1
|
Youth Assets and Alcohol, Tobacco, and Other Drug Use: The Importance of Family Structure. JOURNAL OF PREVENTION (2022) 2024; 45:391-403. [PMID: 38393546 DOI: 10.1007/s10935-024-00775-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
This research analyzed data from the Youth Asset Study (YAS), a 4-year longitudinal investigation designed to examine the prospective influence of youth assets, which are believed to influence behavior at the individual, family, and community levels, on youth risk behaviors. The purpose was to determine if specific youth assets (e.g., responsible choices, family communication, community involvement) differentially protected adolescents from alcohol, tobacco, and other drug use (ATODU) according to family structure (one-parent and two-parent households). Five waves of data were collected annually over four years from a racially/ethnically diverse sample of adolescents (N = 722, 51.5% male, baseline mean age = 14.1 years). Pearson chi-square tests for independence were used to test for significant differences in the prevalence of assets between one-parent and two-parent households. Generalized linear mixed models were used to identify prospective associations between 17 youth assets and ATODU while stratifying by family structure and controlling for sociodemographic characteristics. Compared to adolescents living in one-parent households, adolescents living in two-parent households were significantly more likely to possess six of 17 assets. Among adolescents living in one-parent households, those who possessed any one of eight youth assets were significantly less likely to use ATODU. Among adolescents living in one-parent households, those with any one of seven assets were significantly less likely to use ATODU. Family- and community-level assets had the most significant asset/ATODU associations for adolescents living in one-parent households (AORs ranged from 0.23 to 0.61). Individual-level assets had the most significant asset/ATODU associations for adolescents living in two-parent households (AORs ranged from 0.38 to 0.60). The results suggest that developing asset-based interventions tailored to the adolescents' family structure may be useful in preventing adolescents from engaging in ATODU.
Collapse
|
2
|
Multilevel Risk and Protective Factors for Frequent and Nonfrequent Past-30-Day Marijuana Use: Findings From a Representative Sample of High School Youth. J Stud Alcohol Drugs 2023; 84:508-519. [PMID: 36971761 PMCID: PMC10488312 DOI: 10.15288/jsad.22-00240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/27/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE Research has identified many factors associated with past-30-day (P30D) marijuana use among youth but has not assessed factors that may differentiate youth who use frequently from youth who do not. We took a multilevel approach to identify and compare risk and protective factors associated with frequent and nonfrequent P30D marijuana use among high school students. METHOD Individual-level data were obtained from the 2019 Nevada Youth Risk Behavior Survey (completed by 4,980 high school youth from 99 schools); school-level data were obtained from the state's Department of Education. A multinomial, multilevel model was used to estimate the association between risk and protective factors at the individual and school levels and a three-level frequency of use outcome: no P30D use (0 times), nonfrequent P30D use (1-19 times), and frequent P30D use (≥20 times). RESULTS At the individual level, other P30D substance use, exposure to adverse childhood experiences (ACEs), perceived ease of access, and perceived risk were associated with both frequent and nonfrequent use, but the relationships were generally stronger for frequent use. P30D nonprescription drug use and school connectedness were associated with frequent use only. At the school level, number of students with individualized education programs, number of incidents involving possession of controlled substances, and school type were associated with frequent use only. CONCLUSIONS Individual and school-based interventions designed to address the factors uniquely or strongly associated with frequent marijuana use may prevent escalation from occasional use to more frequent use among high school youth.
Collapse
|
3
|
Youth Assets and Initiation of Sexual Intercourse by Family Structure: A Longitudinal Cohort Study. HEALTH EDUCATION & BEHAVIOR 2022; 49:985-992. [PMID: 35950332 DOI: 10.1177/10901981221116792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The purpose of this study was to assess the protective influence of individual, family, and community assets from the initiation of sexual intercourse (ISI) for adolescents living in one-parent households compared with adolescents living in two-parent households. METHODS Five waves of data were collected annually over a 4-year period (N = 591, 52.5% female, mean age = 14.0 years) from a racially/ethnically diverse sample of adolescents. Extended Cox models were used to assess the relationship between assets and time of ISI while controlling for demographic variables. Potential interactions between adolescent's household structure and assets were examined. RESULTS Five of 17 assets were prospectively and significantly associated with a reduced risk of ISI among adolescents living in one-parent households compared with 11 of 17 assets for adolescents living in two-parent households. Adolescents living in one-parent households who possessed any one of five assets (e.g., general aspirations for the future, relationship with mother, positive peer role models) had between a 27% and 57% lower risk of ISI, whereas adolescents living in two-parent households who possessed any of one of 11 assets (e.g., responsible choices, family communication, community involvement) had between a 20% and 42% lower risk of ISI. CONCLUSION The results suggest that strengthening specific youth assets across multiple dimensions of behavioral influence may decrease the risk of ISI for adolescents living in both one-parent and two-parent households. Public health efforts focused on developing programs to promote asset building tailored to adolescent's family structure are warranted.
