Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 56
Filtrar
1.
Drug Alcohol Depend ; 235: 109442, 2022 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-35461085

RESUMEN

OBJECTIVE: To examine whether young adult opioid misuse reflects a general tendency toward substance use and is influenced by general substance use risk or whether it is a different phenomenon from other drug use. METHODS: At ages 23 (2016) and 26 (2019), a panel of young adults (n = 3794 to 3833) in the United States self-reported their past-month substance use (opioid misuse, heavy drinking, cigarettes, cannabis) and substance-specific risk factors (perceptions of harm; approval of use; and use of each substance by friends and romantic partners). Structural equation models examined non-opioid and opioid-specific associations between latent risk and substance use factors. RESULTS: Opioid misuse and opioid-specific risk factors shared significant variance with latent substance use and latent substance use risk, respectively, which were strongly associated. A statistically significant residual correlation between opioid-specific risk and opioid misuse remained. CONCLUSION: Young adult opioid misuse reflects a general tendency toward substance use and is strongly predicted by risk for substance use. Opioid-specific risk factors play only a small independent role. Existing evidence-based substance use interventions may be effective in preventing opioid misuse among young adults.

2.
JAMA Netw Open ; 5(4): e225127, 2022 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-35377427

RESUMEN

Importance: Characterizing patterns of handgun carrying among adolescents and young adults can inform programs to reduce firearm-related harm. Longitudinal patterns of handgun carrying among rural adolescents have not been identified. Objectives: To assess specific points of intervention by characterizing patterns of handgun carrying by youths in rural communities from early adolescence to young adulthood and to quantify how age at initiation, duration, and frequency of carrying differ across identified patterns. Design, Setting, and Participants: This cohort study uses the control group of the community-randomized trial of the Communities That Care prevention system, conducted among public school students in 12 rural communities across 7 states. Participants self-reported their handgun carrying at 10 data collection points from 12 to 26 years of age (2005-2019). Data were analyzed from January to July 2021. Main Outcomes and Measures: Handgun carrying in the past 12 months. Latent class growth analysis was used to estimate handgun carrying trajectories. Results: In this longitudinal rural sample of 2002 students, 1040 (51.9%) were male; 532 (26.6%) were Hispanic, Latino, Latina, or Latinx; 1310 (65.4%) were White; and the highest level of educational attainment of either parent was a high school degree or less for 649 students (32.4%). The prevalence of handgun carrying in the last 12 months ranged from 5.3% (95 of 1795) to 7.4% (146 of 1969) in adolescence and increased during the mid-20s (range, 8.9% [154 of 1722] to 10.9% [185 of 1704] from 23 to 26 years of age). Among the participants who reported handgun carrying at least once between 12 and 26 years of age (n = 601 [30.0%]), 320 (53.2%) reported carrying a handgun in only 1 wave. Latent class growth analysis indicated 6 longitudinal trajectories: never or low probability of carrying (1590 [79.4%]), emerging adulthood carrying (166 [8.3%]), steadily increasing carrying (163 [8.1%]), adolescent carrying (53 [2.6%]), declining carrying (24 [1.2%]), and high probability and persistent carrying (6 [0.3%]). The earliest mean (SD) age at initiation of handgun carrying occurred in both the adolescent and declining carrying groups at the ages of 12.6 (0.9) and 12.5 (0.7) years, respectively. More than 20% of some groups (emerging adulthood [age 26 years: 49 of 154 (31.8%)], steadily increasing [age 26 years: 37 of 131 (28.2%)], declining [age 13 years: 7 of 23 (30.4%)], and high probability and persistent carrying [age 15 years: 3 of 6 (50.0%)]) reported carrying 40 times or more in the past year by the age of 26 years. Conclusions and Relevance: This study found distinct patterns of handgun carrying from adolescence to young adulthood in rural settings. Findings suggest that promoting handgun safety in rural areas should start early. Potential high-risk trajectories, including carrying at high frequencies, should be the focus of future work to explore the antecedents and consequences of handgun carrying in rural areas.


