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Objective: Young people in urban areas are often the focus of pregnancy and sexually transmitted infection (STI) prevention programmes because of their high risk of unwanted pregnancy and contracting an STI. Young people in rural areas are far less studied but also have a high risk of similar outcomes. This study evaluates Giving Our Girls Inspiration & Resources for Lasting Self-Esteem (GO GIRLS), an after-school pregnancy and STI prevention programme, in a sample of high-risk middle school girls living in rural areas using quasi-experimental methods. Design: GO GIRLS was assessed using the same survey administered at three time points: prior to the start of the programme, directly following completion of the programme and at the end of the school year. The sample for this study was drawn from a larger evaluation of a multi-faceted health initiative conducted over the course of the school year in three rural counties in South Central Florida. Setting: The GO GIRLS programme was implemented in a rural area of South Central Florida. This area has higher rates of teenage pregnancy and poverty and lower educational attainment in comparison with state averages. Method: Propensity scores and nearest-neighbour matching without replacement were used to select a group of girls who did not participate in the programme but were comparable to participants. Programme participants were compared to the propensity score–selected controls on key outcomes using hierarchical linear regression. Results: Findings indicate that at follow-up, girls who participated in GO GIRLS had attitudes more accepting of delaying sexual intercourse than controls. However, participants did not differ in their levels of sex refusal skills at follow-up. Conclusion: This study shows that the GO GIRLS programme has promise for at-risk, rural girls and highlights where future evaluation research is needed.

Objectives. Medical marijuana laws (MMLs) have been suggested as a possible cause of increases in marijuana use among adolescents in the United States. We evaluated the effects of MMLs on adolescent marijuana use from 2003 through 2011. Methods. We used data from the Youth Risk Behavior Survey and a difference-in-differences design to evaluate the effects of passage of state MMLs on adolescent marijuana use. The states examined (Montana, Rhode Island, Michigan, and Delaware) had passed MMLs at different times over a period of 8 years, ensuring that contemporaneous history was not a design confound. Results. In 40 planned comparisons of adolescents exposed and not exposed to MMLs across states and over time, only 2 significant effects were found, an outcome expected according to chance alone. Further examination of the (nonsignificant) estimates revealed no discernible pattern suggesting an effect on either self-reported prevalence or frequency of marijuana use. Conclusions. Our results suggest that, in the states assessed here, MMLs have not measurably affected adolescent marijuana use in the first few years after their enactment. Longer-term results, after MMLs are more fully implemented, might be different.

Purpose To understand the etiology of violence among ethnically diverse men using a nationally representative and longitudinal sample of youth. Methods Participants included 4,322 adolescent men observed from ages 13 to 32 years from the National Longitudinal Study of Adolescent Health (Add Health). We estimated trajectories of violence and used multinomial regression procedures to evaluate multiple domains of risk and protective factors for violence. Results We identified three profiles of violence (nonviolent, desistors, and escalators). There were no substantial differences in the patterns of violent behavior across race or ethnicity; however, the prevalence of violence differed by racial or ethnic group. After accounting for violent behavior at Wave I, we identified peer marijuana use (odds ratio [OR] = 1.20), alcohol use (OR = 1.50), group fighting (OR = 2.23), and Wave I violence (OR = 4.34) as risk factors for desistance, whereas only Wave I violence predicted escalation (OR = 2.27). Conclusions We identified three trajectories of serious violence, including a late-onset group; however, few risk and protective factors were associated with membership in this group. Risk and protective factors for violence before age 13 years should be targeted for prevention.

