Regional Differences in School-Based Physical Therapy: Examination of Therapist and Student Characteristics, Service Delivery, Activities, Interventions, and Outcomes.

AimsThe aim of this study was to examine regional differences in school-based physical therapy practice focusing on the attributes of the school-based physical therapists and students; service delivery approaches, activities, and interventions; and student outcomes. Recognition of regional practices may decrease unnecessary variations, and assist with therapist clinical decision making and efforts to implement evidence-informed practice.MethodsA secondary data analysis of the PT COUNTS data was performed to compare physical therapist and student attributes; service delivery, activities, and interventions; and student outcomes across the Northeast, Southeast, Central, and Northwest regions of the United States.ResultsDifferences in the physical therapist and student characteristics, service delivery, activities, and interventions existed across the regions. There were no regional differences in outcomes when controlling for student functional level.ConclusionRegional differences in school-based practices may be expected and indicative of the influence of contextual factors including state and local policies and procedures that shape school-based service delivery and the characteristics of the therapists and students. Regional differences in practices may not have been of sufficient clinical magnitude to alter outcomes. Physical therapists can use the findings to reflect upon their individual decision making and practices.

Proactive versus Reactive: Strategies in the Implementation of School-based Services for Students with ASD.

Autism spectrum disorder (ASD) is increasingly prevalent, intervention costs are high, and long-term outcomes are poor. Proactive implementation of evidence-based practices (EBPs; Steinbrenner et al., Evidence-Based Practices for Children, Youth, and Young Adults with Autism, 2020) through an assessment or planning process can lead to more effective services (Rubin et al., Admin Policy Mental Health Mental Health Serv Res 43(6), 1023-1028, 2016). The objective of this study is (a) to identify factors associated with the use of proactive versus reactive strategies for school-based services for students with ASD and (b) to examine school personnel perceptions of the use of proactive versus reactive strategies. Data were from a larger project in which 6 semi-structured focus groups were conducted to understand school personnel perceptions of how school districts implement new programs for ASD. Transcripts were coded using an iterative coding and review process. In the present study, primary themes were identified and classified as proactive or reactive. Participants reported both proactive and reactive allocation of district resources for intervention implementation. Reactive implementation was associated with litigation or due process, escalated student behavior, and non-public school placement, whereas proactive implementation was associated with ASD-specific programming, grants, personnel experience with EBPs, and prospective needs assessment. Participants perceived the reactive strategies as disadvantageous, and yet these strategies were sometimes still employed. Understanding the role of proactive and reactive strategies and the factors that influence their use could enable more effective planning for EBP use to improve both cost savings and student outcomes. This study is an important first step to explore resource allocation for school-based services for students with ASD.

Middle School Students' Perceptions of the Lunchroom: Implications for Future Interventions.

The National School Lunch Program provides nutritious and inexpensive lunches, but low participation and food waste are challenges in many schools. Interventions aim to improve participation in the program, but little is known about how students' perceptions affect their participation. This study explored how middle school students in a rural state perceive school food service staff, food served, and lunchroom atmosphere. An online survey was administered to middle school students at six schools participating in a larger lunchroom intervention. Mean perception scores were calculated for all measures. Multilevel logistic regression was used to examine the relationship between perceptions and consumption. Overall perceptions of staff, food, and atmosphere were positive, and students classified as school lunch eaters had more positive perceptions in all three areas than noneaters. Interventions to increase participation in school lunch programs and promote consumption of healthy food items should address multiple factors that contribute to school lunch participation.

Parent Perceptions regarding High School Drug Testing.

BACKGROUND: Adolescent drug use remains a critical public health issue. Almost 38 percent of school districts currently implement student drug testing, and more schools may be considering implementation due to emerging recreational drug use laws. Parents are an essential key stakeholder and decision-maker in school policies. Purpose: The purpose of this study was to examine Colorado parents' perceptions regarding high school drug testing. Methods: A cross-sectional research design was used to assess parental support for implementing drug testing in public high schools. A total of 205 participants completed a survey evaluating support, attitude, and beliefs regarding this policy. Descriptive statistics, chi-square, and logistic regression analyses were conducted to examine the data. Results: The majority of parents perceived that alcohol (68.3%), cannabis (77.6%), and illicit drugs (51.2%) were a problem amongst students at their child's high school. Parents overall were supportive of drug testing students (61.9%), except for parents who were current cannabis users (p = .002). The majority of parents are supportive of drug testing because they believe it could help students resist peer pressure (65.9%), facilitate early intervention (e.g. counseling; 71.2%), while not violating student privacy rights (57.6%) or creating a negative school climate (50.7%). Conclusions/Importance: Parents recognize there may be an adolescent drug use problem. Parental support of drug testing is an important consideration for superintendents/school districts who are contemplating implementation of a drug testing policy for high schools.