Asunto(s)
Conducta del Adolescente , Armas de Fuego , Adolescente , Adulto , Estudios de Cohortes , Humanos , Masculino , Población Rural , Estudiantes , Adulto Joven
3.
J Behav Med ; 2022 Mar 24.
Artículo en Inglés | MEDLINE | ID: mdl-35322313

RESUMEN

The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake.

4.
Contemp Clin Trials ; 112: 106621, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34785305

RESUMEN

Evidence-based parenting interventions play a crucial role in the sustained reduction of adolescent behavioral health concerns. Guiding Good Choices (GGC) is a 5-session universal anticipatory guidance curriculum for parents of early adolescents that has been shown to reduce substance use, depression symptoms, and delinquent behavior. Although prior research has demonstrated the effectiveness of evidence-based parenting interventions at achieving sustained reductions in adolescent behavioral health concerns, public health impact has been limited by low rates of uptake in community and agency settings. Pediatric primary care is an ideal setting for implementing and scaling parent-focused prevention programs as these settings have a broad reach, and prevention programs implemented within them have the potential to achieve population-level impact. The current investigation, Guiding Good Choices for Health (GGC4H), tests the feasibility and effectiveness of implementing GGC in 3 geographically and socioeconomically diverse large integrated healthcare systems. This pragmatic, cluster randomized clinical trial will compare GGC parenting intervention to usual pediatric primary care practice, and will include approximately 3750 adolescents; n = 1875 GGC intervention and n = 1875 usual care. The study team hypothesizes that adolescents whose parents are randomized into the GGC intervention arm will show reductions in substance use initiation, the study's primary outcomes, and other secondary (e.g., depression symptoms, substance use prevalence) and exploratory outcomes (e.g., health services utilization, anxiety symptoms). The investigative team anticipates that the implementation of GGC within pediatric primary care clinics will successfully fill an unmet need for effective preventive parenting interventions. Trial registration: Clinicaltrials.govNCT04040153.


Asunto(s)
Conductas de Riesgo para la Salud , Padres , Adolescente , Ansiedad , Niño , Humanos , Responsabilidad Parental , Padres/educación , Atención Primaria de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto
5.
Addict Behav ; 124: 107118, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34583272

RESUMEN

Simultaneous alcohol and marijuana use (SAM) such that their effects overlap has emerged as a behavior that is riskier than using either substance separately. It has been associated with high-risk binge drinking and driving while intoxicated during young adulthood, and it has been demonstrated to cause greater physical and mental impairment than use of alcohol or marijuana separately. To identify intervention and prevention targets specific to SAM, we examined the relationships between alcohol- and marijuana-specific beliefs and attitudes (risk factors) and self-reported SAM compared to non-simultaneous co-use (CAM) and alcohol use only in the past 30 days in a sample of young adults (n = 1,023, mean age = 23.17; SD = 0.43). Of those who reported drinking alcohol in the past 30 days, 20.7% reported SAM, 12.6% reported CAM, and 66.6% reported using only alcohol. Results from multinomial logistic regression analyses indicated that some marijuana-specific risk factors (e.g., belief that it is not at all wrong for someone their age to use marijuana) differentiated SAM or CAM from alcohol use only, but alcohol-specific risk factors generally did not. However, the perceptions that parents approved of their using marijuana or frequently drinking heavily were associated with a greater likelihood of SAM compared to CAM (OR ranged from 2.25 to 3.53). Findings point to the salience of individuals' attitudes and beliefs around marijuana use and their perception of parental approval of heavy drinking and marijuana use as potential targets for prevention programs targeting risk reduction among young adults.


