Parental involvement and health risk behaviours among school-going adolescents in six African countries

The aim of this study was to assess the association between parental involvement (support and monitoring) and health risk behaviours among adolescents in six African countries. Data were from the cross-sectional Global School-Based Student Health Survey (GSHS) which sampled a total of 16 587 adolescents (mean age 14.6 years, SD = 1.6) from 2009 to 2013. In multivariable regression analyses, adjusted for relevant variables, higher levels of parental involvement were negatively associated with substance use (smoking, other tobacco use, drunkenness and illicit drug use) and violence (being bullied, in a physical fight), injury and truancy. Only high-level parental involvement was associated with use of contraception at most recent sex. Interventions for reducing various health risk behaviours should consider the positive impact of parental involvement.     

Concurrent alcohol and tobacco use among school-going adolescents in Namibia: Prevalence and risk factors

The aim of this study was to investigate the prevalence and risk factors for concurrent alcohol and tobacco use among school-going adolescents in Namibia. Data were from a sample of 4 531 Namibian middle school children (females = 53.1%; mean age = 15.8 years, SD = 1.8 years). They completed the Namibia Global School-based Student Health Survey (GSHS) in 2013. Overall, 74.4% of alcohol users in the past month were frequent tobacco users; whereas 40.5% of tobacco users in the past month were frequent alcohol users. Compared to students who were neither alcohol nor tobacco users (63.1%), concurrent alcohol and tobacco users were more likely to self-report with a lack of parent support, to have used illicit drugs, to have engaged in school truancy, to be sedentary in behaviour, to have engaged in a physical fight, and to have had two or more sexual partners. Substance use prevention and treatment programmes with adolescents should routinely address their risk for comorbid tobacco and alcohol use.     

The Relationship Between Family Stress and Behavioral Health Among African American Adolescents

African American youth, especially those who live in low-income communities, are at increased risk for experiencing higher juvenile justice involvement, poorer mental health, low school engagement, higher illicit drug use, and STIs, relative to their higher income peers and those from other ethnic backgrounds. However, few studies have examined the relationship between family stressors and these multiple youth concerns. This study examines the relationship between family stress (i.e., having an adult in the home with a history of mental illness, substance use, and incarceration) and youth concerns such as substance use, mental health challenges, low school engagement, juvenile justice involvement, and STI risk behaviors. A total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on the above constructs. Logistic regressions controlling for age, gender, socioeconomic status, and sexual orientation indicated that adolescents who reported higher rates of family stress were significantly more likely to report mental health problems, delinquent behaviors, juvenile justice involvement, drug use, risky sex, and lower school engagement factors. Findings suggest that attending to the developmental concerns of youth also requires addressing the needs of the family unit.     

Antecedents of risk-taking behaviour among South African adolescents

This study aimed to investigate contextual predisposition to risk-taking behaviour among South African adolescents. Participants included 194 black adolescents from central South Africa (female = 50.5% between the ages of 16 and 19 years). The adolescents completed a youth risk behaviour survey as well as a questionnaire on their parental, peer, school, and community relationships. Data were analysed by means of multivariate analyses of variance and standard multiple regression analyses in order to predict risk-taking behaviour (violence, substance use, and risky sexual behaviour) from various relationship contexts (parents, peers, school, and community). Irrespective of relationship context, males portray a higher risk for all types of risky behaviour, and the more time adolescents spend with their peers, the higher their risk for engagement in risk-taking behaviour. Parental monitoring predicted a lower risk for portraying risky behaviour.     

School Substance Use Norms and Racial Composition Moderate Parental and Peer Influences on Adolescent Substance Use

Parental and peer influences on adolescent substance use have been well demonstrated. However, limited research has examined how parental and peer influences vary across school contexts. This study used a multilevel approach to examine the effects of school substance use norms and school racial composition in predicting adolescent substance use (a composite measure of alcohol, tobacco, and marijuana use) and in moderating parental and peer influences on adolescent substance use. A total of 14,346 adolescents from 34 schools in a mid‐western county completed surveys electronically at school. Analyses were conducted using hierarchical linear modeling. Results indicated that school‐level disapproval against substance use and percentage of minority students at school were negatively associated with adolescent substance use. School‐level disapproval moderated the association between peer substance use and adolescent substance use, with the association being stronger when school‐level disapproval was lower. School racial composition moderated the influence of parental disapproval and peer substance use on adolescent substance use. Specifically, both the association between parental disapproval and adolescent substance use and the association between peer substance use and adolescent substance use were weaker for adolescents who attended schools with higher percentages of minority students. Findings highlighted the importance of considering the role of school contexts, in conjunction with parental and peer influences, in understanding adolescent substance use.     

