School, Friends, and Substance Use: Gender Differences on the Influence of Attitudes Toward School and Close Friend Networks on Cannabis Involvement.

The school environment is extremely salient in young adolescents' lives. Adolescents who have unfavorable attitudes toward school and teachers are at elevated risk for dropping out of school and engaging in behavioral health risks. Peer network health-a summation of the positive and negative behaviors in which one's close friend group engages-may be one way by which attitudes toward school exert influence on youth substance use. Utilizing a sample of 248 primarily African-American young urban adolescents, we tested a moderated mediation model to determine if the indirect effect of attitude to school on cannabis involvement through peer network health was conditioned on gender. Attitude toward school measured at baseline was the predictor (X), peer network health measured at 6 months was the mediator (M), cannabis involvement (including use, offers to use, and refusals to use) measured at 24 months was the outcome (Y), and gender was the moderator (W). Results indicated that negative attitudes toward school were indirectly associated with increased cannabis involvement through peer network health. This relationship was not moderated by gender. Adolescents in our sample with negative attitudes toward school were more likely to receive more offers to use cannabis and to use cannabis more frequently through the perceived health behaviors of their close friends. Implications from these results point to opportunities to leverage the dynamic associations among school experiences, friends, and cannabis involvement, such as offers and use.

Neighborhood disorder, peer network health, and substance use among young urban adolescents.

BACKGROUND: The current study investigated the moderating effect of peer networks on neighborhood disorder's association with substance use in a sample of primarily African American urban adolescents. METHODS: A convenience sample of 248 adolescents was recruited from urban health care settings and followed for two years, assessing psychological, social, and geographic risk and protective characteristics. A subset of 106 substance using participants were used for the analyses. A moderation model was tested to determine if the influence of neighborhood disorder (percent vacant housing, assault index, percent single parent headed households, percent home owner occupied, percent below poverty line) on substance use was moderated by peer network health (sum of peer risk and protective behaviors). RESULTS: Evidence for hypothesized peer network moderation was supported. A latent growth model found that peer network health is most strongly associated with lower baseline substance use for young adolescents residing in more disordered neighborhoods. Over the course of two years (ages approximately 14-16) this protective effect declines, and the decline is stronger for more disordered neighborhoods. CONCLUSIONS: Understanding the longitudinal moderating effects of peer networks within high-risk urban settings is important to the development and testing of contextually sensitive peer-based interventions. RESULTS: suggest that targeting the potential protective qualities of peer networks may be a promising approach for interventions seeking to reduce substance use, particularly among younger urban adolescents living in high-risk neighborhoods.

Parents, Peers, and Places: Young Urban Adolescents' Microsystems and Substance Use Involvement.

Limited research is available that explains complex contextual and interactive effects of microsystems such as family relationships, peer networks, and place-based influences have on urban adolescent substance use. We contend that research into these complex processes is improved by integrating psychological, social, and geographic data to better understand urban adolescent substance use involvement. Accordingly, we tested a longitudinal, 3-way moderation model to determine if the direct effect of teen-parent relationships on substance use involvement is moderated by peer network characteristics, which in turn is moderated by the risk and protective attributes within urban adolescents' activity spaces, among a sample of 248 adolescents. Results revealed that peer networks moderate the effects of relations with parents on substance use involvement for those adolescents with higher levels of risk attributes within their activity space, but not for those who spend time in locations with less risk. Thus, the teen-parent relationship interacts with peer net-work characteristics, for those urban adolescents whose activity space is constituted within high-risk environments. We conclude that peer networks have important interactive effects with family relationships that influence substance use, and that this is particularly salient for young adolescents who are exposed to risky environments. This finding underscores the importance of continued study into the interrelations among microsystems of urban adolescents, and provides further support that substance use is a social practice that is constituted within the unique geography of young adolescents' lives.

Peer Network Counseling with Urban Adolescents: A Randomized Controlled Trial with Moderate Substance Users.

Close peer networks can affect adolescents' health behaviors by altering their social environments, and thus their risk for and protection against substance use involvement. We tested a 20 minute intervention named Peer Network Counseling that integrates motivational interviewing and peer network strategies with 119 urban adolescents who reported occasional or problem substance use. Adolescents presenting at primary care clinic were randomized to intervention or control conditions and followed for 6 months. Mixed-effect latent growth models were used to evaluate intervention effects on trajectories of alcohol and marijuana use, offers to use substances, and moderation models to test for interactions between intervention condition and peer network characteristics. A significant intervention effect was found for boys for offers to use alcohol from friends (p<.05), along with a trend significant effect for alcohol use (p<.08). Intervention was more effective in reducing marijuana use, vs. control, for participants with more peer social support (p<.001) and with more peer encouragement for prosocial behavior (school, clubs, sports, religious activities); however, intervention did not affect these network characteristics. Results provide support to continue this line of research to test brief interventions that activate protective peer network characteristics among at-risk adolescents, while also raising some interesting gender-based intervention questions for future research.

Young adolescents' perceived activity space risk, peer networks, and substance use.

Adolescent substance use is a developmentally contingent social practice that is constituted within the routine social-environment of adolescents' lives. Few studies have examined peer networks, perceived activity space risk (risk of substance use at routine locations), and substance use. We examined the moderating influence of peer network characteristics on the relationship between perceived activity space risk and substance use among a sample of 250 urban adolescents. Significant interactions were found between peer networks and perceived activity space risk on tobacco and marijuana use, such that protective peer networks reduced the effect of activity place risk on substance use. A significant 3-way interaction was found on marijuana use indicating that gender moderated peer network's effect on activity space risk. Conditional effect analysis found that boys' peer networks moderated the effect of perceived activity space risk on marijuana use, whereas for girls, the effect of perceived activity space risk on marijuana use was not moderated by their peer networks. These findings could advance theoretical models to inform social-environmental research among adolescents.

Prevalence of CMV infection among sexually active adolescents: a matched case-control study.

BACKGROUND: We observed previously that African American adolescents in Richmond reporting infrequent sexual activity had cytomegalovirus (CMV) seroprevalence rates one half that of their adult mothers and caregivers. We therefore sought to determine if sexually active African American adolescents have higher rates of CMV infection than sexually inactive African American adolescents. METHODS: Cases (aged 13-18 years) sought care for a sexually transmitted infection (STI) or pregnancy. Controls were sexually inactive and matched to cases for age, race, and gender and enrolled at the same clinic as cases and sought medical treatment unrelated to an STI. Subjects completed a questionnaire, provided saliva for antibody testing, and were interviewed for determination of sexual activity. RESULTS: Two groups of sexually active cases were enrolled. The first group had a diagnosis of an STI. In this group, both cases and matched controls were seropositive at a rate of 32% (7/22 for cases and 7/22 for controls). In the second group, cases self-reported an STI but objective evidence was lacking. In this group, cases were seropositive at a rate of 38% (six of 16) compared with matched controls among whom 6.3% were seropositive (one in 16). The overall rate of seropositivity in all 38 cases was 34% compared with a rate of 21% for all controls (P=0.3, odds ratio 2.0, 95% confidence interval 0.6-7.5). CONCLUSION: Our results confirm lower rates of CMV infection among the current generation of African American adolescents compared with African American adults in Richmond, and suggest that this is not associated with sexual activity.