Results of a randomized controlled trial of the cannabis eCHECKUP TO GO personalized normative feedback intervention on reducing cannabis use, cannabis consequences, and descriptive norms.

BACKGROUND: The prevalence of cannabis use disorder and its negative consequences among young adults has highlighted the need for prevention and early intervention programs. However, low treatment prevalence persists due to factors such as lack of perceived need, concerns about stigma, and limited access to treatment. To address these barriers, web-based cannabis interventions have been developed, but their efficacy remain limited. This study aims to evaluate the cross-site efficacy of the Cannabis eCHECKUP TO GO program, a web-based Personalized Normative Feedback and Protective Behavioral Strategies intervention for reducing cannabis use frequency and consequences in college students with willingness to change. METHODS: Participants were 781 students from three universities (two in Canada, one in the US) who reported using cannabis in the past month and expressed interest in reducing or engaging in safer cannabis use. The study randomly assigned them to either an experimental group that received personalized normative feedback or a control group that received information on healthy stress management. The study collected follow-up data 4 weeks after the initial intervention and measured participants' frequency of cannabis use, number of cannabis consequences, descriptive and injunctive norms at both time points. RESULTS: The results showed no significant reductions in cannabis use or negative consequences of use. However, students who received personalized normative feedback experienced a significant reduction in descriptive norms related to cannabis use, to be more in line with actual use. CONCLUSION: This study suggests that more targeted interventions may be necessary for university students who are already using and seeking help to reduce their use.

Trajectories of oppositional defiant disorder severity from adolescence to young adulthood and substance use, mental health, and behavioral problems.

Background: Oppositional Defiant Disorder (ODD) is a disruptive behavioral disorder; however, increasing evidence emphasizes irritable mood as a primary symptom of ODD. Objectives: This study investigated whether heterogeneous groups (classes) of individuals can be differentiated based on ODD sub-dimensions (irritability and defiance) or on overall ODD symptoms longitudinally. We also examine associations between ODD trajectory class and comorbid substance use (heavy episodic drinking, cannabis use), mental health (depression and anxiety) and behavioral symptoms (ADHD, aggression and substance use) in both adolescence and young adulthood (controlling for adolescent levels of each of these concerns). Method: Data were from a randomly recruited community sample of 662 Canadian youth (T1 ages 12-18) followed biennially for 10 years (T6 ages 22-29). Results: Growth mixture models revealed trajectories classes of ODD based on severity of symptoms. A three-class solution provided the best fit with Low (n = 119; 18%), Moderate (n = 473; 71.5%), and High (n = 70; 10.6%) ODD classes. Class trajectory differences were similarity based on symptoms severity (rather than type) for symptom sub-dimensions (irritability defiance). Adolescent and young adult substance use, mental health symptoms, and behavioral problems were significantly higher for the High ODD trajectory class compared to both other classes. Youth in the Moderate ODD trajectory class also showed higher comorbid symptoms in adolescence and young adulthood, compared to the Low ODD trajectory class. Conclusion: Early identification of children and adolescents with high or moderate ODD symptoms and interventions that simultaneously address defiance and irritability are supported by the findings.

Contexte: Le trouble oppositionnel avec provocation (TOP) est un trouble du comportement perturbateur; toutefois, des données probantes croissantes soulignent que l'humeur irritable est un symptôme primaire du TOP. Objectifs: La présente étude a investigué si les groupes (classes) hétérogènes de personnes qui peuvent être différentiées au mieux selon les sous-dimensions (irritabilité et défi) ou selon les symptômes généraux du TOP longitudinalement. Nous examinons également les associations entre la classe de trajectoire du TOP et l'utilisation de substances comorbide (lourde consommation d'alcool épisodique, utilisation de cannabis), la santé mentale (dépression et anxiété) et symptômes comportementaux (TDAH, agression et utilisation de substances) tant chez les adolescents que chez les jeunes adultes (contrôler les niveaux adolescents de chacun de ces problèmes). Méthode: Les données provenaient d'un échantillon communautaire recruté au hasard de 662 jeunes Canadiens (âges T1 2­18) suivis tous les deux ans pendant 10 ans (T6 âges 22­29). Résultats: Des modèles de mélange de croissance ont révélé des classes de trajectoire du TOP basées sur la gravité des symptômes. Une solution en trois classes a fourni le meilleur ajustement avec des classes de TOP faible (n = 119; 18 %), modérée (n = 473; 71,5 %), et élevée (n = 70; 10,6 %). Les différences de classes de trajectoire étaient également basées sur la gravité des symptômes (plutôt que sur le type) des sous-dimensions des symptômes (irritabilité, défi). L'utilisation de substances chez les adolescents et les jeunes adultes, les symptômes de santé mentale et les problèmes de comportement étaient significativement plus élevés pour la classe de la trajectoire élevée du TOP comparé aux deux autres classes. Les jeunes de la classe de trajectoire modérée du TOP présentaient aussi des symptômes comorbides plus élevés à l'adolescence et au jeune âge adulte, comparé à la classe de trajectoire faible du TOP. Conclusion: L'identification précoce des enfants et des adolescents présentant des symptômes élevés ou modérés du TOP et les interventions qui prennent en charge simultanément le défi et l'irritabilité sont soutenues par les résultats.

