Do adolescent trajectories of riding with an impaired driver and driving impaired predict similar behaviors in early adulthood?

BACKGROUND: A recent study shows four trajectories of riding with an impaired driver (RWI) and driving while impaired (DWI) from adolescence to emerging adulthood. We examined prospective associations of adolescent RWI/DWI trajectory class with early adulthood RWI/DWI behavior. METHODS: Data were from the NEXT Generation Health Study (NEXT), a nationally representative longitudinal study (N = 2783) beginning with a 10th-grade cohort completing 7 annual assessment waves (W1-W7) between 2010 and 2016 and a later follow-up mixed methods study. Four RWI and DWI trajectories derived from a recently published latent class analysis study (RWI (last 12 months); DWI (last 30 days) dichotomized as ≥ once vs. none) were used: Abstainer, Escalator, Decliner, and Persister. In the follow-up examination, a purposive subsample (N = 105, 26.3 ± 0.5 y/o, Female 50.5%) of NEXT participants were selected by trajectory (31 Abstainers, 33 Escalators, 14 Decliners, and 27 Persisters) for in-depth interviews 4 years after NEXT. In interviews, self-reported RWI events (number of times) related to alcohol (Alc-RWI) or marijuana (MJ-RWI) use in the last 12 months, and DWI events (number of times) related to alcohol (Alc-DWI) & marijuana (MJ-DWI) use in January 2020 (pre-COVID pandemic) were collected using structured surveys. General linear models were used to examine associations of adolescents' RWI/DWI trajectories with early adulthood RWI/DWI behavior, controlling for sex, health status, education attainment, and work hours. RESULTS: The mean number (SD) of Alc-RWI and MJ-RWI events reported by Escalators (3.83(2.48), 2.43(2.77)) and Persisters (3.83(2.43), 3.57(2.54)) were higher (p≤0.05) than Abstainers (0.82(1.42), 0.77(2.04)) and Decliners (1.81 (2.69), 1.38 (2.04)). Similarly, Escalators (1.61 (2.28), 1.88(2.69)) and Persisters (1.96(2.08), 1.93(2.48)) reported more Alc-DWI and MJ-DWI events than Abstainers (0.18 (0.53), 0.42(1.38)) and Decliners (0.00 (0.00), 0.08(0.28)). Linear regression models indicated membership in Escalator and Persister classes compared to Abstainer class was associated (p≤0.01) with higher engagement in RWI/DWI in early adulthood. CONCLUSION: Adolescents with escalating and persistent high RWI/DWI may continue these health risking behaviors into their mid-twenties. Decliners during the transition maintained low RWI/DWI into their mid-twenties. Taken together, these findings suggest that earlier reduction may have long-term effects. Our findings can be used to inform the precision tailoring of prevention efforts aimed at effectively reducing alcohol/drug impairment crash injuries and related deaths among those in early adulthood.

Body size perception and weight control in youth: 9-year international trends from 24 countries.

OBJECTIVES: To examine 9-year trends and relationships regarding misperceptions of body size and dieting for weight loss among adolescents from 24 countries, and explore the influence of country-level overweight prevalence. METHODS: Sociodemographic characteristics, body size perception and dieting for weight loss were assessed in the Health Behaviour in School-aged Children survey conducted in 24 countries cross-sectionally at three time points (2001/2002, 2005/2006 and 2009/2010). Logistic regression models examined change over time in overestimation of body size in non-overweight adolescents, underestimation of body size in overweight adolescents, dieting for weight loss in non-overweight and overweight adolescents and relationships between body size perception and dieting. Analyses were stratified by weight status and sex. Covariates included country-level overweight prevalence, family affluence and country level of development. Body mass index was only included in models examining dieting for weight loss. RESULTS: Country-level overweight prevalence increased over time (11.6-14.7%). Compared with Time 1, overweight adolescents had greater odds of body size underestimation at Time 3 (odds ratio (OR)=1.68 for girls; OR=1.10 for boys), whereas non-overweight adolescents had lower odds of body size overestimation at Time 3 (OR=0.87 for girls; OR=0.89 for boys). Controlling for country-level overweight prevalence attenuated these relationships. Compared with Time 1, overweight and non-overweight boys were 10% more likely to diet at Time 3, whereas overweight and non-overweight girls were 19% and 16%, respectively, less likely to diet at Time 3. Controlling for country-level overweight prevalence did not impact trends in dieting for weight loss. Additionally, the association of self-perceived overweight with increased odds of dieting diminished over time. CONCLUSIONS: Body size perceptions among adolescents may have changed over time concurrent with shifts in country-level body weight. However, controlling for country-level overweight prevalence did not impact trends in dieting for weight loss, suggesting a potentially stronger impact of social comparison on weight-related perceptions than on behavior.

