Determinants of driving under the influence of alcohol or drugs among latino immigrants in miami-dade county, florida.

Little is known about the pre- and postimmigration drinking and drunk- and drugged-driving behavior of Latino immigrants. Despite showing risky drinking behaviors, many recent immigrants of low socioeconomic status (SES) do not drive while impaired by alcohol (DWI) due largely to limited access to a vehicle. This effort examines the DWI and driving while impaired by drugs (DWID) behaviors of Latino immigrants who have access to a vehicle. Data came from an ongoing longitudinal sample of Latino immigrants to Miami-Dade County, Florida. Bivariate analyses and logistic regression were applied. Preimmigration DWI and DWID was the best predictor of postimmigration DWI and DWID. Future interventions should make efforts to (a) identify immigrants who had DWI and DWID in their country of origin and (b) design and deliver specific and culturally relevant messages to persuade them not to engage in DWI and DWID after immigration.

Association of Screening and Brief Intervention With Substance Use in Massachusetts Middle and High Schools.

Importance: Screening and brief intervention (SBI) programs in schools have the potential to provide substance use prevention messages to large numbers of adolescents. This study evaluated the association between exposure to a school-based SBI program and reductions in substance use among youths after enactment of a law that required Massachusetts schools to provide SBI to all students. Objective: To estimate the association between exposure to a school-based SBI program and changes in substance use among youths. Design, Setting, and Participants: In this mixed-method quality improvement study using an effectiveness-implementation hybrid design, stakeholder interviews were conducted to describe the operations, timing, and impressions of SBI implementation at 14 intervention schools in Massachusetts. Repeated cross-sectional surveys of youths in intervention and comparison groups were administered between December 19, 2017, and May 22, 2019, to assess substance use and associated measures of perceived risk, knowledge, and adult support before and approximately 3 months after SBI implementation among exposed groups. A difference-in-differences framework was used to estimate substance use outcomes associated with SBI exposure among students in middle school (grades 7 and 8) and high school (grades 9 and 10) using adjusted overlap-weighted generalized models to account for covariate imbalance between exposed and unexposed school grades. In addition, 14 school staff members were interviewed about implementation. Exposures: Exposure vs nonexposure to a school-based SBI program. Main Outcomes and Measures: Frequency of alcohol, cannabis, and e-cigarette use (measured in days) and any binge drinking in the past 3 months. Results: Between December 2017 and May 2019, 8771 survey responses were collected from 4587 students in grades 7 through 10 who were attending one of 23 participating school districts. The median (IQR) age was 13 (13-14) years (range, 12-17 years); 2226 students self-identified as female (48.5%), 2206 (48.1%) as male, and 155 (3.4%) as transgender or preferred not to answer. Overall, 163 students (3.6%) identified their race as Asian, 146 (3.2%) as Black or African American, 2952 (64.4%) as White, and 910 (19.8%) as mixed or other race (including American Indian or Alaska Native and Native Hawaiian or Pacific Islander); 416 students (9.1%) preferred not to answer or were missing data on race. A total of 625 students (13.6%) identified their ethnicity as Hispanic and 3962 (86.4%) as non-Hispanic. Cannabis use increased over time in both the SBI group (middle school: marginal estimated probability, 0.73 [95% CI, 0.21-2.51] at baseline vs 2.01 [95% CI, 0.60-6.70] at follow-up; high school: marginal estimated probability, 2.86 [95% CI, 0.56-14.56] at baseline vs 3.10 [95% CI, 0.57-16.96] at follow-up) and the control group (middle school: marginal estimated probability, 0.24 [95% CI, 0.05-1.03] at baseline vs 3.38 [95% CI, 0.81-14.18] at follow-up; high school: marginal estimated probability, 1.30 [95% CI, 0.27-6.29] at baseline vs 1.72 [95% CI, 0.34-8.66] at follow-up). e-cigarette use also increased over time in both the SBI group (middle school: marginal estimated probability, 0.81 [95% CI, 0.22-3.01] at baseline vs 1.94 [95% CI, 0.53-7.02] at follow-up; high school: marginal estimated probability, 3.82 [95% CI, 0.72-20.42] at baseline vs 3.51 [95% CI, 0.55-22.59] at follow-up) and the control group (middle school: marginal estimated probability, 0.51 [95% CI, 0.12-2.30] at baseline vs 3.40 [95% CI, 0.72-16.08] at follow-up; high school: marginal estimated probability, 2.29 [95% CI, 0.41-12.65] at baseline vs 3.53 [95% CI, 0.62-20.16] at follow-up). Exposure to SBI was associated with a significantly smaller increase in the rate of cannabis use among middle school students (adjusted rate ratio [aRR], 0.19; 95% CI, 0.04-0.86) and significantly smaller increases in the rates of cannabis and e-cigarette use among all female students (cannabis use: aRR, 0.17 [95% CI, 0.03-0.96]; e-cigarette use: aRR, 0.16 [95% CI, 0.03-0.82]) compared with nonexposure. No other significant differences were observed among students in grades 7 and 8, and no differences were found in any comparison between groups in grades 9 and 10. Conclusions and Relevance: In this quality improvement study, exposure to a school-based SBI program was associated with a significantly smaller increase in the rate of cannabis use among middle school students and significantly smaller increases in the rates of cannabis and e-cigarette use among all female students. These findings suggest that implementation of SBI programs in schools may help to reduce substance use among middle school and female students, and further study of these programs is warranted.