The meaning of pubertal timing and the implications for substance use across adolescence

The purpose of this dissertation was to disentangle the measurement of self-report pubertal timing - the comparative development of an adolescent in relation to peers - in order to determine the longitudinal impact of pubertal timing on substance use across adolescence. Data are from the Context of Adolescent Substance Use study, a school-based longitudinal study of three cohorts, beginning in the 6th to 8th grades (aged 11 to 17, 50% male, 53% White). Study 1 examined the concordance between two self-report measures, stage-normative (based on the PDS) and peer-normative pubertal timing. Kappa statistics were calculated, both as a whole and by demographic subgroup at each age (N=6,425). Most Kappa statistics ranged from poor to modest concordance, indicating that the pubertal timing measures should not be used interchangeably. Study 2 used two longitudinal methods to examine the stability of pubertal timing (N=6,425). When calculating intraclass correlation coefficients (ICC) using one-way ANOVA random effects models, both measures had similar, but poor, stability (stage-normative ICC=.40 and peer-normative ICC=.39). In contrast, latent class analysis (LCA), which determines stability via the underlying response patterns of each measure, showed three stable and distinct response patterns for both measures: always early, always on-time, and always late. Study 3 used latent class growth modeling to test the impact of pubertal timing on current cigarette, alcohol, and marijuana use (N=5,846). Contrasts tested for significant substance use growth model parameter differences between the Study 2 pubertal timing latent classes. For both measures, a higher proportion of early developing adolescents were using substances compared with on-time and, in general, late developers. But using the peer-normative measure, there also was a higher proportion of late developers using cigarettes compared with their on-time peers. The influence on substance use was greatest in early adolescence for both pubertal timing measures and the strength of the relationship was generally stronger using the peer-normative measure. Stage-normative and peer-normative pubertal timing are not synonymous but both are stable throughout adolescence. Early developing adolescents are at greatest risk for substance use and results suggest the social aspects of pubertal development are more influential than the biological aspects

Demographic differences in self-report pubertal status among rural adolescents in the US

While sex and racial/ethnic differences in pubertal development have been noted, most of this research has been in urban areas

Relationship between health risk and school attendance among adolescents

Background/Purpose: The prevalence of childhood obesity and school truancy are contemporary health issues, as millions of children do not attend school, when required. The purpose of this study was to determine the association between intent to be physically active, aerobic fitness, and school absences. Methods: Data from 1907 adolescents from the United States were collected during physical education. Participants completed a valid Theory of Planned Behavior survey and the FitnessGram, with the demographic data obtained from school records. Linear regressions controlling for gender, grade, free/reduced lunch, body mass index, and intent to be physically active were calculated. Results: Adolescents who had positive intentions to be physically active (P \u3c .001), scored higher on the Progressive Aerobic Cardiovascular Endurance Run (PACER) test (P = .006), and ran faster in the mile (P \u3c .001) had fewer unexcused absences compared to students who had negative intentions and lower fitness. Discussion: Adolescents with higher aerobic fitness had fewer unexcused school absences, which suggests that cardiovascular health may be a valuable contributor in decreasing adolescent health and behavior risk, specifically truancy and out-of-school suspensions. Translation to Health Education Practice: Whole-of-school approaches that align physical activities and educational experiences can help adolescents understand the benefits of physical fitness as a prevention strategy

The Stability of Perceived Pubertal Timing Across Adolescence

It is unknown whether perceived pubertal timing changes as puberty progresses or whether it is an important component of adolescent identity formation that is fixed early in pubertal development. The purpose of this study is to examine the stability of perceived pubertal timing among a school-based sample of rural adolescents aged 11 to 17 (N=6,425; 50% female; 53% White). Two measures of pubertal timing were used, stage-normative, based on the Pubertal Development Scale, a self-report scale of secondary sexual characteristics, and peer-normative, a one-item measure of perceived pubertal timing. Two longitudinal methods were used: one-way random effects ANOVA models and latent class analysis. When calculating intraclass correlation coefficients using the one-way random effects ANOVA models, which is based on the average reliability from one time point to the next, both measures had similar, but poor, stability. In contrast, latent class analysis, which looks at the longitudinal response pattern of each individual and treats deviation from that pattern as measurement error, showed three stable and distinct response patterns for both measures: always early, always on-time, and always late. Study results suggest instability in perceived pubertal timing from one age to the next, but this instability is likely due to measurement error. Thus, it may be necessary to take into account the longitudinal pattern of perceived pubertal timing across adolescence rather than measuring perceived pubertal timing at one point in time

Perceived pubertal timing and recent substance use among adolescents: a longitudinal perspective: Perceived pubertal timing and substance use

To determine the longitudinal associations between perceived pubertal timing and recent substance use between the ages of 11 and 17

Biological and Sociocultural Factors During the School Years Predicting Women's Lifetime Educational Attainment.

