Universal School-Based Substance Use Prevention Using Technology-Supported Cooperative Learning.

Substance use in adolescence is a significant public health issue, particularly in early-to-mid adolescence, which represents a window of risk in the etiology of substance abuse and dependence. Substance use during this development period often results from affiliation with deviant peers, who model, facilitate, and reinforce use. Existing school-based substance use prevention programs have historically aimed to build adolescent knowledge regarding the dangers of substance use and/or enhance peer refusal skills. Research finds that these programs have had some success in reducing substance use, but meta-analyses report that average effect sizes are small. In a small one-year cluster randomized trial (12 middle and high schools; N = 813 students; ClinicalTrials.gov: NCT04478240), cooperative learning (CL) was implemented with the support of specialized technology and evaluated for its ability to reduce deviant peer affiliation and, in turn, reduce substance use. CL is a structured approach to small-group learning that provides at-risk youth with the opportunity to build friendships with more prosocial youth, interrupting the process of deviant peer clustering. Multi-level modeling revealed intervention effects for deviant peer affiliation and alcohol use across the sample, while tobacco use was significantly reduced among non-White students; intervention effects for marijuana use were only marginally significant. Effects for dosage were found for all outcomes, suggesting that every lesson taught had a significant impact. We conclude that CL, delivered with the aid of specialized technology, represents a viable option for universal substance use prevention. Future research should attempt to combine this approach with evidence-based prevention curricula.

Review and Evidence Gap Map of mentoring programs for adolescent males with disabilities.

INTRODUCTION: Adolescent males with disabilities face unique challenges, and mentoring programs designed for this population could support more positive long-term outcomes. In the current study, a scoping review of empirical research on such programs was conducted. The review was intended to capture the characteristics of existing mentoring program for males with disabilities and map those characteristics in a way that sheds light on the overall status of the field. METHODS: The review included different types of mentoring (e.g., adult to child, peer to peer, etc.) as long as the program explicitly defined the formation of a long-term relationship between mentor and mentee. The search identified 21 relevant studies that were categorized using four dimensions: 1) Setting (i.e., school/after school, community-based, on-line/virtual, or mixed); 2) Sex (i.e., males only or mixed males/females); 3) Outcomes (i.e., academics, social-emotional skills, health, transition from high school, or program implementation); and 4) Evaluation methodology (i.e., experimental, nonexperimental, or qualitative). The findings are summarized in an Evidence Gap Map. RESULTS: Only three studies used an experimental design, although they were able to demonstrate significant promise in promoting positive outcomes for youth with disabilities. Beyond these studies, however, there was little evidence supporting program efficacy for males with disabilities, as most studies in the sample were nonexperimental in nature. CONCLUSIONS: Overall there are few mentoring programs that target this population, and experimental research on programs that target academic and health outcomes is particularly lacking.

Socialization processes within adolescents' relationships with parents and peers predicting couples' intimate partner violence in adulthood: A social learning perspective.

Previous studies have established that individual characteristics such as violent behavior, substance use, and high-risk sexual behavior, as well as negative relationships with parents and friends, are all risk factors for intimate partner violence (IPV). In this longitudinal prospective study, we investigated whether violent behavior, substance use, and high-risk sexual behavior in early adulthood (ages 22-23 years) mediated the link between family conflict and coercive relationship talk with friends in adolescence (ages 16-17 years) and dyadic IPV in adulthood (ages 28-30 years). A total of 998 individuals participated in multimethod assessments, including observations of interactions with parents and friends. Data from multiple reporters were used for variables of interest including court records, parental and self-reports of violence, self-reports of high-sexual-risk behaviors and substance use, and self- and romantic partner-reports of IPV. Longitudinal mediation analyses showed that violent behavior during early adulthood mediated the link between coercive relationship talk with friends in adolescence and dyadic IPV in adulthood. No other mediation paths were found and there was no evidence of gender differences. Results are discussed with attention to the interpersonal socialization processes by which IPV emerges relative to individual risk factors.

Peer learning can modify the reciprocal relationship between peer support and victimization in middle school.

