Violence involvement, substance use, and sexual activity among Mexican-American and European-American adolescents

Using a Syndemic Framework and Structural Equation Modeling to Assess the Co-occurrence and Mutual Impact of Violence Experiences and Substance Use Behaviors Among Adolescents

Adolescents are at particular risk for multiple violence experiences and substance use behaviors. The extent to which the two clusters of experiences correlate with each other remains unclear. The purpose of this study is to assess the co-occurrence and mutual impact of violence experiences and substance use behaviors in adolescents using structural equation modeling (SEM) based on syndemic theory. This study utilized data collected by 2019 Youth Risk Behavior Survey from a nationally representative sample (N = 13,677). Bivariate associations and correlations between four forms of violence experiences (weapon threats, sexual violence, dating violence, and bullying) and three types of substance use behaviors (e-cigarette smoking, alcohol drinking, and marijuana use) were examined. Two SEM models were built to measure the correlation between the two clusters of variables. The results showed that 36.8% of adolescents experienced at least one form of violence in the past year (22.0% one form, 8.9% two forms, and 5.9% three or more forms) and 42.4% reported one or more types of substance use in the past month (16.3% one type, 14.0% two types, and 12.1% three types). Youths with multiple violence experiences were three to four times more likely to report substance use, and those using three types of substances were two to six times more likely to report violence victimization. All examined associations and correlations between violence experiences and substance use behaviors were statistically significant. In the final SEM model, the four violence variables indicated a syndemic factor and the three substance use variables indicated another syndemic factor. The two syndemic factors were positively correlated (β = .43, p < .05), with 19% of variance being explained by each other. Findings in this study highlight the needs for comprehensive prevention efforts to address the co-occurring and mutually reinforced situation between violence experiences and substance use behaviors in the youth population. Targeted intervention programs and mental health services are needed for adolescents with multiple violence experiences and concurrent substance use behaviors.

Childhood Adversity Trajectories and Violent Behaviors in Adolescence and Early Adulthood

Violence and other antisocial behaviors, including fighting and weapon carrying, are highly prevalent among adolescents but usually decrease in young adulthood. Childhood adversities, including exposure to abuse, intimate partner violence, and household substance use and mental health problems, have been linked to violent behaviors in adolescence and adulthood. However, few studies of childhood adversity as determinants of persistent violent behavior among community-based samples have been conducted. Furthermore, the effects of adversity timing and duration on subsequent violent behaviors are unclear. We examined the association between five childhood adversity trajectories (representing stable-low, stable-mild, decreasing, increasing, and stable-high adversity from birth through age 11.5 years) and physical fighting and weapon carrying at ages 13-20 years among a sample of young adults followed continuously since birth from the Avon Longitudinal Study of Parents and Children (n = 9,665). The prevalence of violent behaviors declined sharply as participants aged (e.g., whereas 42.8% reported engaging in physical fighting in the past year at ages 13-15 years, this dropped to 10.4% at ages 17-20 years). Childhood adversity trajectories exhibited a strong dose-response relation with physical fighting and weapon carrying, with particularly pronounced relations for violent behaviors persisting across both adolescence and early adulthood (e.g., for physical fighting at both ages 13-15 years and 17-20 years compared to no fighting at either period, adjusted odds ratio [aOR] = 1.62, 95% confidence interval [CI] = 1.31-2.00 for stable-mild; aOR = 2.33, 95% CI = 1.64-3.33 for decreasing; aOR = 3.18, 95% CI = 2.20-4.60 for increasing; and aOR = 3.73, 95% CI = 2.13-6.52 for stable-high adversity, compared to stable-low adversity). This work highlights the substantial implications of exposure to childhood adversity for youth violence prevention.

Developing a Smartphone-Based Adjunct Intervention to Reduce Cannabis Use Among Juvenile Justice-Involved Adolescents: A Multiphase Study Protocol (Preprint)

Background

Adolescents involved in the juvenile justice system who use cannabis are at an increased risk of future substance use disorders and rearrest. Many court-involved, nonincarcerated (CINI) youth are referred for services in the community and often encounter multiple barriers to care, highlighting the need for minimally burdensome services that can be delivered in justice settings. Digital health interventions are accessible, easy to implement, and can provide ongoing support but have not been developed to address the unique needs of CINI youth who use cannabis.

Objective

This multiphase study will aim to develop, implement, and pilot test a novel smartphone app, Teen Empowerment through Computerized Health (TECH), to reduce cannabis and other substance use among CINI youth. TECH is conceptualized as a digital adjunct to a brief computerized intervention delivered by our family court partner.

