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Cooperative Extension is in a unique position to address health and wellness concerns across the country, particularly in rural areas with local Extension services. One innovative model, the Health Extension: Advocacy, Research, and Teaching (HEART) Initiative, unites Extension, community organizations, and community members in collaborative activities to address the complex, multifaceted components of substance use disorder. The model utilized a multidisciplinary team and community-based participatory research (CBPR) approach with evidence-based practices to increase Extension's abilities to guide and tailor programming to local needs and to create significant impacts. Cooperative Extension's long history of engagement in the community, with state and federal linkages, creates a trusted source for partnering on behavioral health crises. This multidisciplinary team model increased Cooperative Extension's scope and capacity to respond to substance-related disorders and can be replicated in other areas.

Because of the long history of anti-drug policing in the United States and the criminalization of substance use, clients who use substances are vulnerable to direct and vicarious experiences of police violence. Consequently, those who use substances may face a greater risk of experiencing symptoms of trauma that counselors should address in treatment. We recommend the use of a trauma-informed and abolitionist praxis in clinical and social justice practices as a framework to support clients who use substances and have histories of exposure to police violence.

There are rising cases of disrespect in Kenyan society amid efforts by Christian Religious Education (CRE) in secondary schools to make the learner appreciate and respect their own, and other people's cultural beliefs and practices. The morals of the secondary school graduates enrolled in colleges and society do not reflect the acquisition of values learnt through CRE. Despite the exposure of students to the Christian Religious Education curriculum, cases of disrespect, for instance, drug abuse, abortion, arson in schools, hate speech, religious and ethnic hatred continue being witnessed everywhere. The purpose for this study was to examine the Christian Religious Education teachers' perception on the use of valuing methods for learner value acquisition in National Secondary Schools in Kenya. The objective of the study was to establish the Christian Religious Education teachers' perception on the use of valuing methods for learner value acquisition and to find out the challenges they face in the process. The study was based on the Theory of Development of values. The study adopted mixed methods under the convergent parallel design. The target population of the study was 95 national secondary schools in Kenya with a total of 224 CRE teachers. However, 30% of schools and teachers were sampled. The study sample size was 67 CRE teachers. The study employed stratified and simple random sampling to select the schools for study and purposive sampling technique to select CRE teachers to participate in the study. Data was collected through the questionnaire, document analysis, and interview and observation schedules. The validity and reliability of data collection instruments was done through use of experts and piloting respectively. The quantitative data was analyzed using descriptive statistics presented in frequencies and percentages while the qualitative data was analyzed in thematic coding. The study revealed that CRE teachers are conscious of certain values that the CRE content is to facilitate to learners and are aware that particular content may not only transmit a single value depending on how it is facilitated they are however not keen on being specific on relating particular content to particular values. The main reasons perceived by the teachers to this non-use was noted as overcrowded curriculum, insufficient in-service training and the seeming neglect of the affective domain in teaching and examinations. Much as majority of the teachers do not use valuing methods, they however perceive them as having positive characteristics that can enrich content acquisition by learners. Study recommends that the syllabus be explicit in mentioning particular values in relation to particular teaching content. On this note the study recommends that KICD should work very closely with CRE subject specialists to ensure that the affective domain in the teaching of CRE is given adequate guidance.

This study employs a mixed-methods approach, combining quantitative and qualitative research methodologies to investigate the dynamics of leadership, management, and performance in the context of drug prevention within schools under local administrative organizations. The research pursues three main objectives: (1) to examine the key elements of leadership, management, and performance related to drug prevention in these educational institutions, (2) to analyze the direct, indirect, and combined influences of leadership on the management and performance of drug prevention efforts, and (3) to formulate policy recommendations for influential leadership development models tailored to enhance the management and performance of drug prevention initiatives. Quantitative data were collected from 400 personnel within educational institutes under the Sisaket Local Administrative Organization, utilizing stratified random sampling and a questionnaire with a high-reliability score of 0.978. Concurrently, qualitative insights were from 12 purposively selected educational institutes in the same administrative context through the focused group. The analytical toolkit included frequency, percentage, mean, standard deviation, structural equation analysis, and content analysis. Key findings indicate the appropriateness of utilizing trait-based, behavior-based, and situational leadership alongside Principles of management to construct a comprehensive structural equation model. The performance emerges as primarily influenced by Principles of management, all statistically significant at 0.01 level. In terms of policy suggestions, the focus centers on fostering a knowledgeable and collaborative team, developing leadership skills through cooperation, and creating an organizational culture that supportslearning and development. Thisintegrated leadership development approach isthe picture to significantly impact the effective management and prevention of drug abuse in schools under local administrative organizations.