INTRODUCTION: This research investigated how peer victimization and support are reciprocally related and how Cooperative Learning (CL) can reverse the progressive cascade that, unchecked, can culminate in youth mental health problems. METHODS: The sample (N = 1890; 53% male) was derived from a randomized trial of CL in 15 middle schools in the United States. Students were recruited in the 7th grade. Structural Equation Modeling (SEM) was used to fit our cross-lag difference score model across four waves of data. RESULTS: The results indicated a reciprocal relationship between peer support and victimization across time, suggesting the potential for negative experiences with peers to become amplified over time in a "vicious cycle," negatively impacting mental health. Students in intervention schools reported significantly higher levels of peer support and lower levels of victimization, suggesting that CL can intervene in this cycle, with salutary effects on mental health; CL also demonstrated direct effects on mental health. CONCLUSIONS: The present study indicates that low peer support can be both a precursor to and an outcome of victimization, serving to maintain a vicious cycle that compounds negative effects on student mental health. Further, results demonstrate how CL can reverse this cycle. We conclude that CL can be of particular importance to the prevention field as a universal mental health program that does not require the associated stigma of identifying youth at elevated risk for referral to treatment programs.

Costs and benefits of cooperative learning as a universal school-based approach to adolescent substance use prevention.

Substance use during early adolescence implies a greater likelihood of abuse and dependence in later adolescence or adulthood. In turn, substance abuse and dependence are linked to a variety of maladaptive long-term health-related outcomes that imply significant individual and societal costs. In this paper, we evaluated an approach to substance use prevention that relies on the vital role of peers, who comprise a key risk factor for adolescent substance use. This approach (i.e., cooperative learning, CL) focuses on interrupting the process of deviant peer clustering and providing at-risk youth with the opportunity to build social skills and cultivate friendships with low-risk youth. In addition to testing the efficacy of CL in reducing the number of students who become regular substance users, we also conducted a cost-benefit analysis. Using four waves of data from a cluster-randomized trial (N = 15 middle schools, 1890 students, 47.1% female, 75.2% White, 13.9% of students were receiving special education services), we found that significantly lower percentages of students in the intervention (CL) schools became regular users of tobacco, alcohol, and marijuana. We estimated that the reduction in substance use associated with the implementation of CL resulted in total lifetime benefits of between $1027 and $4621 per student (in 2019 dollars), or between $8.79 and $39.54 for each dollar invested in CL. Benefit/cost ratios would go up to $22.54-$101.39 per dollar invested with the continual implementation of CL, assuming retraining every 5 years. Implications and future research directions are discussed.

The Cascading Effects of Reducing Student Stress: Cooperative Learning as a Means to Reduce Emotional Problems and Promote Academic Engagement.

Adolescents, particularly early adolescents, are vulnerable to stress created by negative peer interactions. Stress, in turn, can lead to increased mental health problems and reduced academic engagement, in addition to negative long-term consequences for cognitive development and physical health. Using four waves (2 years) of data from a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White), we evaluated whether enhancements to peer relations, brought about through carefully structured small-group learning activities (i.e., cooperative learning), could reduce stress and emotional problems and promote academic engagement. We hypothesized that the increased social contact created by cooperative learning would promote greater peer relatedness, reducing student stress and, in turn, reducing emotional problems and promoting academic engagement. Our results confirmed these hypotheses. We conclude that cooperative learning can provide social, behavioral, academic, and mental health benefits for students.

The Effects of Cooperative Learning on Peer Relations, Academic Support, and Engagement in Learning Among Students of Color.

Despite Brown vs. Board of Education, prejudice still exists in the American school system. These attitudes can give rise to negative social experiences for students of color (i.e., discrimination), negatively impacting their mental and physical health and creating disparities in educational outcomes. Rather than seeking to ameliorate these negative experiences, our approach attempts to address the underlying prejudices and, in so doing, reduce these disparities. Using 4 waves of data from a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White), we hypothesized that cooperative learning, which has been shown to reduce prejudice in previous research, would create positive gains in peer relatedness, perceptions of academic support, and engagement in learning, and that gains would be larger for students of color; our results confirmed these hypotheses. Our findings highlight the potential role of cooperative learning in reducing disparities and creating greater equity in education.

The socialization of boys and men in the modern era: An evolutionary mismatch.

This paper examines the misalignment between modern human society and certain male phenotypes, a misalignment that has been highlighted and explored in great detail in the work of Tom Dishion. We begin by briefly enumerating the ongoing developmental difficulties of many boys and young men and how these difficulties affect them and those around them. We then suggest that the qualities that have been advantageous for men and their families in our earlier evolution but that are often no longer functional in modern society are a source of these problems. Finally, we provide a brief review of prevention programs that can contribute to preventing this type of problematic development and eliciting more prosocial behavior from at-risk boys and men. We conclude with an overview of research and policy priorities that could contribute to reducing the proportion of boys and young men who experience developmental difficulties in making their way in the world.

Effects of cooperative learning on peer relations, empathy, and bullying in middle school.