Methods

Following the principles of user-centered design, phase I interviews with CINI youth aged 14-18 years (n=14-18), their caregivers (n=6-8), and behavioral health app developers (n=6-8) will guide the TECH design decisions. Next, in phase II, CINI youth (n=10) will beta test the TECH app prototype for 1 month; their feedback regarding feasibility and acceptability will directly inform the app refinement process. Finally, in phase III, CINI youth (n=60) will participate in a pilot randomized controlled trial for 6 months, comparing the preliminary effectiveness of the adjunctive TECH app on cannabis use outcomes.

Results

Phase I data collection began in September 2020 and was completed in December 2021; 14 CINI youth, 8 caregivers, and 11 behavioral health app developers participated in the study. Phases II and III will occur in 2022 and 2023 and 2023 and 2025, respectively.

Conclusions

This body of work will provide insight into the feasibility and acceptability of a smartphone-based adjunctive intervention designed for CINI youth. Phase III results will offer a preliminary indication of the effectiveness of the TECH app in reducing cannabis use among CINI youth.

International Registered Report Identifier (IRRID)

DERR1-10.2196/35402

A systematic review of socioecological factors, community violence exposure, and disparities for Latinx youth

Community violence exposure poses a public health risk exacerbated by immigration-related stressors and environmental factors, including systemic racism and interpersonal discrimination, socioeconomic disparities, and anti-immigrant laws and policies, that disproportionately impact Latinx-immigrant and systematically minoritized youth. Using the ecological-transactional model of community violence as a conceptual framework, this systematic review was conducted to examine research on exposure to community violence, risk and protective factors, and associated health and mental health sequelae among Latinx youth. The initial search generated 2,152 articles, 291 of which were reviewed for detailed evaluation; ultimately, 59 articles were included. Mexican-origin youth and adolescent samples were the most represented in research studies. Across several studies, Latinx youth reported high rates of violence exposure and poor health or mental health outcomes. The findings revealed important gaps in socioecological factors, with a dearth of evidence establishing macrosystem factors or culturally salient and immigrant-related factors. Notable risk and protective factors at various ecological levels were identified and discussed as key opportunities for future research and points of intervention or prevention efforts for Latinx-immigrant and systematically minoritized youth.

Age at first alcohol use and weapon carrying among adolescents: Findings from the 2019 Youth Risk Behavior Survey

BACKGROUND

Although studies have investigated the association between alcohol use and violent behaviors such as weapon carrying, few studies have examined the association between age at first alcohol use and weapon-carrying among adolescents. The objective of this study was to investigate the association between age at first alcohol use and weapon carrying among adolescents.

METHODS

Data for this study came from the 2019 Youth Risk Behavior Survey. An analytic sample of 13,442 adolescents aged 14-18 years old (51% female) was analyzed using binary logistic regression. The outcome variable investigated in this study was weapon carrying during the past 30 days, and the main explanatory variable investigated was age at first alcohol use.

RESULTS

Of the 13,442 adolescents, 13.5% carried a weapon during the past 30 days, and 15.4% reported having their first alcoholic drink before age 13. In the multivariable logistic regression, adolescents who reported having alcohol before age 13 had more than double the odds of carrying a weapon when compared to those who never had alcohol before age 13 (AOR = 2.32, p < .001, 95% CI = 1.87-2.89). Other significant factors associated with weapon carrying include male gender, victim of bullying, teen dating violence, sexual violence, suicidal ideation, and history of substance use. Adolescents who self-identified as Black/African American or Hispanic were significantly less likely to carry a weapon when compared to adolescents who self-identified as non-Hispanic White.

CONCLUSION

The findings of this study underscore the importance of developing age appropriate intervention strategies to curb early initiation of alcohol use and weapon carrying among adolescents.

“I’ve seen my friend get chopped”: The Influence of Peer Networks on Exposure to Violence Among Homeless Young Adults

Homeless young adults report being exposed to substantial violence and victimization. This often arises through street culture and norms associated with subcultures of violent behavior. In this exploratory study, we applied a decolonizing lens to conduct semi-structured interviews with 18 young adults experiencing homelessness in Victoria, Australia. In this study, we provide a contemporary description of peer relationships among homeless young adults. We examine how these relationships influence exposure to violence, and how young adults perceive and respond to injuries sustained by their peers because of exposure to violence. Findings showed bonds and relationships between homeless young adults appear to imitate the rapport and functions of sibling-kinship that typically exist in supportive family environments. Despite the care and protection provided within close peer relationships, these relationships may also contribute to exposure to violence by way of young adults witnessing violence perpetration and incidences of peers being physically victimized. There is an important duality between the perceived normalization of witnessing peers’ experiences of violence and young adults’ self-reflexive disclosure of vulnerability and helplessness in witnessing these incidents. Study findings have important research and practice implications for recognizing the influence and importance of peer relationships in the delivery of homelessness support programs.

