The role of neighborhood in urban black adolescent marijuana use

Using EMA to explore the role of Black adolescents' experiences in activity spaces in momentary negative emotion and marijuana use

Research examining the role of place in Black adolescents' health behaviors typically examines neighborhoods, with little attention paid to micro geographies such as activity spaces. Understanding experiences in activity spaces may be especially important for Black adolescents living in neighborhoods traditionally characterized as disadvantaged. The SPIN project recruited 75 Black adolescents living in a single neighborhood to complete ecological momentary assessments (EMA) about the activity spaces they encountered over a month. Perceptions of violence and social support in activity spaces in a day are related to marijuana use during the day, relationships partially explained by negative momentary emotions.

Examination of the Relationship Between Daily Perceptions of Collective Efficacy and Marijuana Use Among Black Youth: Does the Location of the Perception Matters?

Neighborhood-level collective efficacy protects Black youth from substance use; however, neighborhood research does not account for the entirety of adolescents' exposure or their perceptions of space which may be critical to understanding the role of context in substance use. To address this limitation, the SPIN Project recruited 65 Black adolescents (M(SD) = 15.32(1.06)) to complete four brief surveys each day for a month describing their perceptions of spaces and marijuana use. Multilevel negative binomial models were estimated to test the relationship between an individual's perceptions of collective efficacy and the marijuana used during a day, and if the location of the observations moderated these relationships. Findings indicated that the perceptions of collective efficacy protected adolescents from marijuana use when occurring within their home neighborhood, but not outside of it; thereby suggesting important variations in adolescents' perceptions based on the location that matter for Black youth marijuana use.

How Community and Individual Risk Factors Mutually Impact Youth's Perceived Safety: A Syndemic Analysis Using Structural Equation Modeling

The purpose of this study was to evaluate the mutual impact of community and individual factors on youth's perceptions of community safety, using structural equation modeling (SEM) conceptualized by syndemic theory. This study used survey data collected from a county wide sample of middle and high school students (N=25,147) in West Central Florida in 2015. The outcome variable was youth's perceptions of community safety. Predictors were latent individual and community factors constructed from 14 observed variables including gun accessibility, substance use, depressive symptoms, and multiple neighborhood disadvantage questions. Three structural equation models were conceptualized based on syndemic theory and analyzed in Mplus 8 using weighted least squares (WLS) estimation. Each model's goodness of fit was assessed. Approximately seven percent of youth reported feeling unsafe in their community. After model modifications, the final model showed a good fit of the data and adhered to the theoretical assumption. In the final SEM model, an individual latent factor was implied by individual predictors measuring gun accessibility without adult's permission (β=0.70), sadness and hopelessness (β=0.52), alcohol use (β=0.79), marijuana use (β=0.94), and illegal drug use (β=0.77). Meanwhile, a community latent factor was indicated by multiple community problems including public drinking (β=0.88), drug addiction (β=0.96), drug selling (β=0.97), lack of money (β=0.83), gang activities (β=0.90), litter and trash (β=0.79), graffiti (β=0.91), deserted houses (β=0.86), and shootings (β=0.93). A second-order syndemic factor that represented the individual and community factors showed a very strong negative association with youth's safe perception (β=-0.98). This study indicates that individual risk factors and disadvantaged community conditions interacted with each other and mutually affected youth's perceptions of community safety. To reduce these co-occurring effects and improve safe perceptions among youth, researchers and practitioners should develop and implement comprehensive strategies targeting both individual and community factors.

Spatial and temporal pattern of cannabis use disorder in California 2010-2019

As cannabis use is being legalized in an increasing number of states, it is important to understand the changing dynamic of the risk in cannabis use disorder (CUD). Shape-based time-series clustering was used to identify ZIP Code Tabulation Areas (ZCTAs) with similar changing pattern in CUD over time. We conducted a cross-sectional logistic regression analysis to investigate the most recent ZCTA socio-demographic characteristics in relation to the changing CUD rates. The emergency discharge rates generally increased during 2010-2016. Increase during 2017-2019 was found in Sacramento and Santa Barbara County. Approximately 13% of ZCTAs showed an increasing trend of hospitalization discharge during 2017-2019. Males and non-Hispanic Black had larger increase than other groups during 2017-2019. The recent growing trend was found associated with greater racial diversity and rural ZCTAs. The findings from this study hold promise for local public health officials to adjust the cannabis intervention strategies in target districts and improve overall health outcomes.

