The combined effect of motivational interviewing and wearable fitness trackers on motivation and physical activity in inactive adults: A randomized controlled trial.

Despite overwhelming adoption of wearable fitness trackers (WFT), it is unclear if they affect physical activity (PA) engagement or PA motivation. We hypothesized that combining a WFT with an effective intervention, motivational interviewing (MI), would positively influence both motivation and PA. A 12-week randomized controlled trial was conducted in 40 adults who did not meet PA recommendations. The four conditions were: a PA education (Educational control, n = 10), a WFT (WFT, n = 10), bi-weekly MI sessions (MI, n = 10), or both interventions (WFT+, n = 10). Motivation and PA were measured through an online survey and actigraphy pre- and post-intervention. Both the WFT+ and MI groups improved autonomous forms and decreased controlled forms of motivation. They also had higher basic psychological needs scores when compared to the Education group post-intervention. We detected no changes in PA. High autonomous motivation at baseline predicted higher post-intervention PA in the WFT+ group but predicted lower post-intervention PA in the WFT group. Results suggests that MI alone or with a WFT can improve basic psychological needs and autonomous forms of motivation for PA, but not PA participation. Individual differences in motivation at baseline may moderate the effect of a WFT on PA. This study was registered at clinicaltrials.gov (NCT490014).

Association between a delay in driving licensure and driving while impaired and riding with an impaired driver among emerging adults.

BACKGROUND: Teens who delay driving licensure may not be subject to graduated driver licensing restrictions that are known to reduce crash risk. We explored the association of delay in licensure with driving while impaired (DWI) and riding with an impaired driver (RWI) among emerging adults. METHODS: Data from the NEXT Generation Health Study, starting with 10th grade (2009-2010), were analyzed. The outcome variables were Wave 7 (W7) self-reported DWI and RWI as dichotomous variables. The independent variable was delay in licensure. Covariates included sex, urbanicity, race/ethnicity, family structure, parent education, family affluence, teen's highest education, minimum legal drinking age laws, and onset age of alcohol use. Descriptive analysis and logistic regressions were conducted. RESULTS: Of 2525 participants eligible for licensure, 887 reported a delay in licensure by 1-2 years (38.9%, weighted) and 1078 by > 2 years (30.3% weighted) across 7 waves. In W7, 23.5% (weighted and hereafter, 5.6% once, 17.8% ≥twice) of participants reported DWI and 32.42% (5.6% once, 25.4% ≥twice) reported RWI. Logistic regressions showed no overall significant association of delay in licensure with either W7 RWI or W7 DWI. However, in stratified analyses, among African American youth, delay in licensure was positively associated with DWI (OR = 2.41, p = 0.03) and RWI (OR = 2.72, p = 0.05). Among those with ≤ high school or lower education by W7, delayed licensure was positively associated with RWI (OR = 2.51, p < 0.01). CONCLUSIONS: While in the overall sample, delayed licensure did not appear to be associated with DWI or RWI, our findings suggest that delayed licensure may be of concern to teen risk of DWI and RWI among African Americans and among those with lower educational attainment. Furthermore, as two-thirds of youth delayed licensure, more research is needed to determine whether this is more of a positive (i.e., protective) factor by reducing their exposure to crash risk or a negative (i.e., risk) factor due to their missing important driver safety stages of graduated driver licensing.

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.

Trends in Yoga, Tai Chi, and Qigong Use Among US Adults, 2002-2017.

OBJECTIVES: To examine the characteristics and temporal trends of yoga, tai chi, and qigong (YTQ) use among US adults. METHODS: Using the 2002, 2007, 2012, and 2017 National Health Interview Surveys, we examined the prevalence, patterns, and predicting factors of YTQ use by Taylor series linear regression, the Wald F χ2 test, and multivariable logistic regression models (n = 116 404). RESULTS: YTQ use increased from 5.8% in 2002 to 14.5% in 2017 (P ≤ .001). Only 6.6% of YTQ users were referred by their medical doctors, and approximately one third disclosed their use of YTQ to medical professionals. Reasons for using YTQ included (1) YTQ was beneficial, (2) YTQ focused on the whole person, and (3) YTQ was natural. Acute and chronic pain, arthritis, and depression were the top 3 medical conditions for which people used YTQ the most. CONCLUSIONS: YTQ use is increasing substantially, mainly because of its natural and holistic healing approach toward health and chronic diseases. Future studies aiming to explore how to best integrate YTQ into the current health care system are warranted.

