A Scoping Review of Determinants of Drinking and Driving Behavior among Young Adult College Students in the US

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

I was pleased to read the manuscript entitled "A scoping review of determinants of drinking and driving behavior among young adult college students in the US" and to review it.

The study objective was to synthesize existing literature to identify factors influencing the prevalence of drinking and driving (DAD) behaviors among college students. The scoping review identified several determinants of DAD among college students in the US, across a range of studies from 2011 to 2021.

The chosen topic is very interesting not only from a theoretical point of view, but also from a practical point of view. The overall impression on the article is positive, the authors have a noticeable professional insight into the problem and a high writing style. The chosen topic is relevant for the journal and can attract the attention of readers. To my knowledge, no similar review has been published so far.

The article is written in the typical format recommended by the PRISMA guidelines. However, some parts of the article are debatable or require correction. Thus, several comments or suggestions can be made.

Title – the title is informative and attracts readers' attention.

Abstract – the abstract is more or less complete and adequately reflects the content of the manuscript, however, research findings and conclussions should be highlighted.

Keywords – it should be revised to avoid compound constructions and repetitions of individual words (for example, 'driving').

Introduction – it provide sufficient theoretical background for the study. All examined research questions and/or hypotheses were introduced and backed by literature. Relevant and unbiased literature was used. The introduction is structured logically and the text is fluent. The rationale of the study is well described and the study problem is stated clearly. The multifaceted purpose of the study is revealed. However, it is still difficult to see the relationship between the topic "determinants of drinking and driving" in the title of the article and the tasks raised here.

Materials and Methods – These are clearly described and are appropriate to answer the proposed research questions. The PRISMA flow diagram is presented.

Results – In general, results are clearly organized and presented. A total of 23 studies from a variety of geographical contexts across the US were included in the final literature review. Thus, reviewed material is abundant. It is structured in a table.

Discussion – supported by the results. The study findings are discussed with relevant literature. It includes also Implications for research and practice with the limits of the study. However, we would like the authors to discuss each risk factor in more detail.

Conclusions – the conclusions must be substantially revised. They must answer the objectives. The content of the presented conclusions is more like implications than conclusions. However, it would be worth pointing out what are the most important risk factors of drinking and driving.

References – references must be submitted according to journal requirements.

General comment – I recommend avoiding complex sentences, some sentences are difficult to understand, for example "The studies offer insights into the patterns, determinants, and implications of DAD among college students. captured data on college students' DAD behavior which may re-sult in RTAs [46], hence the need for this review.".

Thank you for considering my opinion. I encourage authors to keep on working to improve the manuscript.

Author Response

RESPONSE 1: Thank you for the positive feedback on the manuscript as well as the thoughtful comments on the paper.

Title – the title is informative and attracts readers' attention.

Abstract – the abstract is more or less complete and adequately reflects the content of the manuscript, however, research findings and conclusions should be highlighted.

RESPONSE 2: Thank you for the suggestion. We have highlighted the main results and conclusions in the abstract.

Keywords – it should be revised to avoid compound constructions and repetitions of individual words (for example, 'driving').

RESPONSE 3: This is a good suggestion and we have revised our keywords accordingly.

Introduction – it provide sufficient theoretical background for the study. All examined research questions and/or hypotheses were introduced and backed by literature. Relevant and unbiased literature was used. The introduction is structured logically and the text is fluent. The rationale of the study is well described and the study problem is stated clearly. The multifaceted purpose of the study is revealed. However, it is still difficult to see the relationship between the topic "determinants of drinking and driving" in the title of the article and the tasks raised here.

RESPONSE 4: Thank you for the feedback. We have reformatted the introduction to make the relationship between the topic of the article and the tasks of the review better aligned.

Materials and Methods – These are clearly described and are appropriate to answer the proposed research questions. The PRISMA flow diagram is presented.

RESPONSE 5: Thank you for the comment.

Results – In general, results are clearly organized and presented. A total of 23 studies from a variety of geographical contexts across the US were included in the final literature review. Thus, reviewed material is abundant. It is structured in a table.

