Shared and distinct parental influences on teen impaired driving in rural and suburban contexts: A mixed methods study of young drivers.

OBJECTIVE: To explore shared and distinct parental influences on rural and suburban adolescents' riding with an impaired driver (RWI) and driving while impaired (DWI) behaviors during high school. METHODS: Participants in the NEXT Generation Health Study (NEXT) were classified into four RWI/DWI trajectory classes (i.e., Abstainer, Escalator, Decliner, Persister) which described patterns of RWI/DWI from high school to emerging adulthood. A follow-up, in-depth, qualitative interview was conducted with a purposeful selection of participants from each trajectory class between March and September 2020. Guided by Ecodevelopmental Theory, the interview included questions which explored parent-teen influences on driving and RWI/DWI. RESULTS: Imposition of a curfew was a shared parental influence in rural and suburban contexts. Unique to the rural context, parent modeling of RWI/DWI was described as normative and occurring since childhood. CONCLUSIONS: Prevention interventions targeting parent RWI/DWI may reduce their children's risk for RWI/DWI among rural adolescents.

Longitudinal perspectives of riding with a cannabis-impaired driver.

OBJECTIVE: To explore decisions and perceptions of engaging in riding with a cannabis-impaired driver (RWI) during high school and young adulthood to build context around RWI-cannabis events. METHODS: Participants were sampled from the NEXT Generation Health Study (NEXT), a 7-year national cohort study of adolescent health behaviors. Four RWI and driving while impaired (DWI) trajectories classes (i.e., Abstainer, Escalator, Decliner, Persister) were previously derived.A theoretical model based on ecological systems theory guidedin-depth semi-structured interviews to includecomplex, social-developmental and environmental multi-level factors affectingpersonal experiences with RWI-cannabis during high school, after high school, and during young adulthood. Participants (n = 105) were purposively selected from each trajectory class for follow-up, in-depth, qualitative interviews. All interviews were conducted via Zoom between March and September 2020. RESULTS: Two unique themes emerged as facilitators of RWI-cannabis: "Driving Context" and "Trust in Driver". "Legal Concerns" and "Concerns with Safety Emerge with Age" were themes that described deterrents to RWI-cannabis. CONCLUSIONS: Current data suggest that youth RWI-cannabis occurs during daytime hours and while driving to everyday activities. Youth report legal concerns as a potential deterrent to RWI-cannabis in high school and concerns for safety emerge in young adulthood. The multifaceted nature of RWI-cannabis among young drivers identifies potential complexities for programming designed to reduce RWI/DWI-cannabis.

A Nationally Representative Study of Sexual Orientation and High-Risk Drinking From Adolescence to Young Adulthood.

PURPOSE: To determine whether peer drunkenness, parental knowledge about their adolescent's whereabouts and behaviors, and depressive symptoms contribute to sexual orientation disparities in high-risk drinking behaviors; if they do, they would be potential intervention targets. METHODS: Longitudinal survey data from 2,051 adolescents who participated in the NEXT Generation Health Study were analyzed. Latent growth curve and longitudinal path analyses were used to test for indirect effects linking sexual orientation in 11th grade (3.4% males and 8.4% females were sexual minorities) to past 30-day heavy episodic drinking (HED) over 6 years and past year high-intensity binge drinking at 4 years after high school. RESULTS: Sexual minority males were not more likely to engage in high-risk drinking than heterosexual males. In contrast, sexual minority females were more likely than heterosexual females to engage in HED when they were in 11th grade (Odds Ratio = 2.83, 95% confidence interval = 1.43, 5.61), in part because of lower parental knowledge. Sexual minority females also had higher depressive symptoms during the transition from adolescence to young adulthood, which in turn was associated with greater risk of high-intensity binge drinking in young adulthood. Peer drunkenness was a strong risk factor for HED and high-intensity binge drinking among both males and females. DISCUSSION: Sexual minority females reported lower levels of parental knowledge during adolescence and higher levels of depressive symptoms during the transition to young adulthood than heterosexual females. Both factors were associated with high-risk drinking behavior, suggesting developmentally sensitive opportunities to mitigate sexual orientation disparities in high-risk drinking.