Heart rate measures from the Apple Watch, Fitbit Charge HR 2, and electrocardiogram across different exercise intensities.

This study compared heart rate (HR) measurements for the Fitbit Charge HR 2 (Fitbit) and the Apple Watch devices with HR measurements for electrocardiogram (ECG). Thirty young adults (15/15 females/males, age 23.5 ± 3.0 years) completed the Bruce Protocol. HR measurements were recorded from the ECG and both devices every minute. Average HR for each participant was calculated for very light, light, moderate, vigorous and very vigorous intensities based on ECG-measured HR. A concordance correlation coefficient (CCC) was calculated to examine the strength of the relationship between ECG measured HR and HR measured by each device. Relative error rates (RER) were also calculated to indicate the difference between each device and ECG. An equivalence test was conducted to examine the equivalence of HRs measured by devices and ECG. The Apple Watch showed lower RER (2.4-5.1%) compared with the Fitbit (3.9-13.5%) for all exercise intensities. For both devices, the strongest relationship with ECG-measured HR was found for very light PA with very high CCC (>.90) and equivalence. The strength of the relationship declined as exercise intensity increased for both devices. These findings indicate that the accuracy of real-time HR monitoring by the Apple Watch and Fitbit Charge HR2 is reduced as exercise intensity increases.

Risk of Atherosclerotic Cardiovascular Disease Among US Adults: Use of 1999-2014 NHANES Data.

One in four deaths in the US is caused by cardiovascular disease (CVD), and early detection may be a key aspect of prevention. We assessed the probability of a first hard atherosclerotic cardiovascular disease (ASCVD) event within 10 years in US Non-Hispanic White and African American population aged 40-79 years. With data from 16 years of the National Health and Nutrition Examination Survey (NHANES), we utilized the 2013 Pooled Cohort Equations developed by the American College of Cardiology and the American Heart Association to calculate risk scores for a representative sample. NHANES is a repeated, cross-sectional survey aimed at assessing the health and nutritional status of the country. Out of 17,087 eligible participants, a sample of 1876 (11%) remained for the analysis after excluding participants missing data required to compute the scores. Our results showed that 25.2% of the sample had a greater than 10% risk of contracting ASCVD within 10 years, and we also found sex-, race-, and age-based disparities. The ASCVD risk scores can thus be used to evaluate the general cardiac health of the population. Results showed that a quarter of the US adult population was at risk to contract ASCVD in the next 10 years, indicating the need for targeted preventative measures. With the aging population and rise in obesity rates, these results may also indicate trend continuation of high CVD-related morbidity and mortality.

Physical activity and sedentary behavior of US immigrant versus non-immigrant adolescents: findings from the NEXT Generation Health Study data.

OBJECTIVE: This study examined associations of physical activity (PA) and sedentary behavior (SB) with adolescents' immigration status and language spoken at home and with friends. METHODS: Participants (N = 2475) were included from Wave 1 of the NEXT Generation Health Study, a nationally representative 10th-grade cohort study starting in 2009. PA included recommended moderate-to-vigorous PA (MVPA) and vigorous PA (VPA); SB included screen viewing and social-media use. Linear and logistic regressions were conducted controlling for complex survey variables. RESULTS: Adolescents with non US-born compared with US-born parents were less likely to engage in VPA (odds ratio = 0.60, p ≤ .05, 95% CI = 0.38-0.96). Parent country of origin and language spoken were not significantly associated with recommended MVPA engagement. None of screen viewing and social-media use was significantly associated with immigration status. CONCLUSIONS: Recent immigration status was negatively associated with adolescents' PA documenting an important health disparity.

Complementary and alternative medicine use among children with mental health issues: results from the National Health Interview Survey.

