Identification of Important Factors When Measuring School Climate: Latent Construct Validation and Exploration.

BACKGROUND: Researchers regularly must decide what information is necessary to understand school climate and how to include climate in a study. For example, which factors and/or scales should be used, is using just 1 scale for school climate sufficient, and to what extent does the selection of a single scale influence the research findings? AIMS: Understanding what factors to consider and which available scales to review will assist those interested in measuring school climate. METHODS: This study explores 8 validated scales related to school climate. Data used are from a previous study (Social and Character Development cooperative agreement funded by IES #R305L030072 and #R305A080253) that looked at Positive Action, a social emotional and character development program for elementary-, middle-, and high-school students. RESULTS AND CONCLUSION: Scale correlations and factor analyses show how these scales work together to measure overall middle school climate.

Examining associations between prescription stimulant misuse frequency and misuse characteristics by race/ethnicity.

INTRODUCTION: The misuse use of prescription stimulants (MPS) among college students is a pressing public health concern. Past research suggests there is variation in MPS frequency by race/ethnicity. According to the Theory of Triadic Influence, a health behavior can increase in frequency based on experiences and characteristics of the behavior. Thus, our aim was to examine the association between experiences and characteristics of MPS with MPS frequency, by race/ethnicity. METHODS: A probability sample of students attending two California universities completed a paper-based, psychometrically validated, instrument. Students who reported engaging in MPS in their lifetime were also asked questions about frequency, cost per pill, administration routes, sources, and experience with the drug. We used regression analyses to address our research questions, and conducted analyses by racial/ethnic group (i.e. for students identifying as Asian, Latinx, and White). RESULTS: MPS frequency did not vary by race/ethnicity. The influence of characteristics of misuse on frequency varied by race/ethnicity. Additionally, frequency of experiencing the desired outcome was significantly associated with increased MPS frequency across all three racial/ethnic groups. CONCLUSIONS: Characteristics of misuse are important to consider when screening for misuse and potential dependence. Particular attention should be given to these characteristics by race/ethnicity. Implications for future research are discussed.

Perspectives on Deterrents from Students Who Have Discontinued Prescription Stimulant Misuse and Diversion Behaviors.

Although a growing number of studies have sought to understand what motivates the initiation of prescription stimulant misuse and diversion among college students, there has been a lack of studies focused on what motivates behavior cessation. We aimed to explore what motivates prescription stimulant misuse and diversion cessation, from the perspective of college students with a history of having initiated and then discontinued these behaviors. We conducted face-to-face interviews with students who had a history of misuse, diversion, or both, and who had intentionally, either for the short-term or long-term, ceased these behaviors. We audio-recorded, transcribed, and analyzed interviews inductively using a thematic analysis approach. Of the six themes we identified, four applied to both misuse and diversion, while two applied to diversion only. Engaging in related behavior change, seasonality of the behaviors, changes in personal needs, and negative and/or null experiences with the behaviors were themes for both misuse and diversion cessation. Themes that emerged solely for diversion cessation included: moral and legal concerns and not wanting to be perceived as a drug dealer. The information shared by students with first-hand misuse and diversion cessation experience has the potential to guide interventions designed to address prescription stimulant misuse on college campuses.

Mechanisms of Influence on Youth Substance Use for a Social-Emotional and Character Development Program: A Theory-Based Approach.

Background: The Theory of Triadic Influence (TTI) provides a comprehensive framework for understanding adolescent substance use. Objectives: We examined mechanisms by which a TTI-guided social-emotional and character development program, Positive Action (PA), influences adolescent substance use. Study data come from the PA-Chicago, longitudinal matched-pairs cluster-randomized control trial. A diverse, dynamic cohort of approximately 1,200 students from 14 low-performing schools were assessed at eight points of time, between grades 3-8, across a six-year period. Students completed scales related to substance use, self-control, deviant peer affiliation, and school attachment, adapted from the Risk Behavior Survey, Social-Emotional and Character Development Scale, Conventional Friends Scale, and People in My Life Scale. After testing the overall effect of PA on substance use, we used latent growth modeling to assess whether effects on each outcome were mediated by longitudinal changes in three composite measures aligning with the TTIs three streams. Results: Students in PA schools reported fewer experiences with drinking, getting drunk, and overall substance use. In the multiple mediator models, significant indirect effects of PA on substance use via changes in self-control were evident. Conclusions/Importance: Findings are consistent with theory and past research suggesting the influence of self-control on youth substance use. Future studies should include implementation in different settings and additional theory-based measures.Trial RegistrationThis trial is registered at ClinicalTrials.gov NCT01025674.

