Prevalence of emergency contraceptive pill use among Spanish adolescent girls and their family and psychological profiles.

BACKGROUND: Adolescent girls' family context and psychological characteristics play important roles in their sexual behavior, including the use of the emergency contraceptive pill (ECP). This study aims to (1) determine the prevalence of ECP use among girls who have had sexual intercourse and (2) comparatively analyze their family and psychological profiles according to whether they have used ECPs. METHODS: The sample of 1735 Spanish girls aged 15 to 18 came from a representative sample of the 2014 edition of the Health Behaviour in School-aged Children (HBSC) study. Of this sample, 398 girls had sexual intercourse and reported their ECP use. Data collection for the HBSC study was performed through an online questionnaire to which adolescents responded anonymously in school. Data analyses were descriptive and bivariate and were performed with the statistical program IBM SPSS Statistics 23. RESULTS: The results demonstrated that 30.65% of girls who had sexual intercourse used ECPs. Noticeable differences in paternal knowledge and communication with the father were observed between girls who used the ECP at least once and those who did not use it. In contrast, differences between girls who used the ECP once and those who used it twice or more were pronounced with regard to parental knowledge, communication with parents, maternal affection, life satisfaction, sense of coherence and depression. CONCLUSIONS: This work demonstrates a high prevalence of ECP use and a more positive family and psychological profile for girls who used ECP once compared with those who used it twice or more.

Social Support from Developmental Contexts and Adolescent Substance Use and Well-Being: A Comparative Study of Spain and Portugal.

The aim of this study was to analyse the contribution of social support from family, friend and school (teacher and classmate) contexts in substance use (tobacco and alcohol use) and well-being (life satisfaction and health-related quality of life). Participants were 5,784 Portuguese and 22,610 Spanish adolescents aged 11 to 16 years, from the 2014 edition of the Health Behavior in School-aged Children (HBSC) study in Portugal and Spain. Results showed that for a higher life satisfaction, family (p < .001, partial η2 = .032), teacher (p < .001, partial η2 = .018) and classmate (p < .001, partial η2 = .031) support were important in Portugal, and family (p < .001, partial η2 = .056) and friend (p < .001, partial η2 = .015) support in Spain. Similarly, for a better health-related quality of life, all the social support variables were relevant in Portugal (family: p < .001, partial η2 = .063; teacher: p < .001, partial η2 = .032; classmate: p < .001, partial η2 = .054; friend: p < .001, partial η2 = .034) and in Spain (family: p < .001, partial η2 = .054; teacher: p < .001, partial η2 = .014; classmate: p < .001, partial η2 = .018; friend: p < .001, partial η2 = .040). In contrast, only family support (p < .001, partial η2 = .014) was relevant in Portugal for tobacco use. Therefore, social support was more relevant for adolescent well-being than for adolescent substance use, and the most relevant source of support was family support, in both Spain and Portugal.

Social support from developmental contexts and adolescent substance use and well-being: a comparative study of Spain and Portugal

The aim of this study was to analyse the contribution of social support from family, friend and school (teacher and classmate) contexts in substance use (tobacco and alcohol use) and well-being (life satisfaction and health-related quality of life). Participants were 5,784 Portuguese and 22,610 Spanish adolescents aged 11 to 16 years, from the 2014 edition of the Health Behavior in School-aged Children (HBSC) study in Portugal and Spain. Results showed that for a higher life satisfaction, family (p < .001, partial η2 = .032), teacher (p < .001, partial η2 = .018) and classmate (p < .001, partial η2 = .031) support were important in Portugal, and family (p < .001, partial η2 = .056) and friend (p < .001, partial η2 = .015) support in Spain. Similarly, for a better health-related quality of life, all the social support variables were relevant in Portugal (family: p < .001, partial η2 = .063; teacher: p < .001, partial η2 = .032; classmate: p < .001, partial η2 = .054; friend: p < .001, partial η2 = .034) and in Spain (family: p < .001, partial η2 = .054; teacher: p < .001, partial η2 = .014; classmate: p < .001, partial η2 = .018; friend: p < .001, partial η2 = .040). In contrast, only family support (p < .001, partial η2 = .014) was relevant in Portugal for tobacco use. Therefore, social support was more relevant for adolescent well-being than for adolescent substance use, and the most relevant source of support was family support, in both Spain and Portugal (AU)