The objectives of this research were (1) to assess the suitability and feasibility of participatory approaches for the prevention and solution of drug problems of schools under Sisaket Provincial Administrative Organizations and (2) to create a consensus proposing a leadership development model that influences driving effectiveness, management and performance on drug prevention of schools under the local government organization. The informants were the study administrators and teachers who were responsible for prevention and correction drug problem of school, each group of 5 people, and the total of 10 people, obtained by purposive selection. The research instrument was a semi-structured interview. The interviews were conducted during January to March 2023. The research results showed that (1) Participatory approaches for the prevention and solution of drug problems of schools under the local administrative organizations in Sisaket Province of every created item had a suitability assessment at a level higher than the specified criteria and the possibility of implementing the guidelines; and (2) leadership development model that influences management and results of drug prevention operations in schools under the local government organization can be summarized in 5 issues: (1) raising awareness and education (2) developing communication skills (3) building trusted teams (4) being a good role model, and (5) self-reflection and assessment.

Youth interpersonal firearm violence disproportionately affects Black youth, with residential racial segregation as a key determinant. Racially segregated neighborhoods, which are economically isolated (e.g., neighborhood disadvantage), are linked to increased exposure to violence. This exposure, in turn, is a determinant of youth firearm aggression (i.e., using a gun on someone else). Mechanisms from residential racial segregation to firearm aggression, however, have not been evaluated. Therefore, we tested neighborhood disadvantage and exposure to violence as mediators in the association between residential racial segregation and youth firearm aggression. Participants were 338 Black youth who had used drugs in the past 6 months and sought care in an urban emergency department. Using serial mediation analysis, residential racial segregation was indirectly associated with youth firearm aggression via neighborhood disadvantage and then exposure to violence. While researchers have documented the association between structural racism and firearm violence injury and incidents, our study assessed multiple socioecological mechanisms simultaneously. Identifying the downstream socioecological consequences of residential segregation can guide the development of firearm aggression prevention programs addressing the consequences of racism.

Families are key in the healthy development of Latinx sexual minority youth (Latinx SMY), a group that experiences behavioral, mental, and sexual health disparities. Despite this, there are no family-based interventions for Latinx SMY and their families to prevent drug use, sexual risk behaviors, and depressive symptoms. The purpose of this pilot study was to evaluate the preliminary impact (i.e., estimated effect sizes) of "Familias con Orgullo" (FcO) and examine its feasibility and acceptability among 30 Latinx SMY and their parents. Parents and adolescents were randomized to FcO or a control condition and assessed pre/post-intervention. Feasibility was measured based on session completion and effect sizes. Focus groups were conducted to evaluate intervention acceptability. Findings showed promising effects favoring FcO on parent-adolescent communication (d = 0.46) and parental involvement (d = 0.34). There were also promising effects favoring FcO on suicidal thoughts (OR = 0.75) and depression symptoms (OR = 0.69). Finally, 100% of the adolescents in FcO either continued to remain drug-free or transitioned from current use to no use (from baseline to post-intervention) compared to 74% in the control. Effect sizes for condomless sex, parental monitoring, and positive parenting were small. Session completion (above 80%) and focus group findings indicated strong feasibility and acceptability. FcO holds promise for reducing drug use and depressive symptoms and improving family functioning among Latinx SMY.

Objective: Psychoactive substance use is prevalent among young people in Nigeria. However, the dearth of accessible and good-quality treatment for substance use disorders in Nigeria creates a treatment gap. This study evaluated the effectiveness of a substance use prevention education programme (SUPEP) for young people in Nigeria. Design: A quasi-experimental study using a pre- post-test was conducted. The experimental group (n = 100) and comparison group (n = 100) comprised students in four senior secondary schools. Data were collected using a validated self-report questionnaire and the WHO Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) version 3.0. Paired sample t-tests, analysis of covariance (ANCOVA) and generalised and linear mixed models (GLMM) were used for data analysis. Setting: Two hundred young people aged 14-20 years prone to substance use participated in SUPEP in four secondary schools in Enugu State, Southeast, Nigeria. Results: Students' psychoactive substance knowledge and substance use attitudes in the experimental group (p < 0.001) improved significantly post-intervention. ANCOVA results showed that the mean psychoactive substance knowledge score increased significantly between the time points, F(1, 123) = 8.89, p = 0.003. In contrast, mean psychoactive substance use attitudes reduced significantly between the same time points, F(1, 123) = 12.390, p = 0.001. However, no significant difference between the groups was observed in the mean psychoactive substance use behaviour post-intervention. Conclusion: The school-based SUPEP increases psychoactive substance knowledge and improves attitudes. However, the intervention did not reduce substance use among adolescents.

