Alcohol use among Hispanic early adolescents in the United States: an examination of behavioral risk and protective profiles

Alcohol use among in-school adolescents in Sierra Leone

OBJECTIVE

To examine the prevalence of alcohol use and its associated factors among in-school adolescents in Sierra Leone.

DESIGN

Data for the study was sourced from the 2017 Sierra Leone Global School-Based Student Health Survey, a nationally representative survey conducted among in-school adolescents aged 10-19 years using a multistage sampling methodology. Percentages were used to present the prevalence of alcohol use among in-school adolescents. Multivariable binary logistic regression analysis was performed to examine the factors associated with alcohol use among in-school adolescents. The results were presented using adjusted odds ratios (aOR) with their respective 95% confidence interval (CI).

SETTING

Sierra Leone.

PARTICIPANTS

A weighted sample of 1730 in-school adolescents in Sierra Leone.

OUTCOME MEASURE

Current alcohol use.

RESULTS

The prevalence of alcohol use among in-school adolescents was 10.7% (7.3, 15.3). In-school adolescents in senior secondary schools were more likely to use alcohol compared with those in junior secondary school (aOR=2.13; 95% CI 1.37, 3.30). The odds of alcohol use was higher among in-school adolescents who were truant at school relative to those who were not (aOR=2.24; 95% CI 1.54, 3.26). Also, in-school adolescents who were bullied (aOR=1.85; 95% CI 1.24, 2.76), ever engaged in sexual intercourse (aOR=2.06; 95% CI 1.39, 3.06), and used marijuana (aOR=3.36; 95% CI 1.72, 6.53) were more likely to use alcohol compared with those who were not. However, in-school adolescents who reported that their parents understood their problems (aOR=0.52; 95% CI 0.33, 0.82) had a lower likelihood of consuming alcohol.

CONCLUSION

Our study has shown that alcohol use is prevalent among in-school adolescents in Sierra Leone. Grade level, experiences of being bullied, history of sexual intercourse, truancy at school, and previous use of marijuana were the factors influencing alcohol use among in-school adolescents. The findings emphasise the necessity of creating school-based health interventions in Sierra Leone that can effectively identify in-school adolescents potentially vulnerable to alcohol-related issues. Also, existing policies and programmes aimed at reducing alcohol use among in-school adolescents need to be strengthened.

Agentic and Receptive Hope: Understanding Hope in the Context of Religiousness and Spirituality through the Narratives of Salvadoran Youth

Hope contributes to positive development in adolescents, and religious and spiritual contexts may be particularly important for developing and supporting hope. However, extant literature on hope, religion, and spirituality neglects their synergistic relation, leaving questions about how they work together to support development. In this study, we explore how religiousness and spirituality (R/S) inform hope by identifying unique synergies that might be particularly useful in difficult contexts. Multilevel qualitative content analyses of interviews conducted with 18 thriving Salvadoran adolescents (50% female, Mage = 16.39 years, SD = 1.83) involved in a faith-based program provided evidence that the ideological and relational resources associated with R/S informed these adolescents’ agentic and receptive hopes. Agentic hopes, identified through expressed hopeful future expectations, revealed that adolescents held beyond-the-self hopes focused on benefiting three distinct targets: God, community, and family. Youth also described “sanctified hopes”, which were hopes focused on fulfilling God’s purposes directly and indirectly. Analyses of receptive hopes, which consider how hope is shaped and empowered by context, revealed that for these youth, hope was experienced in seven key contexts: self, caring adult relationships, family, God, youth development sponsor, social activities, and peers. Implications for fostering hope in R/S contexts within low-to-middle-income countries are discussed.

