Timothy J. Grigsby

Predictors of alcohol-related negative consequences in adolescents: A systematic review of the literature and implications for future research.

OBJECTIVE To conduct a systematic review of the literature examining risk and protective factors of alcohol related negative consequences (ARNCs) among adolescents. METHODS We conducted a systematic search of original empirical articles published between January 1, 1990 and June 1, 2015. The qualitative synthesis was performed using the Theory of Triadic Influence as a framework. RESULTS Fifty-two studies were reviewed. Intrapersonal (e.g., personality traits, drinking motives and expectancies, depression), interpersonal (e.g., parental and peer alcohol use, violence exposure) and attitudinal factors (e.g., media exposure to alcohol, religiosity) influence ARNCs. Emerging evidence of new trends contributing to ARNCs include ready mixed alcohol drinks and childhood trauma and abuse. CONCLUSIONS Risk factors from all domains of influence were observed. More research is needed on protective factors and how alcohol use interacts with preventive factors in predicting ARNCs. The conceptualization of negative consequences varies significantly between studies and may impact the external validity of previous research.

The Role of Bicultural Stress and Perceived Context of Reception in the Expression of Aggression and Rule Breaking Behaviors Among Recent-Immigrant Hispanic Youth

Adolescent aggression and delinquency impede healthy adjustment in early adulthood and may have particularly serious long-term consequences for minority youth. Therefore, prevention research should examine these behaviors within a sociocultural framework among newer immigrant samples to determine whether, and how, adaptation to life in the US affects these behaviors. This study investigated the role of two sociocultural variables–bicultural stress and negative context of reception–on changes in aggression and rule breaking behaviors over two time points among recently immigrated Hispanic adolescents residing in Los Angeles (N = 136) and Miami-Dade (N = 142) counties. Linear stepwise regression models were used to assess the associations between predictors and behavioral outcomes. Bicultural stress and negative context of reception both had independent associations, above and beyond parental involvement and delinquent peer associations, with changes in aggressive and rule-breaking behavior during the first year of high school. These findings suggest that social, cultural, and interpersonal processes all influence deviant behaviors in recent-immigrant Hispanic populations. We discuss the implications of these finding for prevention and intervention research and practice. We also recommend that future research continue to examine the role of these factors over the course of adolescence and consider sociocultural influences when designing behavioral interventions for Hispanic immigrant populations

Alcohol, tobacco, and other drug misuse prevention and cessation programming for alternative high school youth: a review

BACKGROUND Relative to youth in regular high schools, alternative high school (AHS) youth are at high risk for alcohol, tobacco, and other drug (ATOD) misuse. Prevention and cessation efforts are needed for this population. METHODS A systematic, exhaustive literature search was completed to identify ATOD misuse prevention and cessation research studies with AHS youth. RESULTS For the AHS population, 23 ATOD misuse prevention or cessation program evaluations were located. This review indicated that successful efforts have focused on instruction in motivation enhancement, life coping skills, and decision making. CONCLUSIONS Alcohol, tobacco, and other drug misuse prevention and cessation programming for AHSs is effective, delivered in the classroom or as a school-based clinic. There is little evidence, though, that this programming is effective when delivered through other modalities such as via computer or bridging beyond the school setting. More research and application of evidence-based programming are recommended for youth in AHS settings.

Associations between Gun Violence Exposure, Gang Associations, and Youth Aggression: Implications for Prevention and Intervention Programs

Using cross-sectional data collected from three middle schools in Southeast Los Angeles, we assessed the association of neighborhood violence exposure, gang associations, and social self-control with past week aggression in a sample of minority youth (). Results from Poisson and logistic regression models showed that direct exposure to gun violence, having friends in gangs, and low social self control were all positively associated with past week aggression. Among girls, having gang affiliated family members was positively associated with aggression, whereas among boys having friends in gangs was associated with past week aggression. Subjective expectations of engagement in future interpersonal violence were associated with being male, having friends in gangs, and fear of neighborhood gun violence. We recommend that youth violence prevention and intervention programs address the impact of family, peers, and gun violence on student coping and identify students with low social self-control who could benefit from social and emotional skills training.

Problematic Substance Use Among Hispanic Adolescents and Young Adults: Implications for Prevention Efforts

Using data collected between 2005 and 2012 from a longitudinal study of acculturation patterns and substance use among Hispanic youth in Southern California (N = 2722), we fit multivariate logistic regression models to estimate the association of type and frequency of drug use, friend and parent drug use, cultural orientation (measured by the ARSMA-II), and psychological distress (CES-D score) in 10th grade with problematic substance use (measured with the RAPI) in (i) 11th grade and (ii) young adulthood. We conclude that future intervention efforts with Hispanic adolescents and young adults should target polysubstance and problem users and emphasize inter-individual, structural, and cultural processes as they relate to problematic substance use.