Objective: To determine if treatment of co-occurring adult ADHD and Cannabis Use Disorder (CUD) with extended-release mixed amphetamine salts (MAS-ER) would be effective at improving ADHD symptoms and promoting abstinence. Method: A 12-week randomized, double-blind, two-arm pilot feasibility trial of adults with comorbid ADHD and CUD (n = 28) comparing MAS-ER (80 mg) to placebo. Main outcomes: ADHD: [greater than or equal to] 30% symptom reduction, measured by the Adult ADHD Investigator Symptom Rating Scale (AISRS). CUD: Abstinence during last 2 observed weeks of maintenance phase. Results: Overall, medication was well-tolerated. There was no significant difference in ADHD symptom reduction (MAS-ER: 83.3%; placebo: 71.4%; p = 0.65) or cannabis abstinence (MAS-ER: 15.4%; placebo: 0%; p = 0.27). MAS-ER group showed a significant decrease in weekly cannabis use days over time compared to placebo (p < 0.0001). Conclusions: MAS-ER was generally well-tolerated. The small sample size precluded a determination of MAS-ER's superiority reducing ADHD symptoms or promoting abstinence. Notably, MAS-ER significantly reduced weekly days of use over time.

The network scale-up method (NSUM) is a survey-based method for estimating the number of individuals in a hidden or hard-to-reach subgroup of a general population. In NSUM surveys, sampled individuals report how many others they know in the subpopulation of interest (e.g. "How many sex workers do you know?") and how many others they know in subpopulations of the general population (e.g. "How many bus drivers do you know?"). NSUM is widely used to estimate the size of important sociological and epidemiological risk groups, including men who have sex with men, sex workers, HIV+ individuals, and drug users. Unlike several other methods for population size estimation, NSUM requires only a single random sample and the estimator has a conveniently simple form. Despite its popularity, there are no published guidelines for the minimum sample size calculation to achieve a desired statistical precision. Here, we provide a sample size formula that can be employed in any NSUM survey. We show analytically and by simulation that the sample size controls error at the nominal rate and is robust to some forms of network model mis-specification. We apply this methodology to study the minimum sample size and relative error properties of several published NSUM surveys.

This study examined the clinical utility of the Massachusetts Youth Screening Instrument--Second Version (MAYSI-2) among African American (AA) incarcerated youth and used White incarcerated youth as a comparison group. Data were analyzed for 314 incarcerated youth (193 AA offenders and 121 White offenders) of ages 13-17 years who were adjudicated delinquent from a southeastern United States medium security residential facility. Seven logistic regression and receiver operating characteristic curve (ROC) models were built to determine whether the MAYSI-2 subscales accurately identify committed AA male incarcerated youth who have a mental illness diagnosis on file. Analyses also examined how well the MAYSI-2 subscales identify specific mental illnesses among AA-committed male incarcerated youth. Results demonstrated that no MAYSI-2 subscales accurately identified and categorized AA-committed male incarcerated youth who have mental disorders, and only two subscales (Alcohol/Drug Use, Depressed/Anxious) identified and categorized White committed male incarcerated youth who have a mental disorder. Additional results and implications for research and practice are provided.

Opioid overdose deaths are dramatically increasing in the United States and disproportionately affecting minority communities, with the increasing presence of fentanyl exacerbating this crisis. Developing community coalitions is a long-standing strategy used to address public health issues. However, there is a limited understanding of how coalitions operate amid a serious public health crisis. To address this gap, we leveraged data from the HEALing Communities Study (HCS)--a multisite implementation study aiming to reduce opioid overdose deaths in 67 communities. Researchers analyzed transcripts of 321 qualitative interviews conducted with members of 56 coalitions in the four states participating in the HCS. There were no a priori interests in themes, and emergent themes were identified through inductive thematic analysis and then mapped to the constructs of the Community Coalition Action Theory (CCAT). Themes emerged related to coalition development and highlighted the role of health equity in the inner workings of coalitions addressing the opioid epidemic. Coalition members reported seeing the lack of racial and ethnic diversity within their coalitions as a barrier to their work. However, when coalitions focused on health equity, they noted that their effectiveness and ability to tailor their initiatives to their communities' needs were strengthened. Based on our findings, we suggest two additions to enhance the CCAT: (a) incorporating health equity as an overarching construct that affects all stages of development, and (b) ensuring that data about individuals served are included within the pooled resource construct to enable monitoring of health equity.

A revised way of thinking is essential for promoting harm reduction strategies and reducing the negative implications of injection drug use (IDU). Despite the growth of harm reduction approaches in the United States, there is limited guidance for designing and implementing multi-sector efforts that address the external determinants that promote and facilitate IDU. Current frameworks fail to acknowledge the individual's role and influence in multi-sector change. To address the multifaceted nature of IDU, we must address the complex relationship between people who inject drugs (PWID) and their external environment. As part of a community-academic partnership, a framework was developed to address the gaps in current theoretical models and community practice. Our Harm Reduction Collaboration Framework (HRCF) accepts PWID as key stakeholders and presents a practical framework in which PWID and community organizations partner in decision making to influence policy, systems, and environmental change. We provide examples of two organizations that have made substantive changes in implementing harm reduction strategies in their communities by utilizing the HRCF.

