Search

Background: School assets--such as connectedness, caring relationships with adults, high behavioral expectations from adults, and meaningful participation--are associated with positive outcomes for adolescents. However, little is known about how school assets differ among adolescents with intersecting marginalized identities. Methods: We used the 2013-2014 California Healthy Kids Survey (N = 320,462 students) to examine differences in school assets with respect to sexuality, gender, race/ethnicity, and socioeconomic status using adjusted multilevel linear regression models. Results: Sexual minority, gender minority, racial/ethnic minority, and low socioeconomic status adolescents had significantly lower protective school assets. For all outcomes, the differences between sexual minority and heterosexual adolescents were more pronounced among nontransgender girls than nontransgender boys; however, these differences were not consistently present among racial/ethnic minority students. For school connectedness and meaningful participation, differences for racial/ethnic minorities versus white adolescents were more pronounced among nontransgender girls than nontransgender boys. Differences between transgender adolescents and nontransgender boys were more pronounced for white adolescents compared to some other racial/ethnic minority students. Overall, adolescents with certain multiple marginalized identities had lower school assets. Conclusions: Interventions are needed to strengthen school assets among marginalized students, thereby helping mitigate health and education inequities.

This study investigated whether the presence of school-based health centers (SBHCs) was associated with six substance use behaviors among sexual minority youth (SMY) and their heterosexual peers. Data from the 2015 Oregon Healthy Teens Survey, including 13,608 11th graders in 137 schools (26 with SBHCs) were used in the current study. Multilevel logistic regression analyses were performed. Results revealed significant SBHC by SMY status interactions indicating a relatively lower likelihood of past 30-day alcohol use (23%), binge drinking (43%), use of e-cigarettes (22%), marijuana (44%), and unprescribed prescription drugs (28%) among SMY in SBHC schools compared with non-SMY at SBHC schools. Furthermore, SMY in SBHC schools reported lower likelihood of aforementioned substance use behaviors than SMY attending non-SBHC schools. Conversely, no differences in these outcomes were observed for non-SMY in SBHC and non-SBHC schools. Findings from this study suggest SBHCs may help to mitigate substance use disparities among marginalized populations, such as SMY.

Previous research suggests that the context in which drinking occurs contribute to specific alcohol-related problems. In the current study we assessed how often adolescents attended different contexts in which they could drink, how often they drank in those contexts, and whether drinking patterns and parental monitoring were related to alcohol use in those contexts. We collected survey data from 1,217 adolescents 15-18 years of age in 24 midsized California cities. Measures included past-year frequencies of attending and drinking in restaurants, bars/nightclubs, and outdoor places, typical hours spent at home (i.e., own home or someone else's home), perceptions of parental control and disclosure to parents about free time activities, and demographics. Multilevel zero-inflated negative binomial models were used to assess associations between drinking patterns, parental control, and disclosure and frequency of attending and drinking in specific contexts. There were large variations in attending contexts in which drinking could take place. More frequent drinking was related to less time spent at home, while heavier drinking was associated with more time spent at home. Parental control was related to less frequent attendance at bars/nightclubs, and disclosure to less frequent involvement in outdoor activities and spending more time at home. Among drinkers, frequencies of attendance were strongly related to frequencies of drinking in all contexts except the home. Parental control and disclosure were related to more frequent drinking at restaurants and exposure to bars/nightclubs and drinking at outdoor activities. Parental monitoring may reduce exposure to risks by shifting adolescent contexts for alcohol use.

Background: Improvements in health behaviors and academic outcomes have been associated with school-based health centers (SBHCs). However, underlying mechanisms for these associations have been largely unexamined, particularly among lower-income youth. The current study examines the relationship between SBHCs and school connectedness and whether this relationship differs by youths' socioeconomic status (SES). Methods: Student-level cross-sectional data from 503 traditional high schools in California were analyzed using multilevel regression models. California Healthy Kids Survey 2013-2014 data included information on 3 dimensions of school connectedness and demographic characteristics including SES as measured by parental education. School-level demographic data was gathered from publicly available sources. Results: Although no significant relationship between SBHCs and any of the school connectedness dimensions emerged, there were significant cross-level interactions between SBHCs and parent education. SBHCs were more positively associated with school connectedness (adult caring, adult expectations, and meaningful participation) among lower SES students compared to students with higher SES. Conclusions: SBHCs may be particularly effective in affecting school connectedness among lower income youth populations. This has wide ranging implications with regards to planning (eg, careful selection of where SBHCs can be most effective), and future research (eg, examining the effectiveness of specific SBHC strategies that support connectedness).