Cross-sectional and longitudinal relationships of body mass index with glycemic control in children and adolescents with type 1 diabetes mellitus.

AIMS: Weight gain is an oft-cited outcome of improved glycemic control in adults with type 1 diabetes, though few studies have investigated this in youth. The purpose of this paper was to examine cross-sectional and longitudinal associations of body mass index (BMI, kg/m(2)) with glycemic control in youth with type 1 diabetes (n=340, 12.5 ± 1.7 year, 49% female, duration ≥ 1 year) participating in a 2-year multi-center intervention study targeting family diabetes management. METHODS: BMI was calculated from height and weight measured at clinic visits. Glycohemoglobin (HbA1c) at each visit was assayed centrally. Cross-sectional associations of baseline BMI with glycemic control, and of change in BMI and HbA1c with baseline values, were examined. Longitudinal associations of time-varying BMI and HbA1c were examined using a multilevel linear mixed effects model controlling for time-varying time (months), insulin dose (units/kg/day), regimen, Tanner stage, and time invariant baseline diabetes duration, BMI, treatment group and sociodemographic characteristics. RESULTS: Baseline HbA1c was unrelated to baseline BMI, but was related positively to subsequent BMI change (p=0.04) and inversely to HbA1c change (p=0.002). Baseline BMI was inversely related to BMI change (p=0.01) and unrelated to HbA1c change. In multilevel regression, BMI was related inversely to HbA1c (%) (ß ± SE=-0.11 ± 0.02, p<0.001) and positively to insulin dose (0.23 ± 0.07, p=0.001). In the treatment group only, BMI was positively related to pump regimen (0.18 ± 0.08, p=0.02). CONCLUSIONS: Increased insulin administered to improve glycemic control may contribute to increased BMI in youth with type 1 diabetes, indicating the importance of determining ways to minimize weight gain while optimizing glycemic control.

Cigarette smoking status and recurrent subjective health complaints among US school-aged adolescents.

BACKGROUND: Subjective health complaints are common among adolescents. There is evidence that girls are more likely to register complaints than boys. This study examines gender differences in the relationship between daily smoking and recurrent subjective health complaints in school-aged adolescents in the USA. METHODS: A cross-sectional design with a multistage probability sample was used to survey 13,339 middle and high school students (grades 6 through 10) with the US 2001-2002 Health Behavior in School-Aged Children Survey. RESULTS: Recurrent subjective health complaints were higher for adolescents who smoke daily and experiment with cigarettes than for those who never smoke. In logistic regression analyses, the odds of daily smoking increased twofold for both boys and girls who report recurrent irritability/bad temper. For girls, the odds of daily smoking were higher among those who reported recurrent headache, stomachache and backache compared with never smokers. For boys only recurrent backache and feeling dizzy were associated with increased odds of daily smoking. CONCLUSIONS: The relationship between recurrent subjective health complaints and daily smoking provides new insights into both conditions for school-aged adolescents. Findings from this study suggest different patterns of association between daily smoking and recurrent subjective health complaints occur for girls and boys. Further studies are needed to explore causes and treatment of daily smoking and recurrent health complaints among school-aged children.

The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions.

OBJECTIVES: To describe the methodological development of the HBSC survey since its inception and explore methodological tensions that need to be addressed in the ongoing work on this and other large-scale cross-national surveys. METHODS: Using archival data and conversations with members of the network, we collaboratively analysed our joint understandings of the survey's methodology. RESULTS: We identified four tensions that are likely to be present in upcoming survey cycles: (1) maintaining quality standards against a background of rapid growth, (2) continuous improvement with limited financial resources, (3) accommodating analysis of trends with the need to improve and adapt questionnaire content, and (4) meeting the differing requirements of scientific and policy audiences. CONCLUSIONS: While these challenges are not trivial, the structure of the HBSC network and its long-term experience in working through such challenges renders it likely that HBSC can provide a model of other similar studies facing these tensions.

