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Objectives: To examine associations among adolescents' generated verbal strategies (ie, Simple No, Declarative Statements, Excuse, Alternatives) and underlying nonverbal assertiveness in 2 refusal situations: smoking and shoplifting. Methods: Sixth-grade urban minority students (N = 454) participated in videotaped role-play assessments of peer refusal skills. Results: Differences were found by situation with students demonstrating greater use of Simple No in the smoking refusal and Alternatives in the shoplifting refusal. Nonverbal assertiveness was similar across situations and was associated with Declarative Statements, but only in the smoking refusal. Conclusions: Prevention programs should tailor refusal skills practice to cover multiple situations. [ABSTRACT FROM AUTHOR]

PURPOSE: To examine whether generation of 'socially appropriate' responses or divergent responses to continued peer pressure is a more effective deterrent of actual delinquency. METHODS: The sample of 129 urban adolescents included both boys and girls (51.9% male) and was predominantly black (48.%) and Hispanic (28.7%). They were studied longitudinally from seventh to eighth grade in New York City from 2000-2001. Resistance strategies to offers to smoke and to shoplift were assessed in two separate videotaped role-plays. Socially appropriate responses were defined as assertive and nonaggressive, including the use of a simple no; direct, declarative statements; and offering prosocial alternatives. Divergent responses were defined as multiple unique response types within the same situation regardless of appropriateness. Data were analyzed using hierarchical logistic regressions. RESULTS: High use of divergent responses was consistently associated favorably with changes in delinquency from seventh to eighth grade. High use of divergent responses was associated with lowered likelihood to vandalize, steal or shoplift, and commit multiple acts of any type of delinquency, even after controlling for seventh grade delinquency. Socially appropriate responses showed little association to any delinquent behavior. CONCLUSIONS: Different social pressure situations and contexts may require different responses. As trying to teach effective responses for every single potential peer pressure situation would be impossible, promoting divergent thinking may be an attractive alternative. [ABSTRACT FROM AUTHOR]

PURPOSE: To examine the relationship between low perceived chances for success in life and binge drinking in a sample of economically disadvantaged, predominantly minority, urban adolescents. METHODS: A sample of predominantly black and Hispanic students (N = 774) from 13 inner-city schools completed confidential questionnaires in the 7th, 8th, and 9th grades. Eight items measured students' estimation of achieving certain adaptive life goals. Students who reported that they typically drink five or more drinks per drinking occasion were identified as binge drinkers. RESULTS: Chi-square proportional analyses indicated that rates of binge drinking increased and perceived life chances decreased for both boys and girls from the 7th to 9th grade. A cross-lagged path analytic model revealed that higher perceived life chances in the 7th grade predicted less binge drinking in the 8th grade, whereas binge drinking in the 8th grade predicted lower perceived life chances in the 9th grade, controlling for change over time in both variables. CONCLUSIONS: Low perceived chances of success in life appear to play a role in the initiation and escalation of binge drinking during early adolescence, with a reciprocal relationship between the two factors developing over time. [ABSTRACT FROM AUTHOR]

This study examined the relationship of psychosocial factors with alcohol use for adolescents residing in rural Iowa. This association was also tested separately for boys and girls. Seventh graders (N = 1673) self-reported alcohol use, peer drinking norms, adult drinking norms, drug refusal assertiveness, drug refusal techniques, life skills, pro-drinking attitudes, risk-taking tendency, and perceived family management practices. Data were collected during a 45-minute class period. Multiple regressions indicated that: Peer drinking norms, drug refusal assertiveness, drug refusal techniques, life skills, pro-drinking attitudes and risk-taking tendency were related to drinking measures. Perceived family management skills and drug refusal techniques were associated with drinking for girls but not boys. Risk-taking tendency was related to drinking for boys but not girls. [ABSTRACT FROM AUTHOR]