This study assesses adults' perceptions of and predictors of intention to use prescription drug take-back boxes. This mixed methods study utilized focus groups and an online survey to examine factors related to intention to use a prescription drug take-back box. This study was conducted in [State] during the spring and summer of 2018. Themes identified in focus group data included the importance of take-back box location, benefits of take-back box use (such as reducing opportunities for medication misuse), and barriers to take-back box use (such as lack of awareness, stigma associated with law enforcement). Survey results indicate that pharmacies are the most preferred take-back box location and that attitudes, subjective norms, and perceived behavioral control are statistically significant predictors of intention to use a take-back box. Results suggest that individuals are open to using take-back boxes in secure, convenient locations, but many arsoe unaware of take-back boxes as an option for safe disposal. These findings have implications for health communication and policy efforts designed to increase the use of take-back boxes for prescription drug disposal.

The rise in opioid misuse coincides with increased sexually transmitted infection (STI) and HIV incidence. Transactional sex is an under-researched phenomenon among Black Americans who misuse opioids, and may increase their risk of STI or HIV transmission. Given the disproportionate impact of the opioid epidemic on Black Americans and the risks associated with opioid misuse, the current study aims to investigate sociostructural factors, history of violence, and sexual risk factors associated with transactional sex among Black men and women. A sample of n = 375 Black adult Kentuckians reporting opioid misuse completed a survey including transactional sex, sociostructural, violence history, and sexual risk measures. Results of chi-squares and independent samples t-tests revealed that compared to men who did not report engaging in transactional sex, men who engaged in transactional sex were less educated, reported being sexually assaulted or having an unwanted sexual experience in their lifetime, and were more likely to use opioids or cocaine before or during sex in the last year. Women who engaged in transactional sex had a history of violence, more structural barriers, higher psychological distress, and engaged in more sexual risk behaviors compared to women who did not engage in transactional sex. Implications for future research and interventions with this population are discussed.

Purpose: Infants prenatally exposed to opioids exhibit withdrawal symptomology that introduce physiological noise and can impact newborn hearing screening results. This study compared the referral rate and physiological noise interpreted by number of trials rejected due to artifact on initial newborn hearing screenings of infants with prenatal opioid exposure (POE) and infants with no opioid exposure (NOE). Furthermore, within the POE group, it examined the relationship of referral rates with severity of withdrawal symptomology, and with maternal and infant risk factors. Method: This study used a retrospective cohort design of electronic medical records from six delivery hospitals in South-Central Appalachia. Newborn hearing screenings were conducted using automated auditory brainstem response (ABR) for 334 infants with POE and 226 infants with NOE. Severity of withdrawal symptomology was measured using the Modified Finnegan Neonatal Abstinence Scoring Tool, which includes observation of behaviors that introduce physiological noise. Results: There was no significant difference in newborn hearing screening referral rate between infants with POE and infants with NOE. Referral rate was not affected by maternal or infant risk factors. Infants with POE had statistically significant higher artifact (defined as rejected ABR sweeps) than infants with NOE. There was a strong positive correlation between Finnegan scores and artifact but not referral rates. Sensitivity and specificity analysis indicated artifact decreased substantially after Day 4 of life. Conclusions: Referral rates of infants with POE were similar to those of infants with NOE. Nevertheless, the withdrawal symptomology of infants with POE introduces physiological noise reflected as artifact on ABR, which can affect efficiency of newborn hearing screenings.

Objective: Residential is a common treatment setting for youth with high-severity substance use disorders (SUD). This study evaluated the prevalence of psychiatric symptoms and medication for youth in residential SUD treatment. Methods: Youth in Massachusetts state licensed and funded SUD residential programs completed questionnaires assessing demographics, primary substance of use, and psychopathology symptoms (Youth Self Report [YSR]/Adult Self Report [ASR]). De-identified medication lists were provided by the programs. Descriptive statistics were used to describe the sample. Results: Among the 47 youth who participated, 51.1% were male, 72.3% white, 83% non-Hispanic, mean age 20.7 years. Opioids were the most common primary substance identified by youth (51.1%), and 75% had at least one clinically elevated subscale on the YSR/ASR. Most youth were prescribed at least one medication (89.4%) with a mean of 2.9 medications. Conclusion: Youth in SUD residential treatment frequently have clinically elevated psychiatric symptoms, and psychotropic medication was commonly prescribed.

