A Longitudinal Study of Alcohol and Cannabis Use in Young Adulthood: Exploring Racial and Ethnic Differences in the Effects of Peer and Parental Influences From Middle Adolescence

Pilot Implementation of Guiando Buenas Decisiones, an Evidence-Based Parenting Program for Spanish-Speaking Families, in Pediatric Primary Care in a Large, U.S. Health System: A Qualitative Interview Study

Adolescent substance use is a significant public health problem in the United States and Hispanic youth engage in substance use services at lower rates than other groups. For this under-served group, prevention services delivered in non-stigmatized, non-specialty care settings may increase access to the services. We describe findings from a feasibility pilot of the implementation of a virtual version of Guiando Buenas Decisiones (GBD), a universal, group-based substance use prevention program for parents. It was conducted with Spanish-speaking families and delivered, virtually, in pediatric primary care in a large healthcare system in the U.S. Through qualitative interviews with pediatricians (n =7)  and parents (n = 26), we explored potential barriers and facilitators of GBD enrollment and engagement. Parents and pediatricians alike noted the dearth of universal prevention programming in Spanish and that GBD could help address the need for linguistically appropriate programming. Parents liked the curriculum content, materials and videos; they felt the focus on strengthening family bonds, setting clear expectations and guidelines, the use of family meetings, and the positive tools provided for navigating family conflict were well-aligned with their cultural and family values. Feedback from parents was helpful for informing more personalized and attentive approaches to program outreach and recruitment methods, and for adaptation of recruitment fliers and letters. In this pediatric primary care context serving an underserved population, we found virtual GBD feasible to implement, acceptable and appealing to parents, and judged by pediatricians as a promising, much-needed addition to their prevention armamentarium.

Alcohol Use and Abstinence throughout Adolescence: The Changing Contributions of Perceived Risk of Drinking, Opportunities to Drink, and Self-Control

Objective: Adolescence is characterized by psychosocial and cognitive changes that can alter the perceived risk of negative effects of alcohol, opportunities to drink, and self-control. Few studies have investigated whether these factors change in their contribution to adolescent drinking over time. This study examined associations between perceived risk, opportunities to drink, self-control, and past-year drinking and investigated whether self-control buffers the effect of lower perceived risk and frequent drinking opportunities on the probability of past-year drinking. Method: Data from a four-wave longitudinal study (2015-2020) of 2,104 North Carolina adolescents (Mage = 12.36, SDage = 1.12, at Time 1) were used to assess changes in associations between self-control, perceived risk of drinking, and drinking opportunities on the frequency of past-year drinking. Hypotheses were tested using latent trajectory models. Results: At all timepoints, greater perceived risk, fewer drinking opportunities, and higher self-control were associated with drinking abstinence in the past year. Self-control buffered the impact of frequent drinking opportunities and lower perceived risk on the probability of alcohol use at Times 1-3. Conclusions: Despite expectations that adolescents' ability to navigate their environments improves as they age, associations between risk, protective factors, and past-year drinking were relatively stable over time. Nevertheless, self-control protected against frequent drinking opportunities and lower perceived risk. Strategies that support or relieve the need for self-control (e.g., situation modification) may protect against alcohol use throughout adolescence.

Dual alcohol and cannabis use in male and female adolescents: Relationships with family variables

Family dynamics influence adolescents' use of alcohol and other substances, such as cannabis. The aim of this study was to understand the relationship between family variables and alcohol use, dual use of alcohol and cannabis, and non-use in adolescents according to sex. A cross-sectional study was conducted. The sample comprised 879 adolescents (56.4 % boys; M(SD)age = 14.25 (1.88) years). Multinomial regression analysis showed that for boys, the presence of family conflict increased the likelihood of being an alcohol (OR = 1.19) and dual (OR = 1.23) user rather than a non-user. For girls, communication reduced the probability of being an alcohol user (OR = 0.88), and the presence of consequences for breaking rules reduced the probability of being a dual user rather than a non-user (OR = 0.83) or an alcohol user (OR = 0.84). These findings highlight the importance of family prevention of adolescents' substance use, bearing in mind the participants' sex.