Latent profile analysis of college students' alcohol and cannabis co-use patterns after recreational cannabis legalization.

OBJECTIVE: Evidence is mixed on how young adults' cannabis and alcohol use and co-use patterns have changed following recreational cannabis legalization (RCL). Incorporating measures of frequency and intensity of use we examined changes in college students' use and co-use patterns following RCL. METHOD: Four-year college students (n = 845,589) ages 18-24 years participated in the National College Health Assessment between 2008 and 2018, including students from 7 states that enacted RCL and 42 that did not. Latent profile analyses identified six patterns of use from four indicator variables tapping frequency of cannabis use and frequency and intensity of alcohol use: Abstainers, Light Alcohol Only, Heavy Alcohol Only, Predominantly Heavy Cannabis Use, Moderate Co-use, and Heavy Co-use. RESULTS: Regression models that adjusted for time and person- and institution-level covariates indicated that students' exposure to RCL was associated with lower odds of being in the two alcohol-only use classes, higher odds of being in the Predominantly Heavy Cannabis Use, Heavy Co-Use and Abstainers classes, and was not significantly related to Moderate Co-Use class membership. CONCLUSIONS: RCL was positively associated with patterns of frequent cannabis use and frequent and intense co-use but also with abstinence. Use of alcohol-only became less prevalent after RCL. Research on how RCL influences the prevalence of problematic patterns of substance use will inform and improve prevention efforts.

Associations between participation in a Physical Activity-Based Positive Youth Development Program and Academic Outcomes.

INTRODUCTION: Physical activity-based positive youth development (PYD) programs offer asset building experiences to foster the overall well-being of youth. These programs have the potential to enhance success in other important contexts for children, such as school. However, rigorous examination of this potential impact is needed. METHODS: Propensity score matching was used to compare school outcomes among children who participated in a short, summer physical activity-based PYD program in the USA and children who were from similar backgrounds and from the same school district but did not attend the program. The sample included 149 pairs of students aged 7-12 years (M = 10.11, SD = 1.26) and, in each group, 62% were from ethnically diverse backgrounds, 38% were from primarily Caucasian backgrounds, and 80 were female and 69 were male, and birth years were equally distributed. Ordinal and logistic regression models were used to test for differences between standardized math and language arts test scores, excused and unexcused absences, and total suspensions and expulsions between the two groups. RESULTS: PYD program youth had 55% and 46% greater odds being in the highest math (χ2(1, N = 298) = 4.06, p = .04) and total days attended categories (χ2(1, N = 298) = 5.58, p = .02) respectively. No other significant differences were found. When using a more rigorous quasi-experimental and longitudinal design, participation in a PYD program predicted some but not all academic performance and behaviors. PYD programs may need to be designed to specifically nurture academic skills to consistently impact academic outcomes.

Formative Evaluation of a Pilot Afterschool Physical Activity-Based Positive Youth Development Program.

4-H PALS is an afterschool positive youth development program for pre- and early adolescents delivered within the 4-H platform and designed to use physical activity to promote character development. The conceptual framework for this program, informed by the theory of triadic influence, prioritizes the social environment created during physical activities to promote adaptive outcomes. Given the novelty of the 4-H PALS curriculum, it is important to outline program components and identify both strengths and challenges to be addressed. Thus, this study aimed to document, describe, and conduct a formative evaluation of 4-H PALS. Major themes were identified across leader and participant interviews, program observations, lesson planning notes, attendance records, and intervention team feedback using inductive analysis methods. Three key areas of evaluation were identified: curriculum implementation fidelity, participant engagement with the curriculum and context, and the social environment. The program was successful in creating an affirmative, engaging environment fostering positive self-perceptions and social outcomes for participants. Challenges with logistical and conceptual implementation of the curriculum's character development concepts were identified. This evaluation will inform program refinements, with the goal of preparing the program for an efficacy study examining outcomes among participating youth.

Children exposed to the arrest of a family member: Associations with mental health.

The arrest of a parent or other family member can be detrimental to children's health. To study the impact of exposure to the arrest of a family member on children's mental health and how said association may change across developmental periods, we examined baseline data for children (birth through 11 years) entering family-based systems of care (SOC). Children exposed to the arrest of a family member had experienced significantly more 5.38 (SD = 2.59) different types of potentially traumatic events (PTE) than children not exposed to arrest 2.84 (SD = 2.56). Multiple regression model results showed that arrest exposure was significantly associated with greater behavioral and emotional challenges after controlling for children's age, gender, race/ethnicity, household income, caregiver's education, parenting factors, and other PTE exposure. Further analyses revealed differences in internalizing and externalizing behaviors associated with arrest exposure across developmental levels. This study highlights some of the mental health challenges for children exposed to the arrest of a family member, while adding to our knowledge of how such an event affects children across different developmental periods. More trauma-informed, developmentally appropriate systems need to be in place at all levels to assist children and families experiencing arrest.

