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Lack of sex education in schools has been an ongoing issue in Russia, mainly due to conservative opposition to providing accurate sexual health information openly. Many adolescents may be misinformed about contraceptive methods and may not have reliable access to effective contraception. This study assessed sexual behaviour and knowledge of contraceptives among Russian adolescents in the republic of Bashkortostan. Among a convenience sample of 716 Russian high school youth, 60% lacked information about modern contraceptive methods other than condoms. Being male, older, having had school disciplinary problems, and lifetime use of substances were associated with increased likelihood of having sexual intercourse in one's lifetime. Of the sub-sample of participants who had engaged in sexual intercourse, 43.2% endorsed one or more items on an index of sexual risk taking (e.g. multiple partners, no condom use). Additionally, the use of hard drugs and being of other ethnicity relative to Russian (e.g., mixed, Bashkir, Tartar) was associated with risky sexual behaviour. Lack of knowledge of effective contraceptives and the high prevalence of risky sexual behaviours warrants further research into this topic, as well as a call for sexual education programmes in the country.

Background and aimsRecent work has studied addictions using a matrix measure, which taps multiple addictions through single responses for each type. This is the first longitudinal study using a matrix measure.MethodsWe investigated the use of this approach among former alternative high school youth (average age = 19.8 years at baseline; longitudinal n = 538) at risk for addictions. Lifetime and last 30-day prevalence of one or more of 11 addictions reviewed in other work was the primary focus (i.e., cigarettes, alcohol, hard drugs, shopping, gambling, Internet, love, sex, eating, work, and exercise). These were examined at two time-points one year apart. Latent class and latent transition analyses (LCA and LTA) were conducted in Mplus.ResultsPrevalence rates were stable across the two time-points. As in the cross-sectional baseline analysis, the 2-class model (addiction class, non-addiction class) fit the data better at follow-up than models with more classes. Item-response or conditional probabilities for each addiction type did not differ between time-points. As a result, the LTA model utilized constrained the conditional probabilities to be equal across the two time-points. In the addiction class, larger conditional probabilities (i.e., 0.40-0.49) were found for love, sex, exercise, and work addictions; medium conditional probabilities (i.e., 0.17-0.27) were found for cigarette, alcohol, other drugs, eating, Internet and shopping addiction; and a small conditional probability (0.06) was found for gambling.Discussion and conclusionsPersons in an addiction class tend to remain in this addiction class over a one-year period.

Background: Alternative (or continuation) high schools are institutions designed for students at risk for not graduating due to behavioral, educational, or medical problems. The present study explored the relationship between negative substance use consequences (eg, having trouble at school or work) and noncondom use in this at-risk population and whether these associations varied by sex. Methods: Participants (N = 1101; 62.9% Hispanic; M[subscript age] = 16.85) were sampled from 24 alternative high schools in California, and data were analyzed using cross-sectional multivariate logistic regression models. Results: We observed a relationship between the number of negative substance use consequences and probability of noncondom use at the last sexual encounter for boys (p < 0.001) but not girls (p > 0.05). There were significant associations between specific social consequences (missing school/work) and dependence symptoms (selling personal items to get alcohol or drugs) with noncondom use for boys only. There was a similar association between substance use frequency and noncondom use for boys. Conclusions: These findings suggest that substance use consequences may be a useful and advantageous indicator of risky sexual behaviors such as noncondom use for boys, but not girls, in alternative high school settings. Future research and intervention programming recommendations are discussed.

Objective: Although Hispanic adolescents in the USA are often the focus of sexual health interventions, their response to survey measures has rarely been assessed within evaluation studies. This study documents the test-retest reliability of a wide range of self-reported sexual health values, attitudes, knowledge and behaviours among Hispanic adolescents from low-income, urban communities. Method: Intraclass correlation coefficients were calculated for sexual health scales (knowledge, values about condom use, parent communication, protection self-efficacy and condom-use intentions) in a 2-week sample (N = 86). Cohen's kappa and intraclass correlation coefficients were calculated for behaviours (romantic and sexual behaviours, and sexual health services history) in two separate 2-week samples (N = 86, N = 202). Selected behaviours were also examined for retractions in both 2-week samples and in a 1-year sample (N = 291). Results: Among sexual health scales, test-retest reliability ranged from 0.37 for condom-use intentions to 0.93 for parent communication. Among behaviours, reliability ranged from .27 for use of sexual health services to 1.00 for use of birth control at first sex. Retractions ranged from below 10% for ever having had a steady partner to 50% or more for sexual health services and testing. Conclusion: Test-retest reliability differed greatly across self-reported sexual health values, attitudes, knowledge and behaviours for the three samples of Hispanic adolescents. Overall, however, most items and scales showed good to excellent reliability (i.e. a coefficient greater than 0.60), suggesting that Hispanic adolescents are moderately to highly stable reporters in response to sexual health measures.

