A longitudinal examination of the relationship between adolescent problem behaviors and traffic crash involvement during young adulthood

Psychometric Challenges in the Measurement of Constructs Underlying Criminal Responsibility in Children and Young Adults: A Cross-Sectional Study

At present, many countries have lowered the minimum age of criminal responsibility to deal with the trend of juvenile crime. In practical terms, whether countries advocate for lowering the age of criminal responsibility along with early puberty, or regulating the minimum age of juvenile criminal responsibility through their policies, their deep-rooted hypothesis is that age is tied to adolescents' psychological growth, and, with the rise in age, the capacity for dialectical thinking, self-control, and empathy gradually improves. With this study, we aimed to test whether this hypothesis is valid. The participants were 3,208 students from junior high school, senior high school, and freshman in the S province of the People's Republic of China (PRC). We subjected the gathered materials to independent-samples t-tests, one-way analysis of variance (ANOVA), linear regression analysis, and Bonferroni post hoc test. The influence of the age variable upon dialectical thinking, self-control, and empathy was significant (p = 0.002, p = 0.000, p = 0.072), but only empathy was positively correlated with age variable (B = 0.032); dialectical thinking ability (B = -0.057), and self-control ability (B = -0.212) were negatively correlated with the age variable. Bonferroni post hoc test confirmed these findings. Therefore, we concluded the following: (1) Juvenile criminal responsibility, based on the capacity for dialectical thinking, self-control, and empathy, is not positively correlated with age. (2) Age is not the only basis on which to judge a juvenile's criminal responsibility. (3) More research that directly links age differences in brain structure and function to age differences in legally relevant capacities and capabilities(e.g., dialectical thinking, self-control, and empathy) is needed. (4) Political countries should appropriately raise the minimum age of criminal responsibility and adopt the doli incapax principle in the judicial process.

Behavioral and psychosocial correlates of road traffic injuries: evidence from a nationwide study on Chinese undergraduates

Objective: The purpose of this study was to investigate the prevalence and behavioral and psychosocial correlates of road traffic injuries (RTIs) among Chinese university students.Methods: A cross-sectional survey was conducted among fifty universities in China, using a multi-stage sampling methodology. The participants were asked to report their RTIs in the past year. The chi-square test and binary logistic regression analysis were utilized to identify factors associated with RTIs, including specific types of RTIs.Results: Among the 11,770 participants, a total of 1,482 university students reported at least one RTI yielding an overall weighted injury prevalence of 12.96% over the past year. Estimated weighted prevalence by type was 6.10%, 5.94%, 5.12%, and 5.35% for automobile (car, truck, or bus), bicycle, motorcycle, and pedestrian injuries, respectively. Logistic regression analysis found that students who studied at low-level universities, smoked cigarettes, drank alcohol, slept less than 7 hours, went to bed after 12:00 am, or students with psychological distress were more likely to experience overall and four types of RTIs. Students who studied in the eastern universities had a higher likelihood of automobile injury, motorcycle injury and pedestrian injury than those who studied in western universities.Conclusions: Several critical factors associated with RTIs were identified. These findings have implications for the design and implementation of RTI prevention and interventions programs targeted at university students.

Evaluation of a Road Safety Education Program Based on Driving Under Influence and Traffic Risks for Higher Secondary School Students in Belgium

Road safety education has been recognized as an instrument for reducing road accidents. This study aims to evaluate the road safety education program “Traffic Weeks” among higher secondary school students (age 16–19) in Belgium. The program focuses on driving under influence (DUI) and traffic risks. This study investigates whether the program has an effect on socio-cognitive variables using a questionnaire based on the theory of planned behavior. During the pre-test, 445 students filled in the questionnaire, while 253 students filled in the questionnaire during the post-test. Of these, 175 questionnaires could be matched. The results indicate that the students already had quite a supportive view of road safety at pre-test, with female students showing a more supportive view of road safety than male students. The DUI workshop had a positive effect on most socio-cognitive variables (attitude, subjective norm-friends, and intention) of female students in general education, while the traffic risks workshop only affected perceived behavioral control of female students. In terms of appreciation, students had a significantly higher appreciation of the DUI workshop compared to the traffic risks workshop. During the focus groups, students gave recommendations to improve the program.