Parental Knowledge and Substance Use Among African American Adolescents: Influence of Gender and Grade Level

Parental knowledge is defined as parental awareness and information about a child’s activities, whereabouts, and associations that is obtained through parental monitoring, parental solicitation, or self-disclosure. Increased parental knowledge is generally associated with lower adolescent substance use; however, the influence of various contextual factors, such as adolescent gender and grade level is not well understood, particularly for different racial or ethnic groups. In the present study, we used Hierarchical Generalized Linear Modeling analyses to examine the longitudinal relationship of parental knowledge to adolescent substance use in the context of adolescent gender and grade level among 207 urban African American adolescents in grades 6–11. Results indicated that increased parental knowledge is associated with a concurrent lower likelihood of substance use across all types of substances examined (alcohol, tobacco, marijuana, other drug use, and any drug use), but it did not predict changes in substance use 1 year later for the entire sample. However, analyses by gender and grade level showed that for boys and middle school youth, parental knowledge was a protective factor for increases in substance use across 1 year. Findings are discussed in terms of their implications for prevention and health promotion interventions for adolescent substance use among African American youth.     

Exploring risk and protective mechanisms associated with HIV infection among adolescents in South Africa

This study explored South African adolescents’ perceived risk and protection for HIV infection. Adolescents (N=28) with a mean age of 14.6 years receiving mental health care participated in Focus Group Discussions (FGDs) to engage in an in-depth exploration of their perceived risk and protective mechanisms for HIV prevention. The data were analysed using thematic content analysis. Themes that emerged from the FGDs associated with risk for HIV infection were: Alcohol and illicit drug use; Non-condom use; Prostitution and risky sexual activity with multiple partners; and Non-disclosure of HIV status. Themes that emerged as protective mechanisms included: HIV knowledge and appropriate HIV risk reducing behaviour; and Proactive parental attitudes and behaviour. These findings highlight the importance of ascertaining the perceptions of adolescents about risk and protection from HIV infection in order to inform future programs for HIV prevention among adolescents.     

Cannabis and Amphetamine Use and Socio-Ecological Proximal and Distal Factors Among School-Going Adolescents in Six Pacific Island Countries

The study aimed to assess the prevalence of cannabis and amphetamine use and socio-ecological proximal and distal factors among adolescents in six Pacific Island countries. We analyzed cross-sectional survey data from 9,849 adolescents (mean age 14.2 years, SD?=?1.2) from Cook Islands, Kiribati, Samoa, Solomon Islands, Tonga and Tuvalu that participated in the “Global School-Based Student Health Survey (GSHS)” in 2011–2013. The prevalence of past-month cannabis use was 15.5%, and lifetime amphetamine use was 14.5%, with the highest prevalence in Samoa, 37.1% and 34.6%, respectively. In adjusted mixed-effects logistic regression analysis male gender, personal attributes (anxiety, loneliness, current tobacco use, current alcohol use and school truancy) and environmental stressors (having been in a physical fight, been physically attacked, sustained an injury, hunger and being bullied) were associated with past-month cannabis and/or lifetime amphetamine use. Parental substance use was positively and parental involvement negatively associated with past-month cannabis and/or lifetime amphetamine use. Measures to prevent and control cannabis and amphetamine use in this adolescent population should include personal attributes, environmental stressors and parental support.     

Is there a Relationship between Family Structure and Substance Use among Public Middle School Students?

We investigated the relationship between family structure and substance use in a sample of 2,138 public middle school students in a southern state. The CDC Middle School Youth Risk Behavior Survey was utilized and adjusted logistic regression models were created separately for four race/gender categories (African American females/males, and Caucasian females/males) to examine associations among selected drug use variables (tobacco, alcohol, marijuana and inhalants). Analyses were adjusted for social economic status. Results suggested differences (p ≤ .05) among race/gender groups for the protective effect of living in an intact family (both mother and father, real or adoptive) regarding substance use among middle school students. In addition, family structure appeared to have a stronger relationship with substance use for Caucasians as opposed to African American adolescents. Caucasian adolescents living in cohabitated family households were more likely to report substance use, when compared to those living in intact two-parent households. Adolescents who are undergoing parental divorce may need special attention as they transition into new family structures.     

Prevalence,Correlates and Perceptions Towards Cigarette Smoking Among Male and Female in School Adolescents (Aged 11–18 Years) in South Africa: Results from the 2008 GYTS Study

The aim of this study was to estimate the prevalence and identify correlates of current cigarette use among 8,470 school-going adolescents (aged 11 to 18 years) in South Africa. A cross-sectional study was carried out in 2008 in South Africa within the framework of the Global Youth Tobacco Survey (GYTS). Overall prevalence of current cigarette smoking was 16.5%. Significantly more males (22.8%) than females (10.5%) were current smokers (p < .001). Cigarette smoking among boys and girls was positively associated with parental and/or peer smoking and greater risk perception, and among girls smoking attitudes variables (having more friends among girls, greater attractiveness of boys and weight change) and various higher exposure to smoking advertising and promotion activities were positively associated with cigarette smoking. However, antismoking advertising and community and family education were positively associated with current smoking, while only having school or community special groups or classes for students who want to stop smoking was protective of smoking. Cigarette smoking and other tobacco use is a significant public health problem in South Africa. Public health efforts aimed at preventing adolescent cigarette/tobacco use should incorporate knowledge on the associated factors related to smoking.     

