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This systematic review provides a comprehensive assessment of risk factors related to early sexual intercourse (ESI) among adolescents. We used PRISMA guidelines to identify eligible cohort studies published between January 1999 and December 2020. We searched on three databases: PubMed, Embase and LILACS. Studies were screened for quality and eligibility. Of 2787 identified studies, seven met our inclusion criteria. The studies examined a range of factors, which were organized into four dimensions - individual, family, social and environmental, and sociodemographic. Risk factors with strong associations for ESI were: adolescent and parental substance use, aggression and conduct disorders, family attachment, school achievement, family living situation, and maternal education. Three studies were birth cohorts. This review demonstrates the important roles of substance use, family attachment and academic factors in shaping adolescents' sexual behavior. A strength of this review is its focus on longitudinal studies, enabling exploration of exposures collected before initiation of sexual intercourse., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The present longitudinal study examined the relationship between patterns of cigarette smoking and alcohol use during adolescence and illicit drug abuse (DA) and prescription drug abuse (PDA) in early adulthood. The sample consisted of 984 predominantly minority young adults (57% women) who completed (a) six annual surveys as adolescents attending New York City public schools (grades 7 through 12) and (b) a follow-up telephone interview as young adults (mean age = 23). Findings from a series of latent growth models indicated that growth in cigarette smoking and alcohol use during adolescence each independently predicted DA in adulthood. Baseline levels of alcohol use in 7th grade also predicted DA in adulthood. Growth in alcohol consumption during adolescence predicted PDA in young adulthood. Results indicate that an escalation during adolescence in the use of substances that are legal for adults (cigarettes and alcohol) contributes to greater DA and PDA in young adulthood. One implication of these findings is that interventions that can prevent cigarette smoking and alcohol use during adolescence may also reduce DA and PDA in young adults.

Objectives: This study was conducted to address a critical gap in understanding adolescent sexual health risks in Argentina, a country that has undergone substantial socio-economic changes that made significant strides in education and healthcare., Methods: A secondary data analysis of the 2018 Argentina Global School-based Student Health Survey was performed. In this study, 23,262 sexually active adolescents were categorized into four risk groups based on the predicted granular risk: number of sexual partners and condom use in their last sexual encounter., Results: Males and older adolescents were more prone to high-risk sexual behaviors. Additionally, key psychosocial factors such as loneliness, anxiety, experiences of violence, and school absenteeism were significantly associated with high-risk sexual behaviors. Early alcohol use and recent experiences of hunger were also identified as strong predictors of heightened sexual risk behaviors. Conversely, positive parental engagement and awareness exhibited protective factors., Conclusions: These findings highlight the necessity for policy interventions that focus on mental health support, parental involvement, and awareness of adolescent issues and activities., (© 2024 the author(s), published by De Gruyter, Berlin/Boston.)

Across developed countries, experimentation with alcohol, tobacco, and other drugs often begins in the early adolescent years. Several evidence-based programs have been developed to prevent adolescent substance use. Many of the most rigorously tested and empirically supported prevention programs were initially developed and tested in the United States. Increasingly, these interventions are being adopted for use in Europe and throughout the world. This paper reports on a large-scale comprehensive initiative designed to select, adapt, implement, and sustain an evidence-based drug abuse prevention program in Italy. As part of a large-scale regionally funded collaboration in the Lombardy region of Italy, we report on processes through which a team of stakeholders selected, translated and culturally adapted, planned, implemented and evaluated the Life Skills Training (LST) school-based drug abuse prevention program, an evidence-based intervention developed in the United States. We discuss several challenges and lessons learned and implications for prevention practitioners and researchers attempting to undertake similar international dissemination projects. We review several published conceptual models designed to promote the replication and widespread dissemination of effective programs, and discuss their strengths and limitations in the context of planning and implementing a complex, large-scale real-world dissemination effort., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The aim of the study was to investigate the association between adolescent delinquency and sleep deficiency. A comprehensive set of potential mechanisms underlying this association were also examined. Using data from the National Longitudinal Study of Adolescent to Adult Health, the present study employed sibling fixed effects models to account for unobservable family-level confounders, such as genetic predisposition, parenting style, parental ability, and school and neighborhood environments. In Sobel mediation tests, the following mechanism variables were explored: substance use, school-based relationships, and parent-child relationships. An increase in delinquency (measured by the total number of types of delinquent behavior engaged) was associated with an increased risk of sleep deficiency one year later. Sibling fixed effects models with a lagged dependent variable revealed that this association is robust to adjustment for family-level heterogeneity as well as prior sleep deficiency. Substance use was the most salient pathway linking delinquency to sleep deficiency (17% for binge drinking and 26% for marijuana use), followed by student-teacher relationships (17%) and father-child relationships (16%). The results of this study suggest that policymakers and practitioners may consider developing interventions to help delinquent adolescents avoid substance use and restore disruptions of student-teacher and father-child relationships., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Research has shown that competence enhancement prevention programs for substance use are effective in reducing alcohol use and other problem behaviors. However, less is known about the mechanisms by which high competence helps youth avoid negative outcomes. This study explored whether greater competence is associated with increased levels of psychological wellness that in turn deters subsequent alcohol use. Specifically, 1,459 students attending 22 middle and junior high schools in New York City completed surveys that included measures of competence (decision making, self-efficacy), psychological wellness, and alcohol use. Students completed surveys at baseline, 1-year follow-up, and 2-year follow-up. Data collectors administered the questionnaire following a standardized protocol during a regular 40-min class period. On the basis of a longitudinal structural equation model, adolescents who were highly competent reported greater psychological wellness, which was then associated with less drinking. These findings highlight the potential of alcohol prevention programs designed to enhance competence and psychological wellness.

