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Background: Behavioral disinhibition (externalizing/impulsivity) and behavioral inhibition (internalizing/anxiety) may contribute to the development of alcohol abuse and dependence. But tests of person-by-environment interactions in predicting alcohol use disorders are needed. This study examined the extent to which interactions between behavioral disinhibition, behavioral inhibition and family management during adolescence predict alcohol abuse and alcohol dependence at age 27.Methods: This study used longitudinal data from a community sample of 808 men and women interviewed from ages 10 to 27 in the Seattle Social Development Project. Zero-order correlations followed by a series of nested regressions examined the relationships between individual characteristics (behavioral disinhibition and behavioral inhibition/anxiety) and environment (good vs. poor family management practices during adolescence) in predicting alcohol abuse and dependence criterion counts at age 27.Results: Behavioral disinhibition and poor family management predicted increased likelihood of both alcohol abuse and alcohol dependence at age 27. Behavioral inhibition/anxiety was unrelated to both outcomes. Youths high in behavioral disinhibition were at increased risk for later alcohol abuse and dependence only in consistently poorly managed family environments. In consistently well-managed families, high levels of behavioral disinhibition did not increase risk for later alcohol abuse or dependence.Conclusions: Behavioral disinhibition increases risk for alcohol abuse and dependence in early adulthood only for individuals who experience poor family management during adolescence. Interventions seeking to reduce environmental risks by strengthening consistent positive family management practices may prevent later alcohol abuse and dependence among individuals at risk due to behavioral disinhibition. [ABSTRACT FROM AUTHOR]

Recent advances in prevention science provide evidence that adolescent health and behavior problems can be prevented by high-quality prevention services. However, many communities continue to use prevention strategies that have not been shown to be effective. Studying processes for promoting the dissemination and high-quality implementation of prevention strategies found to be effective in controlled research trials has become an important focus for prevention science. The Communities That Care prevention operating system provides manuals, tools, training, and technical assistance to activate communities to use advances in prevention science to plan and implement community prevention services to reduce adolescent substance use, delinquency, and related health and behavior problems. This paper describes the rationale, aims, intervention, and design of the Community Youth Development Study, a randomized controlled community trial of the Communities That Care system, and investigates the baseline comparability of the 12 intervention and 12 control communities in the study. Results indicate baseline similarity of the intervention and control communities in levels of adolescent drug use and antisocial behavior prior to the Communities That Care intervention. Strengths and limitations of the study's design are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Little is known about men's patterns of substance use around their partner's pregnancy, despite evidence from studies of pregnant women that men's substance use may reduce women's ability to desist from substance use during pregnancy, increase the probability that women will return to use postpartum, and increase the risk of adverse child outcomes. The purpose of this study was to describe the association between pregnancy or partner's pregnancy and month-by-month patterns of binge drinking, daily smoking, and marijuana use among young men and women. METHODS: Data were drawn from the Seattle Social Development Project, which included 412 men and 396 women (age 24 yr) from a community sample of individuals who attended elementary school in the northwestern United States. Event history calendars were used to measure month-by-month patterns of binge drinking, daily smoking, marijuana use, and childbirth over a 3-year period from 1996 to 1999. RESULTS: Births during the calendar period were reported by 131 women and 77 men. Hierarchical generalized linear modeling analyses showed that men's rates of binge drinking and marijuana use were unaffected by their partner's pregnancy. Pregnancy decreased the probability of substance use among women, but use returned to prepregnancy levels within 2 years postpartum. CONCLUSIONS: Men's substance use was not affected by their partner's pregnancy. Pregnancy decreased the probability of substance use among women, but substantial proportions of women users of cigarettes and marijuana used these substances during pregnancy. Many of the women who desisted from substance use while pregnant returned to use after their child was born. [ABSTRACT FROM AUTHOR]

PURPOSE: To examine the convergence in the critiques and recommendations for the future of programs to promote healthy development and prevent problem behaviors among children and adolescents. METHODS: A review of literature captures two streams of thought, those promoting positive youth development approaches to youth programming and those promoting prevention science approaches to youth programming. RESULTS: Results suggest that advocates of positive youth development and prevention science have similar critiques of single-problem-focused prevention programs in the 1980s and early 1990s, and have similar recommendations for the future of youth programming. Further, review of data on youth development suggests that it is important to focus on risk and protection in preventing adolescent problems as well as in promoting positive youth development. CONCLUSIONS: These results suggest that both youth development and prevention science approaches have grown from similar roots and make similar recommendations for the future of youth programming. Further, data on precursors suggest that focusing on promoting protection and reducing risk is likely to prevent problems and promote positive youth development. Yet advocates of these approaches often are at odds, suggesting that the approaches provide different paradigmatic approaches to youth programming. We conclude that cooperation between these two approaches would further progress in the field of youth programming. [ABSTRACT FROM AUTHOR]