Responsive parenting is associated with improved type 1 diabetes-related quality of life.

BACKGROUND: Improved quality of life is an important treatment goal for children and adolescents with type 1 diabetes. While previous research supports a relationship between family environment and quality of life, little research has addressed the relationship of parenting style constructs to quality of life in children with chronic disease. The present investigation assesses the relationship of parent responsiveness and demandingness with diabetes-related quality of life among children and adolescents with type 1 diabetes. METHODS: Baseline and 12-month follow-up self-report assessments were collected on a sample of 81 children with type 1 diabetes participating in an efficacy trial of a behavioural intervention to enhance adherence. The sample had a mean age of 13.3 years (SD=1.7) and duration of diabetes of 7.7 years (SD=3.7). Multiple regression analyses were conducted to determine the relationship of parent responsiveness and demandingness to diabetes-related quality of life at each time point. RESULTS: After adjusting for demographic and diabetes characteristics, as well as diabetes-specific parent-child behaviours, parent responsiveness was significantly associated with baseline diabetes-related quality of life (beta=0.23; P=0.04). This relationship was sustained at 12-month follow-up (beta=0.22; P=0.04) after adjusting for baseline quality of life and treatment group assignment, suggesting that parent responsiveness is associated with improved quality of life. CONCLUSIONS: Findings indicate the importance of a supportive and emotionally warm parenting style in promoting improved quality of life for children with type 1 diabetes. Appropriate parenting skills should be an element of diabetes family management health care.

The impact of family history of breast cancer on women's health beliefs, salience of breast cancer family history, and degree of involvement in breast cancer issues.

Prior investigations have employed the Health Belief Model (HBM) to predict health care utilization and cancer screening behaviors. The HBM is expanded in the current investigation to include issue involvement with breast cancer and salience of breast cancer family history. Differences in the constructs of this expanded HBM, as they relate to mammography screening, between women with positive and negative family histories of breast cancer were assessed in 378 women. Perceived benefits and barriers were found to be similar for women with positive and negative family histories of breast cancer. However, susceptibility, cues to action, salience of family history, and issue involvement were found to be more relevant for women with a positive family history of breast cancer. These findings have implications for interventions directed at increasing compliance with recommendations for breast cancer screening.

Correlations of cardiovascular disease risk factors between African American siblings.

OBJECTIVES: This study examines intrasibling correlations at 2 points during childhood for African American siblings with the same father, different fathers, a father present in the home, and no father present in the home. STUDY DESIGN: Cardiovascular disease (CVD) risk factors were assessed in 267 pairs of African American siblings (visit 1) and in 79 of these siblings approximately 28 months later (visit 2). RESULTS: As a group, correlations of CVD risk factors between African American siblings with the same father were greater than those for African American siblings with different fathers in visit 1 (P <.05). However, having a father present in the home was associated with significantly lower intrasibling correlations for girth and total cholesterol in visit 2 (P <.005). Intrasibling correlations for the 4 family subgroups suggest that CVD risk factors were most similar in siblings who shared the same father but who had no father present in the home. CONCLUSIONS: Intrasibling correlations for African American children were influenced by whether they shared the same father and whether a father was present in their home, reflecting both genetic and environmental influences. Family composition should be considered when family CVD risk factors are used to predict CVD risk in children.

Intrafamilial relations of cardiovascular disease risk factors in African-Americans: longitudinal results from DC SCAN.