Numerous classroom-based interventions have aimed to improve sexual health outcomes for young people, yet few have shown strong, lasting effects. Ecological approaches that address multiple levels of a young person's environment offer largely untapped potential to positively change sexual behaviour. This paper presents results of a cluster-randomised trial of a multicomponent sexuality education intervention that integrated a classroom curriculum, parent education workshops and materials, peer advocate programme, and sexual health services at 10 urban high schools. An implementation evaluation, employing quantitative and qualitative instruments, was conducted to examine whether the individual components of the intervention were delivered as planned and how they were received by the target populations. Multilevel modelling was used to evaluate the effect of the multicomponent intervention on outcomes at one-year follow-up. Results showed that the intervention components were successfully implemented with and well received by target populations. Students receiving the multicomponent intervention reported greater increases in the use of sexual health services (odds ratio [OR] = 1.73, 95% CI = 1.09-2.75) and the likelihood of carrying a condom (OR = 2.71, 95% CI = 1.44-5.09) relative to those receiving a control condition. No effects were found for other behaviours, possibly due to low prevalence of sexual activity in the sample and the small number of schools randomised.

Purpose: The current study aims to examine the influence of contextual and provider-level factors on the implementation fidelity of a research-based substance abuse prevention program. Also, it aims to investigate whether two provider-level factors, self-efficacy and beliefs about the value of the program, statistically moderate and mediate the effects of a provider training intervention on implementation fidelity. Design/methodology/approach: Using generalized mixed-linear modeling, the authors examine relationships between program provider-, organizational, and community-level factors and implementation fidelity in a sample of 50 high school teachers from 43 high schools in eight states across the USA. Fidelity of implementation was assessed utilizing an observation procedure. Findings: Implementation fidelity was negatively associated with the urbanicity of the community and the level of teachers' beliefs about the value of the program, and positively predicted by the organizational capacity of the school. Comprehensive training significantly increased teachers' self-efficacy, which resulted in an increase in implementation fidelity. Research limitations/implications: School-based prevention program implementation is influenced by a variety of contextual factors occurring at multiple ecological levels. Future effectiveness and dissemination studies need to account for the complex nature of schools in analyses of implementation fidelity and outcomes. Practical implications: The authors' findings suggest that both provider- and organizational-level are influential in promoting implementation fidelity. Before implementation begins, as well as throughout the implementation process, training and ongoing technical assistance should be conducted to increase teachers' skills, self-efficacy, and comfort with prevention curricula. Originality/value: The present study is one of the few to examine contextual and provider-level correlates of implementation fidelity and use mediation analyses to explore whether provider-level factors mediate the effects of a provider training intervention on implementation fidelity. (Contains 2 tables and 2 figures.)

The present study provides an implementation fidelity, process, and immediate outcomes evaluation of Project Towards No Drug Abuse (TND), a drug prevention program targeting continuation high school youth (n = 1426) at risk for drug abuse. A total of 24 schools participated in three randomized conditions: TND Only, TND and motivational interviewing follow-up, and no treatment control. Fidelity was high: across program schools the curriculum was implemented as intended and was received favorably by students. Relative to controls, intervention conditions produced effects on hypothesized mediators, including greater gains in program related knowledge, greater reductions in drug use intentions, and positive changes in motivation. However, few generalizations to attitudes and intentions regarding risky sexual behavior were found. The pattern of results suggests that the experimental manipulations worked as intended. (Contains 3 tables.)

The leading substance of misuse among teens after tobacco, alcohol, and marijuana is the use of pain killers. Very few longitudinal studies on prediction of pain killer use have been conducted among teens. This study examined the 1-year prediction of self-reported last 30-day pain killer use controlling for baseline 30-day painkiller use among 1186 alternative high school youth in California. Among demographic, behavioral, psychosocial, and environmental predictors, a multivariable model indicated that: (a) relatively higher levels of baseline pain killer use; (b) white ethnicity; (c) relatively lower levels of depressive symptoms (contrary to previous studies); and (d) those who live with both parents were more likely to report use of pain killer medications in the next year. It is speculated that those with relatively greater access to pain medication, within an at-risk social environment, are those who will use it later on. (Contains 3 tables.)