The Protective Role of Grit against Alcohol and Cannabis Use through Young Adulthood.

Introduction: Problematic substance use in young adulthood is consistently related to negative outcomes later in life. Understanding the factors that protect against problematic substance provides opportunities for early preventive intervention. We examine the protective role of grit - passion and perseverance for long-term goals - on substance use through young adulthood, a period of heightening risks for substance use. Methods: In this research, we use cross-lagged panel models and data from the Victoria Healthy Youth Survey (N = 477, 52% female) to test the reciprocal within-time associations and the directional relationships between grit (passion and perseverance) and substance use (cannabis and alcohol) across three assessments (6 years, ages 18-29). All models controlled for sex and SES. Results: Significant findings show negative within-time associations between passions and perseverance and cannabis use at T1 (ages 18-24) and at T2 (ages 20-26), and significant, negative within-time associations between passion and perseverance and alcohol use (heavy episodic drinking) at T1 but not at T2. No significant across-time associations between passion and perseverance and substance use were found. Conclusion: Preventive interventions to enhance passion and perseverance may provide important targets for interventions for young adults to reduce current substance use. However, grit did not have an effect beyond the stability of cannabis use or alcohol use over time, suggesting effects may act by substituting proactive goals for current substance use.

Transparent, Open, and Reproducible Prevention Science.

The field of prevention science aims to understand societal problems, identify effective interventions, and translate scientific evidence into policy and practice. There is growing interest among prevention scientists in the potential for transparency, openness, and reproducibility to facilitate this mission by providing opportunities to align scientific practice with scientific ideals, accelerate scientific discovery, and broaden access to scientific knowledge. The overarching goal of this manuscript is to serve as a primer introducing and providing an overview of open science for prevention researchers. In this paper, we discuss factors motivating interest in transparency and reproducibility, research practices associated with open science, and stakeholders engaged in and impacted by open science reform efforts. In addition, we discuss how and why different types of prevention research could incorporate open science practices, as well as ways that prevention science tools and methods could be leveraged to advance the wider open science movement. To promote further discussion, we conclude with potential reservations and challenges for the field of prevention science to address as it transitions to greater transparency, openness, and reproducibility. Throughout, we identify activities that aim to strengthen the reliability and efficiency of prevention science, facilitate access to its products and outputs, and promote collaborative and inclusive participation in research activities. By embracing principles of transparency, openness, and reproducibility, prevention science can better achieve its mission to advance evidence-based solutions to promote individual and collective well-being.

Longitudinal cohort study of injury type, settings, treatment and costs in British Columbia youth, 2003-2013.

BACKGROUND: In 2010 in British Columbia (BC), Canada, total injury costs per capita were higher among youth aged 15-24 years than in any other age group. Injury prevention efforts have targeted injuries with high mortality (transportation injuries) or morbidity (concussions). However, the profile and health costs of common youth injuries (types, locations, treatment choices and prevention strategies) and how these change from adolescence to young adulthood is not known. METHODS: Participants (n=662) were a randomly recruited cohort of BC youth, aged 12-18, in 2003. They were followed biennially across a decade (six assessments). RESULTS: Serious injuries (defined as serious enough to limit normal daily activities) in the last year were reported by 27%-41% of participants at each assessment. Most common injuries were sprains or strains, broken bones, cuts, punctures or animal bites, and severe bruises. Most occurred when playing a sport or from falling. Estimated total direct cost of treatment per injury was approximately $2500. In addition, 25% experienced serious injuries at three or more assessments, indicating possible differences that warrents further investigation. CONCLUSIONS: The occurence and health cost of common injuries to youth and young adults are underestimated in this study but are nevertheless substantial. Ongoing surveillence, awareness raising, and prevention efforts may be needed to reduce these costs.