Asunto(s)
Cannabis , Fumar Marihuana , Uso de la Marihuana , Adulto , Consumo de Bebidas Alcohólicas , Etanol , Humanos , Uso de la Marihuana/epidemiología , Adulto Joven
6.
J Dev Life Course Criminol ; 7(1): 66-86, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34150470

RESUMEN

PURPOSE: This paper describes the origins and application of a theory, the social development model (SDM), that seeks to explain causal processes that lead to the development of prosocial and problem behaviors. The SDM was used to guide the development of a multicomponent intervention in middle childhood called Raising Healthy Children (RHC) that seeks to promote prosocial development and prevent problem behaviors. This paper reviews and integrates the tests of the SDM and the impact of RHC. While the original results of both model and intervention tests have been published elsewhere, this paper provides a comprehensive review of these tests. As such this integrative paper provides one of the few examples of the power of theory-driven developmental preventive intervention to understand impact across generations and the power of embedding controlled tests of preventive intervention within longitudinal studies to understand causal mechanisms. METHODS: Application of the SDM in the RHC intervention was tested in a quasi-experimental trial nested in the Seattle Social Development Project (SSDP). SSDP is a longitudinal study of 808 students who attended 18 public schools in Seattle, WA, and whose parents consented for their participation in longitudinal research when they were in Grade 5 (77% of the eligible population in participating schools). Students assented at each survey administration and consented to longitudinal follow-up when they turned 18. Panel subjects were followed and surveyed 15 times from Grade 5 through age 39, with most completion rates above 90%. RESULTS: We describe effects of the full multicomponent RHC intervention delivered in Grades 1 through 6 by comparing outcomes of those children assigned to the full RHC intervention condition to controls from middle childhood through age 39. We also report the effects of the full RHC intervention on the firstborn children of participants compared with the firstborn children of controls. CONCLUSIONS: We discuss use of the theory to guide development and testing of preventive interventions and the utility of nesting intervention tests within longitudinal studies for testing both theory and interventions.

7.
Prev Sci ; 22(4): 452-463, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33837890

RESUMEN

This study estimated sustained impacts and long-term benefits and costs of the Communities That Care (CTC) prevention system, implemented and evaluated in a longitudinal cluster-randomized trial involving 24 communities in seven states. Analyses utilized reports from a longitudinal panel of 4407 participants, followed since the study's baseline in grade 5, with most recent follow-up 12 years later at age 23. Impacts on lifetime abstinence from primary outcomes of substance use and antisocial behavior were estimated using generalized linear mixed Poisson regression analysis, adjusted for individual and community-level covariates. Possible cascading effects on 4-year college completion, major depressive disorder, and generalized anxiety disorder through age 23 were evaluated as secondary outcomes. CTC had a statistically significant global effect on primary outcomes and also on combined primary and secondary outcomes. Among primary outcomes, point estimates suggested absolute improvements in lifetime abstinence of 3.5 to 6.1% in the intervention arm and relative improvements of 13 to 55%; 95% confidence intervals revealed some uncertainty in estimates. Among secondary outcomes, 4-year college completion was 1.9% greater among young adults from intervention communities, a 20% relative improvement. Mental health outcomes were approximately the same across trial arms. Although CTC had small sustained effects through age 23, benefit-cost analyses indicated CTC was reliably cost beneficial, with a net present value of $7152 (95% credible interval: $1253 to $15,268) per participant from primary impacts and $17,919 ($306 to $39,186) when secondary impacts were also included. It remained cost beneficial even when impacts were adjusted downward due to the involvement of CTC's developer in the trial. Findings suggest that broader dissemination of CTC could improve public health and individual lives in the long term and generate positive net benefits to society.


