Nathaniel R. Riggs

Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence

IMPORTANCE Exposure to nicotine in electronic cigarettes (e-cigarettes) is becoming increasingly common among adolescents who report never having smoked combustible tobacco. OBJECTIVE To evaluate whether e-cigarette use among 14-year-old adolescents who have never tried combustible tobacco is associated with risk of initiating use of 3 combustible tobacco products (ie, cigarettes, cigars, and hookah). DESIGN, SETTING, AND PARTICIPANTS Longitudinal repeated assessment of a school-based cohort at baseline (fall 2013, 9th grade, mean age = 14.1 years) and at a 6-month follow-up (spring 2014, 9th grade) and a 12-month follow-up (fall 2014, 10th grade). Ten public high schools in Los Angeles, California, were recruited through convenience sampling. Participants were students who reported never using combustible tobacco at baseline and completed follow-up assessments at 6 or 12 months (N = 2530). At each time point, students completed self-report surveys during in-classroom data collections. EXPOSURE Student self-report of whether he or she ever used e-cigarettes (yes or no) at baseline. MAIN OUTCOMES AND MEASURES Six- and 12-month follow-up reports on use of any of the following tobacco products within the prior 6 months: (1) any combustible tobacco product (yes or no); (2) combustible cigarettes (yes or no), (3) cigars (yes or no); (4) hookah (yes or no); and (5) number of combustible tobacco products (range: 0-3). RESULTS Past 6-month use of any combustible tobacco product was more frequent in baseline e-cigarette ever users (n = 222) than never users (n = 2308) at the 6-month follow-up (30.7% vs 8.1%, respectively; difference between groups in prevalence rates, 22.7% [95% CI, 16.4%-28.9%]) and at the 12-month follow-up (25.2% vs 9.3%, respectively; difference between groups, 15.9% [95% CI, 10.0%-21.8%]). Baseline e-cigarette use was associated with greater likelihood of use of any combustible tobacco product averaged across the 2 follow-up periods in the unadjusted analyses (odds ratio [OR], 4.27 [95% CI, 3.19-5.71]) and in the analyses adjusted for sociodemographic, environmental, and intrapersonal risk factors for smoking (OR, 2.73 [95% CI, 2.00-3.73]). Product-specific analyses showed that baseline e-cigarette use was positively associated with combustible cigarette (OR, 2.65 [95% CI, 1.73-4.05]), cigar (OR, 4.85 [95% CI, 3.38-6.96]), and hookah (OR, 3.25 [95% CI, 2.29-4.62]) use and with the number of different combustible products used (OR, 4.26 [95% CI, 3.16-5.74]) averaged across the 2 follow-up periods. CONCLUSIONS AND RELEVANCE Among high school students in Los Angeles, those who had ever used e-cigarettes at baseline compared with nonusers were more likely to report initiation of combustible tobacco use over the next year. Further research is needed to understand whether this association may be causal.

Concurrent and 2-Year Longitudinal Relations Between Executive Function and the Behavior of 1st and 2nd Grade Children

Concurrent and 2-year longitudinal relations were investigated between two indicators of children’s (n =60; mean age = years 11 months) executive function, inhibitory control and sequencing ability, and behavior problem symptomatology. Dependent measures were parent and teacher reported internalizing and externalizing behavior. Hierarchical multiple regression analyses demonstrated few significant concurrent associations between either inhibitory control or sequencing ability, and behavior problem symptoms. In contrast, baseline inhibitory control predicted decreased teacher reported externalizing, and parent reported externalizing and internalizing behavior problems over a 2-year period. Baseline sequencing ability also predicted decreased teacher reported externalizing and parent reported internalizing behavior over this same time period. Results suggest that some aspects of executive function in early elementary grade-school children may be more strongly associated with change in behavior over time than concurrent behavior. Implications of these findings for the prevention of behavior problems are discussed.