PURPOSE: To examine the developmental relationship between adolescent substance use and risky sexual behavior in young adulthood. A gender-balanced, ethnically diverse urban sample of 808 children in Seattle was surveyed at age 10 years in 1985 and followed prospectively to age 21 years in 1996. Semiparametric group-based modeling was used to determine trajectory groups of binge-drinking, cigarette smoking, marijuana use, and the use of other illicit drugs. Negative binomial regressions and logistic regressions were used to examine whether these trajectory groups predicted the number of sex partners and condom use at age 21 years. Specific forms of adolescent substance use significantly predicted risky sexual behavior at age 21 years, after other substance use and early measures of sexual behavior were controlled. Early binge-drinkers had significantly more sex partners than nonbinge-drinkers. Late onset binge-drinkers and marijuana users had significantly more sex partners and were less likely to use condoms consistently than those who did not binge drink or use marijuana. Experimenters in cigarette smoking, who did not escalate smoking, were more likely to use condoms consistently than nonsmokers. In contrast, the use of other illicit drugs in adolescence did not predict risky sexual behavior at age 21 years. The effects of adolescent substance use on risky sexual behavior at age 21 years differed for youths with developmentally different substance use trajectories in this urban sample disproportionately drawn from high crime neighborhoods. To prevent risky sexual behavior among young adults, attention should be paid to binge-drinking and marijuana use during adolescence. [ABSTRACT FROM AUTHOR]

Like their urban counterparts, adolescents from rural areas are at risk for health and behavior problems, including alcohol and other drug use. This study tested the effects on parenting practices of specific sessions of a parent-training intervention, Preparing for the Drug Free Years, designed to prevent adolescent substance abuse and other problem behaviors. Two hundred and nine rural families were randomly assigned to an intervention or a wait-list control condition. Analyses of covariance comparing adjusted posttest scores revealed that parents in the intervention condition reported significant improvements in parenting behaviors targeted by specific intervention sessions when compared with controls. Effects were most pronounced among mothers. No significant effects were found for nontargeted parenting behaviors, and targeted behaviors were most improved among parents attending relevant program sessions. These results strengthen the internal validity of the study and increase the plausibility that reported improvements were due to the intervention. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many studies of the consequences of binge drinking take a variable-centered approach that may mask developmentally different trajectories. Recent studies have reported qualitatively different binge drinking trajectories in young adulthood. However, analyses of developmental trajectories of binge drinking have not been examined for an important period of drinking development: adolescence. The purpose of this study was to examine young adult outcomes of adolescent binge drinking using an approach that combines person-centered and variable-centered methods. METHODS: Data were from the Seattle Social Development Project, an ethnically diverse, gender balanced sample (n = 808) followed prospectively from age 10 to age 21. Semiparametric group-based modeling was used to determine groups of binge drinking trajectories in adolescence. Logistic regression was used to examine how well the trajectory groups predicted young adult outcomes after demographics, childhood measures, and adolescent drug use were considered. RESULTS: Four distinct trajectories of binge drinking during adolescence were identified: Early Highs, Increasers, Late Onsetters, and Nonbingers. These trajectories significantly predicted positive and negative outcomes in adulthood after controlling for demographic characteristics, early proxy measures of the outcome, and adolescent drug use. CONCLUSIONS: This integrated person- and variable-centered approach provides more information about the effects of specific patterns of binge drinking than studies that employ variable-centered methods alone. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study, guided by the social development model, examined the dynamic patterns and predictors of alcohol and marijuana use onset. METHODS: Survival analysis and complementary log-log regression were used to model hazard rates and etiology of initiation with time-varying covariates. The sample was derived from a longitudinal study of 808 youth interviewed annually from 10 to 16 years of age and at 18 years of age. RESULTS: Alcohol initiation rose steeply up to the age of 13 years and then increased more gradually; most participants had initiated by 13 years of age. Marijuana initiation showed a different pattern, with more participants initiating after the age of 13 years. CONCLUSIONS: This study showed that: (1) the risk of initiation spans the entire course of adolescent development; (2) young people exposed to others who use substances are at higher risk for early initiation; (3) proactive parents can help delay initiation; and (4) clear family standards and proactive family management are important in delaying alcohol and marijuana use, regardless of how closely bonded a child is to his or her mother. [ABSTRACT FROM AUTHOR]

Problem behavior theory predicts that adolescent problem behaviors, including illicit drug use, delinquency, juvenile justice involvement, poor school performance, problem drinking, and sexual involvement, are manifestations of a single behavioral syndrome. Some studies have found the theory valid across genders, and this study tested its validity across racial groups. Multiple group confirmatory factor analysis using self-reports of substance use, delinquency, and juvenile justice system involvement tested problem behavior theory for African American and European American adolescents. Results indicate that multiple pathways are necessary to account for the problem behaviors, and they support previous research indicating system response bias in the processing of youths. Intervention and policy implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