Longitudinal associations between high school sleep characteristics and young adult health outcomes.

STUDY OBJECTIVES: Short sleep duration and evening chronotype are independently associated with negative health outcomes. However, it is unclear how adolescent sleep duration and chronotype are longitudinally associated with health outcomes during early adulthood. METHODS: Participants from the NEXT Generation Health Study (n = 2,783; 54.5% female) completed measures of sleep duration (scheduled day and unscheduled day) and chronotype in high school. Sleep duration, chronotype, general health, depressive symptoms, and psychosomatic symptoms were also assessed 4 years after high school. Latent variables estimated high school scheduled-day sleep duration, unscheduled-day sleep duration, and chronotype using the during high school measures. Two path analyses tested the prospective associations between high school sleep duration (separate models for scheduled and unscheduled days) and chronotype with 4 years after high school health outcomes as mediated by concurrent sleep duration and chronotype. RESULTS: In the scheduled-day model, longer high school sleep duration and later chronotype were associated with longer duration and later chronotype in early adulthood. Longer high school sleep duration was directly associated with fewer psychosomatic symptoms and indirectly associated with fewer depressive and psychosomatic symptoms through longer sleep duration in early adulthood. Later chronotype in high school was indirectly associated with poorer general health, greater depressive symptoms, and greater psychosomatic symptoms in early adulthood through later chronotype. CONCLUSIONS: Findings highlight the roles of scheduled-day sleep duration and evening chronotype in shaping health outcomes and suggest the importance of chronotype and optimal sleep habits among adolescents. CITATION: Maultsby KD, Temmen CD, Lewin D, et al. Longitudinal associations between high school sleep characteristics and young adult health outcomes. J Clin Sleep Med. 2022;18(11):2527-2536.

Is Delayed Driving Licensure Associated With Emerging Adult Health, Education, and Employment?

PURPOSE: Driving licensure remains a major developmental milestone for adolescents as they become more independent to access important health, education, and employment opportunities. Today, more teens are delaying driving licensure than before. We investigated associations of delayed licensure with health, education, and employment 4 years after high school. METHODS: We analyzed data from all seven annual assessments (W1-W7) of the NEXT Generation Health Study, a nationally representative cohort survey starting at 10th grade (W1, 2009-2010). The independent variable was delaying driving licensure (DDL [delaying ≥1 year] vs. No-DDL), defined as participants receiving driver licensure ≥1 year after the initial legal eligibility time until W7. Outcome variables were self-reported health, education, and employment at W7. Covariates included sex, race/ethnicity, family affluence, parental education, and urbanicity. Multinomial logistic regressions were conducted considering complex survey features. RESULTS: No-DDL versus DDL was associated with a higher likelihood of (1) excellent (adjusted odds ratio [AOR] = 2.06, p < .001), good (AOR = 1.74, p < .001), and fair (AOR = 1.34, p = .008) health compared with poor health; (2) completing a 4-year college or graduate school [AOR = 2.71, p < .001] and tech/community college [AOR = 1.92, p = .004] compared with high school or less; and (3) working ≥30 hours/week (AOR = 7.63, p = .011) and working <30 hours/week (AOR = 1.54, p = .016) compared with not working. DISCUSSION: Among emerging adults, no delay in driving licensure was associated with better self-reported health, higher education, and more working hours four years after leaving high school. Although earlier driving licensure increases driving exposure and risk, avoiding DDL appears to provide advantages for health, education, and employment during early adulthood.

Alcohol-related deaths among young passengers: An analysis of national alcohol-related fatal crashes.

