Prochaska model of behavior change targets college students marijuana-impaired driving

Study will create targeted interventions to change behavior in college students

Concerns about marijuana-impaired driving have increased in recent years in the United States. With about half of the nation’s states having legalized recreational use of marijuana – including Rhode Island in 2022 – groups such as the National Highway Traffic Safety Administration have sounded the alarm about driving under the influence of cannabis. 

No group may be more at-risk than college students, less experienced behind the wheel and more prone to risky behavior. In a 2020 survey, about 44% of college students reported using marijuana during the previous year, up from 38% five years earlier. In a separate study, about 29.9% of college students said they had driven under the influence of cannabis – increasing the risk of an accident for these young drivers.

University of Rhode Island psychology professor Andrea Paiva is hoping to help reduce the prevalence of this at-risk behavior and is undertaking a new study that will inform tailored interventions to promote behavior change.

“Marijuana use among college students remains a prevalent public health issue with associated risks including impaired driving,” said Paiva. “The goal of this work is to lay the foundation for developing an intervention to reduce the prevalence of driving under the influence of marijuana. 

“The college years are a period of significant behavioral and lifestyle change,” she added. “Intervening now can have long-lasting effects on individuals’ habits and decision-making processes.”

Paiva has studied health behavior change for more than 20 years. Launched recently, her project, “Applying the Transtheoretical Model to Develop Measures for Readiness for Reduction of Marijuana Use and Driving After Use Among College Kids,” aligns with her goal to develop interventions that reduce the harm associated with risky behaviors.

To develop targeted interventions, Paiva will use the Transtheoretical Model, which provides a framework for assessing and promoting behavior change. Pioneered by renowned URI psychology professor James Prochaska and colleagues about 50 years ago, the model is useful in helping people to change their behavior in stages to achieve better health. Paiva has personally applied to the model on more than 20 behaviors.

The model identifies the stages of change, helping to understand where a person falls within the stages and their readiness to change behavior. Targeted interventions can then be developed to address specific barriers and motivators relevant to each stage, increasing the likelihood of success. “Understanding and enhancing readiness to change these behaviors is critical for developing targeted interventions,” she said.

While the model has been successfully applied to help change many behaviors – including smoking, substance abuse, and depression – it’s yet to be used on marijuana use and driving, Paiva said. “The model offers a structured framework for understanding and facilitating behavior change, making it particularly suitable for addressing cannabis-impaired driving among college students,” she added.

Working with several undergraduate students – including Public Policy Lab fellows Julianna Rodrigues and Jackson Diehl – Paiva will review existing model-based measures and how they can be applied to substance-abuse behaviors. The researchers will also use focus groups of college students to learn their attitudes, beliefs, and behaviors related to marijuana use and driving. They will develop a survey aligned with the model’s conceptional elements that will be piloted with a sample of college students. 

Paiva was recently awarded a Public Policy Lab Fellowship from URI’s Social Science Institute for Research, Education and Policy for the project. 

“Public Policy Lab fellows conduct applied research that is important for community-based organizations and/or state and local government agencies,” said Julie Keller, director of the institute. “For her study, Paiva and her students are partnering with MADD RI [Mothers Against Drunk Driving-Rhode Island] to identify specific ways that the advocacy work of this organization can benefit from this research.”

“I work closely with MADD RI, which focuses on the reduction of impaired driving,” Paiva said. “They are expanding their work to include cannabis and driving and we will work together to see how these missions can be incorporated.”