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Revisión teórica sobre el conocimiento parental en la adolescencia a partir de los trabajos realizados dentro del marco del estudio HBSC-España / No disponible

El conocimiento parental es una dimensión familiar relevante en la etapa evolutiva de la adolescencia. Esta dimensión familiar ha sido uno de los objetos de análisis dentro del equipo español del estudio Health Behaviour in School-aged Children (HBSC). El objetivo de este trabajo es realizar una revisión teórica de los principales trabajos publicados y llevados a cabo dentro del estudio HBSC en España en relación con el conocimiento parental. Estos trabajos han permitido estudiar la evolución del conocimiento parental en diferentes ediciones 2002, 2006, 2010 y 2014 del estudio HBSC, analizar las dimensiones familiares implicadas en que padres y madres consigan conocimiento sobre sus hijos e hijas adolescentes y examinar las posibles repercusiones del conocimiento parental sobre el consumo de sustancias y el bienestar de los chicos y las chicas adolescentes. Por tanto, estos trabajos han contribuido a ampliar el conocimiento científico y aportar interesantes implicaciones prácticas en torno al conocimiento parental en la adolescencia

Parental knowledge is a relevant family dimension in the developmental stage of adolescence. This family dimension has been one of the objects of analysis within Spanish team of the Health Behaviour in School-aged Children (HBSC) study. The aim of this work is to do a theoretical revision of the main published works and carried out within the HBSC study in Spain in relation with parental knowledge. These works have allowed to study the evolution of parental knowledge in different editions 2002, 2006, 2010 and 2014 of the HBSC study, to analyze family dimensions involved in that fathers and mothers get knowledge about their adolescent children, and to examine possible consequences of parental knowledge on adolescent boys’ and girls’ substance use and well-being. Therefore, these works have contributed to increase scientific knowledge and to provide with interesting practical implications about parental knowledge in adolescence

La influencia de las diferencias entre el padre y la madre sobre el ajuste adolescente / The influence of differences between father and mother on adolescent adjustment

Este trabajo se centra en analizar cómo influyen en el consumo de sustancias (tabaco, alcohol y cannabis) y el bienestar psicológico adolescente (calidad de vida relacionada con la salud y satisfacción vital) las diferencias entre el padre y la madre en afecto, promoción de la autonomía, revelación, interés y conocimiento. La muestra estuvo compuesta por 10170 chicos y chicas españoles de 13 a 18 años de familias biparentales que participaron en la edición 2006 del estudio Health Behaviour in School-aged Children (HBSC). Los resultados mostraron que los adolescentes que indicaron que su padre y madre coincidían en presentar altos niveles en las dimensiones familiares analizadas consumieron menos sustancias y tuvieron mejor bienestar psicológico. Por el contrario, el ajuste de los adolescentes cuyos progenitores (padre y madre) tenían bajos niveles en esas dimensiones familiares fue peor. Concretamente, la dimensión más importante para el consumo de sustancias fue el conocimiento parental y para el bienestar psicológico lo fue el afecto parental; la revelación adolescente solo fue relevante para el consumo de alcohol y la calidad de vida, mientras que la promoción parental de la autonomía lo fue para la calidad de vida

This paper analyzes how the differences between father and mother in affection, promotion of autonomy, disclosure, solicitation and knowledge influence on substance use (tobacco, alcohol and cannabis) and psychological well-being (health-related quality of life and life satisfaction).The sample was composed of 10170 boys and girls aged 13 to 18 years from two-parent families who participated in 2006 edition of Health Behaviourin School-aged Children (HBSC) study. Results indicated that adolescents whose both parents had high values for the different family dimensions used less substance and scored higher in psychological well-being. In contrast, the adjustment of adolescents whose both parents had low values for the different family dimensions was worse. Specifically, the most important dimension for substance use was parental knowledge and for psychological well-being was parental affection; adolescent disclosure was only relevant for alcohol use and quality of life, and parental promotion of autonomy for quality of life

Perceived quality of social relations and frequent drunkenness: a cross-sectional study of Spanish adolescents.