After-School Youth Development Programs: A Developmental-Ecological Model of Current Research

Although there has been a rapid increase in funding and attention to after-school programs, there is little understanding of how after-school programs impact childrens developmental trajectories. The heterogeneity of American children makes it very unlikely that all children need after-school programming or that there is but one brand of after-school programming suitable for all youth. We discuss the numerous developmental and contextual factors that may influence which children benefit most from after-school programs as well as the nature of the after-school programs most beneficial to childrens needs. The value of utilizing an ecological and developmental perspective to after-school program evaluation are presented, including the need for improved research designs and more detailed analyses of program type and services as well as a more complete determination of which children benefit the most from after-school participation.

Executive cognitive function and food intake in children.

OBJECTIVE The current study investigated relations among neurocognitive skills important for behavioral regulation, and the intake of fruit, vegetables, and snack food in children. DESIGN Participants completed surveys at a single time point. SETTING Assessments took place during school. PARTICIPANTS Participants were 107 fourth-grade children from a large US city. Ninety-one percent were Latino, and 4% were African-American, which represented school ethnic distribution. MAIN OUTCOME MEASURE(S) Independent variable included was self-reported executive cognitive function (ECF). Dependent variables included self-reported fruit, vegetable, and snack food intake. ANALYSES Primary analyses general linear regression models covarying for appropriate demographic variables. RESULTS Analyses demonstrated that ECF proficiency was negatively related to snack food intake, but was not significantly related to fruit and vegetable intake. CONCLUSIONS AND IMPLICATIONS Since ECF is correlated with snack food intake, future studies may consider assessing the potential of enhancing ECF in health promotion interventions.

Preventing Risk for Obesity by Promoting Self-Regulation and Decision-Making Skills: Pilot Results from the PATHWAYS to Health Program (PATHWAYS).

The overall aim of the two school-based pilot studies was to evaluate whether an approach to prevention that focused on changing child impulse control, decision making, and social competence can be effective in changing attitudes toward food intake and physical activity as risk factors for obesity. The strategy used was to translate specific components of one evidence-based program for violence prevention (Promoting Alternative Thinking Strategies: PATHS) into an elementary school curriculum program for obesity prevention. Both studies demonstrated significant changes in positive attitudes toward self-regulation of appetitive behavior. In addition, Study 2 demonstrated positive changes in actual food choices and television viewing patterns. Implications are that comprehensive efforts to prevent youth risk for obesity should include as one component school-based curricula that target self-regulation and decision-making skills.

Momentary Assessment of Affect, Physical Feeling States, and Physical Activity in Children

OBJECTIVE Most research on the interplay of affective and physical feelings states with physical activity in children has been conducted under laboratory conditions and fails to capture intraindividual covariation. The current study used Ecological Momentary Assessment (EMA) to bidirectionally examine how affective and physical feeling states are related to objectively measured physical activity taking place in naturalistic settings during the course of childrens everyday lives. METHODS Children (N = 119, ages 9-13 years, 52% male, 32% Hispanic) completed 8 days of EMA monitoring, which measured positive affect (PA), negative affect (NA), feeling tired, and feeling energetic up to 7 times per day. EMA responses were time-matched to accelerometer assessed moderate-to-vigorous physical activity (MVPA) in the 30 min before and after each EMA survey. RESULTS Higher ratings of feeling energetic and lower ratings of feeling tired were associated with more MVPA in the 30 min after the EMA prompt. More MVPA in the 30 min before the EMA prompt was associated with higher ratings of PA and feeling energetic and lower ratings of NA. Between-subjects analyses indicated that mean hourly leisure-time MVPA was associated with less intraindividual variability in PA and NA. CONCLUSIONS Physical feeling states predict subsequent physical activity levels, which in turn, predict subsequent affective states in children. Active children demonstrated higher positive and negative emotional stability. Although the strength of these associations were of modest magnitude and their clinical relevance is unclear, understanding the antecedents to and consequences of physical activity may have theoretical and practical implications for the maintenance and promotion of physical activity and psychological well-being in children.

Identifying patterns of eating and physical activity in children: a latent class analysis of obesity risk.