Background: Concerns have been expressed that No Child Left Behind (NCLB) may be reducing the amount of classroom time devoted to subjects other than those for which students are tested. The purpose of this article is to explore whether NCLB legislation has affected the provision of evidence-based drug prevention curricula (EBC) in the nation's middle schools, a subject area that is not assessed by standardized tests. Methods: Data were collected in spring 2005 and spring 2008 from a nationally representative sample of middle schools. Respondents completed a survey regarding their provision of EBC (2005 response rate: 78.1%). We also collected data on schools' adequate yearly progress (AYP) status as of 2005 as a measure of their compliance with NCLB targets. We restricted our sample to schools that responded to our survey in both waves (n = 1324, or 76.9% of those schools responding in 2005) and conducted logistic regression analyses to determine whether those schools not making AYP in 2005 were less likely to be using an EBC in 2008. Results: Our results revealed no relationship between AYP status in 2005 and EBC use in 2008. Analyses of demographic characteristics showed that schools making AYP were more likely to be small and rural, and to serve majority White student populations whose families were characterized by lower levels of poverty. Conclusions: Our failure to find any relationship between AYP status and the provision of EBC suggests that concerns about the potential adverse effects of NCLB on drug use prevention have yet to be validated. Implications of our results are discussed. (Contains 3 tables.)

Most peer group self-identification research has been conducted in the United States. This article examined the generalizability of self-identified group name research among teens in Ufa, a city in the Russian Federation. A cross-sectional, anonymous collection of data on group self-identification, drug use, addiction concern, sensation seeking, and self-rated school performance was collected from 365 10th grade youth in Ufa and 965 10th grade youth in the United States. The results supported the existence of peer group self-identification by youth in both countries and, in general, replicated the findings that youth who self-identify as a High Risk Youth, are relatively likely to use drugs, show greater concern about becoming an addict, report a greater sensation seeking preference, higher levels of depression, and poorer school performance. Implications of these results are discussed. (Contains 2 tables.)

School-based cigarette smoking prevention was initiated shortly after the first Surgeon General's Report in 1964. This article highlights a sequence of events by which school-based tobacco use prevention research developed as a science, and illustrates a pendulum effect, with confidence in tobacco use prevention increasing and decreasing at different points in time. Suggestions are offered to advance school-based smoking prevention research.

In the present study, we describe correlates of 30-day cigarette and alcohol use among two samples of high school students, one in the Russian Federation (n = 365), and one in the United States (n = 965). The correlates used in the analyses are based on the theory of triadic influence, which organizes predictors of adolescent substance use into three distinct types of influence. Overall, correlates from each of the types of influence were significant predictors of substance use in both samples. The most consistent positive predictors of cigarette and alcohol use across countries were friends' substance use and sensation seeking behavior. Perceived harmfulness of drug use was negatively associated with cigarette and alcohol use in both samples. Having a substance abuser in one's family was negatively associated with alcohol use in the Russian sample, but positively associated with alcohol use in the U.S. sample. In general, similar patterns of relationships between predictors and substance use were seen across both countries. (Contains 3 tables.)

This paper examines factors associated with the adoption of evidence-based substance use prevention curricula (EBC) in a national sample of school districts. Substance abuse prevention coordinators in public school districts (n = 1593), which were affiliated with a random sample of schools that served students in Grades 5-8, completed a written survey in 1999. Results indicated that 47.5% of districts used at least one EBC in their schools with middle school grades. Substance use prevention coordinators reported they had the greatest input in decisions about curricula. In a multivariate analysis of factors positively associated with district-level decisions to adopt evidence-based programs, significant factors included input from a state substance use prevention group, use of information disseminated by the National Institute on Drug Abuse or Center for Substance Abuse Prevention, use of local needs assessment data, consideration of research showing which curricula are effective and allocation of a greater proportion of the coordinators time to substance use prevention activities. State and federal agencies should increase their efforts to disseminate information about evidence-based programs, targeting in particular the district substance use prevention coordinator.

This article provides an implementation fidelity evaluation of the fourth experimental trial of Project Towards No Drug Abuse (TND). Two theoretical content components of the curriculum were examined to increase our understanding of the active ingredients of successful drug abuse prevention programs. A total of 18 senior high schools were randomly assigned by block to receive one of three conditions: cognitive perception information curriculum, cognitive perception information + behavioral skills curriculum, or standard care (control). These curricula were delivered to both regular and continuation high schools students (n= 2331) by trained project health educators and regular classroom teachers. Across all program schools, the two different curricula were implemented as intended, were received favorably by students, and showed significant improvements in knowledge specific to the theoretical content being delivered. This pattern of results suggests that the experimental manipulations worked as intended, and thus, permit the attribution of future behavioral outcome differences between conditions to differences in content of Project TND material provided rather than to differences in the fidelity of delivery. Further, our findings indicate that Project TND can be implemented effectively with low and high risk youth in a general environment as well as with high risk youth in a more specialized environment. (Contains 1 footnote and 4 tables.)