The moderating effects of alcohol use with and without parent permission on alcohol risk communication in early adolescence

The frequency of parental alcohol risk communication (ARC) is considered an integral component of socializing youth about alcohol, but the literature offers mixed findings on whether such communication is protective. Early adolescents' prior drinking experiences may moderate the effectiveness of ARC, but evidence for such an interaction is inconsistent. One limitation of this work considering prior drinking experience is that it has not distinguished drinking with versus without parental permission. Parents are one of the earliest sources of information about alcohol use and many parents view allowing adolescents to drink alcohol with permission as a harm reduction strategy, despite some work suggesting the opposite effect. Using a random effects multilevel regression, we tested the unique moderating effects of drinking with and without parental permission on the prospective association between alcohol risk communication and later drinking without parental permission. Adolescent and parent dyads completed 3 annual assessments (first assessment mean age = 12.6, 52% girls, 76% White/non-Hispanic). Results supported a three-way interaction. There was a modest protective effect of parental ARC on later adolescent drinking, but only for adolescents who had prior experience drinking both with and without parental permission. For all other combinations of prior drinking experience, parental communication was not prospectively related to later drinking. These results help clarify the mixed literature on alcohol communication and suggests that ARC may help reduce some of the risk associated with allowing youth to drink alcohol but only for youth who also have experience with alcohol outside of parental supervision.

Cultural Stress Theory in the Context of Family Crisis Migration: Implications for Behavioral Health with Illustrations from the Adelante Boricua Study

On September 20, 2017, Hurricane Maria made landfall in Puerto Rico as a Category 4 hurricane with sustained winds of 155 miles per hour and torrential rains that ravaged the United States territory. In the midst of the crisis, several hundred thousand Maria survivors boarded humanitarian flights and cruise ships, seeking refuge on the United States mainland. More than three years later, tens of thousands of post-Maria migrants remain on the mainland as long-term emigres. In this article, we lay the theoretical/conceptual groundwork for researchers and practitioners interested in understanding the experiences of post-Maria migrants. Specifically, we aim to assist readers in thinking deeply about: [1] why many Puerto Ricans relocated, [2] the experiences of post-Maria migrants en movimiento, and [3] how such experiences shape their lives, behavior, and well-being. In understanding the experiences of post-Maria migrants, several theories/constructs emerge as especially salient. These include "push and pull" models, cultural stress theory and its transnational variants, the concept of crisis migration, and models of cumulative risk. We provide a succinct overview of each of these theories/constructs and describe the broad perspectives that serve as a foundational or orienting paradigm for our work (i.e., the life course perspective, the strengths perspective, and an ecodevelopmental framework). Finally, we provide illustrations of how these theories/concepts apply to emerging data from the Adelante Boricua study, an ongoing research project with post-Maria migrant youth and their parents, supported by funding from the National Institute on Minority Health and Health Disparities.

Health risk behavior and cultural stress among Venezuelan youth: a person centered approach

BACKGROUND

In recent years, more than 5 million Venezuelans have left their once prosperous country, with several hundred thousand settling in the United States (US). At present, our understanding of the health risk behavior profiles of Venezuelan émigré youth, and their links with cultural stress, remains limited.

OBJECTIVES

Drawing from a sample of recently-immigrated Venezuelan youth in the US, we aim to identify subtypes of youth according to their involvement in health risk behaviors (i.e., substance use, sexual risk behavior, violence) and assess the associations between class membership and key constructs related to cultural stress theory (i.e., negative context of reception, family communication/support).

METHOD

Latent profile analysis and multinomial regression were performed using data from a community-based convenience sample of 402 recently-arrived Venezuelan immigrant youth (ages 10-17; 56% male).

RESULTS

We identified five subtype classes: (1) "Abstainer" (36%), (2) "Alcohol Only" (24%), (3) "Alcohol/Tobacco" (24%), (4) "Aggression" (8%), and (5) "Multidimensional Risk" (8%). Compared to Class #1, youth in Classes #3 and #5 reported significantly higher levels of negative context of reception and lower levels of family functioning while controlling for demographic factors. Youth in Class #5 reported the lowest levels of family economic hardship and the longest duration in the US.