Although researchers have developed prevention programs to reduce bullying, the results are mixed, and this may be due to a degree of uncertainty in their theoretical foundation. In particular, these programs share an emphasis on empathy as a personal attribute that can be enhanced among students through the application of specific curricula that will, in turn, contribute to a reduction in bullying behavior. However, the link between empathy and bullying is unclear, as is the ability of bullying prevention programs to actually impact student empathy. In this study, we used a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White) to evaluate the impact of cooperative learning on bullying, and we evaluated whether these effects were mediated by empathy and peer relatedness. Our results indicated that cooperative learning can significantly reduce bullying, and that some of this effect is transmitted via enhancements to affective empathy. Cooperative learning also demonstrated significant positive effects on cognitive empathy, but this did not have an effect on bullying. We also found that the effects of cooperative learning on cognitive and affective empathy were mediated by improvements in peer relatedness. These findings add a degree of clarity to the literature, and also represent the first time, as far as we are aware, that an antibullying program has been found to have significant effects on both cognitive and affective empathy.

Cooperative Learning Effects on Peer Relations and Alcohol Use in Middle School.

We tested a prevention approach aimed at reducing growth in alcohol use in middle school using four waves (2 years) of data from a cluster randomized trial (N = 15 middle schools, 1,890 students, 47.1% female, 75.2% White). Our approach exposed students to a broad cross-section of peers through collaborative, group-based learning activities in school (i.e., cooperative learning). We hypothesized that the increased social contact created by cooperative learning would promote greater peer relatedness, interrupting the process of deviant peer clustering and, in turn, reduce escalations in alcohol use. Our results supported these hypotheses, suggesting that the social nature of cooperative learning, and the emphasis on group work and collaboration, can provide social and behavioral as well as academic benefits for students.

An Experimental Test of Reward & Reminder as a Stand-Alone Program to Prevent Alcohol Sales to Underage Youths.

Reward & Reminder has been a component of community-based preventive efforts against sales of substances (e.g., tobacco) to youth. To date, there has not been a randomized trial of Reward & Reminder as a stand-alone prevention program targeting youth access to alcohol. In this study, we addressed that gap. Data were collected as part of a randomized trial of a school- and community-based prevention program. Our analysis included 23 vendors in control communities and 33 vendors in intervention communities. We visited each vendor at least two times, and vendors in intervention communities received the Reward & Reminder protocol. Using McNemar's Test, which evaluates the degree to which the outlets in each condition moved to a different cell in the contingency table from the first visit to the second (i.e., from yes to no or vice versa), we found that the control outlets did not change (all p values were non-significant). In contrast, the test results for the intervention outlets were significantly more likely to ask for ID (p < .05) and significantly less willing to sell alcohol to young-looking project confederates (p < .05); Asked for Age did not change. We conclude that Reward & Reminder could assist in preventing underage access to alcohol.

Enlisting Peer Cooperation in the Service of Alcohol Use Prevention in Middle School.

This article reports on a cluster randomized trial of cooperative learning (CL) as a way to prevent escalation in alcohol use during middle school (N = 1,460 seventh-grade students, age 12-13, seven intervention and eight control schools). We hypothesized that CL, by bringing students together in group-based learning activities using positive interdependence, would interrupt the process of deviant peer clustering, provide at-risk youth with prosocial influences, and in turn, reduce escalations in alcohol use. Results indicated that CL significantly reduced growth in deviant peer affiliation and actual alcohol use, and effects for willingness to use alcohol were at the threshold of significance (p = .05). CL also attenuated the link between willingness to use alcohol and later alcohol use.

Cooperative Learning in Middle School: A Means to Improve Peer Relations and Reduce Victimization, Bullying, and Related Outcomes.

Peer victimization is a highly stressful experience that impacts up to a third of all adolescents and can contribute to a variety of negative outcomes, including elevated anxiety, depression, drug use, and delinquency, as well as reduced self-esteem, school attendance, and academic achievement. Current prevention approaches (e.g., the Olweus program) have a mixed record in American schools. We propose a new approach to prevention that leverages theory and research surrounding the social aspects of bullying and victimization, particularly peer relations. Our approach attempts to (1) break down the process of homophily among bullies, and (2) provide a mechanism by which socially isolated students can develop new friendships. Our approach asks teachers to increase opportunities for positive peer interaction through carefully structured, group-based learning activities in school (i.e., cooperative learning). We hypothesized that these positive peer interactions would result in reductions in bullying, victimization, perceived stress, and emotional problems, as well as increases in peer relatedness, among more marginalized students. Using a cluster randomized trial with 15 rural middle schools in the Pacific Northwest (N = 1,460 7th grade students), we found that cooperative learning significantly reduced bullying, victimization, and perceived stress for marginalized students (i.e., moderated effects), and reduced emotional problems and enhanced relatedness for all students (i.e., main effects). Given that cooperative learning has already been shown to enhance student engagement and achievement in prior research, our results demonstrate that cooperative learning can be a permanent, sustainable component of teacher training and school culture.

