Carolyn M. Porta

Effective Parenting Interventions to Reduce Youth Substance Use: A Systematic Review

CONTEXT: Parenting interventions may prevent adolescent substance use; however, questions remain regarding the effectiveness of interventions across substances and delivery qualities contributing to successful intervention outcomes. OBJECTIVE: To describe the effectiveness of parent-focused interventions in reducing or preventing adolescent tobacco, alcohol, and illicit substance use and to identify optimal intervention targeted participants, dosage, settings, and delivery methods. DATA SOURCES: PubMed, PsycINFO, ERIC, and CINAHL. STUDY SELECTION: Randomized controlled trials reporting adolescent substance use outcomes, focusing on imparting parenting knowledge, skills, practices, or behaviors. DATA EXTRACTION: Trained researchers extracted data from each article using a standardized, prepiloted form. Because of study heterogeneity, a qualitative technique known as harvest plots was used to summarize findings. RESULTS: A total of 42 studies represented by 66 articles met inclusion criteria. Results indicate that parenting interventions are effective at preventing and decreasing adolescent tobacco, alcohol, and illicit substance use over the short and long term. The majority of effective interventions required ≤12 contact hours and were implemented through in-person sessions including parents and youth. Evidence for computer-based delivery was strong only for alcohol use prevention. Few interventions were delivered outside of school or home settings. LIMITATIONS: Overall risk of bias is high. CONCLUSIONS: This review suggests that relatively low-intensity group parenting interventions are effective at reducing or preventing adolescent substance use and that protection may persist for multiple years. There is a need for additional evidence in clinical and other community settings using an expanded set of delivery methods.

Campus sexual violence resources and emotional health of college women who have experienced sexual assault

Institutional characteristics may help mitigate trauma associated with sexual assault. This study examines associations between resources on college campuses for sexual violence prevention and the emotional well-being of female students who have experienced sexual assault. There were 495 female college students who have experienced sexual assault who provided survey data in 2010–2011. Sexual violence resource data from 28 college campuses were combined with student survey data in multilevel analysis. Dependent variables include diagnosis with anxiety, depression, panic attacks, and PTSD, and models adjust for covariates and clustering of students within colleges. Participants attending colleges with more sexual violence resources had lower rates of mental health conditions than those attending colleges with fewer resources. Colleges are encouraged to expand their array of sexual violence resources to create a supportive environment for victims of sexual assault and to connect affected students with appropriate services.

LGBTQ Youth's Views on Gay-Straight Alliances: Building Community, Providing Gateways, and Representing Safety and Support

BACKGROUND Gay-Straight Alliances (GSAs) are school-based clubs that can contribute to a healthy school climate for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. While positive associations between health behaviors and GSAs have been documented, less is known about how youth perceive GSAs. METHODS A total of 58 LGBTQ youth (14-19 years old) mentioned GSAs during go-along interviews in 3 states/provinces in North America. These 446 comments about GSAs were thematically coded and organized using Atlas.ti software by a multidisciplinary research team. RESULTS A total of 3 themes describe youth-perceived attributes of GSAs. First, youth identified GSAs as an opportunity to be members of a community, evidenced by their sense of emotional connection, support and belonging, opportunities for leadership, and fulfillment of needs. Second, GSAs served as a gateway to resources outside of the GSA, such as supportive adults and informal social locations. Third, GSAs represented safety. CONCLUSIONS GSAs positively influence the physical, social, emotional, and academic well-being of LGBTQ young people and their allies. School administrators and staff are positioned to advocate for comprehensive GSAs. Study findings offer insights about the mechanisms by which GSAs benefit youth health and well-being.

Go-along interviewing with LGBTQ youth in Canada and the United States

ABSTRACT Go-along interviews, which are interviews conducted while being in and moving within participant selected spaces, were conducted with 66 lesbian, gay, bisexual, transgender, and queer adolescents (14–19 years old) in their self-identified communities to explore perceived community attributes, including safe spaces, resources, and supports; this article highlights methodological lessons learned. Successful recruitment in 2 countries and varied community settings required partnership with local lesbian, gay, bisexual, transgender, and queer supporting agencies, including school-based gay–straight alliances. Youth chose to walk, use public transportation, and drive to community locations, identifying numerous formal and informal resources in their communities. Participant reflections highlighted that go-along interviews can be conducted in safe ways that encourage lesbian, gay, bisexual, transgender, and queer youth to express themselves about communities in which they live, study, work, play, and relax.

Chasing the rainbow: lesbian, gay, bisexual, transgender and queer youth and pride semiotics

Abstract While the pride rainbow has been part of political and social intervention for decades, few have researched how lesbian, gay, bisexual, transgender and queer young people perceive and use the symbol. How do lesbian, gay, bisexual, transgender and queer youth who experience greater feelings of isolation and discrimination than heterosexual youth recognise and deploy the symbol? As part of a larger study on supportive lesbian, gay, bisexual, transgender and queer youth environments, we conducted 66 go-along interviews with lesbian, gay, bisexual, transgender and queer youth people from Massachusetts, Minnesota and British Columbia. During interviews, young people identified visible symbols of support, including recognition and the use of the pride rainbow. A semiotic analysis reveals that young people use the rainbow to construct meanings related to affiliation and positive feelings about themselves, different communities and their futures. Constructed and shared meanings help make the symbol a useful tool for navigating social and physical surroundings. As part of this process, however, young people also recognize that there are limits to the symbolism; it is useful for navigation but its display does not always guarantee supportive places and people. Thus, the pride rainbow connotes safety and support, but using it as a tool for navigation is a learned activity that requires caution.

