The use of an ecodevelopmental approach to examining substance use among rural and urban Latino/a youth: peer, parental, and school influences

Parental psychopathology and posttraumatic stress in Puerto Ricans: the role of childhood adversity and parenting practices

BACKGROUND

Parental psychopathology is associated with their children's posttraumatic stress symptoms (PTSS). However, the mechanisms through which this occurs remain unclear. We hypothesized that exposure to childhood adversities is the mechanism linking parental psychopathology to child PTSS and that parenting practices moderated these associations.

METHODS

Participants (N = 1,402) with an average age of 24.03 years old (SD = 2.20), were all Puerto Ricans (50% Male and 50% Female) from the Boricua Youth Study, which is a four-wave longitudinal study spanning almost 20 years, following individuals from childhood (ages 5-13 at Wave 1) to young adulthood. Measured variables include parental psychopathology at Wave 1, childhood adversities and parenting practices at Waves 2-3, and PTSS at Wave 4. A traditional mediation model estimated the association between parental psychopathology and child PTSS via childhood adversities. A moderated mediation model was used to examine whether parenting practices moderated this mediation model.

RESULTS

Results showed that the total effect of parental psychopathology at Wave 1 on PTSS at Wave 4 was fully mediated by childhood adversities at Waves 2-3 (direct effect b = 1.72, 95% CI = [-0.09, 3.83]; indirect effect b = 0.40, 95% CI = [0.15, 0.81]). In addition, the magnitude of this pathway varied by levels of parenting practices (i.e. parental monitoring and parent-child relationship quality). Specifically, the indirect effect of additional adversities in the psychopathology-PTSS link was stronger with higher levels of parental monitoring but weaker with higher parent-child relationship quality scores.

CONCLUSIONS

Intergenerational continuity of psychopathology may be mitigated through the prevention of additional childhood adversities via upstream interventions, emphasizing providing parents with mental health needs with parenting tools. Family-based interventions focused on providing families with the tools to improve parent-child relationships may reduce the negative impact of childhood adversities on mental health across the life course.

Associations between Family Factors and Youth Substance Use Across the Rural-Urban Continuum: A Person-/Variable-Centered Approach

Few studies have evaluated the influence of both family factors and geographic location on youth substance use. To address this gap, a person-/variable-centered approach was used to: (1) identify latent profiles of family risk and protective factors for substance use, (2) test profile membership as a predictor of lifetime and 30-day substance use, (3) test rurality, as measured by school geographic location, as a predictor, and (4) explore interaction effects between profile membership and rurality. Youth (N=9,104; 53% female) residing in a state in the southeastern U.S. completed a statewide substance abuse and risk behavior survey including questions about family risk and protective factors and substance use behaviors. Using latent profile analysis to identify subgroups of participants with similar means and variances on the family factors, four latent profiles emerged. Risk of 30-day and lifetime substance use varied across profiles, with the profile characterized by high family-level protective factors and low family-level risk factors indicating the lowest risk for substance use. Urban youth had increased odds of reporting lifetime marijuana use compared to suburban youth; however, geographic location did not appear to confer significantly increased or decreased risk across other substances. No significant interaction results were found. These results emphasize the importance of family functioning on substance use regardless of geographic location, and that evidence-based prevention programming that reduces family risk, strengthens family protection, and is accessible to all types of communities is important to reducing or delaying substance use among youth.