Transition from nonuse to use of alcohol or binge drinking among adolescents: Secondary analysis of a randomized controlled trial

OBJECTIVE

The objective of this study was to evaluate the predictors of the transition from nonuse of alcohol to the first use of alcohol and the first episode of binge drinking.

METHODS

Data were drawn from a randomized controlled trial conducted with seventh- and eighth-grade students from 72 public schools over a 21-month period in six cities in Brazil. A total of 3298 students who reported that they had never consumed alcoholic beverages and had never engaged in binge drinking at baseline were included in this study. The two binary outcomes were tested concomitantly via structural equation modeling. Maximum likelihood estimates for logistic regression models were performed to evaluate how baseline data regarding risk factors, such as sociodemographic characteristics (socioeconomic status, gender, and age), school experiences (violence and perception of academic performance), and social variables (family and friends), affected the initiation of alcohol use and binge drinking at 9- and 21-month follow-up assessments.

RESULTS

Older age, the perpetration of violent behaviors at baseline and the absence of the father living with the adolescent were predictors of both alcohol use initiation and binge drinking initiation. The #Tamojunto program showed iatrogenic effect for first alcohol use.

CONCLUSIONS

The results indicate the need to develop and implement effective alcohol prevention programs that consider the main characteristics in the prediction model for alcohol consumption and binge drinking, including early intervention for aggressive behaviors at school and parental alcohol use.

Neighborhood Crime and Sexual Transmission Risk Behavior among Black Men Living with HIV

Here, we examined the association of exposure to neighborhood crime with sexual risk-taking behavior among Black men living with HIV. HIV-positive Black men on antiretroviral therapy in California completed an audio computer-assisted self-interview. Crime risk per census block group was derived from the Federal Bureau of Investigation's Uniform Crime Report. Among 193 men, the mean (SD) number of sexual partners among those who were sexually active was 2.7 (3.3). 49% reported condomless sex, and 23% reported sex with an HIV-negative or unknown-serostatus partner. In multivariate analysis, illicit drug use ([IRR=1.86; 95%CI: 1.20-2.89] p=.006), depressive symptoms ([IRR=1.59; 95%CI: 1.03-2.44] p=.03), an undetectable viral load ([IRR=1.91; 95%CI: 1.22-3.00] p=.005), and neighborhood total crime risk ([IRR=1.02; 95%CI: 1.01-1.04] p=.007) remained significant. Among Black men living with HIV, exposure to neighborhood crime is associated with having multiple sexual partners whose HIV status was negative or unknown.

Mapping the Intersections of Violence on Black Women's Sexual Health within the Jim Crow Geographies of Cincinnati Neighborhoods

Who will revere the Black woman? Who will keep our neighborhoods safe for Black innocent womanhood? Black womanhood is outraged and humiliated. Black womanhood cries for dignity and restitution and salvation. Black womanhood wants and needs protection, and keeping, and holding. Who will assuage her indignation? Who will keep her precious and pure? Who will glorify and proclaim her beautiful image? To whom will she cry rape? Abbey Lincoln, 1970.

Exposure to Community Violence and Sexual Behaviors Among African American Youth: Testing Multiple Pathways

African American youth bear a disproportionate burden of sexually transmitted infections. A growing number of studies document that youth exposure to community violence and sexual behaviors are highly correlated. Despite such growing evidence, only a few studies have empirically tested conceptually driven pathways that may account for such relationships. This study seeks to address that gap by exploring multiple pathways linking exposure to community violence and youth sexual behaviors. Using an existing sample of 563 African American youth attending high school, we examined whether possible links between exposure to community violence and sexual activity, sexual risk behaviors were mediated by aggression, low student-teacher connectedness, and negative peer norms. Major findings indicated indirect relationships between exposures to community violence and both sexual activity and risky sex, mediated by aggression and negative peer norms with no significant differences based on gender or socioeconomic status. Overall findings also indicated a significant indirect effect of aggression to risky sex via negative peer norms and from community violence to risky peer norms via aggression. By illuminating ways that community violence, aggression, peer norms, and sexual behaviors are dynamically interrelated, these findings have significant implications for future research and intervention initiatives aimed at addressing the different pathways.

