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Biomedical subjects

Jean T Shope

Publications and source records attributed to Jean T Shope.

15 recordsLinked to original sources
PubMed2006

Longitudinal examination of underage drinking and subsequent drinking and risky driving.

INTRODUCTION: Alcohol use, alcohol misuse, and risky driving from adolescence into young adulthood were compared by drinking onset age. METHODS: Surveys were administered in Grades 5/6, 6/7, 7/8, 10, 12, and at approximately age 23. Participants were placed into Drinking Onset groups based on self-reported alcohol use frequency on the adolescent surveys. Driving records were examined in three age periods: under 21, 21-25, and 26+. RESULTS: The earliest drinking initiators reported higher alcohol use and misuse on each survey, and were more likely to have risky driving offenses before age 21 and to have alcohol driving offenses in all three age periods. DISCUSSION: The earliest drinking initiators engaged in risky drinking behavior and risky driving behavior that was consistently higher than those with later drinking initiation, beginning in adolescence and persisting well into young adulthood.

Accidents, Traffic↗
PubMed2006

Patterns of traffic offenses from adolescent licensure into early young adulthood.

PURPOSE: This article examines adolescent psychosocial and problem behavior characteristics as predictors of traffic offenses from licensure to early young adulthood. METHODS: Data for this study were from a school-based sample that was surveyed in 10th and 12th grades, and again in early young adulthood. In addition, state driver history records were obtained for each participant in the study and provided a complete traffic offense history. RESULTS: Models adjusted for driving exposure showed varying patterns of prediction for men and women across three types of ticketed moving violations (offenses): minor offenses, serious offenses, and alcohol offenses. Although which predictors were significant varied across gender and type of offense, results suggested that more positive psychosocial adjustment predicted lower numbers, greater decreases, and a lower likelihood of increases in offenses from licensure through the early 20s. CONCLUSIONS: Based on this research, implications for intervention include providing parents with the tools and knowledge needed to effectively supervise their teens' driving during the first years of licensure. Also potentially important for their broad positive effects on problem behaviors, including problem driving, are programs that strengthen adolescents' bonds to conventional social institutions and increase their attachment to the people who represent those institutions. Future research should examine the longitudinal sequencing of associations among psychosocial and problem behavior variables, including problem driving.

Accidents, Traffic↗
PubMed2006

Gender differences among young drivers in the association between high-risk driving and substance use/environmental influences.

OBJECTIVE: The primary aim of this article is to assess young drivers' gender differences in the associations between substance use/environmental influences and high-risk driving behavior. METHOD: We determine the association of 12th-grade self-reported substance use/ environmental influences with high-risk driving behavior as quantified by the number of offenses, serious offenses, crashes, and single-vehicle crashes on state driving records during subjects' (N = 3,607; 51% male) first 4 years of licensure. RESULTS: The associations between high-risk driving and substance use/environmental influences were generally stronger among women than among men. When matched by substance-use profiles, women had fewer risky-driving incidents than men. CONCLUSIONS: The results indicate that young women who exhibit high-risk driving behavior deviate more from the general population of young women with respect to alcohol use, alcohol misuse, and marijuana use than high-risk-driving young men differ from other young men. In addition, findings indicate that even if young men and women were to eventually have equal levels of substance use, women would likely retain their lower-risk driving profiles. These findings suggest the need for (1) future research to understand the differential associations, and (2) prevention programs that consider these gender differences.

Accidents, Traffic↗
PubMed2005

A randomized controlled trial of an emergency department-based interactive computer program to prevent alcohol misuse among injured adolescents.

STUDY OBJECTIVE: To determine whether an emergency department (ED)-based laptop computer intervention reduces the normative age-related increase in alcohol misuse compared with standard of care. METHODS: This was a randomized controlled trial conducted from October 11, 1999, to April 14, 2001, in a community teaching hospital and university medical center. Subjects were aged 14 to 18 years and with a minor injury. Controls and intervention participants completed a computer-based questionnaire. Intervention participants also completed a laptop-based interactive computer program to affect alcohol misuse. Main outcome measures were Alcohol Misuse Index (Amidx) and binge-drinking episodes. Follow-up occurred by telephone at 3 and 12 months. Analysis included repeated-measures analysis of variance (alpha=0.05; power 0.80; effect size 0.10). RESULTS: Three hundred twenty-nine participants were randomized to the intervention group, and 326 participants were randomized to the control group. Two hundred ninety-five (89.7%) intervention subjects and 285 (87.4%) control subjects completed 3- and 12-month follow-ups. For intervention and control groups, respectively, mean age was 16.0 and 15.9 years and men composed 66.8% and 66.3% of the groups; Amidx scores were 2.2 and 2.0; binge-drinking episodes were 1.2 and 1.0. Outcomes for intervention and control, respectively, were Amidx (3 months) 1.5 and 1.4; Amidx (12 months) 1.8 and 2.1; binge drinking (3 months) 0.9 and 0.8; and binge drinking (12 months) 1.4 and 1.2. Overall, there were no significant effects (effect size 0.04). No detrimental effects were noted. Subgroup analysis suggested that the intervention may have an effect among subjects with experience drinking and driving (5% of the sample). CONCLUSION: The intervention was not effective in decreasing alcohol misuse among the study population. Further research will be required to determine effectiveness among the subgroup of adolescent minor injury patients who have experience drinking and driving.