This study tested whether effects of a preventive intervention delivered in elementary school showed benefits for the young adult offspring of intervention recipients over 20 years later. The Raising Healthy Children (RHC) intervention, trialed in 18 public schools in Seattle, Washington, from 1980-1986 (grades 1-6), sought to build strong bonds to family and school to promote school success and avoidance of substance use and illegal behavior. Four intervention groups were constituted: full, late, parent training only, and control. Participants were followed through 2014 (age 39 years). Those who became parents were enrolled in an intergenerational study along with their oldest offspring (10 assessments between 2002 and 2018). This study includes young adult offspring (ages 18-25 years; n = 169; 52% female; 4% Asian, 25% Black, 40% multiracial, 4% Native American, 2% Native Hawaiian/Pacific Islander, 25% White, and 14% Hispanic/Latinx) of participants in the original RHC trial. Offspring outcome measures included high school noncompletion, financial functioning, alcohol misuse, cannabis misuse, cigarette use, criminal behavior, internalizing behavior, social skills, and social bonding. A global test across all young adult outcome measures showed that offspring of parents who received the full RHC intervention reported better overall functioning compared to offspring of control group parents. Analyses of individual outcomes showed that offspring of full intervention group parents reported better financial functioning than offspring of control group parents. Findings show the potential of universal preventive interventions to provide long-term benefits that reach into the next generation. ClinicalTrials.gov Identifier: NCT04075019; retrospectively registered in 2019., (© 2023. Society for Prevention Research.)

Importance: There is little information on upstream community-based interventions that reduce the prevalence of handgun carrying among adolescents, especially those growing up in rural areas., Objective: To test whether Communities That Care (CTC), a community-based prevention system focusing on risk and protective factors for behavioral problems early in life, reduces handgun carrying prevalence among adolescents growing up in rural areas., Design, Setting, and Participants: Community-randomized trial of 24 small towns in 7 states assigned randomly to the CTC or control group with outcomes assessed from 2003 to 2011. Participants were youths attending public schools in grade 5 who received consent from their parents to participate (77% of the eligible population) and were repeatedly surveyed through grade 12 with 92% retention. Analyses were conducted from June to November 2022., Interventions: A coalition of community stakeholders received training and technical assistance to install CTC, used local epidemiologic data to identify elevated risk factors and low protective factors for adolescent behavioral problems, and implemented tested preventive interventions for youth, their families, and schools., Main Outcomes and Measures: Handgun carrying (never vs at least once) operationalized in 2 ways: (1) prevalence of past-year handgun carrying, and (2) cumulative prevalence of handgun carrying from grade 6 through grade 12., Results: Overall, the 4407 study participants' mean (SD) age was 12 (.4) years in both CTC (2405 participants) and control (2002 participants) communities in grade 6; about one-half of participants in each group were female (1220 [50.7 %] in the CTC group and 962 [48.1%] in the control group). From grade 6 through grade 12, 15.5% of participants in CTC communities and 20.7% of those in control communities reported carrying a handgun at least once. Youths in CTC communities were significantly less likely to report handgun carrying at a given grade than those in control communities (odds ratio [OR], 0.73; 95% CI, 0.65-0.82). The most pronounced effects were observed in grade 7 (OR, 0.70; 95% CI, 0.42-0.99), grade 8 (OR, 0.58; 95% CI, 0.41-0.74), and grade 9 (OR, 0.65; 95% CI, 0.39-0.91). Cumulatively from grade 6 through grade 12, youths in CTC communities were significantly less likely to report handgun carrying at least once than those in control communities (OR, 0.76; 95% CI, 0.70-0.84). Overall, CTC reduced the prevalence of past-year handgun carrying by 27% at a given grade and by 24% cumulatively through grade 12., Conclusions and Relevance: In this study, CTC reduced the prevalence of adolescent handgun carrying in participating communities., Trial Registration: ClinicalTrials.gov Identifier: NCT01088542.