Group-randomized drug abuse prevention trials customarily designate schools as the unit of assignment to experimental condition; however, students within schools remain the unit of observation. Students nested within schools may show some resemblance based on common (peer) selection or school climate factors (i.e., disciplinary practices, group norms, or rules). Appropriate analyses of any treatment effects must be statistically correct for the magnitude of clustering within these intact social units (i.e., intraclass correlation coefficient [ICC]). There is little reported evidence, however, of variation in ICCs that might occur with studies of racially or geographically diverse populations. The purpose of this study was to generate estimates of intragroup dependence for drug use and psychosocial measures (hypothesized mediators) from three separate drug abuse prevention trials. Clustering for the drug use measures averaged .02 across study and age-groups (range = .002 to .053) and was equivalently small for the psychosocial measures (averaging .03 across studies and age-groups; range = .001 to .149). With few exceptions and across different samples, clustering decreased in magnitude over time. Clustering was largest for peer smoking and drinking norms among white, suburban youth and smallest for alcohol expectancies among urban black youth. Findings are discussed with respect to the influence of social climate factors and group norms in the design and analysis of school-based, drug abuse, prevention programs.

Most drug abuse prevention research has been conducted with predominantly White middle-class adolescent populations. The present study tested a school-based drug abuse preventive intervention in a sample of predominantly minority students (N = 3,621) in 29 New York City schools. The prevention program taught drug refusal skills, antidrug norms, personal self-management skills, and general social skills in an effort to provide students with skills and information for resisting drug offers, to decrease motivations to use drugs, and decrease vulnerability to drug use social influences. Results indicated that those who received the program (n = 2,144) reported less smoking, drinking, drunkenness, inhalant use, and polydrug use relative to controls (n = 1,477). The program also had a direct positive effect on several cognitive, attitudinal, and personality variables believed to play a role in adolescent substance use. Mediational analyses showed that prevention effects on some drug use outcomes were mediated in part by risk-taking, behavioral intentions, and peer normative expectations regarding drug use. The findings from this study show that a drug abuse prevention program originally designed for White middle-class adolescent populations is effective in a sample of minority, economically disadvantaged, inner-city adolescents.

Theoretical models suggest that many diverse psychosocial factors contribute to the etiology of substance use among youth. It has been suggested that substance use is a function of the total number of etiologic factors, rather than a specific type or set of factors. This study examined whether cumulative psychosocial risk and protection measured in the 7th grade predicted alcohol use in the 9th grade across ethnically diverse samples of adolescents. Participants consisted of black (n = 775) and Hispanic (n = 467) inner-city youth and white suburban youth (n = 708). Prevalence rates for alcohol use and risk/protection varied more widely based on ethnic group compared to gender. Black youth reported the fewest risk factors and lowest levels of alcohol use, white youth reported the most risk factors and highest levels of alcohol use, and Hispanic youth reported the fewest protective factors and intermediate levels of alcohol use. Despite these differences, structural equation modeling indicated that a latent factor consisting of cumulative risk, protection, and their interaction significantly predicted later alcohol use for the combined sample as well as for each ethnic/ gender subgroup. However, the proportion of variance explained in alcohol use varied across subgroups, and moderator analyses indicated that protection significantly buffered the effects of risk differentially across subgroups. The strongest protective effects were observed among black inner-city youth. Findings suggest that prevention approaches should focus on enhancing protection in addition to reducing risk, particularly among youth with lower levels of psychosocial protection.

