Lesbian, Gay, and Bisexual Students Experiencing Homelessness and Substance Use in the School Context: A Statewide Study.

PURPOSE: This study explored differences between lesbian, gay, and bisexual (LGB)-housed and homeless students regarding substance use patterns on and off school grounds and the unique contribution of homelessness to substance use in school. METHODS: Data were from the 2013-2015 California Healthy Kids Survey, a statewide survey of school protective factors and risk behaviors. A representative sample of 9th- and 11th-grade students (N = 20,337) was used. Comparisons between housed (n = 19,456) and homeless (doubled up: n = 715; acute homeless: n = 166) LGB students were conducted. We used chi-square tests to compare rates of lifetime, past-30-day, and in-school substance use and conducted multivariate logistic regression models for each substance use variables. RESULTS: Chi-square test results indicated significant differences in rates of substance use among students experiencing homelessness (both categories) and housed LGB students. Lesbian, gay, and bisexual students experiencing homelessness were more likely to report substance use off and on school grounds. Results from logistic regression analyses indicated that LGB students who experience homelessness were significantly more likely to report recent and in-school substance use. For example, students experiencing acute homelessness were about 3 times as likely to report heavy episodic drinking (adjusted odds ratio [AOR] = 3.13; 95% confidence interval [CI] = 2.13, 4.26) and more than 5 times as likely to smoke marijuana in school (AOR = 5.38; 95% CI = 3.46, 8.36), compared to housed LGB students. CONCLUSIONS: LGB students who experience homelessness are at higher risk than housed LGB students of substance use on and off school grounds. Findings highlight the need to provide support in the school context for this subpopulation.

Teen, Queer, and Asian: Lesbian, Gay, Bisexual, Transgender, Queer, Plus Asian American Students' Experiences in Schools.

BACKGROUND: The experiences of youth with intersecting LGBTQ+ and Asian American (AA) identities have been largely unexplored. This study explored these experiences of LGBTQ+ AA California youth with mental health, school climate, and school victimization. METHODS: Drawing from the 2016-2017 California Healthy Kids Survey (N = 326,124), this study utilized secondary data analyses to examine mental health, school climate, and school victimization among students of specific AA ethnicities (eg, Cambodian, Hmong, Vietnamese) and LGBTQ+ identities. The participants in this study included 7th, 9th, and 11th graders from California public schools, with subsamples of lesbian or gay students (N = 13,291), bisexual students (N = 30,127), and transgender students (N = 7916). RESULTS: The results indicated that Asian Indian, Cambodian, Hmong, Japanese, Korean, Laotian, and Other Asian LGBTQ+ students experienced more negative school climate and victimization compared to their Chinese, Filipino, Vietnamese, and white LGBTQ+ peers. For instance, 41.1% of Cambodian transgender students reported they were beaten up compared to 27.1% of white transgender students. Mental health differences between LGBTQ+ AA and LGBTQ+ white students were also found. CONCLUSIONS: This study's findings can inform school administrators and teachers how to best support LGBTQ+ AA populations.

A latent class analysis of the co-occurrence of sexual violence, substance use, and mental health in youth.

Purpose: The purpose of this study was to understand co-occurrence of sexual violence, substance use, and mental health in youth and see if there are differences in experiences among sexual identities, races, and genders. Methods: The 2017 Youth Risk Behavior Survey sampled 14,638 high school students. Latent class analysis was used to understand the relationship between incidence of sexual violence, substance use, and depression and suicidality in a nationally representative sample. The model controlled for demographic and bullying covariates. Results: A four-class solution provided optimal fit. Classes were low risk (51.8%); low violence, frequent substance use, and high depression and suicidal ideation (29.7%); experienced violence and moderate mental health issues(5.1%); and some violence, high substance use, and high depression and suicidal ideation (13.4%). Youth who identified as sexual minority youth were almost 2.5-5 times more likely to be in the three higher risk classes than their heterosexual peers. Those who identified as "I don't know" were almost 3 times more likely to be in the three higher risk classes than heterosexual youth. Multiracial youth had higher likelihood of being in the three riskier classes compared to Caucasian youth. Females were 2.5 and 3 times more likely to be in the low violence and some violence classes compared to males. Conclusion: The study's finding distinct classes of co-occurring behavioral and mental health outcomes fill gaps in the current literature and informs practitioners that LGB youth and bi/multiracial youth were at an elevated risk of co-occurring victimization, substance use, and mental health problems.

Prevalence of Substance Use among Lesbian, Gay, Bisexual, and Transgender Youth in Military Families: Findings from the California Healthy Kids Survey.

BACKGROUND: In addition to the challenges associated with military life, lesbian, gay, bisexual, and transgender (LGBT) youth in military families may face stressors associated with having a stigmatized sexual orientation and/or gender identity or expression, placing them at risk of substance use. To the authors' knowledge, this is the first study exploring substance use outcomes among LGBT youth in military families. OBJECTIVES: This study assessed the role of military connection, LGB identity, and transgender identity on lifetime and past 30-day substance use. METHODS: This study is a secondary data analysis of the 2013-2015 California Healthy Kids Survey (CHKS). The study's participants (n = 634,978) were students attending middle and high schools in nearly all school districts in California. The study outcomes were lifetime and past 30-day cigarette, alcohol, tobacco, and marijuana use. Chi-square tests of associations (including cross-tabulations) and multivariate logistic regressions were conducted to address the study aims. RESULTS: Multivariate logistic regression results indicated that military connection, LGB identity, and transgender identity were significantly associated with an increased odd of lifetime and past 30-day substance use. Compared to military non-transgender youth, military transgender youth had an increased likelihood of past 30-day cigarette use and past 30-day alcohol use. In addition, military LGB youth were 3.62 times as likely as military non-LGB youth to report past 30-day cigarette use. Conclusions/Importance: This study provides researchers with knowledge about the behavioral health of LGBT youth in military families, a vulnerable subgroup within the military-connected youth population, thus informing substance use prevention programs.