Introduction: Many adult smokers have tried electronic cigarettes (e-cigarettes) as a less harmful alternative to combustible cigarettes. There is limited evidence, however, for the extent to which switching to e-cigarettes is associated with better health and functioning among nicotine users approaching their 40s-the beginning of midlife-when many health issues become more evident. This study examined the adoption of e-cigarette use ("vaping") among smokers in their 30s, and its association with diverse measures of healthy and successful aging at age 39., Methods: Data were from the Seattle Social Development Project, a panel study of 808 diverse participants with high retention (88%-91%). A subsample of 156 who used combustible cigarettes (smoked) at age 30 and smoked or vaped at age 39 was selected for analysis. A measure of vaping frequency, relative to combustible cigarette use, was computed from self-reports of past-month vaping and smoking at age 39. Nine measures of health and functioning in the past year were computed at age 39, with nine corresponding measures at age 30., Results: Among smokers at age 30, 36% adopted vaping some or all of the time by age 39. Higher relative vaping frequency was related to 4 of 9 outcomes examined, including significantly more exercise, more constructive engagement, better physical health, and higher SES at age 39, accounting for prior behaviors at age 30., Conclusions: Findings suggest that, among smokers in their 30s, replacing combustible cigarettes with vaping may be associated with key markers of healthy and successful aging to age 39., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Evidence-based parenting interventions play a crucial role in the sustained reduction of adolescent behavioral health concerns. Guiding Good Choices (GGC) is a 5-session universal anticipatory guidance curriculum for parents of early adolescents that has been shown to reduce substance use, depression symptoms, and delinquent behavior. Although prior research has demonstrated the effectiveness of evidence-based parenting interventions at achieving sustained reductions in adolescent behavioral health concerns, public health impact has been limited by low rates of uptake in community and agency settings. Pediatric primary care is an ideal setting for implementing and scaling parent-focused prevention programs as these settings have a broad reach, and prevention programs implemented within them have the potential to achieve population-level impact. The current investigation, Guiding Good Choices for Health (GGC4H), tests the feasibility and effectiveness of implementing GGC in 3 geographically and socioeconomically diverse large integrated healthcare systems. This pragmatic, cluster randomized clinical trial will compare GGC parenting intervention to usual pediatric primary care practice, and will include approximately 3750 adolescents; n = 1875 GGC intervention and n = 1875 usual care. The study team hypothesizes that adolescents whose parents are randomized into the GGC intervention arm will show reductions in substance use initiation, the study's primary outcomes, and other secondary (e.g., depression symptoms, substance use prevalence) and exploratory outcomes (e.g., health services utilization, anxiety symptoms). The investigative team anticipates that the implementation of GGC within pediatric primary care clinics will successfully fill an unmet need for effective preventive parenting interventions. Trial registration: Clinicaltrials.govNCT04040153., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Evidence for use of electronic cigarettes (e-cigs) as a potential aid in quitting or reducing combustible cigarette (c-cig) use is mixed. This study examined the extent to which e-cig initiation among smokers in their 30 s predicted quitting or reducing smoking or nicotine dependence symptoms by age 39, and whether the role of e-cigs in quitting differed by prospectively assessed moderators., Methods: Data were from the Seattle Social Development Project (SSDP), a panel study of 808 diverse participants with high retention. A subsample of 221 smokers at age 33 was selected for analysis. Self-reports of c-cig use and dependence were assessed longitudinally at ages 33 and 39. Sixteen potential moderators were examined, including social demographics, smoking attitudes and desire to quit, other health behaviors and status, and adolescent and early adult assessments of smoking history., Results: The use of e-cigs was consistently associated with a lower likelihood of quitting c-cigs by age 39, after accounting for frequency of prior c-cig use at age 33. This negative association persisted across all moderators examined, although it was nonsignificant among those with a definite desire to cut down. Among those who did not quit smoking, e-cig use had no association with decreases in either quantity of c-cigs used or dependence symptoms., Conclusions: Results indicate that e-cigarette use was not helpful for quitting or reducing combustible cigarette use in the 30 s. Rather, across extensive tests of moderation, e-cig initiation consistently predicted less quitting during this important age period for successful cessation., (Copyright © 2021 Elsevier B.V. All rights reserved.)

This study estimated sustained impacts and long-term benefits and costs of the Communities That Care (CTC) prevention system, implemented and evaluated in a longitudinal cluster-randomized trial involving 24 communities in seven states. Analyses utilized reports from a longitudinal panel of 4407 participants, followed since the study's baseline in grade 5, with most recent follow-up 12 years later at age 23. Impacts on lifetime abstinence from primary outcomes of substance use and antisocial behavior were estimated using generalized linear mixed Poisson regression analysis, adjusted for individual and community-level covariates. Possible cascading effects on 4-year college completion, major depressive disorder, and generalized anxiety disorder through age 23 were evaluated as secondary outcomes. CTC had a statistically significant global effect on primary outcomes and also on combined primary and secondary outcomes. Among primary outcomes, point estimates suggested absolute improvements in lifetime abstinence of 3.5 to 6.1% in the intervention arm and relative improvements of 13 to 55%; 95% confidence intervals revealed some uncertainty in estimates. Among secondary outcomes, 4-year college completion was 1.9% greater among young adults from intervention communities, a 20% relative improvement. Mental health outcomes were approximately the same across trial arms. Although CTC had small sustained effects through age 23, benefit-cost analyses indicated CTC was reliably cost beneficial, with a net present value of $7152 (95% credible interval: $1253 to $15,268) per participant from primary impacts and $17,919 ($306 to $39,186) when secondary impacts were also included. It remained cost beneficial even when impacts were adjusted downward due to the involvement of CTC's developer in the trial. Findings suggest that broader dissemination of CTC could improve public health and individual lives in the long term and generate positive net benefits to society.