BackgroundLifetime educational attainment is an important predictor of health and well-being for women in the United States. In this study, we examine the roles of sociocultural factors in youth and an understudied biological life event, pubertal timing, in predicting women's lifetime educational attainment.MethodsUsing data from the National Longitudinal Survey of Youth 1997 cohort (N = 3889), we conducted sequential multivariate linear regression analyses to investigate the influences of macro-level and family-level sociocultural contextual factors in youth (region of country, urbanicity, race/ethnicity, year of birth, household composition, mother's education, and mother's age at first birth) and early menarche, a marker of early pubertal development, on women's educational attainment after age 24.ResultsPubertal timing and all sociocultural factors in youth, other than year of birth, predicted women's lifetime educational attainment in bivariate models. Family factors had the strongest associations. When family factors were added to multivariate models, geographic region in youth, and pubertal timing were no longer significant.ConclusionOur findings provide additional evidence that family factors should be considered when developing comprehensive and inclusive interventions in childhood and adolescence to promote lifetime educational attainment among girls

Development of the Fitness Education Index: A Scale of Organizational Level Capacity

Purpose: Fitness education is essential for children’s health, but determining the effectiveness of instruction related to health-related fitness is difficult. The present study developed and confirmed the validity of a 20-item scale, adapted from the School Health Index (Centers for Diseases Control and Prevention [CDC], 2014), to evaluate the success of fitness education portion of the Presidential Youth Fitness Program (PYFP) across a sample of 785 teachers. Method: The initial subset (n = 373) represented 353 schools and was used for conducting an exploratory factor analysis. The second subset (n = 412) representing 404 schools, was used to conduct the confirmatory factor analysis. Teachers self-assessed their perceived degree of implementation of fitness education (full, partial, under development, not in place) within their school (i.e., teachers helped students set fitness goals). Results: An initial exploratory factor analysis revealed that the Fitness Education Index questions clustered into six factors. A subsequent confirmatory factor analysis conducted using Mplus concluded the six-factor solution was a good fit (CFI = 0.90, TLI = 0.88, RMSEA = 0.08, SRMR = 0.06). Conclusion: This scale is a valid measure of a school’s readiness to initiate and track progress toward the full implementation of fitness education

“We do it ourselves”: strengths and opportunities for improving the practice of harm reduction

Abstract Background Unprecedented increases in substance-related overdose fatalities have been observed in Texas and the U.S. since the onset of the COVID-19 pandemic and have made clear there is considerable need to reduce harms associated with drug use. At the federal level, initiatives have called for widespread dissemination and implementation of evidence-based harm reduction practices to reduce overdose deaths. Implementation of harm reduction strategies is challenging in Texas. There is a paucity of literature on understanding current harm reduction practices in Texas. As such, this qualitative study aims to understand harm reduction practices among people who use drugs (PWUD), harm reductionists, and emergency responders across four counties in Texas. This work would inform future efforts to scale and spread harm reduction in Texas. Methods Semi-structured qualitative interviews were conducted with N = 69 key stakeholders (25 harm reductionists; 24 PWUD; 20 emergency responders). Interviews were transcribed verbatim, coded for emergent themes, and analyzed using Applied Thematic Analysis with Nvivo 12. A community advisory board defined the research questions, reviewed the emergent themes, and assisted with interpretation of the data. Results Emergent themes highlighted barriers to harm reduction at micro and macro levels, from the individual experience of PWUD and harm reductionists to systemic issues in healthcare and the emergency medical response system. Specifically, (1) Texas has existing strengths in overdose prevention and response efforts on which to build, (2) PWUD are fearful of interacting with healthcare and 911 systems, (3) harm reductionists are in increasing need of support for reaching all PWUD communities, and (4) state-level policies may hinder widespread implementation and adoption of evidence-based harm reduction practices. Conclusions Perspectives from harm reduction stakeholders highlighted existing strengths, avenues for improvement, and specific barriers that currently exist to harm reduction practices in Texas