Exposure to Community Violence Among Low-Income African American Youth in Chicago: A Latent Class Analysis

African American youth are exposed to some of the highest rates of exposure to community violence. However, few studies have explored factors related to exposures and various subtypes of exposures to community violence (i.e., no exposure, witnessing only and being a witness/victim). Among a matched sample of 129 African American youth and their caregivers, no exposure to community violence was correlated with being heterosexual versus being a lesbian, gay, bisexual, and transgender (LGBT) person, having parents who owned their homes versus rented, and having higher authoritarian parenting attitudes. In addition, being a witness/victim of community violence was correlated with any youth substance use, lower levels of school bonding, having less future orientation, less parental home ownership, and an adverse family history. Practice and programmatic considerations are discussed based on these findings.

Bullying and Other Forms of Peer Victimization in Adolescence and Alcohol Use

To examine the relationship between bullying and other forms of peer victimization in adolescence and alcohol use or misuse, all the pertinent studies were reviewed. Fourteen databases were searched. Blind assessments of study eligibility and quality were performed by two independent researchers. Seventy-four studies including 2,066,131 participants across 56 countries all over the world and meeting minimum quality criteria that were enough to ensure objectivity and to not invalidate results were analyzed. Across studies, evidence for a significant association between peer victimization and alcohol use or misuse was conflicting. Results were affected by sample size, definition of victim status, specific forms of peer victimization, and specific types of alcohol consumption. There was some evidence for a number of mediating or moderating variables, such as depression, coping, drinking motives, attachment to school, social support, and gender. Findings are discussed according to stress-coping and self-medication hypotheses. Alternative etiological mechanisms are also considered.

Assessing the Role of Context on the Relationship Between Adolescent Marijuana Use and Property Crimes in Mexico

BACKGROUND

A limited amount of research has been conducted on the association between marijuana use and adolescent crime in developing countries such as Mexico, where crime rates are high and marijuana use is increasing.

OBJECTIVES

To examine the association between the frequency of marijuana use and the likelihood of committing of a property crime, and to identify contextual factors explaining individual differences in the likelihood of committing a property crime.

METHODS

The contribution of marijuana use to property crimes was examined based on two nationwide probabilistic surveys of public high school students, using a multilevel mixed effects logistic regression model.

RESULTS

Marijuana use significantly increased the odds of committing a property crime. Differences between schools were observed in the random effects of marijuana use, suggesting that the likelihood of committing a property crime was differentially affected by contextual factors. In addition, students who were victims of bullying by peers and who had parents that abused alcohol had higher odds of committing a property crime. Perceived disorder in students' schools and neighborhoods also increased students' odds of reporting that they had committed a property crime.

CONCLUSIONS

The importance of the effect of school context on the relationship between marijuana use and the commission of a property crime among Mexican public high school students seemed to increase over time. However, these results may also be due to changes in sampling designs over time.

Psychological distress, drug use, sexual risks and medication adherence among young HIV-positive Black men who have sex with men: exposure to community violence matters

In the USA, Black males are disproportionately affected by community violence and HIV. The aim of this study was to assess whether exposures to community violence are related to psychological distress, drug use, sexual risk behaviors, and medication adherence among a sample of HIV-positive young Black men who had sex with men (YBMSM). Data are from 98 YBMSM ages 18-29 years recruited from Chicago who completed measures on demographics, exposures to community violence, psychological distress, drug use, condomless anal intercourse, and medication adherence. Rates of exposure to community violence were high and youth reported victimization and witnessing numerous types of violence in their lifetime. In adjusted logistic regression analyses, models indicate that YBMSM reporting higher levels of exposure to community violence had significantly higher rates of condomless anal intercourse in the previous 6 months (AOR: 5.33, 95%CI: 1.38-20.55). Additionally, exposure to community violence was positively associated with psychological distress, hard drug use, and use of marijuana as a sex drug. Adherence to HIV antiretroviral medication was negatively associated with community violence (AOR: 0.36, 95%CI: 0.13-0.97). Rates of exposure to community violence are especially high in urban communities. Overall findings suggest that treatment, intervention, and programmatic approaches that include initiatives to address exposure to community violence might correlate with better health-related outcomes for HIV-positive YBMSM.