Impact of a brief psychoeducational intervention for reducing alcohol use and related harm in school leavers

INTRODUCTION AND AIMS

Many young people engage in risky partying behaviours and excessive alcohol use in the transition period following high school graduation. Despite this, there is limited longitudinal research on adolescents before and after school graduation; and limited evaluation of interventions targeting these high-risk periods. The present study aims to address this gap in the literature by examining the impact of brief psychoeducation interventions on substance use, psychological distress and well-being during this important life transition.

DESIGN AND METHODS

Participants were 334 high school leavers (53% female, M_age  = 17.14) from Queensland, Australia. They received either: (i) a psychoeducation intervention on safe partying behaviours; (ii) a reconstructed version of the psychoeducation intervention; or (iii) a standard health curriculum control. Surveys were conducted at baseline; 2 weeks, immediately following post-graduation celebratory event 'Schoolies'; and 4 months, immediately following university orientation 'O-week'.

RESULTS

Significant time by group effects were found for problem drinking, F(2, 227) = 3.07, P < 0.05, and well-being, F(4, 439) = 3.54, P < 0.01. There was stability in problem drinking from baseline to follow-up for the psychoeducation groups but small increases in problem drinking for the control (d = 0.12). Both psychoeducation groups had improvements in well-being scores from baseline to post-Schoolies (d = 0.40; 0.20), which were maintained across time. In contrast, the control condition showed a decrease in well-being scores from baseline to the post O-week follow-up (d = 0.15).

DISCUSSION AND CONCLUSIONS

Brief school-based psychoeducational interventions may result in small improvements in well-being, and possibly stabilise the trajectory of problematic drinking in high-risk environments.

The relationship between motor vehicle collisions and cigarette smoking in Ontario: Analysis of CAMH survey data from 2002 to 2016

Research has shown that tobacco users have an increased risk of collisions compared to nonsmokers. Studies from 1967 through 2013 documented a crude relative risk of collision involvement of about 1.5 among smokers compared to nonsmokers. In January 2009, in response to concerns about the health risks associated with potentially high concentrations of secondhand smoke resulting from smoking in vehicles, the provincial government in Ontario, Canada, introduced legislation restricting smoking in vehicles where children and adolescents are present. We examined the association between reported smoking and involvement in a motor vehicle collision in a large representative sample of adult drivers in Ontario, Canada, from 2002 and 2016, with particular focus on 2002-2008 and 2010-2016, periods before and after the legislation. Data are based on the Centre for Addiction and Mental Health (CAMH) Monitor. Among licensed drivers, prevalence of self-reported collision involvement within the past year for 2002-2008 was 9.39% among those who currently smoked compared to 7.08% of nonsmokers. Following implementation of the legislation, for 2010-2016, the prevalence of collisions for smokers was 7.01% and for nonsmokers was 6.02%. The overall difference for both smokers and nonsmokers between the two time periods was statistically significant; however, the difference between the two groups for the pre-legislation period was significant even after adjusting for potential confounders, while post legislation the difference was not significant. Prior to the legislation, the prevalence of collision was higher among smokers than nonsmokers; following the introduction of the legislation the prevalence was similar for the two groups.

Is there a link between motor vehicle collisions and being a cigarette smoker in Canada? Analysis of survey data from Ontario from 2002 to 2014

OBJECTIVE

Although most research on drugs and driving has focused on the use of alcohol and cannabis, research that has been conducted on cigarette smoking and collisions has found that smokers have an increased collision involvement. Studies dating from 1967 through 2013 have shown a crude relative risk of about 1.5 among smokers compared to nonsmokers. In Canada, the association between smoking and collisions has not been recently investigated. Studies that have examined the association between smoking and collisions often did not control for all confounding factors, such as alcohol use and driving exposure, which have been associated with increased collision rates. Additionally, a number of these studies were examined in countries and at times when prevalence of smoking was much higher than is currently the case in Canada. The purpose of this research is to examine the association between self-reported current smoking and past-year collision involvement, controlling for confounding factors, in a large representative sample of adult drivers in Ontario, Canada, from 2002 and 2014.