Examining the Effectiveness of the WITS Programs in the Context of Variability in Trajectories of Child Development.

This study has two objectives: (1) to report the results of a large-scale, longitudinal evaluation of the WITS Programs that included a large sample of elementary school children (n = 1967) from 27 rural schools (including 16 program schools) and (2) to examine and discuss the effects of average developmental trajectories and of heterogeneity in children's development on intervention outcomes. Data comprise baseline (spring) and four follow-up assessments (5 Waves) from children (N = 1967) and their parents and teachers. WITS stands for Walk away Ignore, Talk it out, and Seek Help ( www.witsprograms.com ). The children in the intervention schools declined more slowly than those in the control schools in their reports of relational victimization. Children in the intervention schools also declined faster in aggression and emotional problems relative to children in control schools. Moderation analyses showed that intervention group children with higher baseline levels of emotional problems declined faster in emotional problems than those with lower problems at baseline. In addition, children in grades 3 and over completed school climate questionnaire and children in control schools who had more negative perceptions of school climate at baseline showed greater increases in these negative perceptions compared to children in the intervention schools. We discuss the potential impact of average trajectories of child development and the within-child heterogeneity in assessments for the interpretation of the findings. We also conclude by highlighting evaluation design modifications that may improve our future ability to examine the effects of preventive interventions for elementary school children.

Co-Use of Alcohol and Cannabis: Longitudinal Associations with Mental Health Outcomes in Young Adulthood.

Increases in cannabis use among young people has heightened concern about the potential interactive health effects of cannabis with other drugs. We examined the longitudinal association between concurrent and simultaneous (SAM) co-use of alcohol and cannabis in young adulthood on mental health symptoms, substance use behaviors, and substance-related harms two years later. Data were drawn from Time 5 (T5; n = 464; 46% male) and 6 (T6; n = 478; 45% male) of the Victoria Healthy Youth Survey. At T5, 42% of participants used alcohol-only, 13% used concurrently, 41% used SAM, 1% were cannabis only users, and 3% abstained from cannabis and alcohol. Boys were more likely to use SAM. Higher T5 SAM use frequency was associated with heavier use of substances, more substance-related harms, and symptoms of psychosis and externalizing problems at T6. T5 Concurrent use was associated with conduct symptoms, illicit drug use, and alcohol use disorders at T6 relative to alcohol-only use. Cannabis is commonly used with alcohol and the findings suggest that any co-use (concurrent or simultaneous) may be problematic in young adulthood. Public health messages need to explicitly inform consumers about the possible consequences of using both alcohol and marijuana and the addictive pharmacological impact of using them together.

Changes in positive and negative peer influences and depressive symptoms from adolescence to young adulthood.

INTRODUCTION: Peers are believed to continue as prominent sources of influence for young adults. However, having peers who use alcohol and drugs is associated with depressive symptoms in young adults and research on the effects of having peers who model positive activities beyond adolescence is scarce. METHOD: In this 10-year study of 644 Canadian youth (52% female), we used multilevel modeling to examine the effects of within-person and between-person differences in the interplay of peer behaviours and changes in depressive symptoms between ages 14 and 25. Data were collected via face-to-face interviews and surveys for private topics. RESULTS: Youth with close friends who used drugs and alcohol consistently reported more depressive symptoms at each age, whereas having friends who engaged in positive activities was associated with fewer depressive symptoms, especially during adolescence. Moreover, at times when youth had more substance-using peers than usual (within person variation), they also reported more symptoms. CONCLUSIONS: Substance-using peer contexts convey both short- and long-term risks for depressive symptoms. However, the protective effects of having peers who are engaged in positive activities, while generally protective, may be reduced in young adulthood. It is possible that older youth withdraw from peers and activities as their depression worsens, and prosocial activities become less supervised by parents, more optional, and more expensive.

Male-Dominated Occupations and Substance Use Disorders in Young Adulthood.

