Impaired driving incidents among women have risen in past decades, making this issue a source of growing concern. In Canada, women now account for one in every five impaired driving incidents as compared to one in thirteen in 1986. In addition, general messages to “not drink and drive” may not be effective with all audiences, and, particularly women. Historically, prevention messaging has been targeted towards males who represent approximately 80% of the impaired driving problem.. To date, little is known about the factors that contribute to the likelihood that women will drive after drinking or accept a ride with a drinking driver. For this reason, it is important to explore the perceptions and experiences of women, who have either driven after drinking or been a passenger of a drinking driver, to provide an empirical foundation to develop a gender-specific response to impaired driving. The limited Canadian research that is available reveals that self-reported driving after drinking among women has remained consistent but that women are more often charged with impaired driving as compared to previous years, and represent a larger proportion of drivers killed in road crashes that test positive for alcohol. More generally, research shows that single, unmarried, or divorced women tend to be more likely to drive after drinking, and age is not considered to be a factor. Women are also more likely than men to have children in the vehicle with them while driving after drinking. Women, however, often report more individual-level factors that influence their involvement, or continuing involvement, in driving after drinking or being a passenger of a drinking driver. Common factors include biological factors, personal estimations, coping-mechanisms, safety and availability of public transportation, and lack of gender-specific educational campaigns. As such, more research to investigate contributing factors and risks of impaired driving among women is imperative, and strategies to address this gap require attention. Of greatest importance, much work is needed to improve the development and delivery of tailored educational resources for women about this problem. This study was designed to fill this gap in the literature by conducting focus groups with women who had driven after drinking any amount of alcohol in the past or been a passenger of a drinking driver. TIRF facilitated a total of seven focus groups between July 2015 and June 2016 with some support from the Ontario Women’s Health Network (OWHN). A total of forty women participated in the study from Sudbury, Ottawa, Owen Sound, Brantford, and Guelph-Wellington. Focus groups were conducted at community and women’s health centres. The groups ranged in size between three to eight participants and lasted approximately two hours, including a half hour education session at the end of each group. The exploratory nature of this research was designed to increase knowledge about the understudied factors that contribute to the risk of impaired driving among women. In particular, the study used a mixed-method approach that was selected to integrate both qualitative and quantitative data collection strategies. The project also incorporated the principles of Inclusion Research that maintains the inclusion of the voices of women in research is critical within health and policy research. The project had three main objectives: * to gauge the level of knowledge among women about the effects of alcohol and the effects of alcohol on driving; * to examine the experiences of women who had driven after consuming any amount of alcohol or been a passenger of a drinking driver; and, * to explore the perceptions of women regarding factors that contributed to, and/or lessened, the risk of drinking and driving and/or riding as a passenger of a drinking driver in their community. Overall, approximately half of the women in this study were aged 45 and older and lived in suburban communities. Many of them were educated, had some level of employment, and were currently without a partner. With regards to personal drinking behaviours, most women indicated they consumed alcohol a few times per month and often had between one and four drinks on these occasions. More women indicated being a passenger of a drinking driver than driving after drinking within the past year. There are some important findings that emerged from the focus groups in relation to the six main topics of discussion. Many women that participated in this study reported some knowledge about the amount of alcohol that they could safely consume and its effects on their ability to drive. However, many of them were equally uncertain about just how much alcohol could be consumed, or how long it would take for alcohol to be eliminated from their body. Participants also had some awareness of the various biological, metabolic and social factors that could influence their ability to metabolize alcohol and their responses were fairly consistent with research about alcohol and driving. However, again, a majority of participants did not appear confident when they identified these various factors, and often presented their answers as questions to the other women in the group, and sought clarification to determine if they were correct. These results suggest that women could benefit from a better understanding of how alcohol affects women and the factors that play a role in this equation. Almost all of the focus group participants reported that their knowledge about the effects of alcohol was based on their personal experiences with intoxication and/or the perceptions of female family members and friends. This finding is a source of concern in light of research that indicates that people often base their judgment about impairment on their own personal estimates (Beuert et al. 2014) although subjective judgments can be incorrect. In addition, a majority of participants reported that men and women could not consume equal amounts of alcohol, and many of them agreed that men could consume more alcohol than women before being unsafe to drive. However, several women were not confident regarding about how much more men could consume as compared to women, or how much alcohol women could safely consume before driving as compared to men. While women were also able to identify some factors that contributed to differences in the amount of alcohol that could be consumed by men as compared to women, and their responses were fairly consistent with research evidence about this topic, again, a number of women were not confident in their responses. Notably, many women presented their responses as questions and/or bluntly acknowledged that they were unsure of their responses. Collectively, these results suggest that women are not well-informed about important differences between men and women in terms of the consumption of alcohol and its impairing effects, and this may contribute to decisions by women to drive after drinking or ride as a passenger of a drinking driver. Women in this study also acknowledged a number of contributing factors that lead to them to drive after drinking or ride as a passenger of a drinking driver. These factors generally included peer pressure, impaired judgment, lack of transportation or affordable transportation, safety concerns, and mental health issues. Many of these factors were similar to factors that were identified in previous research investigating the experiences of women who were convicted of impaired driving in the U.S. This finding is source of concern and indicates that the reasons among convicted female impaired drivers are not dissimilar to those of women who are not detected for drinking and driving. Concern for themselves as well as family and friends was also substantial among women who participated in this study. Not only did women express concern about the potential negative consequences associated with driving after drinking for themselves, it was notable that these women reported that they did not think about potentially harming or injuring someone else until after the fact. There was also a high level of awareness of strategies that could be used to avoid driving after drinking or riding as a passenger of a drinking driver. Top strategies included: the use of personal limits, planning ahead, the buddy system, having a designated driver, changing social circles, using a personal breathalyzer, and reaching out for help and sobriety, although some women noted important barriers to the use of these strategies. Notably, alternative transportation options were not identified as a relevant strategy, and this may be due to the safety concerns that women associate with this strategy. There were also some significant barriers to discussion among women about drinking and driving, and riding as a passenger of a drinking driver that emerged from this study. While most of the women expressed a strong desire for conversation about this topic among women, many of them also acknowledged that they were not informed about the facts to help start a conversation, and that they lacked the skills to discuss this topic. Stigma and shame was also a perceived barrier to discussing this issue with family and friends. While many of the women in this study had some knowledge in relation to each of the six topic areas that were explored, there were also some important gaps in knowledge that can contribute to women choosing to drive after drinking or ride as a passenger of a drinking driver. In particular, effort is needed to correct a common misperception among women that they are able to consume one drink per hour and still drive safely. In addition, messages are needed to increase awareness among women that their subjective estimates of their own level of intoxication are often incorrect, and to improve knowledge about important factors that affect how women metabolize alcohol as compared to men as well as about factors that contribute to women being more impaired after consuming the same amount of alcohol. Messages that are more relevant to the personal experiences of women and that acknowledge the reasons that they may choose to drink and drive or ride as a passenger of a drinking driver would be welcome. Women also agreed that prevention messaging that acknowledges the pressure that women may experience to drink more alcohol in different situations would be helpful. In addition, important gaps in strategies for women to avoid drinking and driving or riding as a passenger of a drinking driver were revealed, although some of these gaps, such as safety concerns associated with alternative transportation options, will be more challenging to overcome. These findings can help inform the development of drinking and driving prevention campaigns for women. Results provide insight regarding the types of knowledge and content that should be included in prevention messaging, important features of prevention messaging that is more appropriate for women and potential ways that such messaging should be delivered. (Author/publisher)
Abstract