Jean T. Shope

A longitudinal study of self-esteem: Implications for adolescent development

This study used a cluster analytic approach to identify self-esteem trajectories among adolescents over a four-year period from sixth to tenth grades (N = 1,160). Four self-esteem trajectories were identified that replicated previous research: (1) consistently high, (2) moderate and rising, (3) steadily decreasing, and (4) consistently low. Female adolescents were more likely to be in the steadily decreasing self-esteem group while male adolescents were more likely to be in the moderate and rising group. African American and white youth were equally distributed across groups. Using repeated measures analysis, we found that youth with consistently high and moderate and rising self-esteem reported developmentally healthier outcomes in Grade 10 than youth in the other two clusters. Outcomes included susceptibility to peer pressure, school grades, and alcohol use. Implications of these results for studying self-esteem and developmental change more generally are discussed.

Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: a randomized controlled trial.

CONTEXT Emergency department (ED) visits present an opportunity to deliver brief interventions to reduce violence and alcohol misuse among urban adolescents at risk of future injury. OBJECTIVE To determine the efficacy of brief interventions addressing violence and alcohol use among adolescents presenting to an urban ED. DESIGN, SETTING, AND PARTICIPANTS Between September 2006 and September 2009, 3338 patients aged 14 to 18 years presenting to a level I ED in Flint, Michigan, between 12 pm and 11 pm 7 days a week completed a computerized survey (43.5% male; 55.9% African American). Adolescents reporting past-year alcohol use and aggression were enrolled in a randomized controlled trial (SafERteens). INTERVENTION All patients underwent a computerized baseline assessment and were randomized to a control group that received a brochure (n = 235) or a 35-minute brief intervention delivered by either a computer (n = 237) or therapist (n = 254) in the ED, with follow-up assessments at 3 and 6 months. Combining motivational interviewing with skills training, the brief intervention for violence and alcohol included review of goals, tailored feedback, decisional balance exercise, role plays, and referrals. MAIN OUTCOME MEASURES Self-report measures included peer aggression and violence, violence consequences, alcohol use, binge drinking, and alcohol consequences. RESULTS About 25% (n = 829) of screened patients had positive results for both alcohol and violence; 726 were randomized. Compared with controls, participants in the therapist intervention showed self-reported reductions in the occurrence of peer aggression (therapist, -34.3%; control, -16.4%; relative risk [RR], 0.74; 95% confidence interval [CI], 0.61-0.90), experience of peer violence (therapist, -10.4%; control, +4.7%; RR, 0.70; 95% CI, 0.52-0.95), and violence consequences (therapist, -30.4%; control, -13.0%; RR, 0.76; 95% CI, 0.64-0.90) at 3 months. At 6 months, participants in the therapist intervention showed self-reported reductions in alcohol consequences (therapist, -32.2%; control, -17.7%; odds ratio, 0.56; 95% CI, 0.34-0.91) compared with controls; participants in the computer intervention also showed self-reported reductions in alcohol consequences (computer, -29.1%; control, -17.7%; odds ratio, 0.57; 95% CI, 0.34-0.95). CONCLUSION Among adolescents identified in the ED with self-reported alcohol use and aggression, a brief intervention resulted in a decrease in the prevalence of self-reported aggression and alcohol consequences. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00251212.

Influences on youthful driving behavior and their potential for guiding interventions to reduce crashes

This paper presents an organized, comprehensive view of the factors known to influence young drivers’ behavior and how those factors might inform interventions to reduce crashes. This effort was done from the perspective of a public health professional, with a background in health behavior and health education, interested in preventing injury and death among young people from motor vehicle crashes. The author’s own studies, selected relevant literature, observation, and experience were considered and organized. A framework of six categories of influences on youthful driving behavior was developed, including the following elements: driving ability, developmental factors, personality factors, demographics, the perceived environment, and the driving environment. It is apparent that a complex set of many different factors influences young drivers’ behavior. To reduce crashes, comprehensive, multilevel interventions are needed that target those factors in the framework that are amenable to change.