Violence Exposure and Early Substance Use in High-Risk Adolescents

This study examines the relationship between violence exposure and early substance use as mediated by trauma symptoms. The Assessment of Liability and Exposure to Substance Use and Antisocial Behavior Scale was used to assess violence exposure at age 10 and substance use by age 12. Mediation analysis indicated direct relationships between violence exposure and tobacco/illegal drug use and indirect relationships between violence exposure and girls' substance use through trauma symptoms. Practitioners should consider violence exposure as a risk factor for early substance use in high-risk youths and potential gender differences in trauma symptom pathways to early substance use.

Correlates of Polyvictimization Among African American Youth: An Exploratory Study

African American adolescents are exposed to high rates of community violence, and recent evidence indicates that these youth may also be at high risk of polyvictimization. Guided by an ecological approach, this study explored individual, familial, and extra-familial correlates of single and multiple forms of violence exposures (i.e., witnessing verbal parental aggression, witnessing or being a victim of community violence exposures) among a sample of 563 urban African American adolescents. Findings indicated that boys reported higher levels of polyvictimization than girls. In addition, the correlates of violence exposures varied by typology and gender. These findings support the development and use of gender-oriented approaches for identifying youth at risk of various types of violence exposures.

Community Violence Exposure and Sexual Behaviors in a Nationally Representative Sample of Young Adults: The Effects of Race/Ethnicity and Gender

This study examined whether exposure to community violence was related to sexual risk behaviors in a nationally representative sample of young adults and if there were gender or racial/ethnic differences in these relationships. The analytic sample for this study was drawn from the National Longitudinal Study of Adolescent Health and was composed of 7,726 unmarried, heterosexual African American, Caucasian, and Hispanic/Latino young adults aged 18 to 27 years old. Approximately 12% of participants reported some community violence exposures, with men and African Americans reporting the highest rates of such exposures. Regression analyses controlling for age, gender, parental education, and family structure indicated that exposures to community violence were associated with earlier sexual debut history, a higher number of sexual partners within the previous 12 months, and a higher number of total sexual partners. Additionally, violence exposures had stronger effects for males and weaker effects for African Americans. Primary and secondary sexual risk prevention initiatives would need to consider how patterns of sexual risk behaviors may be related to exposure to community violence and how such relationships may differ based on gender and race/ethnicity. Future research should also seek to illuminate pathways connecting these 2 major public health concerns.

Adult work commitment, financial stability, and social environment as related to trajectories of marijuana use beginning in adolescence

BACKGROUND

The objective of this study is to examine trajectories of marijuana use among African Americans and Puerto Ricans from adolescence to adulthood, with attention paid to work commitment, financial stability, drug use, and violence.

METHODS

Participants (N = 816) completed in-class questionnaires as students in the East Harlem area of New York City at the first wave and provided follow-up data at 4 additional points in time (mean ages = 14, 19, 24, 29, and 32 years). Among 816 participants, there were 60% females, 52% African American, and 48% Puerto Ricans.

RESULTS

The chronic marijuana user trajectory group compared with the none or low, increasing, and/or moderate marijuana user trajectory group was associated with negative aspects of work commitment, financial stability, and the social environment. The chronic marijuana user group was similar to the increasing marijuana user group on work commitment and financial stability.

CONCLUSIONS

These results suggest that treating marijuana use in late adolescence may reduce difficulty in the assumption of adult roles. Because chronic marijuana users experienced the most adverse effects in each of the domains, they require more intense clinical intervention than moderate marijuana users.

The effect of medical marijuana laws on crime: evidence from state panel data, 1990-2006

Background

Debate has surrounded the legalization of marijuana for medical purposes for decades. Some have argued medical marijuana legalization (MML) poses a threat to public health and safety, perhaps also affecting crime rates. In recent years, some U.S. states have legalized marijuana for medical purposes, reigniting political and public interest in the impact of marijuana legalization on a range of outcomes.

Methods

Relying on U.S. state panel data, we analyzed the association between state MML and state crime rates for all Part I offenses collected by the FBI.

Findings

Results did not indicate a crime exacerbating effect of MML on any of the Part I offenses. Alternatively, state MML may be correlated with a reduction in homicide and assault rates, net of other covariates.

Conclusions

These findings run counter to arguments suggesting the legalization of marijuana for medical purposes poses a danger to public health in terms of exposure to violent crime and property crimes.