BACKGROUND: Mental health issues in children have become a serious public health concern in the U.S. within the past few decades. Emerging evidence suggests that Complementary and Alternative Medicine (CAM) can be beneficial for various mental health issues. However, little is known about the prevalence, reasons, and associated factors of CAM use among this population in the U.S. The purpose of this study is to examine the characteristics of CAM use among U.S. children with mental health issues. METHODS: Utilizing the 2012 National Health Interview Survey data, we used descriptive analysis, Wald F-statistics, and multivariable survey logistic regression models to examine the prevalence, patterns, and associated factors of CAM use in children aged 4-17 (n = 10,233) adjusting for the complex sampling design. RESULTS: CAM use is more popular among children with mental health issues compared with those without (19.2% vs. 10.1%, p < 0.001). Herbal remedies (9.1%), mind-body therapies (5.5%), and chiropractic care (5.3%) were the most frequently used modalities. Primary reasons for children to use CAM are because they are helpful (69.2%), natural (55.9%), and holistic (44.7%). The majority of CAM users perceived CAM therapies are helpful. Predictors of CAM use are children who are female, whose parents had a higher educational level and socioeconomic status, and who had at least one co-morbid medical condition. Only 18.4% of CAM usage was recommended by medical doctors. CONCLUSIONS: Approximately 10 million parents of children with mental health issues reported the use of CAM therapies, mainly because of their desire for a more natural and holistic healthcare approach. Given that the majority of CAM users perceived CAM therapies as helpful, future studies should investigate the unique contributions of CAM in pediatric psychiatric care. Because a low percentage of CAM use was recommended by medical doctors, educational interventions designed to equip medical professionals with CAM knowledge and experience will be conducive to improving effective patient-physician communication in clinical settings. Since CAM use is reported as more prevalent by parents' of children with higher education and family income, effective strategies designed to reduce disparities in accessing promising CAM therapies are warranted.

Emerging adults without a driver's license engage in more transportation-related physical activity to school/work in certain environmental contexts.

The aim was to examine the moderation effect of driving licensure status on the association between different environmental contexts and transportation-related physical activity to and from school and/or work (TPA-SW) among emerging adults. The data were from Wave 4 (n=2026, year 2013) of the NEXT Generation Health Study, an annual assessment of a nationally representative cohort across the nine U.S. Census Divisions. The outcome variable, TPA-SW, was derived from walking or cycling as modes of travel to and from school and/or work. Environmental context variables included residence, college attendance, and work status. Driving licensure status indicated whether or not participants had an independent driver's license. Poisson regression models, adjusted for potential confounders, were used to test interactions between environmental context and driving licensure. There were significant interactions between environmental context and licensure. Interaction contrasts indicated that participants who did not have a driver's license engaged in more TPA-SW than their licensed counterparts if they were living at home (ß=1.10, p<0.001), not attending school (ß=0.73, p<0.001), attending a technical school/community college (ß=1.13, p<0.001), working 1-30 hours/week (ß=0.69, p<0.001), or working 30+hours/week (ß=1.12, p<0.001). Among non-workers, those without a license engaged in less TPA-SW than participants with a license (ß=-0.22, p=0.05). Among emerging adults in certain environmental contexts, delayed driver licensing may result in more physical activity with the possible tradeoff of less transportation mobility.

Residential Neighborhood Amenities and Physical Activity Among U.S. Children with Special Health Care Needs.

Objectives Children with special health care needs (SHCN) have or are at elevated risk for chronic physical, developmental, behavioral or emotional conditions and therefore require specialized health care services. This study examines the relationship between residential neighborhood amenities and physical activity among U.S. children with SHCN. Methods A nationally representative sample of 113,767 children aged 6-17 years was taken from National Survey of Children's Health (NSCH) 2007-2008 and 2011-2012. Residential neighborhood amenities were defined by parent-reported presence or absence of sidewalks, parks/playgrounds, and recreation center. Physical activity was measured by parent-reported number of physically active days (0-7), defined as 20 min or longer during the past week. Negative binomial regressions were performed to estimate the associations between residential neighborhood amenities and physical activity among U.S. children with and without SHCN, adjusting for various neighborhood (detracting condition and safety) and individual characteristics and NSCH sampling design. Results Approximately 23% of young children aged 6-11 years and adolescents aged 12-17 years had SHCN. Number of weekly physically active days was both 4.8 among young children with and without SHCN, and 3.7 and 4.1 among adolescents with and without SHCN, respectively. Among young children with SHCN, neighborhood availability of a recreation center was associated with increased weekly physically active days by 0.23; whereas among young children without SHCN, number of weekly physically active days was not associated with the availability of any amenity. Among adolescents with SHCN, neighborhood availability of parks/playgrounds was associated with increased weekly physically active days by 0.33, whereas neighborhood availability of sidewalks was associated with reduced weekly physically active days by 0.21. Conversely, among adolescents without SHCN, neighborhood availability of a recreation center was associated with increased weekly physically active days by 0.22. Conclusions for Practice Vulnerable health status and high dependence on health care may prevent children with SHCN from being physically active. Provision of adequate amenities in residential neighborhoods could be essential in promoting physical activity and preventing obesity among children/adolescents with SHCN.