Exploring Reddit conversations about mental health difficulties among college students during the COVID-19 pandemic.

Objective: We aimed to explore conversations about mental health difficulties by Reddit users who posted within college subreddits during the COVID-19 pandemic. Participants: Data were collected from the subreddits of 22 California campuses, representing 113,579 anonymous members. Using the following search terms, we retrieved 577 posts (ie, 268 original posts and 309 replies): COVID, Coronavirus, Quarantine, Pandemic, Anxiety, Anxious, Depressed, Depression, Overwhelmed, Stress, and Stressed. Methods: We used inductive, thematic data analysis to explore themes within posts and replies dated from 3/16/2020 to 3/16/2021. Results: We identified the following themes: 1) the COVID-19 pandemic has negatively impacted engagement with learning; 2) remote learning has exacerbated students' mental health difficulties; and 3) students provide and receive social support online. Conclusions: These findings have implications that are particularly relevant as campuses are faced with continuous decisions related to repopulation.

Prescription Stimulant Misuse and Diversion Events Among College Students: A Qualitative Study.

Prescription stimulant misuse and diversion are interrelated behaviors: diversion increases the availability of stimulants for misuse, and persons who misuse are also more likely to divert. To date, research has examined these behaviors using a primarily quantitative lens. We led a qualitative investigation to better understand misuse and diversion events. Data are from a diverse southern California campus where we interviewed students who misuse and/or divert prescription stimulants (32 total interviews: 16 interviews with students who had a history of misuse, and 16 different interviews with students who had a history of diversion). We analyzed interview data inductively. We identified the following themes about misuse and diversion events, several of which intersected during interviews: medication surplus, diversion and misuse hubs, ease of behavior performance, academic stress, and other drugs commonly involved. For diversion, altruism and monetary gain were juxtaposed themes. Across themes, friends and family were influential figures. Implications for prevention, intervention, and future research directions are discussed.

Minimizing Health-Compromising Behaviors via School-Based Programs: An Optimization Approach.

School health programs are united by their desire to promote health and health-related outcomes among youth. They are also united by the fact that their expected effects are contingent on successful program implementation, which is often impeded by a multitude of real-world barriers. Techniques used in management science may help optimize school-based programs by accounting for implementation barriers. In this exploratory study, we present a detailed example of the first known application of linear programming (LP), which is an optimization technique, to Positive Action (PA). PA is a social emotional and character development program that includes a six-unit, teacher-delivered, classroom curriculum. We specify how we used LP to calculate the optimal levels of program implementation needed to minimize substance use, subject to known levels of implementation barriers (e.g., disruptive behavior, teacher education, teacher attitudes towards character development, school resources, and school safety). We found that LP is a technique that can be applied to data from a school health program. Specifically, we were able to develop a model that calculated the number of lessons that should be taught to minimize a specific health-compromising behavior, given expected levels of predetermined implementation barriers. Our findings from this exploratory study support the utility of applying LP during the program planning and implementation processes of school health programs.

Prescription stimulant diversion on a college campus: Intrapersonal, interpersonal and environmental correlates.

INTRODUCTION: Prescription stimulant diversion is a behavior that increases the availability and accessibility of prescription stimulants for purposes such as misuse. As such, we aimed to develop a theory-guided understanding of diversion correlates. METHODS: Data are from a probability sample of 499 undergraduate college students attending one California university. Participants completed a 100-item survey related to prescription stimulant misuse and diversion. We first calculated prevalence of diversion and associations with demographic variables. Next, to examine intrapersonal, interpersonal and environmental correlates of diversion, we estimated three separate nested logistic regression models. RESULTS: Prescription stimulant diversion was reported by approximately 10% of the sample. In the nested logistic analyses, diversion was found to be associated with intrapersonal, interpersonal and environmental variables. CONCLUSIONS: These findings highlight the importance of examining a comprehensive set of correlates to identify subgroups of students at risk for engaging in sharing and/or selling of prescription stimulants.

