Predictors of drinking patterns in adolescence: a latent class analysis

Empirical analysis of health-related behaviors among older Hakka adults: a latent class analysis

Background

Little is known about health-related behaviors of the older Hakka population in China. We aimed to explore the characteristics and correlates of health-related behaviors among older Hakka adults.

Methods

We used data from the China's Health-Related Quality of Life Survey for Older Adults 2018. Latent class analysis (LCA) defined latent classes of health-related behaviors for 1,262 older Hakka adults aged 60 and above. Generalized linear regression and multinomial logistic regression analysis were used to identify factors influencing the number and the latent classes of health-related behaviors, respectively.

Results

The LCA showed that the latent classes could be stratified as the risk group (14.82%), healthy group (55.71%), and inactive group (29.48%). Sex, age, years of education, current residence, living arrangement, average annual household income, and currently employed were associated with the number of healthy behaviors. Compared with the participants in the healthy group, widowed/others (OR = 5.85, 95% CI = 3.27, 10.48), had 15,001-30,000 (OR = 2.05, 95% CI = 1.21, 3.47) and 60,001 or higher (OR = 3.78, 95% CI = 1.26, 11.36) average annual household income, and currently employed (OR = 3.40, 95% CI = 1.99, 5.81) were highly associated with risk group. Additionally, the participants who are widowed/others (OR = 4.30, 95% CI = 2.70, 6.85) and currently employed (OR = 1.95, 95% CI = 1.27, 2.98) were highly associated with the inactive group.

Conclusion

This study identified factors specifically associated with older Hakka adults' health-related behaviors from an LCA perspective. The findings indicate that policymakers should give more attention to older adults living alone and implement practical interventions to promote health-related behaviors among them.

The socio-ecological context of U.S. college student drinking: A latent class analysis

BACKGROUND

U.S. college student drinking typologies often consider quantity and frequency but not the socio-environmental contexts in which students obtain alcohol and drink. Understanding context could be important for preventive interventions.

METHODS

We used latent class analysis (LCA), a person-centered approach to understanding behavior patterns, to identify drinking typologies among 1390 college student drinkers from a representative survey at two interconnected private colleges in the Northeast. Classes were derived from drinking frequency and quantity as well as how students obtain alcohol, where they drink, and their perceptions of peer drinking. Resulting classes were correlated with demographic and developmental characteristics, participation in campus activities and connectedness, and alcohol consequences and protective behaviors.

RESULTS

Four distinct drinking profiles emerged. 'Tasters' (n = 290) included infrequent and low quantity drinkers who drank in dorms with alcohol provided by others. 'Bargoers' (n = 271) included low quantity and moderate frequency drinkers who purchased their own alcohol and drank at bars. 'Partiers' (n = 483) included moderate frequency and quantity drinkers who obtained alcohol from several sources and drank in many locations. 'Bingers' (n = 345) included high frequency and quantity drinkers and binge drinkers, who drank in many locations with alcohol obtained from multiple sources. Classes differed in demographics, age of first drink, campus activities and connectedness, alcohol protective behaviors, and alcohol problems.

CONCLUSION

Heterogeneous patterns of drinking based on quantity, frequency and social/environmental context emerged and suggested the need for different tailored interventions.

Alcohol dependence and heavy episodic drinking are associated with different levels of risk of death or repeat emergency service attendance after a suicide attempt

BACKGROUND

Alcohol use is a multidimensional risk factor for suicidal behaviour. However, suicide prevention strategies often take 'one-size-fits-all' approaches to alcohol use, reflecting an evidence base built on unidimensional measures. Latent Class Analysis can use a range of measures to differentiate distinct patterns of alcohol using behaviour and their associated risks.

METHODS

We analysed Electronic Health Record data from 650 suicidal adults detained for up to 36 h using police powers (Section 136 of the Mental Health Act 1983, amended 2007) to facilitate psychiatric assessment at a Health-Based Place of Safety, a dedicated emergency psychiatric care centre in London, UK. We conducted a Latent Class Analysis of alcohol using behaviours at first detention, and used multivariable logistic regression to estimate the association of each identified latent class with subsequent death or recontact with emergency psychiatric care over a median follow-up of 490 days, adjusting for sex, age and past-year psychiatric diagnosis.

RESULTS

Three classes of alcohol use were identified: low risk drinkers, heavy episodic drinkers and dependent drinkers. The dependent drinking class had twice the odds of death or recontact with emergency psychiatric care as the low risk drinking class (OR 2.32, 95 %CI 1.62-3.32, p < 0.001). Conversely, the heavy episodic drinking class was associated with lower odds of death or recontact than the low risk drinking class (OR 0.66, 95 %CI 0.53-0.81, p < 0.001).

CONCLUSIONS

The risk of adverse outcomes after a suicide attempt are not uniform for different alcohol use classes. Clinical assessment and suicide prevention efforts should be tailored accordingly.

Co-occurrence subgroups of child sexual abuse, health risk behaviors and their associations among secondary school students in China

BACKGROUND

Little is known on the co-occurrence and heterogeneity of child sexual abuse (CSA) or health risk behavior (HRB) prevalence nor the associations among the victims.

OBJECTIVES

To detect the prevalence and subgroups of adolescents reporting CSAs or HRBs, and to examine the association between the subgroups.

