Charles B. Fleming

Adolescent Substance Use Outcomes in the Raising Healthy Children Project: A Two-Part Latent Growth Curve Analysis

Raising Healthy Children (RHC) is a preventive intervention designed to promote positive youth development by targeting developmentally appropriate risk and protective factors. In this study, the authors tested the efficacy of the RHC intervention on reducing adolescent alcohol, marijuana, and cigarette use. Ten public schools, which comprised 959 1st- and 2nd-grade students (54% male students, 18% minority, 28% low socioeconomic status), were matched and assigned randomly to either intervention or control conditions. A 2-part latent growth modeling strategy was used to examine change in both use-versus-nonuse and frequency-of-use outcomes while students were in Grades 6-10. Results indicated significant (p < .05) intervention effects in growth trajectories for frequency of alcohol and marijuana use but not for use versus nonuse. These findings provide support for preventive interventions that take a social development perspective in targeting empirically supported risk and protective factors and demonstrate the use of 2-part models in adolescent substance use research.

Raising healthy children through enhancing social development in elementary school: Results after 1.5 years

This study examined results of a comprehensive, multifaceted longitudinal school-based prevention program called Raising Healthy Children (RHC). RHC focuses on enhancing protective factors with the goal of promoting positive youth development, reducing identified risk factors, and preventing adolescent problem behaviors. Participants included 938 elementary students from first or second grade who were enrolled in 10 area schools in the Pacific Northwest and randomly divided into two groups, those receiving RHC and peer controls. Analyses were conducted 18 months after implementation and focused on academic and behavioral improvements within the school environment. Results using hierarchical linear modeling showed that RHC students, compared to their peers who did not receive the intervention, had significantly higher teacher-reported academic performance (t ratio=2.27, p<.001) and a stronger commitment to school (t ratio=2.16, p<.03). Similarly, teachers reported that RHC students showed a significant decrease in antisocial behaviors (t ratio=−2.43, p<.02) and increased social competency (t ratio=2.96, p<.01) compared to control peers. Regression results from parent-reported outcomes also showed that RHC students had higher academic performance, β=.082, t=2.72, p<.01 and a stronger commitment to school, β=.080, t=2.45, p<.02. Results from this study and their implications for early and long-term prevention are discussed.

Longitudinal Effects of Student Mobility on Three Dimensions of Elementary School Engagement

Working within the developmental science research framework, this study sought to capture a dynamic and complex view of student mobility. Second- through fifth-grade data (N = 1,003, predominantly Caucasian) were drawn from a longitudinal study, and growth curve analyses allowed for the examination of mobility effects within the context of other factors that put children at risk, including behavior problems and family stress. School changes predicted declines in academic performance and classroom participation but not positive attitude toward school. Time-varying factors such as peer acceptance and teacher support had a positive influence on the growth trajectories of child outcomes. Additionally, teacher support had a particularly strong influence on positive attitudes toward school among children who had more school changes.

Family processes for children in early elementary school as predictors of smoking initiation

OBJECTIVES To assess the relationship between family processes measured when children are in early elementary school and initiation of cigarette smoking in early adolescence. METHODS The analysis sample of 810 children was drawn from a longitudinal study of students from a suburban school district in the Pacific Northwest. Predictor variables were assessed when children were in second or third grade, and smoking initiation was measured when the children were in sixth or seventh grade. Measures of family processes were entered separately into logistic regression models that included controls for household structure and income, parent smoking, and peer and child characteristics. RESULTS Measures of child attachment to parent and parent involvement with the childs school were significantly and negatively associated with smoking initiation. Among control variables, parent smoking, child grade level, and child antisocial behavior and depression were the strongest predictors of smoking initiation. CONCLUSIONS The results point to the importance of family bonding and parent supportiveness as protective factors and parent smoking and early childhood antisocial behavior and depression as risk factors for smoking initiation in pre- or early adolescence.

Romantic Relationships and Substance Use in Early Adulthood An Examination of the Influences of Relationship Type, Partner Substance Use, and Relationship Quality

This study used longitudinal data from 909 young adults to examine associations between substance use and the status and quality of romantic relationships. Heavy alcohol use, marijuana use, and cigarette smoking, as well as relationship status, relationship quality, partner substance use, and other salient life circumstances were assessed at four time points in the two years after high school. Marriage, cohabiting relationships, and noncohabiting dating relationships were associated with reductions in heavy drinking and marijuana use relative to non-dating, after adjusting for adolescent substance use; marriage compared to not dating was associated with reductions in cigarette smoking. For those in romantic relationships, partner substance use moderated the associations between relationship quality and substance use for heavy drinking and for marijuana use, supporting the hypothesis derived from the Social Development Model that the protective effect of stronger social bonds depends on the use patterns of the partner to whom an individual is bonded.