METHOD

Data are based on the Centre for Addiction and Mental Health (CAMH) Monitor, an ongoing, rolling telephone survey of Ontario adults that provides epidemiological surveillance of indicators related to alcohol, tobacco, and other drug use, as well as physical and mental health. The survey uses random-digit-dialing methods via Computer-Assisted Telephone Interview, with response rates over 50%.

RESULTS

Prevalence of self-reported collision involvement within the past year for 2002-2014 was 8.6% among those who currently smoke compared to 6.5% of nonsmokers. Logistic regression analysis, controlling for the potential confounding effects of sociodemographics, driving exposure measures, drinking frequency, and hazardous alcohol use, found that the overall odds for collision involvement in the preceding year among current smokers for 2002-2014 was 1.27 (95% confidence interval [CI], 1.06-1.53) times that of nonsmokers.

CONCLUSIONS

These findings indicate that despite a substantial reduction in overall prevalence of smoking in Canada, smokers still have a significantly increased odds of collision involvement, even when controlling for alcohol and exposure. Additionally, the results are consistent with the increased odds/risks of motor vehicle collisions found in other countries.

Factors affecting stability and change in risky driving from late adolescence to the late twenties

The risky driving tendencies of young drivers has been extensively researched, but much less is known about across-time patterns of risky driving behavior and the factors which influence these. This study identified factors associated with stable, increasing and decreasing risky driving trajectories among 751 Australian drivers participating in an ongoing longitudinal study. Five groups were formed on the basis of participants' patterns of risky driving from 19-20 to 27-28 years (i.e., stable low-risk, stable speeding, stable high-risk, increasing and decreasing). Very few participants exhibited a stable high-risk pattern. Characteristics that differentiated the different across-time groups were identified using Multinomial Logistic Regression. The most consistent correlates of risky driving patterns were antisocial behavior, binge drinking and relationship status. Sex, school completion, temperament, civic engagement, and antisocial peer friendships were also correlated with different across-time patterns. The implications of these findings for road safety are discussed.

New Zealand's new alcohol laws: protocol for a mixed-methods evaluation

Background

Alcohol consumption is a major cause of mortality and morbidity globally. In response to strong calls from the public for alcohol law reform, the New Zealand Government recently reduced the blood alcohol limit for driving and introduced the Sale and Supply of Alcohol Act which aim to (1) improve community input into local decision-making on alcohol; (2) reduce the availability of alcohol; and (3) reduce hazardous drinking and alcohol-related harm. In this project we seek to evaluate the new laws in terms of these objectives.

Design and methods

A policy evaluation framework is proposed to investigate the implementation and outcomes of the reforms. We will use quantitative and qualitative methods, employing a pre-post design. Participants include members of the public, local government staff, iwi (Māori tribal groups that function collectively to support their members) and community group representatives. Data will be collected via postal surveys, interviews and analysis of local government documents. Liquor licensing, police and hospital injury data will also be used. Community input into local government decision-making will be operationalised as: the number of objections per license application and the number of local governments adopting a local alcohol policy (LAP). Outcome measures will be the ‘restrictiveness’ of LAPs compared to previous policies, the number (per 1000 residents) and density (per square kilometre) of alcohol outlets throughout NZ, and the number of weekend late-night (i.e., post 10 pm) trading hours. For consumption and harm, outcomes will be the prevalence of hazardous drinking, harm from own and others’ drinking, community amenity effects, rates of assault, and rates of alcohol-involved traffic crashes. Multiple regression will be used to model how the outcomes vary by local government area from before to after the law changes take effect. These measures will be complemented by qualitative analysis of LAP development and public participation in local decision-making on alcohol.

Discussion

The project will evaluate how well the reforms meet their explicit public health objectives.

