Keith J. Zullig

Relationship between perceived life satisfaction and adolescents' substance abuse

PURPOSE To explore the relationship between perceived global life satisfaction and selected substance use behaviors among 5032 public high school students. METHODS The 1997 South Carolina Youth Risk Behavior Survey substance abuse and life satisfaction variables were used. An adjusted polychotomous logistic regression analysis utilizing SAS/SUDAAN, revealed a significant race/gender interaction. Subsequent multivariate models were constructed individually for four race/gender groups. Adjusted odds ratios and 95% confidence intervals were calculated to assess the magnitude of risk for selected substance abuse behaviors and their association with reduced global life satisfaction. RESULTS Cigarette smoking, chewing tobacco, marijuana, cocaine, regular alcohol use, binge drinking, injection drug, and steroid use were significantly (p < .05) associated with reduced life satisfaction for specific race/gender groups (white males; black males; white females; and black females). In addition, age (< or = 13 years) of first alcohol drink, first marijuana use, first cocaine use, and first cigarette smoked were also significantly (p < .05) associated with reduced life satisfaction. CONCLUSION Longitudinal studies are needed to determine whether dissatisfaction with life is a consequence or determinant of substance abuse behavior for adolescents.

School Climate: Historical Review, Instrument Development, and School Assessment.

This study’s purpose is to examine the existing school climate literature in an attempt to constitute its definition from a historical context and to create a valid and reliable student-reported school climate instrument. Five historically common school climate domains and five measurement tools were identified, combined, and previewed by the target audience to determine face validity. The final student sample (N = 2,049) was randomly split into exploratory and confirmatory samples and subjected to factor analytic and structural equation modeling techniques. Factor analysis results confirmed an eight-factor solution (loadings with absolute values > .40). Item factor loadings ranged from .42 to .87. Coefficient alphas ranged from .65 to .91. Preliminary analyses support the reliability and validity of the instrument. This is the first study to balance historical precedent (what to measure) and modern scale development procedures (e.g., structural equation modeling) into a single attempt to measure school climate. Implications and potential uses are discussed.

The association between non-medical prescription drug use, depressive symptoms, and suicidality among college students

PURPOSE Studies have substantiated a relationship between drug use, depression, and suicidality. However, little research has examined this relationship with prescription drugs. Given the prevalence of non-medical prescription drug use (NMPDU) among college students, this study explored the association between general and specific NMPDU, depressive symptoms, and suicidality. METHODS Data from the Fall 2008 National College Health Assessment (NCHA) was utilized (N=22,783). Five separate logistic regression models were employed, with the first combining any NMPDU (antidepressants, painkillers, sedatives, and stimulants) followed by four additional regressions for each drug, and then separated by gender. Models were estimated before and after control for key covariates. RESULTS Approximately 13% of participants reported NMPDU. After covariate adjustment, those who reported feeling hopeless, sad, depressed, or considered suicide were 1.22-1.31 times more likely to report NMPDU (p<.05). Those who reported feeling hopeless, sad, or depressed were 1.18-1.43 times more likely to report opioid painkiller use; those who reported feeling sad, depressed, or considered suicide were 1.22-1.38 times more likely to report stimulant use; those who reported being depressed were 1.36 times more likely to report sedative use; and those who reported feeling hopeless or depressed were 1.44 and 1.91 times more likely to report antidepressant use (p<.05). When the adjusted models were repeated separately by gender, results were more pronounced for females, especially for females who reported painkiller use. CONCLUSIONS Depressive symptoms and suicidality were significantly associated with greater odds of any NMPDU, with painkiller use (especially for females) representing the greatest correlate among college students. Results suggest that students may be inappropriately self-medicating psychological distress with prescription medications.

Validation of the Brief Multidimensional Students' Life Satisfaction Scale Among College Students.

OBJECTIVE To investigate the psychometric properties of the BMSLSS among 522 college students. METHODS Internal consistency reliability explored scale reliability, factor analysis explored construct validity, known-groups validity was assessed by use of items from the National College Youth Risk Behavior Survey and Harvard National Survey of Alcohol Use, and criterion-related validity was explored through analyses with the CDCs Health-Related Quality of Life Scale. RESULTS Acceptable internal consistency reliability, construct, known-groups, and criterion-related validity were established. CONCLUSIONS These findings offer preliminary support for the BMSLSS; it could serve as part of comprehensive evaluations of subjective QOL for program evaluation and/or policy purposes among college students.

Higher coronary heart disease and heart attack morbidity in Appalachian coal mining regions.

BACKGROUND This study analyzes the U.S. 2006 Behavioral Risk Factor Surveillance System survey data (N=235,783) to test whether self-reported cardiovascular disease rates are higher in Appalachian coal mining counties compared to other counties after control for other risks. METHODS Dependent variables include self-reported measures of ever (1) being diagnosed with cardiovascular disease (CVD) or with a specific form of CVD including (2) stroke, (3) heart attack, or (4) angina or coronary heart disease (CHD). Independent variables included coal mining, smoking, BMI, drinking, physician supply, diabetes co-morbidity, age, race/ethnicity, education, income, and others. SUDAAN Multilog models were estimated, and odds ratios tested for coal mining effects. RESULTS After control for covariates, people in Appalachian coal mining areas reported significantly higher risk of CVD (OR=1.22, 95% CI=1.14-1.30), angina or CHD (OR=1.29, 95% CI=1.19-1.39) and heart attack (OR=1.19, 95% CI=1.10-1.30). Effects were present for both men and women. CONCLUSIONS Cardiovascular diseases have been linked to both air and water contamination in ways consistent with toxicants found in coal and coal processing. Future research is indicated to assess air and water quality in coal mining communities in Appalachia, with corresponding environmental programs and standards established as indicated.