Honoring Roots in Multiple Worlds Professionals’ Perspectives on Healthy Development of Latino Youth

Purpose. To obtain contextualized insights from professionals regarding factors that contribute to or inhibit the healthy development of Latino youth. Method. A community-engaged study in which semistructured in-depth interviews were conducted with 30 professionals who work extensively with Latino youth in urban clinics, schools, and other community-based settings. Results. Every key informant expressed opinions regarding factors that contribute to healthy development of Latino youth, ranging from cultural identity and a sense of belonging to family connectedness and adult role models. Contributing and inhibiting factors were characterized by being either intrinsic to the individual (e.g., sense of belonging, hope) or extrinsic (e.g., family support and love, community support). Conclusion. Recognition of and appreciation for the importance of cultural influences in the lives of Latino youth is a critical starting point on which professionals must build to respectfully and successfully encourage healthy youth development. Factors that contribute to the healthy development of Latino youth range from cultural identity and cultural pride to family connectedness, adult role models, and a sense of belonging. In working with Latino young people, professionals must recognize and appreciate cultural influences as foundational to this population’s health and well-being.

Helping Young People Stay Afloat: A Qualitative Study of Community Resources and Supports for LGBTQ Adolescents in the United States and Canada

ABSTRACT LGBTQ youth are at increased risk of poor health outcomes. This qualitative study gathered data from LGBTQ adolescents regarding their communities and describes the resources they draw on for support. We conducted 66 go-along interviews with diverse LGBTQ adolescents (mean age = 16.6) in Minnesota, Massachusetts, and British Columbia in 2014–2015, in which interviewers accompanied participants in their communities to better understand those contexts. Their responses were systematically organized and coded for common themes, reflecting levels of the social ecological model. Participants described resources at each level, emphasizing organizational, community, and social factors such as LGBTQ youth organizations and events, media presence, and visibility of LGBTQ adults. Numerous resources were identified, and representative themes were highly consistent across locations, genders, orientations, racial/ethnic groups, and city size. Findings suggest new avenues for research with LGBTQ youth and many opportunities for communities to create and expand resources and supports for this population.

Substance Use among Sexual Minorities: Has it Actually Gotten Better?

ABSTRACT Background: Despite efforts to decrease substance use, rates among sexual minority youth (SMY) remain higher than among heterosexuals. Substance use is a leading contributor to morbidity and mortality in adulthood, and SMYs use of substances is related to poorer mental and emotional health. Objectives: We sought to document the trends in substance use for a large sample of youth over 14 years with special attention to SMY. In addition, we tested whether there were disparities in substance use behaviors between SMY and heterosexual youth. Last, we examined changes in disparities over time in substance use among SMY. Methods: We analyzed data from 8 waves of the Massachusetts YRBS (N = 26,002, Mage = 16), from 1999 to 2013, to investigate trends and disparities in current tobacco, alcohol, and cannabis use for heterosexual youth and SMY. We used logistic regression interaction models to test whether these disparities have widened or narrowed for SMY, as compared to heterosexuals, over the span of 14 years. Results: In absolute terms, substance use rates decreased for nearly all youth between 1999 and 2013. There were striking disparities in substance use between heterosexual youth and all sexual minority subgroups. These disparities in substance use narrowed among males but remained unchanged or worsened among females. Conclusions/Importance: Trends in substance use are changing over time, but not in the same ways for all sexual minority subgroups. Patterns are worsening for females. These findings suggest that we need to address the needs of LGB populations in novel ways.

Trend Disparities in Emotional Distress and Suicidality Among Sexual Minority and Heterosexual Minnesota Adolescents From 1998 to 2010

BACKGROUND Sexual minority young people have demonstrated higher rates of emotional distress and suicidality in comparison to heterosexual peers. Research to date has not examined trends in these disparities, specifically, whether there have been disparity reductions or increases and how outcomes have differed over time by sex and sexual orientation group. METHODS Minnesota Student Survey data, collected from 9th and 12th graders in 3 cohorts (1998, 2004, 2010) were used to examine emotional distress and suicidality rates. Logistic regression analyses were completed to examine outcome changes over time within and across sexual orientation/sex groups. RESULTS With few exceptions, sexual minority youth are at increased risk of endorsing emotional distress and suicidality indicators in each surveyed year between 1998 and 2010. Young people with both-sex partners reported more emotional distress across all health indicators compared to their opposite-sex partnered peers. With a few exceptions, gaps in disparities between heterosexual and sexual minority have not changed from 2004 to 2010. CONCLUSIONS Disparities in emotional health persist among youth. Research is needed to advance understanding of mental health disparities, with consideration of sexual orientation differences and contextualized to sociocultural status and changes over time. Personalized prevention strategies are needed to promote adolescent mental health.

Forensic Nursing State of the Science: Research and Practice Opportunities

Introduction: The International Association of Forensic Nurses (IAFN) is the only nursing organization advancing the forensic nursing specialty. The organization seeks to advance the profession, and one mechanism for doing so is development of a research agenda. Methods: The purpose of this action-based research study was to aid in the development of a forensic nursing research agenda. The study was carried out in two integral stages: (a) focus groups with IAFN members attending the annual conference and (b) reviewing posted IAFN member listserv material. Results: The findings of this study identified similar gaps of other nursing specialties experiencing “growing pains,” including role confusion and variation in educational preparation. Conclusion: Findings from this study will inform development of the IAFN 5-year research agenda to advance forensic nursing science and evidence-based practice.