Adolescent Precursors of Intensity of Marijuana and Other Illicit Drug Use Among Adult Initiators

This study examined (a) adolescent psychosocial risk factors for frequency (intensity) of marijuana use and for other illicit drug use among those who started using these drugs in early adulthood (adult initiators) and (b) the protective role of parent-adolescent relations in reducing or preventing drug use when adolescents enter early adulthood. The study's participants were male and female youth from a longitudinal prospective study. The participants' mean ages were 17 and 22 years at late adolescence and early adulthood, respectively. Independent measures assessed personality, parental, peer, and self-drug-use factors during late adolescence; dependent measures assessed frequency of marijuana use and other illicit drug use during early adulthood for initiators of the respective drug categories. The authors found that intensity of marijuana use was directly associated with the personality, parental, and self-drug-use domains and indirectly associated with the peer domain. Intensity of other illicit drug use was directly associated with personality and self-drug use. Analyses also revealed that some parent-adolescent relations factors buffered the effects of risk factors for both marijuana and other illicit drug-use intensity, whereas others enhanced the effects of protective factors against other illicit drug-use intensity. The results indicate that there are both commonalities and differences in precursors of marijuana and other illicit drug-use intensity among initiators of these drugs during early adulthood.     

Adolescent precursors of intensity of marijuana and other illicit drug use among adult initiators

This study examined (a) adolescent psychosocial risk factors for frequency (intensity) of marijuana use and for other illicit drug use among those who started using these drugs in early adulthood (adult initiators) and (b) the protective role of parent-adolescent relations in reducing or preventing drug use when adolescents enter early adulthood. The study's participants were male and female youth from a longitudinal prospective study. The participants' mean ages were 17 and 22 years at late adolescence and early adulthood, respectively. Independent measures assessed personality, parental, peer, and self-drug-use factors during late adolescence; dependent measures assessed frequency of marijuana use and other illicit drug use during early adulthood for initiators of the respective drug categories. The authors found that intensity of marijuana use was directly associated with the personality, parental, and self-drug-use domains and indirectly associated with the peer domain. Intensity of other illicit drug use was directly associated with personality and self-drug use. Analyses also revealed that some parent-adolescent relations factors buffered the effects of risk factors for both marijuana and other illicit drug-use intensity, whereas others enhanced the effects of protective factors against other illicit drug-use intensity. The results indicate that there are both commonalities and differences in precursors of marijuana and other illicit drug-use intensity among initiators of these drugs during early adulthood.     

Adolescent Substance Use: Preliminary Examinations of School and Neighborhood Context

In considering the influences of microsystems on adolescent substance use, familial and peer contexts have received the most extensive attention in the research literature. School and neighborhood settings, however, are other developmental contexts that may exert specific influences on adolescent substance use. In many instances, school settings are organized to provide educational services to students who share similar educational abilities and behavioral repertoires. The resulting segregation of students into these settings may result in different school norms for substance use. Similarly, neighborhood resources, including models for substance use and drug sales involvement, may play an important role in adolescent substance use. We briefly review literature examining contextual influences on adolescent substance use, and present results from two preliminary studies examining the contribution of school and neighborhood context to adolescent substance use. In the first investigation, we examine the impact of familial, peer, and school contexts on adolescent substance use. Respondents were 283 students (ages 13 to 18) from regular and special education classrooms in six schools. Although peer and parental contexts were important predictors of substance use, school norms for drug use accounted for variance in adolescent use beyond that explained by peer and parental norms. Data from a second study of 114 adolescents (mean age = 15) examines neighborhood contributions to adolescent substance use. In this sample, neighborhood indices did not contribute to our understanding of adolescent substance use. Implications for prevention are presented.     

Natural Mentors, Mental Health, and Risk Behaviors: A Longitudinal Analysis of African American Adolescents Transitioning into Adulthood

Patterns of substance use are examined in a sample of over 1,200 youth in a non-metropolitan region of New England. Self-reported history and frequency of alcohol, tobacco, marijuana, inhalants, pain medications, and other hard drug use was assessed for 9th and 10th grade students. Latent class analyses identified four patterns of substance use: non-users (22%), alcohol experimenters (38%), occasional polysubstance users (29%), and frequent polysubstance users (10%). Contextual risk and protective factors in the individual, family, peer, and community domains predicted substance use patterns. Youth report of peer substance use had the largest effects on substance use class membership. Other individual characteristics (e.g., gender, antisocial behavior, academic performance, perceived harm from use), family characteristics (e.g., parental drinking, parental disapproval of youth use), and community characteristics (e.g., availability of substances) demonstrated consistent effects on substance use classes. Implications for prevention are discussed from a social-ecological perspective.     