METHODS

Participants were secondary school students in a national survey in China (N = 8746). Self-reported CSA and HRB experiences were collected through a computer assisted questionnaire. Prevalence and confidence intervals were calculated. Multigroup latent class analysis (LCA) was used to examine latent subgroups of CSA and HRB. Dual latent class regression analysis was used to examine the association between CSA and HRB classes.

RESULTS

A total of 8746 students participated in our study. The prevalence of having ever experienced any of the reported seven CSA items was 12.9%. The preferred LCA model consisted of a three-class CSA latent variable, i.e. "Low CSAs"(95.7% of the total respondents), "Verbal or exhibitionism CSAs"(3.3%), and "high multiple CSAs" (1.1%); and a three-class HRB latent variable, i.e. "Low HRBs"(70.5%), "externalizing HRBs" (20.7%), and "internalizing HRBs" (8.7%). Students in the "Verbal or exhibitionism CSAs" or "high multiple CSAs" classes had higher probabilities of being in "externalizing HRBs" or "internalizing HRBs" classes. The probabilities were higher in "high multiple CSAs" class(male externalizing OR 4.05, 95%CI 1.71-9.57; internalizing OR 11.77, 95%CI 4.76-29.13; female externalizing OR 4.97, 95%CI 1.99-12.44; internalizing OR 9.87, 95%CI 3.71-26.25) than those in "Verbal or exhibitionism CSA"(male externalizing OR 2.51, 95%CI 1.50-4.20; internalizing OR 3.08, 95%CI 1.48-6.40; female externalizing OR 2.53, 95%CI 1.63-3.95; internalizing OR 6.05, 95%CI 3.73-9.80).

CONCLUSIONS

Prevalence of CSA items varies. Non-contact CSAs are the most common forms of child sexual abuse among Chinese school students. There are different latent class co-occurrence patterns of CSA items or HRB items among the respondents. CSA experiences are in association with HRB experiences and the associations between latent classes are dose-responded. Multi-victimization has more significantly negative effects. The results could help identify high-risk subgroups and promote more nuanced interventions addressing adverse experiences and risk behaviors among at-risk adolescents.

The impact of an alcohol policy change on developmental trajectories of youth alcohol use: examination of a natural experiment in Canada

OBJECTIVES

In 2015, the Liquor Control Board of Ontario (LCBO) authorized sale of alcohol in some Ontario grocery stores. This research evaluates the impact of the new policy on alcohol use patterns of youth in a quasi-experimental setting with two control groups.

METHODS

The sample consists of 2267 grade 9 students attending 60 secondary schools across Ontario (n = 56) and Alberta (n = 4), who provided 4-year linked longitudinal data (2013-2014 to 2016-2017) in the COMPASS study. The study used the frequency of drinking and the frequency of binge drinking to characterize alcohol use behaviours.

RESULTS

Latent transition analysis found four statuses of alcohol use: abstainer, periodic drinker, low-risk drinker, and high-risk regular drinker. The new policy had no negative impact among periodic and low-risk drinkers, but the risk of transitioning from the abstainer (lowest risk status) to high-risk regular drinker (highest risk status) among the exposed cohort was 1.71 times greater post-policy than pre-policy change, compared with those of Ontario-unexposed (0.50) and Alberta-unexposed cohorts (1.00). The probability of sustaining high-risk drinking among the exposed cohort increased by a factor of 1.76, compared with 1.13-fold and 0.89-fold among the Ontario-unexposed and Alberta-unexposed cohorts, respectively.

CONCLUSION

Youth are more likely to transition from abstinence to high-risk regular drinking, and high-risk regular drinkers are more likely to maintain their behaviours in the jurisdictions exposed to the latest change in LCBO policy authorizing grocery stores to sell alcohol. When formulating policy interventions, youth access to alcohol should be considered in order to reduce their harmful alcohol consumption.

Patterns of Cancer-Related Risk Behaviors Among Construction Workers in Hong Kong: A Latent Class Analysis Approach

Background

Hong Kong's construction industry currently faces a manpower crisis. Blue-collar workers are a disadvantaged group and suffer higher levels of chronic diseases, for example, cancer, than the wider population. Cancer risk factors are likely to cluster together. We documented prevalence of cancer-associated lifestyle risk behaviors and their correlates among Hong Kong construction workers.

Methods

Data were collected from workers at 37 railway-related construction worksites throughout Hong Kong during May 2014. Tobacco use, alcohol consumption, unbalanced nutrition intake, and physical inactivity were included in the analysis. Latent class analysis and multivariable logistic regression were performed to identify the patterns of risk behaviors related to cancer, as well as their impact factors among construction workers in Hong Kong.

Results

Overall, 1,443 workers participated. Latent class analysis identified four different behavioral classes in the sample. Fully adjusted multiple logistic regression identified age, gender, years of Hong Kong residency, ethnicity, educational level, and living status differentiated behavioral classes.

Conclusion

High levels of lifestyle-related cancer-risk behaviors were found in most of the Hong Kong construction workers studied. The present study contributes to understanding how cancer-related lifestyle risk behaviors cluster among construction workers and relative impact factors of risk behaviors. It is essential to tailor health behavior interventions focused on multiple risk behaviors among different groups for further enlarging the effects on cancer prevention.