Conceptualizing the Socio-Built Environment: An Expanded Theoretical Framework to Promote a Better Understanding of Risk for Nonmedical Opioid Overdose Outcomes in Urban and Non-Urban Settings

Nonmedical opioid (NMO) use has been linked to significant increases in rates of NMO morbidity and mortality in non-urban areas. While there has been a great deal of empirical evidence suggesting that physical features of built environments represent strong predictors of drug use and mental health outcomes in urban settings, there is a dearth of research assessing the physical, built environment features of non-urban settings in order to predict risk for NMO overdose outcomes. Likewise, there is strong extant literature suggesting that social characteristics of environments also predict NMO overdoses and other NMO use outcomes, but limited research that considers the combined effects of both physical and social characteristics of environments on NMO outcomes. As a result, important gaps in the scientific literature currently limit our understanding of how both physical and social features of environments shape risk for NMO overdose in rural and suburban settings and therefore limit our ability to intervene effectively. In order to foster a more holistic understanding of environmental features predicting the emerging epidemic of NMO overdose, this article presents a novel, expanded theoretical framework that conceptualizes "socio-built environments" as comprised of (a) environmental characteristics that are applicable to both non-urban and urban settings and (b) not only traditional features of environments as conceptualized by the extant built environment framework, but also social features of environments. This novel framework can help improve our ability to identify settings at highest risk for high rates of NMO overdose, in order to improve resource allocation, targeting, and implementation for interventions such as opioid treatment services, mental health services, and care and harm reduction services for people who use drugs.

Subtypes of Bullying and Types of Substance Use among Urban African American Adolescents: Who Is Likely to Use What?

The present study examined the types of drugs likely to be used by bullies, victims, and bully/victims. Participants comprise African American adolescents from three high schools, one youth church group, two community youth programs, and four public venues in low-income communities in Chicago's Southside. A series of logistic regression analyses and latent class analyses were employed. Victims are likely to use alcohol, marijuana, and lean/krokodil. Bullies were likely to use alcohol and marijuana. Bully/victims were not at risk of any of the substances. Our LCA findings revealed a lower occurrence of substance use among victims although 30% used alcohol and marijuana; more than half of bullies showed high levels of alcohol, marijuana, and lean/krokodil use; a diverse pattern of drug use was shown among bully/victims although their lean/krokodil and crack/cocaine use was higher than other subgroups of bullying. The drugs of choice for African American bullies, victims, or bully/victims are variable.

Neighborhood disadvantage moderates the effect of a mobile health intervention on adolescent depression

This study leverages data from a pilot randomized controlled trial to investigate whether the effectiveness of a text-delivered mHealth intervention targeting adolescent depression and anxiety differs according to residential- and activity space-based measures of exposure to community-level socioeconomic disadvantage. For depression, we find that intervention efficacy is significantly stronger for youth residing in more disadvantaged neighborhoods, even after controlling for individual level socioeconomic status, as well as marginal moderating effects of activity space-based neighborhood disadvantage on treatment efficacy. We do not find evidence of treatment efficacy moderation by neighborhood disadvantage regarding anxiety. While the generalizability of our findings is restricted to this sample and for this intervention, this research serves as a motivating example and initial evidence for how mHealth intervention efficacy can vary by characteristics of the environment, in particular community-level disadvantage. Future clinical research should investigate whether the effectiveness of mHealth interventions may be enhanced by personalization based on an individual's contextual environmental exposures.

Predictors of Early-Onset Cannabis Use in Adolescence and Risks for Substance Use Disorder Symptoms in Young Adulthood

Early detection of risks for substance use disorders is essential to lifelong health and well-being for some youth. Very early-onset use is proposed as an indicator of risk for substance use disorders, but risk and protective factors related to early-onset use have not been identified. The current study compared risk and protective factors that distinguish early- and late-onset cannabis users from abstainers using data collected from a large community sample. The study also examined onset-group differences in participants’ reports of substance use disorder symptoms a decade later. Heavy episodic drinking (early-onset: OR = 7.29 CI = [1.60, 33.19]) and engagement with peers involved in deviant behaviors (early-onset: OR = 2.50 CI = [1.50, 4.13]) are risk factors for early-onset cannabis use. Protective factors, including parent monitoring (early-onset: OR = 0.73 CI = [0.58, 0.93]), engagement with peers involved in positive behaviors (early-onset: OR = 0.54 CI = [0.39, 0.76]), school engagement (early-onset: OR = 0.83 CI = [0.72, 0.96]), and academic grades (early-onset: OR = 0.37 CI = [0.21, 0.65]) also predicted early versus later onset-group differences. Early age of onset may be distinctly related to risk and protective factors previously associated with risks for substance use in all adolescents.

A review investigating the relationship between cannabis use and adolescent cognitive functioning

Given varying state-level laws regarding cannabis use, the objective of the review was to summarize contemporary literature on the relationship between adolescent cognitive function and academic performance with cannabis use. Frequency and quantity of cannabis use were associated with decreased functional connectivity of the brain. Earlier age at cannabis initiation and more frequent use was associated with poorer executive control and academic performance. Social determinants such as minimal parental monitoring, peer use and low social cohesion were associated with more frequent adolescent use. Race/ethnicity and residence were other factors influencing cannabis use. To prevent cannabis use disorders among adolescents, interventions should aim to prevent early initiation that can lead to chronic use in youth who may be more at risk.