Collapse
|
4
|
Adverse childhood experiences and past 30-day cannabis use among middle and high school students: The protective influence of families and schools. Addict Behav 2022; 130:107280. [PMID: 35279622 DOI: 10.1016/j.addbeh.2022.107280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 11/01/2022]
Abstract
Exposure to adverse childhood experiences (ACEs) is a risk factor for adolescent cannabis use (CU). We explored whether family communication and school connectedness can offer direct protection (the compensatory model of resiliency) or moderating protection (the protective factors model of resiliency). Using cluster random sampling, a Youth Risk Behavior Survey (YRBS) was conducted with 5,341 middle school and 4,980 high school students in 2019. Generalized estimating equations were used to estimate whether family communication and school connectedness offered independent direct protection (multiple regression) or moderating protection (multiplicative interaction) in the relationship between ACEs and past 30-day CU. Adjusted prevalence ratios (APR) and 95% confidence intervals (95% CI) were calculated. There was a graded relationship between ACEs and past 30-day CU for all students that was particularly strong among middle school students: 1 ACE (APR = 2.37, 95% CI = 2.16, 2.62), 2 ACEs (APR = 2.89, 95% CI = 2.60, 3.23), 3 ACEs (APR = 5.30, 95% CI = 4.75, 5.90), 4 + ACEs (APR = 7.86, 95% CI = 7.13, 8.67). Results supported the compensatory model of resiliency with both family communication (middle school APR = 0.90, 95% CI = 0.88, 0.93; high school APR = 0.90, 95% CI = 0.87, 0.93) and school connectedness (middle school APR = 0.76, 95% CI = 0.72, 0.79; high school APR = 0.72, 95% CI = 0.68, 0.77) demonstrating a direct, independent protective relationship with past 30-day CU. There was no consistent evidence supporting the protective factors resiliency model.
Collapse
|
5
|
Prospective Associations Between Youth Assets and Truancy Within the Context of Family Structure. THE JOURNAL OF SCHOOL HEALTH 2022; 92:293-299. [PMID: 34907532 DOI: 10.1111/josh.13128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The purpose of this study was to examine the prospective associations between 17 individual, family, and community level youth assets and truancy among adolescents living in 1-parent and 2-parent households. METHODS Five waves of data were collected annually over a 4-year period from a racially/ethnically diverse sample of adolescents (N = 722, 51.5% female, mean age = 14.1 years). Generalized linear mixed models were used to identify prospective associations between youth assets and truancy while stratifying by family structure and controlling sociodemographic characteristics. RESULTS Five of the 17 youth assets were significantly associated (p < .05) with reduced odds of truancy among adolescents living in 1-parent households compared to 10 of 17 assets for adolescents living in 2-parent households. The significant asset/truancy associations were stronger for adolescents living in 1-parent households, whereas for adolescents living in 2-parent households, more of the community assets were significantly protective (p < .05) from truancy. CONCLUSION Assets that focus on supporting adolescents' future aspirations and expectations may reduce truancy among those living in 1-parent households, whereas assets that promote community involvement and increased interaction with teachers and peers may protect adolescents living in 2-parent households from truancy.