Assessment of adolescent weight status: Similarities and differences between CDC, IOTF, and WHO references.

OBJECTIVE: The research sought to determine the reliability of assessing adolescents' weight status based on three standard criteria, Centers for Disease Control and Prevention (CDC) growth charts, International Obesity Task Force (IOTF) standards, and the World Health Organization (WHO) growth references. METHODS: Data from the NEXT Generation Health Study US 10th grade cohort (n=2323, mean age=16.19years) starting in 2009 were used. Kappa statistics assessed agreement of assignment to weight categories. Associations of weight status with perceived body image, weight control intention, and general health were examined using linear regressions accounting for complex survey design. RESULTS: Kappas across weight status criteria were≥.89 and agreement exceeded 90% in all analyses. For all three criteria, overweight and obese participants, compared to normal weight, were significantly more likely to indicate fatter body image, higher weight control intention, and poorer general health; small differences in the regression coefficients by classification method were observed. CONCLUSION: The three criteria of weight status classifications substantially agreed. Associations of weight status with selected health correlates were similar regardless of the methods. Thus, the three classifications can be considered comparable for most research and practice purposes.

Individual, social, and environmental influences on the transitions in physical activity among emerging adults.

BACKGROUND: Youth's physical activity (PA) may change across developmental periods. Although previous studies have observed a decline in levels of PA during adolescence, few studies have explored trends in PA during the transition from adolescence to young adulthood and what factors may impact the transitional change. The purpose of this study was to examine changes and predictors of change over time in PA from 10(th) grade to post-high school. METHODS: The NEXT Generation Health Study recruited a nationally-representative cohort of US 10(th)-graders, and administered longitudinal surveys in four waves (years) to follow up the participants to their first year after high school. Using transition models, the self-reported outcomes, moderate-to-vigorous PA (MVPA) and vigorous PA (VPA) each of which was repeatedly measured by one question, were modelled in association with wave-4 environmental-status variables and time-varying covariates. RESULTS: There was a continuous decline in the proportion of respondents who met or exceeded the minimum recommended level for either MVPA (from 55.97 to 34.33 %) or VPA (from 65.96 to 54.90 %) from W1 to W4. Higher scores of peer PA, family support and VPA planning were prospectively associated with higher likelihood of meeting the MVPA/VPA recommendations. At wave 4, compared to those not working, attending 4-year colleges, or living on campus, participants working full/part time, not attending school or attending community-college level schools, and living at home or in own place were more likely to engage in MVPA. CONCLUSIONS: Peer PA, family support, self-regulatory skills, and environmental status after high school are critical factors that can promote MVPA/VPA among adolescents and emerging adults.

Peer Passenger Norms and Pressure: Experimental Effects on Simulated Driving Among Teenage Males.

OBJECTIVE: Serious crashes are more likely when teenage drivers have teenage passengers. One likely source of this increased risk is social influences on driving performance. This driving simulator study experimentally tested the effects of peer influence (i.e., risk-accepting compared to risk-averse peer norms reinforced by pressure) on the driving risk behavior (i.e., risky driving behavior and inattention to hazards) of male teenagers. It was hypothesized that peer presence would result in greater driving risk behavior (i.e., increased driving risk and reduced latent hazard anticipation), and that the effect would be greater when the peer was risk-accepting. METHODS: Fifty-three 16- and 17-year-old male participants holding a provisional U.S., State of Michigan driver license were randomized to either a risk-accepting or risk-averse condition. Each participant operated a driving simulator while alone and separately with a confederate peer passenger. The simulator world included scenarios designed to elicit variation in driving risk behavior with a teen passenger present in the vehicle. RESULTS: Significant interactions of passenger presence (passenger present vs. alone) by risk condition (risk-accepting vs. risk-averse) were observed for variables measuring: failure to stop at yellow light intersections (Incident Rate Ratio (IRR)=2.16; 95% Confidence Interval [95CI]=1.06, 4.43); higher probability of overtaking (IRR=10.17; 95CI=1.43, 73.35); shorter left turn latency (IRR=0.43; 95CI=0.31,0.60); and, failure to stop at an intersection with an occluded stop sign (IRR=7.90; 95CI=2.06,30.35). In all cases, greater risky driving by participants was more likely with a risk-accepting passenger versus a risk-averse passenger present and a risk-accepting passenger present versus driving alone. CONCLUSIONS: Exposure of male teenagers to a risk-accepting confederate peer passenger who applied peer influence increased simulated risky driving behavior compared with exposure to a risk-averse confederate peer passenger or driving alone. These results are consistent with the contention that variability in teenage risky driving is in part explained by social influences.