Local variation in cannabis use patterns among young adults in the San Francisco Bay Area

This study evaluated whether neighborhood-level disorder, social cohesion, and perceived safety, were associated with days of cannabis use in the prior month in a representative sample of young adults in Alameda and San Francisco Counties in California (N = 1272). We used multiscale geographically weighted regression, modeled by county, to measure associations between cannabis use days and neighborhood attributes, adjusting for sociodemographic characteristics and self-rated health. Positive associations were found between number of cannabis use days and neighborhood disorder, and greater perceived safety. Higher levels of social cohesion predicted fewer cannabis use days. Racial/ethnic, sex and, socioeconomic compositions of participants residing in areas with significant neighborhood-level associations varied substantially, suggesting that risk factors for young adult cannabis use may be highly localized. Public health efforts in cannabis education and intervention should be tailored to fit the culture and composition of local neighborhoods.

Residential Greenspace and Urban Adolescent Substance Use: Exploring Interactive Effects with Peer Network Health, Sex, and Executive Function

While urban greenspace is increasingly recognized as important to mental health, its role in substance use is understudied. This exploratory study investigates the interaction of greenspace with peer network health, sex, and executive function (EF) in models of substance use among a sample of disadvantaged, urban youth. Adolescents and their parents were recruited from a hospital in the mid-Atlantic region of the U.S. Residential greenspace at the streetscape level was derived from analysis of Google Street View imagery. Logistic regression models were used to test the moderating effect of greenspace on the association between peer network health and substance use, as well as additional moderating effects of sex and EF. The significant negative association of peer network health with substance use occurred only among youth residing in high greenspace environments, a moderating effect which was stronger among youth with high EF deficit. The moderating effect of greenspace did not differ between girls and boys. Greenspace may play an important role in moderating peer influences on substance use among disadvantaged, urban adolescents, and such moderation may differ according to an individual's level of EF. This research provides evidence of differences in environmental susceptibility regarding contextual mechanisms of substance use among youth, and it informs the development of targeted substance use interventions that leverage social and environmental influences on adolescent substance use.

Drifting Tobacco Smoke Exposure among Young Adults in Multiunit Housing

This study evaluated young adults' exposure to drifting secondhand smoke in San Francisco County housing units using the 2014 Bay Area Young Adult Health Survey (N = 1363). Logistic and geographically weighted regression models were used to determine whether residing in multiunit housing or in areas with greater neighborhood disorder were risk factors for exposure, and how drifting smoke exposure varied spatially within San Francisco County. Residing in buildings with five or more units significantly increased the odds of reporting drifting smoke exposure [OR (3.5 1.3, 9.9)], but neighborhood disorder did not have a significant association in the fully adjusted logistic regression model. At the local level, however, neighborhood disorder was significantly associated with exposure in lower income residential and downtown areas. Multiunit housing was significantly associated with exposure across all neighborhoods.

Recreational Marijuana Legalization and Use Among California Adolescents: Findings From a Statewide Survey

OBJECTIVE

The legalization of recreational marijuana use and retail sales raises concerns about possible effects on marijuana use among adolescents. We evaluated the effects of recreational marijuana legalization (RML) in California in November 2016 on use among adolescents and investigated subgroup differences in these effects.

METHOD

We analyzed data from successive cross-sectional samples of 7th, 9th, and 11th grade students (N = 3,330,912) who participated in the California Healthy Kids Survey from 2010-2011 to 2018-2019. Participants reported grade, sex, ethnicity, race, and lifetime and past-30-day marijuana use.

RESULTS

Multilevel analyses showed that RML was associated with increases in the likelihood of lifetime (odds ratio = 1.18, 95% CI [1.15, 1.21], p < .01) and past-30-day marijuana use (odds ratio = 1.23, 95% CI [1.20, 1.26], p < .01) relative to previous downward trends. RML was more strongly associated with increases in prevalence of marijuana use among 7th versus 9th and 11th graders, females versus males, non-Hispanic versus Hispanic youth, and White versus African American, American Indian/Native Alaskan, and multiracial youth. Overall, RML was not significantly associated with frequency of past-30-day use among users, although stronger positive associations between RML and frequency of use were found for 11th graders, Asian Americans, and African Americans. The association was weaker for females.

CONCLUSIONS

RML in California was associated with an increase in adolescent marijuana use in 2017-2018 and 2018-2019. Demographic subgroup differences in these associations were observed. Evidence-based prevention programs and greater local control on retail marijuana sales may help to reduce marijuana availability and use among adolescents.