Collapse
|
6
|
Attempted Suicide Among Adolescents in Military Families: The Mediating Role of Adverse Childhood Experiences. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:11743-11754. [PMID: 31976794 DOI: 10.1177/0886260519900976] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Research has shown that adolescents in military families have higher rates of suicidal behaviors compared to their nonmilitary peers. This is typically attributed to military-specific stressors, but exposure to adverse childhood experiences (ACEs) may also play a role. Our primary research objective was to determine whether cumulative exposure to ACEs mediates the relationship between military family involvement and attempted suicide. A two-stage cluster random sampling design was used to randomly sample 5,336 students from 98 high schools. Students were asked whether a parent or other adult in their home was serving on active duty in the military and attempted suicide in the past 12 months was assessed. Six measures of childhood abuse and household dysfunction were summed, and the ACE score was categorized as 0, 1, 2, and 3-6 ACEs. Weighted logistic regression and multinomial regression were used to assess differences in ACEs and attempted suicide, controlling for sex, age, race/ethnicity, rurality, and qualification for free/reduced lunch. To investigate potential mediation effects of ACEs on the relationship between military family and attempted suicide, we conducted path analyses controlling for demographics. Compared to their peers, students in military families had higher exposure to ACEs (1 ACE: adjusted odds ratio [AOR] = 1.49, 95% confidence interval [CI] = [0.88, 2.53], 2 ACEs: AOR = 2.07, 95% CI = [1.23, 3.48], and 3-6 ACEs: AOR = 2.57, 95% CI = [1.54, 4.27]) and twice the odds of attempting suicide in the past 12 months (AOR = 2.16, 95% CI = [1.30, 3.61]). Mediation analyses showed that cumulative exposure to ACEs completely mediated the relationship between military family involvement and attempted suicide. The study results highlight the need for trauma-informed approaches to mental health promotion with military families.
Collapse
|
7
|
A longitudinal study of the protective influence of youth assets on juvenile arrest. J Public Health (Oxf) 2021; 43:295-301. [PMID: 31665366 DOI: 10.1093/pubmed/fdz119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/16/2019] [Accepted: 08/21/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The objective of this study was to determine the separate and cumulative influence of individual, family and community assets on juvenile arrest rates in a cohort of youth. METHODS Five waves of data were collected from 1111 youth and their parents living in randomly sampled census tracts in a Midwestern state. Computer-assisted, in-person data collection methods were used to measure assets within individual (six assets), family (four assets) and community (six assets) domains. Extended Cox models were used to assess the relationship between the number of assets and time to first juvenile arrest, while controlling for known confounders. RESULTS Nine of 16 assets across individual, family and community domains were prospectively associated with a reduction in arrest rates. There was a relationship between the number of assets youth possess within individual, family and community domains and rates of arrest. For example, compared to youth with zero to one community assets, those with three [adjusted hazard ratio (AHR): 0.52; 95% confidence interval (CI): 0.30-0.88], four [AHR: 0.57; 95% CI: 0.34-0.97] or five to six [AHR: 0.45; 95% CI: 0.25-0.82] community assets had lower risk of arrest. CONCLUSIONS Public health efforts focused on developing policies and programs to promote asset building across multiple domains of influence are warranted.
Collapse
|
8
|
Adverse Childhood Experiences and Suicidal Behaviors Among Youth: The Buffering Influence of Family Communication and School Connectedness. J Adolesc Health 2021; 68:945-952. [PMID: 33039270 DOI: 10.1016/j.jadohealth.2020.08.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE The main objectives of this study were to determine (1) whether family communication and school connectedness offer protection against suicidal behaviors in the presence of adverse childhood experiences (ACEs; direct protective effect) and (2) whether family communication or school connectedness buffer the association between ACEs and suicidal behaviors (interacting protective effect) on the multiplicative and additive scales. METHODS Data were obtained from a western state's 2019 Youth Risk Behavior Survey that included 5,341 middle school and 4,980 high school participants. Generalized linear models were used to estimate whether family communication and school connectedness offered direct protection against suicidal behaviors or buffered the association between ACEs and suicidal behaviors using adjusted prevalence ratios and corresponding 95% confidence intervals. RESULTS Family communication and school connectedness offered direct protection against suicidal behaviors in the presence of ACEs (a 1-unit higher score was associated with a 32%-42% lower prevalence of suicidal behaviors for middle school youth and a 27%-39% lower prevalence of suicidal behaviors for high school youth). There was evidence that family communication and school connectedness buffered the association between ACEs and suicidal behaviors on the multiplicative scale. CONCLUSIONS The findings provide support for the development and implementation of interventions that build family communication and school connectedness to reduce suicidal behaviors. Furthermore, screening for trauma and suicidal behaviors is warranted.