Proteomic profiling of human sera for discovery of potential biomarkers to monitor abstinence from alcohol abuse.

Although numerous biomarkers or biomarker candidates have been discovered to detect levels of drinking and intervals of time after last drinking episode, only a few biomarkers have been applied to monitor abstinence in a longer interval (≥6 wks) from alcohol abuse. Considering sample sources, sensitivity, and specificity, new biomarkers from blood with better accuracy are needed. To address this, serum proteomic profiles were compared between pre- and post- treatment samples from subjects seeking treatment for alcohol abuse and dependence in an intensive 6 wk daily outpatient program using high-abundance plasma protein immunodepletion and LC-MS/MS techniques. Protein identification, quantification, candidate biomarker selection, and prioritization analyses were carried out. Among the 246 quantified serum proteins, abundance of 13 and 45 proteins in female and male subjects were significantly changed (p ≤ 0.05), respectively. Of these biomarker candidate proteins, 2 (female) and 8 (male) proteins were listed in category 1, with high area under the receiver operating characteristic curve, sensitivity, specificity, and fold change. In summary, several new biomarker candidates have been identified to monitor abstinence from alcohol abuse.

Trajectories of eating behaviors in a nationally representative cohort of U.S. adolescents during the transition to young adulthood.

BACKGROUND: Diets of U.S. adolescents and adults do not meet recommendations, increasing risk of chronic disease. This study examined trajectories and predictors of eating behaviors in U.S. youth from age 16-20 years, and evaluated longitudinal associations of eating behaviors with weight outcomes. METHODS: Data come from the first four waves (years) of the NEXT Generation Health Study, a nationally representative cohort of U.S. students in 10(th) grade during the 2009-2010 school year (n = 2785). Annual surveys queried frequency of food group intake (times/day of fruit and vegetables, whole grains, sugar-sweetened soda, sweet and salty snacks), and meal practices (days/week of breakfast, family meals, fast food, and television during meals). Body mass index (BMI, kg/m(2)) was calculated from self-reported height and weight. Adjusted generalized estimating equations and linear mixed models with multiple imputation for missing data estimated eating behavior trajectories overall and by baseline weight status (normal weight = 5 ≤ BMI%ile < 85, overweight = 85 ≤ BMI%ile < 95, obese = BMI%ile ≥ 95), accounting for the complex sampling design. Separate GEE models estimated longitudinal associations of food group frequencies with meal practices and of BMI with eating behaviors. RESULTS: Eating behaviors tracked strongly from wave 1-4 (residual intraclass correlation = 41% - 51%). Across all baseline weight categories, frequency of food group intake and meal practices decreased over time, except for fast food, which remained stable. Fruit/vegetable intake frequency was associated positively with family meals (ß ± SE = 0.33 ± 0.05) and breakfast (0.18 ± 0.03), and inversely with fast food (-0.31 ± 0.04), while whole grain intake frequency was associated positively with family meals (0.07 ± 0.02), television meals (0.02 ± 0.009) and breakfast (0.04 ± 0.01). Soda and snacks were positively associated with television meals (0.08 ± 0.008 and 0.07 ± 0.009, respectively) and fast food (0.24 ± 0.02 and 0.20 ± 0.03, respectively), while soda was inversely associated with breakfast frequency (-0.05 ± 0.01). Time-varying BMI was unrelated to eating behaviors other than an inverse association with time-varying snacks (-0.33 ± 0.12). CONCLUSIONS: Strong tracking over time supports the importance of early establishment of health-promoting eating behaviors in U.S. adolescents. Findings suggest meal practices may be important intervention targets. Lack of evidence for hypothesized associations of BMI and eating behaviors indicates the need for research confirming these findings using more precise measures of dietary intake.

