The power of local research to inform adverse childhood experiences in substance use prevention in adolescents and adults.

BACKGROUND: The impact of adverse childhood experiences on substance use has been well reported, however, less well documented is looking at the comparison of youth and adult substance use and their respective adverse childhood experiences. This study leveraged local data sources to support prevention efforts inside a state-level working group and examined research questions that explored the relationship between reported adverse childhood experiences and substance use for youth and adult samples at the state level. METHODS: This study conducted a series of logistic regression models (95% CI) between substance use outcomes with different age group populations to investigate the relationship between adverse childhood experiences and substance use for each group. Adverse childhood experiences scores and substance use were examined using two Arizona datasets: 1) Arizona Youth Survey (n = 42,009) and 2) the Behavioral Risk Factor Surveillance System (n = 5328). RESULTS: The results of youth and adult datasets were consistent: users with adverse childhood experiences scores of 4 to 6 had a positive association with more substance use. When the variables were examined, showing the entire sample of youth and adult groups compared to those subgroups with a score of zero, a score of 1 to 3, and a score of 4 to 6, the overall pattern was the same; the more frequent use of substances was directly associated to the group with higher scores. Additionally, findings support increased attention on prevention and intervention efforts with higher reports of adverse childhood experiences as well as substance use. CONCLUSIONS: These findings demonstrate how local research can help prioritize prevention resources and increase the value of data-based decision-making. Policy-makers and providers can examine youth and adult data to compare priorities and assess for planning purposes. Specifically, it is possible to replicate known research findings, identify the most impacted subpopulations, and forecast the community's future needs.

Racial Disparities in School Lunch Program Participation and Cigarette Use: Evidence from Arizona Youth Survey Data.

Background: Cigarette and other tobacco product use among youth has become a serious public health issue in the United States. Thus, it is important to understand the social and contextural factors of cigarette use, especially for the young population. This study explores the relationship between participation in the National School Lunch Program (NSLP) and youth cigarettes use. Further, this study examines how this relationship differs across racial/ethnic groups. Methods: The 2016 Arizona Youth Survey (n = 34,373) data and multivariate logistic regressions were used to examine the association between NSLP participation (free and reduced-cost) and youth cigarette use, both lifetime and past 30-day smoking behaviors. In addition, subgroup analyses were conducted to test the racial disparities in NSLP participation and cigarette use. Results: Results showed that free lunch participation was associated with significantly higher odds of youth cigarette use, both lifetime (OR = 1.25; p < .001) and in the past 30-days (OR = 1.14; p < .05). However, reduced-cost lunch participation was associated with significantly higher odds only for lifetime cigarette use (OR = 1.20; p < .01). Subgroup analyses revealed differences across the six racial/ethnic groups. White and Latinx youth showed a significant relationship between NSLP participation and lifetime cigarette smoking, whereas only Latinx youth showed a significant relationship between NSLP participation and past 30-day smoking. Implications: The findings suggest that intervention approaches to smoking cessation and prevention should be tailored to different racial/ethnic groups to account for their differences. Given the findings that youth (especially Latinxs) who participate in free and reduced-cost lunch programs are at a higher risk of using cigarettes than youth who do not, this study suggests that health intervention programs can enhance their reach and effectiveness by building partnerships with schools with sizable NSLP programs.