Health-Related Quality of Life Among Central Appalachian Residents in Mountaintop Mining Counties

OBJECTIVES We examined the health-related quality of life of residents in mountaintop mining counties of Appalachia using the 2006 national Behavioral Risk Factor Surveillance System. METHODS Dependent variables included self-rated health; the number of poor physical, poor mental, and activity limitation days (in the past 30 days); and the Healthy Days Index. Independent variables included metropolitan status, primary care physician supply, and Behavioral Risk Factor Surveillance System behavioral and demographic variables. We compared dependent variables across 3 categories: mountaintop mining (yes or no), other coal mining (yes or no), and a referent nonmining group. We used SUDAAN MULTILOG and multiple linear regression models with post hoc least squares means to test mountaintop mining effects after adjusting for covariates. RESULTS Residents of mountaintop mining counties reported significantly more days of poor physical, mental, and activity limitation and poorer self-rated health (P < .01) compared with the other county groupings. Results were generally consistent in separate analyses by gender and age. CONCLUSIONS Mountaintop mining areas are associated with the greatest reductions in health-related quality of life even when compared with counties with other forms of coal mining.

A Comparative Analysis of Health-Related Quality of Life for Residents of U.S. Counties with and without Coal Mining

Objectives. We compared health-related quality of life (HRQOL) in mining and non-mining counties in and out of Appalachia using the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Methods. Dependent variables included self-rated health, the number of poor physical and mental health days, the number of activity limitation days (in the last 30 days), and the Centers for Disease Control and Prevention Healthy Days Index. Independent variables included the presence of coal mining, Appalachian region residence, metropolitan status, primary care physician supply, and BRFSS behavioral (e.g., smoking, body mass index, and alcohol consumption) and demographic (e.g., age, gender, race, and income) variables. We compared dependent variables across a four-category variable: Appalachia (yes/no) and coal mining (yes/no). We used SUDAAN® Multilog and multiple linear regression models with post-hoc least-squares means to test for Appalachian coal-mining effects after adjusting for covariates. Results. Residents of coal-mining counties inside and outside of Appalachia reported significantly fewer healthy days for both physical and mental health, and poorer self-rated health (p<0.0005) when compared with referent U.S. non-coal-mining counties, but disparities were greatest for people residing in Appalachian coal-mining areas. Furthermore, results remained consistent in separate analyses by gender and age. Conclusions. Coal-mining areas are characterized by greater socioeconomic disadvantage, riskier health behaviors, and environmental degradation that are associated with reduced HRQOL.

Sexual orientation and disordered eating behaviors among self-identified male and female college students

This study compared the risk of a) clinically diagnosed eating disorders, and b) disordered eating behaviors, separately among three groups of United States college students, controlling for known covariates. These groups included college students self-identifying as: 1) gay/lesbian; 2) bisexual; and, 3) unsure, with self-identified heterosexuals as the reference. Data from the American College Health Associations National College Health Assessment II (2008-2009) were utilized (N=110,412). Adjusted logistic regression analyses, stratified by self-reported gender, examined the effect of self-identified sexual identity on clinical eating disorder diagnosis and disordered eating behaviors. Covariates included self-reported binge drinking (past 2 weeks), stress (last 12 months), smoking (past 30 days), depression (past 12 months), fraternity/sorority membership, college athletics participations, and race. Additional logistic regression sub-analyses examined sexual minorities only, with gay/lesbian as the referent. Gay, unsure, or bisexual men were at significantly increased odds to report both clinical eating disorders and disordered eating behaviors when compared to heterosexual men in both the unadjusted and adjusted models (p<.002). All sexual minority men and women were significantly more likely to report dieting to lose weight compared to heterosexual men and women (p<.002). Targeted disordered eating and eating disorder prevention efforts are needed for those who are sexual minorities, particularly for sexual minority men.

Capacity-Related Innovations Resulting From the Implementation of a Community Collaboration Model for School Improvement

A new genus of district and school improvement models entails partnerships with other organizations and new working relationships with families, community leaders, and youths. The Ohio Community Collaboration Model for School Improvement (OCCMSI) is one such model. It enables partners to leverage family and community resources for learning, healthy development, and overall success in school. This study presents qualitative research findings about the key capacities developed by 6 schools and 6 districts piloting the OCCMSI. Process and product innovations, as well as facilitators and barriers, were tracked as these sites progressed with their implementation efforts. Implications are drawn in relation to how these new and expanded capacities might be prioritized by district and school leaders, consultants, and other professionals involved in partnership-centered models of school improvement.

The brief multidimensional students' life satisfaction scale-college version.

OBJECTIVES To investigate the psychometric properties of the BMSLSS-College among 723 college students. METHODS Internal consistency estimates explored scale reliability, factor analysis explored construct validity, and known-groups validity was assessed using the National College Youth Risk Behavior Survey and Harvard School of Public Health College Alcohol Study. Criterion-related validity was explored through analyses with the CDCs health-related quality of life scale and a social isolation scale. RESULTS Acceptable internal consistency reliability, construct, known-groups, and criterion-related validity were established. CONCLUSIONS Findings offer preliminary support for the BMSLSS-C; it could be useful in large-scale research studies, applied screening contexts, and for program evaluation purposes toward achieving Healthy People 2010 objectives.