Testing pathways linking exposure to community violence and sexual behaviors among African American youth

Exposure to community violence and HIV sexual risks are two major public health concerns among youth. This study tests various pathways linking exposure to community violence and sexual behaviors among African American adolescents. Using a sample of 563 (61% females) African American youth attending high school we examined whether problematic psychological symptoms, low school engagement, and/or negative perceptions of peer norms about safer sex functioned as pathways linking exposure to community violence and sexual behaviors. Major findings indicated that, for boys, the relationship between exposure to community violence and sexual début and sexual risk behaviors were linked by aggression. In addition, the relationship between exposure to community violence and sexual risk behaviors were linked by negative perceptions of peer attitudes about safer sex. For girls, the relationship between exposure to community violence and sexual début was linked by aggression and negative perceptions of peer attitudes about safer sex. These findings provide support for pathways linking exposure to community violence to sexual behaviors.

Substance abuse in high school students in association with socio-demographic variables in northwest of iran

BACKGROUND

Substance abuse in adolescents and its often tragic consequences, including addiction, is one of the preventable major public health problems. The aims of this paper were to estimate the prevalence of substance abuse and to evaluate its some associated factors in adolescents of Tabriz City (northwest of Iran).

METHODS

A self-administered questionnaire was completed in 4903 randomly selected students with mean age of 15.7 years old. The aim of the questionnaire was obtaining information on substance abuse, socio-economical information, cigarette smoking behavior, general risk taking behavior, self-esteem, attitude towards smoking and self-injury as well as demographical characteristics.

RESULTS

Prevalence of substance abuse was 1.4% (95% CI: 1.1-1.7) which was different statistically significant between boys (2.4%) and girls (0.6%) (P<0.001). Older age (OR=1.43), not living with parents (OR=2.34), having general risk taking behavior (OR=2.26), higher smoking stage (OR=2.39), lower self-esteem (OR=1.09) and positive attitude toward smoking (OR=1.08) were factors associated with student's ever use of substance.

CONCLUSION

The result has shown low prevalence of substance abuse in Iranian adolescents. Our findings showed some associated factors such as lower self-esteem with adolescent's substance abuse.

Examining risk and protective factors for alcohol use in lesbian, gay, bisexual, and transgender youth: a longitudinal multilevel analysis

OBJECTIVE

Lesbian, gay, bisexual, and transgender (LGBT) youth are at increased risk for alcohol misuse, but little is known about the psychosocial and demographic factors that are associated with these differences over time. The purpose of this study was to investigate change in alcohol use across development. We aimed to describe group/demographic differences in alcohol use, the effects of psychosocial variables on drinking within persons (i.e., psychological distress, sexual orientation-based victimization, and perceived family support), and the interactions between demographic differences and longitudinal psychosocial variables in predicting rates of alcohol use.

METHOD

The current study used data from the longest running longitudinal study of LGBT youth. Hierarchical linear modeling was used to examine both demographic differences and psychosocial predictors of alcohol use in an ethnically diverse sample of 246 LGBT youth (ages 16-20 years at baseline) across five time points over 2.5 years.

RESULTS

Drinking increased significantly over time in a linear fashion, although it tended to increase more rapidly among male LGBT youth compared with females. Analyses of group differences revealed lower average rates of drinking for African American and female LGBT youth, and there were no differences between bisexual youth and gay/lesbian youth. Psychological distress and sexual orientation-based victimization were associated with increased alcohol use at each wave of data collection for female LGBT youth only. Perceived family support at each wave was negatively associated with alcohol use for all LGBT youth.

CONCLUSIONS

Findings indicate that there is significant heterogeneity in the etiological pathways that lead to alcohol use in LGBT youth and that correlates of drinking are similar to those found in general populations. These crucial findings indicate that existing alcohol interventions also may be effective for LGBT youth and open up a wider array of prevention and treatment options for this at-risk population.

Gender differences in risky sexual behavior among urban adolescents exposed to violence

PURPOSE

The purpose of this study was to use an ecological lens to explore gender differences in risky sexual behavior among urban adolescents exposed to violence.

DATA SOURCES

This was a secondary analysis of data from a larger behavioral intervention trial that targeted drinking behaviors among adolescents. Data from a total of 2,560 male and female urban adolescents between the ages of 14 and 21 were analyzed for personal, interpersonal, and community exposure to violence and risky sexual behavior.

CONCLUSIONS

Violence has an impact on sexual risk. For females, carrying a weapon (p= 0.020) and feeling safe in intimate relationships (p= 0.029) were individual correlates of risky sexual behavior, while for males, race/ethnicity (p= 0.019) and being in a physical fight (p= 0.001) were significant correlates of risky sexual behavior.

IMPLICATIONS FOR PRACTICE

Risky sexual behavior among adolescents may lead to negative reproductive health outcomes. Nurse practitioners are in an excellent position to affect change in this population through their frequent contact with adolescents in a variety of community and school-based venues. Nurse practitioners are also well-prepared to identify at-risk adolescents and provide them with individualized care, education, and support.