Measuring outcome expectancy value of leisure-time physical activity for African Americans.

A scale was adapted from existing scales to measure the outcome expectancy value (EV) as one of contributory factors to leisure-time physical activity (LTPA) and was administered to 649 African American adults. The eligible participants (N = 569) for the analysis were split into three subsamples (rate = 0.5 : 0.25 : 0.25) respectively for Exploratory Factor Analysis (N = 285) and cross-validation (N = 142 for the calibration group and N = 142 for the validation group) to evaluate the psychometric properties of the scale. Item analysis of the scale provided adequate psychometric properties. The 2-factor solution with positive and negative outcome EV subscales was supported based on the exploratory factor analysis and the multiple-group confirmatory factor analysis for both the calibration and validation samples. The results support the factorial construct validity and criterion validity of the outcome EV scale applied to assess LTPA in a sample of church-going African Americans.

Motivation and planning as mediators of the relation between social support and physical activity among U.S. adolescents: a nationally representative study.

BACKGROUND: More than half of U.S. high-school students do not meet the moderate and vigorous physical activity (MVPA) 5 hours per week recommendation. The purpose of this study was to determine how individual dimensions (motivation and planning) mediate the relationship of social context with physical activity by integrating available measures of personal characteristic including internal/external motivations (derived from Self-Determination Theory -SDT]) for MVPA, MVPA planning, peer MVPA, and parental support to better understand adolescent MVPA. METHODS: Survey responses of a nationally representative cohort of 11th graders (N=2439) in the NEXT Generation Health Study were analyzed with structural equation modeling. RESULTS: Adolescent MVPA was directly, significantly associated with MVPA planning (ß=0.17), peer MVPA (ß=0.21), and internal motivation (ß=0.50). Internal motivation was associated with peer MVPA (ß=0.31), parental support for MVPA (ß=0.16), and external motivation (ß=0.40). A significant relation between parental support and external motivation (ß=0.31) was also found. CONCLUSIONS: Adolescents with higher internal motivation and more active friends were more likely to engage in MVPA. The results are consistent with SDT and suggest that planning is an important construct for adolescent MVPA.

The Phenomenon of Teen Delay in Driving Licensure: Considerations at the Intersection of Mobility and Social Welfare for Emerging Adults.

In 2021, there were 11.7 million licensed young drivers in the U.S. This is 1.5 million fewer young drivers compared to 2007. The phenomenon of delay in driving licensure among teens has notable implications for opportunities positioning them for life success when transitioning into emerging adulthood and in later life.

Adolescent Parental Monitoring Offers Protection Against Later Recurrent Driving After Drinking.

PURPOSE: Driving after drinking is a preventable threat to public health. We examined the prospective association of adolescent-reported parental monitoring knowledge (PMK) with recurrent driving after drinking in emerging adulthood. METHODS: We analyzed six annual rounds (1-4, 6, 11) of the National Longitudinal Survey of Youth 1997 with a sample of 5,261 participants. PMK variables were created to recategorize parental monitoring measures by age of the youth. Recurrent driving after drinking was measured in 2002 and 2007 and dichotomized. Unadjusted and adjusted binary logistic regressions analyzed the association of PMK at ages 14, 15, 16, and 17 with recurrent drinking after driving in 2002 (ages 18-23) and 2007 (ages 22-28). Adjusted models included age, sex, race, household income, and education. RESULTS: Mother's PMK from ages 14 to 17 was inversely associated with recurrent driving after drinking in 2002 (adjusted odds ratios [AORs]: 0.89 [p = .003, age 14], 0.93 [marginal p = .062, age 15], 0.88 [p = .0003, age 16], 0.88 [p = .0003, age 17]). By 2007, the only significant association between mother's PMK and recurrent driving after drinking was for age 16 (AOR: 0.95, p = .017). For father's PMK, significant inverse associations were only found for ages 16 and 17 with 2002 recurrent driving after drinking (AORs: 0.93, p = .025 and .88, p = .0005) and age 15 (AOR: 0.95, p = .021) with 2007 recurrent driving after drinking. DISCUSSION: Adolescent perceived PMK appears to offer protection against recurrent driving after drinking in emerging adulthood. This protective effect appears to wane as youth reach their mid-twenties.