Adolescent↗
PubMed2005

Drinking behavior from high school to young adulthood: differences by college education.

BACKGROUND: Recent serious alcohol-related events have raised public awareness of the prevalence of at-risk alcohol use among college undergraduates, but heavy alcohol consumption during late adolescence and young adulthood is not limited to college students. Alcohol consumption typically peaks in young adulthood regardless of education level, and risks related to alcohol misuse are shared by young adults, regardless of their educational choices. Differences in alcohol risk between college-attending and non-college-attending young adults are generally small, and emphasize the need for research examining the drinking patterns of both of these groups. METHODS: To better understand patterns of at-risk alcohol use and its association with education, this study compared at-risk alcohol use from 12 grade to young adulthood (age 24) in a sample of never-married young adults. Three groups were formed based on completed education when the survey was administered in young adulthood: high school or less, postsecondary education without a four-year college degree, and completed college. RESULTS: Men who completed college experienced the greatest increase in at-risk drinking from grade 12 to young adulthood; however, their at-risk alcohol use did not differ markedly from men in the other education groups in young adulthood. Men who did not complete college had high levels of alcohol risk in 12 grade and maintained or increased those levels in young adulthood, demonstrating a pattern of prolonged risk. Women whose completed education was high school or less experienced the fewest increases in at-risk alcohol use. Education group differences were not explained by place of residence or employment status. CONCLUSIONS: These results emphasize the need to intervene early to prevent at-risk alcohol use, and emphasize that at-risk alcohol use is neither unique, nor necessarily the highest among individuals who complete college.

Adolescent↗
PubMed2005

Adolescent predictors of traffic crash patterns from licensure into early young adulthood.

This paper examines differences in the adolescent psychosocial and problem behavior characteristics of individuals who have stable-low, increasing, stable-high and decreasing frequencies of motor vehicle crashes from licensure into early young adulthood. Problem Behavior Theory was used as the guiding theoretical framework. Study data were collected when the participants were in 10th and 12th grades, and during a young adulthood follow-up telephone survey conducted five to six years later (n = 1,936). For men, stable high crash rates were associated with less parental monitoring and more substance use, and a stable low crash rates were associated with better marks in school. For women, stable high crash rates were associated with poorer marks in school and more substance use, and patterns of both decreasing and stable high crash rates were associated with less parental monitoring and less parental orientation. It is concluded that patterns of motor vehicle crashes are associated with adolescent psychosocial and problem behavior characteristics. Interventions targeting these factors may have broad positive effects on problem behaviors, including problem driving and motor vehicle crashes. In addition, the results of this study may be useful in designing traffic safety policies that target individuals whose psychosocial characteristics indicate that they are at high risk of being involved in a crash.

Accidents, Traffic↗
PubMed2004

Michigan's graduated driver licensing program: evaluation of the first four years.

INTRODUCTION: To evaluate the four-year outcome of Michigan's graduated driver licensing (GDL) program, motor-vehicle crash data for 16-year-old drivers in 1996 (pre-GDL), and 1998-2001 (post-GDL) were analyzed. METHOD: Relative risks and 95% confidence intervals for several crash types were computed, and pre-post-GDL population-based crash rates were compared. Reductions in crash risks among 16-year-olds previously found in 1998 and 1999 were generally maintained in 2000 and 2001. RESULTS: Reductions in crash risk among 16-year-olds from 1996 to 2001 were 29% for all, 44% for fatal, 38% each for nonfatal-injury and fatal-plus-nonfatal-injury, 32% for day, 31% for evening, 59% for night, 32% for single-vehicle, and 28% for multi-vehicle crashes. Even after adjusting for more general population-wide changes among drivers 25 years and older that might have contributed to changes in 16-year-old crash risk, reductions remained impressive (19% for all crashes in 2001). IMPACT ON INDUSTRY: As one approach to reducing teenage motor-vehicle morbidity and mortality, GDL remains promising.

Accidents, Traffic↗
PubMed2004

Adolescent developmental antecedents of risky driving among young adults.