INTRODUCTION: There is consensus that riding with an impaired driver (RWI) constitutes a major threat to public health. The aim of this study was to characterize the factors contributing to the motor-vehicle deaths of 15-20 year-old (y/o) passengers that RWI with a peer. METHOD: Secondary analyses of the 2010-2018 Fatality Analysis Reporting System. 5,673 passengers aged 15-20 y/o killed while riding in passenger cars with a driver aged 21 or older, 3,542 of these drivers also aged 15-20 y/o. Analyses were conducted between October 2019 and December 2020. RESULTS: Sixty-three percent of the young passengers were killed while riding with a driver 15-20 y/o. Of these drivers, 26.8% had a blood alcohol concentration (BAC) >0.00 g/dL and 77.1% had a BAC ≥0.08 g/dL. Compared with those occurring during the day on weekdays, fatalities of young passengers who RWI with a peer driver with a BAC ≥ 0.08 g/dL often occurred on weekend nights (OR = 8.2) and weekday nights (OR = 5.2), and when the passenger and driver were both male (OR = 1.8). Race/ethnicity was not a significant contributor to RWI fatalities. CONCLUSIONS: Most 15-20 y/o RWI fatalities occurred on weekends, at night, when the driver was a young peer with a high BAC, and the passenger and driver were male. The high prevalence of fatalities in these high-risk situations suggests that young driver-passenger dynamics may contribute to alcohol-related fatalities. Practical Applications: To curb RWI fatalities among underage passengers, countermeasures should focus not only on underage drinking drivers and riders, but also on drinking drivers of all ages. Prevention should increase focus on situations in which both the young passenger and young driver are males.

Autonomous motivation and action planning are longitudinally associated with physical activity during adolescence and early adulthood.

We examined the associations of autonomous motivation, controlled motivation, and physical activity (PA) planning with PA participation over six years across the adolescent-to-adult transition. Participants from the NEXT Generation Health Study, a nationally representative cohort study of U.S. 10th graders (N=2785), completed surveys yearly from 2010 to 2016 (four years post-high school). This study used data from Waves 2 (W2) through 7 (W7). Data were analyzed using growth models accounting for the complex survey design and controlling for sex, race/ethnicity, and body mass index. A piecewise growth model with two pieces (Piece 1: W2-W4; Piece 2: W4-W7) indicated that PA declined during late adolescence (W2-W4) (b=-0.31, ß=-0.22, p<.001), but did not decline after the transition into early adulthood (W4-W7) (b=-0.08, ß=-0.04, p=.052). Autonomous motivation was positively associated with PA at all waves (b=0.23-0.33, ß=1.90-4.37, p<.001). Controlled motivation was only positively associated with PA at W3 (12th grade) (b=0.13, ß=1.54, p=.011). PA planning varied significantly between individuals and significantly predicted PA (b=0.44, ß=0.21, p<.001). Although PA decreased significantly during late adolescence, PA did not decrease significantly after transitioning into early adulthood (one to four years post-high school). Elevated autonomous motivation and PA planning were consistently and significantly associated with higher PA, suggesting that these may be useful intervention targets during this adolescent-to-adult transition.

Validation of a continuous measure of cardiometabolic risk among adolescents.

OBJECTIVES: We validated a continuous cardiometabolic risk (CMR) measure among adolescents. METHODS: Five metabolic syndrome (MetS) components including waist circumference, triglycerides, high-density lipoprotein cholesterol, fasting blood glucose, and mean arterial pressure were assessed in a national cohort of U.S. adolescents (n=560; 16.5 ± 0.5 y/o at baseline) in 10th grade (2010, Wave 1 (W1)), and follow-up assessments four (W4) and seven (W7) years later. Separately by wave, linear regressions were fitted to each MetS component controlling for age, sex, and race/ethnicity, and yielded standardized residuals (Z-scores). Wave-specific component Z-scores were summed to obtain composite CMR Z-scores. Four- and seven-year CMR change (CMR-diff W1-W4 and W1-W7). and average CMR risk (CMR-avg; (W1 + W4)/2 and (W1 + W7)/2) were calculated using the CMR Z-scores. W7 MetS was determined using adult criteria. Student's t-test and receiver operating characteristic (ROC) curve were conducted. RESULTS: Participants meeting the adult criteria for MetS at W7 (74 of 416, 17.8%) had statistically significant (p<0.01) higher values for W1 CMR Z-scores (0.92 vs. -0.21), W4 CMR Z-scores (1.69 vs. -0.28), W7 CMR Z-scores (2.21 vs. -0.55), W1-W4 CMR-avg (1.53 vs. -0.27), W1-W7 CMR-diff (1.29 vs. -0.21), and W1-W7 CMR-avg (1.46 vs. -0.48) than those not meeting MetS criteria. Most results were similar for males and females in the sex-stratified analyses. The areas under the ROC curve were 0.61, 0.71, and 0.75 for W1, W4 and W7 Z-scores. CONCLUSIONS: Findings support the validity of the continuous CMR Z-scores calculated using linear regression in evaluating and monitoring CMR profiles from adolescence to early adulthood.