Social ecological determinants of youth violence among ethnically diverse Asian and Pacific Islander students

This study assesses the relative fit of risk/protective and social ecological models of youth violence among predominantly Asian and Pacific Islander students. Data from a 2007 survey of two multi-ethnic high schools in Hawai'i were used. The survey assessed interpersonal youth violence, suicidality and risk and protective factors. Two models of youth violence (risk/protective and social ecological) were tested using structural equation modeling. We found good fits for the risk/protective model (χ(2) = 369.42, df = 77, P < .0001; CFI = .580; RMSEA = .066) and the ecological model (χ(2) = 1763.65, df = 292, P < .0001; CFI = .636; RMSEA = .076). The risk/protective model showed the importance of coping skills. However, the ecological model allowed examination of the interconnectivity among factors. Peer exposure to violence had no direct influence on individuals and peer influence was fully mediated by school climate. Furthermore, family factors directly contributed to peer exposure, community, and individual risk/protection. These findings have significant implications for intervention and prevention efforts and for the promotion of positive, competent, and healthy youth development. While few family and school-based programs have been developed and evaluated for adolescents, they have the greatest potential for success.

Urban seventh grade students: a report of health risk behaviors and exposure to violence

The health of adolescents and the adults they will become can be linked to the health-related behaviors they adopt as children. To replicate a pilot study with a more culturally diverse population a descriptive, correlational study was undertaken with 379 seventh grade students. Key findings from this study include (a) students exposed or involved in violence (e.g., fighting and carrying a weapon) were more likely to report smoking cigarettes, (b) nearly a quarter (24%) of students have smoked cigarettes at some time, and (c) almost half of the students (48%) reported having at least one alcoholic drink. Middle school can be critical time in the life of an adolescent who may be faced with opportunities to experiment with and participate in health risk behaviors. School nurses, practitioners, and other health care professionals are in an ideal position to assess the type of and level of participation by an adolescent in a health risk behavior.

Effects of the Positive Action programme on problem behaviours in elementary school students: a matched-pair randomised control trial in Chicago

This study examined the effects of the Positive Action (PA) programme in Chicago Public Schools on problem behaviours among a cohort of elementary school students from grade three through grade five. Using a matched-pair, randomised control design with 14 elementary schools, approximately 510 fifth-graders self-reported lifetime substance use, serious violence-related behaviour, and current bullying and disruptive behaviours. Three-level (i.e. students nested within schools within school pairs) overdispersed Poisson models were used to examine programme effects on the number of items endorsed for each of the four outcomes. Findings indicated that students in the intervention endorsed 31% fewer substance use behaviours (incidence rate ratio [IRR] = 0.69), 37% fewer violence-related behaviours (IRR = 0.63) and 41% fewer bullying behaviours (IRR = 0.59), respectively, compared to students in the control schools. Reduction in reported disruptive behaviours was of a similar magnitude (27%, IRR = 0.73), but was not statistically significant. These results replicate findings of an earlier randomised trial of the PA programme and extend evidence of its effectiveness to youth attending large urban school systems.

Does Alcohol Use Predict Violent Behaviors? The Relationship Between Alcohol Use and Violence in a Nationally Representative Longitudinal Sample

The current study examined the relationship between alcohol and violence using a longitudinal survey of adolescents ages 11-26. Data were derived from 10,828 adolescents in the National Longitudinal Study of Adolescent Health (Add Health) Waves I-III. Survey logistic regression was used to examine the relationship between alcohol use and violence. Even after adjustment for baseline, consistent alcohol use predicted violence in young adulthood (OR =1.41; 95% CI [1.03, 1.91]); however, violence was not predictive of problematic alcohol use. Overall, consistent alcohol use appears to be a predictor of serious physical violence, whereas physical violence does not predict problematic alcohol use.

Does marijuana use lead to aggression and violent behavior?

Marijuana use and violent behavior are causing widespread public concern. This article reviews theory and research on the relation between marijuana use and aggressive/violent behavior. It is evident from the inconsistent findings in the literature that the exact nature of the relation remains unclear. This article identifies several possible reasons for these contradictory findings and provides suggestions for future research. In particular, more research is needed on the different subtypes of aggressive behavior. Further research is also needed to elucidate the associations between gender, marijuana use, and violent behavior. Likewise, an important task for future research is to continue to tease apart the complex relations between gang involvement, marijuana use, and violent behavior. Longitudinal studies also warrant further investigation. Moreover, future research should control for several potentially confounding variables.