Collapse
|
9
|
Adverse childhood experiences and co-occurring psychological distress and substance abuse among juvenile offenders: the role of protective factors. Public Health 2021; 194:42-47. [PMID: 33857872 DOI: 10.1016/j.puhe.2021.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/16/2021] [Accepted: 02/14/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to estimate associations between cumulative exposure to adverse childhood experiences (ACEs), protective factors, and co-occurrence among male and female juvenile offenders. STUDY DESIGN Cross-sectional study. METHODS Validated measures of ACEs, internal resilience, external youth assets, psychological distress, and substance abuse were collected from 429 youths involved in the juvenile justice system in Nevada. A three-level outcome variable was created using the psychological distress and substance use measures: no problems, one problem, or co-occurring problems. Hierarchical multinomial logistic regression models were used to determine the independent, direct, and moderating impact of the protective factors on ACEs and the outcome. RESULTS Internal resilience, family communication, school connectedness, peer role models, and non-parental adult role models were associated with lower odds of co-occurrence compared to having no problems (adjusted odds ratios [AORs] ranged from 0.11 to 0.33). When ACEs were added to the model, internal resilience and all assets except for one (non-parental adult role models) continued to offer protection against co-occurrence. Internal resilience was the only protective factor that significantly moderated the association between ACEs and co-occurrence (AOR, 0.24; 95% CI, 0.06, 0.99). CONCLUSION Most protective factors decreased co-occurring mental health and substance abuse problems in the presence of ACE exposure and internal resilience moderated the relationship between ACEs and co-occurrence. Juvenile justice systems should use positive youth development approaches to help prevent co-occurrence among youths.
Collapse
|
10
|
Cannabis use and driving under the influence: Behaviors and attitudes by state-level legal sale of recreational cannabis. Prev Med 2020; 141:106320. [PMID: 33161068 PMCID: PMC8083159 DOI: 10.1016/j.ypmed.2020.106320] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND As states continue to legalize the sale of recreational cannabis, there is a need to study attitudes and behaviors regarding driving after cannabis use. The purpose of this study was to describe US adults' attitudes and behaviors regarding driving after cannabis use by state-level legal sale of recreational cannabis, and to determine whether these associations differ by frequency of cannabis use. METHODS Data were collected from a national sample of 17,112 adults in the United States. Weighted adjusted prevalence ratios and 95% confidence intervals were used to compare the prevalence of behaviors and attitudes by state-level legal sale of recreational cannabis. Analyses were repeated among recent cannabis users, stratifying by cannabis use status. RESULTS Driving after cannabis use was more prevalent in legal cannabis sales states; however, so were potentially protective attitudes related to cannabis use and driving. After stratifying by frequency of use, daily/almost daily, weekly/monthly, and past 12-month users from states with legal recreational cannabis sales had significantly lower prevalence of driving after cannabis use and higher prevalence of protective attitudes compared to those from states without legal recreational sales. Risk perceptions were lower for cannabis than alcohol. CONCLUSIONS Public health messaging campaigns to reduce driving and riding after cannabis use and to improve attitudes regarding driving after cannabis use are warranted across all U.S. states, regardless of legalization status.
Collapse
|
11
|
Prospective relationships between youth assets, negative life events, and binge drinking in a longitudinal cohort of the youth. Ann Epidemiol 2020; 46:24-30. [PMID: 32532370 DOI: 10.1016/j.annepidem.2020.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/26/2020] [Accepted: 04/25/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to investigate whether individual, family, and community assets can 1) protect youth from binge drinking in the face of negative life events and 2) modify the relationship between negative life events and binge drinking. METHODS Data from waves 2-5 of the Youth Asset Study were analyzed. Generalized estimating equations were used to assess the relationship between negative life events, assets, and binge drinking. Multiplicative and additive interaction between negative life events and assets was evaluated. RESULTS When included in the same model as negative life events, individual, family, and community assets had a graded, protective relationship with binge drinking, with strongest protection for those with the greatest number of assets. For example, youth with 3 [adjusted odds ratio (AOR):0.78, 95% confidence interval (CI): 0.65-0.93], 4 [AOR: 0.60, 95% CI: 0.49-0.73], 5 [AOR: 0.53, 95% CI: 0.41-0.69], and 6 [AOR: 0.42, 95% CI: 0.28-0.63] assets within the community domain had a significantly lower odds of binge drinking than youth with 0-2 community assets. No significant interactions were observed. CONCLUSIONS The findings suggest that while youth who are exposed to negative life events are at risk for binge drinking, building assets across individual, family, and community domains can have a protective influence.