Influence of Family and Community Socioeconomic Status on the Risk of Adolescent Drug Use

Background: Adolescent drug use increases the risk of mental, physical and social problems later in life and so it is important to understand its complex etiology that likely includes socioeconomic status (SES). We undertook the present analysis using data from a population-based retrospective cohort study to examine the influence of family and community SES in relation to adolescent drug use. We hypothesized that lower levels of community and parental SES would increase the risk of use and that there would be stronger associations for the more proximate family-level factors. Methods: We used self-administered questionnaires (N=1,402) to obtain information on use of marijuana, inhalants, heroin, cocaine/crack, psychedelics/hallucinogens, Ritalin without a prescription, and club drugs during adolescence. Family SES was gathered from birth certificate data on maternal educational level and paternal occupation. Community SES characteristics at birth, age 10 and age 18 were obtained from the US Census Bureau. Results: An increased risk of adolescent drug use was associated with lower maternal education, non-white collar occupations among fathers, and lower community median income, and poverty and unemployment levels at age 18. The strongest associations were seen for the use of multiple drugs (Risk Ratio (RR): 1.7, 95% CI: 1.4-2.2), inhalants (RR: 2.5, 95% CI: 1.5-2.2), crack/cocaine (RR: 2.8, 95% CI: 1.7-4.5), psychedelics/hallucinogens (RR: 1.8, 95% CI: 1.4-2.4), and club/designer drugs (RR: 1.8, 95% CI: 1.2-2.7) among adolescents whose mothers had only a high school education. Conclusions: These results suggest that use of certain drugs during adolescence is associated with both family and community SES measures. However, maternal education appears to have the greatest influence on use, suggesting that a multi-level approach that engages mothers is needed to prevent adolescent drug use.

Adolescent Depression and Substance Use: the Protective Role of Prosocial Peer Behavior

Adolescents with depression disorders have higher rates of substance use. In order to advance contextually relevant mental health interventions, basic research is needed to test social ecological mechanisms hypothesized to influence adolescent depression and substance use. Accordingly, we conducted growth curve modeling with a sample of 248 urban adolescents to determine if depression's effect on substance use was dependent upon peer network health (sum of peer risk and protective behaviors) and activity space risk (likelihood of high-risk behaviors at routine locations). Results showed that peer network health moderated the effects of depression on substance use, but this effect was not altered by activity space risk. These findings suggest the importance of peer network health relative to depression and substance use, particularly for young adolescents.

Perceived neighborhood disorder and frequency of marijuana use among emerging adult African American females

Emerging adult African American females are at increased risk for cannabis use disorders. Ecological models suggest that African Americans' increased risk for substance use disorders and associated adverse outcomes may result from chronic exposure to contextual disadvantages, such as living in economically deprived and disorganized communities. However levels of vulnerability for developing cannabis use disorders vary, even among residents of disadvantaged neighborhoods. Therefore, studies focused on within group differences are necessary. This study examined the relationship between frequency of marijuana use and perceived neighborhood disorder. The sample included 117 African American emerging adult females (M_age = 23.6 ± 3.4). After providing informed consent, participants completed a semi-structured interview that included the Neighborhood Environment Scale and a self-report measure of marijuana use. Additionally, participants provided a urine sample that was tested for the presence of psychoactive drugs. 46% tested positive for marijuana and 45% reported using marijuana in the past 30 days. 27% reported frequent/heavy use. Results from multinomial logistic regression analysis indicated a significant relationship between perceived neighborhood disorder and heavy marijuana use (AOR = 3.3; 95% CI = 1.06 - 10.29). Findings suggest African American emerging adult female residents of economically disadvantaged neighborhoods who appraise their environments as disorganized may be at heighten risk for problematic marijuana use and should be targeted for intervention. Moreover, the findings support the need for multi-systems interventions. As policy makers consider the legalization of marijuana, it is important that differences in marijuana use behaviors and negative outcomes across groups and contexts are taken into consideration.

Polygenic and environmental influences on the course of African Americans' alcohol use from early adolescence through young adulthood

The study examined (a) whether alcohol use subgroups could be identified among African Americans assessed from adolescence through early adulthood, and (b) whether subgroup membership was associated with the interaction between internalizing symptoms and antisocial behavior polygenic risk scores (PRSs) and environmental characteristics (i.e., parental monitoring, community disadvantage). Participants (N = 436) were initially recruited for an elementary school-based prevention trial in a Mid-Atlantic city. Youths reported on the frequency of their past year alcohol use from ages 14-26. DNA was obtained from participants at age 21. Internalizing symptoms and antisocial behavior PRSs were created based on a genome-wide association study (GWAS) conducted by Benke et al. (2014) and Tielbeek et al. (2017), respectively. Parental monitoring and community disadvantage were assessed at age 12. Four classes of past year alcohol use were identified: (a) early-onset, increasing; (b) late-onset, moderate use; (c) low steady; and (d) early-onset, decreasing. In high community disadvantaged settings, participants with a higher internalizing symptoms PRS were more likely to be in the early-onset, decreasing class than the low steady class. When exposed to elevated community disadvantage, participants with a higher antisocial behavior PRS were more likely to be in the early-onset, increasing class than the early-onset, decreasing and late-onset, moderate use classes.