RESPONSE 6: Thank you for the feedback.

Discussion – supported by the results. The study findings are discussed with relevant literature. It includes also Implications for research and practice with the limits of the study. However, we would like the authors to discuss each risk factor in more detail.

RESPONSE 7: We appreciate the reviewer's feedback regarding the need for a more detailed discussion of each risk factor identified in the review. In response to this suggestion, we have revised the discussion section to provide additional details for identified risk factor, supported by the study findings and relevant literature.

Conclusions – the conclusions must be substantially revised. They must answer the objectives. The content of the presented conclusions is more like implications than conclusions. However, it would be worth pointing out what are the most important risk factors of drinking and driving.

RESPONSE 8: Thank you for the recommendation. We acknowledge the distinction between implications and conclusions and agree that the conclusions should succinctly summarize the key findings and identify the most important risk factors of drinking and driving (DAD) among college students. In response to the reviewer's comment, we have revised the conclusion section to provide more focused and conclusive statements that directly address the study objectives and highlight the most salient risk factors identified in our review.

References – references must be submitted according to journal requirements.

RESPONSE 9: Thank you for bringing this oversight to our attention. We have updated the manuscript to conform to journal requirements where appropriate.

General comment – I recommend avoiding complex sentences, some sentences are difficult to understand, for example "The studies offer insights into the patterns, determinants, and implications of DAD among college students. captured data on college students' DAD behavior which may result in RTAs [46], hence the need for this review."

RESPONSE 10: Thank you for bringing this to our attention. We have reviewed and revised the manuscript to improve its readability.

Thank you for considering my opinion. I encourage authors to keep on working to improve the manuscript

RESPONSE 11: We appreciate the critical appraisal and thoughtful suggestions to improve the manuscript.

 

Reviewer 2 Report

Comments and Suggestions for Authors

This manuscript provides an excellent review of the sub-topics it considered.  However, it has taken an exclusively back-ended approach to the issues it raises.  The "front end" issue of the incessant and pervasive targeting of college-age populations to the intense marketing by the alcoholic beverage industry, with the use of social media, on-site promotions and give-aways, psychological manipulation, and glamorization of intoxicated behaviors, especially as concerns potential sexual attractiveness, do not seem to have been considered.  Please address these concerns in a more comprehensive revision. 

Author Response

RESPONSE: Thank you for your insightful feedback on our manuscript. We appreciate your attention to the broader contextual factors influencing drinking behaviors among college students. We agree that the marketing tactics employed by the alcoholic beverage industry, particularly those targeting college-age populations through social media, promotions, and etc. play a significant role in shaping drinking norms and behaviors. However, our review did not identify any such factors as predictors of drinking and driving—the focus of our review paper. Nevertheless, we have updated the discussion section to acknowledge this point and recommend future research related to alcohol-induced behaviors such as drinking and driving.

 

Reviewer 3 Report

Comments and Suggestions for Authors

The manuscript has a number of strengths: a well-defined research question, an in-depth and comprehensive search of the literature, and a thoughtful synthesis of the existing evidence regarding the determinants of drinking and driving behavior among US college students. The use of the Social Ecological Model (SEM) framework helps the authors organize their results to ensure a clear and systematic presentation.

The main research question addressed in this manuscript is to identify the determinants (i.e., risk and protective factors) influencing the prevalence of drinking and driving (DAD) behavior among college students and young adults in the United States.

The topic is of very high relevance to public health and the field of research in substance abuse. Although some of the early research has examined the determinants of DAD among college students, it is important to review the research so it will categorize determinants into intrapersonal/psychological, interpersonal/social, environmental, and policy-related factors in a categorization that is both comprehensive and updated. What makes this study particularly valuable is its focus on the intricate interplay of these determinants and the emphasis placed on informing targeted interventions and policies.