This article examined associations between male-dominated occupations and substance use disorders in young adulthood, accounting for adolescent experiences of work intensity (more than 15 hr a week at 16 to 17 years of age) and substance use (i.e., smoking, heavy drinking, cannabis, and illicit drug use). The moderating effects of biological sex and coming from a family with a low socioeconomic status (SES) were also assessed. Data were from a 10-year prospective study of community-based youth aged 12-18 in 2003 (T1; N = 662; 48% male; Mage = 15.5, SD = 1.9). Their occupations at ages 22-29 were categorized so that higher scores indicated more male-dominated occupations. Young adults in male-dominated occupations (more than 75% males) had lower education, worked in less prestigious occupations, and earned higher hourly wages than those in the other gendered-occupation groups. Work intensity in high school was associated with substance use at ages 18-25 and substance use was also associated with alcohol- and cannabis-use disorder symptoms and illicit drug use in young adulthood (ages 22-29). Adding to these effects, employment in a male-dominated occupation was associated with more cannabis-use disorder symptoms for the low, but not the high SES group. Public health messages need greater focus on preventing substance use disorders among individuals employed in male-dominated jobs in young adulthood. Efforts to promote self-assessment of problematic substance use and motivation to change may be particularly important for young workers.

Trajectories of peer victimization in elementary school children: Associations with changes in internalizing, externalizing, social competence, and school climate.

The current study examines the developmental changes (internalizing and externalizing symptoms, social competence, and experiences of school climate) in children who follow distinct trajectories of peer victimization in a sample of elementary school children across 2 years. Data were from children, and their parents and teachers, in Grades 1-3 followed across five waves. Latent class analyses revealed four distinct victimization trajectory groups characterized by chronically high, increasing, decreasing, or low-stable levels across time. Multilevel analyses showed that children in the chronically high peer victimization group had higher initials levels of internalizing and externalizing symptoms, lower levels of social competence, and poorer experiences of school climate compared to children in the low-stable group. Over time, children in the increasing group had slower rates of increases in social competence than children in the low-stable group and had worsening experiences of school climate compared to children in the low-stable peer victimization group. Findings suggest children who are chronically victimized may be at a developmental disadvantage compared to children who report little or declining peer victimization over time.

Disruption of Transitions in High-Risk Substance Use from Adolescence to Young Adulthood: School, Employment, and Romantic Relationship Factors.

Background: Few studies have examined social-contextual moderators of substance use transitions from adolescence to young adulthood. A better understanding of the extent to which school, employment, and romantic relationships can disrupt high-risk use patterns could inform strategies for substance use prevention and treatment.Objective: The current study examines the extent school, employment, and relationship factors can disrupt transition in high-risk substance use patterns from adolescence to young adulthood.Method: Data were collected biennially from 662 youth in six assessments across ten years (2003-2013). Using latent transition analysis (LTA) that examined transition is substance use classes, we examined school, employment, and relationship moderators of use transitions.Results: Few differences were found during adolescence with the most significant findings occurring in the transition from adolescence to young adulthood. Examining the transitions from adolescence to young adulthood (W4 to W6), we found evidence that school, employment, and relationship status disrupted problematic substance use patterns, such that, individuals that indicated entering school, working full-time, or getting married or entering a relationship were more likely to transition to a low-risk substance use class than remain in the high-risk class.Conclusions/Importance: Findings underscore the importance of school completion, obtaining stable career employment, and quality relationship to help reduce high-risk substance use patterns leading into young adulthood. Prevention and intervention efforts should consider the diverse needs of youth and be prepared to provide a wide range of services that include educational opportunities and career development if they want to reduce high-risk substance use patterns.

Patterns of marijuana use and physical health indicators among Canadian youth.

We examine how trajectories of marijuana use in Canadian youth (ages 15 to 28) are related to physical health indicators in adolescence and young adulthood. Youth were initially recruited in 2003 (N = 662; 48% male; ages 12 to 18) and followed for six waves. Five trajectories of marijuana use (Abstainers-29%, Occasional users-27%, Decreasers-14%, Increasers-20% and Chronic users-11%) were identified. Chronic users reported more physical symptoms, poorer physical self-concept, less physical activity, poorer eating practices, less sleep, and higher number of sexual partners during adolescence than other classes. Decreasers also reported poorer physical self-concept and poorer eating practices than abstainers. Other trajectory classes showed few significant health problems. Chronic users also reported more acute health problems (i.e. serious injuries, early sexual debut, higher number of sexual partners, greater likelihood of having a STI) in young adulthood than all other classes contributing to costs of healthcare. Youth who engage in early, frequent and continued use of marijuana from adolescence to young adulthood are at-risk of physical health problems in adolescence and young adulthood.