The present study examined the effectiveness of a substance abuse prevention program in preventing tobacco and alcohol use among elementary school students in grades 3 through 6. The prevention program teaches social resistance skills and general personal and social competence skills. Rates of substance use behavior, attitudes, knowledge, normative expectations, and related variables were examined among students (N =1090) from 20 schools that were randomly assigned to either receive the prevention program (9 schools, n = 426) or serve as a control group (11 schools, n = 664). Data were analyzed at both the individuallevel and school-level. Individual-level analyses controlling for gender, race, and family structure showed that intervention students reported less smoking in the past year, higher anti-drinking attitudes, increased substance use knowledge and skills-related knowledge, lower normative expectations for smoking and alcohol use, and higher self-esteem at the posttest assessment, relative to control students. School-level analyses showed that annual prevalence rate was 61% lower for smoking and 25% lower for alcohol use at the posttest assessment in schools that received the prevention program when compared with control schools. In addition, mean self-esteem scores were higher in intervention schools at the posttest assessment relative to control schools. Findings indicate that a school-based substance abuse prevention approach previously found to be effective among middle school students is also effective for elementary school students. [ABSTRACT FROM AUTHOR]

Most research of ethnic differences in adolescent drug use resorts to combining all Hispanic individuals into one group. This study focused on polydrug use among adolescents residing in an innercity region by Hispanic ethnicity (Puerto Rican versus Dominican) and gender. Puerto Rican and Dominican students in 22 New York City middle schools participated. Sixth and seventh graders completed self-report questionnaires with measures of the three gateway drugs (cigarettes, alcohol, and marijuana) at baseline (N = 849) and at a one-year followup (N = 678). In the first year of middle school, gender moderated the effect of Hispanic ethnicity on lifetime polydrug use. Specifically, Dominican boys reported greater polydrug use than Dominican girls, but use was similar across gender for Puerto Rican adolescents. In the second year of middle school, this pattern extended to more serious levels of polydrug use as measured by current polydrug use and composite polydrug frequency. Consequently, both Hispanic ethnicity and gender mattered in determining adolescent polydrug use. [ABSTRACT FROM AUTHOR]

This study examined the moderating influences of psychosocial functioning on the relation between perceived neighborhood risk and alcohol, cigarette, and marijuana use in a sample of inner-city, ethnic minority youths. Perceived neighborhood risk assessed gang activity, fighting, and neighborhood toughness. Measures of psychosocial functioning assessed intrapersonal and interpersonal skills implicated as correlates and predictors of early-stage drug use. Neighborhood risk uniquely predicted alcohol, cigarette, and marijuana use; however, some relations were qualified by level of psychosocial functioning. Negative affect, peer relations, and social concern moderated the effects of neighborhood risk on alcohol use. Negative affect moderated the relations between neighborhood risk and cigarette use. Risk-taking and family relations moderated the relations between neighborhood risk and marijuana use. Overall, the size of these effects was small and underscores the need to include a wider range of conceptually relevant measures. Longitudinally, neighborhood risk was uniquely associated with less protection and greater polydrug use, controlling for early levels of psychosocial risk and protection. Net of prediction, both risk and protection were associated equivalently with neighborhood risk. Findings indicate a need to develop a more complete understanding of the precise manner in which environmental risk increases susceptibility to early-stage drug use. [ABSTRACT FROM AUTHOR]