Asunto(s)
Trastornos de Ansiedad , Trastorno Depresivo Mayor , Escolaridad , Prevención Primaria , Trastornos Relacionados con Sustancias , Trastornos de Ansiedad/prevención & control , Niño , Análisis Costo-Beneficio , Trastorno Depresivo Mayor/prevención & control , Humanos , Estudios Longitudinales , Prevención Primaria/economía , Trastornos Relacionados con Sustancias/prevención & control , Estados Unidos , Adulto Joven
8.
Nicotine Tob Res ; 23(3): 518-526, 2021 02 16.
Artículo en Inglés | MEDLINE | ID: mdl-31970409

RESUMEN

INTRODUCTION: Reducing cigarette use is a major public health goal in the United States. Questions remain, however, about the potential for the social environment in the adult years-particularly in the 30s and beyond-to influence cigarette use. This study tested pathways hypothesized by the social development model to understand the extent to which social environmental factors at age 33 (eg, involvement with smokers or with physically active people) contribute to changes in cigarette use from age 30 to age 39. Both combustible and electronic cigarette use were investigated. METHODS: Data were from the Seattle Social Development Project, a longitudinal study of 808 diverse participants with high retention. Self-reports assessed social developmental constructs, combustible and electronic cigarette use, and demographic measures across survey waves. RESULTS: At age 30, 32% of the sample reported past-month cigarette use. Using structural equation modeling, results showed high stability in cigarette use from age 30 to 39. After accounting for this stability, cigarette-using social environments at age 33 predicted personal beliefs or norms about smoking (eg, acceptability and social costs), which in turn predicted combustible cigarette use at age 39. Cigarette-using environments, however, directly predicted electronic cigarette use at age 39, with no significant role for beliefs about smoking. CONCLUSIONS: Cigarette use was highly stable across the 30s, but social environmental factors provided significant partial mediation of this stability. Pathways were different for combustible and electronic cigarette use, however, with personal smoking norms playing an important role for the former but not the latter. IMPLICATIONS: This study addresses the need for longitudinal investigation of social mechanisms and cigarette use in the 30s. Findings reinforce efforts to prevent the uptake of cigarettes prior to the 30s because, once started, smoking is highly stable. But social environmental factors remain viable intervention targets in the 30s to disrupt this stability. Addressing personal norms about smoking's acceptability and social costs is likely a promising approach for combustible cigarette use. Electronic cigarettes, however, present a new challenge in that many perceived social costs of cigarette use do not readily translate to this relatively recent technology.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Fumadores/psicología , Cese del Hábito de Fumar/métodos , Medio Social , Vapeo/epidemiología , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Motivación , Autoinforme , Fumadores/estadística & datos numéricos , Reducción del Consumo de Tabaco , Encuestas y Cuestionarios , Estados Unidos/epidemiología
9.
Addiction ; 116(5): 1224-1232, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33140475

RESUMEN

BACKGROUND AND AIMS: There is a public health concern that the use of e-cigarettes among non-smoking young adults could be associated with transition to combustible cigarette use. The current study is a quasi-experimental test of the relationship between e-cigarette use and subsequent combustible cigarette use among young adult non-smokers, accounting for a wide range of common risk factors. DESIGN: Logistic regression was used to predict combustible cigarette use on three or more occasions at age 23 years based on age 21 e-cigarette use. Inverse probability weighting (IPW) was used to account for confounding variables. SETTING: Data were drawn from the Community Youth Development Study (CYDS), a cohort study of youth recruited in 2003 in 24 rural communities in seven US. states PARTICIPANTS: Youth in the CYDS study (n = 4407) were surveyed annually from ages 11 to 16, and at ages 18, 19, 21 and 23 years (in 2016). The sample was gender balanced (50% female) and ethnically diverse (20% Hispanic, 64% white, 3% black and 12% other race or ethnicity). The current study was limited to participants who had never used combustible cigarettes by age 21 (n = 1825). MEASUREMENTS: Age 21 use of e-cigarettes and age 23 use of combustible cigarettes (three or more occasions) were included in the regression analysis. Age 11-19 measures of 22 common predictors of both e-cigarette and combustible cigarette use (e.g. pro-cigarette attitudes, peer smoking, family monitoring) were used to create IPWs. FINDINGS: After applying IPW, e-cigarette use at age 21 was associated with a twofold increase in odds of combustible cigarette use on three or more occasions 2 years later (odds ratio = 2.16, confidence interval 1.23, 3.79). CONCLUSIONS: Among previously never-smoking US young adults, e-cigarette use appears to be strongly associated with subsequent combustible cigarette smoking, over and above measured preexisting risk factors.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Productos de Tabaco , Vapeo , Adolescente , Adulto , Niño , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Masculino , No Fumadores , Puntaje de Propensión , Adulto Joven
10.
Am J Prev Med ; 59(3): 309-316, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32654862

