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Objectives: New prevention approaches that use engaging and innovative technologies are needed to reduce high rates of substance use and violence among university students. The present study developed and pilot-tested virtual reality (VR) technology that presented university students with immersive environments where they practiced skills with virtual peers. Methods: After viewing e-learning modules with prevention content, students engaged with immersive VR module prototypes to practice cognitive-behavioral skills for preventing risk behaviors, including assertive communication, negotiation, compromise, conflict resolution, and bystander intervention strategies. Results: Paired t-tests showed increases in life skills knowledge and anti-violence attitudes among students from the pretest to posttest assessments. Students and educators were enthusiastic about the VR prototypes, rating them as feasible, relevant, appealing, engaging, and innovative for prevention. Participants provided feedback on ways to improve the VR experience by including a greater variety of conflict situations, more nuanced branched scenarios and response options, and a more complete representation of all scenario outcomes. Conclusions: Findings suggest that VR scenarios are a promising strategy for enhancing life skills to help prevent health risk behaviors among university students., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Authors G.J.B., C.W., and S.M.S. are employees at National Health Promotion Associates (NHPA), which markets the Life Skills Training prevention program. K.W.G is a former employee of NHPA and currently serves as a consultant to NHPA.

This study examined the prevalence and psychosocial predictors of the non-medical use of prescription and over-the-counter (OTC) medications and compared these to cigarette, marijuana, and alcohol use in a cohort of early adolescents ( N = 1887) aged 11 to 13, a critical risk period for the initiation of substance use. Participants were students attending 22 middle schools in the northeastern United States. Participants completed surveys in the classroom, the first in the sixth grade and a second in the seventh grade, and the rate of overall substance use more than doubled from 5.5% to 11.9% over this period. Predictors of the onset of non-medical prescription and over-the-counter drug misuse overlapped substantially with those for marijuana and other substances. The perception of friends' substance use and the belief that substance use can help you deal with problems predicted the onset of marijuana use, OTC medication misuse, and prescription drug misuse. Decision-making skills were protective for the onset of all substance use outcomes. The findings of this study have important implications for prevention and suggest that a single comprehensive approach may be sufficient for preventing multiple forms of substance use onset during early adolescence.

Most universal drug abuse prevention efforts target early adolescents with the goal of delaying or preventing the onset of substance use. The present study examined long-term follow-up data from a large-scale randomized trial of a school-based prevention program that used cognitive-behavioral skills-training techniques to enhance social and personal competence skills and drug refusal skills. The preventive intervention was implemented in junior high schools, and pretest data were collected from students in the classroom. Approximately 13 years later, follow-up data were collected by mail from 2042 young adults. Rates of overall lifetime illicit drug use, as well as lifetime marijuana use, marijuana intoxication, and lifetime non-medical pill use, were lower among students who received the prevention program (Life Skills Training) during junior high school compared to control group participants. These findings support the hypothesis that comprehensive, universal school-based prevention programs can produce long-term effects on illicit drug use behavior., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Botvin has a financial interest in the Life Skills Training (LST) program and his consulting company, National Health Promotion Associates (NHPA), provides teacher training and technical assistance for LST. Dr. Griffin is a consultant to NHPA., (© The Author(s) 2023.)

Sexual violence and substance use are important public health problems among university students. The present study examined rates of sexual violence victimization, perpetration, and substance use among first-year university women. Participants ( n = 974) attending 14 universities across the United States completed an online confidential survey at the beginning and again later in their first year. The sample included women who identified as heterosexual, bisexual, lesbian, and asexual or questioning. The mean age was 19.1 years and 71.4% were White. Rates of victimization involving sexual harassment and sexual acts without consent were higher among sexual minority women relative to heterosexual women, with bisexual women being most likely to report these outcomes. Compared to heterosexual women, sexual minority women reported more frequent cigarette smoking, marijuana use and intoxication, use of club drugs, and overall illicit drug use. Across sexual violence and substance use outcomes, bisexual women reported the highest rates. Sexual minority women reported more accurate beliefs about sexual violence and consent relative to heterosexual women. Over the course of the first year, bisexual women and those who used illicit substances were more likely to report new incidents of sexual violence victimization. Implications for prevention of sexual violence among women, including sexual minorities, are discussed.

Background: Effective school-based programs for preventing substance abuse offer considerable public health potential. Yet limited class time and uneven implementation fidelity can be barriers to widespread adoption and high-quality implementation. A hybrid digital approach may be effective and help address these barriers., Objective: To evaluate the effectiveness of a hybrid substance abuse prevention program for middle school students consisting of e-learning modules and in-person class sessions., Design: Twenty-three United States (U.S.) middle schools were randomly assigned either to an intervention condition (13 schools) or a treatment-as-usual control condition (10 schools) where standard health education material was delivered. There were 1,447 participants who completed the pre-test and post-test assessments, of which 48.3% were male and 51.7% female., Intervention: The hybrid digital intervention consisted of 14 brief e-learning modules and six classroom sessions adapted from an evidence-based program designed for classroom implementation to increase knowledge of adverse consequences of substance use and improve social skills, personal coping skills, and skills for resisting social influences to smoke, drink, or use drugs., Measures: Participating students completed online pre-test and post-test surveys to assess substance use, knowledge, and life skills., Results: There were significant reductions in substance use for the hybrid digital condition compared to the control condition as well as significant increases in health knowledge, skills knowledge, and life skills., Conclusions: A hybrid digital approach to substance abuse prevention is effective and offers potential for overcoming common barriers to widespread adoption and high-quality implementation., Competing Interests: Authors CW, CB, SS, and GB are employees at National Health Promotion Associates (NHPA), which markets the program adapted and tested in this project. Author KG is a former employee of NHPA and currently serves as a consultant to NHPA., (Copyright © 2022 Griffin, Williams, Botvin, Sousa and Botvin.)