工读学校学生的物质滥用行为及其关键影响因素分析

选取西南某省工读学校的193名工读学生参加问卷调查,拟考察工读生的物质滥用行为特点,并初步探索影响工读生物质滥用行为的关键因素以及各关键因素的相对影响力。结果发现:(1)工读生中存在较严重的每日吸烟(49%)、大量饮酒(41%)和毒品使用行为(41%),女生的毒品使用行为约是男生的两倍(74%vs.35%);(2)父母物质滥用行为与态度、同伴物质滥用行为与态度、同伴压力、抵制效能感是影响工读生出现物质滥用行为的关键影响因素;(3)在工读生物质滥用行为影响因素的关系模型中,父母诸因素可以显著地预测同伴诸因素,同时,父母和同伴特点又通过影响工读生的抵制效能感,间接地预测工读生的三种物质滥用行为。其中,父母诸因素对工读生的物质滥用行为和抵制效能感的预测力大于同伴的作用。     

Illicit drug use and risky sexual behavior among African American and Puerto Rican urban adolescents: the longitudinal links

The authors assessed whether (a) early illicit drug use predicted later risky sexual activity, (b) early risky sex predicted later illicit drug use, and (c) common factors affected both risky sexual behavior and illicit drug use. African American and Puerto Rican youth completed questionnaires in their classrooms at Time 1 (T1) and face-to-face interviews with the authors in their homes 5 years later at Time 2 (T2). Logistic regression analyses showed the association between T1 illicit drug use and T2 risky sexual activity and between T1 risky sexual behavior and T2 illicit drug use. With few exceptions, T1 illicit drug use was associated with all of the T2 risky sexual behaviors. After controlling for demographic factors, the authors found that multiple sex partners at T1 was not related to illicit drug use at T2. Condom use at T1 was related to illicit drug use at T2, whereas sexually transmitted diseases and adolescent pregnancy were not related to this drug use. The findings indicated that assessments of and treatments for substance use should focus on the risky sexual behaviors that seem to accompany illicit drug use.     

Inattention as a key predictor of tobacco use in adolescence

The authors examined the prediction from inattention to tobacco use among 2 cohorts (ages 7 and 13) of a community sample followed to young adulthood. Changes in self-reported tobacco use were tested with marginal transitional regression models, using parent and teacher ratings of inattention, hyperactivity-impulsivity, and other psychopathology, along with other factors, as predictors. Inattention, but not hyperactivity-impulsivity, significantly predicted adolescent tobacco use and young adult daily tobacco use. Peer substance use, parental substance use, and conduct disorder also predicted increases in tobacco use. African American ethnicity was strongly protective against later tobacco use.     

The Protective Effects of Religious Beliefs on Behavioral Health Factors Among Low Income African American Adolescents in Chicago

Religious involvement has long been argued to have protective effects for negative behavioral health outcomes for vulnerable youth. This study builds on the existing resilience literature and need for more studies that examine protective factors associated with behavioral health. A sample of 638 low-income African American adolescents in Chicago to examine within group variations of the influence of religious involvement on delinquency, school engagement, substance use and sexual risk behaviors, and whether such relationships differ by gender, sexual orientation, and socioeconomic status. Logistic regression findings documented that greater religious involvement was protective with regards to lower rates of delinquency, drug use, risky sexual behaviors and higher rates of school engagement, and that gender, sexual orientation and socioeconomic status varied for several of these relationships. Overall findings are discussed with regards to future research.     

Psychosocial correlates of substance use behaviors among African American youth

Cross-sectional data were collected on substance use behaviors and potential correlates in 1,494 African American students enrolled in grades 5-12 in eight schools in a central Alabama school district. Using a risk and asset framework, self-reported recent alcohol, cigarette, and marijuana use were analyzed by identifying and measuring levels of influence, including individual, family, and school. For alcohol and marijuana use, recurrent risk factors were age, being hit by a parent, affiliation with gangs, and a tolerant attitude of peers toward drug use. For cigarette use, risk factors were peer-oriented: associations with gangs or cohorts holding lenient attitudes about substance use. For all substances, salient asset factors were academic achievement and parental monitoring. Findings suggest that efforts to reduce substance use behaviors should be directed at adolescents in terms of academic achievement and grade level as well as their social environments. For the latter, peer/family risks and family/school assets should be the foci for programs to minimize the short- and long-term consequences of these behaviors. Hence, the emphasis should be placed on modeling attitudes, preventing gang and family violence, encouraging parental supervision, and building positive teacher-student interactions.