A Cross-Site Partnership to Examine Implementation and Sustainability of a School-Based Trauma Program.

Objectives: Schools have been identified as an ideal setting for increasing access to mental health services particularly for underserved minority youth. The emerging field of implementation science has begun to systematically investigate strategies for more efficiently integrating evidence-based practices into community settings. Significantly less translational research has focused specifically on the school setting. To address this need, we examined the implementation of a school-based trauma intervention across three distinct regions. Design: We conducted key informant interviews guided by Mendel's Framework of Dissemination in Health Services Intervention Research with multiple school stakeholders to examine what school organizational characteristics influence the adoption and implementation process and sustainability of Cognitive Behavioral Intervention for Trauma in Schools (CBITS). Participants were selected from schools in three geographic regions in the United States: Western, Midwestern, and Southern. Results: Our findings reveal that while sites had some common organizational factors that appeared to facilitate implementation, regions differed in how they compensated for less robust implementation domains. Across all regions, school stakeholders recognized the need for services to support students impacted by trauma. In the Western region, there was no centralized district policy for implementation; therefore, implementation was facilitated by school-level change agents and supervision support from the district mental health unit. In the Midwestern region, centralized district policies drove implementation. In both the Midwestern and Southern regions, implementation was facilitated by collaboration with a local mental health agency. Conclusions: This study contributes to the paucity of empirical information on the organizational factors that influence the implementation of evidence-based mental health interventions in schools. Our findings reveal that different implementation strategies across policies, structures, and resources can result in implementation of a school-based intervention. Frameworks such as Mendel's can be helpful in identifying areas of strength and improvement of implementation within a school organization.

Applying a Trauma Informed School Systems Approach: Examples from School Community-Academic Partnerships.

Objectives: Schools can play an important role in addressing the effects of traumatic stress on students by providing prevention, early intervention, and intensive treatment for children exposed to trauma. This article aims to describe key domains for implementing trauma-informed practices in schools. Design: The Substance Abuse and Mental Health Administration (SAMHSA) has identified trauma-informed domains and principles for use across systems of care. This article applies these domains to schools and presents a model for a Trauma-Informed School System that highlights broad macro level factors, school-wide components, and tiered supports. Community partners from one school district apply this framework through case vignettes. Results: Case 1 describes the macro level components of this framework and the leveraging of school policies and financing to sustain trauma-informed practices in a public health model. Case 2 illustrates a school founded on trauma-informed principles and practices, and its promotion of a safe school environment through restorative practices. Case 3 discusses the role of school leadership in engaging and empowering families, communities, and school staff to address neighborhood and school violence. Conclusions: This article concludes with recommendations for dissemination of trauma-informed practices across schools at all stages of readiness. We identify three main areas for facilitating the use of this framework: 1) assessment of school staff knowledge and awareness of trauma; 2) assessment of school and/or district's current implementation of trauma-informed principles and practices; 3) development and use of technology-assisted tools for broad dissemination of practices, data and evaluation, and workforce training of clinical and non-clinical staff.

Speech and language therapy service delivery: overcoming limited provision for children.

OBJECTIVES: To test an alternative Speech and Language Therapy (SLT) service delivery model based on partnerships between a University and local schools and charities, and to report on the impact and feasibility of intervention based on long-term outcome measures and three case studies with individual analysis of Reliable Change. STUDY DESIGN: The following six-step model was tested: 1-establishing partnerships; 2-flagging children; 3-pre-treatment SLT assessment; 4-reporting and discussion with parents and teachers; 5-treatment; 6-post-treatment assessment. Case studies are presented. METHODS: A partnership was established with one kindergarten in a pre-test and a total of 25 kindergartens during the second phase of the process. A group of 139 children were then flagged and assessed. The following long-term outcomes (18 months post-therapy) were investigated: phonetic-phonological standardised test percentiles and raw scores; receptive and expressive language percentiles and raw scores according to a standardised language test; percentage of syllables stuttered; duration of stuttering moments; academic achievement in norm-tests' core areas (mathematics, Portuguese language and social studies). Case studies and a 95% credible interval analysis to assess Reliable Change are presented. RESULTS: Seventy five (54%) children needed SLT support. Fifty (67%) of those children returned to the clinic for long-term assessments and the analysis of all outcome measures showed significant improvements in their performance, 18 months post-therapy. Case Studies Reliable Change analysis revealed a statistically significant improvement, which also clearly shows the feasibility and the positive impact of the intervention. CONCLUSIONS: This specialised and differentiated care network constitutes an alternative delivery system of SLT services that addresses the lack of support currently experienced by children and their families. The long-term outcome measures and the 95% credible interval analysis are reliable methods to determine the impact of interventions.