School Protective Factors and Substance Use Among Lesbian, Gay, and Bisexual Adolescents in California Public Schools.

PURPOSE: The majority of studies examining substance use among lesbian, gay, and bisexual (LGB) youth have focused on a wide array of risk factors (e.g., victimization). Few studies have explored the protective role of schools. This study aims to fill this gap in the literature and inform programs aimed at reducing substance use among LGB youth. More specifically, this study explores the extent to which school connectedness and support from teachers and other adults at school are associated with substance use among LGB youth in school and within the past 30 days. METHODS: A secondary analysis of the 2013-2015 California Healthy Kids Survey (CHKS) was conducted to examine associations between school protective factors (i.e., school connectedness and adult support) and substance use among LGB youth, above and beyond a key risk factor, school victimization. The study outcomes were past 30-day and in-school use of cigarettes, alcohol, marijuana, inhalants, prescription pain medication, and other illegal drugs. RESULTS: Overall, school connectedness and school adult support were associated with lower odds of substance use. For example, higher levels of school connectedness were associated with 22% decreased odds of past 30-day inhalant use (adjusted odds ratio [AOR] = 0.78; 95% confidence interval [CI] = 0.72-0.86), and 25% decreased odds of past 30-day prescription pain medication use (AOR = 0.75; 95% CI = 0.69-0.82). Higher levels of adult support in school were also associated with 17% decreased odds of marijuana use on school property in the past 30 days (AOR = 0.83; 95% CI = 0.77-0.91). CONCLUSION: The results indicate a need for substance use prevention programs that integrate school connectedness and adult support in school.

Substance Use Among Transgender Students in California Public Middle and High Schools.

BACKGROUND: Transgender adolescents face tremendous social stress in families and schools, which often leads to behavioral health disparities. This study assessed whether rates of substance use were higher among transgender adolescents when compared to nontransgender adolescents. METHODS: This study is a secondary data analysis of the 2013-2015 California Healthy Kids Survey (CHKS) that examines whether rates of substance use are higher among transgender youth when compared to nontransgender youth. Participants included 4778 transgender and 630,200 nontransgender students in middle and high schools in nearly all school districts in California. The study outcomes were lifetime, recent, and in-school use of cigarettes, tobacco, alcohol, marijuana, cocaine, and ecstasy as well as nonmedical use of prescription painkillers, diet pills, Ritalin or Adderall, and cold medicine. RESULTS: Transgender students were about 2-1/2 times more likely as nontransgender students to use cocaine/methamphetamine in their lifetime (odds ratio [OR] = 2.53; 95% confidence interval [CI] = 2.18-2.95) and about 2.8 times as likely to report past 30-day inhalant use (OR = 2.80; 95% CI = 2.41-3.26). Transgender students were more than twice as likely to report past 30-day prescription pain medication use (OR = 2.19; 95% CI = 1.90-2.53) and more than 3 times as likely to use cigarettes in school (OR = 3.37; 95% CI = 2.84-3.99). CONCLUSIONS: The study's findings indicate a need for community- and school-based interventions that reduce substance use among transgender youth.

Examining the Relationship Between School Climate and Peer Victimization Among Students in Military-Connected Public Schools.

In the Iraq and Afghanistan war context, studies have found that military-connected youth- youth with parents and/or siblings serving in the military-have higher rates of school victimization than their nonmilitary-connected peers. A positive school climate-where students perceive high levels of school connectedness, caring relationships and high expectations from adults, and meaningful participation-is associated with lower rates of victimization in secondary public schools. Based on a survey of 7th, 9th, and 11th grade students (N =14,493) enrolled in 6 military-connected school districts (districts that have a significant proportion of military-connected students), this study explores victimization rates and the role of school climate, deployment, and school transitions in the victimization of military-connected students and their civilian peers. The findings indicate that deployment and school transitions were significant predictors of physical violence and nonphysical victimization. In addition, multiple school climate factors were significantly associated with physical violence and nonphysical victimization. The authors conclude with a discussion of future directions for research on school climate, victimization, and military-connected youth.

The promotional role of school and community contexts for military students.

This article examines how supportive public school environments can serve as a promotional context for the development of children and adolescents from military families. The authors integrate theory and research from multiple research strands (e.g., human development, studies of at-risk youth, educational reform, goodness of fit theory, and school climate) to outline how public schools can support the development of all children and adolescents. This article provides further support for the supposition that school climates and the social-ecological contexts surrounding a school (e.g., universities, communities, school districts) have the potential to protect at-risk children and adolescents from an array of negative social, emotional, and psychological outcomes. The authors draw linkages between these research domains and the development of military children and adolescents. Promotional civilian school environments embedded within supportive and inclusive contexts can create a social infrastructure that supports the development of military children and adolescents. The authors argue that this conceptual approach can create a foundation for interventions and research that focuses on schools as normative supportive developmental settings for military children and youth during challenging times of war (e.g., deployments and multiple school transitions). This article concludes with a discussion of future directions in research on the development of military children and adolescents. Based on a heuristic conceptual model that outlines areas needing further research, the authors call for a deeper theoretical and empirical integration of school climate and external contextual factors surrounding the school. Investigating the social and organizational dynamics within these contexts can result in a more comprehensive picture of the development of military children and adolescents.