"It All Starts With the Parents": A Qualitative Study on Protective Factors for Drug-Use Prevention Among Black and Hispanic Girls

Using intersectionality theory as a theoretical framework, this qualitative study uncovered the protective factors present among black and Hispanic adolescent girls living in an urban, under-resourced neighborhood in the Northeastern United States. The sample used in this study includes eight focus groups that consisted of adolescent females only (N = 57). Female participants were sampled through six youth-serving summer programs throughout the target city. The female participants were between 11 and 17 years of age, with 73% self-identifying as black (n = 45) and 26% (n = 12) as Hispanic. Thematic analysis using an intersectional approach was used to analyze the narratives of participants in the study. Three main themes arose: environmental context, parent-child communication about drug use, and parental modeling. Participants were critically aware of their environmental context which normalized drug use. However, participants identified protective factors such as parents communicating about drug use and parental modeling to girls in the sample as the most salient factors against substance use in their community. Findings provide insight for researchers, social workers, and interventionists to create and implement family-centered, strengths-based substance-abuse prevention programs that are racial, ethnic, and gender specific for black and Hispanic adolescent girls.

Neighborhood context and transitions in marijuana use among urban young adults

BACKGROUND

In emerging adulthood when many youth are maturing out of marijuana use, Blacks continue to have high rates of use and disorder. Theory suggests that factors tied to neighborhood disadvantage may partially explain this phenomenon but research is limited.

OBJECTIVES

This study examines the influence of neighborhood physical and social disorder on transitions in marijuana use during emerging adulthood in a low-income urban sample.

METHODS

379 primarily Black young adults residing in low-income neighborhoods in Baltimore City were followed-up annually from ages 18 to 21. Neighborhood environment was evaluated using a valid and reliable field-rater assessment of the residential block. Longitudinal latent class and latent transition analyses were performed.

RESULTS

Fit indices supported three-classes of marijuana use: no use, infrequent use and frequent use. Between ages 18 and 21, young adults tended to transition toward lower levels of use. However, neighborhood physical disorder was associated with transitioning to increased marijuana use (no use to frequent use; AOR = 2.712; p = .023) while positive neighborhood social activity was associated with a decreased risk (AOR = 0.002; p = .013). Neighborhood social activity was also associated with decreases in use (frequent to infrequent use; AOR = 2.342; p = .020). Conclusions/Importance: These findings demonstrate that physical disorder within the context of a low-income urban neighborhood adversely impacts marijuana use. However, even in the presence of physical disorder, interventions that foster collective efficacy among residents through positive social activity may prevent initiation and progression of marijuana use.

The Impact of the Urban Neighborhood Environment on Marijuana Trajectories During Emerging Adulthood

Although there is little difference in rates of marijuana use between White and Black youth, Blacks have significantly higher rates of marijuana use and disorder in young adulthood. Theory suggests that factors tied to social disadvantage may explain this disparity, and neighborhood setting may be a key exposure. This study sought to identify trajectories of marijuana use in an urban sample during emerging adulthood, neighborhood contexts that predict these trajectories and social role transitions or "turning points" that may redirect them. Data are from a longitudinal cohort study of 378 primarily Black emerging adults who were first sampled in childhood based on their residence in low-income neighborhoods in Baltimore City and followed up annually. Group-based trajectory modeling identified three groups: No Use (68.8%), Declining Use (19.6%), and Chronic Use (11.7%). Living in close proximity to an alcohol outlet, and living in a neighborhood with more female-headed households and higher rates of violent crime increased the odds of membership in the Chronic Use group relative to No Use. Living in a neighborhood with more positive social activity increased the odds of membership in the Declining Use group relative to No Use. Not receiving a high school diploma or GED, pregnancy, and parenting also increased the odds of membership in the Declining Use group relative to No Use. These findings provide support that minority youth living in socially toxic and disordered neighborhoods are at increased risk of continuing on a trajectory of marijuana use during emerging adulthood while positive social activity in neighborhoods has the potential to redirect these negative trajectories. Besides taking on the responsibilities of parenting, emerging adults in the marijuana user groups had similar educational and family outcomes, suggesting that early marijuana use may have long-term implications.