SOCIO-EMOTIONAL AND CHARACTER DEVELOPMENT: A Theoretical Orientation.

More and more researchers are studying socio-emotional and character development (SECD). The rise and progress in SECD research is encouraging, but there is a critical issue with such a multidisciplinary and fast-developing field: SECD research and evaluation can be more consistent to prevent heterogeneity in definitions and disparate theoretical, measurement, and program models. After summarizing SECD-related literature, I recommend the theory of triadic influence (TTI) as a force to generate consistency and a resource to assist in guiding the design and evaluation of SECD-related programs. The theory fills a gulf in the literature that seeks an ecological theory aligned with SECD-related programs and etiology. The recommendation of the TTI stems from 3 main advantages: (1) The TTI integrates a full range of risk and protective factors in a detailed mediation and moderation framework; (2) it takes a comprehensive view of all the stakeholders in the educational system (i.e., youth, schools, families, and communities); (3) and its utility has been substantiated by empirical evidence from a variety of fields. I discuss applications of the TTI in SECD-related work and suggest improvements for etiology research and the design and evaluation of SECD programs.

The effect of cognitive load on decision making with graphically displayed uncertainty information.

An experiment examined the ability of five graphical displays to communicate uncertainty information when end users were under cognitive load (i.e., remembering an eight-digit number). The extent to which people could accurately derive information from the graphs and the adequacy of decisions about optimal behaviors based on the graphs were assessed across eight scenarios in which probabilistic outcomes were described. Results indicated that the load manipulation did not have an overall effect on derivation of information from the graphs (i.e., mean and probability estimation) but did suppress the ability to optimize behavioral choices based on the graph. Cognitive load affected people's use of some graphical displays (basic probability distribution function) more than others. Overall, the research suggests that interpreting basic characteristics of uncertainty data is unharmed under conditions of limited cognitive resources, whereas more deliberative processing is negatively affected.

Using social-emotional and character development to improve academic outcomes: a matched-pair, cluster-randomized controlled trial in low-income, urban schools.

BACKGROUND: School-based social-emotional and character development (SECD) programs can influence not only SECD but also academic-related outcomes. This study evaluated the impact of one SECD program, Positive Action (PA), on educational outcomes among low-income, urban youth. METHODS: The longitudinal study used a matched-pair, cluster-randomized controlled design. Student-reported disaffection with learning and academic grades, and teacher ratings of academic ability and motivation were assessed for a cohort followed from grades 3 to 8. Aggregate school records were used to assess standardized test performance (for entire school, cohort, and demographic subgroups) and absenteeism (entire school). Multilevel growth-curve analyses tested program effects. RESULTS: PA significantly improved growth in academic motivation and mitigated disaffection with learning. There was a positive impact of PA on absenteeism and marginally significant impact on math performance of all students. There were favorable program effects on reading for African American boys and cohort students transitioning between grades 7 and 8, and on math for girls and low-income students. CONCLUSIONS: A school-based SECD program was found to influence academic outcomes among students living in low-income, urban communities. Future research should examine mechanisms by which changes in SECD influence changes in academic outcomes.

Preventing negative behaviors among elementary-school students through enhancing students' social-emotional and character development.

PURPOSE: Examine the effects of a comprehensive, school-wide social-emotional and character development program using a positive youth development perspective. Specifically, we examined a mediation mechanism whereby positive academic-related behaviors mediated the intervention effects on substance use, violence, and sexual activity. DESIGN: Matched-pair, cluster-randomized, controlled design. SETTING: Twenty (10 intervention and 10 control) racially/ethnically diverse schools in Hawaii. SUBJECTS: Elementary-aged students (N = 1784) from grade 5. INTERVENTION: The Positive Action program. MEASURES: Students self-reported their academic behaviors, together with their substance use, violence, and voluntary sexual activity; teachers rated students' academic behaviors, substance use, and violence. ANALYSIS: Structural equation modeling. RESULTS: Students attending intervention schools reported significantly better academic behavior (B = .273, SE = .039, p < .001) and significantly less substance use (B = -.970, SE = .292, p < .01, incidence-rate ratio [IRR] = .379), violence (B = -1.410, SE = .296, p < .001, IRR = .244), and sexual activity (B = -2.415, SE = .608, p < .001, odds ratio = .089); boys reported more negative behaviors than girls. Intervention effects on student-reported substance use, violence, and sexual activity were mediated by positive academic behavior. Teacher reports corroborated these results, with rated academic behavior partially mediating the effects of the intervention on rated negative behaviors. CONCLUSION: This study (1) provides evidence that adds insight into one mechanism through which a social-emotional and character development program affects negative outcomes and (2) supports social-emotional and character development and positive youth development perspectives that posit that focusing on youths' assets may reduce negative behaviors.