Marijuana trajectories and associations with driving risk behaviors in Canadian youth.

Objective: Research on risky driving practices involving marijuana use among youth and young adults often relies on cross-sectional data, which fail to account for longitudinal changes in substance use patterns. A better understanding of the longitudinal patterns of marijuana use and its effect on risky driving practices during young adulthood is needed in order to better inform prevention efforts. The current study examined whether different longitudinal patterns of marijuana use across the transition from adolescence to young adulthood are associated with impaired driving risks in young adulthood. Methods: Data were from the longitudinal Victoria Healthy Youth Survey, which interviewed youth biennially on 6 occasions across 10 years (2003 to 2013). Results: Youth who reported consistently high levels of marijuana use from adolescence to young adulthood (chronic users) and youth who reported increasing levels of use across this period (increasers) were more likely to engage in risky impaired driving behaviors compared to the other 3 user groups (occasional users, decreasers, and abstainers). Frequency of marijuana use was also predictive of impaired driving risks in young adulthood after controlling for individual characteristics (age, sex, socioeconomic status, age of onset of marijuana use), frequency of other substance use (heavy episodic drinking and illicit drug use), and simultaneous use of marijuana and other substances (alcohol and illicit drugs). By young adulthood, youth who use marijuana more than once a week are more likely to simultaneously use alcohol and engage in heavy episodic drinking. They are also more likely take driving risks. Conclusions: Harm reduction strategies and legislative approaches targeting impaired driving risks associated with marijuana use should include approaches to target these high-risk groups and to reduce simultaneous use of alcohol.

Is there a positive side to sensation seeking? Trajectories of sensation seeking and impulsivity may have unique outcomes in young adulthood.

INTRODUCTION: High levels of sensation seeking and impulsivity in adolescence are typically associated with risky behaviours; limited research has examined the relation of these traits to positive outcomes. Given that adolescence is a sensitive developmental period that can impact success later in life, we adopt the Positive Youth Development Framework to better understand how the development of self-reported sensation seeking and impulsivity may be differentially related to positive markers of early adulthood. METHOD: Data are from the Victoria Healthy Youth Survey (T1 N = 662; 52% female), a six-wave longitudinal cohort study of Canadian youth. Parallel process latent class growth analysis estimated trajectories of sensation seeking and impulsivity identifying classes of youth (ages 14-28). Controlling for baseline age, sex, and socio-economic status, linear regression analyses examined how longitudinal patterns (classes) of sensation seeking and impulsivity were related to positive markers of early adulthood. RESULTS: Three classes of youth were identified. These varied in levels and trajectories of change in sensation seeking (Ss) and impulsivity (I): LowSs-LowI, 26%; HighSs-HighI, 35%; ModerateSs-LowI, 38%. In young adulthood (T6; ages 22-29), youth in the LowSs-LowI and ModerateSs-LowI classes had significantly higher educational and occupational achievement, and lower financial strain, compared to youth in the HighSs-HighI class. Further, the ModerateSs-LowI class was associated with the highest levels of income and well-being. CONCLUSIONS: Findings identified differential trajectories of sensation seeking and impulsivity, with youth in the ModerateSs-LowI class, followed by the LowSs-LowI class, reporting the most positive outcomes in young adulthood.

Associations Between Marijuana Use Trajectories and Educational and Occupational Success in Young Adulthood.

Adolescence and young adulthood is a critical stage when the economic foundations for life-long health are established. To date, there is little consensus as to whether marijuana use is associated with poor educational and occupational success in adulthood. We investigated associations between trajectories of marijuana use from ages 15 to 28 and multiple indicators of economic well-being in young adulthood including achievement levels (i.e., educational attainment and occupational prestige), work characteristics (i.e., full vs part-time employment, hours worked, annual income), financial strain (i.e., debt, trouble paying for necessities, delaying medical attention), and perceived workplace stress. Data were from the Victoria Healthy Youth Survey, a 10-year prospective study of a randomly recruited community sample of 662 youth (48% male; Mage = 15.5), followed biennially for six assessments. Models adjusted for baseline age, sex, SES, high school grades, heavy drinking, smoking, and internalizing and oppositional defiant disorder symptoms. Chronic users (our highest risk class) reported lower levels of educational attainment, lower occupational prestige, lower income, greater debt, and more difficulty paying for medical necessities in young adulthood compared to abstainers. Similarly, increasers also reported lower educational attainment, occupational prestige, and income. Decreasers, who had high early use but quit over time, showed resilience in economic well-being, performing similar to abstainers. Groups did not differ on employment status or perceived workplace stress. The findings indicate that early onset and persistent high or increasingly frequent use of marijuana in the transition from adolescent to young adulthood is associated with risks for achieving educational and occupational success, and subsequently health, in young adulthood.