Introduction: Reducing cigarette use is a major public health goal in the United States. Questions remain, however, about the potential for the social environment in the adult years-particularly in the 30s and beyond-to influence cigarette use. This study tested pathways hypothesized by the social development model to understand the extent to which social environmental factors at age 33 (eg, involvement with smokers or with physically active people) contribute to changes in cigarette use from age 30 to age 39. Both combustible and electronic cigarette use were investigated., Methods: Data were from the Seattle Social Development Project, a longitudinal study of 808 diverse participants with high retention. Self-reports assessed social developmental constructs, combustible and electronic cigarette use, and demographic measures across survey waves., Results: At age 30, 32% of the sample reported past-month cigarette use. Using structural equation modeling, results showed high stability in cigarette use from age 30 to 39. After accounting for this stability, cigarette-using social environments at age 33 predicted personal beliefs or norms about smoking (eg, acceptability and social costs), which in turn predicted combustible cigarette use at age 39. Cigarette-using environments, however, directly predicted electronic cigarette use at age 39, with no significant role for beliefs about smoking., Conclusions: Cigarette use was highly stable across the 30s, but social environmental factors provided significant partial mediation of this stability. Pathways were different for combustible and electronic cigarette use, however, with personal smoking norms playing an important role for the former but not the latter., Implications: This study addresses the need for longitudinal investigation of social mechanisms and cigarette use in the 30s. Findings reinforce efforts to prevent the uptake of cigarettes prior to the 30s because, once started, smoking is highly stable. But social environmental factors remain viable intervention targets in the 30s to disrupt this stability. Addressing personal norms about smoking's acceptability and social costs is likely a promising approach for combustible cigarette use. Electronic cigarettes, however, present a new challenge in that many perceived social costs of cigarette use do not readily translate to this relatively recent technology., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

There are stable between-person differences in an internalizing "trait," or the propensity to experience symptoms of internalizing disorders, such as social anxiety, generalized anxiety disorder, and depression. Trait internalizing may serve as a marker of heightened risk for problem alcohol outcomes (such as heavier drinking, binge drinking, or alcohol dependence). However, prior research on the association between internalizing symptoms and alcohol outcomes has been largely mixed in adolescence, with more consistent support for an association during adulthood. It may be that trait internalizing is only associated with problem alcohol outcomes in adulthood, after individuals have gained experience with alcohol. Some evidence suggested that these effects may be stronger for women than men. We used data from a community sample (n = 790) interviewed during adolescence (ages 14-16) and again at ages 21, 24, 27, 30, 33, and 39. Using generalized estimating equations, we tested the association between trait internalizing and alcohol outcomes during both adolescence and adulthood, and tested whether adult trait internalizing mediated the association between adolescent trait internalizing and adult alcohol outcomes. Trait internalizing in adulthood (but not adolescence) was associated with more frequent alcohol use, binge drinking and symptoms of alcohol use disorders, and mediated the effects of adolescent trait internalizing on alcohol outcomes. We observed no moderation by gender or change in these associations over time. Understanding the developmental pathways of trait internalizing may provide further insights into preventing the emergence of problem alcohol use behavior during adulthood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Few longitudinal studies are capable of identifying criminal career profiles using both self-report and official court data beyond the 30s. The current study aims to identify criminal career profiles across three developmental periods using self-report data, validate these profiles with official court records and determine early childhood predictors. Data came from the Seattle Social Development Project (n = 808). Latent Class Analysis was used to examine criminal careers from self-reported data during adolescence (aged 14-18), early adulthood (aged 21-27) and middle adulthood (aged 30-39). Official court records were used to validate the classes. Childhood risk and promotive factors measured at ages 11-12 were used to predict classes. Findings revealed four career classes: non-offending (35.6%), adolescence-limited (33.2%), adult desister (18.3%) and life-course/persistent (12.9%). Official court records are consistent with the description of the classes. Early life school and family environments as well as having antisocial beliefs and friends differentiate membership across the classes. The results of this study, with a gender-balanced and racially diverse sample, bolster the current criminal career knowledge by examining multiple developmental periods into the 30s using both self-report and official court data., (© 2020 John Wiley & Sons Ltd.)