Transitions into and out of light and intermittent smoking during emerging adulthood

INTRODUCTION The purpose of this study was to examine transitions in smoking from adolescence into emerging adulthood and to identify factors that might influence these transitions, specifically, movement into and out of light and intermittent smoking. METHODS This study used Markov models to examine movement across three stages of smoking (nonsmoking, light and intermittent smoking, and heavy smoking) from adolescence into emerging adulthood. Biannual data were collected from 990 young men and women from the 12th grade until 2 years after high school. RESULTS At each timepoint, most youth were nonsmokers. Those who were heavy smokers in 12th grade had a 79% chance of also being heavy smokers 2 years after high school. Between 17% and 21% of participants were light and intermittent smokers at each timepoint, and the likelihood of remaining so at the next timepoint ranged from 56% to 72%. Less than one-half of the 12th-grade light and intermittent smokers were light and intermittent smokers 2 years later, and 3% of the sample were light and intermittent smokers across all assessments. Prevalence and transition rates did not differ by gender. College attendees reported less smoking than nonattendees before and after their transition to college, and attendees compared with nonattendees who smoked were less likely to transition from light and intermittent to heavy smoking and remain heavy smokers. Binge drinking was significantly related to 12th-grade smoking stage and to transitions from nonsmoking to smoking. Overall, few emerging adults maintained light and intermittent smoking consistently over time. DISCUSSION Light and intermittent smoking during emerging adulthood may not be the same phenomenon as light and intermittent smoking in adulthood.

Latent Growth Modeling of the Relationship Between Depressive Symptoms and Substance Use During Adolescence

To explicate the nature of the relationship between depressive symptoms and substance use, the authors conducted research that incorporated both individual and group approaches and utilized longitudinal data across development. Multiple-group latent growth curve models were used to assess specific dimensions (cross-sectional and longitudinal correlation, within-individual change, and movement off developmental trajectories) of the relationship between depressive symptoms and substance use during adolescence and how this relationship differs by gender. Annual survey data from 8th through 11th grade were provided by 441 girls and 510 boys in the Raising Healthy Children project (E. C. Brown, R. F. Catalano, C. B. Fleming, K. P. Haggerty, & R. D. Abbott, 2005). Levels of depressive symptoms and substance use in early adolescence were positively associated for alcohol, marijuana, and cigarette use for girls, but only for marijuana use for boys. Individual changes in depressive symptoms and substance use across adolescence were positively associated for each type of substance use. Evidence was also found for positive association between episodic expressions of depressive symptoms and alcohol use that fell outside developmental trajectories. Predictive relationships across constructs were not found, with the exception of higher level of depressive symptoms in early adolescence predicting less increase in alcohol use.

Level and Change in Reading Scores and Attention Problems During Elementary School as Predictors of Problem Behavior in Middle School

This study examined heterogeneity in change in reading test scores and attention problems during middle childhood and whether heterogeneity in change in these variables predicted later problem behavior. Our sample consisted of 783 students recruited from 10 Pacific Northwest schools. For both reading scores and teacher report of attention problems, latent growth curve models of annual data from Grades 3 to 6 showed statistically significant heterogeneity in initial level and change. Level and change factors for both variables were statistically significant predictors of problem behavior in 7th grade. In a combined model that included growth factors for both reading and attention problems, only level of attention problems had a unique and statistically significant association with problem behavior.

Raising Healthy Children: Examining the Impact of Promoting Healthy Driving Behavior within a Social Development Intervention

This study evaluated the impact of two targeted family sessions focused on driving issues delivered within the context of the Raising Healthy Children project. The Raising Healthy Children project began in the fall of 1993, drawing students in the 1st or 2nd grades from 10 schools. Schools were assigned to an intervention or control condition, and the school-wide, family- and student-focused preventive intervention to address developmentally salient risk and protective factors was delivered during elementary and middle school. The family driving sessions were administered to families in the intervention condition prior to and after teenagers received their drivers license. The first session consisted of a home visit with families designed to help parents and their children improve decision-making skills concerning driving and to develop clear standards and expectations regarding driving-related behavior. A second session, at the time of licensure, was designed to help parents and teens develop a written contract that stated family expectations, a plan for monitoring compliance with these expectations, and consequences for compliance or non-compliance.Consistent with the studys group-randomized design, intervention effects were assessed with multi-level logistic regression models in which students were grouped by their original school assignment. These models assessed specific effects of the driving sessions by adjusting for control variables measured when students were in 8th grade, prior to the driving sessions. Results indicated that students in the intervention group were more likely than students in the control group to report that they had a written driving contract (p = .003, OR = 4.98), and had participated in making the driving rules in the family (p = .025, OR = 1.70). Further, students in the intervention group reported significantly fewer risky behaviors including driving under the influence of alcohol (p = .021, OR = .45) and driving with someone who had been drinking (p = .038, OR = .56).

Drug use predictors of partner violence in opiate-dependent women

This paper examines the use of specific drugs as longitudinal predictors of violence between domestic partners in a sample of women in methadone treatment for opiate addiction. Crack cocaine use, use of other forms of cocaine, and tranquilizer use are each modestly to moderately positively associated with partner violence victimization. Women who were heavy users of these drugs were more likely to be hit, slapped, or shoved by their partners than light users or nonusers of these drugs. Three possible explanations of these associations are considered.