OBJECTIVE: The risk of injury or death due to motor vehicle crash is highest from ages 16 to 35. Crash rates are associated with driver's gender, age, inexperience, emotional states, thrill seeking, personality factors and substance use. The developmental trajectories of psychosocial and nondriving problem behavior that lead to risky driving behavior, however, are not well understood. This study examined the longitudinal patterns of adolescent psychosocial behavior and substance use of five risky driving groups. METHOD: Longitudinal data were gathered from 2,085 subjects (1,110 women) surveyed in young adulthood and at least once previously in high school (i.e., 10th and/or 12th grade). Based on young adult data, participants were classified into five groups differing in type and level of risky driving. Analyses compared the adolescent psychosocial and substance use development of the participants in the risky driving groups. RESULTS: A low level of parental monitoring, greater parental permissiveness, a weaker social bond and high levels of and rapid increases in substance use characterized the developmental trajectories of young adult risky drivers. CONCLUSIONS: These developmental traits identify individuals who are likely to endanger themselves and others through risky driving and who should receive early interventions to reduce the likelihood of subsequent risky driving.

Accidents, Traffic↗
PubMed2003

Driving and alternatives: older drivers in Michigan.

METHOD: A statewide telephone survey of Michigan drivers and former drivers aged 65 and older collected information on transportation mode choices, experience with alternatives to driving, and whether drivers planned for when they could no longer drive. RESULTS: Results showed that most older adult households owned at least one automobile, and that the automobile was the primary mode of transportation. Most former drivers obtained rides from relatives and friends. Use of public transportation was low, and some seniors were not aware of available public transportation services. Older drivers did not plan for driving cessation. Over half the drivers who perceived a likelihood of driving problems within 5 years expected to keep driving beyond 5 years. IMPACT ON INDUSTRY: Because of their lifelong reliance on the automobile, their desire to drive themselves, and their lack of experience with public transportation, efforts to enhance the mobility of older people should consider this background while alternatives to the personal automobile are developed.

Aged↗
PubMed2003

Improving older driver knowledge and self-awareness through self-assessment: the driving decisions workbook.

PURPOSE: This study aims to assess whether the Driving Decisions Workbook, a self-assessment instrument for older drivers, increased self-awareness and general knowledge. This study also assessed perceptions regarding its usefulness, particularly as a tool for facilitating discussions within families of older drivers. A secondary purpose of the study was to determine if problems identified by drivers in the workbook related to problems they had with actual driving. DESIGN AND METHODS: The Driving Decisions Workbook was administered along with a questionnaire and a road test. A convenience sample of 99 licensed drivers aged 65 and above was used. RESULTS: After completing the workbook, about three fourths of the participants reported being more aware of changes that could affect driving. Fourteen percent reported that they had discovered a change in themselves of which they had not been previously aware. All respondents found the workbook to be at least a little useful and thought the workbook could help facilitate family discussions. Workbook responses were positively correlated with overall road test scores. Significant correlations were also noted between the road test and a majority of workbook subsection responses. IMPLICATIONS: This study indicates that the workbook may be a useful first-tier assessment instrument and educational tool for the older driver. It may encourage an older driver to drive more safely and/or to seek clinical assessment, and help in facilitating discussions about driving within their families.

Accidents, Traffic↗
PubMed2003

Graduated driver licensing in the United States: evaluation results from the early programs.

BACKGROUND: Seventeen states enacted graduated driver licensing (GDL) programs that were implemented from 1996 through 1999 and for which evaluations are of interest. METHODS: We received evaluation results reported for six states for which data were available. Summarizing results is difficult in other than the most global terms because of differences in pre-GDL programs, differences in GDL programs, and differences in evaluation methodology. RESULTS: All states identified some crash reduction among teen drivers following GDL implementation. This positive effect was observed across different geographic regions, and with different GDL programs. Simple counts are down-fewer teens are experiencing crashes and becoming injured. After calculating crash rates to adjust for changes over time in populations or licensed drivers, reductions generally were still found. Population-adjusted risks of injury/fatal crash involvement of 16-year-old drivers in Florida and Michigan were reduced by 11% and 24%, respectively. Population-adjusted risks of any crash involvement of 16-year-old drivers in Michigan and North Carolina were reduced by 25% and 27%, respectively. Reductions in night (restricted hours) crash risk were impressive in Florida, Michigan, and North Carolina. A comparison state design was only possible in the Florida evaluation, and results showed greater crash reductions under GDL. Change-point analyses of Michigan's crash data trends over time provided additional support of GDL's effectiveness in reducing crashes. DISCUSSION: Taken as a whole, and including the preliminary findings from California, Ohio, and Pennsylvania, these reports demonstrate the early effectiveness of GDL in reducing the crash risk of teen drivers. The impact of these studies and others to come will guide future research, practice, and policy.