School-based health centers (SBHCs) can take specific steps to provide culturally competent care for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, potentially impacting well-being. A needs assessment survey was conducted among a convenience sample of SBHC administrators and medical directors to assess climates and actions supportive of LGBTQ quality medical care. Half (53%) of the SBHCs surveyed (N = 66) reviewed print materials for negative LGBTQ stereotypes, and 27.3% conducted exhaustive materials review. Regional differences were detected: 46.2% of Southern SBHCs conducted any materials review compared to 91.3% in the West and all in the East and Midwest (?[superscript 2], p < 0.001). In the last academic year, 45.5% conducted no medical provider trainings, and 54.5% conducted no general staff trainings on providing care for LGBTQ youth. On intake forms, 85.4% included preferred names, but only 23.5% included preferred pronoun. There are significant gaps in the extent to which SBHCs provide culturally competent care. These findings can guide future training and advocacy.

Using an experimental study design (N = 41), we examined whether participation in an informal writing assignment, specifically writing a letter to a friend about course content, improved exam scores in an undergraduate child development course. Findings indicated that participating in the writing assignment significantly improved scores on an exam which included both a multiple-choice component and an essay. No effect emerged for a quiz that included only multiple-choice questions. These findings indicate that writing assignments that require students to summarise and paraphrase newly-learned material may improve performance on exams that have a written component to them. (Contains 3 tables.)

This study investigated the association between school-based health centers (SBHCs) and sexual behavior and contraceptive use among 11th graders. The sample included 134 high schools (27 schools with SBHCs) and 11,840 students who participated in the 2015 Oregon Healthy Teens Survey. Multilevel logistic regressions found positive associations between SBHC presence and healthy sexual behavior (OR = 1.23, p < 0.05) and contraceptive use (OR = 1.31, p < 0.01). Associations were stronger at schools with at least 50% of students receiving free or reduced price lunch. Among SBHC schools, prescribing and dispensing contraceptives onsite was positively related to contraceptive use among students who had sex within the past 3 months (OR = 1.77, p < 0.01). Findings suggest that exposure to SBHCs in general, and availability of specific reproductive health services, may be effective population-based strategies to support healthy sexual behaviors among youth.

Background: School-based health centers (SBHCs) have been associated with many positive health and academic outcomes. The current study extends previous research and examines possible differences in the association between SBHC exposure and adolescent alcohol, tobacco, and other drug use by race/ethnicity, sex, and socioeconomic status (SES). Methods: California Healthy Kids Survey data from 504 traditional high schools in California were linked with publicly available data on SBHCs and school demographics. Multilevel logistic regression analyses were conducted controlling for school and individual characteristics. Results: Significant interactions suggest that SBHC exposure was inversely associated with past 30-day alcohol use, binge drinking, and cigarette and e-cigarette use among African American youth and negatively associated with cigarette and marijuana use among Asian youth, relative to whites. There was also a significant interaction between SBHC exposure and parent education for past 30-day alcohol use and binge drinking. No significant sex interactions were observed. Conclusions: SBHC exposure appears to be inversely related to substance use among youth in some ethnic minority groups and youth of lower SES. This may have implications regarding SBHC placement and investment. Additional research is necessary to understand the mechanisms through which SBHCs may influence adolescent substance use and other health behaviors.

Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online surveys were administered to 18- and 19-year-old college students from a northern California public university (N = 183; 39.9% men; 32.2% Latino). Results: Women reported higher overall K-SRHC service access point scores than men. Findings indicated that gender and family planning self-efficacy were the strongest correlates of K-SRHC service access points. Men with a regular source of health care had higher K-SRHC service access points than men without. Conclusions: Results suggest that college men need additional education about how to access sexual and reproductive health services to support their own and their partner's health.

ObjectivesTo examine how legal age status, gender, and self-reported reasons for pregaming are linked to pregaming for two common drinking contexts: a bar and a Greek party.MethodParticipants who reported pregaming at least once a month (n = 2888 students aged 18-25 years) were recruited from 30 colleges/universities across the United States.ResultsMany students pregame for social reasons regardless of pregaming destination. Multivariate analyses indicated that legal age students were more likely than underage students to pregame before going to a bar, whereas the opposite was true with respect to pregaming for a Greek party. Women were more likely than men to pregame before going to a bar or a Greek party, whereas men reported higher levels of consumption while pregaming for these destinations compared with women.ConclusionsThe present findings suggest areas for targeted intervention efforts and promising avenues for research on context-specific pregaming behaviors among college students.