RESUMEN

INTRODUCTION: Rates of adolescent substance use have decreased in recent years. Knowing whether nonmedical marijuana legalization for adults is linked to increases or slows desirable decreases in marijuana and other drug use or pro-marijuana attitudes among teens is of critical interest to inform policy and promote public health. This study tests whether nonmedical marijuana legalization predicts a higher likelihood of teen marijuana, alcohol, or cigarette use or lower perceived harm from marijuana use in a longitudinal sample of youth aged 10-20 years. METHODS: Data were drawn from the Seattle Social Development Project-The Intergenerational Project, an accelerated longitudinal study of youth followed both before (2002-2011) and after nonmedical marijuana legalization (2015-2018). Analyses included 281 youth surveyed up to 10 times and living in a state with nonmedical marijuana legalization between 2015 and 2018 (51% female; 33% white, 17% African American, 10% Asian/Pacific Islander, and 40% mixed race or other). RESULTS: Multilevel modeling in 2019 showed that nonmedical marijuana legalization predicted a higher likelihood of self-reported past-year marijuana (AOR=6.85, p=0.001) and alcohol use (AOR 3.38, p=0.034) among youth when controlling birth cohort, sex, race, and parent education. Nonmedical marijuana legalization was not significantly related to past-year cigarette use (AOR=2.43, p=0.279) or low perceived harm from marijuana use (AOR=1.50, p=0.236) across youth aged 10-20 years. CONCLUSIONS: It is important to consider recent broad declines in youth substance use when evaluating the impact of nonmedical marijuana legalization. States that legalize nonmedical marijuana for adults should increase resources for the prevention of underage marijuana and alcohol use.


Asunto(s)
Cannabis , Fumar Marihuana , Productos de Tabaco , Adolescente , Consumo de Bebidas Alcohólicas , Niño , Femenino , Humanos , Legislación de Medicamentos , Estudios Longitudinales , Masculino , Fumar Marihuana/epidemiología , Fumar , Productos de Tabaco/legislación & jurisprudencia , Consumo de Alcohol en Menores , Adulto Joven
11.
J Adolesc Health ; 66(4): 416-422, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31987724

RESUMEN

PURPOSE: Adolescent handgun carrying is a behavioral marker for youth interpersonal conflicts and an intervention point for violence prevention. Our knowledge about the epidemiology of adolescent handgun carrying mainly pertains to urban settings. Evidence on the initiation age, cumulative prevalence, and longitudinal patterns of this behavior and on handgun-related norms and peer behavior among male and female rural adolescents is scant. METHODS: We used data from the control arm of the Community Youth Development Study, a community-randomized controlled trial of the Communities That Care prevention system. Annually, 1,039 males and 963 females were surveyed from Grade 6 (2005) to age 19 years (2012) in 12 rural towns across seven U.S. states. RESULTS: In Grade 6, 11.5% of males and 2.8% of females reported past-year handgun carrying. Between Grade 6 and age 19 years, 33.7% of males and 9.6% of females reported handgun carrying at least once. Among participants who ever reported handgun carrying, 34.0% of males and 29.3% of females did so for the first time in Grade 6. Among participants who ever reported handgun carrying, 54.6% of males and 71.7% of females did so only one time over the seven study assessments. Greater proportions of participants who reported handgun carrying than those who did not do so endorsed prohandgun norms and had a peer who carried among both males (Grade 10: prevalence difference = 57%; 95% CI: 46%-67%) and females (Grade 10: prevalence difference = 45%; 95% CI: 12%-78%). CONCLUSIONS: Rural adolescent handgun carrying is not uncommon and warrants etiologic research for developing culturally appropriate and setting-specific prevention programs.