AIM: The aim of the study was to examine, for female and male students separately, whether perceived quality of relationships with peers and parents and relations in school predict self-reported frequent drunkenness among Spanish adolescents. METHODS: The Spanish data from the Health Behaviour in School-aged Children Study (HBSC) 2010 survey were used including 1177 female and 1126 male students aged between 15 and 16 years. RESULTS: For both genders, students reporting low school satisfaction had increased odds of frequent drunkenness. Among females, low and medium levels of classmate support were associated with decreased odds of frequent drunkenness, whereas low perceived maternal knowledge as well as medium and low satisfaction with the family increased odds of being frequently drunk. The proportion of male students reporting medium satisfaction with friendships had significantly lower odds of frequent drunkenness compared with those with high level of satisfaction with friendships. CONCLUSION: We found different associations between perceived quality of social relations and frequent drunkenness among male and female students. Results showed that social relations seemed to better predictors of frequent drunkenness among female than male students and that other factors than social relations may contribute to explain excessive alcohol use among Spanish adolescents.

Understanding the joint effects of family and other developmental contexts on the sense of coherence (SOC): a person-focused analysis using the Classification Tree.

Using a person-focused approach, the present study sought to identify meaningful constellations of contextual factors that led to predominantly high and low levels of sense of coherence (SOC). Specifically, the contributions of the quality of parent-child relationships, teacher and classmate support, models of behaviour in the peer group, and neighbourhood assets were examined in a representative sample of Spanish adolescents aged 13 to 18 that had taken part in the 2010 edition of the study Health Behaviour in School-aged Children. The quality of parent-child relationships emerged as the main predictor of SOC for the whole sample, but the remaining factors also made significant contributions, which underlines the importance of the simultaneous analysis of the main contexts in adolescents' lives. Additionally, the identified constellations usually included compensatory effects, so no factor should be considered to be completely determining. Interestingly, the role of support at school was different depending on contextual profiles.

Sense of coherence and substance use in Spanish adolescents. Does the effect of SOC depend on patterns of substance use in their peer group?

The aims of this work were to analyse the relationships between sense of coherence (SOC) and substance use among Spanish adolescents and to examine the potential moderator effect of the patterns of substance use in the peer group. Sample consisted of 5475 Spanish adolescents aged 15 to 18 from the 2010 edition of the Health Behaviour in School-aged Children (HBSC) study. Statistical analysis included cluster analysis to identify groups of adolescents according to their peer group's patterns of substance use and logistic regression with SOC and peers' pattern of consumption as predictors of current tobacco use, current alcohol use, life-time drunkenness and current drunkenness. The results showed that a strong SOC seemed to reduce the adolescents' likelihood of involving in tobacco use and drunkenness, but it was not associated with being a current drinker. In addition, the protective effect of SOC was moderated by peers' patterns of substance use. Specifically, SOC had a significant protective influence in adolescents whose peer group showed either a nonconsumption pattern or a pattern of frequent alcohol use and occasional drunkenness; but the protective effect of SOC disappeared if peers showed a pattern of consumption that included illegal drugs. In conclusion, SOC tends to act as a protective personal variable with respect to substance use during adolescence, but the influence exerted by the peer group seems to moderate the aforementioned protective effect of SOC.

Sentido de coherencia y consumo de sustancias en adolescentes españoles. ¿Depende el efecto del SOC de los patrones de consumo de sustancias del grupo de iguales? / Sense of coherence and substance use in Spanish adolescents. Does the effect of SOC depend on patterns of substance use in their peer group?

Los objetivos de este trabajo fueron analizar las relaciones entre el sentido de coherencia (SOC) y el consumo de sustancias en los adolescentes españoles y el potencial efecto moderador de los patrones de consumo de sustancias en el grupo de iguales en dicha relación. La muestra constaba de 5475 adolescentes españoles de 15 a 18 años, participantes en la edición 2010 del estudio Health Behaviour in School-aged Children (HBSC). Los análisis estadísticos consistieron en análisis de cluster, para identificar grupos de adolescentes según los patrones de consumo de sustancias en su grupo de iguales, y regresión logística, con el SOC y los patrones de consumo en el grupo de iguales como predictores del consumo actual de tabaco y alcohol, episodios de embriaguez alguna vez en la vida y en la actualidad. Los resultados mostraron que un fuerte SOC parecía reducir la probabilidad de consumo de tabaco y episodios de embriaguez, pero no se asoció con el consumo actual de alcohol. Además, el efecto protector del SOC estaba moderado por los patrones de consumo del grupo de iguales. En concreto, el SOC tuvo un efecto protector significativo en los adolescentes cuyo grupo de iguales mostraba un patrón de no consumo o de frecuente consumo de alcohol y episodios de embriaguez ocasionales, pero el efecto del SOC desapareció si el patrón de consumo de los iguales incluía drogas ilegales. En conclusión, el SOC tiende a actuar como un factor protector individual respecto al consumo de sustancias durante la adolescencia, pero la influencia del grupo de iguales parece moderar dicho efecto protector del SOC (AU)

