Policy Recommendations for Meeting the Grand Challenge to Ensure Healthy Development for All Youth

This brief was created forSocial Innovation for America’s Renewal, a policy conference organized by the Center for Social Development in collaboration with the American Academy of Social Work & Social Welfare, which is leading theGrand Challenges for Social Work initiative to champion social progress. The conference site includes links to speeches, presentations, and a full list of the policy briefs

Long-Term Effects of Self-Control on Alcohol Use and Sexual Behavior among Urban Minority Young Women

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, a demographic group at elevated risk for negative outcomes related to sexual health. We tested whether psychosocial functioning measured at the beginning of high school predicted classes of risk behaviors when girls were tracked longitudinally into young adulthood. Latent class analysis indicated three distinct profiles based on high risk drinking and sexual behavior (i.e., multiple sex partners) in young adulthood. The largest class (73% of the sample) reported low levels of risky drinking and sexual behavior. The next largest class (19%) reported high risk drinking and low risk sexual behavior, and the smallest class (8%) reported high levels of both behaviors. Compared to women from other racial/ethnic groups, black women were more likely to be categorized in the high risk drinking/low risk sex class. Multinomial logistic regression indicated that self-control in adolescence had a broad and enduring protective effect on risk behaviors eight years later and was associated with a greater probability of being in the low risk drinking/low risk sex class. Findings are discussed in terms of understanding the phenotypic expressions of risk behavior as they relate to early psychosocial development and the long-term protective function of self-control in reducing high risk drinking and sexual behaviors

Preventing Daily Substance Use among High School Students Using a Cognitive-Behavioral Competence Enhancement Approach

The present study tested the effectiveness of a substance abuse prevention program for deterring tobacco, alcohol, and marijuana use among high school students. The prevention program teaches social resistance skills and general personal and social competence skills. Rates of substance use behavior were examined among students (N = 452) from 12 public high schools that were randomly assigned to either receive the prevention program (5 schools, n = 196) or serve as a treatment-as-usual control group (7 schools, n = 256). The impact of the prevention program was tested using composite indicators of daily substance use based on items measuring the frequency of smoking, drinking, drunkenness, marijuana use, and marijuana intoxication. Data were analyzed using generalized estimating equations to adjust for school-level clustering. Comparison of the posttest adjusted means (controlling for school clustering, gender, race/ethnicity, and family structure) revealed that the intervention produced significant prevention effects on daily substance use, both in terms of a daily polysubstance use index and the proportion of daily substance users across experimental condition. Findings indicated that there were 52% fewer daily substance users in the intervention condition compared to controls. Conclusions drawn from this study are that: (1) daily substance use can be prevented in high school students using a competence enhancement approach that addresses key risk and protective factors; (2) prevention approaches that are effective for middle school students can also be effective for high school students, if adapted to be developmentally appropriate; and (3) universal prevention approaches delivered by classroom teachers with minimal specialized training offer the potential for widespread dissemination and a cost-effective approach to an important public health problem

Onset of the Non-Medical Use of Prescription and Over-the-Counter Medications during Early Adolescence: Comparison with Alcohol, Tobacco, and Marijuana

This study examined the prevalence and psychosocial predictors of the non-medical use of prescription and over-the-counter (OTC) medications and compared these to cigarette, marijuana, and alcohol use in a cohort of early adolescents (N = 1887) aged 11 to 13, a critical risk period for the initiation of substance use. Participants were students attending 22 middle schools in the northeastern United States. Participants completed surveys in the classroom, the first in the sixth grade and a second in the seventh grade, and the rate of overall substance use more than doubled from 5.5% to 11.9% over this period. Predictors of the onset of non-medical prescription and over-the-counter drug misuse overlapped substantially with those for marijuana and other substances. The perception of friends’ substance use and the belief that substance use can help you deal with problems predicted the onset of marijuana use, OTC medication misuse, and prescription drug misuse. Decision-making skills were protective for the onset of all substance use outcomes. The findings of this study have important implications for prevention and suggest that a single comprehensive approach may be sufficient for preventing multiple forms of substance use onset during early adolescence