This study examines the association between school-based health center (SBHC) presence and school-wide measures of academic achievement and college preparation efforts. Publicly available educational and demographic data from 810 California public high schools were linked to a list of schools with an SBHC. Propensity score matching, a method to reduce bias inherent in nonrandomized control studies, was used to select comparison schools. Regression analyses, controlling for proportion of English-language learners, were conducted for each outcome including proportion of students participating in three College Board exams, graduation rates, and meeting university graduation requirements. Findings suggest that SBHC presence is positively associated with college preparation outcomes but not with academic achievement outcomes (graduation rates or meeting state graduation requirements). Future research must examine underlying mechanisms supporting this association, such as school connectedness. Additional research should explore the role that SBHC staff could have in supporting college preparation efforts.

This article reports on the development and psychometric properties of the Adolescent Sexual Expectancies Scale (ASEXS). Data were obtained from three annual longitudinal surveys of youth aged 10-17 at the first administration (N = 932 at Wave 3). Confirmatory factor analyses indicated that 4 correlated factors corresponding to Social Risk, Social Benefit, Health Risk, and Pleasure adequately represented the expectancy items. High alpha coefficients and stability across survey waves indicated good internal and test-retest reliability for these factors. Latent variable autoregressive analyses indicated that Social Risk expectancies predicted changes in sexual behavior over the course of the study. Multigroup analyses established that the measurement and predictive models were equivalent for males and females and across age groups. The ASEXS provides researchers with a useful measure for examining adolescents' expectancy beliefs about the consequences of sexual behavior.

This study assessed agreement level about the occurrence of past-year male-to-female partner violence (MFPV) and female-to-male partner violence (FMPV) among a sample of 897 blue-collar couples. Intimate partner violence (IPV) was measured with the Physical Assault subscale of the revised Conflict Tactics Scales (CTS2). Agreement level was assessed with Cohen's kappa statistic. Lower-bound estimates (based on couple agreement that an IPV event occurred) and upper-bound estimates (based on uncorroborated reports from either partner that an IPV event occurred) were calculated. Results indicated low agreement for most IPV behaviors ([kappa] less than 0.40). Estimated lower- and upper-bound rates for MFPV were 6.7% and 21.2%, for FMPV, 7.1% and 24.2%, and for any IPV, 10.1% and 30.2%. Findings suggest that single-point IPV prevalence estimates are biased; lower- and upper-bound estimates using collateral reports should be calculated when possible. In addition, findings underscore the importance of conducting IPV research among understudied populations, such as working-class couples, that may be at elevated IPV risk. (Contains 3 tables.)

The effects of parental attitudes, practices, and television mediation on adolescent sexual behaviors were investigated in a study of adolescent sexuality and media (N = 887). Confirmatory factor analyses supported an eight-factor parenting model with television mediation factors as constructs distinct from general parenting practices. Logistic regressions indicated that adolescents reporting greater parental disapproval and limits on viewing at Wave 1 were less likely to initiate oral sex between Waves 1 and 2. Adolescents who reported more sexual communication with parents were more likely to initiate oral sex. Results for vaginal intercourse were similar to those for oral sex. Coviewing was a significant negative predictor of initiation of sexual behavior. Parental attitudes and television mediation can delay potentially risky adolescent sexual behaviors.

Objectives: The authors examined whether the relationship between alcohol expectancies and sexual experiences while drinking differed between Latino and white college students. Participants: The authors considered students if they were white or Latino, unmarried, aged 18-25 years, reported any drinking, and had at least 1 sexual partner in the present school year. Methods: The investigators collected surveys from a random sample of 13,868 undergraduate students from the 14 California public university campuses. They used tests of group differences and hierarchical multiple regressions. Results: Social-facilitation alcohol expectancies were associated with the total number of different alcohol-related sexual experiences among Latino students. Neither social facilitation nor sexual-enhancement alcohol expectancies were differentially predictive of white or Latino students' frequency of sexual experiences. Conclusions: Additional research is necessary to determine whether concepts targeted by alcohol prevention programs operate in a differential manner for Latino students. (Contains 1 table.)