CONCLUSION

It is vital that we support both Venezuelan youth who abstain from risk behavior and, at the same time, develop and implement programs that target the needs of those who are at elevated risk for serious consequences related to substance use, sexual risk behavior, and violence.

Preconception and Prenatal Predictors of Early Experiences of Risk and Protection Among Alaska Children

OBJECTIVES

Our objective was to identify preconception and prenatal predictors of early experiences of co-occurring risk and protective factors to help target prevention efforts to the highest-need families prior to the birth of the child.

METHODS

Data were from the Alaska Longitudinal Child Abuse and Neglect Linkage project and the 2012-2014 Alaska Child Understanding Behaviors Survey. We used latent class analysis and Vermunt's three-step approach to examine predictors of latent classes of risk and protective factors among Alaska children.

RESULTS

Among children of Alaska Native/American Indian mothers, financial (OR 2.02, 95% CI 1.04, 3.90) and partner stress (OR 2.06, 95% CI 1.02, 4.10) prior to childbirth, maternal education < 12 years (OR 2.29, 95% CI 1.05, 4.96), and maternal substance use (OR 2.52, 95% CI 1.30, 4.89) were associated with a higher likelihood of membership in a high risk/moderate protection class as compared to a low socioeconomic status/high protection class. Among children of non-Native mothers, partner stress prior to childbirth (OR 3.92, 95% CI 1.08, 14.19), maternal education < 12 years (OR 2.69, 95% CI 1.24, 5.81), maternal substance use (OR 2.69, 95% CI 1.24, 5.81), younger maternal age (OR 0.87, 95% CI 0.80, 0.95), and a greater number of children (OR 1.62, 95% CI 1.09, 2.41) were associated with a higher likelihood of membership in a moderate risk/high protection class as compared to a low risk/moderate protection class.

CONCLUSIONS

Results can inform eligibility criteria for prenatal home visiting programs and prenatal screening in Alaska to ensure prevention programming and referrals are directed to families most in need of additional support.

Trends in Perceived Access to Marijuana Among Adolescents in the United States: 2002-2015

OBJECTIVE

There is concern that changes in marijuana-related policy and public opinion may lead to increased access to marijuana among young people in the United States. However, little research has been conducted on changes in youth's perceptions of marijuana access, and studies have yet to systematically examine trends in perceived access across key sociodemographic and externalizing behavioral subgroups.

METHOD

Using population-based data collected between 2002 and 2015 as part of the National Survey on Drug Use and Health, we examined trends in perceived marijuana access among non-Hispanic White, African American, and Hispanic adolescents (ages 12-17, n = 221,412). Following the trend analysis method outlined by the Centers for Disease Control and Prevention, we conducted logistic regression analyses to test for secular trends.

RESULTS

Between 2002 and 2015, we observed a 27% overall reduction in the relative proportion of adolescents ages 12-17-and a 42% reduction among those ages 12-14-reporting that it would be "very easy" to obtain marijuana. This pattern was uniformly observed among youth in all sociodemographic subgroups (i.e., across age, gender, race/ethnicity, household income) and among youth reporting involvement/no involvement in most measures of substance use (alcohol, marijuana) and delinquency (handgun carrying, attacks). However, perceived very easy access remained stable among youth reporting tobacco use and criminal justice system involvement.

CONCLUSIONS

Despite the legalization of recreational and medical marijuana in some states, our findings suggest that, with the notable exception of adolescent tobacco users and juvenile offenders, perceptions that marijuana would be very easy to obtain are on the decline among American youth.

[Alcohol consumption and physical violence among adolescents: which is the predictor?]

