in adjusted analyses, rural adolescents were not significantly more likely to drive under the influence (OR = 1.19; P = .055), but they were significantly more likely to ride with a driver under the influence (OR = 1.18; P = .002).
Our findings suggest that riding with a driver under the influence rather than driving under the influence may be a more pressing public health issue for adolescents in rural areas. Future research focused on the formative work necessary to build novel, culturally tailored interventions should be conducted to minimize the associated substantial burden of motor vehicle deaths within rural adolescents.
本研究旨在探讨农村地理位置在青少年酒后驾车和乘坐酒后驾车者车辆的可能性中的重要性，同时控制学生、学校和县级的各种因素。
使用多水平二元回归分析对 2013 年乔治亚州学生健康调查（GSHS）II （一项对乔治亚州公立学校学生健康状况的全州评估）的数据进行分析，以检查城乡地区青少年酒后驾车（11 和 12 年级学生；n = 114907）和酒后乘车（9-12 年级学生；n = 258610）流行率的差异，除了控制学校层面的种族、性别和收入外，还控制了县级教育水平、失业率、酒精使用和吸烟情况。
在不同地区，学生报告酒后乘车（10.32%）的可能性是酒后驾车（4.16%）的两倍。虽然在未调整的分析中，农村青少年的这两种结果都更有可能发生，但在调整后的分析中，农村青少年酒后驾车的可能性并不显著更高（OR = 1.19；P =.055），但他们更有可能酒后乘车（OR = 1.18；P =.002）。
我们的研究结果表明，对于农村地区的青少年来说，乘坐酒后驾车者的车辆而不是酒后驾车可能是一个更紧迫的公共卫生问题。应该开展未来的研究，重点关注建立新的、具有文化特色的干预措施所需的基础工作，以最大限度地减少农村青少年中与机动车辆死亡相关的巨大负担。