The aims of this work were to analyse the relationships between sense of coherence (SOC) and substance use among Spanish adolescents and to examine the potential moderator effect of the patterns of substance use in the peer group. Sample consisted of 5475 Spanish adolescents aged 15 to 18 from the 2010 edition of the Health Behaviour in School-aged Children (HBSC) study. Statistical analysis included cluster analysis to identify groups of adolescents according to their peer group’s patterns of substance use and logistic regression with SOC and peers’ pattern of consumption as predictors of current tobacco use, current alcohol use, life-time drunkenness and current drunkenness. The results showed that a strong SOC seemed to reduce the adolescents’ likelihood of involving in tobacco use and drunkenness, but it was not associated with being a current drinker. In addition, the protective effect of SOC was moderated by peers’ patterns of substance use. Specifically, SOC had a significant protective influence in adolescents whose peer group showed either a non consumption pattern or a pattern of frequent alcohol use and occasional drunkenness; but the protective effect of SOC disappeared if peers showed a pattern of consumption that included illegal drugs. In conclusion, SOC tends to act as a protective personal variable with respect to substance use during adolescence, but the influence exerted by the peer group seems to moderate the aforementioned protective effect of SOC (AU)

Analysis of the importance of family in the development of sense of coherence during adolescence.

AIMS: The aim of this work was to study the influence of several family dimensions on sense of coherence (SOC) in adolescence, controlling the possible effects from the demographic variables, gender and age. METHODS: The sample consisted of 7580 adolescents between the ages of 13 and 18, who had taken part in the 2010 edition of the WHO Health Behaviour in School-aged Children study in Spain. RESULTS: The results showed that there were no significant gender differences in SOC levels. However, age had a significant influence on SOC. Higher levels of SOC were found in adolescents aged 13 and 14 compared to older participants. Family variables explained 18% of SOC variability, with affection, easy communication with parents, and parental knowledge as the most outstanding variables. In addition, positive relationships between parents and family affluence had a significant role in explaining SOC levels. CONCLUSIONS: The results suggest that the family context plays an important role in providing meaningful experiences for the development of a strong SOC in adolescence.

Análisis de clúster de la actividad física y las conductas sedentarias de los adolescentes españoles, correlación con la salud biopsicosocial / Cluster analysis of the physical activity and sedentary behaviour of spanish adolescents with respect to their biopsychosocial health

Esta investigación forma parte de la edición 2006 el estudio Health Behavior in School-aged Children (HBSC). Los datos que se presentan constituyen una muestra de 21811 adolescentes españoles de 11 a 18 años. Realizando análisis de clúster, Modelo Lineal General, pruebas de significación y tamaños de efecto, se obtiene información relevante acerca de los hábitos de actividad física y sedentarismo de los adolescentes españoles, evidenciando la situación de riesgo de los adolescentes mayores, especialmente en el caso de las chicas. Estos resultados tienen la fortaleza de relacionarse con una puntuación global de salud, obteniéndose indicadores claros de las ventajas que supone para los adolescentes un estilo de vida activo. Además, estos datos aportan información de interés en relación con la hipótesis de desplazamiento, muy discutid a en la literatura científica. En definitiva, este trabajo aporta claves interesantes para el debate teórico y para la intervención práctica en el campo de la actividad física durante la adolescencia (AU)

This study is part of the 2006 edition of the Health Behaviour in School-Aged Children (HBSC) study. The data presented was drawn from a sample of 21,811 Spanish adolescents ranging from 11 to 18 years of age. Through a cluster analysis, General Lineal Model, significance and effect size tests, we obtained relevant information about the physical activity habits and sedentary behaviours of Spanish adolescents. It is evident that there is a risk situation in older adolescents, especially girls. These results have the advantage of relating to a global health score; clear indicators of the advantages of an active lifestyle for adolescents were obtained. Furthermore, these data provide information that is relevant to the displacement hypothesis, which is widely discussed in the scientific literature. In short, this paper provides interesting keys for theoretical debate and practical action in the field of physical activity during adolescence (AU)