Health-risk behaviors in early adolescence

The major morbidities and mortalities of adolescents are related to preventable risky behaviors, but how, when, and in whom these behaviors develop in early adolescence is unknown. The purpose of this study was to determine which set of risk factors and protective resources of school-age children were best predictors of health-risk behaviors in early adolescence. A longitudinal, cohort sequential design was used with a diverse sample of 1,934 children in grades 4 through 8. Parents provided demographic and neighborhood data for children through a mailed survey. Children completed valid scales annually at schools, using audio-computer-assisted self-interviewing (A-CASI) technology. Significant gender and racial/ethnic differences were found in carrying a weapon and using alcohol. Higher perceived levels of stress increased the risk for alcohol use as did riding in a car with a driver who was drinking. Health behaviors exhibited while in 4th through 6th grades protected early adolescents from alcohol use and riding in a car with a driver who was drinking. A parent's education and perceived safety in neighborhood protected against carrying a weapon and smoking. Many findings are similar to those of national samples, but others show positive differences in this localized sample, over 50% of whom were Latino. Protective resources suggest numerous nursing interventions to promote healthy adolescent development.

Examination of Sex and Race Differences in Longitudinal Predictors of the Initiation of Adolescent Dating Violence Perpetration

We examined longitudinal predictors of dating violence perpetration and determined if predictors varied by sex and race. Analyses were with 1,666 adolescents who completed questionnaires in a fall and spring semester. Depression, marijuana use, and aggression against peers predicted perpetration by girls but not by boys. Anxiety predicted perpetration by white adolescents and anger predicted perpetration by black adolescents. Number of friends using dating violence was a predictor for all groups. Black girls were more likely to initiate dating violence than all other groups. The findings can inform the development of programs for the primary prevention of adolescent dating violence.

Prevalence and patterns of alcohol consumption and health-risk behaviors among high school students in Thailand

BACKGROUND

Underage drinking is a significant social and public health problem in Thailand. We report the prevalence and patterns of alcohol consumption and associated health-risk behaviors using data from a 2007-2008 national school survey.

METHOD

A cross-sectional survey using a self-administered questionnaire was conducted among 50,033 high school and vocational college students from 201 schools in 40 provinces between December 2007 and February 2008.

RESULTS

The prevalence rates of past-year drinking, past-30-day binge drinking, and drinking until intoxication were 25.5, 9.5, and 17.3% in boys and 14.5, 3.7, and 7.2% in girls, respectively. Higher school levels, lower grades, living with someone other than their own parents, and having family members with substance or alcohol problems were significantly associated with all kinds of drinking. Binge drinkers were significantly more likely to have drinking consequences, e.g., driving after drinking, nausea and vomiting, and having a hangover than were nonbinge drinkers. The rates of other behavior and emotional problems were 2.5 to 6.7 times as likely in drinkers as nondrinkers, including smoking (35.1% vs. 4.9%), prescription drug misuse (17.7% vs. 6.7%), illicit substance use (17.8% vs. 2.4%), carrying a weapon (6.5% vs. 1.8%), feeling depressed (23.2% vs. 10.9%), suicidal attempt (10.5% vs. 3.8%), and sexual intercourse (30.5% vs. 5.7%).

CONCLUSION

Alcohol consumption is a serious problem among adolescents in Thailand and is strongly associated with various health-risk behaviors. Effective age- and gender-specific interventions should be implemented to discourage underage drinking and associated adverse health and social consequences.

Cognitive coping moderates the association between violent victimization by peers and substance use among adolescents

OBJECTIVE

This study tested whether violent victimization by peers was associated with alcohol and tobacco use among adolescents, and whether adaptive coping styles moderated associations.

METHODS

A total of 247 urban Mexican-American and European-American adolescents aged 16-20 years were interviewed.

RESULTS

Independent of demographics and violent perpetration, adolescents victimized by violence reported greater alcohol and tobacco use. Adolescents who engaged in higher levels of behavioral coping (e.g., problem solving) reported less substance use, independent of violence variables. Interaction effects showed that violent victimization was associated with greater substance use only among adolescents who engaged in lower levels of cognitive coping (e.g., focusing on positive aspects of life). Substance use was relatively low among adolescents who engaged in higher levels of cognitive coping, regardless of whether they had been victimized.

CONCLUSIONS

Enhancement of cognitive coping skills may prevent engagement in substance use as a stress response to violent victimization.