A scoping review of school-level risk and protective factors of youth cannabis use: An application of the socio-ecological model

Risk and protective factors for cannabis use exist at various levels of influence, and the school environment can play a key role in preventing cannabis use and initiation as most youth. By using the socio-ecological model to hierarchically characterize school-specific risk and protective factors, a wholistic approach to school-based cannabis use prevention can be demonstrated. This study uses scoping review methodology to describe current research on school-level risk and protective factors of youth cannabis use. The socio-ecological model was used as a guiding framework to characterize the literature. PubMed, Embase, and Scopus were used to retrieve original research articles published between 2010 and 2020 that examined cannabis use as a main outcome of interest. Articles that examined school-related risk and protective factors within participants who were 18 years old or younger were included. Articles that met the pre-established criteria were extracted and categorised by theme based on levels of the socio-ecological framework. Four levels of risk and protective factors related to the school environment were identified (individual, interpersonal, community, and societal). A majority of school-based research examined individual and societal factors that influenced youth cannabis use. Our findings suggest most available research has focused on individual and societal school-level factors of cannabis use. A number of consistent themes were identified, however, findings were mixed and demonstrate the need for a more critical examination of research in order to understand which risk and protective factors are most influential among youth.

Delinquency, Substance Use, and Risky Sexual Behaviors among Youth who are involved in the Justice System and Predominantly Reside in Rural Communities: Patterns and Associated Risk Factors

There is a significant gap in research examining the prevalence of problem behaviors among youth involved in the juvenile justice system in rural areas. The current study sought to address this gap by exploring the behavioral patterns of 210 youth who were on juvenile probation in predominantly rural counties and who were identified as having a substance use disorder. First, we examined the correlation among 7 problem behaviors representing different forms of substance use, delinquency, and sexual risk-taking and 8 risk factors related to recent service utilization, internalizing and externalizing difficulties, and social support networks. Then, we used latent class analysis (LCA) to identify distinct behavioral profiles based on the observed problem behaviors. LCA identified a 3-class model representing distinct groups labeled Experimenting (70%), Polysubstance Use + Delinquent Behaviors (24%), and Diverse Delinquent Behaviors (6%). Finally, we assessed differences (i.e., ANOVA, χ2) in each risk factor across the behavioral profiles. Important similarities and differences in the association among the problem behaviors, behavioral profiles, and the risk factors were revealed. These findings underscore the need for an interconnected behavioral health model within rural juvenile justice systems that is able to address youths' multidimensional needs including criminogenic, behavioral, and physical health needs.

Perception of Parental Knowledge by Parents and Adolescents: Unique Effects on Recent Substance Use in a Latinx Sample

The main objective of the current study is to analyze how the unique perspectives from both parents and children in regards to parental knowledge of the child's whereabouts, activities, and friendships are related to the adolescent's recent substance use four months later. Differences between parents and children, as well as between male and female adolescents are examined. Data come from a Latinx sample (mostly Mexican-origin) of 523 parent-adolescent dyads from Arizona (US) using a multi-informant approach (parent and adolescent reports). The results indicate that parents, especially mothers, report higher levels of parental knowledge than adolescents do. The structural equation modeling (SEM) results for the total sample indicate that both parents' and adolescents' unique perception of the level of parental knowledge is negatively related to the adolescents' recent alcohol and cannabis use four months later. Further, multi-group SEM results split by gender indicate that parents' unique perception of higher levels of parental knowledge is only marginally related to lower alcohol use for both males and females, whereas adolescents' unique perception is negatively related to alcohol and cannabis use (significantly) and tobacco use (marginally) for both males and females. No significant gender differences were found in the effects of parental knowledge on substance use. Findings suggest that parents' and adolescents' perceptions seem to be quite distinctive and independent from each other. Implications of these results regarding intervention programs for preventing substance use are discussed.

Psychosocial Correlates of Marijuana Use among Pregnant and Nonpregnant Adolescent Girls

STUDY OBJECTIVE

Pregnant and nonpregnant populations in the United States report marijuana as the most commonly used illicit drug. Patterns of marijuana use and psychosocial correlates are unclear among non-treatment-seeking teenage girls. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: The objective of this study was to use cross-sectional data to examine the psychosocial correlates of recent marijuana use among a sample of 646 pregnant and nonpregnant adolescent girls presenting to urban primary care clinics (mean age = 15.6 years, SD = 1.9 years; 65% African American; 8.8% pregnant).