Age-varying effects of cannabis use frequency and disorder on symptoms of psychosis, depression and anxiety in adolescents and adults.

AIMS: We tested the age-varying associations of cannabis use (CU) frequency and disorder (CUD) with psychotic, depressive and anxiety symptoms in adolescent and adult samples. Moderating effects of early onset (≤ 15 years) and sex were tested. DESIGN: Time-varying effect models were used to assess the significance of concurrent associations between CU and CUD and symptoms of psychosis, depression and anxiety at each age. SETTING AND PARTICIPANTS: Adolescent data (V-HYS; n = 662) were collected from a randomly recruited sample of adolescents in Victoria, British Columbia, Canada during a 10-year period (2003-13). Adult cross-sectional data (NESARC-III; n = 36 309) were collected from a representative sample from the United States (2012-13). MEASUREMENTS: Mental health symptoms were assessed using self-report measures of diagnostic symptoms. CU was based on frequency of past-year use. Past-year CUD was based on DSM-5 criteria. FINDINGS: For youth in the V-HYS, CU was associated with psychotic symptoms following age 22 [b = 0.13, 95% confidence interval (CI) = 0.002, 0.25], with depressive symptoms from ages 16-19 and following age 25 (b = 0.17, 95% CI = 0.003, 0.34), but not with anxiety symptoms. CUD was associated with psychotic symptoms following age 23 (b = 0.51, 95% CI = 0.01, 1.01), depressive symptoms at ages 19-20 and following age 25 (b = 0.71, 95% CI = 0.001, 1.42) and anxiety symptoms ages 26-27 only. For adults in the NESARC-III, CU was associated with mental health symptoms at most ages [e.g. psychotic symptoms; age 18 (b = 0.22, 95% CI = 0.10, 0.33) to age 65 (b = 0.36, 95% CI = 0.16, 0.56)]. CUD was associated with all mental health symptoms across most ages [e.g. depressive symptoms; age 18 (b = 0.96, 95% CI = 0.19, 1.73) to age 61 (b = 1.11, 95% CI = 0.01, 2.21)]. Interactions with sex show stronger associations for females than males in young adulthood [e.g. V-HYS: CUD × sex interaction on psychotic symptoms significant after age 26 (b = 1.12, 95% CI = 0.02, 2.21)]. Findings were not moderated by early-onset CU. CONCLUSIONS: Significant associations between cannabis use (CU) frequency and disorder (CUD) and psychotic and depressive symptoms in late adolescence and young adulthood extend across adulthood, and include anxiety.

How Program Users Enhance Fidelity: Implementing the WITS Programs in Rural Canadian Elementary Schools.

Research on the processes that enhance implementation fidelity is needed to increase understanding of ways to advance the uptake and sustainability of evidence-based programs (Berkel et al. in Prevention Science, 12, 23-33, 2011; Berkel et al. 2017). We propose and test a theoretical model of interrelations among implementation fidelity (i.e., adherence to program components), and rarely investigated activities of program users that may enhance fidelity; namely integration of program strategies into daily activities and children's use of program strategies (CUoPS). These were assessed across the initial 2 years of the implementation of the WITS peer victimization prevention programs in 16 Canadian rural schools. WITS stands for Walk away, Ignore, Talk it out, and Seek help. All schools were implementing the program. We examined the interrelations among these implementation indicators and their effects on child outcomes targeted by the WITS Programs (i.e., social responsibility, prosocial leadership, peer victimization, emotional symptoms, and aggression). Four implementation assessments were collected from children (n = 1326), their parents, and teachers in the fall and spring of two academic years. The within-time correlations among fidelity, integration, and CUoPS were significant at each assessment. Cross-lagged models showed fidelity and integration, and CUoPS and integration were reciprocally related during each academic year. CUoPS predicted higher subsequent levels of fidelity during and across academic years. Suggestions are given for training and coaching to enhance teachers' integration of program strategies into daily life and for creating opportunities for school staff to observe children using program strategies in order to enhance implementation fidelity.