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 Michigans crash data trends over time provided additional support of GDLs 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.

Adolescent antecedents of high-risk driving behavior into young adulthood: substance use and parental influences

Driver history data, in combination with previously collected tenth-grade questionnaire data, for 4403 subjects were analyzed by Poisson regression models to identify the significant substance use and parental characteristics predicting subsequent high-risk driving of new drivers (starting at age 16) through age 23-24 years. Substance use (cigarettes, marijuana, and alcohol) reported at age 15 was shown to be an important predictor of subsequent excess risk of serious offenses and serious crashes for both men and women. In addition, negative parental influences (lenient attitudes toward young peoples drinking; low monitoring, nurturance, family connectedness), were also demonstrated to increase the risk of serious offenses and serious crashes for both men and women.

Environmental Correlates of Adolescent Substance Use and Misuse: Implications for Prevention Programs

The research in the areas of peer, family and community environmental effects on adolescent substance use and misuse clearly and consistently shows that peer substance use behavior is the primary predictor of adolescent alcohol use. Peer norms, however, are more important in the prediction of adolescent alcohol misuse. Parental norms and monitoring are secondary to the peer variables, but still of significance in the prediction of adolescent alcohol use and misuse. The intrapersonal construct of susceptibility to peer pressure is as important as the peer and parent variables in the prediction of both alcohol use and misuse in adolescence.

Brief motivational interviewing intervention for peer violence and alcohol use in teens: one-year follow-up.

BACKGROUND AND OBJECTIVES: Emergency department (ED) visits present an opportunity to deliver brief interventions (BIs) to reduce violence and alcohol misuse among urban adolescents at risk for future injury. Previous analyses demonstrated that a BI resulted in reductions in violence and alcohol consequences up to 6 months. This article describes findings examining the efficacy of BIs on peer violence and alcohol misuse at 12 months. METHODS: Patients (14–18 years of age) at an ED reporting past year alcohol use and aggression were enrolled in the randomized control trial, which included computerized assessment, random assignment to control group or BI delivered by a computer or therapist assisted by a computer. The main outcome measures (at baseline and 12 months) included violence (peer aggression, peer victimization, violence-related consequences) and alcohol (alcohol misuse, binge drinking, alcohol-related consequences). RESULTS: A total of 3338 adolescents were screened (88% participation). Of those, 726 screened positive for violence and alcohol use and were randomly selected; 84% completed 12-month follow-up. In comparison with the control group, the therapist assisted by a computer group showed significant reductions in peer aggression (P < .01) and peer victimization (P < .05) at 12 months. BI and control groups did not differ on alcohol-related variables at 12 months. CONCLUSIONS: Evaluation of the SafERteens intervention 1 year after an ED visit provides support for the efficacy of computer-assisted therapist brief intervention for reducing peer violence.

Rates and Correlates of Violent Behaviors Among Adolescents Treated in an Urban Emergency Department

PURPOSE Violence is a leading cause of death for adolescents in inner-city settings. This article describes violent behaviors in relation to other risk behaviors (e.g., substance use) among adolescents screened in an urban emergency department (ED). METHODS Patients aged 14-18 years were approached to self-administer a computerized survey assessing violent behaviors (i.e., physical aggression), substance use (cigarettes, alcohol, marijuana), and weapon carriage. RESULTS A total of 1128 adolescents (83.8% participation rate; 45.9% male; 58.0% African-American) were surveyed. In the past year, 75.3% of adolescents reported peer violence, 27.6% reported dating violence, and 23.5% reported carrying a weapon. In the past year, 28.0% drank alcohol, 14.4% binge drank, 5.7% reported alcohol-related fighting, and 36.9% smoked marijuana. Logistic regression analyses predicting violent behaviors were significant. Teens reporting peer violence were more likely to be younger, African-American, on public assistance, carry a weapon, binge drink, and smoke marijuana. Teens reporting dating violence were more likely to be female, African-American, carry a weapon, binge drink, screen positive for alcohol problems, and smoke marijuana. Teens reporting alcohol-related fighting were more likely to carry a weapon, binge drink, screen positive for alcohol problems, and smoke marijuana. CONCLUSIONS Adolescents presenting to an urban ED have elevated rates of violent behaviors. Substance use (i.e., binge drinking and smoking marijuana) is an important risk factor for violent behaviors among urban adolescents. Universal screening and intervention protocols to address multiple risk behaviors, including violent behaviors and substance use, may be useful to prevent injury among adolescents presenting to the urban ED.

