Familial aggregation of traffic injury related risky behaviors

Abstract

Introduction and Objectives: A key approach to reducing and managing diseases and crashes is to focus on identifying and, minimizing modifiable risk factors including associated high-risk behaviors. Behavior represents the most intricate phenotype that can be examined. Despite numerous studies investigating the prevalence of high-risk traffic and non-traffic associated behaviors and the environmental factors influencing their occurrence, there is a scarcity of research on the existence of family aggregation of high-risk traffic and non-traffic associated behaviors. Therefore, this study aims to explore the familial aggregation of risky traffic and non-traffic behaviors for father-child, mother-child, siblings, and spouses. Material and Methods: The present study was conducted in two phases: 1- Developing a comprehensive tool for identifying high-risk behaviors and 2- Assessing family aggregation patterns and determining the geographical distribution of high-risk traffic and non-traffic behaviors. This cross-sectional study took place in Tabriz city in 2023. The source population was the family medicine clinic at Asadabadi Hospital. In this study, the heads of households were chosen as proband. Probands were randomly selected from the daily client list, and if they agreed to take part in the study, their first-degree family members (wife and children) were then invited. The Generalized Estimating Equations (GEE) was employed to assess family aggregation among spouses, father-children, mother-children, and siblings. Results: The ICC for the core component, optional component, and the total tool were calculated as (ICC=0.86, 95% CI: (0.79-0.91)), (ICC=0.88, 95% CI: (0.81-0.92)), and (ICC=0.87, 95% CI:(0.82-0.92)), respectively, with an overall Cronbach's alpha of 0.85. In this study the response rate was 95.6%. The familial aggregation of risky driving behavior among father-offspring was 1.69 (OR= 1.69, 95% CI: (0.84-3.29)) in total score, 1.79 (OR= 1.76, 95% CI: (1.02-3.04)) in violations subscale, 1.23 (OR= 1.23, 95% CI: (1.30-3.81)) in slip subscale, and 1.06 (OR= 1.06, 95% CI: (0.56-2)) in lapse subscale. Significant familial aggregation was found between mothers-children (OR= 1.33, 95% CI: (1.1-1.86)), as well as between fathers-children (OR= 1.4, 95% CI: (1.06-2.01)), and in the total score of high-risk traffic behaviors among pedestrians. There was a notable familial aggregation between fathers-children in terms of alcohol consumption (OR=1.98, 95% CI: (1/08-2/5). The northwest, southwest, and khavaran were identified as the top two regions for exhibiting numerous high-risk behaviors. Conclusion and Discussion: The Persian version of this tool was introduced as a valid and reliable tool for evaluating high-risk behaviors. According to the findings of this study, familial aggregation was found to be associated with many high-risk traffic and non-traffic behaviors. The most significant family aggregation was observed between fathers-children and siblings. Therefore, regardless of the genetic or environmental factors contributing to these family aggregation, family members play a crucial role in the occurrence and severity of risky behaviors on each other. This study showed that implementing family-based interventions alongside broader interventions targeting the general population in societies is crucial. Additionally, the high prevalence of multiple risk factors in certain areas of Tabriz municipality suggests that these areas should be prioritized for supportive actions and environmental improvements.