Belief patterns and drug use in a sample of Brazilian youth: an exploratory latent class analysis

Objective:

Adolescent substance abuse is a public health concern worldwide, and its prevention is the subject of numerous programmatic efforts. Yet, little research exists on the structure of drug-related belief patterns in youth and their utility in preventive program planning. The aim of this study is to determine the structure of drug-related beliefs among 12-15-year-old students in Brazil using latent class analysis.

Methods:

De-identified survey data were obtained from the baseline sample (n=6,176) of a randomized controlled trial on the #Tamojunto drug use prevention program in Brazilian middle schools. Using 11 survey items assessing drug-related beliefs as indicators, four models were run and assessed for goodness-of-fit. For the best fitting model, demographic variables and substance use across latent classes were assessed.

Results:

Model fit statistics indicated that the best fit was a three-class solution, comprising a large Drug-Averse Beliefs class (80.9%), a smaller Permissive Beliefs class (12.7%), and an Inconsistent Beliefs class (6.4%). Respondents in the Permissive Beliefs and Inconsistent Beliefs classes reported greater past-year drug use, were slightly older and less likely to be female than those in the Drug-Averse Beliefs class.

Conclusions:

These results indicate that conceptualizing drug beliefs as a categorical latent variable may be useful for informing prevention. Longitudinal studies are needed to establish temporality and assess further applicability of this construct.

[Patterns of Drinking Behaviors and Predictors of Class Membership among Adolescents in the Republic of Korea: A Latent Class Analysis]

PURPOSE

Despite the high drinking rates and the complexity of drinking behaviors in adolescents, insufficient attention has been paid to their drinking patterns. Therefore, we aimed to identify patterns of adolescent drinking behaviors and factors predicting the distinct subgroups of adolescent drinking behaviors.

METHODS

We analyzed nationally representative secondary data obtained in 2017. Our final sample included 24,417 Korean adolescents who had consumed at least one glass of alcohol in their lifetime. To investigate patterns of drinking behaviors, we conducted a latent class analysis using nine alcohol-related characteristics, including alcohol consumption levels, solitary drinking, timing of drinking initiation, and negative consequences of drinking. Furthermore, we investigated differences in demographics, mental health status, and characteristics of substance use across the latent classes identified in our study. To do so, we used the PROC LCA with COVARIATES statement in the SAS software.

RESULTS

We identified three latent classes of drinking behaviors: current non-drinkers (CND), binge drinkers (BD), and problem drinkers (PD). Compared to the CND class, both BD and PD classes were strongly associated with higher academic year, lower academic performance, higher levels of stress, suicidal ideation, lifetime conventional or electronic cigarette use, and lifetime use of other drugs.

CONCLUSION

Health professionals should develop and implement intervention strategies targeting individual subgroups of drinking behaviors to obtain better outcomes. In particular, health professionals should consider different characteristics across subgroups of adolescent drinking behaviors when developing the interventions, such as poor mental health status and other substance use among binge and problem drinkers.

Heterogeneity in the Co-occurrence of Substance Use and Posttraumatic Stress Disorder: A Latent Class Analysis Approach

Objective: Posttraumatic stress disorder (PTSD) often co-occurs with substance use (SU). Although there has been independent research on subgroups of participants based on their PTSD or SU responses, rarely are PTSD-SU typologies examined consistent with a precision medicine approach (and corresponding person-centered statistical approaches). The current study examined the nature and construct validity (covariates of depression, physical aggression, verbal aggression, anger, hostility, reckless and self-destructive behaviors [RSDB]) of the best-fitting latent class solution in categorizing participants based on PTSD (PTSD Checklist for DSM-5) and alcohol/drug use responses (Alcohol Use and Disorders Identification Test Alcohol Consumption Questions, Drug Abuse Screening Test). Methods: The sample included 375 trauma-exposed participants recruited from Amazon's Mechanical Turk online labor market. Results: Latent class analyses indicated an optimal three-class solution (low PTSD/SU, moderate PTSD/drug and high alcohol, and high PTSD/SU). Multinomial logistic regressions indicated that depression (OR = 1.22) and frequency of RSDBs (OR = 1.20) were significant predictors of the moderate PTSD/drug and high alcohol class versus the low PTSD/SU class. Depression (OR = 1.55) and frequency of RSDBs (OR = 1.19) were significant predictors of the high PTSD/SU class versus the low PTSD/SU class. Only depression (OR = 1.27) was a significant predictor of the high PTSD/SU class versus the moderate PTSD/drug and high alcohol class. Conclusions: Results provide construct validity support for three meaningful latent classes with unique relations with depression and RSDBs. These findings improve our understanding of heterogeneous PTSD-SU comorbidity patterns and highlight acknowledgment of such subtyping (subgrouping) in considering differential treatment options, treatment effectiveness, and resource allocation.

Associations between young adult men's patterns of alcohol use and sexual behavior: A latent profile analysis of two independent samples

Men's alcohol consumption and casual sexual behavior peak in early adulthood. Although there is a strong positive association between these behaviors, most studies have utilized a between-subjects approach rather than a person-centered approach to assess this relationship. A person-centered approach allows for an examination of subgroups of drinkers that may differ in their casual sexual behaviors. To address this gap, secondary data analyses were conducted with two independent samples totaling 906 men between the ages of 18 and 29 from the Midwestern United States. In both studies, participants reported their alcohol expectancies and consumption, sexual behaviors, and sexual attitudes. Multiple group latent profile similarity analyses were conducted using the alcohol-related variables. Four similar profiles emerged in both samples; thus, the data were combined. Casual sex-related variables were then examined in relation to the profiles. The two lighter drinking groups differed from one another in their alcohol consumption and sexual attitudes; however, they did not differ in their alcohol expectancies or number of sex partners. The two heavier drinking groups differed from one another in their liquid courage expectancies, alcohol consumption, one-time-only partners, and sexual attitudes; however, they did not differ from each other in their sex-drive expectancies or lifetime partners. Person-centered approaches can be used to develop more tailored interventions, particularly for those at greater risk for the negative health consequences of engaging in sexual behavior with multiple one-time-only partners.