The scope of this integrative review was to investigate the association between alcohol consumption and physical violence in the literature, with an emphasis on identifying the predictor between them. A search was conducted in the Lilacs, Medline and SciELO databases, adopting "violence," "alcohool drinking" and "adolescent" as descriptors. It included articles published between 2005 and 2014 that analyzed the association between alcohol consumption and physical violence using multivariate analysis. Of the total of 1667 articles located, 29 met the inclusion criteria. Alcohol consumption was investigated more as a predictor of involvement in physical violence when the teenager is the perpetrator or the victim of violence, with a significant association found in 19 studies. However, when victimization was investigated as a predictor (7 studies), most of these (6) revealed no significant association with the intake of alcoholic beverages. The consumption of alcohol has proven to be the predictor of physical violence for both the teen perpetrator and for the adolescent victim of violence. However, having been the victim of violence in childhood and adolescence may also lead adolescents to alcohol consumption.

Trends in drug offers among adolescents in the United States, 2002-2014

BACKGROUND

Being offered illicit drugs is a critical factor leading to drug initiation and other psychosocial risk behaviors among adolescents in the United States. However, there exist few studies examining the recent trends in drug offers among adolescents, particularly across racial/ethnic subgroups. The present study examines trends and psychosocial/behavioral correlates of drug offers among adolescents of the three largest racial/ethnic groups.

METHODS

We used data from the 2002-2014 National Survey on Drug Use and Health of adolescents aged 12-17, which include African-American, Hispanic, and White adolescents (n = 199,700) in the U.S. We estimated the prevalence of past-month drug offers by race/ethnicity, and conducted logistic regression analyses to test the significance of the trends and to examine the correlates of drug offers.

RESULTS

Overall, the prevalence of drug offers decreased significantly from 16.3% in 2002 to 12.3% in 2014, reflecting a 24.5% reduction in the relative proportion of adolescents who were offered drugs. While the decreasing trends were observed in all subgroups (e.g., race/ethnicity), the decreases were more limited among African-American and Hispanic youth than White youth. As a result, while no differences were observed at the outset of the study, a higher proportion of African-American and Hispanic adolescents were offered drugs between 2012 and 2014.

CONCLUSIONS

Findings suggest a general decline in drug offers among adolescents in the U.S., but racial/ethnic differences in prevalence were identified. This underscores the importance of further efforts to understand the racial/ethnic differences in drug offers and suggests the need for culturally-sensitive drug prevention programs.

Trends in Fighting and Violence Among Adolescents in the United States, 2002-2014

OBJECTIVES

To examine trends in and correlates of fighting and violence among youths from the 3 largest racial/ethnic groups in the United States.

METHODS

We derived race/ethnicity-specific prevalence estimates for fighting, group fighting, and attacks with intent to harm from the National Survey on Drug Use and Health, a population-based study of youths aged 12 to 17 years.

RESULTS

The prevalence of youth fighting and violence decreased significantly in all racial/ethnic groups over the study period (2002-2014), dropping from a high of 33.6% in 2003 to a low of 23.7% in 2014, reflecting a 29% decrease in the relative proportion of young people involved in these behaviors. However, there was also a clear severity gradient in which year-by-year point estimates for fighting and violence were consistently highest among non-Hispanic African American youths, followed by Hispanic and then non-Hispanic White youths.

CONCLUSIONS

Although fighting and violence are on the decline among young people in general and across racial/ethnic subgroups, there is a stable pattern of disparities in youth involvement in these behaviors.

Mapping risk factors for substance use: Introducing the YouthMap12

BACKGROUND

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Self-Efficacy, Religiosity, and Crime: Profiles of African American Youth in Urban Housing Communities

Youth reporting independently elevated levels of religiosity and self-efficacy tend to abstain from externalizing behavior. However, little is known about the ways in which religiosity and self-efficacy interrelate to impact youth externalizing. Drawing from a sample of African American youth from public housing communities (N = 236), we use latent profile analysis to identify subtypes of youth based on self-reported religiosity and self-efficacy and, in turn, examine links with crime. Compared to youth in other subgroups, those classified as both highly religious and highly self-efficacious reported less involvement in minor and severe delinquency, but not violence.

