Drinking, Teen, Driving Under the Influence, Underage Drinking
Conditions
Brief summary
Project MADD was designed to attempt to curb the alarming trends related to drunk driving and to move the field forward by testing a brief parent-intervention's ability to change adolescents' drinking, impaired driving, and riding with impaired driver behaviors. The aim of this project is to provide an easy-to-implement and low-cost alternative parent-based intervention that can be widely disseminated to address this important public health problem.
Detailed description
Drunk driving is a major public health problem. The National Highway Traffic Safety Administration reported nearly 10,000 people died in alcohol-related crashes in the U.S. in 2014. The problem is further magnified when one considers that each year over 1.3 million drivers in the U.S. are arrested for alcohol-impaired driving. As alarming as these statistics are they pale by comparison to estimates indicating that they only represent 1% of the 121 million self-reported episodes of alcohol-impaired driving among U.S. drivers each year. The proposed research will attempt to curb these alarming trends and move the field forward by conducting a randomized controlled trial testing a brief parent intervention's ability to change adolescents' drinking, impaired driving, and riding with impaired driver behaviors. Prior brief parent-based interventions fro this lab have provided sufficient preliminary evidence of participation, communication, and efficacy for changing under-age drinking to warrant a large-scale comprehensive study. The study will use an extremely rigorous design that meets the Society for Prevention Research Criteria for Efficacy as described in Flay et al., a nationally representative sample assessed at 3-waves (baseline, 6 mo. and 12 mo.) to examine generalizability and sustained effects, and an oversampled Hispanic/Latino subgroup to examine the parent-intervention's potential to reduce a health disparity in an underserved population. The aims are as follows: Aim 1: Evaluate the efficacy of the parent intervention (short and long term); Aim 2: Examine mediators of the PBI that directly influence drinking, impaired driving, and riding with impaired driver behaviors; and Aim 3: Identify moderators to help inform future tailoring and improvement in intervention effectiveness. To the extent that the research is successful, it will provide an easy to implement and low cost alternative that can be widely disseminated to address this important public health problem.
Interventions
BEHAVIORALMADD Materials
Handbook developed by MADD and the PI to guide parents in discussing underage drinking, behaviors, and consequences with their teens
BEHAVIORALSurgeon General Materials
Information published by the Surgeon General about teens and drinking
Sponsors
National Institutes of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Penn State University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Intervention model description
1 group receives the MADD parent intervention; the second group receives parent materials from the Surgeon General; and the third group is TAU
Eligibility
Sex/Gender
ALL
Age
15 Years to 18 Years
Healthy volunteers
Yes
Inclusion criteria
* Parent and teen both consent (forming a dyad testing unit); They are part of GfK's KnowledgePanel pool of participants
Exclusion criteria
* Outside of the teen age range
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Typical Weekend Drinking (DDQ) | Baseline, 6 month follow-up, and 12 month follow-up | Typical weekend drinking was assessed using the Daily Drinking Questionnaire (DDQ; Collins et al., 1985), which asked teens to indicate the number of drinks they consumed on a typical Friday and Saturday during the past 6 months. These two items were summed to create the number of typical weekend drinks. Higher scores indicate the teen consumed a higher number of drinks on a typical weekend. |
| Declining to Ride With Impaired Drivers | T4 (12-months post-baseline) | Declining riding with impaired drivers was assessed with two items adapted from Hultgren et al (2018). Teens were asked to indicate the number of times they declined a ride from a driver that consumed alcohol and the number of times they declined a ride from a driver that consumed any drug other than alcohol (e.g., marijuana, opioids) in the past 6 months. Responses were summed to indicate the number of times they declined rides from impaired drivers in the past 6 months. Higher scores indicate the participant declined more rides from impaired drivers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Willingness to Ride in a Car With an Impaired Driver | Baseline, 6 month follow-up, and 12 month follow-up | Willingness to ride in a car with an impaired driver was assessed with two items adapted from Hultgren et al. (2018). Teens responded using a 7-point scale that ranged from (0) Strongly disagree to (6) Strongly agree on their level of agreement to the following statements, I am willing to be a passenger in a vehicle when the driver has consumed alcohol. and I am willing to be a passenger in a vehicle when the driver has consumed any drug other than alcohol (e.g., marijuana, ecstasy, opioids).. Responses were averaged to create a mean score. Higher scores indicate the participant is more willing to be a passenger in a car with an impaired driver. |
Countries
United States
Participant flow
Recruitment details
Parent-teen dyads were recruited from a nationally representative predetermined Web panel (KnowledgePanel, KP) maintained by the consumer company Ipsos. KP members were randomly selected through probability-based sampling of addresses from the U.S. Postal Services' Delivery Sequence File which covers approximately 97% of U.S. households. Only individuals who were sampled through these probability-based techniques were eligible to participate.