Previous research suggests that alcohol and drug use among youth may be a function of the total number of etiologic factors present, rather than a specific type of factor. Furthermore, a growing number of studies have found that psychosocial protective factors are important in countering the effects of psychosocial risk. The present study evaluated the buffering effect of cumulative protection on adolescent alcohol use in the presence of high and moderate cumulative risk. A sample of 4,851 7th graders from 37 inner-city schools participated. Students with high scores on the cumulative risk factor index engaged in more alcohol use compared to those with low scores; those with high scores on the cumulative protective factor index engaged in less alcohol use relative to those with low scores. For participants at low risk, level of protection did not affect most measures of alcohol use. However, for both moderate and high risk groups, adolescents with high protection engaged in less alcohol use than those with low protection. These findings suggest that comprehensive alcohol use prevention programs for youth should focus on enhancing a variety. of protective factors in addition to reducing risk. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationships among problem behaviors during early adolescence. Specifically this investigation examined the association between drug use and aggression among a sample of inner-city adolescents. Eighth graders (N = 517; 49% boys) attending three New York City schools completed an anonymous questionnaire. Self-reported aggressive and unsafe behavior were associated with initiation of drug use (smoking, drinking alcohol, smoking marijuana). Sex differences were also found for aggressive behavior, victimization, and unsafe behavior. The data have implications for prevention because reducing drug use might also decrease aggressive and unsafe behavior. Social competence skills training, which has been found effective in drug use prevention programs, can be expanded to cover aggressive behavior and engagement in unsafe behavior. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Vulnerability to adolescent alcohol use is often predicated on low social competence and poor social resistance skills. As a result, many prevention programs focus on improving assertiveness and drug-specific refusal skills to build resilience. However, individual differences in the rate at which youth acquire these skills may regulate their degree of alcohol use. The current study used longitudinal growth curve modeling with four-year panel data to examine the dynamic relations between refusal skills and alcohol use. Additional variables of theoretical interest that were controlled for included gender, risk-taking, grades, social competence, and self-control. The estimated means for alcohol use indicated that on average these adolescents increased their alcohol us by a factor of 140% over a four-year period. Refusal skill efficacy declined by a factor of 13% over the same time frame. Higher initial skill level predicted a slower rate of alcohol usage; conversely higher initial alcohol use predicted a slower acquisition of refusal skills. Grades enhanced the rate of refusal skill acquisition and females acquired refusal skills faster than males. Socially competent youth declined more rapidly in their refusal ability and increased their alcohol use more rapidly than youth with low social competence. Self-control was associated with lower initial levels of alcohol use and higher initial level of refusal skills. These findings support a dual focus on social resistance skills and personal self-control strategies to reduce motivations for alcohol use. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if ethnic and gender differences in polydrug use exist among a cohort of inner-city adolescents during the three-year middle school period. Students in 22 urban schools completed self-report questionnaires with measures of drug use (smoking, drinking, and marijuana use) at three annual assessments. For participating students, (N=2354), analyses of variance were conducted to test for ethnic group (Asian, Black, Hispanic, White) and gender differences in polydrug use. Ethnic differences were found for polydrug use measures at each assessments point. Asian and Black adolescents generally reported less polydrug use than White and Hispanic youth. When gender differences were evident, boys engaged in more use than girls. The relatively high rates of polydrug use indicate that prevention intervention programs that target multiple substances may be more efficient in reducing overall risk than prevention programs that focus on a single substance (e.g., smoking prevention only). [ABSTRACT FROM AUTHOR]

This study examined personal life events and neighborhood stress as determinants of alcohol use among urban, minority youth. Personal events included disruptive and beneficial life experiences, whereas neighborhood stress assessed gang involvement and perceived neighborhood toughness. Analyses were constructed to examine the ability of several key measures of psychosocial functioning to moderate relations between life events, neighborhood stress, and alcohol use. Positive outcomes (e.g., family communication) and internal health locus of control buffered the effects of negative life events on alcohol use. High levels of absenteeism exacerbated the effects of neighborhood stress on alcohol use. Both positive and negative life events and neighborhood stress uniquely predicted alcohol use controlling for risk, gender, and ethnicity. Findings are discussed in terms of extending current etiology models to include stressful life events and contextual factors as predictors of early-stage alcohol use. [ABSTRACT FROM AUTHOR]

Adolescent smoking continues to rise in the United States. Individual from economically-disadvantaged households appear at high risk for smoking. This study focused on a sample of economically-disadvantaged adolescents attending New York City schools (N = 1875). Longitudinal predictors of smoking from four domains (socio-demographic background information, social influences to smoke, social and personal competence, and individual differences) were tested. Social influences to smoke, from mothers and friends, both predicted smoking one year later. Poor decision-making skills, and low psychological well-being also predicted subsequent smoking. Conclusion: These findings support social learning theory (Bandura, 1977) and problem behavior theory (Jessor, 1991). Furthermore, the results suggest that training adolescents to resist social influences to smoke, to problem solve and make sound decisions, and how to cope with psychological distress are among the key components for effective smoking prevention. [ABSTRACT FROM AUTHOR]