A Typology of Substance Use Among Pregnant Teens in the United States

OBJECTIVES

Previous research suggests that, in general, youth who become pregnant during their teenage years tend to report elevated levels of substance use prior to conception and substantial reductions in use during pregnancy. While such studies provide insight into aggregate patterns of adolescent substance use in relation to pregnancy, they may have the unintended effect of masking the behavioral heterogeneity of pregnant teens.

METHODS

The present study employs data from a large, population-based study of adolescents in the United States. We employ latent class analysis to identify subgroups of pregnant adolescents (ages 12-17; n = 810) on the basis of variables measuring the past 12-month and past 30-day use of an extensive array of substances.

RESULTS

Results revealed a four class solution. Classes were identified as Class 1: Abstainers (n = 344, 42.47 %), Class 2: Drinkers (n = 303, 37.41 %), Class 3: Alcohol and Cannabis Users (n = 77, 9.51 %), and Class 4: Polydrug Users (n = 86, 10.62 %). The Abstainers class had the highest proportion of Hispanic youth (34.3 %) as well as the highest proportion of youth residing in households earning less than $20,000 per year (44.2 %). The Polydrug Users class had the highest proportion of youth who were in late adolescence (75.58 %), non-Hispanic white (54.65 %), high-income (13.95 %), and in their first trimester of pregnancy (58.33 %).

CONCLUSIONS FOR PRACTICE

Findings point to an important degree of heterogeneity among pregnant teens and may have implications for the development of interventions designed for youth exhibiting disconcerting patterns of substance use prior to pregnancy.

Attacks Intended to Seriously Harm and Co-occurring Drug Use Among Youth in the United States

BACKGROUND

While it is known that substance use and violence co-occur, less is understood in terms of how this relationship might vary based on the degree of youth involvement in violence.

OBJECTIVES

This study sought to examine the prevalence and degree that substance use disorders (SUD) and related intrapersonal and contextual factors were associated with violent attacks.

METHOD

Repeated cross-sectional data from a population-based study (National Survey on Drug Use and Health) of youth ages 12-17 (n = 216,852) in the United States between 2002 and 2013 were pooled to increase the analytic sample size. Survey multinomial regression was used to examine psychosocial and substance use differences between youth reporting episodic (1-2 times, n = 13,091; 5.84%) and repeated violent attacks (3+ times, n = 1,819; 0.83%) in contrast with youth reporting no attacks. Additional analyses examined the association of sociodemographic, intrapersonal, and contextual factors with SUD among youth reporting violent attacks.

RESULTS

The prevalence of SUD among youth with no attacks was 6% compared to 22% among episodic and 36% among repeatedly violent youth. Violence-involved youth were substantially more likely to experience elevated sensation-seeking, easy drug access, and recent drug offers and less likely to benefit from religiosity and protective substance use beliefs.

CONCLUSIONS/IMPORTANCE

Findings highlight the importance of distinguishing between the various gradations of violence among youth in understanding the relationship between substance use and violence, and shed light on the intrapersonal and contextual factors that can help identify violent youth at greatest risk for substance use problems.

Handgun carrying among White youth increasing in the United States: New evidence from the National Survey on Drug Use and Health 2002-2013

The objective of the present study was to examine trends and correlates of handgun carrying among adolescents ages 12-17 in the United States. Data was derived from the National Survey on Drug Use and Health (NSDUH) involving non-Hispanic White, African American, and Hispanic respondents ages 12-17 (n=197,313) and spanning the years 2002-2013. Logistic regression was used to examine significance of trend year and correlates of previous 12-month handgun carrying. The overall self-reported prevalence of handgun carrying was 3.4%. The prevalence of handgun carrying during 2004-2005 was significantly higher for African-Americans (4.39%) compared to non-Hispanic Whites (3.03%). However, by 2012-2013, non-Hispanic Whites (4.08%) completely diverged and reported carrying handguns significantly more than both African-American (2.96%) and Hispanic (2.82%) youth. Male gender and a number of externalizing behaviors were significant correlates of handgun carrying; however, we also found evidence of differential correlates with regard to such factors as drug selling, parental affirmation, and income by race/ethnicity. To our knowledge, this is the largest study of handgun carrying among youth in the United States. Findings indicate that although at historically low levels handgun carrying is on the rise but only among non-Hispanic Whites. Differential correlates among racial/ethnic groups suggest prevention programming and policies may need modifications depending on group and geographic locale targeted.