Self-efficacy, sensation seeking, right attitude, and readiness to change among alcohol drinkers in a Thai vocational school

Introduction

The prevalence of alcohol use in teenagers has been increasing every year. The majority of alcohol drinkers were vocational students when compared with other educational settings. Sixty percent of Thai vocational students were found to use alcohol.

Methods

Our research was a cross-sectional study in 306 vocational students, using the Alcohol Consumption Questionnaire, the ASSIST-Y (Alcohol, Smoking, and Substance Involvement Screening Test-Youth) screening tool and a self-administered questionnaire. The association between alcohol drinking with sensation seeking, self-efficacy, right attitude and readiness to change factors were analyzed by binary logistic regression.

Results

Most students were males (57.5%) and 15–17 years of age (70.9%). Seventy-six-point eight percent of vocational students were in the lifetime drinker group. The binge drinker group was 32.7% and 10.5% were classified in a light drinker group. Sensation seeking was strongly associated with the binge drinker group and the light drinker group, especially the disinhibition dimension (adjusted odds ratio [OR] = 1.64, 95% CI: 1.34–2.00 and [OR] = 1.57, 95% CI: 1.19–2.06, respectively).

Conclusions

Our research found sensation seeking, especially the disinhibition dimension was a significant factor for monitoring drinking behavior. We recommended that every vocational student should be monitored for sensation seeking factors.

•

The sensation seeking was the factor that significantly increased the risk of binge drinking.

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The disinhibition dimension was strongly associated with alcohol drinking.

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The self-efficacy and right attitude toward substance use were the protective factors for binge drinking.

Multiple brief interventions in police custody: The MuBIC randomized controlled study for primary prevention in police custody. Protocol and preliminary results of a feasibility study in the Paris metropolitan area, France

BACKGROUND

The 15- to 35-year-old population has little contact with the health care system and is exposed to risk factors. Several studies demonstrated the feasibility of brief interventions (BIs) in different settings, e.g., in addiction medicine during police custody, where arrestees are entitled to a medical examination. Approximately 700,000 individuals are detained in police custody in France annually, and custody is an opportunity for young people to be medically examined. The characteristics of the detainees and previous experience with BIs suggest that custody is an opportunity to contribute to primary prevention. We propose to investigate the feasibility of such a contribution.

OBJECTIVES

The aim of this article is to present a study protocol and some preliminary results. The primary research objective is to assess the feasibility of performing brief interventions without a specific topic in police custody settings in arrestees aged 15-35 years. The secondary research objectives include i) testing four strategies for engaging in BIs that maximize the chances of success of the BI; ii) identifying the determinants that can orient the practitioner's choice to use a specific strategy over another one; and iii) analysing the differences between individuals who engage in BIs and those who do not and, in those who do engage, the determinants of success of the intervention.

METHODS

A two-step randomized and prospective study: i) randomization of eligible patients into 4 groups of 500 patients each; analysis of the response rates for each strategy; performance of the BI; and analyses of the associated factors and ii) a real-life, full-scale phase study evaluating the effectiveness of BIs performance of the BI; and analyses of the interventions. Analyses of the determinants of a positive response to BI, of success and of the topic of intervention will be conducted.

EXPECTED RESULTS

The rates of BI performed, rates of success, and characteristics associated with response and with success are the main expected results. Additionally, the development and assessment of filter questions and an improved BI dedicated to primary prevention for police custody settings will be attained.

Uneven progress in reducing exposure to violence at home for New Zealand adolescents 2001-2012: a nationally representative cross-sectional survey series

OBJECTIVE

To explore trends, and identify risk factors, that may explain changes in adolescent exposure to family violence over time.

METHODS

Data for this study was drawn from the Youth 2000 series of cross-sectional surveys, carried out with New Zealand high school students in 2001, 2007 and 2012. Latent class analysis was used to understand different patterns of exposure to multiple risks for witnessing violence at home among adolescents.

RESULTS

Across all time periods, there was no change in witnessing emotional violence and a slight decline in witnessing physical violence at home. However, significant differences were noted between 2001 and 2007, and 2007 and 2012, in the proportion of adolescents who reported witnessing emotional and physical violence. Four latent classes were identified in the study sample; these were characterised by respondents' ethnicity, concerns about family relationships, food security and alcohol consumption. For two groups (characterised by food security, positive relationships and lower exposure to physical violence), there was a reduction in the proportion of respondents who witnessed physical violence but an increase in the proportion who witnessed emotional violence between 2001 and 2012. For the two groups characterised by poorer food security and higher exposure to physical violence, there were no changes in witnessing of physical violence in the home. Implications for public health: In addition to strategies directly aimed at violence, policies are needed to address key predictors of violence exposure such as social disparities, financial stress and alcohol use. These social determinants of health cannot be ignored.