The purpose of the study was to explore the relationship between the exposure of adolescents in the seventh and eighth grades to cigarette advertising and their being smokers. A survey questionnaire given to 602 adolescents assessed their exposure to cigarette advertising and provided measures of their smoking behavior, demographic characteristics, and some psychosocial variables. The results indicated that exposure to cigarette advertising and having friends who smoked were predictive of current smoking status. Adolescents with high exposure to cigarette advertising were significantly more likely to be smokers, according to several measures of smoking behavior, than were those with low exposure to cigarette advertising. The findings extend previous research identifying factors that may play a role in the initiation and maintenance of smoking among adolescents. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if ethnic and gender differences in alcohol use exist among a cohort of inner-city adolescents during each of the 3 years of middle school. Students in 22 urban schools completed selfreport questionnaires with measures of alcohol use (frequency of drinking, amount of drinks per occasion, and frequency of drunkenness) at three annual assessments. Of the participating students, 2312 identified themselves as Asian, Black, Hispanic or White. Analyses of variance were conducted to test for ethnic group (Asian, Black, Hispanic, White) and gender differences in alcohol use. Ethnic differences were found for all three alcohol measures at each assessment point. Boys drank more frequently than girls during the first 2 years. Asian and Black adolescents appeared to be at lower risk for alcohol use. [ABSTRACT FROM AUTHOR]

Adolescent alcohol use remains a pressing problem. Identifying which groups are at greater risk of alcohol use helps in understanding the etiology of drinking and the development of alcohol prevention programs. Little epidemiologic information regarding alcohol use among inner-city minority adolescents is available. This study examined the relationship between patterns of alcohol use and ethnic group, a black group consisting primarily of African-Americans and Caribbean/West Indians and a Hispanic group of predominantly Puerto Ricans and Dominicans, among urban youth. Hispanic youth reported greater experience with alcohol than black youth. Dominican adolescents drank more frequently, drank more per drinking occasion, and planned to drink more in the future than Puerto Rican adolescents. Similarly, Caribbean/West Indian youth drank more frequently, became drunk more often, drank more per drinking occasion, and planned to drink more in the future relative to African-American youth. In general, gender did not moderate the relationship with alcohol. This study indicates that only considering ethnic group membership is not sufficient because there were important subgroup differences in patterns of alcohol use for both Hispanics and Blacks. Implications for prevention are discussed. [ABSTRACT FROM AUTHOR]

There have been only a limited number of studies that examine drug use among homeless youth and there have been no studies to date on drug use with adolescents living in homeless families. This study examined predictors of tobacco, alcohol, and marijuana use with homeless adolescents and preadolescents (N = 234) living in shelters for homeless families. Structured interviews were conducted on self-reported drug use, as well as background variables, social environmental influences, and individual characteristics hypothesized to promote drug use. Logistic-regression analyses revealed that social influences (friends and family drug use) are strong predictors of experimental drug use and intentions to use drugs, as are several psychological factors (psychological well-being, assertiveness, and social support). Implications of the findings for effective prevention programs for homeless and other high risk youth are discussed. [ABSTRACT FROM AUTHOR]

National survey data indicate that drug use among our nation's secondary school youth is once again on the rise. Nowhere is this concern more dramatic than with inner-city youth who seem disproportionately affected by the risks associated with drug use. Urban youth residing in public housing developments may be extremely vulnerable as a result of their exposure to high rates of crime, unrelenting poverty, and drug use. To better understand the role of public housing conditions in the etiology of adolescent drug use, we examined a sample of youth living in housing developments and youth living in conventional housing. Correlates and predictors of alcohol and drug use included measures of cognitive efficacy, social influences, normative expectations, drug-refusal skills, family management, psychological distress, and alcohol-related expectancies. Overall, there were few significant mean differences in psychosocial functioning or drug behavior for the two groups. Hierarchical moderated multiple regression analyses indicated that public housing status buffered against the negative effects of high levels of perceived alcohol availability on drinking behavior, whereas youth living in conventional housing with high grades reported lower alcohol involvement. Findings are discussed in terms of their implications for developing effective prevention approaches targeting urban youth residing in public housing. [ABSTRACT FROM AUTHOR]

This study tested the effectiveness of a drug abuse prevention intervention with a predominantly minority sample of seventh-grade students (N = 721) in 7 urban schools in New York City. The drug abuse prevention curriculum teaches social resistance skills within the context of a broader intervention promoting general personal and social competence and implemented by regular classroom teachers. Results indicated that this approach was effective on several behavioral measures of current drug use including measures of polydrug use and on intention measures relevant to future drug use. Furthermore, there was some evidence for factors presumed to mediate the effects of this type of intervention (normative expectations and refusal skills). The significance of these findings is that they provide further support for the generalizability to a minority inner-city adolescent population of an approach previously found to be effective with white middle-class adolescent populations. In addition, this is the first time that effects have been shown with inner-city minority youth for the use of multiple drugs. [ABSTRACT FROM AUTHOR]