We used latent class analysis (LCA) to identify heterogeneous subgroups with respect to behavioral obesity risk factors in a sample of 4th grade children (n = 997) residing in Southern California. Multiple dimensions assessing physical activity, eating and sedentary behavior, and weight perceptions were explored. A set of 11 latent class indicators were used in the analysis. The final model yielded a five‐class solution: “High‐sedentary, high‐fat/high‐sugar (HF/HS) snacks, not weight conscious,” “dieting without exercise, weight conscious,” “high‐sedentary, HF/HS snacks, weight conscious,” “active, healthy eating,” and “low healthy, snack food, inactive, not weight conscious.” The results suggested distinct subtypes of children with respect to obesity‐related risk behaviors. Ethnicity, gender, and a socioeconomic status proxy variable significantly predicted the above latent classes. Overweight or obese weight status was determined based on the Centers for Disease Control and Prevention BMI (kg/m2)‐for‐age‐and‐sex percentile (overweight, 85th percentile ≤BMI <95th percentile; obese, 95th percentile ≤BMI). The identified latent subgroup membership, in turn, was associated with the childrens weight categories. The results suggest that intervention programs could be refined or targeted based on childrens characteristics to promote effective pediatric obesity interventions.

Social Networks and Community Prevention Coalitions

This study investigates the links between community readiness and the social networks among participants in Communities That Care (CTC), community-based prevention coalitions. The coalitions targeted adolescent behavior problems through community risk factor assessments, prioritization of risk factors, and selection/implementation of corresponding evidence-based family, school, and community programs. Key leaders (n = 219) in 23 new CTC sites completed questionnaires focusing on community readiness to implement CTC and the respondents’ personal, work, and social organization links to other key leaders in the community. Outside technical assistants also completed ratings of each community’s readiness and early CTC functioning. Measures of network cohesion/integration were positively associated with readiness, while centralization was negatively associated. These results suggest that non-centralized networks in which ties between members are close and direct may be an indicator of community readiness. In addition, we found different associations between readiness and different domains of social relations. Editors’ Strategic Implications: The authors present the promising practice of using social network analysis to characterize the functioning of local prevention coalitions and their readiness to implement a community-based prevention initiative. Researchers and community planners will benefit from the lessons in this article, which capitalizes on a large sample and multiple informants. This work raises interesting questions about how to combine the promotion of coalition functioning while simultaneously encouraging diversity of coalition membership.

Examining the Potential of Community-Based After-School Programs for Latino Youth

Results are presented from two pilot studies examining the potential influence of community-based after-school programs (ASPs) on regionally diverse Latino youth of varying ages. Study 1 examined relations between dimensions of ASP attendance and content, and ethnic identity development, and self-worth in urban Latino adolescents. In this study, higher ratings of the ASP’s emphasis on ethnic socialization were associated with a more developed ethnic identity, while greater intensity of ASP participation and perceptions of ASP quality were associated with higher levels of self-worth. Study 2 examined relations between ASP participation and development of concentration and emotion regulation skills in rural Latino grade-school youth. In this study, youth who regularly attended the ASP demonstrated significantly better concentration and regulation skills than those who did not regularly attend, if they exhibited preexisting concentration and regulation problems. Findings illustrate how ASPs with varying strategies, activities, and assessment tools can be evaluated in the interest of designing future large-scale investigations into ASPs and Latino positive youth development.

Neurocognition as a Moderator and Mediator in Adolescent Substance Misuse Prevention

Discussed are potential roles for neurocognitive function in models of substance misuse prevention. Regional heterogeneity in the time-course of brain development appears to be one contributor to adolescent substance misuse vulnerability as areas of the brain related to reward, pleasure, novelty seeking, and emotion achieve functional maturity much earlier in development than do frontal-cortical areas of the brain responsible for self-regulation of behavior and higher order cognitive decision-making. We review the literature related to the development of neurocognitive systems known to correlate with substance misuse and suggest roles for neurocognition in models of substance misuse prevention outcomes. Implications and future directions for neurocognitive models of substance misuse prevention are also discussed.