Prescription stimulant misuse avoidance self-efficacy: Correlates and moderation by race/ethnicity.

This study examined whether personality characteristics, attention deficit hyperactivity disorder (ADHD) symptomology, psychological distress, and religiosity were associated with prescription stimulant avoidance self-efficacy and whether these relationships were moderated by race/ethnicity among a probability sample of 1,053 college students. We used regression analyses to examine associations between avoidance self-efficacy and the independent variables of interest, and moderation analyses to identify whether these associations were moderated by race/ethnicity. Inattention, hyperactivity, sensation seeking, and psychological distress were inversely associated with prescription stimulant avoidance self-efficacy, whereas religiosity had a direct association. Moreover, greater inattention was a risk factor for lower self-efficacy among students identifying as White but not for students identifying as Asian. Increased religiosity was a risk factor for students identifying as Latinx, whereas it was a protective factor for students identifying as White. Prevention implications are discussed.

Pharmacological cognitive enhancement: Examining the ethical principles guiding college students' abstention.

OBJECTIVES: To understand the ethical principles guiding college students' abstention from pharmacological cognitive enhancement (PCE), and to determine the correlates associated with endorsing different principles. DESIGN: One-stage cluster sampling was used to implement a paper-based survey among undergraduate students attending one university in the U.S. Thematic analysis was used to explore the ethical principles guiding PCE abstention. Multivariate logistic regression analyses were used to examine sociodemographic correlates associated with endorsed ethical principles. PARTICIPANTS: Of the 499 eligible students who completed the survey (student response proportion: 94.7%), 259 students had a negative attitude towards PCE, did not engage in PCE, and provided reasons for abstention. RESULTS: The thematic analysis resulted in the identification of eight themes, with respondents often endorsing more than one theme per response. The three themes most endorsed were non-malfeasance (i.e., avoiding PCE to prevent harm), disapproval of drugs (i.e., a moral opposition to substance use) and dosage beneficence (i.e., adhering to dosage guidance to promote health). The sociodemographic correlates associated with endorsing each theme varied across themes. CONCLUSIONS: Students abstain from PCE for a multitude of reasons, many of which are guided by ethical principles. These findings may be incorporated into future prevention programming messages.

Childhood Protective Factors and a Prevention Program Reduce Later Problem Behaviors.

Prior research has yet to elucidate how constellations of protective factors in childhood and prevention efforts simultaneously may influence youth involvement in problem behaviors across different points in development. The current study examines how latent classes of social and emotional learning (SEL) skills, parent-child relationships, and peer influences in third grade and receipt of an ongoing SEL intervention predict substance use and violence in fifth and eighth grade. The urban, predominantly low-income, sample (N = 1,169) was nested in 14 schools that were randomly assigned to the Positive Action program or business-as-usual. Membership in a latent class reflecting protective childhood factors predicted less substance use and violence in fifth grade; however, the SEL program predicted less substance use and violence in eighth grade. Findings generally support that SEL interventions can successfully target and boost developmentally appropriate positive behaviors and can prevail over initial risk factors with enough time and exposure.

Racial/ethnic variation in mental health correlates of substance use among college students.

This study investigated mental health indicators, substance use, and their relationships, by race/ethnicity. A probability sample of 1,053 students at two California universities self-reported their frequency of substance use and rated their experience with indicators of mental health. One-way analysis of variance (ANOVA), chi-square tests, and multivariate censored regression models were estimated to examine which indicators of mental health were associated with each substance use form by race/ethnicity. Results from the one-way ANOVA and chi-square tests showed differences in substance use prevalence and mental health by race/ethnicity. For example, students who identified as White demonstrate a higher prevalence for every form of substance use in comparison to the Asian, Latino, and "All other" categories. Results from the regression showed, among Whites, inattention was associated with prescription stimulant misuse, and psychological distress was associated with marijuana use. Among Latinos, inattention was associated with cocaine and prescription stimulant use. Among Asians, psychological distress was associated with tobacco use and the misuse of prescription painkillers. Findings highlight the need to ensure subpopulations receive needed services.