Associations of mental health with driving while impaired and risky driving in emerging adults.

OBJECTIVE: Examined cross-sectional associations of driving while impaired (DWI) and risky driving with mental and psychosomatic health among U.S. emerging adults. METHODS: Data were from years 1-4 after high school (waves 4-7) of the NEXT Generation Health Study, a nationally representative study starting with 10th grade (2009-2010). Outcome variables were DWI (dichotomous variable: ≥ 1 day vs. 0 days in the last 30 days) and risky driving Checkpoints Self-Reported Risky Driving Scale (C-RDS). Independent variables included depressive symptoms and psychosomatic symptoms. Multivariate logistic and linear regressions were conducted with complex survey features considered. RESULTS: Higher depressive and psychosomatic symptoms were associated with modestly higher likelihood of DWI (Adjusted odds ratio [AOR] ranged from 1.02 to 1.03 and from 1.04 to 1.05, respectively) and higher C-RDS scores (b ranged from 0.06 to 0.12 and from 0.08 to 0.23, respectively) in years 1-4 after high school. CONCLUSIONS: Depressive and psychosomatic symptoms were associated with greater DWI and risky driving in all 4 years after high school. Negative mental and psychosomatic health should be targeted components of DWI and risky driving prevention to lower fatal motor vehicle crashes among emerging adults.

Three Dimensions of Sleep, Somatic Symptoms, and Marijuana Use in U.S. High School Students.

PURPOSE: This study aimed to investigate potential bidirectional relations between key sleep characteristics and somatic symptoms with past 30-day marijuana use in high school students. METHODS: Participants from the NEXT Generation Health Study (n = 2,770) reported on 10th and 11th grade (W1 and W2) sleep characteristics and somatic symptoms and 12th grade (W3) past 30-day marijuana. Multivariate logistic regressions and path analyses were conducted. RESULTS: Sleep duration was not associated with marijuana use. However, later W1 chronotype, greater W1 social jetlag, W1 trouble falling asleep, W1 trouble staying asleep, and W1 somatic symptoms were associated with increased odds of W3 past 30-day marijuana use. Path models indicated direct associations between W1 chronotype and W3 past 30-day marijuana use, and W1 social jetlag and W3 past 30-day marijuana use. CONCLUSIONS: Later sleep timing was longitudinally associated with past 30-day marijuana use. Improved understanding of sleep health, specifically chronotype and social jetlag as risk factors for marijuana use is warranted, which may inform additional screening targets and interventions that address these associated domains.

Alcohol- and speeding-related fatal crashes among novice drivers age 18-20 not fully licensed at the time of the crash.