National survey data indicate that illicit drug use has steadily increased among American adolescents since 1992. This upward trend underscores the need for identifying effective prevention approaches capable of reducing the use of both licit and illicit drugs. The present study examined long-term follow-up data from a large-scale randomized prevention trial to determine the extent to which participation in a cognitive-behavioral skills-training prevention program led to less illicit drug use than for untreated controls. Data were collected by mail from 447 individuals who were contacted after the end of the 12th grade, 6.5 years after the initial pretest. Results indicated that students who received the prevention program (Life Skills Training) during junior high school reported less use of illicit drugs than controls. These results also support the hypothesis that illicit drug use can be prevented by targeting the use of gateway drugs such as tobacco and alcohol.

Background: Based on current trends, smoking will remain a major public health problem in the 21st century. Effective smoking prevention approaches offer the best hope for decreasing the rise in adolescent smoking rates. Competence enhancement approaches to smoking prevention are among the most successful. Yet, there is not a full understanding of how effective prevention approaches work. This study tests whether a deficiency in competence (poor decision-making skills and low personal efficacy) is linked to acquiring beliefs in the perceived benefits of smoking and whether these perceived benefits are then related to subsequent smoking., Methods: A sample of 1459 students attending 22 middle and junior high schools in New York City participated. Students completed surveys at baseline, 1-year follow-up and 2-year follow-up during a regular class period. They self-reported smoking, decision-making skills, personal efficacy and beliefs in the perceived benefits of smoking., Results: The tested structural equation model had a good fit and was parsimonious and consistent with the theory underlying the competence approach to smoking prevention., Conclusions: This research highlights the importance of addressing decision-making skills, personal efficacy, and beliefs in the social benefits of smoking within adolescent smoking prevention programs., (Copyright 2000 American Health Foundation and Academic Press.)

Objective: Most adolescents experiment with alcohol, and the use of alcohol typically escalates during the teenage years. The present study examined how several risk and protective factors measured during early adolescence were associated with heavy drinking in a sample of high school seniors., Method: As part of a school-based survey, seventh-grade students (N = 1,132) reported degrees of experimentation with alcohol and cigarettes. Several psychosocial factors deemed to be important in the etiology of drinking were also assessed. Students were followed-up in the twelfth grade, when 16% were categorized as heavy drinkers based on drinking and drunkenness frequency and quantity typically consumed., Results: Logistic regression analyses revealed that heavy drinking was predicted by having had experimented with alcohol or cigarettes, having had a majority of one's friends drink and having had poor behavioral self-control in early adolescence. In addition, several effects were limited to either boys or girls. For example, positive alcohol expectancies predicted greater later heavy drinking in boys, while friends' smoking predicted later heavy drinking in girls., Conclusions: The findings suggest that early intervention programs aimed at preventing alcohol use by addressing the social and psychological determinants of alcohol use may have important preventive effects in terms of later heavy drinking.

Objective: To test whether higher levels of general competence are linked to more frequent use of refusal assertiveness that is in turn related to less subsequent smoking among inner city adolescents., Methods: Longitudinal study conducted during three year middle school or junior high school period. A sample of 1459 students attending 22 middle (ages 11-14 years) and junior high (ages 12-15 years) schools in New York City participated. Students completed surveys at baseline, one year follow up, and two year follow up. The students self reported smoking, decision making skills, personal efficacy, and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardised protocol. These data were collected in school during a regular 40 minute class period., Results: Based on the tested structural equation model, decision making and personal efficacy (that is, general competence) predicted higher refusal assertiveness and this greater assertiveness predicted less smoking at the two year follow up. The tested model had a good fit and was parsimonious and consistent with theory., Conclusions: Adolescent smoking prevention programmes often teach refusal skills in order to help youth resist peer pressure to smoke. The present findings suggest that teaching general competence skills as well may help to reduce smoking because youth with better personal efficacy and decision making skills are better able to implement smoking refusal strategies.

Numerous alcohol and drug abuse prevention trials have included social resistance training as a strategy for reducing early-stage adolescent alcohol use. Evaluations of these trials has shown them to be moderately effective, although the precise impact of the resistance training in comparison to other programmatic features has not been clearly identified. The current study examined the extent to which assertiveness and related social skills, personal competence (perceived cognitive mastery), and refusal efficacy predict alcohol involvement. Males were at greater risk for poor refusal skills and reported higher alcohol involvement. Cross-sectionally, youth characterized by poor social skill development reported lower refusal efficacy, lower grades, poor competence, and more alcohol use. Poor refusal efficacy was associated with more risk-taking, lower grades, less competence, and more alcohol use. Longitudinally, both poor refusal skills and risk-taking were associated with higher alcohol use. High personal competence was associated with lower alcohol use in both the eighth and tenth grades, but had no long-term effects on alcohol use. Findings highlight the close interplay between perceived competence and refusal skill efficacy, both of which should be included as essential components of school-based prevention strategies.