Importance: Trials of preventive interventions for children that were implemented in the 1980s have reported sustained positive outcomes on behavioral and health outcomes into adulthood, years after the end of the intervention. This present study examines whether intervention in childhood may show sustained benefits across generations., Objective: To examine possible intervention outcomes on the offspring of individuals (now parents) who participated in the Raising Healthy Children preventive intervention as children in the elementary grades., Design, Setting, and Participants: This nonrandomized controlled trial was conducted in public elementary schools serving high-crime areas in Seattle, Washington. The panel originated in Seattle but was followed up locally and in out-of-state locations over time. Data analyzed in this study were collected from September 1980 to June 2011, with follow-up of the firstborn offspring (aged 1 through 22 years) of 182 parents who had been in the full intervention vs control conditions in childhood. Their children were assessed across 7 waves in 2 blocks (2002-2006 and 2009-2011). Data were analyzed for this article from September 2018 through January 2019., Interventions: In grades 1 through 6, the Raising Healthy Children intervention provided elementary school teachers with methods of classroom management and instruction, first-generation (G1) parents with skills to promote opportunities for children's active involvement in the classroom and family, and second-generation (G2) child with social and emotional skills training., Main Outcomes and Measures: Outcomes examined in the third-generation (G3) offspring were self-regulation (emotion, attention, and behavioral regulation), cognitive capabilities, and social capabilities. Risk behaviors, including substance use and delinquency, were examined from age 6 years to study completion. Early onset of sexual activity was examined from age 13 years to study completion. Intent-to-treat analyses controlled for potential confounding factors., Results: A total of 182 G3 children were included in this analysis (72 in the full intervention and 110 in the control condition; mean age at first wave of data collection, 7 [range, 1-13] years). Significant differences in the offspring of intervention parents were observed across 4 domains: improved early child developmental functioning (ages 1-5 years; significant standardized β range, 0.45-0.56), lower teacher-rated behavioral problems (ages 6-18 years; significant standardized β range, -0.39 to -0.46), higher teacher-rated academic skills and performance (ages 6-18 years; significant standardized β range, 0.34-0.49), and lower child-reported risk behavior (ages 6-18 years; odds ratio for any drug use [alcohol, cigarettes, or marijuana], 0.27 [95% CI, 0.10-0.73])., Conclusions and Relevance: To our knowledge, this is the first study to report significant intervention differences in the offspring of participants in a universal childhood preventive intervention. Cost-benefit analyses have examined the benefits of childhood intervention in the target generation. The present study suggests that additional benefits can be realized in the next generation as well., Trial Registration: ClinicalTrials.gov Identifier: NCT04075019.

This study examined associations of neighborhood structural factors (census-based measures, socioeconomic disadvantage, and residential stability); self-reported measures of general and substance use-specific risk factors across neighborhood, school, peer, and family domains; and sociodemographic factors with substance use among 9th grade students. Data drawn from the Seattle Social Development Project, a theory-driven longitudinal study originating in Seattle, WA, were used to estimate associations between risk factors and past month cigarette smoking, binge drinking, marijuana use, and polysubstance use among students (N = 766). Results of logistic regression models adjusting for neighborhood clustering and including all domains of risk factors simultaneously indicated that neighborhood socioeconomic disadvantage was associated with a significantly higher likelihood of cigarette smoking, binge drinking, and polysubstance use, but not marijuana use. In fully controlled models, substance use-specific risk factors across neighborhood, school, peer, and family domains were also associated with increased likelihood of substance use and results differed by the outcome considered. Results highlight substance-specific risk factors as an intervention target for reducing youth substance use and suggest that further research is needed examining mechanisms linking neighborhood socioeconomic disadvantage and youth substance use.

Elementary schools can be effective sites for universal preventive interventions. Less is known about how long effects of intervention in elementary grades last. Can they improve outcomes in adulthood? To test effects of a social developmental intervention in the elementary grades on adult life through the 30s, the Seattle Social Development Project, a nonrandomized controlled trial, followed all consenting 5th-grade students (N = 808) from 18 Seattle public elementary schools from age 10 (in 1985) to age 39 (in 2014), with 88% retention. The sample was gender balanced and ethnically and economically diverse. The full intervention, called Raising Healthy Children, continued from Grades 1 through 6 and consisted of teacher in-service training in classroom management and instructional methods; cognitive, social, and refusal skills training for children; and parent workshops in child behavior monitoring and management, academic support, and anticipatory guidance. Using structural equation modeling, we examined intervention effects from age 30 to age 39 across 9 constructs indicating 3 domains of adult life: health behavior, positive functioning, and adult health and success. An omnibus test across all 9 constructs indicated a significant positive overall intervention-control difference. Examined individually, significant intervention effects included better health maintenance behavior, mental health, and overall adult health and success. Significant effects were not found on substance use disorder symptoms, sex-risk behaviors, or healthy close relationships in the 30s. Results indicate that sustained, theory-based, multicomponent intervention in the elementary grades can produce lasting changes in health maintenance, mental health, and adult functioning through the 30s.