Objective: We offer an overview of ADHD research using mouse models of nicotine exposure. Method: Nicotine exposure of C57BL/6 or Swiss Webster mice occurred during prenatal period only or during the prenatal and the preweaning periods. Behavioral, neuroanatomical and neurotransmitter assays were used to investigate neurobiological mechanisms of ADHD and discover candidate ADHD medications. Results: Our studies show that norbinaltorphimine, a selective kappa opioid receptor antagonist is a candidate novel non-stimulant ADHD treatment and that a combination of methylphenidate and naltrexone has abuse deterrent potential with therapeutic benefits for ADHD. Other studies showed transgenerational transmission of ADHD-associated behavioral traits and demonstrated that interactions between untreated ADHD and repeated mild traumatic brain injury produced behavioral traits not associated with either condition alone. Conclusion: Preclinical models contribute to novel insights into ADHD neurobiology and are valuable tools for drug discovery and translation to benefit humans with ADHD.

This study aims to identify the use of social networking sites by Jordanian university students to spread health awareness about the dangers of drugs. This study followed the descriptive analytical approach, and a questionnaire was developed to match the study dimensions. The study population consisted of students from the University of Jordan, who were randomly selected (600 males and females). The study showed a significant effect of the University of Jordan students' use of social networking sites in spreading awareness about the danger of drugs. Also, there was a statistically significant difference at [alpha] = 0.05 for the Jordanian university students' use of social networking sites in spreading awareness about drug dangers. In addition, there were differences in the respondents' answers to the questionnaire due to the gender variable in favor of males. Furthermore, the results showed no differences according to the school year variable. In light of the current results, the study confirms the need to use social media to spread health awareness about the dangers of drugs, especially among students, because of the great damage to their health and society. Especially, university students are the educated group in society, and they have the role of educating others, not drug addiction.

The article investigates four vulnerable learners and their histories of drug misuse in rural schools. The purpose of this study was to conduct a situational analysis with a view to understanding the current drug abuse situation in Zimbabwean rural schools and giving some recommendations on what needs to be done to lessen its effects. The study's mode of investigation was qualitative. As means of gathering data, focus groups and participatory research were used. The participatory research design employed by the study unearthed evidence that indicates that drug abuse has an adverse effect on a learner's cognitive optimal functioning both in the community and school contexts. The study's findings point to the necessity of teaching parents how to prioritise their responsibilities and liberate them from the mental poverty they currently experience, which is a societal construct that keeps them from finishing their work with their learners. The study further found out that the absence of guidance and counselling exposes learners to more drug abuse cases and culture, thus having a two-pronged impact on the optimal functioning of rural learners. The study makes some recommendations for how the school and the community should work together and coordinate their efforts to manage the experiences of vulnerable students in order to achieve cognitive optimal functioning for rural learners in Zimbabwe. [Note: The page range (155-175) shown on the PDF is incorrect. The correct page range is 155-174.]

The current study aims to investigate the effects of a strategic plan developed by the involvement of the family, community, and Buddhist institutions in Thai vulnerable youth knowledge, attitudes, and behavioral changes. The sample included 302 vulnerable adolescents from Khon Kaen, Thailand. The utilization of systematic sampling was observed based on income, marital status, and neighborhood. 10 governmental employees also took part in an interview designed to investigate the participants' changes in behaviors of drug abuse. The instruments include a strategic plan for the drug prevention of vulnerable children, a test of drug prevention knowledge, a satisfaction survey, and a semi-structured interview. The data were obtained by a pre-post-test on the samples' knowledge of drug prevention, an attitude survey, and an authorities' interview. Frequency, percentage, mean score, SD, and t-test were used to examine the data. The content analysis assessed qualitative data. The findings reveal how a strategic plan designed by institutions concerned with human development led to the development of knowledge, attitudes, and positive behavioral changes among at-risk teenagers.

Background: The research involved 170 adolescents from Brazil and Ecuador, ages 12 to 19, comprising 87 Brazilians and 83 Ecuadorians, with a gender distribution of 95 females and 75 males. Purpose: Examine the correlation between impulsivity, emotional symptoms, and the use of alcohol and drugs among teenagers in these countries. Methods: Implemented Addiction Severity Index (ASI-version 6), Barratt Impulsiveness Scale for Young People (BIS-11 and BIS-Brief), a Sociodemographic Questionnaire, and Strength and Difficulties Questionnaire (SDQ). Results: Findings indicated a significant link between higher impulsivity levels and increased alcohol consumption across both nations. Specifically, adolescents with greater impulsivity were 1.18 times more likely to consume alcohol (OR = 1.18, 95% CI [1.017-1.374]), and the likelihood of alcohol use escalated with age, with older teenagers 1.80 times more prone to drinking (OR = 1.80, 95% CI [1.285-2.541]). Discussion: Brazilian adolescents exhibited more emotional symptoms than their Ecuadorian counterparts. No gender differences were found in alcohol use, though females showed more emotional symptoms and males had more positive peer interactions. Translation to Health Education Practice: The research highlights the need for culturally sensitive health education interventions targeting these issues to promote healthier behaviors among adolescents.