Epidemiological research indicates that the prevalence rate of drug use among adolescents has risen steadily during this decade, and although alcohol use has stabilized it is still highly prevalent. Psychosocial etiological models have typically examined main effects of risk and protective factors. This study examined moderating effects of intrapersonal skills on social (peer and parental) risks associated with alcohol and marijuana use among eighth-grade rural adolescents, an understudied population. Results indicated that the relationships of peer and parental attitudes, and peer usage to alcohol and marijuana use, are moderated by adolescents' decision-making and self-reinforcement skills. Social risk factors were strongly associated with increased alcohol and marijuana use among adolescents with poor intrapersonal skills. However, good decision-making and self-reinforcement skills diminished the influence of social risk factors on substance use. Results are discussed in terms of implications for psychosocial models of alcohol and drug use, and for designing effective school-based universal prevention interventions.

Background: There is limited evidence addressing the impact of adverse childhood experiences (ACEs) on adolescent sexual risk behaviors and pregnancy. In this study, we examined whether individual and cumulative ACEs increased the risk of unhealthy sexual behaviors and adolescent pregnancy. To inform intervention efforts, potential mediating mechanisms focusing on youth developmental assets were examined to explain the association., Methods: Analyses included 88,815 (9th and 11th grade) students who completed the Minnesota Student Survey in the spring of 2016., Results: Adolescents who reported each category of ACEs were more likely to initiate sex, have multiple sex partners, engage in unprotected sex, and be involved in pregnancy. Different youth assets, included self-regulation skills, connectedness to school, not skipping school, and academic performance, were associated with lower likelihood of sexual initiation and sexual risk-taking. They served as important mediators to reduce, though not completely diminish, the adverse effects of ACEs on sexual initiation and adolescent pregnancy., Conclusions: The results suggest that the relationship between ACEs and adolescent sexual risk behaviors and pregnancy is strong and graded. Effective school initiatives and intervention efforts should encourage the development of self-regulation and connectedness to school among teens who had been exposed to ACEs., (© 2020 American School Health Association.)

Purpose: Despite the high drinking rates and the complexity of drinking behaviors in adolescents, insufficient attention has been paid to their drinking patterns. Therefore, we aimed to identify patterns of adolescent drinking behaviors and factors predicting the distinct subgroups of adolescent drinking behaviors., Methods: We analyzed nationally representative secondary data obtained in 2017. Our final sample included 24,417 Korean adolescents who had consumed at least one glass of alcohol in their lifetime. To investigate patterns of drinking behaviors, we conducted a latent class analysis using nine alcohol-related characteristics, including alcohol consumption levels, solitary drinking, timing of drinking initiation, and negative consequences of drinking. Furthermore, we investigated differences in demographics, mental health status, and characteristics of substance use across the latent classes identified in our study. To do so, we used the PROC LCA with COVARIATES statement in the SAS software., Results: We identified three latent classes of drinking behaviors: current non-drinkers (CND), binge drinkers (BD), and problem drinkers (PD). Compared to the CND class, both BD and PD classes were strongly associated with higher academic year, lower academic performance, higher levels of stress, suicidal ideation, lifetime conventional or electronic cigarette use, and lifetime use of other drugs., Conclusion: Health professionals should develop and implement intervention strategies targeting individual subgroups of drinking behaviors to obtain better outcomes. In particular, health professionals should consider different characteristics across subgroups of adolescent drinking behaviors when developing the interventions, such as poor mental health status and other substance use among binge and problem drinkers., Competing Interests: The authors declared no conflict of interest., (© 2019 Korean Society of Nursing Science.)

Purpose: This study aimed to identify the general characteristics and health behaviors of students with non-therapeutic substance use. Methods: This secondary data analysis used data from the 17th Korea Youth Risk Behavior Web-based Survey (2021). Analyses of the 54,848 adolescents used descriptive statisics, the Rao--Scott χ² test, and logistic regression. Results: The risk factors for substance use among students were anxiety, loneliness, living separately from family, suicidal ideation, e-cigarette use, and high stress. Conclusion: The findings help identify the risk factors for non-therapeutic drug use among adolescents. Since South Korea does not have a drug prevention program for its adolescent population, an educational plan based on these findings could help prevent adolescent substance abuse. [ABSTRACT FROM AUTHOR]