This study examined whether bullies, victims, and aggressive victims (those who are both bullies and victims) differed on classroom social network variables, gender, and ethnicity. Survey data were collected from a primarily Latino and Asian sample of 1,368 Southern California 6th graders (mean age = 11.3 years). Logistic regression analyses were performed to determine whether network characteristics and ethnicity were associated with each of the outcome variables. Consistent with social cognitive theory, friends' participation in aggressive behaviors was positively associated with being a bully or an aggressive victim, and negatively associated with being a victim. Consistent with social dominance theory, the number of friendship nominations received was negatively associated with being a victim. Female bullies received fewer friendship nominations, but had a higher proportion of reciprocated friendships. Victims were disproportionately Asian. The findings suggest that bullying prevention efforts targeting highly aggressive students may also diffuse to their friends, and that assertiveness training in handling aggressive situations may successfully combat bullying and aggression.

Interactivity has been shown to be a critical element of effective drug abuse prevention programs. This study examined the contents of Project Towards No Drug Abuse, a program that has revealed strong effects only when delivered in a highly interactive version. Types of teacher and student interactive messages were identified. It is speculated that explicit action on the part of the teacher to have students make statements and ask questions of one another may be the essence of effective drug education program delivery. Suggestions for future research on interactivity were made. (Contains 2 tables.)

Used data from a statewide sample of 5,870 eighth graders in California to examine the correlates of smoking prevalence estimates. Best friends' smoking accounted for the largest proportion of the variance in prevalence estimates. Smoking by peers may give adolescents the impression that smoking is more normative and prevalent than it actually is. (SLD)

Little systematic research attention has been devoted to the impact of natural disasters on adolescent substance use. The present study examined relationships among exposure to Hurricane Rita, post-traumatic stress (PTS) symptoms, and changes in adolescent substance use from 13 months pre-disaster to seven and 19 months post-disaster. Subjects were 280 high school students in southwestern Louisiana who participated in a drug abuse prevention intervention trial prior to the hurricane. Two-thirds of participants were female and 68% were white. Students completed surveys at baseline (13 months pre-hurricane) and two follow-ups (seven and 19 months post-hurricane). Results indicated a positive bivariate relationship between PTS symptoms, assessed at 7 months post-hurricane, and increases in alcohol (p < .05) and marijuana use (p < .10) from baseline to the 7 months post-hurricane follow-up. When these associations were examined collectively with other hurricane-related predictors in multivariate regression models, PTS symptoms did not predict increases in substance use. However, objective exposure to the hurricane predicted increases in marijuana use, and post-hurricane negative life events predicted increases in all three types of substance use (ps < .10). These findings suggest that increased substance use may be one of the behaviors that adolescents exhibit in reaction to exposure to hurricanes.

BACKGROUND: Little is known about the context in which school-based suspicionless random drug testing (SRDT) occurs. The primary purpose of the current study was to describe school districts' responses to students' first positive result in districts with SRDT programs. METHODS: Data were collected in spring 2005 from 1612 drug prevention coordinators in a nationally representative sample of 1922 school districts (83.9% response rate), of which 205 districts reported SRDT in high school grades. RESULTS: Respondents reported an array of consequences for students with an initial positive SRDT, including requiring parents or guardians to meet with school officials (88.4%) and requiring students to participate in an education, counseling, or treatment program (60.8%). However, some districts also reported consequences contraindicated by federal advisory guides, such as notifying law enforcement officials (45.1%) and suspending the student from an athletic team (65.0%) or from school (31.0%). Some respondents may have conflated their districts' responses to for cause and random tests. Districts generally had available key services for students testing positive, including professional counseling for substance use problems (87.3%) and referrals to counseling services (91.9%). CONCLUSIONS: More understanding is needed of schools' responses to students who test positive following the administration of SRDT, available advisory guides concerning best practices should be more effectively disseminated, and appropriate training and technical assistance should be available to schools with SRDTs. Keywords: drugs; organization and administration of school health programs; school health services., Interest in 'whole-school' or environmental approaches to school-based drug prevention has recently increased. (1) Some of these approaches seek to improve students' connectedness to schools; (2-4) others suggest strategies to [...]