This research examines gender and racial/ethnic differences in substance use trajectories during early adolescence among American Indian and non-Native adolescents.Substance use trajectories were evaluated among 684 adolescents (50% female, 51% American Indian) across five assessments over 9th and 10th grades. Youth were drawn from six rural towns within the Cherokee Nation, a nonreservation tribal jurisdiction that includes a high proportion of American Indians embedded within a predominantly White population. Past-month substance use was based on self-report and was dichotomized into "used" versus "did not use," with the exception of alcohol, which was trichotomized into "none," "1 or 2 days," or "3-30 days."Using growth mixture modeling with full-information maximum-likelihood estimation, we determined that between two and three different trajectory classes best described the data for each substance. Males had a higher probability compared with females of following a trajectory of chewing tobacco use (20% vs. 6%, respectively) and using multiple substances (24% vs. 19%, respectively). Females had a higher probability compared with males of following a trajectory of prescription drug misuse (11% vs. 6%, respectively). Individuals who followed trajectories of alcohol use or heavy drinking were also more likely to follow trajectories of other substance use.Identifying gender and racial/ethnic differences in patterns of substance use at this stage of development will inform gender-sensitive and ethnically sensitive prevention programs targeting specific substance use. These results will be particularly informative given the lack of evidence regarding trajectories of substance initiation within largely American Indian populations.

Aims This study sought to more precisely delineate the mechanisms by which two early elementary school-based, universal (i.e., applied to the entire population regardless of risk status) preventive interventions increased survival to first tobacco cigarette smoked. Specifically, we examined whether the interventions’ effect on survival to first use was via the reduction of offers to smoke and/or through preventing the transition from first offer to smoking. Methods A total of 678 urban first-graders were assigned randomly to the classroom-centered (CC), or the family–school partnership (FSP), or a control classroom condition. Youth were followed annually until 1 year beyond their anticipated high school graduation (mean age ∼18 years). Discrete-time survival analyses on 628 youth evaluated the impact of the CC and FSP interventions on first tobacco offer and initial tobacco smoking once offered. Findings The risk of being offered tobacco was reduced among both CC and FSP intervention groups relative to the control group, although the reduction was only statistically significant for the CC intervention. Neither intervention condition reduced the transition to smoking once offered tobacco to smoke. Conclusion The CC intervention appeared to have its effect on survival to first cigarette smoked by delaying the first offer to smoke. Preventive interventions focused on refusal skills during the middle school years may be necessary to reduce the likelihood of the transition to smoking once offered.

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.

Access to alcohol among individuals under 21 years of age continues to be a public health concern with approximately 5000 youth deaths attributable to alcohol each year (US Department of Health and Human Services 2007). To date, there is no research on youth access to alcohol from commercial sources within rural communities with large populations of Native American families. We evaluated commercial access to alcohol by underage-appearing female confederates in 4 rural towns within the Cherokee Nation, a non-reservation tribal jurisdiction that includes a high proportion of Native Americans embedded within a predominately White population. Alcohol purchase attempts were conducted approximately every 4 weeks on 10 occasions for a total of 997 alcohol purchase attempts. In addition to purchase attempt outcome, we collected data on characteristics of the outlets and clerks. Alcohol was sold to confederates without use of age identification on 23 % of all purchase attempts. Across repeated attempts, 76 % of outlets sold alcohol to a confederate at least once. Males and younger clerks were more likely to sell alcohol to the confederates. Grocery stores and gas stations were more likely to sell alcohol to the confederate than liquor stores, but this effect was no longer significant once seller age was accounted for in a multivariable model. Three out of 4 outlets sold alcohol to young-appearing buyers at least once across repeated attempts. Results reinforce the continuing need for regular enforcement of laws against selling alcohol to minors.

Many of the public health and social challenges confronting our society have their basis in child and adolescent development. Understanding the developmental underpinnings of such issues as obesity...

Cognitive control has long been a validated construct to explain risk for drug abuse. Research evidence suggests that cognitive-control interventions show promise for future preventive intervention and treatment efforts across development. Biomarkers of the efficacy of these interventions have also been identified. To examine the potential of utilizing developmental cognitive neuroscience to guide cognitive-control interventions for the prevention and treatment of substance use disorders, the National Institute on Drug Abuse held a research roundtable in Rockville, Maryland, in May 2010. The research presented at the roundtable and reviewed in this Special Section of Child Development Perspectives highlights the promise of cognitive-control interventions for enhancing, or ameliorating deficits in, executive functions relevant to substance use disorders, as well as the promise of neuroscience techniques for guiding the conceptualization of these interventions.