Studies of psychosocial risk and adolescent drug use among minority youth have been primarily descriptive in nature. This may be an unfortunate oversight, particularly because developmental studies indicate that cultural factors play an important role in the etiology of mental health problems. Utilizing data obtained from a sample of minority control students participating in a longitudinal school-based drug prevention trial, we examined the role of ethnic identity as it moderates the relations between several domains of psychosocial risk and alcohol and marijuana use. A risk-factor methodology was used to construct additive risk indices that reflected key domains of a psychosocial model of deviant behavior. Results of cross-sectional analyses indicated that ethnic identity moderated the effects of alcohol-related expectancies, knowledge, and social skills for alcohol use; whereas ethnic identity moderated the effects of social influences, competence, and social skills for marijuana use. Results of longitudinal analyses found that ethnic identity moderated the effects of social skills on alcohol use and in some instances uniquely predicted both alcohol and marijuana use, controlling for risk. Findings are discussed in terms of the formative role of cultural factors as they shape vulnerability to adolescent alcohol and drug use. [ABSTRACT FROM AUTHOR]

This study examined the relationship between language use and initiation of alcohol use among Hispanic adolescents (Puerto Rican, Dominican, Colombian, Ecuadorian). Logistic regression analysis revealed that adolescents who spoke Spanish with their parents had lower odds of having a drink relative to adolescents who spoke English and Spanish with their parents. Adolescents who only spoke English with their friends had lower odds of ever drinking relative to adolescents who spoke English and Spanish with their friends. Social influences to drink and being Dominican or Colombian also predicted alcohol use. Analyses were conducted separately by sex. Results are discussed in terms of the implications for prevention. [ABSTRACT FROM AUTHOR]

Problem behavior theory has been a useful adjunct to explaining the etiology of adolescent drug use. However, the conceptual appropriateness of social-psychological theories of drug use with minority youth has rarely been tested empirically. In addition to normative developmental transitions associated with adolescence, minority youth may encounter sociopolitical and economic hardships that spawn despair, hopelessness, and personal anomie, which may independently engender drug use. Using cross-sectional data from a cohort of 8th grade, urban, black youth, we tested several latent-variable structural equation models which posited that general deviance would mediate the influence of cognitive efficacy (i.e., skills mastery and personal competence) and, separately, personal anomie. Models were psychometrically sound and accounted for large portions of variation. Results showed that the influence of hopelessness, loneliness, and suicidal thinking was entirely mediated by physical aggression, sensation-seeking, unsafe, and unconventional behavior. Personal competence had both direct and indirect influences on drug use. Findings underscore the continued primacy of deviance in predicting drug use for minority youth and the necessity of incorporating affective influences into current cognitive-behavioral intervention strategies. [ABSTRACT FROM AUTHOR]

To explore the attitudes of a multi-ethnic sample (African-American, Caucasian, Latino) of parents, a telephone survey was conducted with 297 parents whose children attend school in New York City (98 African-Americans, 100 Latinos, and 99 Caucasians). The survey interview assessed a wide range of issues related to AIDS and AIDS education. In a series of logistic regressions that controlled for education, we compared each ethnic group (African-Americans, Latinos) with Caucasians as the reference. The majority of parents indicated that they supported AIDS education efforts in the schools, but there was considerable mistrust of the government and health professionals, particularly among the African-American parents. African-American and Latino parents were more likely to perceive AIDS as a threat and believe that AIDS education is more effective for Caucasians. We discuss implications for AIDS prevention and recommend strategies to overcome barriers to AIDS education and prevention in multi-ethnic communities. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine how much young adolescents know about AIDS and AIDS risk and to identify areas of confusion that might serve as important targets of educational intervention. A multiethnic (43% white, 33% black, 18% Latino) sample of 303 seventh-grade students (48% male) in 3 schools in the greater New York area completed questionnaires assessing knowledge, attitudes, and behavioral intentions concerning AIDS and AIDS risk. Consistent with previous studies with older adolescents, the major finding in this study was that young adolescents had a high degree of knowledge concerning AIDS and AIDS risk. There were 2 areas of confusion concerning AIDS risk. Specifically, 31% of adolescents did not correctly identify 'not having sex' as the most effective way of preventing AIDS, and 33% believed that AIDS could be spread through casual contact. Findings are discussed in terms of their implications for prevention. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate underlying mechanisms of the association between early pubertal timing and both aggression and delinquency among a sample of minority males and females from an urban community. METHODS: The association between perceived early pubertal maturation and aggressive or delinquent behaviors for African American and Latino males and females (n = 1366) was examined, as well as pathways between early maturation and these negative outcomes longitudinally across 6th, 7th, and 8th grades. RESULTS: Early maturers reported higher mean levels of both aggression and delinquency at all time points regardless of gender or ethnicity. Associating with delinquent peers in 6th grade fully mediated the association between early maturation and both aggression and delinquency at all time points. Early maturers did not differentially associate with greater numbers of delinquent peers in either 7th or 8th grade. CONCLUSIONS: These results provide valuable information regarding at-risk groups and inform future intervention efforts. [ABSTRACT FROM AUTHOR]

