Emotional health predictors of substance use initiation during middle school.

This study aimed to evaluate whether emotional health factors, including anxiety and depression, stress, and social support, are associated with earlier youth initiation of alcohol and illicit substances during middle school (from the sixth to the eighth grade). Data for this study were from the Developmental Pathways Project, a longitudinal study of 521 youth sampled from the Seattle Public Schools. Discrete time survival analyses were used to assess the effects of depression, anxiety, stress, and support on initiation of substance use, measured every 6 months at five time points between sixth and eighth grade. Youth who had initiated prior to sixth grade had significantly higher levels of depressive symptoms. In multivariate survival analyses controlling for child race/ethnicity, gender, and socioeconomic status, and accounting for conduct problems, youth who reported higher levels of separation anxiety/panic symptoms were at decreased risk for early alcohol initiation. Children with higher levels of perceived teacher support had a significantly lower risk of alcohol initiation during early follow-up periods. Recent stressful life events in Grade 6 were associated with significantly greater risk of initiating an illicit substance by Grade 8. The current findings highlight the role of stress in the initiation of illicit substance use and suggest that teacher support is associated with lower risk for very early alcohol use. Future research examining anxiety as a predictor of substance use should distinguish between subtypes of anxiety.

Trends in perinatal and infant health disparities between rural American Indians and Alaska natives and rural Whites.

OBJECTIVES: We examined disparities in perinatal care, birth outcomes, and infant health between rural American Indian and Alaska Native (AIAN) persons and rural Whites over time. METHODS: We compared perinatal and infant health measures for 217 064 rural AIAN births and 5 032 533 rural non-Hispanic White births. RESULTS: Among American Indians and Alaska Natives, unadjusted rates of inadequate prenatal care (1985-1987, 36.3%; 1995-1997, 26.3%) and postneonatal death (1985-1987, 7.1 per 1000; 1995-1997, 4.8 per 1000) improved significantly. However, disparities between American Indians and Alaska Natives and Whites in adjusted odds ratios (AORs) of postneonatal death (1985-1987, AOR = 1.55; 95% confidence interval [CI] = 1.41, 1.71; 1995-1997, AOR = 1.46; 95% CI = 1.31, 1.64) and adjusted risk ratios (ARRs) of inadequate prenatal care (1985-1987, ARR = 1.67; 95% CI = 1.65, 1.69; 1995-1997, ARR = 1.84; 95% CI = 1.81, 1.87) persisted. CONCLUSIONS: Despite significant decreases in inadequate prenatal care and postneonatal death among American Indians and Alaska Natives, additional measures are needed to close persistent health gaps for this group.

Condom use, frequency of sex, and number of partners: multidimensional characterization of adolescent sexual risk-taking.

Sexual health research often relies on single risk indicators. However multi-variable composites may better capture the underlying construct of risk-taking. Latent Profile Analysis identified subgroups based on condom use consistency, partner numbers, and sex frequency among 605 adolescents. Three profiles were identified for each of grades 8 to 10 (Condom Users, Few Partners, and Risk-Takers) and 4 in grades 11 and 12 (Condom Users, One Partner Two Partners, and Risk-Takers). Inconsistent condom use groups reported more non-condom (and often less effective) birth control use and STD and pregnancy histories. Females had greater representation in the Few Partners, One Partners, and Two Partners groups, which also contained increasing proportions of participants in each subsequent year. Males had greater representation in the Risk-Takers group. A profile approach to measurement has methodological advantages, can add to substantive knowledge, and can inform content, timing, and targets of sexual health interventions.

Predictors of children's cortisol activation during the transition to kindergarten.

The purpose of the present study was to identify predictors of children's cortisol responses after the transition to kindergarten. Morning salivary cortisol was measured in 50 children 1 week before and 1 week after they began kindergarten. Children who experienced a greater degree of change between their preschool and kindergarten routines and who had infrequent preschool experiences exhibited the largest increases in morning cortisols after kindergarten entry. Children whose parents indicated that they would have an easier, rather than more difficult, time adapting to kindergarten also tended to be more reactive in their morning cortisol levels after kindergarten entry. Results provide new insight into experiential and individual-difference factors that predict children's physiological reactivity and self-regulation during times of transition and potential stress.

Children's beliefs about smoking.

Children's beliefs about smoking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that, relative to those in earlier grades, children in higher grades held more positive beliefs about the positive outcomes of smoking and the long-term negative consequences of smoking, but there was no association between grade level and beliefs about the immediate negative consequences of smoking. Children in higher grades also perceived more favorable norms toward smoking. There were few gender or race/ethnicity differences at these ages in children's beliefs about smoking. These outcome and normative beliefs were related to smoking behavior. Of the nine beliefs about the effects of smoking, all but two were significantly related to smoking behavior.