New Zealand adolescents' concerns about their alcohol use and access to services: Associations with ethnicity and other factors

Using a national survey of 8,500 New Zealand high school students, we investigated adolescents' concerns about their drinking, associated factors including help-seeking preferences and access to health care services, and how these varied by ethnicity and level of socioeconomic deprivation. Approximately 23.9% of the 3,704 current drinkers reported concerns (i.e., being worried about their drinking and/or having tried to cut down). Regression analyses revealed that Māori and Pacific youth were more likely than their New Zealand European peers to be concerned about their drinking. Concerned drinkers were more likely than nonconcerned drinkers to report hazardous drinking behaviors and alcohol-related problems, but these associations varied by age, ethnicity, and socioeconomic deprivation. Help-seeking preferences differed strongly by ethnicity. Concerned drinkers, and Māori and Pacific drinkers, were more likely to report difficulties accessing health care and alcohol and drug services. The factors associated with adolescents' drinking concerns and paradoxical difficulties accessing health care highlight the importance of engaging adolescents in developing responsive and equitable services.

Factors Associated With Levels of Risky Drinking in Adolescent Alcohol Users in Taiwan: A Secondary Data Analysis

BACKGROUND

Drinking is largely viewed as a socialized behavior; however, our understanding of factors associated with levels of risky drinking is limited in cultures where underage drinking is relatively unacceptable.

PURPOSE

The aims of this study were to define the different levels associated with risky drinking and to examine the factors that are associated with these levels.

METHODS

We used data from the Child and Adolescent Behavior in Long-Term Evolution project. Of the 2184 students who participated in the 2006 Child & Adolescent Behavior in Long-Term Evolution survey, 1591 self-reported prior use of alcohol and had complete questionnaire data that could be used in secondary data analysis. The main study variables that were used in this study to assess levels of risky drinking included frequency of drinking, amount of drinking, and frequency of intoxication. We used ordinal logistic regression to analyze the relationships between levels of risky drinking and associated factors.

RESULTS

In the study sample, 9.55% were classified with high-risk drinking behavior, 22.51% were classified with medium-risk drinking behavior, and 67.94% were classified with low-risk drinking behavior. Having a mother or peers who used alcohol, being encouraged to consume alcohol by older adults or peers, high alcohol availability, high positive alcohol expectancies, low negative alcohol expectancies, and low alcohol refusal efficacy were all associated with higher levels of risky drinking.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Decreasing the availability of alcohol, developing appropriate alcohol expectancies, and increasing alcohol refusal skills may help decrease the development of high-risk drinking behavior in adolescents. Our study furthers the understanding of underage alcohol use in societies with low alcohol consumption.

Mapping risk factors for substance use: Introducing the YouthMap12

BACKGROUND

In adolescence, psychological problems and regular use of alcohol, cigarettes, cannabis and other drugs (AOD) tend to cluster together, strongly indicating that certain groups of young people are at elevated risk of developing a problematic use of AOD.

OBJECTIVE

The aim of the present study was to develop an easy-to-implement screening instrument to identify subgroups of young people with different psychological problems at risk of problem use of AOD.

METHOD

3589 randomly selected young Danes between 15 and 25years of age, from a national survey (n=2702) and a municipality survey (n=887), answered a 12-item questionnaire (YouthMap12) with 6 items identifying externalizing problems (EP6) and 6 items identifying internalizing problems (IP6). Latent class analysis (LCA) was used to characterize groups at risk, and associations were estimated between EP6 and IP6 and regular use of AOD, and between latent class membership and regular use of AOD.

RESULTS

LCA identified 6 classes with varying degrees of externalizing and internalizing problems: 70% of youth were in the low problem score class, and the remaining 30% were at various levels of risk. Regular use of cigarettes, cannabis and alcohol was strongly associated with classes characterized by externalizing problems, while over-the-counter and prescription medicine was strongly associated with classes characterized by internalizing problems.

CONCLUSIONS

Youth at risk of problem use of AOD can be identified using a simple and easily administered instrument.

An Empirical Assessment of the Sensitivity of Mixture Models to Changes in Measurement

The current study explored the extent to which variations in self-report measures across studies can produce differences in the results obtained from mixture models. Data (N = 854) come from a laboratory analogue study of methods for creating commensurate scores of alcohol- and substance-use-related constructs when items differ systematically across participants for any given measure. Items were manipulated according to four conditions, corresponding to increasing levels of alteration to item stems, response options, or both. In Study 1, results from latent class analyses (LCA) of alcohol consequences were compared across the four conditions, revealing differences in class enumeration and configuration. In Study 2, results from factor mixture models (FMM) of alcohol expectancies were compared across two of the conditions, revealing differences in patterns and magnitude of the factor loadings and thresholds. The results suggest that even subtle differences in measurement can have substantively meaningful effects on mixture model results.