INTRODUCTION: Some teens may intentionally delay their driving licensure until age 18 or later, thereby skipping the learning and driver safety benefits provided by graduated driver licensing (GDL) programs. Delaying driving initiation could elevate teen crash risk once they begin driving. This study compares the prevalence of alcohol use and speeding among individuals aged 18-20 y/o who were not fully licensed drivers (NFLD) at the time of the fatal crash with that of their fully licensed counterparts (FLD). MATERIALS AND METHODS: Data came from the 2010-2017 Fatality Analysis Reporting System (FARS). Census data were added to measure mean household income at drivers' zip code. Bivariate (chi-square) and logistic regressions were used to assess the likelihood young drivers were alcohol-positive and/or speeding at the time of the crash as a function of drivers' license status, demographic, socioeconomic, and the strength of GDL programs in the state. RESULTS: Compared with females and White drivers age 18-20 y/o, males, Latino, and Black drivers were more likely to be NFLD at the time of the fatal crash (p < .0001). Living in zip codes with low median household income (p < .001) and the strength of GDL restrictions (p < .0001) were associated with individuals being NFLD at the time of the fatal crash. Alcohol-related fatal crashes were more prevalent among NFLD than FLD (p < .02). CONCLUSIONS: The study provides indirect evidence suggesting that alcohol use may be more detrimental for NFLD than for FLD.

Attitudes, Subjective Norms, and Perceived Behavioral Control Associated with Age of First Use of Cannabis among Adolescents.

BACKGROUND: Prevention of early age initiation of cannabis use is a national priority, highlighting the importance of identifying cannabis-specific attitudes, norms, and perceived behavioral control in relation to initiation age. METHODS: Data were from the NEXT Generation Health Study, a national longitudinal sample of US adolescents followed from 10th grade (N = 1850). Cannabis-specific attitudes, norms, and perceived behavioral control were assessed at 10th grade. Age of first use was reported retrospectively 2-3 years after high-school and participants were categorized as early initiators (<14 years; 3.8%), high-school (HS) initiators (14-18 years; 35.6%), post-HS initiators (>18 years; 8.3%), or never users (52.3%). RESULTS: Relative to never users, early initiators were more likely to endorse pro-use attitudes (AOR [adjusted odds ratio] = 2.39, 95% confidence interval [CI] = 1.27-4.50), less disapproving parental attitudes toward use (AOR = 2.50, 95% CI = 1.45-4.28), higher cannabis use among friends (AOR = 3.81, 95% CI = 2.21-6.60), and higher ease of access (AOR = 2.10, 95% CI = 1.14-3.87); HS initiators were similarly more likely to report less disapproving attitudes toward use (AOR = 1.55, 95% CI = 1.25-1.91), higher cannabis use among friends (AOR = 2.81, 95% CI = 2.18-3.65), and higher ease of access (AOR = 1.66, 95% CI = 1.21-2.28). CONCLUSIONS: Earlier cannabis initiation was associated with more favorable cannabis attitudes, subjective norms, and perceived behavioral control, highlight these variables as potential intervention targets.

Factors Contributing to Delay in Driving Licensure Among U.S. High School Students and Young Adults.

PURPOSE: More teens delay in driving licensure (DDL). It is conceivable they miss Graduated Driver Licensing (GDL) safety benefits. We assessed prevalence, disparities, and factors associated with DDL among emerging adults. METHODS: Data used were from all seven waves (W1-7) of the NEXT Generation Health Study (W1 in 10th grade [2009-2010]). The outcome variable was DDL (long-DDL [delayed >2 years], intermediate-DDL [delayed 1-2 years] versus no-DDL), defined as participants receiving driver licensure ≥1 year after initial eligibility. Independent variables included sex, urbanicity, race/ethnicity, family structure, parental education, family affluence, parental monitoring knowledge, parent perceived importance of alcohol nonuse, and social media use. Logistic regressions were conducted. RESULTS: Of 2,525 participants eligible for licensure, 887 (38.9%) reported intermediate-DDL and 1,078 (30.1%) long-DDL. Latinos (adjusted odds ratio [AOR] = 2.5 vs. whites) and those with lower affluence (AOR = 2.5 vs. high) had higher odds of intermediate-DDL. Latinos (AOR = 4.5 vs. whites), blacks (AOR = 2.3 vs. whites), those with single parent (AOR = 1.7 vs. both biological parents), whose parents' education was high school or less (AOR = 3.7 vs. bachelor+) and some college (AOR = 2.0 vs. bachelor+) levels, and those with lower affluence (AOR = 4.4 vs. high) had higher odds of long-DDL. Higher mother's monitoring knowledge (AOR = .6) was associated with lower odds of long-DDL, but not intermediate-DDL. CONCLUSIONS: Some teens that DDL "age out" of protections afforded to them by GDL driver restrictions. Minority race/ethnicity, socioeconomic status, urbanicity, and parenting factors contribute to DDL. Further study of these factors and their individual/collective contributions to DDL is needed to understand potential unintended consequences of GDL, particularly in more vulnerable youth.