Background: There is an established link between depression and drug use among adolescents. This relationship holds true for Hispanic youth, for whom familial relationships are especially impactful toward health outcomes. Purpose: Our purpose was to examine the relationships between family functioning and adolescent and parent depressive symptoms, and the indirect effects of depressive symptoms on the relationship between family functioning and adolescent drug use. Methods: Participants were 231 Hispanic adolescents (52.9% female, M[subscript age] = 13.90 ± 1.37) and their parents (93.0% female, M[subscript age] = 43.24 ± 6.64) enrolled in an RCT. Data on depressive symptoms, drug use, and family functioning were collected and a latent variable was specified using four indicators of family functioning (positive parenting, monitoring, communication, and involvement). A structural equation model approach was utilized. Results: Youth family functioning predicted youths' depressive symptoms which predicted their own drug use. Youths' depressive symptoms mediated the relationship between youth family functioning and drug use. Discussion: Findings suggest that adolescents' perceptions of family functioning plays a role in preventing depressive symptoms and drug use among Hispanic youth. Translation to Health Education Practice: Teaching students of the role that family support and depressive symptoms play in the manifestation of drug use may be an effective approach to preventing drug use.

Quality relationships among families and teachers in early care and education (ECE) hold promise to nurture resilience among children impacted by adversity. However, little is known about how adverse childhood experiences (ACEs) may affect the interactions between families and teachers. This study uses quantitative survey data from families (N = 235) and qualitative interview data from teachers (N = 13) to examine the link between children's adversity and family-teacher relationship quality (knowledge, attitudes, practices) in ECE. Quantitative results indicate that when a child has experienced more of the ACEs conventionally studied (e.g. maltreatment, parent substance abuse or mental illness), parents are more likely to perceive lower quality practices with teachers, but when a child has experienced more ACEs on an extended measure (e.g., bullying, discrimination), parents are more likely to perceive higher quality practices with teachers. Qualitative results indicate that teachers report challenges in relationships with families when children experience trauma or adversity, but that ACEs also can present an opportunity to strengthen family-teacher relationships. Findings can inform professional development for teachers focused on strategies to work with families facing adversity, as well as policies related to program standards (e.g., family engagement) and interventions to improve family-teacher relationships quality.

In this article examining the history of social emotional learning (SEL) in the United States, Kelsey A. Dalrymple and Joel M. Phillips use an intellectual history approach to demonstrate that the development of contemporary SEL was significantly influenced by different sociocultural, political, and economic factors. They highlight how metaphorical wars waged by presidential administrations from the 1960s to the 1990s shaped public policy and societal attitudes toward minoritized and marginalized groups and describe how education became a key strategy to battle many of the perceived ills and behaviors associated with those groups. Outlining ongoing debates on SEL, they argue that acknowledging the racialized and socioeconomic roots of SEL can help inform contemporary policy and practice and also educate advocates and critics alike on the ways SEL may serve to address and/or perpetuate long-standing social injustices.

Objective: To compare the prevalence and trajectories of risky health behaviors in sexual minority (SM; lesbian/gay/bisexual/questioning/asexual) versus heterosexual undergraduates across their first year of post-secondary. Participants: First-year undergraduates (N = 704, M[subscript age] = 17.97 years, 24% SM) from a midsized Canadian university. Methods: Students completed monthly (September-April) online questionnaires assessing substance use (binge drinking, tobacco, cannabis, illicit drug use) and disordered eating (binge eating, fasting, purging). Results: At the outset of the academic year, SM students endorsed more frequent cannabis use, illicit drug use, fasting, and binge eating, but less frequent tobacco use, versus heterosexual students. Over the year, SM students' binge drinking frequency declined less than that of heterosexual students, but their illicit drug use decreased while that of their heterosexual peers increased, and all students reported declining disordered eating frequency. Conclusions: Campus wellness initiatives for SM students should offer prevention and harm-reduction strategies prior to or shortly after their arrival on campus.

Objective: Kratom use represents a growing risk for public health. The present study examined demographic and behavioral factors linked with kratom use. Participants: Participants were college students in the United States who participated in the 2019-2020 Healthy Minds Study. Methods: Participants completed survey-based assessment of kratom use and related demographic, behavioral, and mental health variables. Results: Kratom use was linked with being White, male or transgender/gender nonconforming, identifying as a sexual minority, use of alcohol or marijuana, and depressive symptoms. Kratom use was not uniquely linked to exercise or anxiety. Conclusions: The results of the present study can be used to inform initial targeting of efforts to reduce kratom use among college students.