Participants by arm
| Arm | Count |
|---|---|
| MADD Materials Handbook developed by MADD and the PI to guide parents in discussing underage drinking, behaviors, and consequences with their teens
MADD Materials: Handbook developed by MADD and the PI to guide parents in discussing underage drinking, behaviors, and consequences with their teens | 393 |
| Surgeon General Materials Information published by the Surgeon General about teens and drinking
Surgeon General Materials: Information published by the Surgeon General about teens and drinking | 393 |
| Active Control Received HPV vaccine info | 390 |
| Total | 1,176 |
Baseline characteristics
| Characteristic | MADD Materials | Total | Active Control | Surgeon General Materials |
|---|---|---|---|---|
| Age, Categorical Parent Participants <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Parent Participants >=65 years | 8 Participants | 22 Participants | 8 Participants | 6 Participants |
| Age, Categorical Parent Participants Between 18 and 65 years | 385 Participants | 1154 Participants | 382 Participants | 387 Participants |
| Age, Categorical Teen Participants <=18 years | 393 Participants | 1176 Participants | 390 Participants | 393 Participants |
| Age, Categorical Teen Participants >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Teen Participants Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous Parent Participants | 46.58 years STANDARD_DEVIATION 7.44 | 46.75 years STANDARD_DEVIATION 7.61 | 46.77 years STANDARD_DEVIATION 7.65 | 46.90 years STANDARD_DEVIATION 7.76 |
| Age, Continuous Teen Participants | 16.29 years STANDARD_DEVIATION 1.09 | 16.33 years STANDARD_DEVIATION 1.09 | 16.33 years STANDARD_DEVIATION 1.09 | 16.37 years STANDARD_DEVIATION 1.11 |
| Ethnicity (NIH/OMB) Parent Participants Hispanic or Latino | 106 Participants | 293 Participants | 90 Participants | 97 Participants |
| Ethnicity (NIH/OMB) Parent Participants Not Hispanic or Latino | 287 Participants | 883 Participants | 300 Participants | 296 Participants |
| Ethnicity (NIH/OMB) Parent Participants Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Teen Participants Hispanic or Latino | 115 Participants | 316 Participants | 98 Participants | 103 Participants |
| Ethnicity (NIH/OMB) Teen Participants Not Hispanic or Latino | 278 Participants | 860 Participants | 292 Participants | 290 Participants |
| Ethnicity (NIH/OMB) Teen Participants Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Parent Participants American Indian or Alaska Native | 5 Participants | 14 Participants | 7 Participants | 2 Participants |
| Race (NIH/OMB) Parent Participants Asian | 13 Participants | 34 Participants | 12 Participants | 9 Participants |
| Race (NIH/OMB) Parent Participants Black or African American | 32 Participants | 102 Participants | 39 Participants | 31 Participants |
| Race (NIH/OMB) Parent Participants More than one race | 19 Participants | 48 Participants | 11 Participants | 18 Participants |
| Race (NIH/OMB) Parent Participants Native Hawaiian or Other Pacific Islander | 1 Participants | 2 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Parent Participants Unknown or Not Reported | 21 Participants | 56 Participants | 15 Participants | 20 Participants |
| Race (NIH/OMB) Parent Participants White | 302 Participants | 920 Participants | 305 Participants | 313 Participants |
| Race (NIH/OMB) Teen Participants American Indian or Alaska Native | 6 Participants | 8 Participants | 2 Participants | 0 Participants |
| Race (NIH/OMB) Teen Participants Asian | 15 Participants | 40 Participants | 13 Participants | 12 Participants |
| Race (NIH/OMB) Teen Participants Black or African American | 32 Participants | 100 Participants | 33 Participants | 35 Participants |
| Race (NIH/OMB) Teen Participants More than one race | 31 Participants | 84 Participants | 30 Participants | 23 Participants |
| Race (NIH/OMB) Teen Participants Native Hawaiian or Other Pacific Islander | 1 Participants | 3 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Teen Participants Unknown or Not Reported | 20 Participants | 48 Participants | 11 Participants | 17 Participants |
| Race (NIH/OMB) Teen Participants White | 288 Participants | 893 Participants | 300 Participants | 305 Participants |
| Sex: Female, Male Parent Participants Female | 223 Participants | 640 Participants | 204 Participants | 213 Participants |
| Sex: Female, Male Parent Participants Male | 170 Participants | 536 Participants | 186 Participants | 180 Participants |
| Sex: Female, Male Teen Participants Female | 179 Participants | 579 Participants | 203 Participants | 197 Participants |
| Sex: Female, Male Teen Participants Male | 214 Participants | 597 Participants | 187 Participants | 196 Participants |
| Teen Riding with Impaired Drivers Measures Declining to ride with impaired driver | 0.51 units on a scale STANDARD_DEVIATION 1.33 | 0.44 units on a scale STANDARD_DEVIATION 1.28 | 0.37 units on a scale STANDARD_DEVIATION 1.17 | 0.44 units on a scale STANDARD_DEVIATION 1.32 |