Genetic influences can protect against unresponsive parenting in the prediction of child social competence.

Although social competence in children has been linked to the quality of parenting, prior research has typically not accounted for genetic similarities between parents and children, or for interactions between environmental (i.e., parental) and genetic influences. In this article, the possibility of a Gene x Environment (G × E) interaction in the prediction of social competence in school-age children is evaluated. Using a longitudinal, multimethod data set from a sample of children adopted at birth (N = 361), a significant interaction was found between birth parent sociability and sensitive, responsive adoptive parenting when predicting child social competence at school entry (age 6), even when controlling for potential confounds. An analysis of the interaction revealed that genetic strengths can buffer the effects of unresponsive parenting.

Alcohol, marijuana, and tobacco use trajectories from age 12 to 24 years: demographic correlates and young adult substance use problems.

Substance use trajectories were examined from early adolescence to young adulthood among a diverse sample of 998 youths. Analysis of longitudinal data from ages 12 to 24 identified distinct trajectories for alcohol, marijuana, and tobacco use. Modeling revealed 8 alcohol, 7 marijuana, and 6 tobacco use trajectories. Analyses assessed risk for substance use problems in early adulthood within each trajectory, as well as overlap among alcohol, marijuana, and tobacco use trajectories. Findings confirmed that adolescents with early- and rapid-onset trajectories are particularly vulnerable to the development of problematic substance use in early adulthood. However, analyses also identified an escalating high school onset trajectory for alcohol and for marijuana use that was equally prognostic of problem use in adulthood. Moreover, tobacco use in early adolescence was associated with developing high-risk marijuana and alcohol use patterns. Random assignment to the Family Check-Up intervention was found to reduce risk for membership in the high-risk marijuana use trajectories, suggesting that family-based approaches delivered during adolescence can prevent escalations to problematic substance use. These findings suggest the importance of developmental heterogeneity and equifinality in considering prevention for alcohol and drug use.

Examining Change in Therapeutic Alliance to Predict Youth Mental Health Outcomes.

OBJECTIVE: To examine the link between therapeutic alliance and youth outcomes. METHOD: The study was conducted at a group-home with 112 youth with a disruptive-behavior diagnosis. Therapeutic alliance was collected routinely via youth and staff report. Outcome data were collected using youth and staff reports of externalizing behavior as well as behavioral incidents occurring during care. Outcome data were collected following intake into services and at 6 and 12 months of care. Data were analyzed to examine (1) if youth behavior problems at intake were predictive of therapeutic alliance and (2) if changes in alliance were predictive of subsequent youth outcomes. These were conducted with a 6-month service-delivery model and replicated with a 12-month model. RESULTS: There was some support for the first hypothesis, that initial levels of youth externalizing behavior would be related to alliance ratings; however, most of the effects were marginally significant. The second hypothesis, that changes in therapeutic alliance would be related to subsequent youth outcomes, was supported for the 6-month model, but not the 12-month model. CONCLUSIONS: Changes in therapeutic alliance may be predictive of youth outcomes during care. Additional research into examining therapeutic alliance trajectories is warranted to improve mental health services for youth.

Adolescent deviant peer clustering as an amplifying mechanism underlying the progression from early substance use to late adolescent dependence.