Asunto(s)
Conducta del Adolescente , Armas de Fuego/estadística & datos numéricos , Población Rural , Adolescente , Adulto , Femenino , Humanos , Estudios Longitudinales , Masculino , Prevalencia , Distribución por Sexo , Encuestas y Cuestionarios , Estados Unidos , Violencia , Adulto Joven
12.
Prev Sci ; 20(6): 894-903, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31124023

RESUMEN

Although family-based prevention programs have been shown to be effective at reducing adolescent substance use, it is often difficult and costly to recruit and retain parents in programs administered in person. The current study tested whether program engagement and parenting practices could be improved by offering parents in a self-directed family program access to a private Facebook group. Parents of middle school children (N = 103) were recruited through paid Facebook ads to a 5-week self-directed teen substance use prevention program to be completed at home together by parents and their children. Two thirds of parents (N = 72) were randomly assigned to a moderated private Facebook group that provided a forum for parents in the study to interact with each other, and one third (N = 31) were randomized to use the intervention materials without additional support. Relatively few parents participated in the Facebook group and most did not find the experience useful. However, satisfaction with the program assessed 3 months after program completion was high among all parents and most parents engaged with the materials, irrespective of Facebook group assignment. Overall, parents reported significantly lower conflict and more household rules 6 months post-intervention compared to baseline. Parenting practices did not change more among those assigned to the Facebook group than among parents who used the materials on their own. The current findings suggest that providing opportunities for parents to interact online while participating in a self-directed family intervention may not help to increase engagement or improvements in parenting practices, particularly when few parents engage with each other.


Asunto(s)
Procesos de Grupo , Responsabilidad Parental , Medios de Comunicación Sociales , Adolescente , Conducta del Adolescente , Colorado , Humanos , Evaluación de Programas y Proyectos de Salud , Trastornos Relacionados con Sustancias/prevención & control , Encuestas y Cuestionarios , Washingtón
14.
Prev Sci ; 20(2): 235-245, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-29504048

RESUMEN

Permissive attitudes and norms about marijuana use and perceptions of low harm from use are considered risk factors for adolescent marijuana use. However, the relationship between risk and use may be reciprocal and vary across development and socializing domains. We examined the bidirectional relationships between marijuana-specific risk factors in individual, parent, peer, and community domains and adolescent marijuana use. Longitudinal data came from a sample of 2002 adolescents in 12 communities. Controlling for sociodemographic covariates and communities in which the individuals resided, autoregressive cross-lagged models examined predictive associations between the risk factors and marijuana use. After accounting for concurrent relationships between risk and use and stability in behavior over time, early adolescence and the transition to high school were particularly salient developmental time points. Specifically, higher risk in all four domains in grades 7 and 9 predicted greater use 1 year later. Moreover, youth's perception of lax community enforcement of laws regarding adolescent use at all time points predicted increases in marijuana use at the subsequent assessment, and perceived low harm from use was a risk factor that prospectively predicted more marijuana use at most of the time points. Finally, greater frequency of marijuana use predicted higher levels of risk factors at the next time point in most socializing domains throughout adolescence. Prevention programs should take into account developmental transitions, especially in early adolescence and during the transition to high school. They also should focus on the reciprocal relationships between use and risk across multiple socializing domains.