Neural processes during adolescent risky decision making are associated with conformity to peer influence.

Adolescents demonstrate both heightened sensitivity to peer influence and increased risk-taking. The current study provides a novel test of how these two phenomena are related at behavioral and neural levels. Adolescent males (N = 83, 16-17 years) completed the Balloon Analogue Risk Task (BART) in an fMRI scanner. One week later, participants completed a driving task in which they drove alone and with a safety- or risk-promoting peer passenger. Results showed that neural responses during BART were associated with participants' behavioral conformity to safe vs. risky peer influence while later driving. First, the extent that neural activation in the anterior cingulate cortex (ACC) scaled with decision stakes in BART was associated with conformity to risky peer influence. Additionally, stake-modulated functional connectivity between ventral striatum (VS) and risk processing regions (including ACC and insula) was associated with safer driving under risky peer influence (i.e. resistance to risky peer influence), suggesting that connectivity between VS and ACC as well as insula may serve a protective role under risky peer influence. Together, these results suggest that adolescents' neural responses to risky decision making may modulate their behavioral conformity to different types of peer influence on risk taking.

Crash rates over time among younger and older drivers in the SHRP 2 naturalistic driving study.

OBJECTIVE: To examine crash rates over time among 16-17-year-old drivers compared to older drivers. METHODS: Data were from a random sample of 854 of the 3,500 study participants in SHRP 2, a U.S. national, naturalistic driving (instrumented vehicle) study. Crashes/10,000 miles by driver age group, 3-month period, and sex were examined within generalized linear mixed models. RESULTS: Analyses of individual differences between age cohorts indicated higher incidence rates in the 16-17-year old cohort relative to older age groups each of the first four quarters (except the first quarter compared to 18-20 year old drivers) with incident rate ratios (IRR) ranging from 1.98 to 18.90, and for the full study period compared with drivers 18-20 (IRR = 1.69, CI = 1.00, 2.86), 21 to 25 (IRR = 2.27, CI = 1.31, 3.91), and 35 to 55 (IRR = 4.00, CI = 2.28, 7.03). Within the 16-17-year old cohort no differences were found in rates among males and females and the decline in rates over the 24-month study period was not significant. CONCLUSIONS: The prolonged period of elevated crash rates suggests the need to enhance novice young driver prevention approaches such as Graduated Driver's Licensing limits, parent restrictions, and post-licensure supervision and monitoring. Practical Applications: Increases are needed in Graduated Driver's Licensing limits, parent restrictions, and postlicensure supervision and monitoring.

Learner Driver Experience and Teenagers' Crash Risk During the First Year of Independent Driving.