Despite advances in prevention science and practice in recent decades, the U.S. continues to struggle with significant alcohol-related risks and consequences among youth, especially among vulnerable rural and Native American youth. The Prevention Trial in the Cherokee Nation is a partnership between prevention scientists and Cherokee Nation Behavioral Health to create, implement, and evaluate a new, integrated community-level intervention designed to prevent underage drinking and associated negative consequences among Native American and other youth living in rural high-risk underserved communities. The intervention builds directly on results of multiple previous trials of two conceptually distinct approaches. The first is an updated version of CMCA, an established community environmental change intervention, and the second is CONNECT, our newly developed population-wide intervention based on screening, brief intervention, and referral to treatment (SBIRT) research. CMCA direct-action community organizing is used to engage local citizens to address community norms and practices related to alcohol use and commercial and social access to alcohol among adolescents. The new CONNECT intervention expands traditional SBIRT to be implemented universally within schools. Six key research design elements optimize causal inference and experimental evaluation of intervention effects, including a controlled interrupted time-series design, purposive selection of towns, random assignment to study condition, nested cohorts as well as repeated cross-sectional observations, a factorial design crossing two conceptually distinct interventions, and multiple comparison groups. The purpose of this paper is to describe the strong partnership between prevention scientists and behavioral health leaders within the Cherokee Nation, and the intervention and research design of this new community trial.

Adolescence is an exciting and challenging period of maturation, rapid brain development, and developmental changes in neurobiological, neurocognitive, and neurobehavioral processes. Although behavioral therapies available for adolescent substance abuse have increased, effectiveness research in this area lags considerably behind that of clinical research on treatment for drug-abusing adults. Behavioral treatment approaches show significant promise for treating drug-abusing adolescents, but many have not incorporated innovations in neuroscience on brain development, cognitive processes, and neuroimaging. Linking developmental neuroscience with behavioral treatments can create novel drug abuse interventions and increase the effectiveness of existing interventions for substance-abusing adolescents. Contemporary research on brain development, cognition, and neuroscience is ripe for translation to inform developmentally sensitive drug abuse treatments for adolescents. Neuroscientists and interventionists are challenged to build mutual collaborations for integration of neuroscience and drug abuse treatment for adolescents.

Aggressive, disruptive behavior during early childhood has been linked to a number of later negative outcomes, one of them being adolescent marijuana use. This study evaluates the impact of two first-grade universal interventions (classroom-centered and family–school partnership) on the development of aggression in early childhood (grades 1–3) and marijuana use in adolescence (grades 8–12) via a latent transition longitudinal mixture model. For males, despite the significant proximal impact of the classroom-centered intervention on trajectory class membership of early childhood aggression, as well as the significant association between aggression trajectory class membership and marijuana use longitudinal latent class membership, the predicted probabilities of being in the high frequency marijuana use class did not differ significantly by intervention status, though in the expected direction. Associations for females are limited to the proximal impact of the classroom-centered intervention on trajectory class membership of aggression. This study extends the prior work of Petras et al. (Prev Sci 12:300–313, 2011) by considering that aggressive, disruptive behavior during early childhood is linked not only to adolescent aggressive, disruptive behavior (i.e., homotypic continuity) but also to adolescent marijuana use (i.e., heterotypic continuity) and by considering that an early intervention may influence later non-targeted behaviors through these heterotypic developmental pathways. Implications for developmental theories and substance abuse prevention are discussed.

Emerging brain-imaging findings suggest that developmental differences in the structure and activity of brain regions involved in motivation and behavior control may contribute to risky behavior in adolescence. Adolescence may be characterized by robust motivational neurocircuitry that is relatively unhindered by developing cognitive control neurocircuitry. However, how developmental differences in brain structure or function depend on task features or other experimental contexts, or whether observed differences are functionally relevant for real-world risky behavior, is not well understood. The challenge of attributing adolescent risk taking to developmental patterns of brain morphology and brain activity underscores the need for future research sensitive to development and the contexts of adolescence.