A Mixed-Methods Approach Examining Illicit Prescription Stimulant Use: Findings From a Northern California University.

Preventing the illicit use of prescription stimulants, a particularly high-risk form of substance use, requires approaches that utilize theory-guided research. We examined this behavior within the context of a random sample of 554 undergraduate students attending a university in northern California. Approximately 17% of students self-reported engaging in this behavior during college; frequency of misuse per academic term ranged from less than once to 40 or more times. Although most misusers reported oral ingestion, a small proportion reported snorting and smoking the drug. The majority of misusers reported receiving the drug at no cost, and the primary source of the drug was friends. Misusers were motivated by both academic (e.g., to improve focus) and non-academic (e.g., to experiment) reasons. Our thematic analyses of an open-end question revealed that students abstaining from illicit use of prescription stimulants did so primarily for reasons related to health risks, ethics, and adherence regulations. Results from adjusted logistic regression analyses showed that correlates of the behavior were intrapersonal, interpersonal, and environmental in nature. We conclude that characteristics of misuse are a cause for concern, and correlates of the behavior are multifaceted. These findings, in addition to insights provided by students who choose not to engage in this behavior, suggest that a number of prevention approaches are plausible, such as a social norms campaign that simultaneously corrects exaggerated beliefs about prevalence while also illustrating why abstainers, in their own words, choose to abstain.

Can Universal SEL Programs Benefit Universally? Effects of the Positive Action Program on Multiple Trajectories of Social-Emotional and Misconduct Behaviors.

Behavioral trajectories during middle childhood are predictive of consequential outcomes later in life (e.g., substance abuse, violence). Social and emotional learning (SEL) programs are designed to promote trajectories that reflect both growth in positive behaviors and inhibited development of negative behaviors. The current study used growth mixture models to examine effects of the Positive Action (PA) program on behavioral trajectories of social-emotional and character development (SECD) and misconduct using data from a cluster-randomized trial that involved 14 schools and a sample of predominately low-income, urban youth followed from 3rd through 8th grade. For SECD, findings indicated that PA was similarly effective at improving trajectories within latent classes characterized as "high/declining" and "low/stable". Favorable program effects were likewise evident to a comparable degree for misconduct across observed latent classes that reflected "low/rising" and "high/rising" trajectories. These findings suggest that PA and perhaps other school-based universal SEL programs have the potential to yield comparable benefits across subgroups of youth with differing trajectories of positive and negative behaviors, making them promising strategies for achieving the intended goal of school-wide improvements in student outcomes.

Meeting the Challenges of Longitudinal Cluster-Based Trials in Schools: Lessons From the Chicago Trial of Positive Action.

We describe challenges in the 6-year longitudinal cluster randomized controlled trial (CRCT) of Positive Action (PA), a social-emotional and character development (SECD) program, conducted in 14 low-income, urban Chicago Public Schools. Challenges pertained to logistics of study planning (school recruitment, retention of schools during the trial, consent rates, assessment of student outcomes, and confidentiality), study design (randomization of a small number of schools), fidelity (implementation of PA and control condition activities), and evaluation (restricted range of outcomes, measurement invariance, statistical power, student mobility, and moderators of program effects). Strategies used to address the challenges within each of these areas are discussed. Incorporation of lessons learned from this study may help to improve future evaluations of longitudinal CRCTs, especially those that involve evaluation of school-based interventions for minority populations and urban areas.

Effects of the Positive Action Program on Indicators of Positive Youth Development Among Urban Youth.

This study evaluated effects of Positive Action, a school-based social-emotional and character development (SECD) intervention, on indicators of positive youth development (PYD) among a sample of low-income, ethnic minority youth attending 14 urban schools. The study used a matched-pair, cluster-randomized controlled design at the school level. A multiple-measure self-report protocol assessed four key strengths and resources for PYD: self-concept, peer affiliations, ethics, and social skills. Students (n=1170) were assessed from grades 3 to 8, the duration of the intervention, with drop-outs and late entrants included in analyses. Growth curve analyses revealed evidence of favorable program effects on each of the four types of resources. The study contributes to PYD research by providing evidence for school-based interventions in low-income, urban contexts for ethnic minority youth.