The current study explored the relationships between parenting practices and adolescent drug use. Suburban middle school students (N = 2129) completed survey that included measures of perceived parental monitoring, discipline and setting an anti-drug message as well as measures of drug-related knowledge, attitudes and peer norms. Results indicated that effective parenting practices had a direct protective effect in terms of adolescent drug use and that the protective effect of parenting practices remained signifcant after including the effects of parenting on adolescent drug-related knowledge, attitudes and perceived norms in a structural equation model. These findings suggest that effective parenting practices have a robust protective effect on youth drug use via multiple pathways that extend beyond parenting effects on the most proximal predictors of adolescent drug use. [ABSTRACT FROM AUTHOR]

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.)

Individuals use a variety of strategies to manage their thoughts, emotions, and behaviors across the lifespan. In this study, we used latent class analysis to derive distinct subtypes of self-management skills in early adolescence and latent transition analysis to examine whether movement between different classes was associated with later young adult alcohol use. Assessments of behavioral self-control, affective self-regulation, and cognitive self-reinforcement were obtained in the seventh and 10th grades from students participating in two independent drug prevention trials (control group participants only, N = 3,939). Assessment of alcohol use was obtained when participants were young adults (23-26). A model distinguishing four subtypes of self-management skills fit best for both the seventh and 10th grades. While findings indicated modest stability in class structure over time, maintaining class membership characterized by high cognitive self-reinforcement and high affective self-regulation was consistently protective in terms of young adult alcohol use relative to movement from this to other classes. Transitions in class membership involving an expansion of self-management strategies were protective and associated with lower levels of young adult alcohol use and transitions involving a contraction of self-management strategies associated with higher young adult alcohol use. This study illustrates the important use of person-centered techniques to exemplify how typologies of self-management during adolescence can play a protective role in young adult alcohol use.

Background: Universal school-based prevention programs for alcohol, tobacco, and other drug use are typically designed for all students within a particular school setting. However, it is unclear whether such broad-based programs are effective for youth at risk for substance use and violence in juvenile justice settings., Method: The present study tested the feasibility, appropriateness, and efficacy of a preventive intervention to reduce risk factors for substance use and delinquency among youth in juvenile justice diversionary settings by promoting positive youth development and building personal strengths and prosocial relationships. Participants in the study (N = 288) were predominantly male (69%) and in the 9th grade (14 years old) or higher (91%), received the preventive intervention, and completed confidential questionnaires at the pre-test and post-test., Results: The majority of youth who participated in the intervention rated the program topics (77.9%) and activities (72%) as appropriate for their age, would recommend it to their peers (73.6%), and would use the skills learned in the future (85.4%). Comparison of post-test adjusted means revealed that the prevention program had a significant positive impact on key knowledge, attitudes, and skills including goal-setting, stress-management, and communication skills., Conclusions: The findings indicate that an evidence-based prevention approach adapted for youth diversionary settings can be effectively implemented and well-received by participating youth, and can produce positive changes in psychosocial skills and protective factors known to prevent multiple risk behaviors among youth. Future efforts to implement substance use prevention in community juvenile justice settings may benefit from highlighting a positive youth development, skills-based approach.