Compared to other published material, this study gives the most recent and comprehensive analysis of the determinants of DAD among college students. The authors, using the Social Ecological Model (SEM) as the guiding framework, present clear visibility of a number of factors influencing this risky behavior at different levels in a very systematic way. The study also discusses emerging issues that the current knowledge base could have, therefore laying the way forward for concurrent substance use and identifying gaps for future research efforts.

The conclusions presented in the study are consistent with the evidence and arguments presented throughout the paper. The authors justify the high degree of complexity of determinants that influence DAD behaviors among college students by calling for multi-component intervention strategies that deal with individual, social, environmental, and policy-related factors. The conclusions also speak to the importance of targeted interventions on college campuses and that institutions of higher education can play a role by promoting changes and raising awareness among healthcare providers.

The references cited in the review are extensive and largely relevant to the topic. This confirms the extensive use of literature from a variety of sources, including seminal works, recent studies, and relevant reports from government agencies and other respectable organizations. The references are very wide and cover all aspects concerning DAD among college students, such as prevalence, risk factors, consequences, and intervention strategies.
The tables and figures are informative and well-organized.

However, there is very little further clarification needed, with minor clarifications that may contribute to and increase the quality and impact of the manuscript.

1. The introduction is wordy and imprecise. The following modifications should be undertaken in the introduction: remove some of the background information that was given and state, with clarity, the objectives of this scoping review.

2. Methods: Briefly describe how article screening and data extraction were done. Also, briefly review how the disagreements between the reviewers and the synthesis of data were done.
a. Provide more details on the article screening and data extraction processes, including how disagreements between reviewers were resolved.
b. Discuss the potential limitations of the included studies, such as reliance on self-reported data and the cross-sectional nature of most studies, and how these might impact the interpretation of the findings.
c. A clearer description of how the article screening and data extraction were conducted, including how discrepancies from the reviewers should be handled if they disagree on the suitability of the articles for inclusion. Some potential limitations of the included studies should be highlighted, such as the common reliance on self-reported data and the cross-sectional nature of most studies and how these could affect the interpretation of the findings.

3. Results: Use subheadings within each level of the SEM framework to improve readability and help guide the reader through the findings.

4. Implication: Elaborate on the implications of the findings for prevention and intervention strategies. Discuss possible contributions of this study to the field and provide more detailed recommendations for future research based on the above-mentioned identified gaps in the literature.

5. Limitations: Possible shortcomings not only of the considered scoping review methodology but also of the included studies are to be presented and discussed more critically. It will be taken into consideration how the limitations had an impact on the interpretation and generalizability of the findings.

Author Response

RESPONSE 1: Thank you for the positive feedback and time spent reviewing our manuscript.

RESPONSE 2: We have revised the introduction to streamline the narrative and now clearly state the objectives of the review.

RESPONSE 3: Section 2.2 of the methods provides details on article screening and extraction. We have included additional details to clarify how disagreements were resolved and how data were synthesized.

RESPONSE 4: Thank you for the comment. While we included the limitations of included studies in section 4.2, we have updated this section to include details on how this may impact the interpretation of results.

RESPONSE 5: Please see above responses.

RESPONSE 6: Subsection headings 3.1-3.4 describe each level of the SEM framework to organize results according to the SEM framework.

RESPONSE 7: We appreciate the reviewer's thoughtful feedback and recognize the importance of elaborating on the implications of our findings for prevention and intervention strategies, as well as providing more detailed recommendations for future research. In our revised manuscript, we expand upon the discussion to highlight the practical applications of our findings and offer recommendations for addressing the identified gaps in the literature (see sections 4.1 and 4.2).

RESPONSE 8: Please see above responses and revisions to the manuscript.

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for providing this improved revision.  However, I am somewhat disappointed at the down-playing if the important, real-time and persistent influence of exposure to all of the various marketing programs that bombard college-age individuals.  I fear that all of the efforts you have encouraged will continue to be overwhelmed by the huge investments in promotion by the alcoholic beverage industry.

 

PS:  on line 130, instead of "inputted into" do you not mean "entered"?