Writing Readiness Inventory Tool in Context (WRITIC): reliability and convergent validity.

BACKGROUND/AIM: This study examined the reliability and convergent validity of the Writing Readiness Inventory Tool in Context, a measurement evaluating writing readiness in kindergarten children (aged from five to six years). METHODS: Test-retest reliability was established with 59 children, inter-rater reliability with 72 children and convergent validity with 119 children. All participants were typically developing kindergarten children. Convergent validity was examined with the Beery-Buktenica Developmental Test of Visual-Motor Integration and the Nine-Hole Peg Test. RESULTS: We found excellent test-retest and inter-rater reliability on the future norm-referenced subdomain 'Task performance' of Writing Readiness Inventory Tool in Context with intra-class correlation coefficient ranging from 0.92 to 0.95. On the other criterion-referenced subdomains, we found fair to good reliability with intra-class correlation coefficient ranging from 0.70 to 1.0 and weighted Kappa ranging from 0.30 to 0.89. Correlations with the Beery-Buktenica Developmental Test of Visual-Motor Integration and the Nine-Hole Peg Test were moderate with rs ranging from 0.34 to 0.40 and these are comparable with correlations in other handwriting studies. CONCLUSION: Writing Readiness Inventory Tool in Context is an assessment of writing readiness that is stable over time and between raters. The expected moderate correlations with the Beery-Buktenica Developmental Test of Visual-Motor Integration and the Nine-Hole Peg Test support the construct of writing readiness.

The Role of Implementation Climate in Moderating Educator Use of Evidence-Based Practices and Outcomes for Autistic Students.

Ensuring effective use of evidence-based practice (EBP) for autism in schools is imperative due to the significantly increasing number of autistic students receiving school services each year. High-quality EBP use has proven challenging in schools. Research indicates implementation climate, or how EBP are supported, rewarded, and valued, and EBP resources are related to successful implementation. However, limited understanding of system-level contextual factors that impact EBP implementation for school-based providers makes development of appropriate implementation supports challenging. Understanding these factors is crucial for selecting and tailoring implementation strategies to support EBP scale up. In this observational study, California school-based providers (n = 1084) completed surveys related to implementation climate, leadership, autism experience and EBP implementation (use, competence, knowledge). Student outcomes included state level academic and behavioral indicators. Using an implementation science framework (Aarons et al., in Administration and Policy in Mental Health and Mental Health Services Research 38:4-23, 2011) and multilevel modeling, we examined the relationship between EBP Implementation and student outcomes and the moderation effects of provider and district level factors. Higher implementation climate predicted better EBP implementation outcomes, and proved more impactful when provider hands-on autism experience was low. Greater EBP resources predicted a higher percentage of students who met math standards only when district poverty level was high. Our findings suggested moderating effects on EBP implementation from both provider and system level factors. Implementation climate and resources may be especially key in addressing equity issues related to high poverty schools in which teachers often have less autism experience.

A Qualitative Examination of the Impact of COVID-19 on Transition Services for Autistic Youth.

The coronavirus (COVID-19) pandemic has caused widespread disturbances in many human and social service programs. Several studies have examined special education programming adaptations since the onset of the pandemic; however, there has yet to be documentation of pandemic-related changes to transition programming and the impact of these changes for autistic youth. The purpose of this qualitative study was to examine changes in transition programming for autistic youth amid the changing educational landscape. We conducted 12 interviews with caregivers (n = 5) and school providers (n = 7) about transition programming for autistic youth and the COVID-19 impact to these services. The pandemic had positive and negative effects on many aspects of transition programming, including student-focused planning, student development, interagency and interdisciplinary collaboration, family involvement, and program structure and attributes. Elucidation of the ways that the COVID-19 pandemic impacted transition programming from the perspectives of multiple stakeholders has important implications for school personnel and can help to inform the future directions for the field of transition programming research.