Importance: One mechanism for teenagers' elevated crash risk during independent driving may be inadequate learner driving experience. Objective: To determine how learner driver experience was associated with crash risk during the first year of independent driving. Design, Setting, and Participants: Youth aged 15.5 to 16.1 years at recruitment were eligible to participate. Participants' vehicles were instrumented with sensors, and driving was recorded during the learner period through 1 year of independent driving. Data were collected from January 2011 through August 2014 in southwestern Virginia. Exposures: The amount, consistency and variety of practice, driving errors, and kinematic risky driving (KRD) rates during the learner period were recorded. Surveys, including one on sensation-seeking personality traits, were assessed at baseline. Main Outcomes and Measures: Cox proportional hazard regressions examined associations between individual characteristics and learner driving experience with driving time to first crash and all crashes in the first year of independent driving. So that hazard ratios (HRs) can be directly comparable, units of measurement were standardized to the interquartile range. Results: Of 298 individuals who responded to recruitment, 90 fulfilled the criteria and 82 completed the study (of whom 75 were white [91%] and 44 were girls [54%]). Teenage participants drove a mean (SD) of 1259.2 (939.7) miles over 89 days during the learner period. There were 49 property-damage crashes and/or police-reportable crashes during independent driving. Factors associated with driving time to first crash included higher sensation-seeking personality scale scores (HR, 1.67 [95% CI, 1.08-2.57] per 0.75-unit increase), learner driving KRD rates (HR, 1.27 [95% CI, 1.12-1.43] per 9.24-unit increase), and learner driving errors (HR, 0.44 [95% CI, 0.22-0.86] per increase of 6.48 errors). Similar results were obtained for all crashes in the first year, with the addition of consistency of learner driving practice (HR, 0.61 [95% CI, 0.38-0.99] per 0.23-unit increase). Conclusions and Relevance: Individual characteristics and learner driving experiences were associated with crash risk during independent driving. As expected, there was an association between sensation seeking and crashes. Elevated KRD rates during the learner period may reflect risky driving behavior among novices or tolerance to abrupt maneuvers by parents who supervise driving. Consistent practice throughout the learner period could reduce teenage crash risk, which is supported by learning theories indicating distributed practice is effective for developing expertise. Errors during practice may constitute learning events that reinforce safer driving. Physicians could encourage parents to provide opportunities for regular practice driving and monitor their teenager's KRD rates during the learner period using in-vehicle or smartphone-based technology.

Longitudinal Associations of 12th-Grade Binge Drinking With Risky Driving and High-Risk Drinking.

OBJECTIVE: To study the longitudinal associations of 12th-grade binge drinking with driving while impaired (DWI), riding with an impaired driver (RWI), blackouts, extreme binge drinking, and risky driving (self-reported Checkpoints Risky Driving Scale) among emerging adults up to 4 years after leaving high school. METHODS: The data were all 7 waves (W 1 to W 7 of the NEXT Generation Health Study; a US nationally representative study (N = 2785) with a probability cohort of 10th-graders (mean age = 16.2 years; SE = 0.03) starting in the 2009-2010 year. Binary and ordinal logistic regressions were used for the analysis. RESULTS: Binge drinking prevalence in W1 to W3 was 27.2%, 23.8%, and 26.8%, respectively. Twelfth-grade binge drinking was associated with a higher likelihood of DWI, RWI, blackouts, and risky driving in W4 to W7 and extreme binge drinking in W7. Adolescents who binged ≥3 times in high school were more likely to DWI, RWI, blackout (W4 to W7), be involved in extreme binge drinking (W7), and report riskier driving several years after high school. In some waves, parental practices appeared to have enduring effects in protecting against DWI, RWI, and blackouts. CONCLUSIONS: Twelfth-grade binge drinking is a robust predictor of early adulthood DWI, RWI, blackout, extreme binge drinking, and risky driving. Our study suggests that ongoing parental practices could be protective against DWI, RWI, and blackouts once adolescents transition from high school into early adulthood. Prevention programs that incorporate binge drinking-focused screening and bolster parental practices may reduce the likelihood of later major alcohol-related health-risk behaviors and consequences in emerging adults.

Neighbourhood context and binge drinking from adolescence into early adulthood in a US national cohort.