RESULTS

In Poisson regression analysis, frequency of marijuana use was significantly associated with greater likelihood of pregnancy (incident rate ratio [IRR], 1.30; 95% CI, 1.03-1.65), alcohol use (IRR, 1.11; 95% CI, 10.08-1.14), condomless sex (IRR, 1.95; 95% CI, 1.61-2.37), parents' drug use (IRR, 1.04; 95% CI, 1.02-1.05), and negative peer influences (IRR, 1.12; 95% CI, 1.10-1.16).

CONCLUSION

Marijuana use among adolescent girls in this sample was associated with a number of risk behaviors as well as parental and peer influences. Culturally sensitive screening and intervention approaches for marijuana use among adolescent girls should address multiple individual, relationship, and community factors, to prevent unwanted pregnancy as well as to reduce marijuana use during this vulnerable time.

Tobacco use: prevalence, pattern, and predictors, among those aged 15-49 years in Nigeria, a secondary data analysis

INTRODUCTION

Tobacco use is a major global public health challenge. It is a risk factor for most leading causes of death, and its health impacts span from conception to adulthood. This study aims to analyse tobacco use data from the 2013 Nigerian Demographic and Health Survey (NDHS), assessing the prevalence, pattern, and socio-demographic correlates of tobacco use among Nigerians aged 15-49 years.

METHODS

A secondary data analysis involving 2013 NDHS was done. Data on 17 322 respondents were extracted from 36 800 participants. This number represents respondents with complete data on outcome variables of interest. Primary Sampling Unit defined on the basis of Enumeration Areas from the 2006 census was used. Head of selected household, all men and women aged 15-49 were studied. Data was collected using questionnaires. A chi-squared test and a binary logistic regression model were used in the analysis.

RESULTS

Generally, 6.6% of the respondents smoked cigarettes, 1.7% used snuff, 0.4% smoked pipe, and 0.2% chewed tobacco. Based on gender, 6.6% males and 6.3% females smoked cigarettes, 0.3% males and 0.4% females smoked cigarettes as well as used snuff. Predictors of cigarette use included being in age group 25-34 years (AOR 5.8; 95% CI 4.6-7.2), being ≥35 years (AOR 4.1; 95% CI 4.1-6.8), having attained primary education (AOR 1.4; 95% CI 1.2-1.8), living in north region (AOR 1.3; 95% CI 1.1-1.5), as well as being a Moslem (AOR 0.6; 95% CI 0.5-0.7).

CONCLUSIONS

A minor proportion of both genders uses tobacco with the commonest form being cigarettes. The commonest combination was cigarettes and snuff, even on stratification by gender. The identified predictors were age in categories, educational level and religion.

Long-term effectiveness of a combined student-parent and a student-only smoking prevention intervention among 7th grade school children in Berlin, Germany

BACKGROUND AND AIMS

In Germany, the smoking prevalence among adolescents is among the highest in Europe. Our aim was to evaluate the long-term effectiveness of a combined student-parent and a student-only smoking prevention programme to reduce the smoking prevalence among 7th grade students in Berlin.

DESIGN

Three-armed cluster-randomized controlled trial (RCT). Schools as cluster units were randomized into (i) student intervention, (ii) combined student-parent intervention or (iii) control group, with follow-up after 12 and 24 months.

SETTING

High schools and integrated secondary schools in Berlin, Germany.

PARTICIPANTS

Seventh grade students aged 11-16 years. We included 47 schools, 161 classes and 2801 students [50.1% girls, mean age ± standard deviation (SD) = 13.0 ± 0.6 years].

MEASUREMENTS

The primary outcome was self-reported regular smoking (at least one cigarette per day) after 24 months (point prevalence). Further self-reported outcomes were other smoking behaviours as well as parental rules and attitudes towards smoking. Comparisons were calculated as odds ratios (OR) with 95% confidence intervals (CI).