Collapse
|
12
|
Prospective Associations Among Youth Assets and Alcohol, Tobacco, and Other Drug Use in a Hispanic Youth Population. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2020. [DOI: 10.1177/0739986320915171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study’s purpose was to determine whether specific youth assets (conceptualized as influencing health behavior at the individual, family, or community level) were prospectively associated with reduced alcohol, tobacco, and other drug use (ATD) in a sample of Hispanic youth. A longitudinal community-based study was conducted with five waves of data collected annually over 4 years. Participants were Hispanic youth (14.1 years old; 53% female) and their parents ( N = 306 youth/parent pairs). Generalized linear mixed models were used to determine the prospective influence of 17 youth assets on ATD over five waves of data. Results indicated that Hispanic youth with three of seven individual-level assets (e.g., educational aspirations), any of four family-level assets (e.g., family communication), or with one of six community-level assets (e.g., positive peer role models) were significantly less likely to engage in ATD. The results suggest that assets protect Hispanic youth from ATD and that family-level assets may be particularly important.
Collapse
|
13
|
Exposure to adverse childhood experiences and early initiation of electronic vapor product use among middle school students in Nevada. Addict Behav Rep 2020; 11:100266. [PMID: 32467855 PMCID: PMC7244918 DOI: 10.1016/j.abrep.2020.100266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 12/30/2022] Open
Abstract
1 in 5 middle school students had used EVPs and 5.1% initiated before age 11. A strong graded relationship between cumulative ACEs and early initiation of EVPs was observed. Hispanic, rural, and military family students were also at risk for early initiation of EVPs.
Introduction The use of electronic vapor products (EVPs) among youth has increased significantly in recent years, yet little is known about factors associated with initiation of EVPs during early adolescence. The purpose of this study was to explore the relationship between chronic exposure to adverse childhood experiences (ACEs) and early initiation of EVPs in a representative sample of middle school students. Methods 5,464 students from 113 middle schools (grades 6–8) completed the Nevada Youth Risk Behavior Survey (YRBS) in the spring of 2017. Six abuse and household dysfunction measures were used to calculate a cumulative ACE score (range 0–6). Initiation of EVPs (e-cigarettes, e-cigars, e-pipes, vape pipes, vaping pens, e-hookahs, and hookah pens) before age 11 was considered early initiation. Weighted logistic regression was used to assess the relationship between cumulative ACE exposure and early initiation of EVPs after controlling for sex, age, race/ethnicity, rurality, free or reduced lunch status, and military family involvement. Results Nearly 1 in 5 middle school students (18.6%) reported using EVPs, 6.7% had used EVPs during the past 30 days, and 5.1% started using EVPs before age 11. After controlling for sociodemographics, a strong graded relationship between cumulative ACE exposure and early initiation of EVPs was observed: 1 ACE (AOR = 1.60; 95% CI = 0.99–2.59), 2 ACEs (AOR = 2.29; 95% CI = 1.33–3.93), and 3–6 ACEs (AOR = 3.43, 95% CI = 2.20–5.36) compared to no ACEs. Conclusions Screening for ACEs in school-based settings may be a feasible approach for identifying students who may be at-risk for early initiation of EVPs.