When Marijuana Is Used before Cigarettes or Alcohol: Demographic Predictors and Associations with Heavy Use, Cannabis Use Disorder, and Other Drug-related Outcomes

Recent loosening of state and federal policy restrictions on marijuana, along with changes in social norms regarding marijuana use and decreases in prevalence of other types of substance use, may lead to increases in youth initiating marijuana before other types of substances such as alcohol and tobacco. We investigated predictors and potential consequences of initiating marijuana before other drugs for youth aged 12-21-years in the USA. Nationally representative, cross-sectional survey data from the US National Survey on Drug Use and Health supplied self-reported age of first marijuana, cigarettes, alcohol, other tobacco, and other illegal drug use among 12-21-year-old samples from 2004 to 2014 (n = 275,559). We first examined the degree to which initiating marijuana use first was associated with sex, age, race/ethnicity, and survey year. Then, we examined whether using marijuana first predicted heavy marijuana use, cannabis use disorder (CUD), alcohol use disorder (AUD), nicotine dependence (ND), or lifetime use of other illegal drugs. Among all survey youth (substance users and non-users), the proportion using marijuana first increased from 4.8 to 8.8% from 2004 to 2014. Those using marijuana first (vs. alcohol or cigarettes first) were more likely to be male and older and Black, American Indian/Alaskan Native, multiracial, or Hispanic than White or Asian. Among substance users and adjusting for age of onset and the number of substances used, using marijuana first was associated higher odds of heavy current marijuana use and CUD. In recent years, youth have been increasingly likely to use marijuana as their first drug and sequence of initiation is associated with race/ethnicity, gender, and age. Using marijuana first might increase the chance of heavy use and CUD.

Young Urban Adolescents' Activity Spaces, Close Peers, and the Risk of Cannabis Use: A Social-Spatial Longitudinal Analysis

BACKGROUND

An understudied, yet important area of youth development research is the examination of how place affects critical psychosocial processes such as identity formation, problem solving, emotional regulation, and in particular with adolescents, belongingness, autonomy, social competency, and behavioral health. A growing spatially informed literature indicates that youth interact with meaningful places as environmental strategies, shaping developmental trajectories related to behavioral health.

OBJECTIVES

The objective is to investigate the relationship between place preference and health behavior among adolescents, with a focus on substance use behavior, specifically, cannabis use. We theorize that cannabis use is associated with place preference for urban, city types of places, and that this particular place preference interacts with close peer network behaviors.

METHODS

To understand the role of preferred locations, close peer relations, and mental health on cannabis use, 248 adolescents (ages 13 to 14) were studied longitudinally. Logistic regression models tested the moderating effects of peer network health (sum of close friends risk and protective behaviors) on selecting city locations (urban stress/neighborhoods) as preferred places, and subsequent cannabis use.

RESULTS

Results indicated that peer network health moderated the effects of choosing city locations as favorite, increasing the odds of cannabis use more than eight-fold at 24 months.

CONCLUSIONS

Favorite places located in city environments appear to interact with peer risk behaviors influencing the cannabis use of young urban adolescents, even after controlling for the influence of baseline cannabis use, neighborhood disorder the home neighborhood, age, gender, and mental health effects.

The interplay between externalizing disorders polygenic risk scores and contextual factors on the development of marijuana use disorders

Externalizing disorders have been extensively linked to substance use problems. However, less is known about whether genetic factors underpinning externalizing disorders and environmental features interact to predict substance use disorders (i.e., marijuana abuse and dependence) among urban African Americans. We examined whether polygenic risk scores (PRS) for conduct disorder (CD) and attention-deficit hyperactivity disorder (ADHD) interacted with contextual factors (i.e., parental monitoring, community disadvantage) to influence risk for marijuana use disorders in a sample of African American youth. Participants (N=1,050; 44.2% male) were initially recruited for an elementary school-based universal prevention trial in a Mid-Atlantic city and followed through age 20. Participants reported on their parental monitoring in sixth grade and whether they were diagnosed with marijuana abuse or dependence at age 20. Blood or saliva samples were genotyped using the Affymetrix 6.0 microarrays. The CD and ADHD PRS were created based on genome-wide association studies conducted by Dick et al. (2010) and Demontis et al. (2017), respectively. Community disadvantage was calculated based on census data when participants were in sixth grade. There was an interaction between the CD PRS and community disadvantage such that a higher CD PRS was associated with greater risk for a marijuana use disorder at higher levels of neighborhood disadvantage. This finding should be interpreted with caution owing to the number of significance tests performed. Implications for etiological models and future research directions are presented.

Correlates of prescription opioid misuse among Black adults: Findings from the 2015 National Survey on Drug Use and Health

BACKGROUND

Prescription drug misuse, especially opioid misuse, has become a public health crisis in the US. While much research attention has been focused on prescription drug misuse, a number of notable gaps in the literature remain. The current research addresses one of these gaps by examining racial/ethnic variation in prescription opioid misuse among adults.