Iguales, familia y participación en actividades deportivas organizadas durante la adolescencia / Peers, family and participation in organized sport activities during adolescence

El objetivo de este trabajo es examinar la influencia de la presencia de la actividad deportiva en el grupo de iguales y la familia en la frecuencia con que los adolescentes realizan actividades deportivas organizadas. Se empleó una muestra de 9821 adolescentes escolarizados españoles de entre 11 y 18 años procedentes de la edición 2010 del Estudio internacional Health Behaviour in School-aged Children (HBSC). Los resultados obtenidos mediante análisis multivariante de Answer Tree, indican que el género fue el mejor predictor de la actividad deportiva organizada, siendo la participación notablemente mayor en los chicos. En cuanto al papel del resto de variables, la presencia de la actividad deportiva en el grupo de iguales y las actividades familiares fueron las variables más influyentes en los chicos. En las chicas, en cambio, la edad surgió como primer factor y la influencia de familia y grupo de iguales fue distinta dependiendo de la edad. En conclusión, familia e iguales parecen ser influencias significativas en la implicación en actividades deportivas, aunque su papel es distinto dependiendo del género y la edad del adolescente (AU)

This study aimed to examine the influence of sport activities by peer groups and the family on the frequency of adolescents’ participation in organized sport activities. A sample of 9,821 Spanish adolescent schoolchildren between the ages of 11 and 18 from the 2010 edition of the international study on Health Behaviour in School-Aged Children (HBSC) was used. The results obtained by means of an Answer Tree multivariate analysis indicated that gender was the best predictor of organized sport activity, with participation being notably higher in boys. As for the role of other variables, the practice of sport in peer and family activities were the most influential variables for boys. On the contrary, in the girls’ case, age appeared as the first factor and the influence of sport in family activities and the peer group was different depending on age. In conclusion, family and peers seem to be significant influences on involvement in sport, despite having different roles according to the adolescents’ gender and age (AU)

Parental knowledge and adolescent adjustment: substance use and health-related quality of life.

This study analyses two models (maternal and paternal) in which parental care and sources of parental knowledge moderated the relationship between parents' knowledge about their adolescents' lives and adolescents' substance use and health-related quality of life. The sample was made up of 15942 Spanish adolescents who participated in the 2006 edition of Health Behavior in School-aged Children Study. Results showed that increased parents' knowledge about their adolescents' lives reduced adolescents' substance use and increased their quality of life. With respect to the moderation relationship, a limited effect was found. However, parental care and sources of parental knowledge used by both parents generally had main effects on adolescents' substance use and health-related quality of life, with care being the most relevant variable in the health-related quality of life, while knowledge was the most relevant one for substance use.

Parental knowledge and adolescent adjustment: substance use and health-related quality of life

This study analyses two models (maternal and paternal) in which parental care and sources of parental knowledge moderated the relationship between parents’ knowledge about their adolescents’ lives and adolescents’ substance use and health-related quality of life. The sample was made up of 15942 Spanish adolescents who participated in the 2006 edition of Health Behavior in School-aged Children Study. Results showed that increased parents’ knowledge about their adolescents’ lives reduced adolescents’ substance use and increased their quality of life. With respect to the moderation relationship, a limited effect was found. However, parental care and sources of parental knowledge used by both parents generally had main effects on adolescents’ substance use and health-related quality of life, with care being the most relevant variable in the health-related quality of life, while knowledge was the most relevant one for substance use (AU)

Este trabajo analiza dos modelos (materno y paterno) en los que el afecto parental y los procedimientos de obtención del conocimiento parental moderaron la relación entre el conocimiento que los padres tenían sobre la vida de sus hijos adolescentes con el consumo de sustancias y la calidad de vida relacionada con la salud de éstos. La muestra estuvo compuesta por 15.942 adolescentes españoles que participaron en la edición 2006 del estudio Health Behavior in School-Aged Children. Los resultados mostraron que el conocimiento que los padres tenían sobre las vidas de sus hijos redujo su consumo de sustancias e incrementó su calidad de vida. Respecto a las relaciones de moderación, se encontró que tenían un efecto pequeño, aunque el afecto parental y los procedimientos de obtención del conocimiento parental utilizados por ambos progenitores, tuvieron efectos principales sobre las variables de consumo de sustancias y calidad de vida, siendo el afecto la variable más relevante en la calidad de vida relacionada con la salud, mientras que el conocimiento lo fue para el consumo de sustancias (AU)