Asunto(s)
Conducta del Adolescente/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Abuso de Marihuana/epidemiología , Adolescente , Femenino , Humanos , Masculino , Fumar Marihuana/epidemiología , Uso de la Marihuana/epidemiología , Grupo Paritario , Factores de Riesgo , Conducta Social , Violencia/estadística & datos numéricos
15.
Am J Public Health ; 108(5): 659-665, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29565666

RESUMEN

OBJECTIVES: To evaluate whether the effects of the Communities That Care (CTC) prevention system, implemented in early adolescence to promote positive youth development and reduce health-risking behavior, endured through age 21 years. METHODS: We analyzed 9 waves of prospective data collected between 2004 and 2014 from a panel of 4407 participants (grade 5 through age 21 years) in the community-randomized trial of the CTC system in Colorado, Illinois, Kansas, Maine, Oregon, Utah, and Washington State. We used multilevel models to evaluate intervention effects on sustained abstinence, lifetime incidence, and prevalence of past-year substance use, antisocial behavior, and violence. RESULTS: The CTC system increased the likelihood of sustained abstinence from gateway drug use by 49% and antisocial behavior by 18%, and reduced lifetime incidence of violence by 11% through age 21 years. In male participants, the CTC system also increased the likelihood of sustained abstinence from tobacco use by 30% and marijuana use by 24%, and reduced lifetime incidence of inhalant use by 18%. No intervention effects were found on past-year prevalence of these behaviors. CONCLUSIONS: Implementation of the CTC prevention system in adolescence reduced lifetime incidence of health-risking behaviors into young adulthood. Clinicaltrials.gov identifier: NCT01088542.


Asunto(s)
Servicios de Salud Comunitaria/métodos , Trastorno de la Conducta Social , Trastornos Relacionados con Sustancias , Violencia , Adolescente , Conducta del Adolescente , Adulto , Niño , Femenino , Humanos , Incidencia , Masculino , Conducta de Reducción del Riesgo , Trastorno de la Conducta Social/epidemiología , Trastorno de la Conducta Social/prevención & control , Trastorno de la Conducta Social/terapia , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/prevención & control , Trastornos Relacionados con Sustancias/terapia , Estados Unidos , Violencia/prevención & control , Violencia/estadística & datos numéricos , Adulto Joven
16.
Eval Health Prof ; 41(2): 270-289, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29463119

RESUMEN

Earlier intention-to-treat (ITT) findings from a community-randomized trial demonstrated effects of the Communities That Care (CTC) prevention system on reducing problem behaviors among youth. In ITT analyses, youth were analyzed according to their original study community's randomized condition even if they moved away from the community over the course of follow-up and received little to no exposure to intervention activities. Using inverse probability weights (IPWs), this study estimated effects of CTC in the same randomized trial among youth who remained in their original study communities throughout follow-up. Data were from the Community Youth Development Study, a community-randomized trial of 24 small towns in the United States. A cohort of 4,407 youth was followed from fifth grade (prior to CTC implementation) to eighth grade. IPWs for one's own moving status were calculated using fifth- and sixth-grade covariates. Results from inverse probability weighted multilevel models indicated larger effects for youth who remained in their study community for the first 2 years of CTC intervention implementation compared to ITT estimates. These effects included reduced likelihood of alcohol use, binge drinking, smokeless tobacco use, and delinquent behavior. These findings strengthen support for CTC as an efficacious system for preventing youth problem behaviors.


Asunto(s)
Conducta del Adolescente , Servicios de Salud Comunitaria/organización & administración , Promoción de la Salud/organización & administración , Problema de Conducta , Adolescente , Consumo Excesivo de Bebidas Alcohólicas/epidemiología , Consumo Excesivo de Bebidas Alcohólicas/prevención & control , Niño , Servicios de Salud Comunitaria/estadística & datos numéricos , Femenino , Promoción de la Salud/estadística & datos numéricos , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/prevención & control , Uso de Tabaco/epidemiología , Uso de Tabaco/prevención & control , Estados Unidos/epidemiología
17.
Prev Sci ; 19(4): 559-569, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29116552