BACKGROUND: Few studies have examined intrafamilial patterns of cardiovascular disease (CVD) risk factors in African-American families or identified potential influences on these patterns. This study examines the effects of age and sex of child on correlations between siblings during childhood as well as between mothers and their offspring in African-American families at two points in time. METHODS: CVD risk factors were assessed in a sample of 267 pairs of African-American siblings and their mothers. One hundred nine of these families were selected for a second assessment of CVD risk factors approximately 28 months later. RESULTS: Older siblings had significantly greater correlations than younger siblings with mothers' low-density lipoproteins (r = 0.61 versus r = 0.43 for older and younger siblings, respectively), apolipoprotein A-I (r = 0. 46 versus r = 0.16), and lipoprotein (a) (r = 0.71 versus r = 0.34). Correlations between female siblings were significantly higher than between male siblings for total cholesterol (r = 0.74 versus r = 0. 18 for female versus male siblings), triglycerides (r = 0.56 versus r = 0.05), and apolipoprotein B (r = 0.72 versus r = 0.31); they were also higher between female siblings than between mixed-sex siblings for measures of adiposity (r = 0.46 versus r = 0.19) and total cholesterol (r = 0.74 versus r = 0.27). CONCLUSIONS: Significant intrafamilial correlations for African-American children were influenced by both age and sex of siblings, reflecting potential genetic and environmental influences. Assessing family patterns of CVD risk factors in high-risk populations may assist in the early identification of children who can benefit most from intervention.

Perception of friends' use of alcohol, cigarettes, and marijuana among urban schoolchildren: a longitudinal analysis.

Relations between adolescents' substance use and perceptions of their friends' substance use were examined cross-sectionally and longitudinally in a predominantly African-American school district. Fourth- and fifth-grade students were surveyed and tracked for 4 consecutive years. Cross-sectional samples included 3,073, 5,955, 7,701, and 6,616 students in years 1 to 4, respectively; the longitudinal sample included 1,802 students surveyed in every year. Self-reported substance use of friends and classmates also was assessed. Perceived friends' substance use had a stronger association with prior substance use than friends' self-reported substance use in every year. Perceived family use and classmates' self-reported use also made independent contributions to regression models. Longitudinal structural equation analyses indicated that perceived friends' use is more likely to be a product of an adolescent's previous substance use than a precursor of subsequent substance use. The findings contradict prevailing theories on the influence of peers on substance use.

Early adolescents' substance use and life stress: concurrent and prospective relationships.

Life stress during early adolescence has been linked to substance use. Few studies have investigated whether the amount of control the child has over stress moderates this relationship even though the role of personal control is of increasing theoretical importance. Relationships between controllable and uncontrollable life stress and substance use were investigated in 303 urban, African-American fourth and fifth graders (152 males, 151 females). Controllable life stress contributed to six regression equations predicting children's substance use both cross-sectionally and longitudinally, even when selected demographic and personal variables were controlled. Evidence supporting a similar role for uncontrollable life stress was not found.

Parental and peer influences on food consumption of preschool African-American children.

Sources of social influence on urban African-American preschool children's food consumption were coded from videotapes of noontime and evening meals of 42 children. The frequency of eating prompts was associated with the age of the child, the source (mothers, fathers, age mates, other adults, and day-care staff), and socioeconomic status. The success of the prompt in changing the child's eating behavior was dependent on the type of prompt.

Comparison of dietary intake methods with young children.

To select a valid method for obtaining dietary intake of preschool children, food intake of 17 children (8 in daycare programs and 9 in home care) was measured for three days. Each day, home caregivers and daycare staff were asked to recall what the child had eaten during the previous 24 hours. After the third day, the Willett Food Frequency Questionnaire was administered to assess intake during the preceding seven days, which included the three days of measured foods. There were no significant differences between means from measured and recalled intake. Although the children's gender and care status (daycare versus home care) made no difference in measured intake, there were significant differences in recalled intake for energy and percent of calories from saturated fat. In this study the questionnaire did not provide an accurate assessment of measured intake and could not replace the dietary recall.

How maternal characteristics influence differences between mothers' and teachers' ratings of Type A behavior in black preschool children.

Because of the increased use of reports of Type A behavior pattern (TABP) in preschool-age children, parents are sometimes asked to provide reports on their children in circumstances in which teachers' reports may be inappropriate or unavailable. This article contrasts mothers' and teachers' reports of TABP for 158 urban, black preschool children. Mothers provided self-reports of their own Type A behavior (FTAS). Mothers' scores were weakly correlated with teachers' scores and the FTAS reports. Mothers' reports of TABP for the children were significantly higher than those of the teachers. Reports of children's TABP by high-Type A mothers were significantly higher than reports by low-Type A mothers, whereas teachers' reports showed no difference between children of low- and high-TABP mothers. Results are discussed in terms of how some mothers may project personal characteristics onto their children and how the findings can be used in interpreting mothers' reports.