Evidence-based preventive interventions for adolescent substance use, violence, and mental health issues are increasingly being adapted and disseminated internationally. In the present paper, we report the results of an effectiveness study that was part of a comprehensive initiative by a coalition of health promotion organizations in the Lombardy region of Italy to select, culturally adapt, implement, evaluate, and sustain an evidence-based drug abuse prevention program developed in the USA. Findings are presented from a large-scale effectiveness study of the Life Skills Training prevention program among over 3000 students attending 55 middle schools in Italy. The prevention program taught drug refusal skills, antidrug norms, personal self-management skills, and general social skills. Relative to comparison group students, students who received the prevention program were less likely to initiate smoking at the post-test and 2-year follow-up, and less likely to initiate weekly drunkenness at the 1-year follow-up. The program had direct positive effects on several cognitive, attitudinal, and skill variables believed to play a protective role in adolescent substance use. The findings from this study show that a drug abuse prevention program originally designed for adolescents in the USA is effective in a sample of Italian youth when a rigorous and systematic approach to cultural adaptation is followed that incorporates the input of multiple stakeholders.

This study explored the relationship between trajectories of affective self-regulation skills during secondary school and young adult substance use in a large multi-ethnic, urban sample ( N = 995). During secondary school, participants completed a measure of cognitive and behavioral skills used to control negative, unpleasant emotions or perceived stress. As young adults, participants reported on the frequency and quantity of their alcohol, cigarette, and marijuana use in a telephone interview. Controlling for demographic variables, self-regulation did not significantly change over adolescence, although there was significant variation in participants' rates of growth and decline. Lower seventh grade self-regulation and less steep increases in self-regulation were predictive of higher young adult substance use. Male participants had significantly lower initial self-regulation and higher young adult substance use. The results suggest that interventions that build affective self-regulation skills in adolescence may decrease the risk of young adult substance use.

Research concerning the etiology and prevention of substance misuse has led to the development of preventive interventions that are theory-based and effective. One such approach, Life Skills Training (LST), targets key etiologic factors using a conceptual framework derived from social learning theory and problem behavior theory. LST has been extensively tested in a series of randomized trials and found effective in preventing the use/misuse of alcohol, tobacco, marijuana, and other psychoactive drugs. Research demonstrates that it is effective when implemented under different delivery conditions, by different program providers, with different age groups, and with different populations. Follow-up studies provide evidence of the long-term effectiveness of LST. Independent economic analysis indicates that LST produces cost savings of as much as $38 for every dollar invested. Finally, LST offers the potential of reducing other health risk behaviors and fostering academic success., (© WILEY PERIODICALS, INC.)

Adolescents (aged 12-14 years) from the United States (n = 539) and Japan (n = 644) completed surveys regarding tobacco use, perceptions of friend and peer smoking, and their own likelihood of using smoking refusal skills. U.S. youth were more likely to report lifetime or monthly tobacco use, whereas Japanese youth were more likely to smoke ≥20 cigarettes per week. High perceived friend and peer smoking prevalence predicted lifetime smoking, whereas direct refusal skill use (e.g., "saying no") predicted less lifetime tobacco use. Results are discussed in terms of cultural influences that may mediate the effect of risk factors on U.S. and Japanese youth.

The purpose of the present study was to investigate risk and protective factors for intimate partner violence (IPV) victimization in a high-risk sample of predominantly minority young adults from low-income urban communities. Participants were 1,130 individuals (57.9% women) ages 21 to 26 who participated in a telephone interview assessing IPV victimization, violence-related behaviors, and sexual behaviors. Results indicated that about 20.9% of participants reported experiencing one or more IPV incidents in their lifetime. Based on previous research, we examined lifetime violence, lifetime number of sexual partners, number of children, education, and religious service attendance as predictors of IPV. Results from a multivariate logistic regression showed that lifetime violence-related behaviors, number of lifetime sexual partners, and number of children were significant risk factors for IPV. The link between children and IPV risk: (a) was moderated by education for women and men and (b) was stronger for women (vs. men). These findings suggest that training for coping with stress and anger, endorsement of safe sex practices, and greater support for education may be effective strategies for preventing and reducing IPV among high-risk populations.

