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    Research News Roundup: October 12, 2023

    Associations Between Parental Drinking and Alcohol Use Among Their Adolescent Children: Findings from a National Survey of United States Parent-Child Dyads

    Journal: Journal of Adolescent Health, 2023, doi: 10.1016/j.jadohealth.2023.05.028

    Authors: Michele K. Bohm & Marissa B. Esser


    Purpose: Underage drinking is common and costly. This study examined associations between parent and child drinking using recent United States national survey data.

    Methods: We analyzed responses of 740 parent-child dyads from 2020 SummerStyles and YouthStyles surveys. Parents and their adolescent children answered questions about past 30-day alcohol use. We estimated prevalence of adolescent drinking and explored differences by sociodemographics. A multivariable logistic regression model assessed whether parents’ drinking behaviors were associated with drinking among their children.

    Results: Overall, 6.6% of adolescents drank alcohol, with no significant differences by sociodemographics. Adolescents whose parents drank frequently (≥5 days/month), or binge drank, had significantly higher odds of drinking than adolescents whose parents did not drink or did not binge drink, respectively.

    Discussion: Parents could drink less to reduce the likelihood of drinking among their children. Implementation of effective population-level strategies (e.g., increasing alcohol taxes, regulating alcohol sales) can reduce excessive drinking among both adults and adolescents.

    To read the full text of the article, please visit the publisher’s website.

    Longitudinal Relationships Among Exclusionary School Discipline, Adolescent Substance Use, and Adult Arrest: Public Health Implications of the School-To-Prison Pipeline

    Journal: Drug Alcohol & Dependence, 2023, doi: 10.1016/j.drugalcdep.2023.110949

    Authors: Seth J. Prins, Ruth T. Shefner, Sandhya Kajeepeta, Natalie Levy, Precious Esie, & Pia M. Mauro


    Purpose: Exclusionary school discipline is an initiating component of the school-to-prison pipeline that is racialized and may lead to short- and long-term negative substance use and criminal legal outcomes. However, these impacts, and racial disparities therein, have not been well explored empirically at the individual-level.

    Procedures: We analyzed data from the National Longitudinal Study of Adolescent to Adult Health (1995-2009). We fit survey-weighted multivariable logistic regression models to estimate reciprocal relationships between exclusionary discipline and adolescent substance use, between these factors and subsequent exposure to the adult criminal legal system, and whether these relationships were modified by race or ethnicity.

    Results: We found that students reporting substance use had 2.07 (95% CI 1.57, 2.75) times greater odds of reporting subsequent school discipline, and students exposed to school discipline had 1.59 (95% CI 1.26, 2.02) times greater odds of reporting subsequent substance use. Substance use and school discipline were associated with 2.69 (95% CI 2.25, 3.22) and 2.98 (95% CI 2.46, 3.60) times the odds of reporting subsequent adult criminal legal system exposure, respectively. There was little evidence of effect modification by race/ethnicity.

    Conclusions: Findings indicate that school discipline and substance use are reciprocally associated and have direct implications for adolescent health and future criminal legal system exposure.

    To read the full text of the article, please visit the publisher’s website.

    Development of an Addiction Recovery Patient-Reported Outcome Measure: Response to Addiction Recovery (R2AR)

    Journal: Substance Abuse Treatment, Prevention, and Policy, 2023, doi: 10.1186/s13011-023-00560-z

    Authors: Elisabeth Okrant, Sharon Reif, & Constance M. Horgan


    Background: Recovery, a primary goal of addiction treatment, goes beyond abstinence. Incorporating broad domains with key elements that vary across individuals, recovery is a difficult concept to measure. Most addiction-related quality measurement has emphasized process measures, which limits evaluation of treatment quality and long-term outcomes, whereas patient-reported outcomes are richer and nuanced. To address these gaps, this study developed and tested a patient-reported outcome measure for addiction recovery, named Response to Addiction Recovery (R2AR).

    Methods: A multi-stage mixed methods approach followed the Patient-Reported Outcomes Measurement Information System (PROMIS) measure development standard. People with lived experience (PWLE) of addiction, treatment providers, and other experts contributed to item distillation and iterative measure refinement. From an item bank of 356 unique items, 57 items were tested via survey and interviews, followed by focus groups and cognitive interviews.

    Results: Face validity was demonstrated throughout. PWLE rated item importance higher and with greater variance than providers, yet both agreed that “There are more important things to me in my life than using substances” was the most important item. The final R2AR instrument has 19 items across 8 recovery domains, spanning early, active, and long-term recovery phases. Respondents assess agreement for each item as (1) a strength, and (2) importance to ongoing recovery.