Collapse
|
14
|
Youth assets and alcohol-related problems among male and female youth: Results from a longitudinal cohort study. Prev Med 2019; 123:192-196. [PMID: 30930260 DOI: 10.1016/j.ypmed.2019.03.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 11/26/2022]
Abstract
Youth who experience alcohol-related problems are at increased risk for developing alcohol dependence. Identifying factors associated with adolescent alcohol-related problems is essential, but most studies have focused on risk factors or a limited number of protective factors, with little attention to sex differences. We assessed the prospective association between 17 assets and alcohol-related problems among male and female youth. A 4-year cohort study with 1, 111 youth living in randomly-selected census tracts in the Oklahoma City Metropolitan Area was conducted. Follow-up for the current study began at wave 2 (2004/2005; N = 1079). Seventeen assets at the individual-, family-, and community-levels were measured. Five questions documented alcohol-related problems in the past 12 months. Generalized linear mixed models evaluated the prospective influence of assets on alcohol-related problems, separately for males and females. Models controlled for age, race/ethnicity, family structure, and parental income. Overall, females had more assets than males, but the protective influence of assets on alcohol-related problems over time was stronger for males. Six assets uniquely protected males (responsible choices [AOR = 0.58, 95% CI = 0.36-0.94], educational aspirations [AOR = 0.54, 95% CI = 0.31-0.93], parental monitoring [AOR = 0.41, 95% CI = 0.27-0.64], community involvement [AOR = 0.57, 95% CI = 0.34-0.97], use of time for groups/sports [AOR = 0.64, 95% CI = 0.42-0.97], and school connectedness [AOR = 0.51, 95% CI = 0.34-0.77]), and 3 uniquely protected females (general self-confidence [AOR = 0.62, 95% CI = 0.40-0.96], good health practices [AOR = 0.67, 95% CI = 0.47-0.95], and relationship with mother [AOR = 0.53, 95% CI = 0.36-0.80]). Strengthening youth assets across multiple domains may decrease alcohol-related problems for both males and females; however, gender-specific approaches to asset building are also warranted.
Collapse
|
15
|
Abstract
PURPOSE The study's purpose was to improve the psychometric properties of the Youth Asset Survey (YAS). DESIGN Longitudinal cohort study with youth and parents recruited via door-to-door canvassing to participate in a 5-wave, 4-year study that assessed prospective associations among youth assets and youth health-related behaviors. Additional test items were added in the last 2 waves of a study to improve the YAS. SETTING Households in randomly selected census tracts located in the Oklahoma City metropolitan area. PARTICIPANTS Youth and their parents (N = 1111 parent/child dyads). Youth demographic characteristics at wave 4 were mean age = 17.3 (standard deviation = 1.62) years; 53% female, 41% white, 28% Hispanic, 24% African American, and 6% other. MEASURES Sixty-eight items assessing 17 youth asset constructs and 8 single items assessing youth risk behaviors. ANALYSIS Confirmatory factor analysis and generalized linear models were conducted to assess construct reliability and predictive validity, respectively. RESULTS Cronbach α for the revised asset constructs ranged from .72 to .82, predictive validity was strong, and all revised asset constructs were assessed via 4 items. CONCLUSIONS Researchers and practitioners have an improved 68-item YAS-Revised, freely available for their use, which measures 17 youth assets with good reliability, validity, and functionality.
Collapse
|
16
|
Prospective impact of individual, family and community youth assets on adolescent suicide ideation. J Epidemiol Community Health 2018; 73:219-224. [PMID: 30470699 DOI: 10.1136/jech-2017-210107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 07/02/2018] [Accepted: 11/02/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Studies have found that youth assets have a protective influence on many risk behaviours. However, the relationship between youth assets and adolescent suicide ideation is poorly understood. The purpose of this study was to determine if youth assets were prospectively associated with suicide ideation. METHODS Four waves of data were collected from 1111 youth and their parents living in randomly sampled census tracts that were stratified by income and race/ethnicity using census data. Computer-assisted, in-person data collection methods were used to measure assets at the individual (6 assets), family (4 assets) and community (6 assets) levels. Generalised linear mixed models were used to prospectively assess the relationship between the number of individual-level, family-level and community-level assets and suicide ideation, while controlling for known confounders. RESULTS About half of the sample was female (53%). Participants were racially/ethnically diverse (white (41%), Hispanic (29%) and black (24%)). Eleven of the 16 assets were associated with reduced odds of suicide ideation. In addition, there was a graded relationship between the number of assets at each level (individual, family and community) and the odds of suicide ideation. For example, compared with youth with 0-2 family assets, those with 3 (OR 0.61; 95% CI 0.42 to 0.90) or 4 (OR 0.32; 95% CI 0.21 to 0.51) family assets had lower odds of suicide ideation. CONCLUSIONS This prospective analysis showed a protective relationship between youth assets and suicide ideation, with the greatest protection among youth with the most assets. Interventions designed to build youth assets may be a useful strategy for reducing adolescent suicide ideation.