An evaluation of graduated driver licensing programs in North America using a meta-analytic approach

Most jurisdictions in North America have some version of graduated driver licensing (GDL). A sound body of evidence documenting the effectiveness of GDL programs in reducing collisions, fatalities and injuries among novice drivers is available. However, information about the relative importance of individual components of GDL is lacking. The objectives of this study are to calculate a summary statistic of GDL effectiveness and to identify the most effective components of GDL programs using a meta-analytic approach. Data from 46 American States, the District of Columbia and 11 Canadian jurisdictions are used and were obtained from the Fatality Analysis Reporting System (FARS) for the U.S. and from Transport Canadas Traffic Accident Information Database (TRAID) for Canada. The timeframe of this evaluation is 1992 through 2006, inclusive. Relative fatality risks and their 95% confidence intervals were calculated using fatality counts and population data for target and comparison groups, both in a pre-implementation and post-implementation period in each jurisdiction. The target groups were 16-, 17-, 18- and 19-year-old drivers. The comparison group was 25-54-year-old drivers. The relative fatality risks of all jurisdictions were summarized using the random effects DerSimonian and Laird model. Meta-regression using Restricted Maximum Likelihood (REML) and Markov Chain Monte Carlo (MCMC) Gibbs sampling was also conducted. Strong evidence in support of GDL was found. GDL had a positive and significant impact on the relative fatality risk of 16-year-old drivers (reduction of 19.1%). Significant effects were found for meta-regression models with 16-, 18- and 19-year-old drivers. These effects include length of night restriction in the learner stage, country, driver education in the learner stage and in the intermediate stage, whether night restrictions are lifted in the intermediate stage for work purposes, passenger restriction in the intermediate stage, whether passenger restrictions in the intermediate stage are lifted if passengers are family members, and whether there is an exit test in the intermediate stage. In conclusion, several GDL program components have an important effect on the relative fatality risk of novice drivers. These results help understand how such effects are achieved.

The Role of Personality Characteristics in Young Adult Driving

Background. Motor vehicle injury is the major cause of mortality among young adults. Information about the individual characteristics of those who drive dangerously could enhance traffic safety programs. The goal of this research was to examine the association between various personality-related characteristics and risky driving behaviors. Methods. Young adults in Michigan, USA (n = 5,362) were surveyed by telephone regarding several personality factors (risk-taking, hostility, aggression, tolerance of deviance, achievement expectations) and driving behaviors (competitive driving, risk-taking driving, high-risk driving, aggressive driving, and drink/driving). Michigan driver records were obtained to examine offenses, serious offenses, driving offense points, crashes and serious crashes in the three pre-interview years. Multivariate regression analyses, adjusting for age, race, and marital status were conducted separately by sex to identify personality factors related to driving. Results. For men and women, greater risk-taking propensity, physical/verbal hostility, aggression, and tolerance of deviance were significant predictors of a competitive attitude toward driving, risk-taking driving, high-risk driving, driving aggression, and drink/driving. Greater risk-taking propensity, physical/verbal hostility, aggression, and to a small degree, expectations for achievement predicted higher numbers of offenses, serious offenses, and points. Conclusion. Traffic safety policies and programs could be enhanced through recognition of the role personality factors play in driving behavior and the incorporation of this knowledge into the design and implementation of interventions that modify the behaviors associated with them.