Impact of adding Level II and III trauma centers on volume and disease severity at a nearby Level I trauma center

BACKGROUND

As emergency care becomes increasingly regionalized, systems planners must determine how system expansion impacts existing system assets. We hypothesized that accrediting new Level II and III trauma centers impacted the trauma patient census and severity at a nearby Level I trauma center and estimated the magnitude of the impact.

METHODS

We conducted an interrupted time series analysis using monthly patient counts during the past 10 years for five trauma centers located near one another in Pennsylvania. The Level I center (TC-A) operated for the entire period. A Level II center 39 miles away was accredited after 70 months (TC-B), one Level III center 46 miles away was accredited after 95 months but lost accreditation after 11 months (TC-C), and two other Level III centers 40 miles and 45 miles away were accredited after 107 months (TC-D and TC-E).

RESULTS

Monthly patient volume at the Level I center, which increased gradually over the study and summed to 25,120 patients, decreased by 10.8% (p < 0.05) when TC-B was accredited and decreased by an additional 12.9% (p < 0.05) when TC-D and TC-E were accredited simultaneously. No change stemmed from temporarily accrediting TC-C. Ultimately, the Level I center treated 1,903 fewer patients than expected over 51 months, an 11.9% volume reduction, and patient severity remained consistent but mortality decreased.

CONCLUSION

Accrediting Level II and Level III trauma centers reduced patient volume and reduced overall mortality at a nearby Level I center. Strategic planning of statewide trauma systems can help balance rapid access to care with maintenance of adequate annual patient volumes of critically injured patients.

LEVEL OF EVIDENCE

Epidemiologic study, Level IV.

Interaction between socio-demographic characteristics: traffic rule violations and traffic crash history for young drivers

Young drivers' high traffic violation involvement rate and significant contribution to traffic crashes compared to older drivers creates the need for detailed analyses of factors affecting young drivers' behaviors. This study is based on survey data collected from 2,057 18-29 year old young adults. Data were collected via face-to-face questionnaire surveys in four different cities in Turkey. The main objective of this study is to identify the relationship between socio-demographic characteristics, traffic rule violations, and traffic crashes among young drivers. Four main traffic rule violations are examined: red light violations, seat belt violations, speeding, and driving under the influence of alcohol, which are decisive in determining driving behavior and traffic crashes. The survey investigates the socio-demographic characteristics, traffic rule violation behavior and traffic crash histories of young adults. Four hypothetical scenarios were prepared for each traffic rule violation and data from the scenarios were modeled using the ordered probit model. Significant variables affecting each traffic rule violation are stated. Finally, significant variables that interact with crash involvements were investigated with binary logit models. According to the data analysis, 23.9% of drivers stated that they were involved in at least one traffic crash within the last three years. This crash rate increases to 38.3% for those who received at least one traffic citation/violation in last three years and peaks to 47.4% for those who were fined for seat belt violations in last three years.

Unlicensed driving and other related health risk behaviors: a study of Montana high school students

PURPOSE

Health risk behaviors tend to cluster in young people, not least among young drivers. Less is known about the health risk profile of young unlicensed drivers. This study investigates health risk behaviors among young unlicensed drivers compared to both their licensed and driving peers, and their non-driving peers.

METHODS

High school students participating in the Youth Risk Behavior Surveillance System in Montana (US) and age-eligible to have a driver's license were studied (n=5985), categorized according to their self-reported car driving and license practice (licensed driving, unlicensed driving, and non-driving). Ten health risk behaviors, of which four were related to car riding/driving, were considered. Multinomial logistic regression was used to compile sex-specific odds ratios (with 95% confidence intervals) of adopting those behaviors using licensed drivers as a reference and adjusting for age and race/ethnicity.

RESULTS

Health risk behaviors tended to be more common among unlicensed drivers than other groups, although some behaviors were prevalent in all groups (i.e., alcohol use and lack of seat belt use). As a consequence, for both male and female students, there was a significant association between unlicensed driving and most health risk behaviors, except for being involved in a physical fight and riding with a drinking driver among female students.

CONCLUSIONS

Young unlicensed drivers are more likely than licensed drivers to adopt several health risk behaviors both in car driving/riding or otherwise, in particular alcohol use and cigarette smoking. This challenges any simplistic approach as unlicensed driving in youth is not an isolated act suggesting public health and traffic safety initiatives.