FINDINGS

At baseline, 2.3% of the students reported that they smoked regularly. After 24 months, 7.8% and 7.0% were regular smokers in the student-only intervention and the student-parent intervention, respectively, compared with 10.1% in the control group. The OR for being a regular smoker was 0.81 (0.34-1.92) for the student-parent intervention versus control, 0.95 (CI = 0.41-2.22) for the student-only intervention versus control and 0.85 (0.38-1.89) for student-parent intervention versus student-only intervention.

CONCLUSION

A combined student-parent smoking prevention intervention delivered via secondary schools in Berlin, Germany did not result in a statistically significant reduction in regular smoking compared with a control group or a student-only intervention. The student-only intervention did not result in a significant reduction in regular smoking compared with the control group.

Adolescent Alcohol Use in Spain: Connections with Friends, School, and Other Delinquent Behaviors

This study examined the connections between adolescent alcohol use in Alicante, Spain and variables reflecting adolescents' academic problems, potentially delinquent behaviors, friends' alcohol consumption, and friendship quality. Information about alcohol use and a number of school and social variables was collected from adolescent students (N = 567) who completed the National Students School-Based Drug Survey in a classroom setting. Results suggested that gender was not significantly associated with alcohol use, although alcohol use increased with age and was more likely for adolescents enrolled in public schools compared to private. After controlling for age and type of school (public vs. private), academic problems explained 5.1% of the variance in adolescents' alcohol use, potentially delinquent behaviors explained 29.0%, friends' alcohol use 16.8%, and friendship quality 1.6%. When all unique predictors from these four models were included in a comprehensive model, they explained 32.3% of the variance in adolescents' alcohol use. In this final model, getting expelled, participating in a fight, going out at night, the hour at which one returns, and the number of friends who have consumed alcohol were uniquely and positively associated with adolescents' alcohol use. These results provide important information about multi-system influences on adolescent alcohol use in Alicante, Spain and suggest potential areas of focus for intervention research.

Examination of the community-specific prevalence of and factors associated with substance use and misuse among Rural and Urban adolescents: a cross-sectional analysis in Bosnia and Herzegovina

OBJECTIVE

The community of residence (ie, urban vs rural) is one of the known factors of influence on substance use and misuse (SUM). The aim of this study was to explore the community-specific prevalence of SUM and the associations that exist between scholastic, familial, sports and sociodemographic factors with SUM in adolescents from Bosnia and Herzegovina.

METHODS

In this cross-sectional study, which was completed between November and December 2014, the participants were 957 adolescents (aged 17 to 18 years) from Bosnia and Herzegovina (485; 50.6% females). The independent variables were sociodemographic, academic, sport and familial factors. The dependent variables consisted of questions on cigarette smoking and alcohol consumption. We have calculated differences between groups of participants (gender, community), while the logistic regressions were applied to define associations between the independent and dependent variables.

RESULTS

In the urban community, cigarette smoking is more prevalent in girls (OR=2.05; 95% CI 1.27 to 3.35), while harmful drinking is more prevalent in boys (OR=2.07; 95% CI 1.59 to 2.73). When data are weighted by gender and community, harmful drinking is more prevalent in urban boys (OR=1.97; 95% CI 1.31 to 2.95), cigarette smoking is more frequent in rural boys (OR=1.61; 95% CI 1.04 to 2.39), and urban girls misuse substances to a greater extent than rural girls (OR=1.70; 95% CI 1.16 to 2.51,OR=2.85; 95% CI 1.88 to 4.31,OR=2.78; 95% CI 1.67 to 4.61 for cigarette smoking, harmful drinking and simultaneous smoking-drinking, respectively). Academic failure is strongly associated with a higher likelihood of SUM. The associations between parental factors and SUM are more evident in urban youth. Sports factors are specifically correlated with SUM for urban girls.

CONCLUSIONS

Living in an urban environment should be considered as a higher risk factor for SUM in girls. Parental variables are more strongly associated with SUM among urban youth, most probably because of the higher parental involvement in children' personal lives in urban communities (ie, college plans, for example). Specific indicators should be monitored in the prevention of SUM.