BACKGROUND: Underage binge drinking is a serious health concern that is likely influenced by the neighbourhood environment. However, longitudinal evidence has been limited and few studies have examined time-varying neighbourhood factors and demographic subgroup variation. METHODS: We investigated neighbourhood influences and binge drinking in a national cohort of US 10th grade students at four times (2010-2014; n = 2745). We estimated odds ratios (OR) for past 30-day binge drinking associated with neighbourhood disadvantage, personal and property crime (quartiles), and number of liquor, beer and wine stores within 5 km, and then evaluated whether neighbourhood associations differ by age, sex and race/ethnicity. RESULTS: Neighbourhood disadvantage was associated with binge drinking before 18 [OR = 1.54; 95% confidence interval (1.14, 2.08)], but not after 18 years of age. Property crime in neighbourhoods was associated with a higher odds of binge drinking [OR = 1.54 (0.96, 2.45)], an association that was stronger in early adulthood [4th vs 1st quartile: OR = 1.77 (1.04, 3.03)] and among Whites [4th vs 1st quartile: OR = 2.46 (1.03, 5.90)]. Higher density of liquor stores predicted binge drinking among Blacks [1-10 stores vs none: OR = 4.31 (1.50, 12.36)] whereas higher density of beer/wine stores predicted binge drinking among Whites [one vs none for beer: OR = 2.21 (1.06, 4.60); for wine: OR = 2.04 (1.04, 4.03)]. CONCLUSIONS: Neighbourhood conditions, particularly those related to economic circumstances, crime and alcohol outlet density, were related to binge drinking among young adults, but associations varied across age and individual characteristics.

Close Friends' Drinking and Personal Income as Mediators of Extreme Drinking: A Prospective Investigation.

OBJECTIVE: This study examined longitudinal associations between college attendance, residence on- or off-campus, and work status during the first 2 years after high school with extreme binge drinking at 4 years after high school and tested peer drinking and personal income at 3 years after high school as mediators. METHOD: Data were drawn from Waves 4-7 of the NEXT Generation Health Study (n = 2,081). Multinomial logistic regressions and mediation analyses were conducted. Extreme binge drinking was measured using the largest number of drinks on a single day in the past year. RESULTS: Univariate analyses indicated that attending university, living on campus, and working more than 30 hours at any point during the first 2 years after high school were associated with increased risk of drinking two to three times above the binge drinking threshold (relative risk ratios [RRR] ranged from 1.79 to 5.70). In multivariate analyses, dropping out of university was associated with drinking two times above the binge drinking threshold (RRR = 4.88), whereas living on campus (RRR = 4.54) and working more than 30 hours (RRR = 5.26) were associated with increased risk of drinking three times above the binge drinking threshold. Close friends' drinking and personal income were significant mediators. CONCLUSIONS: Living on campus and working more than 30 hours per week during the first 2 years after high school increased risk for drinking three times above the binge drinking threshold at 4 years after high school.

Sexual Orientation and Sleep Behaviors in a National Sample of Adolescents Followed Into Young Adulthood.

STUDY OBJECTIVES: Sexual minority adolescents experience mental and physical health disparities attributable to increased discrimination and minority stress. These same factors may also impair sleep health, although available literature on this topic is limited. This study examined longitudinal associations between adolescent sexual minority status and seven sleep behaviors in young adulthood and tested depressive symptoms and overweight as mediators. METHOD: Data were drawn from Waves 2 (11th grade) to 7 (4 years after high school) of the NEXT Generation Health Study, a national longitudinal cohort study of US adolescents (n = 1946; 6.3% sexual minorities). RESULTS: There were no significant sexual orientation disparities in sleep duration, trouble falling asleep, trouble staying asleep, or trouble waking up during young adulthood. Relative to heterosexual females, sexual minority females had higher odds of snoring/stop breathing (36.6% versus 19.2%; adjusted odds ratio = 2.57; 95% confidence interval = 1.30, 5.09) and reported more frequent daytime sleepiness (b = 0.66, 95% confidence interval = 0.05, 1.27). Mediation analyses revealed that female sexual minority status was associated with increased risk of snoring/stop breathing though overweight status (mediated 43.6% of total effect) and was also associated with increased daytime sleepiness through higher depressive symptoms (mediated 70.8% of total effect). CONCLUSIONS: Among US youth, no sexual orientation disparities were found except for snoring/stop breathing and daytime sleepiness among females. Sexual orientation disparities in these aspects of sleep are partially due to worse mental and physical health among sexual minority females, highlighting depressive symptoms and overweight problems as potential intervention targets. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Title: Health Behavior in School-Aged Children: NEXT Longitudinal Study 2009-2016; Identifier: NCT01031160.