Exploring Parental Influence on the Progression of Alcohol Use in Mexican-Heritage Youth: a Latent Transition Analysis

Mexican-heritage youth are members of the fastest growing minority group and are at particular risk for substance use including alcohol consumption. Youth face numerous risk factors including positive descriptions of substance use on media and peer offers that are potentially ameliorated by parental anti-substance use socialization efforts. Guided by primary socialization theory and the theory of planned behavior, the present study posited eight research questions to identify discrete subgroups/patterns of Mexican-heritage youth alcohol use behavior and parental influence on youth outcomes. Longitudinal survey data (n = 1147) from youth in 29 public schools located in Phoenix, Arizona, were collected over 3 years. Latent class and transition analyses identified four discrete subgroups characterized by response patterns of alcohol use behaviors and perceptions in Mexican-heritage youth: (1) non-drinker, (2) potential drinker, (3) experimenter, and (4) regular drinker. Targeted parent-child communication about alcohol and parental monitoring were found to be significant predictors for youth alcohol use. Research implications and future directions are suggested.

Adolescents’ experiences and perceived (dis)advantages of the three main outlet types for alcohol purchases

Based on the existing literature, relevant determinants of availability for on-premises locations, off-premises locations, and the Internet were qualitatively explored and categorized by “experts” consisting of underage alcohol purchasers. In total, 14 focus group discussions were conducted with 94 Dutch adolescents. For on-premises locations, the high prices were perceived as the biggest disadvantage, and the ease to circumvent legal age limits as the biggest advantage. For off-premises locations, the cheap pricing was perceived as the most positive aspect, and the legal age limit as the biggest disadvantage. For online purchases, the waiting time was perceived as the most negative aspect, and the proximity of online stores as the biggest advantage.

Population Behavior Patterns in Response to the Risk of Influenza A(H7N9) in Hong Kong, December 2013-February 2014

Background

A novel avian influenza A(H7N9) virus, first identified in Mainland China in February and March 2013, caused an outbreak in humans in April and May, 2013. Closure of live poultry markets in some affected cities dramatically reduced numbers of cases during summer of 2013, but the epidemic resurged during the winter 2013–14, increasing reported cases to 393 in Mainland China as of 30 March 2014.

Purpose

The study aimed to explore population behavior patterns responding to an epidemic of influenza A(H7N9) virus.

Method

Three cross-sectional surveys were conducted among 1000, 680, and 1011 respondents in December 2013, January 2014, and February 2014, with response rates of 68.0, 64.4, and 66.6 %, respectively, in Hong Kong. Adults were recruited and interviewed using random digit-dialing telephone survey. Latent class analysis was employed to explore heterogeneity in protective behavior patterns across the three surveys. Multinomial regression models were developed to determine factors associated with latent class membership.

Results

Three comparable latent classes were identified across the three surveys: Moderate hygiene compliance (Class 1), High hygiene compliance (Class 2), and Vigilance (Class 3). The prevalence of Class 1 was 48–52 % across the three surveys while Class 3 prevalence increased significantly from 13 % in the Dec-2013 survey to 20 % in the Feb-2014 survey. Compared with Class 1, Class 3 were more likely to be female, older, better educated, married, perceive higher susceptibility to H7N9, attribute greater severity to H7N9, report higher current worry, and anticipated worry about H7N9 infection.

Conclusion

The three classes reflect different levels of adoption of protection and thereby may have different levels of vulnerability toward contracting H7N9 infection. It appears that as the epidemic intensifies, Class 2 (Good hygiene compliance) members are likely to transfer to Class 3 (Vigilance) while Class 1 (Moderate hygiene compliance) could be unchanged. The young, mostly single males and those with lower educational achievement represent a group for whom public health messages need to be targeted.

Correlates of problematic unrecorded alcohol consumption in Sikkim, Northeast India - Results from a cross-sectional pilot survey

The magnitude and consequences of unrecorded alcohol consumption, defined as home brewed or clandestinely produced illicit liquor or surrogate alcoholic beverage has been little investigated in India. A significant portion of all alcohol consumed globally is unrecorded, therefore these consumers constitute a significant population. Sikkim, a province in Northeast India, lies in the foothills of the Himalayas. Unrecorded alcohol use is traditionally prevalent, with more than ten types available. This study investigated correlates of problematic unrecorded alcohol consumption in rural and urban communities of Sikkim. A cross-sectional, community-based pilot survey was conducted. Intensive case-finding recruited current heavy users (at least 3 days/week) of unrecorded alcohol of either sex above 16 years of age. On enrolment, participants responded to a socio-demographic instrument including 12 questions on their pattern of alcohol consumption and a 4-item CAGE questionnaire. Alcohol problems exist significantly among the young adult population. Although consumption of unrecorded alcohol is traditional in Sikkim, it has emerged as an important public health problem, with alarmingly high rates of problematic consumption. This is also expected to have significant economic costs. Therefore, prevention and treatment measures are an urgent need as well as policy decisions on production and sales of unrecorded alcohol.

Parental monitoring and family relations: associations with drinking patterns among male and female Mexican students

INTRODUCTION

Parental monitoring and family relations are recognized as protective factors for youth alcohol use. The purpose of this study was to investigate perceived parental monitoring and family relations among subgroups of Mexican youths with different patterns of drinking behaviors and consequences.

METHODS

A latent profile analysis (LPA) identified profiles of drinking behavior in a cross-sectional survey of entering first year university students. Multinomial regression examined associations between parental monitoring, family relations and drinking profiles among 22,224 students.

RESULTS

Both lower perceived parental monitoring and weaker perceived family relations were associated with heavier drinking profiles among males and females, but more strongly associated with female than male heavier drinking profiles. Being older, having parents with lower education, and not living with parents were also associated with lower parental monitoring and weaker family relations. There was a general trend of lower parental monitoring and weaker family relations as the profiles increased from Non/Infrequent-No Consequences to Excessive-Many Consequences Drinkers. Lower perceived parental monitoring and weaker perceived family relations were more strongly associated with drinking profiles among females than among males. Both the parental monitoring and family relations scales had similar associations with drinking profiles.

