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Mun EY, Li X, Lineberry S, Tan Z, Huh D, Walters ST, Zhou Z, Larimer ME. Do Brief Alcohol Interventions Reduce Driving After Drinking Among College Students? A Two-step Meta-analysis of Individual Participant Data. Alcohol Alcohol 2021; 57:125-135. [PMID: 33592624 PMCID: PMC8753781 DOI: 10.1093/alcalc/agaa146] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/28/2020] [Accepted: 11/22/2020] [Indexed: 11/14/2022] Open
Abstract
Aims College students who drink are at an increased risk of driving after drinking and alcohol-involved traffic accidents and deaths. Furthermore, the persistence of driving after drinking over time underscores a need for effective interventions to prevent future drunk driving in adulthood. The present study examined whether brief alcohol interventions (BAIs) for college students reduce driving after drinking. Methods A two-step meta-analysis of individual participant data (IPD) was conducted using a combined sample of 6801 college students from 15 randomized controlled trials (38% male, 72% White and 58% first-year students). BAIs included individually delivered Motivational Interviewing with Personalized Feedback (MI + PF), Group Motivational Interviewing (GMI), and stand-alone Personalized Feedback (PF) interventions. Two outcome variables, driving after two+/three+ drinks and driving after four+/five+ drinks, were checked, harmonized and analyzed separately for each study and then combined for meta-analysis and meta-regression analysis. Results BAIs lowered the risk of driving after four+/five+ drinks (19% difference in the odds of driving after drinking favoring BAIs vs. control), but not the risk of driving after two+/three+ drinks (9% difference). Subsequent subgroup analysis indicated that the MI + PF intervention was comparatively better than PF or GMI. Conclusions BAIs provide a harm reduction approach to college drinking. Hence, it is encouraging that BAIs reduce the risk of driving after heavy drinking among college students. However, there may be opportunities to enhance the intervention content and timing to be more relevant for driving after drinking and improve the outcome assessment and reporting to demonstrate its effect.
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Affiliation(s)
- Eun-Young Mun
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Xiaoyin Li
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Shelby Lineberry
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Zhengqi Tan
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - David Huh
- School of Social Work, University of Washington, Seattle, WA 98105, USA
| | - Scott T Walters
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Zhengyang Zhou
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Mary E Larimer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98105, USA
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Dora-Laskey AD, Goldstick JE, Buckley L, Bonar EE, Zimmerman MA, Walton MA, Cunningham RM, Carter PM. Trajectories of Driving after Drinking among Marijuana-Using Youth in the Emergency Department: Substance Use, Mental Health, and Peer and Parental Influences. Subst Use Misuse 2019; 55:175-187. [PMID: 31502499 PMCID: PMC6980673 DOI: 10.1080/10826084.2019.1660675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The psychosocial correlates and longitudinal trajectories of driving after drinking (DAD) among youth remain understudied in at-risk populations. Objectives: We investigated the relationships of DAD trajectories and negative peer and parental influences, substance use, and mental health among predominantly marijuana-using youth seeking emergency department (ED) treatment. Methods: Data were from a 2-year prospective cohort study of drug-using patients (97.4% used marijuana) ages 14-24 seeking ED care for assault injury, or as part of a non-assaulted comparison group. Validated surveys measured DAD behaviors and correlates at baseline, 6, 12, 18, and 24 months. Latent class growth analysis identified characteristic DAD trajectory groups; baseline predictors were analyzed descriptively and using multinomial logistic regression. Results: Three DAD trajectory groups were identified among driving-age youth (n = 580): no DAD (NDAD; 55.2%), low-steady (LDAD; 29.0%), and high-declining (HDAD; 15.9%). In unadjusted analyses, HDAD youth were older, but otherwise similar to other groups demographically. Compared to NDAD, LDAD and HDAD group members had higher rates of drug and alcohol use disorders (p < .001). Further, HDAD group members had higher rates of anxiety symptoms and were more likely to be diagnosed with PTSD or depression than NDAD or LDAD youth (p < .05). Negative peer and parent influences were significantly higher in progressively more severe trajectory groups (p < .01). Adjusted effects from the multinomial model were analogous for peer and parental influences and substance use disorders, but not mental health. Conclusion: DAD is strongly associated with negative social influences and substance use disorders among marijuana-using youth, reinforcing their importance when developing interventions.
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Affiliation(s)
- Aaron D Dora-Laskey
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan, USA
- University of Michigan Addiction Center, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Hurley Medical Center, Flint, Michigan, USA
| | - Jason E Goldstick
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan, USA
| | - Lisa Buckley
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan, USA
- The University of Queensland, St. Lucia, Queensland, Australia
| | - Erin E Bonar
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan, USA
- University of Michigan Addiction Center, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Marc A Zimmerman
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan, USA
- University of Michigan Youth Violence Prevention Center, Ann Arbor, Michigan, USA
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | - Maureen A Walton
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan, USA
- University of Michigan Addiction Center, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebecca M Cunningham
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan, USA
- Hurley Medical Center, Flint, Michigan, USA
- University of Michigan Youth Violence Prevention Center, Ann Arbor, Michigan, USA
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Michigan, USA
| | - Patrick M Carter
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Injury Prevention Center, Ann Arbor, Michigan, USA
- University of Michigan Youth Violence Prevention Center, Ann Arbor, Michigan, USA
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