Healthful behaviors: do they protect African-American, urban preadolescents from abusable substance use?

PURPOSE: Relationships between positive health behaviors and abusable substance use in preadolescent, urban, African-American schoolchildren were investigated. DESIGN: Personal interviews and classroom surveys were used to assess health behavior and abusable substance use cross-sectionally. SETTING: All respondents resided in the District of Columbia and attended the public school system. SUBJECTS: The sample consisted of 303 urban, African-American fourth and fifth graders (151 boys, 152 girls). MEASURES: Classroom surveys assessed drinking, drinking without parental knowledge, smoking, use of other abusable substances, friends' use, self-esteem, and academic performance. Personal interviews assessed children's diet, exercise, overall health behavior, and socioeconomic status. RESULTS: Logistic regressions showed that children who engaged in more health behaviors (exercise and proper nutrition) were one-third less likely to have smoked (OR=0.66) or to have drunk alcohol (OR=0.63) than those who engaged in fewer healthful activities. However, when gender, socioeconomic status, self-esteem, academic performance, personal use, and friends' use of other abusable substances were controlled, relationships were no longer statistically significant. CONCLUSIONS: These findings suggest that although positive health behaviors appear to be inversely related to abusable substance use in urban, African-American preadolescents, the relationship may be spurious.

Investigating children's knowledge and understanding of AIDS.

Though AIDS education in schools reaches many adolescents, the incidence of adolescent HIV infection has risen dramatically. Reasons for failure to properly educate adolescents include not educating children prior to adolescence and neglecting to assess and address children's varying levels of cognitive development when designing AIDS education programs. Citing examples from a study of more than 600 elementary-age schoolchildren, this paper focuses on the importance of assessing children's understanding of disease processes rather than accepting their use of key phrases in appropriate contexts as reflecting knowledge, and using the level at which they understand disease processes rather than age as the primary determinant of students' readiness for comprehending AIDS-related concepts. Guidelines for assessing how well children understand disease processes, including use of nonleading probes, are presented.

Alcohol, cigarette, and marijuana use among fourth-grade urban schoolchildren in 1988/89 and 1990/91.

A public-school-based epidemiological survey of fourth-grade students in Washington, DC, was performed in 1988/89 (n = 4675) and 1990/91 (n = 4678). Comparisons of data for the two periods revealed that the lifetime prevalence of self-reported alcohol use, alcohol use without parental knowledge, and smoking more than a puff of cigarettes declined; marijuana use and cigarette experimentation did not. Seven variables were associated with use. Declines were observed in perceived peer pressure to use; seeing a family member/friend selling drugs; and being offered alcohol, cigarettes, or marijuana by peers. No declines were observed in family use, perceived friends' use, being bothered a lot if best friends use, or seeing someone else selling drugs.

Elementary schoolchildren's use of alcohol, cigarettes and marijuana and classmates' attribution of socialization.

In each of 2 years beginning in fourth and fifth grades, urban elementary public schoolchildren completed surveys about abusable substance use and health promoting behaviors and completed an instrument that permitted each child to have a socialization score attributed by classmates. A factor weighted 12-item scale was developed from 15 items in three domains (personal, interpersonal and school). The scale was positively correlated over the 2 years and positively correlated with a healthful activities scale in both years. Conditional multiple logistic regression, matching on school classroom, indicated that socialization was negatively associated with use of alcohol without parental permission and cigarettes in both years (grades 4-5, grades 5-6) and with use of marijuana in year 1. Socialization measured in year 1 was negatively associated with cigarette use in year 2 and with onset of use from year 1 to year 2. Shyness, a non-socialization scale item, was negatively associated with use of cigarettes in both years and with use of alcohol without permission and use of marijuana in year 2. Being 'good at sports' was an attribute positively associated with alcohol use without permission and cigarette use in year 2. Results suggest that elementary schoolchildren can ascribe social characteristics to their classmates that are associated with and predict health related behaviors.