METHODS

We use data from the 2015 NSDUH to identify correlates of prescription opioid misuse among Black respondents aged 18 and older. The NSDUH defines prescription drug misuse as the use of prescription drugs in any way a doctor did not direct respondents to use them, including (a) without a prescription of their own; (b) in greater amounts, more often, or longer than told to use; or (c) in any other way a doctor did not tell respondents to use the drug.

RESULTS

Findings indicate that Black respondents have a very similar prevalence rate of prescription opioid misuse compared to White respondents. A number of factors (i.e., gender, socioeconomic status, educational attainment) were significantly correlated with prescription opioid misuse only among Black respondents. In addition, many factors (i.e., depression, general health, other illicit drug use, being approached by a drug dealer) were significantly associated with prescription opioid misuse among both Black and White respondents.

CONCLUSIONS

The current research identified a number of unique correlates of prescription opioid misuse among Black adults. To more effectively deal with the current public health crisis, research must identify risk factors among various groups within the population.

Neighborhood Contexts and Marijuana Use Among Urban Dwelling Emerging Adult Men

Neighborhoods are key socio-environmental contexts for marijuana use during emerging adulthood. This study examined the relationships between neighborhood context, traditional masculine norms (status, toughness, and anti-femininity), and marijuana use among 119 majority African American emerging adult men in a small urban community. Poisson regression models were used to determine the associations between neighborhood problems, social cohesion, and marijuana use. Moderator effects were examined to determine if masculinities modified these associations. Neighborhood problems and social cohesion were positively associated with marijuana use. Men who had a lower endorsement of some traditional masculine norms had greater marijuana use compared to men with a higher endorsement of these norms. These findings have implications for intervention strategies and policies.

Individual, peer, and family factor modification of neighborhood-level effects on adolescent alcohol, cigarette, e-cigarette, and marijuana use

BACKGROUND

Neighborhood factors reported subjectively by residents and measured objectively at the census tract are both associated with adolescent alcohol, tobacco (cigarette and electronic cigarette), and other drug (marijuana) (ATOD) use. Less clear is how these neighborhood factors are longitudinally associated with each substance. Equivocal findings may be due to lack of consideration of individual, peer, and family effect modifiers, which could help adolescents overcome exposure to stressful neighborhood environments.

METHODS

We used multivariate logistic regressions with interaction terms to test whether parental monitoring, resistance self-efficacy (RSE) and being around peers who use ATOD modified the association between four subjective and objective neighborhood measures and odds of using each substance measured one year later among 2539 high school students and college freshmen originally recruited from middle schools in Southern California.

RESULTS

Census tract-level disadvantage was not longitudinally associated with ATOD use. However, perceptions of higher neighborhood disorganization, less social cohesion, and more neighborhood problems with alcohol and drug use were associated with higher odds of ATOD use. Higher RSE and weaker affiliations with peers who use ATOD consistently buffered negative effects of neighborhood disorganization and neighborhood problems with alcohol and drugs on past year ATOD use.

CONCLUSIONS

Community-level programs that increase social cohesion among neighbors, neighborhood monitoring of deviant behaviors, and better policing of open drug selling may prevent ATOD use. Programs should also target RSE and minimize affiliations with peers who use ATOD, which could reduce the magnitude of the association with ATOD, even for adolescents living in the most at-risk neighborhoods.

Neighborhood disorder, peer network health, and substance use among young urban adolescents

BACKGROUND

The current study investigated the moderating effect of peer networks on neighborhood disorder's association with substance use in a sample of primarily African American urban adolescents.

METHODS

A convenience sample of 248 adolescents was recruited from urban health care settings and followed for two years, assessing psychological, social, and geographic risk and protective characteristics. A subset of 106 substance using participants were used for the analyses. A moderation model was tested to determine if the influence of neighborhood disorder (percent vacant housing, assault index, percent single parent headed households, percent home owner occupied, percent below poverty line) on substance use was moderated by peer network health (sum of peer risk and protective behaviors).

RESULTS

Evidence for hypothesized peer network moderation was supported. A latent growth model found that peer network health is most strongly associated with lower baseline substance use for young adolescents residing in more disordered neighborhoods. Over the course of two years (ages approximately 14-16) this protective effect declines, and the decline is stronger for more disordered neighborhoods.

CONCLUSIONS

Understanding the longitudinal moderating effects of peer networks within high-risk urban settings is important to the development and testing of contextually sensitive peer-based interventions.

RESULTS

suggest that targeting the potential protective qualities of peer networks may be a promising approach for interventions seeking to reduce substance use, particularly among younger urban adolescents living in high-risk neighborhoods.

Does the Assessment of Recovery Capital scale reflect a single or multiple domains?

Objective

The goal of this study was to determine whether the 50-item Assessment of Recovery Capital scale represents a single general measure or whether multiple domains might be psychometrically useful for research or clinical applications.