CONCLUSIONS

Findings suggest that drinking norms and values may contribute to any protective influences of parental monitoring and family relations on Mexican youths' drinking. Research about changes in drinking norms, contextual factors, and youth-parent trust would inform the utility of parental monitoring or family relations as protective strategies against alcohol misuse among Mexican and Mexican American youths and also youths from other backgrounds.

Adolescent alcohol-drinking frequency and problem-gambling severity: adolescent perceptions regarding problem-gambling prevention and parental/adult behaviors and attitudes

BACKGROUND

The study examined in adolescents how alcohol-drinking frequency relates to gambling-related attitudes and behaviors and perceptions of both problem-gambling prevention strategies and adult (including parental) behaviors/attitudes.

METHODS

A survey assessing alcohol, gambling, and health and functioning measures in 1609 high school students. Students were stratified into low-frequency/nondrinking and high-frequency-drinking groups, and into low-risk and at-risk/problematic gambling groups.

RESULTS

High-frequency drinking was associated with at-risk/problematic gambling (χ(2)(1,N = 1842) = 49.22, P < .0001). High-frequency-drinking versus low-frequency/nondrinking adolescents exhibited more permissive attitudes towards gambling (e.g., less likely to report multiple problem-gambling prevention efforts to be important). At-risk problematic gamblers exhibited more severe drinking patterns and greater likelihood of acknowledging parental approval of drinking (χ(2)(1, N = 1842) = 31.58, P < .0001). Problem-gambling severity was more strongly related to gambling with adults among high-frequency-drinking adolescents (odds ratio [OR] = 3.17, 95% confidence interval [95% CI] = [1.97, 5.09]) versus low-frequency/nondrinking (OR = 1.86, 95% CI = [0.61, 2.68]) adolescents (interaction OR = 1.78, 95% CI = [1.05, 3.02]).

CONCLUSIONS

Interrelationships between problematic drinking and gambling in youth may relate to more permissive attitudes across these domains. Stronger links between at-risk/problem gambling and gambling with adults in the high-frequency-drinking group raises the possibility that interventions targeting adults may help mitigate youth gambling and drinking.

Multiple substance use patterns in adolescents-A multilevel latent class analysis

BACKGROUND

Multiple substance use among adolescents is associated with a number of negative consequences. Therefore, we aim to investigate multiple substance use patterns among young adolescents and identify possible multilevel predictors.

METHODS

We analyzed a longitudinal sample of 2490 German students (51% male; Mage=13.32, SD=0.57) at 45 schools in four German states (Bremen, Hesse, North Rhine-Westphalia, Schleswig-Holstein), who completed two assessments in fall, 2010 and fall, 2013. We conducted multilevel latent class analysis for follow-up data on a variety of outcomes, and tested our final 3-class-model for possible baseline predictors. Follow-up substance use measures included lifetime use, current use, and amount of substance for cigarettes and alcohol. Baseline covariates comprised age, gender, socio-economic status, bullying, victimization, peer and parental use, type of school, and health certification of school.

RESULTS

We identified three latent classes: non-users (n=1541; 61.9%), experimenters (n=722; 29.0%), and multiusers (n=227; 9.1%). Experimental consumption was predicted by higher baseline age (OR=1.71; 1.31-2.24), paternal drinking (OR=2.89; 1.23-6.79), and school type (OR=2.57; 1.83-3.61), while multiuse was predicted by peer smoking (OR=2.94; 1.80-4.80) and drinking (OR=2.13; 1.32-3.44), maternal drinking (OR=6.26; 2.02-19.43), bullying (OR=1.69; 1.15-2.48), higher age (OR=1.92; 1.40-2.62), and school type (OR=4.76; 2.75-8.24) compared to the non-users class.

CONCLUSIONS

Prevention and further research on multiple substance use need to concentrate on social influence models and behavior-related interventions, especially at schools without a college-preparatory track.

Gestational Alcohol Exposure and Other Factors Associated With Continued Teenage Drinking

Purpose A longitudinal cohort of adolescents who initiated drinking before age 15 were studied to determine which factors distinguished between early initiators who continued to drink (persisters) from those who stopped drinking (desisters). There were 308 early initiators in the total sample (n = 917); 247 were persisters, and 61 were desisters. Method A stepwise discriminant analysis identified differences between the two groups. Considered risk/protective factors were parenting practices, peer drinking, child and maternal depression, child behavior, prenatal alcohol exposure, home environment, and demographic factors. Results Desistence was significantly related to African American race and more parental strictness. Exposure to ≥1 drink/day during pregnancy and high levels of autonomy from parents were significant predictors of persistent drinking. Conclusions Early initiation places adolescents at risk for continued and heavier drinking. Identifying characteristics of those who start early but do or do not continue drinking can inform education programs to better target the most appropriate adolescents.