Collapse
|
17
|
An Investigation of Youth Assets and Physical Activity and BMI Using a Longitudinal Cohort Design. Am J Health Promot 2018; 32:1751-1754. [PMID: 29649897 DOI: 10.1177/0890117118769561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Substantial research has demonstrated that assets (eg, family communication, school connectedness) protect youth from participation in numerous risk behaviors. However, very few studies have explored the relationship between assets and positive health behaviors. This study investigated prospective associations among assets and physical activity (PA) and body mass index (BMI). DESIGN Longitudinal design with 5 waves of data collected annually over a 4-year period. SETTING Community-based setting with participants recruited via door-to-door canvasing of homes located in stratified (by race and income) randomly selected census tracts and blocks. PARTICIPANTS Participants were 1111 youth (baseline mean age = 14.3 years [SD = 1.6]; 53% female; 40.6% white, 28.6% Hispanic, 24.4% black, 6.4% other) and their parents. MEASURES Weekly participation in PA, BMI, and 14 youth assets representing multiple levels of influence (individual, family, and community). ANALYSIS Generalized linear mixed models assessed associations among the assets and PA and BMI over the 5 waves of data. RESULTS There was a significant and graded relationship between assets and weekly participation in PA. For example, at the community-asset level, PA minutes were higher among youth with 2 assets ( P = .006), 3 assets ( P = .0006), and 4 to 5 assets ( P < .0001) compared to youth with 0 to 1 assets. No effects were found for BMI. CONCLUSION Asset-based health promotion programs for youth may promote positive health behaviors and prevent participation in risk behaviors.
Collapse
|
18
|
Community-Level Exposure to the Rural Mining Industry: The Potential Influence on Early Adolescent Alcohol and Tobacco Use. J Rural Health 2018; 34:304-313. [PMID: 29388274 DOI: 10.1111/jrh.12288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Rural youth have higher rates of alcohol and tobacco use compared to their urban counterparts. However, the economic dependence of rural communities may differentially influence risk behaviors. While research has shown that adults working in mining have elevated rates of alcohol and tobacco use, the influence of living in a mining community on early adolescent substance use is unknown. METHODS Using data from a representative sample of 4,535 middle school students in a state with heavy reliance on mining, we conducted weighted logistic regression to investigate whether community-level mining economic dependence influences rural-urban differences in adolescent alcohol and tobacco use. All models adjusted for sociodemographics, military family involvement, parental monitoring, and length of residence. FINDINGS Over one quarter of the sampled students lived in rural counties and approximately half of these counties met the USDA mining economic typology. After stratifying rural counties by mining and nonmining economic dependence, students in rural mining counties had significantly higher odds of all measures of alcohol use (AORs ranged from 1.83 to 3.99) and tobacco use (AORs ranged from 1.61 to 5.05) compared to students in urban counties. Only use of smokeless tobacco was higher among students in rural nonmining counties. CONCLUSIONS Our findings demonstrate rural-urban disparities in adolescent substance use that are particularly pronounced among youth living in counties with economic dependence on mining. Future research on this subject should include a wider range of community-level factors that may have specific relevance in rural settings to inform the development of population-level interventions.
Collapse
|
19
|
Sexual Identity, Adverse Childhood Experiences, and Suicidal Behaviors. J Adolesc Health 2018; 62:198-204. [PMID: 29223563 PMCID: PMC5803435 DOI: 10.1016/j.jadohealth.2017.09.022] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 09/01/2017] [Accepted: 09/02/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE The objective of this study was to examine the influence of sexual identity and adverse childhood experiences (ACEs) on suicidal behaviors in a population-based sample of high school students. METHODS A two-stage cluster random sampling design was used to recruit 5,108 students from 97 high schools. A total of 4,955 students (97%) provided information that allowed for classification of sexual identity into three groups: (1) lesbian, gay, or bisexual (LGB) (10%); (2) not sure (4.6%); and (3) heterosexual (85.4%). Five measures of childhood abuse and household dysfunction were summed, and the ACE score was categorized as 0, 1, 2, and 3-5 ACEs. Weighted logistic regression was used to assess the influence of sexual identity, ACEs, and their interaction on suicide ideation and attempts in the past 12 months. RESULTS Compared with heterosexual students, those who were LGB and were not sure had higher odds of suicide ideation and attempts. There was also a graded relationship between cumulative ACE exposure and suicidal behaviors. Although sexual identity/ACE interaction was not observed, LGB/not sure students who experienced a high number of ACEs were disproportionately affected. Compared with heterosexual students with 0 ACE, LGB/not sure students with 0 ACE (adjusted odds ratio [AOR] = 3.32, 95% confidence interval [CI] = 1.96-5.61), 1 ACE (AOR = 6.58, 95% CI = 4.05-10.71), 2 ACEs (AOR 13.50, 95% CI = 8.45-21.58), and 3-5 ACEs (AOR = 14.04, 95% CI = 8.72, 22.62) had higher odds of suicide ideation. A similar pattern was observed for suicide attempts. CONCLUSIONS LGB and students not sure of their sexual identity with greater exposure to ACEs have disproportionately high levels of suicide ideation and attempts. Trauma-informed interventions for these populations are warranted.