Increased Prescribing of Psychotropic Drugs or School-Based Services for Children with Disabilities? Associations of These Self-control-Boosting Strategies with Juvenile Violence at the State Level.

The increasing rates at which psychotropic drugs have been prescribed to children and adolescents in the USA in the last three decades (since the early 1990s) have prompted questions about whether this trend is associated with the "great American crime decline." Medicalization can be considered one of the strategies to remedy children's neuropsychological deficits and improve their self-control. Another possible remedy is school-based services for children with learning disabilities, mandated by the Individuals with Disabilities Education Improvement Act (IDEA) of 2004. Using state-level panel data analyses for years 1990-2014 (with the main focus on 2000-2014 outcomes), the current study estimates associations between these two developmental self-control remedies-medicalization and school-based services-and minor, moderate, and severe types of juvenile violence, while controlling for relevant covariates (both time-varying and time-invariant). The results of mixed-effects linear regression analyses accounting for powerful time trends show a strong association between increases in school-based services for children with learning disabilities and declines in all types of juvenile violence. Another strong and consistent finding that emerges in the analyses is the link between reductions in child poverty at the state level and decreases in juvenile violence, both contemporaneously and over time. Psychotropic drug prescribing to children (measured using Supplemental Security Income rolls of children with mental health conditions) exhibits inconsistent or insignificant effects. The findings of this study have substantial theoretical and policy implications and indicate the importance of strengthening school-based services for children with disabilities and reducing child poverty as essential violence prevention tools.

The role of social determinants of health in the receipt of school services after traumatic brain injury: A focus review on underserved pediatric populations.

BACKGROUND: Return to school is key for community re-integration after a traumatic brain injury (TBI). School support facilitates and ensure a successful transition back to school. However, access to school services is not uniform among U.S. children. OBJECTIVE: To describe school services for children with TBI from minoritized backgrounds and highlight population-specific risk factors and facilitators for accessing services. METHODS: Narrative review of the literature including studies on return to school after a mild-complicated, moderate, or severe TBI, among children enrolled in the U.S. school system. We describe receipt of services, enabling and risk factors, and outcomes, for minority children. RESULTS: There is a gap in knowledge regarding return to school among minoritized children with TBIs. Studies have few participants from racial and ethnic minority backgrounds, or low income or rural communities. Transgender and non-binary youth are not represented in present research efforts. Studies highlight larger barriers to receipt of school services among minority children and additional barriers associated with their minority status. CONCLUSION: Diversity in the U.S pediatric population is increasing. Minoritized populations are at increased risk for TBI and poor outcomes. Research focused on the needs of these populations is required to optimize school return after TBI hospitalization and overall post-discharge care.

School-Based Mental Health Initiative: Potentials and Challenges for Child and Adolescent Mental Health.

School-based mental health support services allow children and adolescents easy access to services without requirement of traveling to clinics and hospitals. We describe a School Mental Health Support Scheme (SMHSS) piloted in Hong Kong and discuss the challenges and learnings from the experience. This conceptual paper argues that accessibility is not the only advantage of such services. Teachers are significant others in child development, alongside with families. They play a central role in impacting the children's/adolescents' needs for competence and adult attachment, while schools provide an expanded social network of peers for one's social relationship. The fulfillment of these needs has powerful implications in the mental health of the children/adolescents. Teachers can help students to develop a sense of competence with self-worth and self-identity via providing guidance and feedback, whether they be on one's strengths or weaknesses, with acceptance, tolerance and unconditional positive regard. Particularly, the latter define a form of teacher-student relationship or adult attachment that offers the children/adolescents emotional security and nourishment, protecting them from failings and adversities. Teachers can also supervise and guide their students' social development with peers at schools. A recent meta-analysis has found preliminary evidence that those school-based mental health services integrated into the teachers' routine teaching activities are more effective. Teachers, who are overworked and stressed by the schools' overemphasis on academics and grades, have yet to fully grasp their unique roles in supporting students with mental health needs. This paper ends by advocating a paradigm shift in which both the healthcare professionals and educators should forge a mutually beneficial collaboration in jointly enhancing the mental health of children/adolescents at schools.