Una aproximación a la evaluación de la eficacia de un programa de prevención de drogodependencias en Educación Secundaria en Andalucía / An approach to the assessment of the effectiveness of a drug use prevention program in Secondary Education in Andalusia

El presente artículo se centra en el análisis del consumo de sustancias de los escolares andaluces de los cuatro cursos de Educación Secundaria Obligatoria de dos estudios diferentes: el Estudio Health Behaviour in School-aged Children (HBSC) en su edición de 2006 y un estudio que evalúa la implementación del programa Prevenir para vivir en el ámbito educativo. Para ello, analiza, por un lado, el consumo de tabaco, alcohol y cannabis de todos los adolescentes andaluces de secundaria del Estudio HBSC, y, por otro, selecciona a dos grupos de adolescentes escolarizados para examinar y comparar su consumo: un grupo de adolescentes del Estudio HBSC que no había formado parte de ningún programa de prevención de drogodependencias y en cuyos centros educativos no había personal que hubiera recibido formación en estos temas (llamado grupo control del HBSC) y otro grupo que había formado parte del programa de prevención de drogodependencias Prevenir para vivir y lo había hecho, además, con personal especializado (denominado grupo experimental Prevenir para vivir). Los resultados indican, por un lado, un mayor consumo en todas las sustancias en los cursos más altos de la Secundaria; y, por otro, al comparar a ambos grupos, no siempre se observa la tendencia de ser los adolescentes que han recibido programas de prevención de drogodependencias con personal especializado los que presentan con más frecuencia un patrón de consumo más saludable. Por lo que, estos resultados deben interpretarse como un apoyo limitado a los programas de prevención de drogodependencias (AU)

This article examines the analysis of drug use among Secondary Education students in Andalusia from two different studies: the Health Behavior in School-aged Children Study (HBSC), in its 2006 edition, and a study assessing the implementation of the Prevenir para Vivir (“Prevent to Live”) drug use prevention program in the education field. To this end, on the one hand the paper analyzes the use of tobacco, alcohol and cannabis among Andalusian adolescents on the HBSC Study, and on the other, selects two groups of adolescents to examine and compare their drug use: a group from the HBSC Study who had not participated in any drug use prevention program and in whose schools the staff had not received training in relation to these issues (called HBSC Control Group),and a group of adolescents who had participated in the Prevenir para Vivir drug use prevention program working with specialized staff (called Prevenir para Vivir Experimental Group). The results indicate, first, higher levels of drug use in older students than in younger ones; and, second, on comparing the two groups, that adolescents who have received drug prevention programs with specialized staff are not always those most likely to present healthier drug use. These results must therefore be interpreted as offering only limited support to drug use prevention programs (AU)

[An approach to the assessment of the effectiveness of a drug use prevention program in secondary education in Andalusia]. / Una aproximación a la evaluación de la eficacia de un programa de prevención de drogodependencias en Educación Secundaria en Andalucía.

This article examines the analysis of drug use among Secondary Education students in Andalusia from two different studies: the Health Behavior in School-aged Children Study (HBSC), in its 2006 edition, and a study assessing the implementation of the Prevenir para Vivir ("Prevent to Live") drug use prevention program in the education field. To this end, on the one hand the paper analyzes the use of tobacco, alcohol and cannabis among Andalusian adolescents on the HBSC Study, and on the other, selects two groups of adolescents to examine and compare their drug use: a group from the HBSC Study who had not participated in any drug use prevention program and in whose schools the staff had not received training in relation to these issues (called HBSC Control Group), and a group of adolescents who had participated in the Prevenir para Vivir drug use prevention program working with specialized staff (called Prevenir para Vivir Experimental Group). The results indicate, first, higher levels of drug use in older students than in younger ones; and, second, on comparing the two groups, that adolescents who have received drug prevention programs with specialized staff are not always those most likely to present healthier drug use. These results must therefore be interpreted as offering only limited support to drug use prevention programs.