We explored changes in self-management skills and substance use from 7th to 11th grade in a multiwave study of predominantly minority adolescents ( N = 1,756). Using latent growth curve analysis, we found that substance use significantly increased, whereas self-management skills significantly decreased. In a parallel process model, we found that participants who reported higher self-management skills in the 7th grade had smaller increases in substance use. Participants who had larger decreases in self-management skills tended to have greater increases in substance use. We also explored the influence of grades and gender and found that (a) participants with higher grades at baseline had lower initial substance use, higher initial self-management skills, and smaller increases in substance use, and (b) male participants had greater increases in substance use. These results suggest that the provision of self-management skills may be an effective strategy for preventing substance-use initiation and escalation during adolescence.

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors.

This study evaluated bidirectional associations between substance use, aggression, and delinquency across sixth, seventh, and eighth grades using data available from a large study of urban minority youth (n = 2,931). Group-based trajectory analysis revealed trajectories of aggression, delinquency, and substance use which support the existence of both adolescent-limited and life-course persistent offenders. In addition, a pattern of decreasing aggression was observed during middle school. Clear temporal associations were observed between developmental changes in aggression, delinquency, and substance use. Notably, the decreasing aggression trajectory was as likely to be associated with high trajectories of substance initiation as was the high aggression trajectory. Furthermore, trajectories of delinquency were differentially associated with future substance use; however, substance use trajectories did not predict trajectories of delinquency. There were few gender differences in the developmental progression of these problem behaviors during middle school with only two exceptions, males were more likely to follow a trajectory of decreasing aggression and a trajectory of high stable delinquency. Evaluations of ethnic/racial differences in the trajectory group membership also revealed few differences. The results of this study provide important information regarding interconnections between developmental changes in problem behavior that occur during the middle school years, highlighting groups that may be missed via traditional analytic approaches that predict mean changes., (© 2010 Wiley-Liss, Inc.)

The theory of sensation seeking has conceptualized this construct as a stable personality trait associated with a variety of problem behaviors. Reckless behavior theory posits that increases in reckless behavior during adolescence can be attributed, in part, to increases in sensation seeking. This study evaluated patterns of stability and change in sensation seeking among 868 urban, minority youth (53% female), followed longitudinally across middle school (6th-8th grades). Group-based trajectory analysis identified a stable low group (20%), a moderate increasing group (60%), and a stable high group (20%) each of which demonstrated unique associations with changes in problem behaviors. Stable low sensation seekers reported consistently low levels of aggression, delinquency, and substance use across middle school. Moderate increasing sensation seekers reported significant increases in these risk behaviors over time from levels near zero in the 6th grade. Stable high sensation seekers reported high, stable levels of aggression and delinquency upon entry into middle school as well as significant increases in substance use across middle school. These results lend support to both theories and highlight a need for caution when categorizing adolescents as high or low sensation seekers.

Substantial progress has been made in developing prevention programs for adolescent drug abuse. The most effective interventions target salient risk and protective factors at the individual, family, and community levels and are guided by relevant psychosocial theories regarding the etiology of substance use and abuse. This article reviews the epidemiology, etiologic risk and protective factors, and evidence-based approaches that have been found to be most effective in preventing adolescent substance use and abuse. Exemplary school- and family-based prevention programs for universal (everyone in population), selected (members of at-risk groups), and indicated (at-risk individuals) target populations are reviewed, along with model community-based prevention approaches. Challenges remain in widely disseminating evidence-based prevention programs into schools, families, and communities., (Copyright (c) 2010 Elsevier Inc. All rights reserved.)

This pilot study examined whether refusal assertion as defined by a proven drug prevention program was associated with adolescent perceptions of effectiveness by comparing two sets of coded responses to adolescent videotaped refusal role-plays (N = 63). The original set of codes was defined by programmatic standards of refusal assertion and the second by a group of high school interns. Consistency with programming criteria was found for interns' ratings of several indicators of verbal and non-verbal assertiveness. However, a strategy previously defined by the program as effective was perceived as ineffective by adolescents while another deemed ineffective and problematic by intervention developers was viewed as effective. Interns endorsed presenting detailed and reasonable arguments as an effective refusal strategy while short, simple statements were deemed ineffective. This study suggests the importance of including adolescent perspectives in the design, delivery, and evaluation of drug prevention strategies.