Objective: In the current study, the authors assessed whether a new online alcohol-misuse prevention course (College Alc) is more effective at reducing alcohol use and related consequences among drinkers and nondrinkers. Participants: The authors compared incoming college freshmen who reported any past 30-day alcohol use before the beginning of the semester with those who did not. Method Summary: The authors randomly assigned students who completed a precollege baseline survey to either complete a 3-hour noncredit version of College Alc or serve as members of a control group. The authors conducted a follow-up survey 3 months later. Results: Findings indicated that among freshmen who were regular drinkers before college, College Alc appeared to reduce the frequency of heavy drinking, drunkenness, and negative alcohol-related consequences. Among freshmen who did not report any past-30-day alcohol use before college, College Alc did not appear to have any beneficial effects. Conclusions: Results suggest that College Alc may be an effective program for students with a history of alcohol use. (Contains 2 tables and 3 figures.)

This study examined the short-term effects of a web-based alcohol misuse and harm prevention course (College Alc) among incoming freshmen at a California public university. Analysis results indicated that at the end of the fall semester, students randomly assigned to College Alc (n = 173) had a higher level of alcohol-related knowledge and less positive attitude toward alcohol use than students in the control group (n = 197). Students assigned to College Alc also reported a somewhat higher level of intentions to use strategies to minimize alcohol-related harm. College Alc did not have any effects on other targeted psychosocial factors (e.g., alcohol expectancies), alcohol use and heavy drinking, and alcohol-related problems. Observed effect sizes were generally small, suggesting that College Alc may have no effect on students' risk for alcohol misuse and related harm. (Contains 2 tables.)

This study examined whether a comprehensive set of psychosocial factors was equally predictive of both adolescent vaginal intercourse and oral sex among 1,105 adolescents aged 12-16. Logistic regressions were used to examine the relationships between parental communication, religiosity, bonding to school, heavy drinking, sex expectancies, normative beliefs, and both oral sex and vaginal intercourse. Age, gender, bonding to school, heavy drinking, and negative health expectancies predicted both oral sex and vaginal intercourse. Parental communication was associated with vaginal intercourse but not oral sex. Behavior-specific normative beliefs were differentially associated with oral and vaginal sex.

The study of drinking contexts has become an increasingly fertile area of research in prevention science. Each drinking event has a series of contextual characteristics unique to that event. Where [...]

Objective: This study examined racial/ethnic differences in the association between college attendance and heavy alcohol use and factors that may underlie this relationship. Method: Interview data collected from 12,993 young adults who participated in the National Longitudinal Study of Adolescent Health were analyzed to determine if 4- or 2-year college status is differentially associated with heavy alcohol use for five racial/ethnic groups (white, black, Hispanic, Asian, Other) and to assess the explanatory value of selected social and psychological factors. Results: Four-year college status was positively associated with heavy alcohol use among white young adults but inversely related to heavy drinking among blacks and Asians. Two-year college status also was inversely associated with heavy drinking among blacks, Hispanics and Others. Among whites, the association between 4-year college attendance and heavy drinking was partially explained by living away from parents, friends' heavy drinking and time socializing with friends. Among blacks, the inverse relationship between college attendance and heavy alcohol use was partially explained by lower levels of friends' heavy drinking, depression and delinquency. Friends' heavy drinking also partially explained observed relationships between college attendance and heavy drinking among Asians and Others. Conclusions: Four-year college attendance increases the likelihood of heavy alcohol use among white young adults but may decrease the likelihood of heavy drinking among blacks and Asians. Two-year college attendance also may reduce the risk for heavy drinking among blacks, Hispanics and young adults who are Native American or multi-ethnic. Social and psychological factors partly explain these relationships and also differ for racial/ethnic groups., NATIONAL EPIDEMIOLOGICAL STUDIES have consistently found a higher prevalence and frequency of heavy alcohol use, typically defined as five or more consecutive alcoholic beverages, among college students relative to other [...]

This study's purpose was to examine whether school‐based health centers (SBHCs) support mental health indicators among sexual minority youth (SMY). Data came from the 2015 Oregon Healthy Teens Survey with 13,608 11th graders in 137 public high schools in Oregon. Regression results revealed significant SBHC by SMY status interactions indicating relative reductions in likelihood of depressive episodes (30%), suicidal ideation (34%), and suicide attempts (43%) among SMY in schools with SBHCs. SMY students in SBHC schools reported lower likelihood of a past‐year depressive episode, suicidal ideation, and suicide attempt versus those attending non‐SBHC schools. Conversely, no differences in these outcomes were observed for non‐SMY by SBHC status. SBHCs may help reduce mental health disparities among SMY, a marginalized, underserved population. [ABSTRACT FROM AUTHOR]