Age-related changes in the relationship between alcohol use and violence from early adolescence to young adulthood

Background

Despite the accumulation of studies examining the link between alcohol use and violence, no studies to our knowledge have systematically set out to detect age-related differences in these relationships. This limitation inhibits important insights into the stability of the relationship between alcohol use and violence among youth across varying ages.

Method

Study findings are based on repeated, cross-sectional data collected annually as part of the National Survey on Drug Use and Health between 2002 and 2013. We combined a series of nationally representative cross-sections to provide a multi-year string of data that, in effect, reflects a nationally representative non-traditional cohort. We conducted logistic regression analyses to examine the cross-sectional association between non-binge and binge drinking and violent attacks among youth between ages 12 (2002) and 24/25 (2013).

Results

With respect to the association between non-binge alcohol use and violence, the only significant relationship identified—while controlling for sociodemographic and drug use factors—was for youth at age 13 (2003; OR = 1.97, 95% CI = 1.04–3.72). For binge drinking, we identified a distinct pattern of results. Controlling for sociodemographic, drug use factors, and school enrollment, binge drinking was significantly associated with violence between ages 13 (2003) and 20 (2010) with the largest odds ratios observed during the early adolescent period.

Conclusions

Non-binge drinking is associated with violent behavior at age 13. Binge drinking was found to be associated with violence among youth through age 20; however, the relationship dissipates when youth arrive at the legal drinking age of 21.

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.

Racial and ethnic trends and correlates of non-medical use of prescription opioids among adolescents in the United States 2004-2013

PURPOSE

Our objective was to elucidate the trends in non-medical use of prescription opioids (NMUPO) among whites, African-Americans, and Hispanic adolescents in the United States. An additional aim was to examine the sociodemographic, behavioral, and psychosocial correlates of NMUPO across each of these aforementioned racial and ethnic groups.

METHODS

Data was derived from the National Survey on Drug Use and Health (NSDUH) involving non-Hispanic white, African American, and Hispanic respondents ages 12-17 (n = 164,028) and spanning the years 2004-2013. Consistent with prior NSDUH-based studies, respondents reporting use within the previous 12 months were classified as nonmedical prescription opioid users. Logistic regression was used to examine significance of trend year and correlates of NMUPO.

RESULTS

Non-Hispanic white youth consistently reported higher levels of NMUPO as did older adolescents (ages 15-17) and females. However, there was a decrease in the prevalence of NMUPO overall driven largely by a significant decline (p < 0.001) in NMUPO among non-Hispanic whites of approximately 35% over the study period such that by 2013 no statistically significant differences across race/ethnicity remained. Further, logistic regression models found that externalizing behaviors such as comorbid drug use and fighting was associated with NMUPO and religiosity and parental involvement were identified as protective correlates.

CONCLUSIONS

To our knowledge, this is the first study to identify a declining trend in NMUPO among adolescents. Although the present study findings provide a source for optimism, there is still a relatively high prevalence of NMUPO and it remains to be seen whether our findings portend a long-term decline. Given the harm done by NMUPO, continued awareness and targeted prevention efforts should be implemented.

The long-term effects of school dropout and GED attainment on substance use disorders

BACKGROUND

Epidemiologic research suggests that 14% of the population do not complete high school, and dropout has been linked to mental health conditions, substance use, chronic health problems, and criminal behavior. Few studies have assessed whether attainment of the general education development (GED) credential is protective from substance use.

PURPOSE

To assess the long-term outcomes of school dropout and GED attainment on past year substance use disorders, age of onset, and current smoking status.

