Webster J Matthew, Dickson Megan F, Jamison Shawn M, Staton Michele
University of Kentucky.
J Appalach Health. 2025 Jan 29;6(4):105-114. doi: 10.13023/jah.0604.09. eCollection 2025.
Despite the known risks associated with substance use following incarceration, no studies have examined substance-impaired driving as a post-incarceration health risk behavior in rural Appalachia.
The present study examined differences by impaired driving following incarceration and identified predictors of impaired driving in sample of rural Appalachian women with a history of drug use and risky sex.
Women (N=340) from three rural Appalachian jails completed a baseline interview in jail and follow-up interviews at six and 12 months post-release. Interview questions included demographic characteristics and information on substance use risk, mental health, criminal legal system involvement, and impaired driving. Data were collected from 2012 to 2019. Secondary data analysis performed in 2024 compared women who reported driving impaired during the 12-month follow-up period (n=76) to those who did not (n=257). A multivariable logistic regression was performed to identify predictors of impaired driving.
Lifetime arrests, substance use risk, and symptoms of major depressive disorder were associated with impaired driving. The logistic regression model indicated that participants with major depressive disorder symptoms had twice the odds of driving impaired in the year following incarceration. Implications: Almost one-fourth of women in the sample reported driving impaired during the follow-up period, suggesting that impaired driving should be examined as a post-release health risk behavior for rural Appalachian women in future research. Furthermore, study findings highlight an important opportunity for targeted prevention and intervention for women who may experience increased risk as they return to rural Appalachian communities following incarceration.
尽管已知监禁后使用药物存在风险，但尚无研究将药物影响下的驾驶作为阿巴拉契亚农村地区监禁后的健康风险行为进行考察。
本研究考察了监禁后药物影响下驾驶的差异，并确定了有吸毒和危险性行为史的阿巴拉契亚农村女性样本中药物影响下驾驶的预测因素。
来自阿巴拉契亚农村地区三所监狱的340名女性在监狱完成了基线访谈，并在释放后6个月和12个月进行了随访访谈。访谈问题包括人口统计学特征以及关于药物使用风险、心理健康、刑事法律系统参与情况和药物影响下驾驶的信息。数据收集时间为2012年至2019年。2024年进行的二次数据分析将在12个月随访期内报告有药物影响下驾驶行为的女性（n = 76）与未报告的女性（n = 257）进行了比较。进行多变量逻辑回归以确定药物影响下驾驶的预测因素。
终身被捕次数、药物使用风险和重度抑郁症症状与药物影响下驾驶有关。逻辑回归模型表明，有重度抑郁症症状的参与者在监禁后一年内药物影响下驾驶的几率是其他人的两倍。
样本中近四分之一的女性在随访期内报告有药物影响下驾驶行为，这表明在未来研究中，应将药物影响下驾驶作为阿巴拉契亚农村女性释放后的健康风险行为进行考察。此外，研究结果凸显了一个重要机会，即对那些在监禁后返回阿巴拉契亚农村社区可能面临更高风险的女性进行有针对性的预防和干预。
