Characterization of Young Adult Impaired Driving Offenders and Response to Indicated Prevention

Introduction: Driving under the influence of substances, referred to as impaired driving, continues to be a major cause of suffering, injuries, and death. For example, more than 10,000 people died in alcohol-impaired driving crashes in 2010 in the U.S., comprising a third of driving fatalities. Compared to other age groups, incidence of impaired driving arrests and crash fatalities are highly elevated among people transitioning to adulthood. Prevention efforts within this at-risk population can be improved by understanding how individual differences among young adults affect response to intervention.

Methods: In Analysis 1, we analyzed three-year recidivism rates in Maine for 1,095 young adults arrested for impaired driving. We compared those who participated in two group-delivered prevention programs, an intervention as usual (IAU) versus PRIME For Life® (PFL). PFL is an empirically-based and manualized indicated prevention program used with people who have shown problematic substance use (such as being arrested for impaired driving). In Analysis 2, we analyzed data collected in 9 states from 1,096 PFL participants who had been arrested for impaired driving. We first used Latent Class Analysis to identify participant risk profiles (classes) based on a number of behavioral and cognitive indicators (e.g., past use, intended future use, and risk perceptions). We then expanded into a Latent Transition Analysis to characterize the types of transitions made by each of these classes of individuals from baseline to posttest.

Results: In Analysis 1, IAU participants showed greater recidivism in terms of subsequent arrests for impaired driving than those attending PFL (OR = 1.43, p = .05). In Analysis 2, we identified multiple classes that differed from each other in risk characteristics and levels. Transition probabilities varied depending on baseline class membership, and gender played a role in risk profile membership and outcomes.

Conclusions: Despite the challenges faced by prevention programs with young adults, indicated prevention efforts can elicit positive outcomes. That being said, the likelihood of benefit may depend on one’s risk profile. Results have implications for prevention programs in terms of content, potential matching of participant characteristics to content, whether some types of individuals may be best assigned to more intensive intervention, and the clinical significance of outcomes.