Alcohol and other drug (AOD) use problems among college students continue to represent a public health epidemic. In 2019, historically high rates of binge-drinking and marijuana use were reported among college-age adults, and the detrimental effects of excessive AOD use in college, such as poorer academic performance, sexual assault, injury or overdoses, and a range of other negative consequences, have been well-documented. Thus, there is a continued need for effective implementation of evidence-based, cost-effective interventions aimed at reducing risks associated with collegiate AOD use. Guided Self Change (GSC) is a brief intervention involving motivational enhancement and cognitive-behavioral strategies and has demonstrated effectiveness in reducing AOD use problems. Its brevity, client-driven style, and concrete here-and-now focus are appealing to individuals struggling with mild to moderate AOD use problems. In order to successfully intervene with collegians with AOD use problems attending minority-serving institutions, GSC requires developmental and cultural tailoring. The current report describes the developmental and cultural tailoring of GSC for emerging adult Latinx collegians, as well as our consumer-driven addition of mindfulness content. Key components of our GSC program are documented through qualitative feedback, quantitative results, and case vignettes.

This study explored substance use trajectories and associations with mental health among an ethnically/racially diverse college student sample before and during the COVID-19 pandemic. We combined repeated cross-sections and panel data from a total of 3,247 college students assessed with an online survey in 2018, 2019, and in three waves in 2020. We estimated trends in substance use and their relation to mental health over the survey waves using generalized estimating equations (GEE). Our results revealed notable associations between 30-day substance use patterns, time of assessment, and psychological well-being. These findings suggest a complex interplay between access to substances, context of substance use, and mental health. We discuss several initiatives that have been launched in response to the results of this ongoing study. Such initiatives may serve as examples for expanding similar efforts to other commuter colleges to prevent further increases in mental health problems and risky substance use.

Objective: The purpose of this study was to examine patterns of concurrent cannabis and other substance use and their differential associations with cannabis-related problems and academic outcomes in college students. Participants: Participants were undergraduate students (N = 263; M age = 19.1 years; 61.2% female) who were eligible if they used cannabis at least 3 days in the past month (M = 10.1 days). Method: Substance use, academic-related outcomes, and measures of Cannabis Use Disorder (CUD) severity and problems were obtained in an online survey. Results: The five groups evaluated were cannabis-only users (5.3%), cannabis and alcohol (47.1%), cannabis, alcohol and cigarettes (16.7%), cannabis, alcohol and other substances (14.8%), or all-substances (16%). Cannabis-only and all-substance users reported using cannabis most frequently (ps [less than or equal to] 0.034), but only the latter reported greater CUD severity, problems, and poorer academic outcomes. Discussion: College student polysubstance users may be at increased risk for poorer outcomes compared to cannabis-only users and other groups.

Youth who are lesbian, gay, bisexual, and who identify with other sexual orientations (LGB +) are at higher risk for illicit drug use and have higher rates of mental illness. The current study examined the prevalence of illicit drug use among LGB+ persons and assessed the moderating effect of mental illness. Cross-sectional data from the 2015, 2017, and 2019 Youth Risk Behavioral Surveillance System were aggregated. The outcome was any reported use of cocaine, inhalants, heroin, methamphetamines, ecstasy, or hallucinogens. The primary exposure was self-reported sexual orientation category (i.e. heterosexual, gay/lesbian, bisexual, and not sure). Self-reported depressive symptoms were tested as a moderator. Logistic regression models assessed main and interactive effects. Gay or lesbian students [AOR = 1.87 95% CI: 1.45, 2.43], bisexual students [AOR = 2.07 95% CI: 1.77, 2.42], and those unsure of their sexual orientation [AOR = 1.99 95% CI: 1.65, 2.39] had increased odds of illicit drug use. Odds were higher among LGB+ youth who did not have depressive symptoms (p < 0.001). Odds of illicit substance use was significantly greater in youth identifying as gay and lesbian, bisexual, and students who were not sure about their sexual orientation and among LGB+ youth without depressive symptoms. Targeted, but non-stigmatizing, prevention programs are needed.

Background: The opioid epidemic has created unprecedented challenges in the United States (US), including hundreds of thousands of lives lost to overdose in the past five years. Expansion of prevention and treatment for opioid use disorder (OUD) is urgently needed, as evidence-based strategies exist but many remain unable to access life-saving services. Purpose: To inform school health and mental health providers, educators and school administrators about the causes and consequences of the US opioid epidemic and to provide practical solutions for engineering multi-tiered systems of support for children and families affected by the epidemic, including through opioid misuse, OUD, and opioid overdose. Methods: We review the literature on the history of and current challenges associated with the opioid epidemic in the US. Results: The collateral damage of OUD is pervasive, impacting children and families across the US. We found no health education programs focusing on this topic in US schools, underscoring a critical need and cogent practice/policy avenue. Discussion: Schools are uniquely positioned to respond to the opioid epidemic, but school health and mental health providers, educators, and other professionals who work in schools must have accurate knowledge of the opioid epidemic, understand the challenges it is causing for children and families, and be familiar with best practices in prevention and treatment. Translation to Health Education Practice: This review provides a succinct overview of the history of the opioid epidemic, examines its impacts on children and families, and provides a call to action for schools to partner in our national response.