    Conclusion: R2AR allows PWLE to define what is important to their recovery. It is designed to support treatment planning as part of clinical workflows and to track recovery progress. Inclusion of PWLE and providers in the development process enhances its face validity. Including PWLE in the development of R2AR and using the tool to guide recovery planning emphasizes the importance of patient-centeredness in designing clinical tools and involving patients in their own care.

    To read the full text of the article, please visit the publisher’s website.

    An Urgent Need for School-Based Diversion Programs for Adolescent Substance Use: A Statewide Survey of School Personnel

    Journal: Journal of Adolescent Health, 2023, doi: 10.1016/j.jadohealth.2023.04.006

    Authors: Jessica Liu, Rebecca Butler, Amy Turncliff, Caroline Gray, Stacey Lynch, Jennie Whittaker, Vanessa Iroegbulem, … Randi M. Schuster


    Purpose: There has been growing interest in reserving punishment as a last resort to address substance use in schools. However, there is significant variability in adoption of alternative approaches. This study reported school personnel’s perceptions of diversion programs, identified characteristics of schools/districts that currently have diversion programs, and defined barriers of implementation of diversion programs.

    Methods: One hundred fifty six school stakeholders from Massachusetts’ K-12 schools, including district administrators, principals and vice principals, school resource officers, guidance counselors, and nurses, completed a web-based survey in May-June 2020. Participants were recruited through e-mail distributed via professional listservs, direct school outreach, and community coalitions. The web survey queried beliefs, attitudes, and actions that schools take regarding substance use infractions as well as perceived barriers to implementing diversion programs.

    Results: Participants endorsed strong beliefs that punishment was an appropriate school response for student substance use, particularly for nontobacco-related infractions. Despite these personal beliefs, diversion programs were rated as more effective but less commonly used than punitive approaches (37% of respondents reported having diversion programs in their schools/districts vs. 85% used punitive approaches) (p < .03). Punishment was more likely to be used to respond to cannabis, alcohol, and other substances compared to tobacco (p < .02). Primary barriers of implementing diversion programs included funding, staff training, and parental support.

    Discussion: Based on school personnel perceptions, these findings lend further support for a transition away from punishment and toward more restorative alternatives. However, barriers to sustainability and equity were identified that warrant consideration when implementing diversion programs.

    To read the full text of the article, please visit the publisher’s website.

    Social Media Use and Subsequent E-Cigarette Susceptibility, Initiation, and Continued Use Among US Adolescents

    Journal: Preventing Chronic Disease, 2023, doi: 10.5888/pcd20.220415

    Authors: Juhan Lee, Suchitra Krishnan-Sarin, & Grace Kong


    Introduction: Social media has a large amount of e-cigarette content. Little is known about the associations between social media use and a wide range of e-cigarette use behaviors, including susceptibility, initiation, and continued use. We analyzed national data on US adolescents to assess these associations.

    Methods: We used data on adolescents participating in the Population Assessment of Tobacco and Health (PATH) Study Wave 4 (2016-2018) and Wave 5 (2018-2019). We conducted 2 models: 1) a multinomial logistic regression on e-cigarette use susceptibility and use behaviors at Wave 5 by social media use at Wave 4 among adolescents who never used e-cigarettes at Wave 4 and 2) a binomial logistic regression on current e-cigarette use at Wave 5 by social media use at Wave 4 among adolescents who ever used e-cigarettes at Wave 4.

    Results: Among adolescents who never used e-cigarettes at Wave 4 (n = 7,872), daily social media use (vs never) was associated with a higher likelihood of being susceptible to e-cigarette use (adjusted odds ratio [aOR] =1.46; 95% CI, 1.20-1.78), past e-cigarette use (aOR = 3.55; 95% CI, 2.49-5.06), and current e-cigarette use (aOR = 3.45; 95% CI, 2.38-5.02) at Wave 5. Among adolescents who ever used e-cigarettes at Wave 4 (n = 794), we found no significant association between social media use at Wave 4 and continued e-cigarette use at Wave 5.

    Conclusion: Our study found that social media use is associated with subsequent susceptibility to e-cigarette use and initiation but not with continued use of e-cigarettes among US adolescents. These findings suggest that understanding and addressing the association between social media and e-cigarette use is critical.

    To read the full text of the article, please visit the publisher’s website.