Adolescent - perceived maternal relationship during adolescence and pap smears during young adulthood

We examined racial and ethnic disparities and whether adolescent-perceived maternal relationship quality was associated with pap smear uptake among women emerging adulthood. Longitudinal data were derived from 7,224 emerging adult women who participated in the National Longitudinal Study of Adolescent Health (Add Health) waves I and III. Women who were older, non-Hispanic white, born in the U.S., had higher education and health insurance were more likely to report pap smears (p\u3c0.05). In crude and multivariable regression analyses, every one unit increase in maternal relationship quality was associated with an increase in odds of pap smear uptake OR=1.14, 95% CI [1.03-1.28] and OR=1.11, 95% CI [1.00-1.24], respectively. This study contributes to the literature by evaluating adolescent-perceived maternal relationship quality as a predictor of preventive health decision-making in women emerging adulthood. These results suggest that women with higher quality maternal relationships were more likely to adhere to cervical cancer screening guidelines

Prevalence and correlates of alcohol and tobacco use among pregnant women in the United States: evidence from the NSDUH 2005–2014

Alcohol and tobacco use during pregnancy are among the strongest and most preventable risk factors for adverse neonatal health outcomes, but few developmentally sensitive, population-based studies of this phenomenon have been conducted. To address this gap, the present study examined the prevalence and correlates of alcohol and tobacco use among pregnant adolescents (aged 12–17) and adults (aged 18–44) in the United States. Data were derived from the population-based National Survey of Drug Use and Health (80,498 adolescent and 152,043 adult women) between 2005 and 2014. Findings show disconcerting levels of past-month use among pregnant women with 11.5% of adolescent and 8.7% of adult women using alcohol, and 23.0% of adolescent and 14.9% of adult women using tobacco. Compared to their non-pregnant counterparts, pregnant adolescents were less likely to report past 30-day alcohol use (AOR = 0.52, 95% CI = 0.36–0.76), but more likely to report past 30-day tobacco use (AOR = 2.20, 95% CI = 1.53–3.18). Compared to their non-pregnant adult counterparts, pregnant adults were less likely to report using alcohol (AOR = 0.06, 95% CI = 0.05–0.07) and tobacco (AOR = 0.47, 95% CI = 0.43–0.52). Compared to pregnant abstainers, pregnant women reporting alcohol/tobacco use were more likely to have had a major depressive episode in the past 12 months, report criminal justice system involvement, and endorse comorbid alcohol/tobacco use. Given alcohol and tobacco's deleterious consequences during pregnancy, increased attention to reducing use is critical. Findings suggest that tobacco use is especially problematic for both adolescents and adults and is strongly linked with depression and criminal justice involvement, especially among adults

Attacks intended to seriously harm and co-occurring drug use among youth in the United States

BACKGROUND: While it is known that substance use and violence co-occur, less is understood in terms of how this relationship might vary based on the degree of youth involvement in violence. OBJECTIVES: This study sought to examine the prevalence and degree that substance use disorders (SUD) and related intrapersonal and contextual factors were associated with violent attacks. METHOD: Repeated cross-sectional data from a population-based study (National Survey on Drug Use and Health) of youth ages 12–17 (n = 216,852) in the United States between 2002 and 2013 were pooled to increase the analytic sample size. Survey multinomial regression was used to examine psychosocial and substance use differences between youth reporting episodic (1–2 times, n = 13,091; 5.84%) and repeated violent attacks (3+ times, n = 1,819; 0.83%) in contrast with youth reporting no attacks. Additional analyses examined the association of sociodemographic, intrapersonal, and contextual factors with SUD among youth reporting violent attacks. RESULTS: The prevalence of SUD among youth with no attacks was 6% compared to 22% among episodic and 36% among repeatedly violent youth. Violence-involved youth were substantially more likely to experience elevated sensation-seeking, easy drug access, and recent drug offers and less likely to benefit from religiosity and protective substance use beliefs. CONCLUSIONS/IMPORTANCE: Findings highlight the importance of distinguishing between the various gradations of violence among youth in understanding the relationship between substance use and violence, and shed light on the intrapersonal and contextual factors that can help identify violent youth at greatest risk for substance use problems

Age-related changes in the relationship between alcohol use and violence from early adolescence to young adulthood

BACKGROUND: Despite the accumulation of studies examining the link between alcohol use and violence, no studies to our knowledge have systematically set out to detect age-related differences in these relationships. This limitation inhibits important insights into the stability of the relationship between alcohol use and violence among youth across varying ages. METHOD: Study findings are based on repeated, cross-sectional data collected annually as part of the National Survey on Drug Use and Health between 2002 and 2013. We combined a series of nationally representative cross-sections to provide a multi-year string of data that, in effect, reflects a nationally representative non-traditional cohort. We conducted logistic regression analyses to examine the cross-sectional association between non-binge and binge drinking and violent attacks among youth between ages 12 (2002) and 24/25 (2013). RESULTS: With respect to the association between non-binge alcohol use and violence, the only significant relationship identified—while controlling for sociodemographic and drug use factors—was for youth at age 13 (2003; OR = 1.97, 95% CI = 1.04–3.72). For binge drinking, we identified a distinct pattern of results. Controlling for sociodemographic, drug use factors, and school enrollment, binge drinking was significantly associated with violence between ages 13 (2003) and 20 (2010) with the largest odds ratios observed during the early adolescent period. CONCLUSIONS: Non-binge drinking is associated with violent behavior at age 13. Binge drinking was found to be associated with violence among youth through age 20; however, the relationship dissipates when youth arrive at the legal drinking age of 21