Background: High cannabis use rates among American Indian (AI) adolescents necessitate the identification of factors that protect against early cannabis initiation. Methods: Data collected from 279 AI middle school students attending reservation-based schools in 2018 and 2019 were analyzed. Three waves of data, with approximately 6 months between each, were used. A repeated measures latent class analysis examined a school-related protective factor index over three waves. The predictive power of lifetime cannabis use on school protection class membership was estimated, along with differences in past month cannabis use at follow-up 2 across school protection classes while holding baseline use constant. Results: Four school protection classes were identified: high, moderate, low, and declining protection. Abstinence at baseline was associated with an increased odds of membership in the high protection class compared to the moderate and low protection classes. Students with consistent and high school protection throughout middle school were significantly less likely to report past month cannabis use at follow-up 2 compared to other classes. Implications for School Health Policy, Practice, and Equity: Maintaining a high level of school protection throughout middle school substantially lowers the odds of cannabis use among AI adolescents. Conclusions: Interventions to promote school-related protective factors in this population are essential and should be designed and tested.

Empathy is linked to decreased relapse in patients with substance abuse. Educational programming for nursing and medical students focused on developing empathy, but no research has been done on how drug education can alter perceptions and empathy toward addiction. This study examined the influence of a drugs course on attitudes toward addiction. Pre-and post-course surveys measured empathy toward addiction, and qualitative descriptions. Overall empathy remained steady but students trended toward promoting more social programs and support. Descriptions changed from a focus on lack of willpower to vulnerabilities, suggesting that a single course could exert influence on perceptions of addiction.

In today's global world, many people can move across borders as travelling has become much easier in many ways. However, the securitization of borders has not been relaxed, implying that multilingual police-civilian interactions are becoming more 'commonplace'. Within the framework of conversation analysis, this article presents a novel study on multilingual police border checks. These are police encounters "on the ground" (not in police custody), and as such, there are no interpreters or language experts present. Focusing on the analysis of a single-case police encounter in which participants have to rely on a second language (English) that none of them are proficient in (i.e., 'novice-novice interaction'), this article examines practices that speakers use to resolve a crime involving the illegal possession of drugs. In addition, some complementary findings from other border checks are presented. Overall, this study shows that participants attempt to achieve intersubjectivity by using interactional (and embodied) practices (e.g., word choice, repair, speech simplification) oriented toward recipient design. By doing so, participants shape the progressivity of the encounter and ultimately achieve their objectives in the interaction. As such, this article shows how a high-stake (police) multilingual situation can also be resolved in the absence of a language expert.

Background: Despite recent declines, youth nicotine vaping remains seen by experts as a national public health epidemic. Few, if any, researchers have examined how related high-profile and school-based prevention programs such as LifeSkills Training (LST) are further disseminated with cooperation from research-to-practice entities as well as the tobacco industry. Purpose: Provides a systems-driven documentary analysis of efforts pertaining to prevention entities at the University of Colorado, Boulder, as well as LST, and the tobacco industry. Methods: Employs focused synthesis data collection with constant comparative analyses. Results: Likely previously unseen and related to LST, is the degree to which prevention entities with a public mission appear to cooperate among themselves and with the tobacco industry as part of a longstanding, if not elaborate, school-based drug prevention social system characterized by patterned evidence of opaque or furtive representations and/or activities. Discussion: Along with limitations, summarizes a research-to-practice social system likely compromising school-based prevention and, in turn, the health of the young people they serve. Theorizes a symbolic politics explanatory mechanism while providing recommendations toward transparency for more informed school-based prevention decision-making. Translation to Health Education Practice: Emphasizes the National Commission for Health Education Credentialing Inc. (NCHEC) critical thinking and program evaluation competencies.

This is part II of a two-part series on integrating a physical activity component in delivering health lessons to elementary and middle school students. The purpose of this series is to illustrate how health content can be implemented with hands-on activities, physical experiments, visual illustrations that are associated with a specific lesson focus, or physical tasks that require students to repeatedly practice memory recall. Two physical activities in the following five health education topics are provided in this article: (1) alcohol, tobacco and other drugs; (2) communicable and chronic diseases; (3) consumer and community health; (4) environmental health; and (5) injury prevention and safety. Corresponding National Health Education Standards and twenty-first-century skills for each activity are also provided. Similar to part I of the series, a few of the designs can be implemented with a different lesson focus or health topic. Examples are discussed at the end of the article.