Effects of a School-Based Social-Emotional and Character Development Program on Health Behaviors: A Matched-Pair, Cluster-Randomized Controlled Trial.

There is considerable research that suggests that school-based social-emotional programs can foster improved mental health and reduce problem behaviors for participating youth; in contrast, much less is known about the impact of these programs on physical health, even though some of these programs also include at least limited direct attention to promoting physical health behaviors. We examined the effects of one such program, Positive Action (PA), on physical health behaviors and body mass index (BMI), and tested for mediation of program effects through a measure of social-emotional and character development (SECD). Participating schools in the matched-pair, cluster-randomized trial were 14 low-performing K-8 Chicago Public Schools. We followed a cohort of students in each school from grades 3 to 8 (eight waves of data collection; 1170 total students). Student self-reports of health behaviors served as the basis for measures of healthy eating and exercise, unhealthy eating, personal hygiene, consistent bedtime, and SECD. We collected height and weight measurements at endpoint to calculate age- and gender-adjusted BMI z-scores. Longitudinal multilevel modeling analyses revealed evidence of favorable program effects on personal hygiene [effect size (ES) = 0.48], healthy eating and exercise (ES = 0.21), and unhealthy eating (ES = -0.19); in addition, BMI z-scores were lower among students in PA schools at endpoint (ES = -0.21). Program effects were not moderated by either gender or student mobility. Longitudinal structural equation modeling demonstrated mediation through SECD for healthy eating and exercise, unhealthy eating, and personal hygiene. Findings suggest that a SECD program without a primary focus on health behavior promotion can have a modest impact on outcomes in this domain during the childhood to adolescence transition.

The Illicit Use of Prescription Stimulants on College Campuses: A Theory-Guided Systematic Review.

The illicit use of prescription stimulants (IUPS) is a substance use behavior that remains prevalent on college campuses. As theory can guide research and practice, we provide a systematic review of the college-based IUPS epidemiological literature guided by one ecological framework, the theory of triadic influence (TTI). We aim to assess prevalence, elucidate the behavior's multietiological nature, and discuss prevention implications. Peer-reviewed studies were located through key phrase searches (prescription stimulant misuse and college, "prescription stimulant misuse" and "college," illicit use of prescription stimulants in college, and nonmedical prescription stimulant use in college students) in electronic databases (PubMed, PubMed Central, and EBSCO Host) for the period 2000 to 2013. Studies meeting inclusion criteria had their references reviewed for additional eligible literature. Statistically significant correlates of IUPS in the 62 retrieved studies were organized using the three streams of influence and four levels of causation specified in the TTI. Results show that the prevalence of IUPS varies across campuses. Additionally, findings suggest the behavior is multifaceted, as correlates were observed within each stream of influence and level of causation specified by the TTI. We conclude that IUPS is prevalent in, but varies across, colleges and is influenced by intrapersonal and broader social and societal factors. We discuss implications for prevention and directions for future research.

Party Characteristics, Drinking Settings, and College Students' Risk of Intoxication: A Multi-Campus Study.

We examined party characteristics across different college drinking settings, associations between party characteristics and likelihood of drinking to intoxication, and the mediating role of perceived prevalence of intoxicated partygoers. Students (N = 6903) attending 14 public universities in California during the 2010 and 2011 fall semesters completed surveys on individual and party characteristics in six unique settings (e.g., residence hall). We used descriptive statistics to examine party characteristics by setting. We estimated multilevel logistic regression models to identify party characteristics associated with drinking to intoxication, and we used RMediation to determine significance of mediating effects. Individual and party characteristics varied by drinking context. Greater time at a party was associated with drinking to intoxication at five of six settings, while larger party size was significant only for outdoor settings. Enforcing the legal drinking age and refusing to serve intoxicated patrons were associated with lower likelihood of intoxication at Greek and off-campus parties. The presence of a keg was associated with drinking to intoxication at Greek, off-campus and outdoor parties; at bars, cover charges and drink promotions were positively associated with drinking to intoxication. In four of six settings, we found evidence of significant mediating effects through perceived prevalence of intoxicated partygoers. Findings highlight risk and protective characteristics of parties by drinking setting, and have prevention implications.