Exposure to traumatic events and the behavioral health of children enrolled in an early childhood system of care.

Children may be exposed to numerous types of traumatic events that can negatively affect their development. The scope to which studies have examined an array of events among young children has been limited, thereby restricting our understanding of exposure and its relationship to behavioral functioning. The current cross-sectional study describes traumatic event exposure in detail and its relationship to behavioral health among an at-risk sample of young children (N = 184), under 6 years of age, upon enrollment into an early childhood, family-based, mental health system of care. Caregivers completed home-based semistructured interviews that covered children's exposure to 24 different types of traumatic events and behavioral and emotional functioning. Findings indicated that nearly 72% of young children experienced 1 or more types of traumatic events. Multiple regression model results showed that exposure was significantly associated with greater behavioral and emotional challenges with children's age, gender, race/ethnicity, household income, and caregiver's education in the model. These findings highlight the prevalence of traumatic exposures among an at-risk sample of young children in a system of care and suggest that this exposure is associated with behavioral and emotional challenges at a young age.

Decision making for risk management: a comparison of graphical methods for presenting quantitative uncertainty.

Previous research has shown that people err when making decisions aided by probability information. Surprisingly, there has been little exploration into the accuracy of decisions made based on many commonly used probabilistic display methods. Two experiments examined the ability of a comprehensive set of such methods to effectively communicate critical information to a decision maker and influence confidence in decision making. The second experiment investigated the performance of these methods under time pressure, a situational factor known to exacerbate judgmental errors. Ten commonly used graphical display methods were randomly assigned to participants. Across eight scenarios in which a probabilistic outcome was described, participants were asked questions regarding graph interpretation (e.g., mean) and made behavioral choices (i.e., act; do not act) based on the provided information indicated that decision-maker accuracy differed by graphical method; error bars and boxplots led to greatest mean estimation and behavioral choice accuracy whereas complementary cumulative probability distribution functions were associated with the highest probability estimation accuracy. Under time pressure, participant performance decreased when making behavioral choices.

Direct and Mediated Effects of a Social-Emotional and Character Development Program on Adolescent Substance Use.

Mitigating and preventing substance use among adolescents requires approaches that address the multitude of factors that influence this behavior. Such approaches must be tested, not only for evidence of empirical effectiveness, but also to determine the mechanisms by which they are successful. The aims of the present study were twofold: 1) To determine the effectiveness of a school-based social-emotional and character development (SECD) program, Positive Action (PA), in reducing substance use (SU) among a sample of U.S. youth living in a low-income, urban environment, and 2) to test one mechanism by which the program achieves its success. We used longitudinal mediation analysis to test the hypotheses that: 1) students attending PA intervention schools engage in significantly less SU than students attending control schools, 2) students attending PA intervention schools show significantly better change in SECD than students attending control schools, and 3) the effect of the PA intervention on SU is mediated by the change in SECD. Analyses revealed program effects on both SECD and SU, a relationship between SECD and SU, and the effects of PA on SU were completely mediated by changes in SECD. Future research directions and implications for school-based social-emotional and character development efforts and substance use prevention are addressed.

Improving elementary school quality through the use of a social-emotional and character development program: a matched-pair, cluster-randomized, controlled trial in Hawai'i.

BACKGROUND: School safety and quality affect student learning and success. This study examined the effects of a comprehensive elementary school-wide social-emotional and character education program, Positive Action, on teacher, parent, and student perceptions of school safety and quality utilizing a matched-pair, cluster-randomized, controlled design. The Positive Action Hawai'i trial included 20 racially/ethnically diverse schools and was conducted from 2002-2003 through 2005-2006. METHODS: School-level archival data, collected by the Hawai'i Department of Education, were used to examine program effects at 1-year post-trial. Teacher, parent, and student data were analyzed to examine indicators of school quality such as student safety and well-being, involvement, and satisfaction, as well as overall school quality. Matched-paired t-tests were used for the primary analysis, and sensitivity analyses included permutation tests and random-intercept growth curve models. RESULTS: Analyses comparing change from baseline to 1-year post-trial revealed that intervention schools demonstrated significantly improved school quality compared to control schools, with 21%, 13%, and 16% better overall school quality scores as reported by teachers, parents, and students, respectively. Teacher, parent, and student reports on individual school-quality indicators showed improvement in student safety and well-being, involvement, satisfaction, quality student support, focused and sustained action, standards-based learning, professionalism and system capacity, and coordinated team work. Teacher reports also showed an improvement in the responsiveness of the system. CONCLUSIONS: School quality was substantially improved, providing evidence that a school-wide social-emotional and character education program can enhance school quality and facilitate whole-school change.