Perceived parent needs in engaging with therapeutic supports for children with disabilities in school settings: An exploratory study.

BACKGROUND: Parent engagement in therapeutic services for children with disabilities could optimize service delivery while addressing service disparities. However, service providers must first understand parents' needs to effectively involve parents. AIMS: This study examines what needs parents identify as important when engaging with school-based therapies and how well these needs are being met. METHODS AND PROCEDURES: Parents of children with Individualized Education Plans rated statements related to their needs for trust, information, support and guidance, and personal needs when engaging with their child's therapies. Parents also provided demographic information on them and their child[ren] with a disability. OUTCOMES AND RESULTS: Parents endorsed an average of 83 % of needs as important but 51 % of needs as unmet. On average, 65 % of needs related to feeling trusted by service providers were met. In contrast, needs related to receivings upport and guidance (M = 58 %), information (M = 55 %), and addressing parent's own needs (M = 53 %) were frequently unmet. Parents indicated that needs related to feeling trusted by service providers were most frequently met. In contrast, needs related to receiving information were most frequently unmet. Race/ethnicity and number of children with a disability influenced the number of needs endorsed as important and unmet. CONCLUSION: This feasibility study suggests that parents find a variety of needs regarding their interactions with school-based providers as important to them. However, given the high proportion of needs indicated being unmet, significant gaps likely exist in effectively engaging parents, especially for Parents of Color and parents with multiple children with disabilities. IMPLICATIONS: This study provides a list of tangible needs school-based providers can use to improve parent engagement with school-based therapies. School-based providers and administrators can use the needs identified as important and unmet in this study to create actionable steps that aim to improve parent engagement in school-based services.

Understanding Racial and Ethnic Disparities in Autism-Related Service Use Among Medicaid-Enrolled Children.

Racial and ethnic disparities in the use of nine common autism-related services among Medicaid-enrolled children with autism spectrum disorder (ASD) were examined, distinguishing between school and other community-based outpatient settings. Using 2012 Medicaid Analytic Extract data, we identified 117,848 continuously enrolled children with ASD. Several racial and ethnic disparities were found, varying by geography. Black, Asian, and Native American/Pacific Islanders received fewer outpatient services compared with white children, but there was no disparity for Latinx children. Black and Asian children received more school-based services than white children. Disparities in case management/care coordination services were largest and present in each minority group. Geographic variation in receipt of services suggests targets for policy intervention to improve access for minorities with ASD.

Navigating School-Based Special Education Services: A Self-Paced Virtual Learning Module.

Introduction: Children with disabilities are particularly vulnerable to school failure, as they are more likely than their peers to experience school dropout and academic struggles. Early identification of learning difficulties and access to special education services are critical to the success of children with disabilities. However, few pediatricians feel competent in screening for risks of school failure and/or assisting families with navigating the special education system. Due to restricted duty hours and limited scheduled didactic time during residency, flexible training options are needed to fill this educational gap and address this systems-based practice competency. Methods: We developed a 30-minute self-paced virtual learning module aimed at educating pediatric residents on strategies for navigating the special education system. The module used a knowledge, attitudes, and self-efficacy framework, as well as case examples and pictorial relationships to illustrate concepts. Wilcoxon signed rank tests were conducted to assess changes in total knowledge, attitude, and self-efficacy scores. Results: After completion of the module, residents' self-efficacy total scores significantly increased (r = .88, p = .001), suggesting that they were more confident in their ability to identify, recognize, and advocate for special education services. Discussion: This virtual learning module successfully increased resident self-efficacy in screening for school failure and navigating the special education system. This highly feasible, self-paced training module can be modified to fit demanding resident schedules and serves as a potential tool to teach trainees and other pediatric providers about the special education system.

The relationship between portable school-based oral health prevention services and subsequent oral health treatment.

OBJECTIVES: This study examines whether a portable, school-based, preventive oral health program was associated with reduced use of treatment services over time. METHODS: We obtained encounter data from Community Health Center, Inc. (CHC) in Connecticut that operates such a program. We followed cohorts of children for 4 years, examining change in ratio of treatment to total services in the fourth year, following receipt of portable preventive care in the prior 3 years. The sample included 3,006 children 4.5 to 15 years old on their first visit during 2005-2015. We used structural equation path models to assess change in the dependent variable, controlling for available demographics and service use patterns. We conducted additional sensitivity analyses to assess robustness of our findings. RESULTS: We found a reduction in ratio of treatment (particularly restorative) to total services in the fourth year, given receipt of portable preventive care in the third year (direct impact) and receipt of portable preventive care in prior years (indirect impact). Older children and those covered by Medicaid (versus privately insured) had a higher ratio of treatment to total services in the fourth year. CONCLUSIONS: Our retrospective analysis showed CHC portable dental program may reduce the use of treatment services over time among underserved children. This program is an example of a viable approach that could be emulated elsewhere if regulations allow remote supervision of hygienists and reimbursement levels are adequate.