The relationship between family-based adverse childhood experiences and substance use behaviors among a diverse sample of college students

INTRODUCTION Research suggests that college students are an especially vulnerable subset of the population for substance use and misuse. However, despite evidence of the high prevalence of adverse childhood experiences (ACE) among students and the link between family-based ACE and substance use among older adults, this relationship remains understudied in college populations. Moreover, whether ACE represents a shared risk across substance use behaviors and ethnic groups is unknown. METHODS Data are student responses (n=2953) on the 2015 American College Health Associations National College Health Assessment II (ACHA-NCHA II) administered at one of the largest, most diverse public universities in California. Multivariable logistic and negative binomial regression models tested the association between individual and accumulated ACE and past 30-day alcohol, tobacco, marijuana, and illicit drug use, past 12-month prescription medication misuse and polysubstance use. RESULTS Between 50% and 75% of students involved in substance use were ACE exposed. There was a significant dose-response relationship between ACE and substance use and polysubstance use. Although accumulated ACE increased risk for substance use, there was considerable ethnic variability in these associations. CONCLUSIONS The graded effects of ACE for substance use underscore the link between family-based stressors and these behaviors in emergent adult college students. Our findings make a compelling case for investing in health initiatives that prioritize ACE screening and access to trauma-informed care in campus communities. Continued research with college populations is needed to replicate findings and clarify the role of ethnicity and culture in trauma response and help seeking behaviors.

Perceived discrimination, cultural identity development, and intimate partner violence among a sample of Hispanic young adults.

Objective: Despite the prevalence of interpersonal violence (IPV), scientific understanding of the risk and protective factors for unidirectional and bidirectional IPV, and especially the role of sociocultural variables in these behaviors, is limited. This study investigates the association between ethnic-identity search, ethnic-identity affirmation, perceived discrimination, and unidirectional (victimization only, perpetration only) and bidirectional (reciprocal violence) IPV behaviors among foreign-born and U.S.-born Hispanic young adults. Method: Data are from Project RED (Reteniendo y Entendiendo Diversidad para Salud), a study investigating the effect of psychosocial and sociocultural factors on health behavior among a community sample of Hispanic young adults in Southern California (n = 1,267). Results: Approximately 40% of the sample reported unidirectional or bidirectional IPV, with significant gender differences across the three categories. Compared with men, women had approximately 70% lower odds of victimization (OR = 0.31, 95% CI = 0.15–0.71), over twice the odds of perpetration (OR = 2.53, 95% CI = 1.98–3.62), and 35% higher odds (OR = 1.35, 95% CI = 1.04–1.81) of bidirectional IPV. Higher ethnic-identity affirmation was protective for victimization (OR = 0.86, 95% CI = 0.81–0.99) and bidirectional IPV (OR = 0.72, 95% CI = 0.62–0.89), whereas higher perceived discrimination scores increased the odds for bidirectional IPV (OR = 1.37 95% CI = 1.26–1.56) and was particularly detrimental for foreign-born participants. Conclusion: Intervention strategies should consider gender-specific risk profiles, cultural contexts, and the influence of sociocultural stressors. Addressing the harmful effects of perceived discrimination and leveraging the protective effects of ethnic-identity affirmation may be promising IPV-prevention strategies for Hispanic young adults. Future research directions and implications are discussed.

Evaluation of an Audio-Visual Novela to Improve Beliefs, Attitudes and Knowledge toward Dementia: A Mixed-Methods Approach

ABSTRACT Objectives: Dementia is a clinical syndrome characterized by progressive degeneration in cognitive ability that limits the capacity for independent living. Interventions are needed to target the medical, social, psychological, and knowledge needs of caregivers and patients. This study used a mixed methods approach to evaluate the effectiveness of a dementia novela presented in an audio-visual format in improving dementia attitudes, beliefs and knowledge. Methods: Adults from Los Angeles (N = 42, 83% female, 90% Hispanic/Latino, mean age = 42.2 years, 41.5% with less than a high school education) viewed an audio-visual novela on dementia. Participants completed surveys immediately before and after viewing the material. Results: The novela produced significant improvements in overall knowledge (t(41) = −9.79, p < .0001) and led to positive increases in specific attitudes toward people with dementia but not in beliefs that screening would be beneficial. Qualitative results provided concordant and discordant evidence for the quantitative findings. Conclusions: Results indicate that an audio-visual novela can be useful for improving attitudes and knowledge about dementia, but further work is needed to investigate the relation with health disparities in screening and treatment behaviors. Clinical Implications: Audio visual novelas are an innovative format for health education and change attitudes and knowledge about dementia.

Changes in the strength of peer influence and cultural factors on substance use initiation between late adolescence and emerging adulthood in a Hispanic sample

ABSTRACT We examine whether peer substance use and cultural factors differentially influence the initiation of tobacco, alcohol, and marijuana use in adolescence and emerging adulthood (EA) among a community-based sample of Hispanics. Participants provided data in 11th grade (M = 16.8 years old, SD = 0.54) and emerging adulthood (M = 20.3 years old, SD = 0.6). Peer tobacco use had a stronger association with initiation of tobacco use in emerging adulthood (OR = 1.46, 95% CI = 1.13, 1.89) than in adolescence (OR = 1.20, 95% CI = 1.03, 1.40), but this pattern was not observed with initiation of alcohol or marijuana use. Cultural orientation is associated with initiation of tobacco use during EA but not with initiation of alcohol or marijuana use.

A Perspective on Cigarette Smoking During Alcohol and Substance Use Treatment

Individuals in treatment for substance use continue to smoke at higher rates than the general population of the United States. This editorial presents a different perspective on cigarette smoking that might reflect aspects of the subculture of individuals who, representing a heterogeneous population, smoke while recovering from substance use associated problems. We discuss factors that independently and, in combination, influence cigarette smoking during treatment and recovery from substance use. We conclude that more qualitative research is needed to understand which factors, not typically emphasized in standard tobacco cessation programming, may contribute to cigarette smoking cessation for this population.