Depressive symptom trajectories and physical health: Persistence of problems from adolescence to young adulthood.

BACKGROUND: We examine how depressive symptom trajectories are related to adolescent and young adult subjective health, health-promoting, health-risk, and sexual risk behaviors, as well as cardiometabolic risks. METHOD: Data came from a community-based sample of youth (N = 662; 52% female) followed biannually, six times across 10 years. Latent class growth analysis identified four depressive symptom trajectories which were compared on adolescent (T1; ages 12-18) and young adult (T6; ages 22-29) health indicators. RESULTS: The Low stable trajectory (49%) showed the fewest health risks. The Persistent high trajectory (9%) reported higher physical symptoms, lower physical self-concept, less physical activity and sleep, and higher rates of smoking and sexual risk behaviors than the Low stable trajectory and risks for physical symptoms, physical self-concept, and physical activity worsened in young adulthood. Increasers (21%) showed risks for physical symptoms, physical activity, and sleep in adolescence and problems for physical symptoms and physical self-concept persisted in young adulthood. Decreasers (22%) showed risks for physical symptoms, physical self-concept, physical activity, and sleep in adolescence but these risks resolved into young adulthood. LIMITATIONS: Findings may not generalize to ethnic minorities. Sex differences were not examined due to sample size limitations and most variables, except cardiometabolic risks, were self-reported. CONCLUSIONS: Findings suggest early treatment of depressive symptoms that includes strategies addressing physical symptoms, physical self-concept, and physical activity may prove beneficial. Screening youth for physical symptoms and declines in health-promoting behaviors may also identify youth at risk of depression onset and progression.

Transitions in the use of multiple substances from adolescence to young adulthood.

BACKGROUND: Research indicates that many adolescents frequently use multiple substances. This study examines stability and transitions in the use and co-use of multiple substances (cigarette, alcohol, marijuana, illicit drugs) from adolescence to young adulthood. METHODS: Data were collected biennially from 662 youth in six assessments across ten years (2003-2013). We used latent class analysis (LCA) to classify youth by substances used at each wave and used latent transition analysis (LTA) to examine transition probabilities across waves. RESULTS: At each wave, a three-class model best fit the data. Classes included a poly-use class, that had the highest probabilities of use among all substances, a co-use class, that had high probabilities of use of alcohol and marijuana, and an alcohol-dominate class that started with low probabilities of use among all substances but showed increasing probabilities of alcohol use, at later ages. LTA showed that the probability of remaining in the poly-use class was the most stable from one wave to the next, followed by the alcohol-dominate class, and the co-use class. The most transitions occurred for the co-use class, with more individuals transitioning to the poly-use class than to the alcohol-dominate class. CONCLUSIONS: Strong stability among adolescent substance use classes was found between waves. Transitions were typically to classes using more substances, although, transitions to use fewer substances was evident for some individuals. Distinguishing stable and transitioning classes of substance use and co-use provides opportunities for prevention and intervention to disrupt high-risk use classes.

Ethical Challenges in Promoting the Implementation of Preventive Interventions: Report of the SPR Task Force.

Prevention science researchers and practitioners are increasingly engaged in a wide range of activities and roles to promote evidence-based prevention practices in the community. Ethical concerns invariably arise in these activities and roles that may not be explicitly addressed by university or professional guidelines for ethical conduct. In 2015, the Society for Prevention Research (SPR) Board of Directors commissioned Irwin Sandler and Tom Dishion to organize a series of roundtables and establish a task force to identify salient ethical issues encountered by prevention scientists and community-based practitioners as they collaborate to implement evidence-based prevention practices. This article documents the process and findings of the SPR Ethics Task Force and aims to inform continued efforts to articulate ethical practice. Specifically, the SPR membership and task force identified prevention activities that commonly stemmed from implementation and scale-up efforts. This article presents examples that illustrate typical ethical dilemmas. We present principles and concepts that can be used to frame the discussion of ethical concerns that may be encountered in implementation and scale-up efforts. We summarize value statements that stemmed from our discussion. We also conclude that the field of prevention science in general would benefit from standards and guidelines to promote ethical behavior and social justice in the process of implementing evidence-based prevention practices in community settings. It is our hope that this article serves as an educational resource for students, investigators, and Human Subjects Review Board members regarding some of the complexity of issues of fairness, equality, diversity, and personal rights for implementation of preventive interventions.