Trajectory Outcomes of Teens that Ride with Impaired Drivers & Drive Impaired

7.项目总结 与受损司机(RWI)一起驾驶和在受损时驾驶(DWI)在高中很普遍 学生们。几十年来，车祸一直是青少年死亡的主要原因。在……里面 2015年，美国的机动车撞车死亡人数创下50年来最大增幅。这 包括酒后驾车死亡人数显著增加，其中1人酒后驾车死亡 每51分钟发生一次，每5名乘客中就有1人死亡。不过，酒精和大麻 继续成为美国年轻人的首选药物，尽管在高潮期间长期使用药物的速度缓慢下降 在学校，每年的流行率仍然很高。几个因素可以预测高中生未来的RWI/DWI，例如 作为重度间歇性饮酒，被认为是酒精/药物使用的同龄人规范，父母监督较低 知识，以及对RWI的接触。最近的研究还表明， RWI/DWI和家庭-成人暴露和行为建模。青少年大量饮酒/吸毒 与轨迹相关的研究探索了成年后新出现的结果(例如健康、就业、大学 注册)。然而，尽管交通准入与这些领域之间存在众所周知的关系， 作为接触和参与RWI/DWI的直接结果，人们对这些结果知之甚少。此外， 目前的研究很大程度上没有解释RWI/DWI暴露和参与是如何发展的。考虑到复杂性 在可能影响RWI/DWI的过程中，需要一个社会生态学理论框架来系统地 以及对关系(多层次影响)和互动(社会环境)的全面表征 塑造正在形成的成年结局。我们提出了一种非常新颖的多阶段混合方法研究 应用生态发展理论(ET)框架来表征青少年的RWI/DWI行为 并确定它们与新兴市场中的健康、就业和高等教育入学人数之间的关联 成人期。首先，我们将分析7波纵向青少年健康数据(NIH的下一代 健康研究-从2009-2010学年春季学期开始跟踪美国10年级学生，直到 当前日期)以便表征RWI/DWI轨迹类别及其与健康、就业、 和高等教育入学的新兴成人期。接下来，我们将使用混合方法来生成ET- 关于RWI/DWI暴露和参与如何发展和影响初成年的驱动假说 在同伴、家庭、学校和环境影响的背景下产生的结果。最后，我们将使用系统 根据RWI/DWI建立观察结果差异的解释模型的动力学建模 轨迹类。我们最终的理论驱动的解释模型将促进对青少年的理解 RWI/DWI行为，并为后续创新和多层次干预的发展提供信息 重点是预防RWI/DWI和加强青少年成功地过渡到 即将进入成年期。

7. PROJECT SUMMARY Riding with an Impaired (RWI) driver and Driving While Impaired (DWI) is prevalent among high school students. Motor vehicle crashes have remained the leading cause of death among adolescents for decades. In 2015, the U.S. encountered the largest percent increase in motor vehicle crash fatalities in 50 years. This included a significant increase in alcohol-impaired driving fatalities with 1 alcohol-impaired driving death occurring every 51 minutes and 1 in every 5 deaths occurring in passengers. Still, alcohol and marijuana continue as the drugs of choice for American youth and despite a slow secular decline in use during high school, annual prevalence remains high. Several factors predict future RWI/DWI in high school students, such as heavy episodic drinking, perceived peer norms of alcohol/substance use, low parental monitoring knowledge, and exposure to RWI. Recent studies also demonstrate the intimate relationship between RWI/DWI and household-adult exposure and behavior modeling. Extensive adolescent alcohol/drug use trajectory-related research has explored emerging adulthood outcomes (e.g. health, employment, college enrollment). However, despite the well-known relationship between transportation access and these domains, little is known about these outcomes as a direct result of exposure and engagement in RWI/DWI. Further, current studies largely do not explain how RWI/DWI exposure and participation develops. Given the complexity of the processes that may affect RWI/DWI, a social ecological theoretical framework is needed for systematic and full characterization of the relationships (multi-level influences), and interactions (social environmental) that shape emerging adulthood outcomes. We propose a highly novel multistage mixed methods study that employs the Ecodevelopmental Theoretical (ET) framework to characterize adolescent RWI/DWI behaviors and determine their association with health, employment, and higher education enrollment in emerging adulthood. First, we will analyze 7 waves of longitudinal adolescent health data (NIH's NEXT Generation Health Study - following U.S. 10th graders since Spring semester of the 2009-2010 academic year until the current date) in order to characterize RWI/DWI trajectory classes and their relationship to health, employment, and higher education enrollment in emerging adulthood. Next, we will use mixed methods to generate ET- driven hypotheses about how RWI/DWI exposure and participation develops and affects emerging adulthood outcomes within the context of peer, family, school, and environmental influences. Finally, we will use system dynamics modeling to build an explanatory model for observed outcome differences according to RWI/DWI trajectory classes. Our final theory driven explanatory model will advance the understanding of adolescent RWI/DWI behaviors and inform the subsequent development of an innovative and multi-level intervention focused on prevention of RWI/DWI and the enhancement of successful transitions of adolescents into emerging adulthood.