RESUMEN

Despite strong evidence that family programs are effective in preventing adolescent substance use, recruiting parents to participate in such programs remains a persistent challenge. This study explored the feasibility of using Facebook to recruit parents of middle school students to a self-directed family program to prevent adolescent drug use. The study used paid Facebook ads aiming to recruit 100 parents in Washington and Colorado using marijuana- or parenting-focused messages. All ad-recruited parents were also invited to refer others in order to compare Facebook recruitment to web-based respondent-driven sampling. Despite offering a $15 incentive for each successfully referred participant, the majority of the screened (70.4%) and eligible (65.1%) parents were recruited through Facebook ads. Yet, eligibility and consent rates were significantly higher among referred (76.6 and 57.3%, respectively) than Facebook-recruited parents (60.0 and 36.6%, respectively). Click-through rates on Facebook were higher for marijuana-focused than parenting-focused ads (0.72 and 0.65%, respectively). The final sample (54% Facebook-recruited) consisted of 103 demographically homogeneous parents (female, educated, non-Hispanic White, and mostly from Washington). Although Facebook was an effective and efficient method to recruit parents to a study with equal to better cost-effectiveness than traditional recruitment strategies, the promise of social media to reach a diverse population was not realized. Additional approaches to Facebook recruitment are needed to reach diverse samples in real-world settings and increase public health impact of family programs.


Asunto(s)
Conducta del Adolescente , Terapia Familiar , Selección de Paciente , Medios de Comunicación Sociales , Trastornos Relacionados con Sustancias/prevención & control , Adolescente , Adulto , Niño , Colorado , Comunicación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Responsabilidad Parental , Encuestas y Cuestionarios , Washingtón
18.
J Adolesc Health ; 61(6): 743-746, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28970063

RESUMEN

PURPOSE: Concern that asking about a specific behavior could elicit that behavior is often cited as a reason that communities and schools should not administer surveys about youth drug use. In this study, we investigated if this question-behavior effect exists related to substance use. We examined if simply asking a student about their current drug use leads to an increase in drug use 1 year later. METHOD: This study tests the validity of the question-behavior effect on youth drug use in a longitudinal panel of 2,002 elementary school students. The sample of students was drawn from the Community Youth Development Study, a community-randomized test of the Communities That Care prevention system. If the prevalence of self-reported drug use in sixth grade in a sample surveyed in fifth and sixth grades was higher than in an accretion sample surveyed only in sixth grade, the difference could indicate a question-behavior effect. RESULTS: Results from logistic regression analyses did not provide any evidence of a question-behavior effect on 30-day or lifetime prevalence of alcohol, tobacco, inhalant, or marijuana use reported in sixth grade. CONCLUSIONS: Asking youth about drug use in a survey did not increase the rates of self-reported drug use measured 1 year later. The absence of evidence of a question-behavior effect should ease concerns of communities and schools when administering surveys asking youth about their drug use.


Asunto(s)
Conducta del Adolescente , Autoinforme , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Adolescente , Consumo de Bebidas Alcohólicas/epidemiología , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Fumar Marihuana/epidemiología , Prevalencia , Asunción de Riesgos , Fumar/epidemiología , Estudiantes/psicología
19.
J Community Psychol ; 44(3): 391-398, 2016 04.
Artículo en Inglés | MEDLINE | ID: mdl-27872502

RESUMEN

For community-level approaches to preventing depression, measures of depression that are brief as well as valid are needed, particularly given competing demands in surveys for assessment of other outcomes including substance use, delinquency, and their associated risk factors. This study examined the validity of a four-item adolescent depression measure, the Communities That Care Brief Depression Scale (CTC-BDS). Data were from a survey of adolescents (N = 3,939) participating in the Community Youth Development Study (CYDS), a community-randomized trial involving 24 U.S. towns. The Patient Health Questionnaire nine-item (PHQ-9) was the criterion standard used to define major depressive disorder (MDD). Sensitivity and specificity of the CTC-BDS were both > .8 at a cutpoint of 6 and the area under the receiver operating characteristic curve was .91. Its strong psychometric properties and brevity make the CTC-BDS a useful measure for communities to monitor levels of youth depression.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...