The stability of alcohol consumption between age 16 and 26: Evidence from a National Birth Cohort Study

This study examined the association between moderate drinking at age 16 (adolescence) and alcohol consumption at age 26 (young adulthood), whilst controlling for possible confounding effects at the individual and family level (assessed at birth and age 10). Using the British Cohort Study (BCS70), 6515 respondents provided data on their adolescent alcohol consumption and other behaviours. Of these, 4392 also completed the survey at age 26. Consumption patterns established in adolescence persisted, to a large degree, into early adulthood. Those adolescents who drank moderately in adolescence drank significantly less in adulthood than those adolescents who drank to heavy or hazardous levels. Implications for health promotion strategies and guidance are discussed.

Adolescent Alcohol Use Patterns From 25 European Countries

This study’s purpose is to describe European adolescents’ alcohol use patterns by grouping adolescents regarding their current alcohol use by cluster analysis (CA). Discriminant and latent profile analyses (LPA) evaluate and validate the solution that will be described further by ANOVAs. From 25 European countries, 57,771 students (49.4% male, 13.87 years) are grouped using hierarchical and k-means clustering. Alcohol use is measured by frequency of drinking occasions during the previous month and number of beverages consumed on the last drinking occasion. CA suggests four drinking patterns: mild (73.6%), episodic (20.0%), frequent (3.8%), and heavy episodic use (2.5%). Discriminant analysis attests a classification reliability of 94%, and confirmatory LPA replicates the cluster solution with a satisfying model fit. Three of the found patterns fulfill criteria for heavy drinking and underline the importance of individualized indicated prevention by promoting responsible use.

Daily tobacco smoking, heavy alcohol use, and hashish use among adolescents in southern Sweden: A population-based multilevel study

Introduction

The aim of this study was to investigate school contextual effects on daily tobacco smoking, heavy alcohol use and hashish use among adolescents, using multilevel analyses adjusting for individual-level factors.

Methods

The 2012 public health survey among adolescents in Skåne includes pupils in ninth grade in primary school (predominantly 15–16 years old) and second grade in secondary school (gymnasium) (predominantly 17–18 years old). Multilevel logistic regressions were performed.

Results

The prevalence of all three behaviors was higher in the second grade in the gymnasium. Several sociodemographic, psychosocial and parental factors were associated with these behaviors. In the ninth grade, variance partition coefficients (VPCs) for tobacco smoking decreased from 10.2% in the empty model to 1.9% in the fully adjusted model, for heavy alcohol use from 6.5% to 6.3%, while VPCs for hashish increased from 9.9% to 11.0%. In the second grade, VPCs for daily tobacco smoking decreased from 13.6% in the empty model to 6.5% in the fully adjusted model, VPCs for heavy alcohol use decreased from 4.6% to 1.7%, and VPCs for hashish use increased from 7.3% to 8.3%.

Conclusions

Daily tobacco smoking (in both grades) and heavy alcohol use in the second grade in the gymnasium may be preventable by actions directed against individual-level protective factors including social capital, social support and peer/parent behavior and attitude, while interventions directed at school contexts may be more important for alcohol use in the ninth grade and hashish use in both grades.

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Smoking (both grades) and alcohol use (higher grade) depend on individual factors.

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Alcohol use (lower grade) and hashish use (both grades) depend more on school context.

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Trust is associated with all three behaviors, with the exception of hashish use in higher grade.

The Hawke's Bay Condom Card Scheme: a qualitative study of the views of service providers on increased, discreet access for youth to free condoms

OBJECTIVES

The incidence of sexually transmitted infections and unplanned pregnancies in adolescence is of concern. The Hawke's Bay District Health Board, New Zealand, set up a pilot condom card scheme ('the Scheme') to allow 13- to 24-year-olds, deemed suitable for the Scheme, to access free condoms from pharmacies on presentation of a Condom Card. Our study explored the views of service providers of a pilot Condom Card Scheme.

METHODS

Qualitative interviews were conducted with 17 service providers (nurses, pharmacists, pharmacy staff) between February and April 2013.

KEY FINDINGS

Our findings showed that the Scheme was viewed positively by service providers, who indicated almost universal support for the Scheme to continue. However, participants noted a perceived lack of advertising, low number of sites for collection of condoms, lack of flexibility of the Scheme's criteria relating to who could access the scheme and issues with some pharmacy service providers, all of which led to a number of recommendations for improving the Scheme.

CONCLUSIONS

The views of service providers indicate broad support for the continuation of the Scheme. Canvassing young people's suggestions for improving the Scheme is also essential.

Perceived quality of social relations and frequent drunkenness: a cross-sectional study of Spanish adolescents

AIM

The aim of the study was to examine, for female and male students separately, whether perceived quality of relationships with peers and parents and relations in school predict self-reported frequent drunkenness among Spanish adolescents.

METHODS

The Spanish data from the Health Behaviour in School-aged Children Study (HBSC) 2010 survey were used including 1177 female and 1126 male students aged between 15 and 16 years.

RESULTS

For both genders, students reporting low school satisfaction had increased odds of frequent drunkenness. Among females, low and medium levels of classmate support were associated with decreased odds of frequent drunkenness, whereas low perceived maternal knowledge as well as medium and low satisfaction with the family increased odds of being frequently drunk. The proportion of male students reporting medium satisfaction with friendships had significantly lower odds of frequent drunkenness compared with those with high level of satisfaction with friendships.

CONCLUSION

We found different associations between perceived quality of social relations and frequent drunkenness among male and female students. Results showed that social relations seemed to better predictors of frequent drunkenness among female than male students and that other factors than social relations may contribute to explain excessive alcohol use among Spanish adolescents.