Background: Lower socioeconomic status (SES) has been associated with higher rates of smoking. Few longitudinal studies have examined indicators of SES at both the neighborhood- and individual-level over time in conjunction with proximal risk factors of cigarette smoking., Purpose: To examine associations of time-varying measures of SES, demographic factors, and proximal risk factors for smoking net of average trajectories of smoking behavior from ages 30 to 39 in a community sample., Methods: Data from the Seattle Social Development Project (N = 752), a theory-driven longitudinal study originating in Seattle, WA, were used to estimate trajectories of smoking from age 30 to 39. Time-varying measures of neighborhood poverty, coworker smoking, partner smoking, depression, anxiety, education, income, marital status, and parenthood were associated with smoking over time using latent growth curve modeling., Results: Results indicated that living in higher poverty neighborhoods was uniquely associated with a greater likelihood of smoking net of average trajectories of smoking from age 30 to 39, gender and race/ethnicity, time-varying measures of SES and demographics, and time-varying measures of proximal risk factors for smoking., Conclusions: Living in higher poverty neighborhoods presents a unique risk for smoking among adults aged 30 to 39 above and beyond multiple aspects of SES and other potential mechanisms relating SES to smoking., (© Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The current study examines the continuity in comorbidity between substance use and internalizing mental health problems from adolescence to adulthood and investigates the general and specific predictors of comorbidity across development. Participants were drawn from the Seattle Social Development Project (N = 808), a gender-balanced, ethnically diverse longitudinal panel. Structural equation modeling was used to examine risk factors for comorbid substance use and internalizing problems in family and peer social environments; substance use- and mental health-specific social environments (family tobacco, alcohol, and marijuana use; family history of depression); and individual risk factors (behavioral disinhibition). Latent factors were created for comorbid substance use and mental health problems at ages 13-14 and comorbidity of substance abuse and dependence symptoms and mental health disorder symptoms at ages 30-33 and included indicators of anxiety, depression, alcohol, tobacco, and marijuana problems. Comorbid problems in adolescence predicted later comorbidity of disorders in adulthood. In addition, family tobacco environment and behavioral disinhibition predicted adolescent comorbidity, while family history of depression was associated with adult comorbidity. Finally, family and peer substance use in adolescence predicted substance use (alcohol, tobacco, and marijuana) both in adolescence and adulthood. The pattern of results suggests that comorbidity in adolescence continues into adulthood and is predicted by both general and behavior-specific environmental experiences during adolescence. Findings clarify the etiology of comorbid internalizing and substance use problems and suggest potential preventive intervention targets in adolescence to curb the development of comorbidity in adulthood.

Permissive attitudes and norms about marijuana use and perceptions of low harm from use are considered risk factors for adolescent marijuana use. However, the relationship between risk and use may be reciprocal and vary across development and socializing domains. We examined the bidirectional relationships between marijuana-specific risk factors in individual, parent, peer, and community domains and adolescent marijuana use. Longitudinal data came from a sample of 2002 adolescents in 12 communities. Controlling for sociodemographic covariates and communities in which the individuals resided, autoregressive cross-lagged models examined predictive associations between the risk factors and marijuana use. After accounting for concurrent relationships between risk and use and stability in behavior over time, early adolescence and the transition to high school were particularly salient developmental time points. Specifically, higher risk in all four domains in grades 7 and 9 predicted greater use 1 year later. Moreover, youth's perception of lax community enforcement of laws regarding adolescent use at all time points predicted increases in marijuana use at the subsequent assessment, and perceived low harm from use was a risk factor that prospectively predicted more marijuana use at most of the time points. Finally, greater frequency of marijuana use predicted higher levels of risk factors at the next time point in most socializing domains throughout adolescence. Prevention programs should take into account developmental transitions, especially in early adolescence and during the transition to high school. They also should focus on the reciprocal relationships between use and risk across multiple socializing domains.

Purpose: The present study examined whether risk factors during adolescence, including substance use, depression, overweight status, and young adult educational attainment, mediated the association between low childhood socioeconomic status (SES) and higher body mass index (BMI) in adulthood. We also evaluated whether the hypothesized pathways differed based on racial group status., Methods: Participants from the Seattle Social Development Project were followed from ages 10 to 39years. Thepresent study included white (n = 381), African American (n = 207), and Asian American (n = 171) participants. Structural equation models tested pathways linking low childhood SES to BMI from ages 24 to 39 years. Multiple-group modeling was used to test potential racial differences., Results: Analyses indicated racial differences in the pathways linking low childhood SES with adult BMI. For whites, overweight status and educational attainment were significant mediators. For Asian Americans, there was an unmediated and significant pathway between low childhood SES and low adult BMI. For African Americans, there were no significant mediated or unmediated pathways., Conclusions: Results stress that the pathways that link childhood SES with adult BMI may operate differently based on race. Research is particularly needed to identify mechanisms for African Americans in order to better inform obesity prevention efforts., (Copyright © 2018 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Earlier intention-to-treat (ITT) findings from a community-randomized trial demonstrated effects of the Communities That Care (CTC) prevention system on reducing problem behaviors among youth. In ITT analyses, youth were analyzed according to their original study community's randomized condition even if they moved away from the community over the course of follow-up and received little to no exposure to intervention activities. Using inverse probability weights (IPWs), this study estimated effects of CTC in the same randomized trial among youth who remained in their original study communities throughout follow-up. Data were from the Community Youth Development Study, a community-randomized trial of 24 small towns in the United States. A cohort of 4,407 youth was followed from fifth grade (prior to CTC implementation) to eighth grade. IPWs for one's own moving status were calculated using fifth- and sixth-grade covariates. Results from inverse probability weighted multilevel models indicated larger effects for youth who remained in their study community for the first 2 years of CTC intervention implementation compared to ITT estimates. These effects included reduced likelihood of alcohol use, binge drinking, smokeless tobacco use, and delinquent behavior. These findings strengthen support for CTC as an efficacious system for preventing youth problem behaviors.