Use of a social and character development program to prevent substance use, violent behaviors, and sexual activity among elementary-school students in Hawaii.

OBJECTIVES: We assessed the effectiveness of a 5-year trial of a comprehensive school-based program designed to prevent substance use, violent behaviors, and sexual activity among elementary-school students. METHODS: We used a matched-pair, cluster-randomized, controlled design, with 10 intervention schools and 10 control schools. Fifth-graders (N = 1714) self-reported on lifetime substance use, violence, and voluntary sexual activity. Teachers of participant students reported on student (N = 1225) substance use and violence. RESULTS: Two-level random-effects count models (with students nested within schools) indicated that student-reported substance use (rate ratio [RR] = 0.41; 90% confidence interval [CI] = 0.25, 0.66) and violence (RR = 0.42; 90% CI = 0.24, 0.73) were significantly lower for students attending intervention schools. A 2-level random-effects binary model indicated that sexual activity was lower (odds ratio = 0.24; 90% CI = 0.08, 0.66) for intervention students. Teacher reports substantiated the effects seen for student-reported data. Dose-response analyses indicated that students exposed to the program for at least 3 years had significantly lower rates of all negative behaviors. CONCLUSIONS: Risk-related behaviors were substantially reduced for students who participated in the program, providing evidence that a comprehensive school-based program can have a strong beneficial effect on student behavior.

Longitudinal patterns of binge drinking among first year college students with a history of tobacco use.

BACKGROUND: Underage heavy episodic drinking is a major contributor to alcohol-related morbidity/mortality. Reports indicate underage binge drinking among college students is widespread and has remained stable over the past decade. This study describes individual characteristics and calendar-specific events associated with binge drinking episodes over the course of freshman college academic year (2002-2003). METHODS: Students (N=827, age 18 years), with a prior history of tobacco use, attending a large Midwest university completed weekly web-based surveys on the number of drinks consumed for each of the past 7 days over the duration of 35 consecutive weeks (avg. number of weeks reported 16.0+/-10.5). RESULTS: Average prevalence of binge episodes across the academic year was 17.2+/-14.4%, 23.6+/-8.3%, and 66.3+/-11.2% for weekdays, Thursdays, and weekend days, respectively. Two-level random effects logit survival models for repeated events indicated the prevalence of weekday and Thursday binge drinking was associated with specific university/community events (Local festival odds ratio [OR] 6.03, 95% confidence interval [CI] 4.34-8.36), holidays (New Year's Eve OR 18.48, CI 12.83-26.63), and academic breaks (Spring Break OR 6.45, CI 4.57-9.08). Expected associations of younger age of first heavy drinking, past 12-month drinking, and experiencing negative consequences from heavy drinking were observed. CONCLUSIONS: Although individual characteristics were related to engaging in a binge episode, binge episodes were strongly associated with time-specific calendar events. Effective interventions to prevent immediate and long-term health consequences associated with binge drinking should consider environmental and institutional policy-level controls to reduce high levels of binge drinking on college campuses connected with holidays and university/community events.

Use and safety perceptions regarding herbal supplements: a study of older persons in southeast Idaho.

Herbal supplements (HS) are used by older persons and are often perceived as safe, although there is limited research that examines why this perception exists. A questionnaire was developed and pilot tested to investigate the use and perceived safety of HS among a convenience sample of 112 adults aged 60 to 92 in southeast Idaho. Fifty-five percent of the participants (n = 62) reported using HS in the past. Ninety-five percent (n = 59) of those using HS and 75% (n = 37) of nonusers reported they believed most or some HS were safe. Perception of herbal supplement safety was greatly influenced by family and friends, and HS users had a greater perception of safety than nonusers (p < or = .001). The top reasons for perceived safety given by HS users were that HS: (1) can be purchased without a prescription, (2) can be purchased in many locations, and (3) are natural.