A systematic and methodological review of interventions for young people experiencing alcohol-related harm

AIMS

This review identified published studies evaluating interventions delivered outside educational settings, designed for young people with existing alcohol use problems, or who participate in behaviour that places them at high risk of alcohol-related harm, critiqued their methodology and identified opportunities for new interventions.

METHODS

A systematic search of the peer-reviewed literature interrogated 10 electronic databases using specific search strings, limited to 2005-09. No additional studies were found by a librarian searching other collections and clearing-houses, or by hand-searching review paper reference lists. The 1697 articles identified were reviewed against criteria from the Dictionary for the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.

RESULTS

The methodological quality of existing studies is variable, and needs to be both more rigorous and more consistent. Particular problems include the lack of blinding outcome assessors, a reliance solely on self-report measures, highly variable consent and follow-up rates, infrequent use of intention-to-treat analyses and the absence of any economic or cost analyses. The range of interventions evaluated is currently limited to individually focused approaches, almost exclusively implemented in the United States.

CONCLUSIONS

There is a great need for more intervention trials for young people at high risk of experiencing alcohol-related harm that are both methodologically rigorous and have a broader community focus, to complement the psychological interventions that currently dominate the relevant literature. Such trials would improve outcomes for high-risk young people themselves and would improve the evidence base, both in their own right and by facilitating future meta-analyses.

Adolescent, and their parents, attitudes towards graduated driver licensing and subsequent risky driving and crashes in young adulthood

PROBLEM

Although Graduated Driver Licensing Systems (GDLS) have helped reduce young driver crash rates, they remain significantly over-represented in crash statistics. To be effective GDLS rely heavily on support for the legislation by those directly involved; parents to enforce the restrictions and adolescents to comply. There is some evidence that practices regarding GDLS restrictions influence adolescent driving outcomes in the early stage of licensure. However there has been no examination undertaken on the influence of parent and adolescent attitudes toward GDLS on adolescents' driving behavior and crash experiences as they move into their young adult years. The aim of this research was to examine these relationships.

METHOD

This investigation was based on a longitudinal study of a birth cohort, and uses data collected when the cohort members were aged 15, 18, and 21years. At age 15 both adolescent and their parent attitudes toward GDLS were measured. At age 18 adolescent GDLS attitudes were measured again. The association between these measures and self-reported risky driving behavior and crash involvement at age 21 were examined.

RESULTS

Negative attitudes toward the learner supervisor restriction for males, and negative attitudes toward a GDLS for females were strongly associated with risky driving and crash involvement as young adults.

IMPACT ON INDUSTRY

Targeting interventions to improve adolescents and parents understanding of the reasons for graduated licensing and the specific restrictions may improve attitudes and views and thereby contribute to a reduction in risky driving behaviors and crash risk among young adults.

Alcohol intoxication and mental health among adolescents--a population review of 8983 young people, 13-19 years in North-Trøndelag, Norway: the Young-HUNT Study

BACKGROUND

The aims of this study were to describe alcohol use among Norwegian teenagers and investigate the associations between mental health problems and alcohol intoxications with focus on age and gender.

METHODS

Population based, cross-sectional survey addressing all adolescents aged 13-19 years, attending secondary or high school in North - Trøndelag County, Norway. 8983 youths (91%) answered the Young-HUNT questionnaire in the 1995-1997 survey. Logistic regression models were used to study associations.

RESULTS

80% of the respondents reported that they had tried drinking alcohol, and 57% had been intoxicated at least once. The proportion of the students, which had tried alcohol, was equal in both genders and increased with age. Attention problems and conduct problems were strongly associated with frequent alcohol intoxications in both genders. Anxiety and depressive symptoms among girls were also related to high numbers of intoxications

CONCLUSION

Gender differences in number of alcohol intoxications were small. There was a close association between both conduct and attention problems and high alcohol consumption in both genders. Girls with symptoms of anxiety and depression reported more frequent alcohol intoxications.