| Teen Riding with Impaired Drivers Measures Impaired driving | 0.16 units on a scale STANDARD_DEVIATION 0.87 | 0.11 units on a scale STANDARD_DEVIATION 0.71 | 0.08 units on a scale STANDARD_DEVIATION 0.55 | 0.10 units on a scale STANDARD_DEVIATION 0.68 |
| Teen Riding with Impaired Drivers Measures Passenger in car with impaired driver | 0.57 units on a scale STANDARD_DEVIATION 2 | 0.52 units on a scale STANDARD_DEVIATION 1.85 | 0.46 units on a scale STANDARD_DEVIATION 1.72 | 0.52 units on a scale STANDARD_DEVIATION 1.82 |
| Teen Typical Weekly Drinking (DDQ) | 0.23 units on a scale STANDARD_DEVIATION 0.97 | 0.22 units on a scale STANDARD_DEVIATION 0.94 | 0.23 units on a scale STANDARD_DEVIATION 1.01 | 0.20 units on a scale STANDARD_DEVIATION 0.85 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 393 | 0 / 393 | 0 / 390 |
| other Total, other adverse events | 0 / 393 | 0 / 393 | 0 / 390 |
| serious Total, serious adverse events | 0 / 393 | 0 / 393 | 0 / 390 |
Outcome results
Primary
Declining to Ride With Impaired Drivers
Declining riding with impaired drivers was assessed with two items adapted from Hultgren et al (2018). Teens were asked to indicate the number of times they declined a ride from a driver that consumed alcohol and the number of times they declined a ride from a driver that consumed any drug other than alcohol (e.g., marijuana, opioids) in the past 6 months. Responses were summed to indicate the number of times they declined rides from impaired drivers in the past 6 months. Higher scores indicate the participant declined more rides from impaired drivers.
Time frame: T4 (12-months post-baseline)
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MADD Materials | Declining to Ride With Impaired Drivers | 0.61 units on a scale | Standard Deviation 1.56 |
| Surgeon General Materials | Declining to Ride With Impaired Drivers | 0.56 units on a scale | Standard Deviation 1.38 |
| Active Control | Declining to Ride With Impaired Drivers | 0.31 units on a scale | Standard Deviation 0.99 |
Comparison: It was also hypothesized that teens in the SG and MADD conditions would report significantly more declining rides with impaired drivers than those in the AC group.p-value: <0.01Tukey's Post-Hoc
Primary
Typical Weekend Drinking (DDQ)
Typical weekend drinking was assessed using the Daily Drinking Questionnaire (DDQ; Collins et al., 1985), which asked teens to indicate the number of drinks they consumed on a typical Friday and Saturday during the past 6 months. These two items were summed to create the number of typical weekend drinks. Higher scores indicate the teen consumed a higher number of drinks on a typical weekend.
Time frame: Baseline, 6 month follow-up, and 12 month follow-up
Population: Participants included in analyses from T4 (12-month post-baseline assessment).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MADD Materials | Typical Weekend Drinking (DDQ) | 0.53 units on a scale | Standard Deviation 1.56 |
| Surgeon General Materials | Typical Weekend Drinking (DDQ) | 0.53 units on a scale | Standard Deviation 1.57 |
| Active Control | Typical Weekend Drinking (DDQ) | 0.38 units on a scale | Standard Deviation 1.23 |
Comparison: It was hypothesized that drinking would increase from baseline to 12-month follow-up for those in the AC, but not for those in the SG and MADD conditions.p-value: >0.05Tukey's Post-Hoc
Secondary
Willingness to Ride in a Car With an Impaired Driver
Willingness to ride in a car with an impaired driver was assessed with two items adapted from Hultgren et al. (2018). Teens responded using a 7-point scale that ranged from (0) Strongly disagree to (6) Strongly agree on their level of agreement to the following statements, I am willing to be a passenger in a vehicle when the driver has consumed alcohol. and I am willing to be a passenger in a vehicle when the driver has consumed any drug other than alcohol (e.g., marijuana, ecstasy, opioids).. Responses were averaged to create a mean score. Higher scores indicate the participant is more willing to be a passenger in a car with an impaired driver.
Time frame: Baseline, 6 month follow-up, and 12 month follow-up
Population: Participants included in analyses from T3 (6-months post-baseline). These analyses examine participants willingness to ride in a car with an impaired driver.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| MADD Materials | Willingness to Ride in a Car With an Impaired Driver | 1.22 units on a scale | Standard Error 0.03 |
| Surgeon General Materials | Willingness to Ride in a Car With an Impaired Driver | 1.22 units on a scale | Standard Error 0.03 |
| Active Control | Willingness to Ride in a Car With an Impaired Driver | 1.22 units on a scale | Standard Error 0.03 |
Comparison: It was hypothesized that participants in the MADD and SG groups would be significantly less willing to ride in a car with an impaired driver than those in the AC group.p-value: >0.01Tukey's Post-Hoc