Methods

Data are from a cross-sectional de-identified existing program evaluation information data set with 1,138 clients entering substance use disorder treatment. Principal components and iterated factor analysis were used on the domain scores. Multiple group factor analysis provided a quasi-confirmatory factor analysis.

Results

The solution accounted for 75.24% of the total variance, suggesting that 10 factors provide a reasonably good fit. However, Tucker’s congruence coefficients between the factor structure and defining weights (0.41–0.52) suggested a poor fit to the hypothesized 10-domain structure. Principal components of the 10-domain scores yielded one factor whose eigenvalue was greater than one (5.93), accounting for 75.8% of the common variance. A few domains had perceptible but small unique variance components suggesting that a few of the domains may warrant enrichment.

Conclusion

Our findings suggest that there is one general factor, with a caveat. Using the 10 measures inflates the chance for Type I errors. Using one general measure avoids this issue, is simple to interpret, and could reduce the number of items. However, those seeking to maximally predict later recovery success may need to use the full instrument and all 10 domains.

Does substance use moderate the association of neighborhood disadvantage with perceived stress and safety in the activity spaces of urban youth?

BACKGROUND

This study investigates the association of activity space-based exposure to neighborhood disadvantage with momentary perceived stress and safety, and the moderation of substance use on those associations, among a sample of 139 urban, primarily African American, adolescents.

METHOD

Geospatial technologies are integrated with Ecological Momentary Assessment (EMA) to capture exposure to neighborhood disadvantage and perceived stress and safety in the activity space. A relative neighborhood disadvantage measure for each subject is calculated by conditioning the neighborhood disadvantage observed at the EMA location on that of the home neighborhood. Generalized estimating equations (GEE) are used to model the effect of relative neighborhood disadvantage on momentary perceived stress and safety, and the extent to which substance use moderates those associations.

RESULTS

Relative neighborhood disadvantage is significantly associated with higher perceived stress, lower perceived safety, and greater substance use involvement. The association of relative neighborhood disadvantage with stress is significantly stronger among those with greater substance use involvement.

CONCLUSION

This research highlights the value of integrating geospatial technologies with EMA and developing personalized measures of environmental exposure for investigating neighborhood effects on substance use, and suggests substance use intervention strategies aimed at neighborhood conditions. Future research should seek to disentangle the causal pathways of influence and selection that relate neighborhood environment, stress, and substance use, while also accounting for the role of gender and family and peer social contexts.

Risky Substance Use Environments and Addiction: A New Frontier for Environmental Justice Research

Substance use disorders are widely recognized as one of the most pressing global public health problems, and recent research indicates that environmental factors, including access and exposure to substances of abuse, neighborhood disadvantage and disorder, and environmental barriers to treatment, influence substance use behaviors. Racial and socioeconomic inequities in the factors that create risky substance use environments may engender disparities in rates of substance use disorders and treatment outcomes. Environmental justice researchers, with substantial experience in addressing racial and ethnic inequities in environmental risk from technological and other hazards, should consider similar inequities in risky substance use environments as an environmental justice issue. Research should aim at illustrating where, why, and how such inequities in risky substance use environments occur, the implications of such inequities for disparities in substance use disorders and treatment outcomes, and the implications for tobacco, alcohol, and drug policies and prevention and treatment programs.

Racial differences and the role of neighborhood in the sequencing of marijuana and tobacco initiation among urban youth

BACKGROUND

With patterns of initiation of tobacco and marijuana changing, there is increasing evidence that marijuana use may serve as an antecedent to tobacco use among adolescents. However, studies have not fully characterized the prevalence of these patterns among vulnerable youth and have rarely examined the factors that predict the sequencing of onset of tobacco and marijuana use.

METHODS

Utilizing longitudinal data from a sample of urban youth followed from age 6 to age 18, the authors identify the sequencing of initiation of tobacco and marijuana and test whether race and 5 neighborhood factors (i.e., perceived disorder, drug activity, drug access, exposure to violence, and exposure to violent victimization) predict onset sequencing.

RESULTS

Various sequencing patterns were observed, with 12.4% of the sample initiating marijuana use before tobacco use was initiated. In adjusted logistic regression models, black youth were 2.66 times as likely as whites to initiate marijuana before tobacco compared with initiating tobacco before marijuana (P = .032). Youth with greater exposure to violent victimization were 3.89 times as likely to initiate marijuana first than initiate tobacco first (P = .002). Other neighborhood factors were not statistically significantly associated with sequencing.

CONCLUSIONS

Black youth and youth with greater exposure to victimization had an increased risk of initiating marijuana before tobacco, which suggests that this pattern may be rooted in specific risk factors. Substance use prevention efforts should consider taking into account that marijuana use may put certain youth at risk of initiating tobacco. Future research needs to monitor sequencing, as well as risk factors for and consequences of the various patterns, particularly since marijuana use and the mixing of tobacco and marijuana use are gaining acceptability in general populations.