BACKGROUND: Early substance use co-occurs with youths' self-organization into deviant peer groups in which substance use is central to social interaction. We hypothesized that the social dynamics of deviant peer groups amplify the risk of progressing from early use to later dependence, and that this influence occurs over and above escalations in use that typically accompany early substance use and membership in deviant groups. METHODS: Our study used a longitudinal, multimethod dataset consisting of 998 adolescents and their families. Participants were recruited from middle schools in a large metropolitan area in the Pacific Northwest. The sample was 47.3% female and ethnically diverse (42.3% European American, 29.1% African American, and 28.6% other, including biracial). We examined deviant peer clustering as a mediator between early substance use and later dependence, controlling for proximal levels of use, SES, early antisocial behavior, and parental monitoring. Tobacco, alcohol, and marijuana use were assessed at ages 12, 13, and 16-17. Past-year nicotine, alcohol, and marijuana dependence (DSM-IV) was assessed at age 19. Youth and parent reports and observational data were used to assess deviant peer clustering at age 16-17, and youth reported on antisocial behavior and parental monitoring at ages 12 and 13. RESULTS: Early substance use predicted increased likelihood of dependence on tobacco, alcohol, and marijuana by late adolescence. Deviant peer affiliation mediated these links, even when accounting for proximal levels of substance use. CONCLUSIONS: Early substance use not only promotes escalations in use across adolescence but also provides entry into a deviant social context that contributes to increased risk of dependence. Our results emphasize the importance of identifying and intervening in early substance use before it becomes an organizing factor in friendship selection and interaction. Deviant peer clusters are clearly an important avenue for intervention when seeking to interrupt the progression to substance dependence.

Preventing high-risk sexual behavior in early adulthood with family interventions in adolescence: outcomes and developmental processes.

Adolescent study participants who engaged in a brief, family-centered intervention (the Family Check-Up, FCU) were later assessed for the intervention's effects on high-risk sexual behavior (HRSB) in early adulthood (age 22). Participants (N = 998 adolescents and their families) were randomly assigned to a family-centered intervention in sixth grade and were offered a gated, multilevel intervention that included (a) a school-based family resource center, (b) the FCU, and (c) more intensive, family-based treatment. All services were voluntary, but high-risk families were actively recruited into the FCU. Approximately 23% of the intervention families engaged in the FCU and approximately 18% engaged in more intensive treatment. Using an intent-to-treat design, we found that the direct effect of the FCU on HRSB was not significant; however, an analysis of the developmental processes indicated that intervention families demonstrated improved family relationship quality when compared to control families, which in turn resulted in lower levels of HRSB in early adulthood. Furthermore, the significant effect of family relationship quality on HRSB was mediated by differences in parental monitoring and early sexual activity, and these effects varied as a function of gender and ethnicity. Indirect effects of the FCU on HRSB were significant via multiple different pathways. The implications of these findings for enhancing the impact of family-centered interventions are discussed.

Engagement matters: lessons from assessing classroom implementation of steps to respect: a bullying prevention program over a one-year period.

Steps to Respect: A Bullying Prevention Program (STR) relies on a social-ecological model of prevention to increase school staff awareness and responsiveness, foster socially responsible beliefs among students, and teach social-emotional skills to students to reduce bullying behavior. As part of a school-randomized controlled trial of STR, we examined predictors and outcomes associated with classroom curriculum implementation in intervention schools. Data on classroom implementation (adherence and engagement) were collected from a sample of teachers using a weekly on-line Teacher Implementation Checklist system. Pre-post data related to school bullying-related outcomes were collected from 1,424 students and archival school demographic data were obtained from the National Center for Education Statistics. Results of multilevel analyses indicated that higher levels of program engagement were influenced by school-level percentage of students receiving free/reduced lunch, as well as classroom-level climate indicators. Results also suggest that higher levels of program engagement were related to lower levels of school bullying problems, enhanced school climate and attitudes less supportive of bullying. Predictors and outcomes related to program fidelity (i.e., adherence) were largely nonsignificant. Results suggest that student engagement is a key element of program impact, though implementation is influenced by both school-level demographics and classroom contexts.

Predicting response to intensive multimodal inpatient treatment: a comparison of single- and multiple-class growth modeling approaches.

In a modest body of research, personality functioning assessed via performance-based instruments has been found to validly predict treatment outcome and, to some extent, differential response to treatment. However, state-of-the-science longitudinal and mixture modeling techniques, which are common in many areas of clinical psychology, have rarely been used. In this article, we compare multilevel growth curve modeling (MLM) and latent class growth modeling (LCGM) approaches with the same data set to illustrate the different research questions that can be addressed by each method. Global Assessment of Functioning (GAF) scores collected at 6 points during the course of a long-term multimodal inpatient treatment of 58 severely and persistently mentally ill adults were used to model the trajectory of treatment outcome. Pretreatment Rorschach-based markers of personality functioning and other markers of psychiatric severity were examined as covariates in each modeling approach. The results of both modeling approaches generally indicated that more psychologically impaired clients responded less favorably to treatment. The LCGM approach revealed 2 unique trajectories of improvement (a persistently low group and a higher starting, improving group). Personality functioning and baseline psychiatric variables significantly predicted group membership and the rate of change within the groups. A side-by-side examination of these 2 methods was found to be useful in predicting differential treatment response with personality functioning variables.