Collapse
|
20
|
Prevalence and Correlates of Any and Frequent Synthetic Cannabinoid Use in a Representative Sample of High School Students. Subst Use Misuse 2016; 51:1139-46. [PMID: 27191966 DOI: 10.3109/10826084.2016.1160121] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is increasing evidence that Synthetic Cannabinoid (SC) use is associated with adverse health effects, but little is known about the prevalence of SC use and risk and protective factors for SC use among adolescents. OBJECTIVES To determine the prevalence and correlates of any and frequent SC use in a representative sample of high school students. METHODS The 2013 Youth Risk Behavior Survey was administered to 3,928 high school students in Nevada. A state-added question assessed any and frequent SC use (10 or more times). Weighted logistic regression identified factors for both outcomes. RESULTS 17.3% of students reported SC use and 4.3% used SCs frequently. As expected, there were strong associations between SC use and other substance use. After controlling for substance use, any SC use was associated with being Hispanic (AOR = 1.74; 95% CI = 1.27, 2.38) and living in a rural county (AOR = 1.68; 95% CI = 1.26, 2.23). Frequent SC use was higher among students who were male (AOR = 2.14; 95% CI = 1.19, 3.84), 18 years of age (AOR = 2.34; 95% CI = 1.18, 4.67), lived in a rural county (AOR = 1.84; 95% CI = 1.11, 3.04), and were offered, sold, or given illegal drugs on school property (AOR = 2.40; 95% CI = 1.53, 3.79). Protective factors for frequent SC use included high parental monitoring (AOR = 0.54; 95% CI = 0.31, 0.93) and sports team participation (AOR = 0.61; 95% CI = 0.37, 0.99). CONCLUSIONS/IMPORTANCE SC prevention policies and programs should focus on adolescents who live in rural settings and engage in substance use. Initiatives to address drug availability as school and promote parent involvement are also warranted.
Collapse
|
21
|
|
22
|
Abstract
The term juxta-facet cyst summarizes synovial cysts, arising from degenerated facet joints and ganglion cysts, developing from mucinous degeneration of periarticular connective tissue. Most juxta-facet cysts are observed at the L4/5 level, which generally has the most motion within the lumbar spine. In this retrospective study 31 juxta-facet cysts in 28 patients were detected within 2898 lumbar MRI studies over a 2-year period (frequency 1%). 24 patients complained of back and lower extremity pain, the other 4 patients had unilateral back pain. In 7 cases radicular symptoms were observed, in 6 patients a neurogenic claudication. In 78% of the patients juxta-facet cysts were responsible for clinical symptoms. MRI is the diagnostic imaging technique of choice due to a high sensitivity. The juxta-facet cysts were located extradural, laterally to the thecal sack and adjacent to a degenerated facet joint. In all but one cases the cysts showed a signal intensity equivalent to cerebrospinal fluid. T2-weighted pulse sequences in sagittal orientation were very useful in delineating the hypointense cyst wall. In 1 patient with acute radicular pain MRI demonstrated a subacute hemorrhage within a juxta-facet cyst. Calcifications and gas-filled cysts can be missed with MRI, but will be demonstrated by computed tomography. 45% of the juxta-facet cysts showed an enhancement of the cyst wall after injection of Gd-DTPA. Spontaneous reduction or resolution of the cyst may occur during rest. Injection of corticosteroids into the corresponding facet joint may reduce the inflammatory process and resolve the symptoms in up to 70%. Surgical resection of the cyst is indicated in case of intractable pain and significant neurologic deficit and generally produces good relief from radicular symptoms.
Collapse
|