METHODS

Longitudinal data were included for lifetime substance users who participated in the National Epidemiological Survey on Alcohol and Related Conditions (Waves I and II). Eligible participants (N=30,608) were classified as having completed high school, dropped out of high school and did not complete a GED, or completed GED at Wave I. Survey logistic regression analyses were used to determine whether high school graduation status was associated with substance use disorders and smoking at Wave II.

RESULTS

Multivariate results suggest that participants who dropped out of high school (OR=1.53; p<.01) or attained a GED were more likely to have a past year marijuana use disorder (OR=1.62 p<.01) compared to high school graduates. High school dropouts were also more likely to be current smokers (OR=1.88; p<.05) than graduates.

CONCLUSIONS

High school dropouts have higher long-term rates of marijuana use disorder and smoking in adulthood than graduates. Attainment of a GED does not appear to be protective from marijuana use disorders in adulthood.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Associations between neighborhood alcohol availability and young adolescent alcohol use

We investigated the association between alcohol outlet density and adolescent alcohol use, including whether this association differed by sociodemographic characteristics. We geocoded and mapped active license data from the year 2011 to calculate the number of outlets within multiple circular buffers of varying sizes (density), centered at households of adolescents ages 10-16 (n = 2,724). We examined 2 indicators of alcohol use: any lifetime use, but not in past month, and any past month heavy use. Cross-sectional hierarchal multivariate regression analyses were used to examine associations between alcohol outlet density and alcohol use, including the potential moderating effect of age, gender, race/ethnicity, and socioeconomic status. Analyses controlled for neighborhood-level socioeconomic status and accounted for census tract-level clustering. A higher number of on- and off-premise outlets within 0.10, 0.25, and 0.50 miles around the respondents' homes was associated with higher odds of being a heavy drinker. In addition, the number of on-premise outlets within the 0.25-mile radius was associated with greater odds of lifetime drinking. For on-premise outlets where minors were not allowed (clubs/bars), we observed a positive and significant association between clubs/bars within the 0.25-mile buffer zone and higher odds of both lifetime and heavy drinking. Findings suggest that youth who are exposed to higher densities of on-premise alcohol outlets are at risk for both lifetime use and recent heavy use. It is critical to advocate for stricter laws limiting the number of alcohol outlets in neighborhoods, including clubs/bars where minors are restricted, and putting into place more stringent enforcement of age identification requirements to limit distribution of alcohol to minors.

Substance use and teen pregnancy in the United States: evidence from the NSDUH 2002-2012

INTRODUCTION

Few, if any, studies have systematically examined the relationship between substance use and teen pregnancy using population-based samples. We aim to provide a comprehensive examination of substance use among pregnant adolescents in the United States.

METHOD

Employing data from the National Survey on Drug Use and Health between 2002 and 2012 (n=97,850), we examine the prevalence of the past 12-month and the past 30-day substance use and substance use disorders among pregnant and non-pregnant adolescents (ages 12-17). We also examine psychosocial and pregnancy-related correlates of current substance use among the subsample of pregnant adolescents (n=810).

RESULTS

Pregnant teens were significantly more likely to have experimented with a variety of substances and meet criteria for alcohol (AOR=1.65, 95% CI=1.26-2.17), cannabis (AOR=2.29, 95% CI=1.72-3.04), and other illicit drug use disorders (AOR=2.84, 95% CI=1.92-4.19). Pregnant early adolescents (ages 12-14; AOR=4.34, 95% CI=2.28-8.26) were significantly more likely and pregnant late adolescents (ages 15-17; AOR=0.71, 95% CI=0.56-0.90) significantly less likely than their non-pregnant counterparts to be current substance users.

CONCLUSIONS

Study findings point not only to a relationship between pregnancy and prior substance use, but also suggest that substance use continues for many teens during pregnancy. We found that substance use is particularly problematic among early adolescents and that the prevalence of substance use attenuates dramatically as youth progress from the first to the second and third trimesters of pregnancy.