Accidents, Traffic↗
PubMed2003

Examining trajectories of adolescent risk factors as predictors of subsequent high-risk driving behavior.

PURPOSE: To examine the effects on early high-risk driving behavior of changes over time (trajectories) in adolescent alcohol use, friends' support for drinking, susceptibility to peer pressure, and tolerance of deviance. METHODS: Statewide driving data were obtained for 4813 subjects who had completed at least two previous school-based questionnaires. The self-administered questionnaire data provided predictor measures from 5th through 10th grades. Trajectory information on predictor measures was summarized using each measure's slope over time and level at the 10th grade data collection (last value). Regression models used serious offenses, alcohol-related offenses, serious crashes, and alcohol-related crashes as outcomes, trajectory measures as predictors, and produced parameter estimates adjusted for demographic measures. Probabilities of having a serious offense or serious crash for five sample trajectories on each measure were obtained from the estimated regression models. RESULTS: All four predictor measures were important, particularly in predicting serious offenses, alcohol-related offenses, and alcohol-related crashes. The highest probabilities for young adult high-risk driving were found among those with consistently high or increasingly high trajectories of friends' support for drinking, susceptibility to peer pressure, and tolerance of deviance. CONCLUSIONS: Programs to prevent adolescent risk behavior should take into account environmental and personality influences. Prevention efforts need to emphasize preserving low levels, preventing increases, and promoting decreases over time of adolescent risk factors for unhealthy behaviors, such as high-risk driving.

Accidents, Traffic↗
PubMed2003

Feasibility of using an interactive laptop program in the emergency department to prevent alcohol misuse among adolescents.

STUDY OBJECTIVE: Alcohol, the most commonly used substance among adolescents, is frequently associated with injury. Effective interventions to prevent adolescent alcohol use and misuse in acute care settings are lacking. A laptop-based alcohol prevention program could reinforce other prevention efforts that adolescents may receive. We determined the feasibility of using an interactive laptop program with adolescent emergency department (ED) patients to prevent alcohol use and misuse. METHODS: We used the recruitment phase of a randomized controlled trial at an academic medical center and an urban teaching hospital. Patients were aged 14 to 18 years and presented within 24 hours of an acute injury. Measures included patient recruitment, mechanism of injury, injury severity score, alcohol use characteristics, and patients' opinion of the computer program. RESULTS: Of 843 eligible patients, 671 (79.6%) were enrolled and 655 (77.7%) completed the program. Parent or guardian reluctance was the most frequent reason for refusal. The participants averaged 16.0 years of age (range 14 to 18 years; SD 1.5 years), 66.9% were male, and 68.3% were white. Approximately 71% reported "ever" drinking. Recent alcohol use (past 3 months) by those "ever" drinking was as follows: 62.3% drank, 31.2% got drunk, and 37.4% binge drank. Seventy-four percent of recent drinkers reported that the program made them rethink their alcohol use. Ninety-four percent of participants liked the program. Only 5.3% required assistance with the program. CONCLUSION: Use of an interactive computer program in the ED appears feasible. Further work is being done to evaluate the effectiveness of the program in reducing alcohol-related behaviors among adolescents.

Academic Medical Centers↗
PubMed2002

Drinking-driving as a component of problem driving and problem behavior in young adults.

OBJECTIVE: This study replicated and extended a conceptual model of drinking-driving and its relationship to other problem behavior to determine (1) if the model characterized the problem driving and problem behavior of young adults from the general population and (2) if the model applied to women as well as to men. METHOD: Telephone survey data (measures of drinking-driving, drug-driving, risky driving, problem drinking, drug use and delinquent behavior) collected from young adults (N = 4,230, 53% female) were used in structural equation modeling. Two models were developed--one for problem driving and one for problem behavior--each testing the structural associations among latent variables and testing them as latent indicators of common second-order latent variables. RESULTS: The results supported the hypothesis that drinking-driving (along with problem drinking, drug use and delinquent behavior) is an indicator of problem behavior in the general population sample. Also, drinking-driving, drug-driving and risky driving were demonstrated to be indicators of a common construct: problem driving. The models fit the data equally well for both young men and young women, and a crossvalidation conducted on an independent sample confirmed the results. CONCLUSIONS: The results provide empirical support for the inclusion of drinking-driving and problem driving in an extended model of Problem Behavior Theory. Drinking-driving, drug-driving and risky driving all relate to a common construct: problem driving. These results have important implications for research and for interventions to treat or prevent drinking-driving, especially among young adults.

Adult↗