School-based fluoride varnish programs: a national survey.

PURPOSE: To identify and describe school-based fluoride varnish (FV) programs in K-12 grades children in the United States. METHODS: This cross-sectional study utilized an online, self-administered survey to identify and describe school-based FV programs in 2016. Several public health directories, mainly The Association of States and Territorial Dental Directors directory, were contacted to identify FV programs. The survey's questionnaire included 23 closed-ended questions regarding program description, assessment, and process. RESULTS: Of 85 identified programs, 52 responded (response rate = 61 percent) with 40 school-based FV programs in operation in 27 states. About 85 percent of responding programs apply FV as part of an existing school-based program. Dental sealants on permanent teeth are the most common procedure provided in addition to FV (92 percent). One-third of programs apply FV once a year versus 28 percent that apply FV twice a year. CONCLUSIONS: Evidence-based guidelines for FV in school-based programs are needed to ensure cost-effectiveness and continuity.

Predictive validity of kindergarten assessments on handwriting readiness.

We investigated the predictive value of a new kindergarten assessment of handwriting readiness on handwriting performance in first grade as evaluated by the Systematic Screening for Handwriting Difficulties (Dutch abbreviation: SOS). The kindergarten assessment consisted of the Writing Readiness Inventory Tool In Context (WRITIC), the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery™VMI) and the Nine-Hole Peg Test (9-HPT). The WRITIC evaluates in kindergarten children (aged 5-6 years) prewriting skills, the Beery™VMI and 9-HPT evaluate visual motor integration and fine-motor coordination, all elements important for handwriting readiness. In kindergarten, 109 children (55 boys; mean age 70 months, SD 4.8 months) were tested with the WRITIC, Beery™VMI and 9-HPT and one year later in first grade (mean age 85 months, SD 4.5 months) with the SOS. A multivariable linear mixed model was used to identify variables that independently predict outcomes in first grade (SOS): baseline scores on WRITIC-TP, Beery™VMI, 9-HPT, 'sustained attention,' 'gender,' 'age' and 'intervention' in the intermediate period. The results showed that WRITIC-TP, Beery™VMI, and 9-HPT, 'sustained attention,' 'gender' and 'intervention' had all predictive value on the handwriting outcome. Thereby WRITIC-TP was the main predictor for outcome of SOS-Quality, and Beery™VMI and 9-HPT were the main predictors of SOS-Speed. This kindergarten assessment of WRITIC-TP, Beery™VMI, and 9-HPT contributes to the detection of children at risk for developing handwriting problems.

Belief patterns and drug use in a sample of Brazilian youth: an exploratory latent class analysis

Objective: Adolescent substance abuse is a public health concern worldwide, and its prevention is the subject of numerous programmatic efforts. Yet, little research exists on the structure of drug-related belief patterns in youth and their utility in preventive program planning. The aim of this study is to determine the structure of drug-related beliefs among 12-15-year-old students in Brazil using latent class analysis. Methods: De-identified survey data were obtained from the baseline sample (n=6,176) of a randomized controlled trial on the #Tamojunto drug use prevention program in Brazilian middle schools. Using 11 survey items assessing drug-related beliefs as indicators, four models were run and assessed for goodness-of-fit. For the best fitting model, demographic variables and substance use across latent classes were assessed. Results: Model fit statistics indicated that the best fit was a three-class solution, comprising a large Drug-Averse Beliefs class (80.9%), a smaller Permissive Beliefs class (12.7%), and an Inconsistent Beliefs class (6.4%). Respondents in the Permissive Beliefs and Inconsistent Beliefs classes reported greater past-year drug use, were slightly older and less likely to be female than those in the Drug-Averse Beliefs class. Conclusions: These results indicate that conceptualizing drug beliefs as a categorical latent variable may be useful for informing prevention. Longitudinal studies are needed to establish temporality and assess further applicability of this construct.