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

7.项目摘要 与受损（RWI）驾驶员一起驾驶和受损（DWI）驾驶在高中中很普遍 学生几十年来，机动车撞车一直是青少年死亡的主要原因。在 2015年，美国遭遇了50年来机动车事故死亡人数的最大增幅。这 包括酒精受损驾驶死亡人数显著增加，其中1人因酒精受损驾驶死亡 每51分钟发生一次，每5名乘客中就有1人死亡。尽管如此，酒精和大麻 继续作为美国年轻人的首选药物，尽管在高血压期间使用缓慢下降， 在学校，年流行率仍然很高。有几个因素可以预测高中生未来的RWI/DWI，例如 严重的间歇性饮酒，酒精/物质使用的感知同伴规范，父母监督不足 知识和暴露于RWI。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 与成人教育相关的研究探讨了成人教育的新成果（如健康、就业、大学教育）。 登记）。然而，尽管交通运输与这些领域之间的关系众所周知， 对于这些结果作为暴露和参与RWI/DWI的直接结果知之甚少。此外，本发明还 目前的研究基本上没有解释RWI/DWI暴露和参与是如何发展的。考虑到 在可能影响RWI/DWI的过程中，需要一个社会生态理论框架来系统地 以及关系（多层次影响）和相互作用（社会环境）的充分表征， 塑造成年期的结果。我们提出了一个非常新颖的多阶段混合方法研究， 采用生态发展理论（ET）框架来描述青少年RWI/DWI行为 并确定他们与健康，就业和高等教育入学率的关系， 成年首先，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，一直跟踪美国10年级学生， 当前日期），以表征RWI/DWI轨迹类别及其与健康，就业， 和高等教育的入学率。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成年期的驱动假设 在同伴、家庭、学校和环境影响的背景下取得成果。最后，我们将使用系统 动力学建模，以根据RWI/DWI建立观察到的结局差异的解释性模型 弹道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，并为创新和多层次干预的后续发展提供信息 重点是预防RWI/DWI和促进青少年成功过渡到 成年初显期

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.