Changing perspectives on marijuana use during early adolescence and young adulthood: Evidence from a panel of cross-sectional surveys

Introduction. Prior research has often overlooked potential cohort differences in marijuana views and use across adolescence and young adulthood. To begin to address this gap, we conduct an exploratory examination of marijuana views and use among American youth using a panel of cross-sectional surveys. Method. Findings are based on repeated, cross-sectional data collected annually from adolescents (ages 12-17; n = 230,452) and young adults (ages 18-21; n = 120,588) surveyed as part of the National Survey on Drug Use and Health between 2002 and 2014. For each of the birth years between 1986 and 1996, we combined a series of nationally representative cross-sections to provide multi-year data strings designed to approximate nationally representative cohorts. Results. Compared to youth born in the mid-to-late 1980s, youth born in the mid-1990s reported significantly higher levels of marijuana disapproval during the early adolescent years (Age 14: 1988 = 64.7%, 1994 = 70.4%) but lower levels of disapproval during the young adult years (Age 19: 1988 = 32.0%, 1994 = 25.0%; Age 20: 1988 = 27.9%, 1994 = 19.7%). Moreover, the prevalence of marijuana use among youth born in 1994 was significantly lower—compared to youth born in 1988—at age 14 (1988: 11.39%, 1994: 8.19%) and significantly higher at age 18 (1988: 29.67%, 1994: 34.83%). This pattern held even when adjusting for potential confounding by demographic changes in the population across the study period. Conclusions. We see evidence of changes in the perceptions of marijuana use among youth born during the late twentieth century.2018-01-0

Characteristics of adults involved in alcohol-related intimate partner violence: results from a nationally representative sample

Background More than 12 million women and men are victims of partner violence each year. Although the health outcomes of partner violence have been well documented, we know very little about specific event-level characteristics that may provide implications for prevention and intervention of partner violence situations. Therefore, the purpose of this study is to evaluate substance abuse and dependence as risk factors for event-level alcohol-related intimate partner violence (IPV). Methods Data were derived from Wave II of the National Epidemiological Survey on Alcohol and Related Conditions (2004–2005). Eligible participants (N = 2,255) reported IPV the year before the survey. Negative binomial and ordinal regression methods were used to assess risk factors for alcohol use during IPV. Results Respondent PTSD was the only mental health diagnosis related to alcohol use during IPV (OR = 1.45). Marijuana use was related to respondents’ use of alcohol during IPV (OR = 2.68). Respondents’ meeting the criteria for alcohol abuse/dependence was strongly associated with respondent drinking (OR = 10.74) and partner drinking (OR = 2.89) during IPV. Conclusion Results indicate that PTSD, marijuana use disorders, alcohol abuse and dependence are associated with more frequent alcohol use during IPV. In addition, it is important to consider that the patient who presents in emergency settings (e.g., hospitals or urgent care facilities) may not be immediately identifiable as the victim or the perpetrator of partner violence. Therefore, screening and intervention programs should probe to further assess the event-level characteristics of partner violence situations to ensure the correct service referrals are made to prevent partner violence

Using mHealth to Increase Treatment Utilization Among Recently Incarcerated Homeless Adults (Link2Care): Protocol for a Randomized Controlled Trial

Background: There is a significant revolving door of incarceration among homeless adults. Homeless adults who receive professional coordination of individualized care (ie, case management) during the period following their release from jail experience fewer mental health and substance use problems, are more likely to obtain stable housing, and are less likely to be reincarcerated. This is because case managers work to meet the various needs of their clients by helping them to overcome barriers to needed services (eg, food, clothing, housing, job training, substance abuse and mental health treatment, medical care, medication, social support, proof of identification, and legal aid). Many barriers (eg, limited transportation, inability to schedule appointments, and limited knowledge of available services) prevent homeless adults who were recently released from incarceration from obtaining available case management, crisis management, substance abuse, and mental health services. Objective: The aim of the Link2Care study is to assess the effectiveness of a smartphone app for increasing case management and treatment service utilization, and in turn reduce homelessness and rearrest. The goals of this research are to (1) assess the impact of an innovative smartphone app that will prompt and directly link recently incarcerated homeless adults to community-based case management services and resources and (2) utilize in-person and smartphone-based assessments to identify key variables (eg, alcohol or drug use, social support, psychological distress, and quality of life) that predict continued homelessness and rearrest. Methods: Homeless adults (N=432) who enroll in a shelter-based Homeless Recovery Program after release from the Dallas County Jail will be randomly assigned to one of the three treatment groups: (1) usual case management, (2) usual case management plus smartphone, and (3) usual case management with a study-provided smartphone that is preloaded with an innovative case management app (smartphone-based case management). Those assigned to smartphone-based case management will receive smartphones that prompt (twice weekly) connections to shelter-based case managers. The app will also offer direct links to case managers (available during normal business hours) and crisis interventionists (available 24 hours a day, 7 days a week) with the touch of a button. Results: Recruitment began in the spring of 2018, and data collection will conclude in 2021. Conclusions: This research represents an important step toward integrated service connection and health care service provision for one of the most underserved, high need, and understudied populations in the United States. Trial Registration: ClinicalTrials.gov NCT03399500; https://clinicaltrials.gov/ct2/show/NCT03399500 (Archived by WebCite at http://www.webcitation.org/6zSJwdgUS) Registered Report Identifier: RR1-10.2196/986

Attacks Intended to Seriously Harm and Co-occurring Drug Use Among Youth in the United States

While it is known that substance use and violence co-occur, less is understood in terms of how this relationship might vary based on the degree of youth involvement in violence