Objectives: To evaluate whether the effects of the Communities That Care (CTC) prevention system, implemented in early adolescence to promote positive youth development and reduce health-risking behavior, endured through age 21 years., Methods: We analyzed 9 waves of prospective data collected between 2004 and 2014 from a panel of 4407 participants (grade 5 through age 21 years) in the community-randomized trial of the CTC system in Colorado, Illinois, Kansas, Maine, Oregon, Utah, and Washington State. We used multilevel models to evaluate intervention effects on sustained abstinence, lifetime incidence, and prevalence of past-year substance use, antisocial behavior, and violence., Results: The CTC system increased the likelihood of sustained abstinence from gateway drug use by 49% and antisocial behavior by 18%, and reduced lifetime incidence of violence by 11% through age 21 years. In male participants, the CTC system also increased the likelihood of sustained abstinence from tobacco use by 30% and marijuana use by 24%, and reduced lifetime incidence of inhalant use by 18%. No intervention effects were found on past-year prevalence of these behaviors., Conclusions: Implementation of the CTC prevention system in adolescence reduced lifetime incidence of health-risking behaviors into young adulthood. Clinicaltrials.gov identifier: NCT01088542.

There is broad agreement that neighborhood contexts are important for adolescent development, but there is less consensus about their association with adolescent smoking and alcohol use. Few studies have examined associations between neighborhood socioeconomic contexts and smoking and alcohol use while also accounting for differences in family and peer risk factors for substance use. Data drawn from the Seattle Social Development Project (N = 808), a gender-balanced (female = 49%), multiethnic, theory-driven longitudinal study originating in Seattle, WA, were used to estimate trajectories of smoking and alcohol use from 5th to 9th grade. Time-varying measures of neighborhood socioeconomic, family, and peer factors were associated with smoking and alcohol use at each wave after accounting for average growth in smoking and alcohol use over time and demographic differences. Results indicated that living in more socioeconomically disadvantaged neighborhoods, lower family income, lower family general functioning, more permissive family smoking environments, and affiliation with deviant peers were independently associated with increased smoking. Lower family functioning, more permissive family alcohol use environments, and deviant peers were independently associated with increased alcohol use. The effect of neighborhood disadvantage on smoking was mediated by family income and deviant peers while the effect of neighborhood disadvantage on alcohol use was mediated by deviant peers alone. Family functioning and family substance use did not mediate associations between neighborhood disadvantage and smoking or alcohol use. The results highlight the importance of neighborhood, family, and peer factors in early adolescent smoking and alcohol use. Future studies should examine the unique association of neighborhood disadvantage with adolescent smoking net of family socioeconomics, functioning, and substance use, as well as peer affiliations. Better understanding of the role of contextual factors in early adolescent smoking and alcohol use can help bolster efforts to prevent both short and long harms from substance use.

Purpose: Concern that asking about a specific behavior could elicit that behavior is often cited as a reason that communities and schools should not administer surveys about youth drug use. In this study, we investigated if this question-behavior effect exists related to substance use. We examined if simply asking a student about their current drug use leads to an increase in drug use 1 year later., Method: This study tests the validity of the question-behavior effect on youth drug use in a longitudinal panel of 2,002 elementary school students. The sample of students was drawn from the Community Youth Development Study, a community-randomized test of the Communities That Care prevention system. If the prevalence of self-reported drug use in sixth grade in a sample surveyed in fifth and sixth grades was higher than in an accretion sample surveyed only in sixth grade, the difference could indicate a question-behavior effect., Results: Results from logistic regression analyses did not provide any evidence of a question-behavior effect on 30-day or lifetime prevalence of alcohol, tobacco, inhalant, or marijuana use reported in sixth grade., Conclusions: Asking youth about drug use in a survey did not increase the rates of self-reported drug use measured 1 year later. The absence of evidence of a question-behavior effect should ease concerns of communities and schools when administering surveys asking youth about their drug use., (Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: The present study is a prospective examination of the relationship between regular marijuana use from adolescence through young adulthood and mental health outcomes at age 33., Methods: Data came from a gender-balanced, ethnically diverse longitudinal panel of 808 participants from Seattle, Washington. Outcomes included symptom counts for six mental health disorders. Regular marijuana use was tracked during adolescence and young adulthood. Regression analyses controlled for demographics and early environment, behaviors, and individual risk factors., Results: Nonusers of marijuana reported fewer symptoms of alcohol use disorder, nicotine dependence, and generalized anxiety disorder than any category of marijuana users. More persistent regular marijuana use in young adulthood was positively related to more symptoms of cannabis use disorder, alcohol use disorder, and nicotine dependence at age 33., Conclusions: Findings highlight the importance of avoiding regular marijuana use, especially chronic use in young adulthood. Comprehensive prevention and intervention efforts focusing on marijuana and other substance use might be particularly important in the context of recent legalization of recreational marijuana use in Washington and other U.S. states., (Copyright © 2017 Elsevier B.V. All rights reserved.)