Disparities in many maternal and child health outcomes persist in the United States. Mothers and children who live in poverty are at higher risk for a variety of mental, physical, emotional, and behavioral health problems, including depression, obesity, child maltreatment, teenage problem behaviors, drug abuse, and lower educational attainment.1 Moreover, the 2010 US Census revealed that 20% of children in the United States are living in poverty with an overrepresentation of African American and Hispanic children.2 Boys born to African American or Hispanic mothers may be disproportionately at risk for experiencing negative health outcomes depending on their socioeconomic status in combination with other individual, family, community and environmental factors.3 While the focus on mothers and children is essential and important for public health, the role of fathers has been often overlooked. Fathers can offer additional health and economic resources, including access to quality health care. Through tangible and emotional support for mothers, fathers can provide a healthy start for their sons prenatally and over the life course. When paternal resources are absent or insufficient, the health and development of mothers and sons may suffer. To adequately assess health disparities in boys and men, data on father characteristics and resources is a critical component.4 Father and son playing. Printed with permission of Corbis. The National Children’s Study (NCS),5 mandated by the Children’s Health Act of 2000, is the largest and most detailed study in the United States focused on children’s health and development. It will examine the relationships between environmental exposures and genetics on growth, development and health, including health disparities among children in the United States from prenatal to adulthood. The NCS Vanguard Study serves as a paradigm for the future NCS Main Study with the inclusion of fathers in data collection and measures that assess father involvement and its impact on maternal and child health disparities. The inclusion of fatherhood data in large, national surveys allows for sufficient statistical power to examine meaningful factors related to paternal support for mothers and sons among diverse racial, ethnic, and socioeconomic status groups. Although research suggests that the engagement, accessibility and involvement of fathers with their sons may influence child socioemotional, cognitive, and health outcomes, fatherhood data has lagged behind that on the role of mothers. Recruitment and retention of fathers from diverse families along with mothers and sons present a difficult but worthwhile challenge to public health researchers. Novel data and analyses on fathers and sons have exciting potential to inform the future of maternal, paternal, child, and family health disparities.

This study tests a model of reciprocal influences between absenteeism and youth psychopathology using three longitudinal datasets (Ns= 20745, 2311, and 671). Participants in 1st through 12th grades were interviewed annually or bi-annually. Measures of psychopathology include self-, parent-, and teacher-report questionnaires. Structural cross-lagged regression models were tested. In a nationally representative dataset (Add Health), middle school students with relatively greater absenteeism at study year 1 tended towards increased depression and conduct problems in study year 2, over and above the effects of autoregressive associations and demographic covariates. The opposite direction of effects was found for both middle and high school students. Analyses with two regionally representative datasets were also partially supportive. Longitudinal links were more evident in adolescence than in childhood.

Developmental models highlight the impact of early risk factors on both the onset and growth of substance use, yet few studies have systematically examined the indirect effects of risk factors across several domains, and at multiple developmental time points, on trajectories of substance use and adult adjustment outcomes (e.g., educational attainment, mental health problems, criminal behavior). The current study used data from a community epidemiologically defined sample of 678 urban, primarily African American youth, followed from first grade through young adulthood (age 21) to test a developmental cascade model of substance use and young adult adjustment outcomes. Drawing upon transactional developmental theories and using growth mixture modeling procedures, we found evidence for a developmental progression from behavioral risk to adjustment problems in the peer context, culminating in a high-risk trajectory of alcohol, cigarette, and marijuana use during adolescence. Substance use trajectory membership was associated with adjustment in adulthood. These findings highlight the developmental significance of early individual and interpersonal risk factors on subsequent risk for substance use and, in turn, young adult adjustment outcomes.

Previous research on pubertal timing has either evaluated contextual predictors of early puberty or negative adjustment outcomes associated with off-time development, especially early maturation. In this study, we integrated these 2 lines of research by evaluating the moderating influence of early childhood household risk on associations between early puberty and 8th-grade substance use in a longitudinal sample of 1,070 participants. We determined trajectories of early childhood household risk using group-based trajectory analysis. Rates of early maturation were higher but not significantly so in groups with high household risk. Early timing was associated with higher rates of substance initiation only among individuals with a history of high household risk.

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.