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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.

Adolescents who break the law have experienced situations that increase the likelihood of becoming involved in criminal activities such as drug use, gang involvement, adverse economic conditions, among others. All this, added to their stage of human development, which is characterized by physical, cognitive, social and emotional changes, can lead them to have deficiencies in their cognitive processes and at the same time present educational difficulties. The purpose of this study is to evaluate different cognitive processes of these adolescents in comparison to a control group with similar characteristics but who have not committed any crime and whose education has not been interrupted. For this purpose, were included (n = 62) adolescent offenders and (n = 62) adolescent non-offenders of male sex and aged 14 to 18 years was taken. Basic sociodemographic data on their education and psychoactive substance use were collected, as well as cognitive data with tests such as Ineco Frontal Screening for executive functions, Montreal Cognitive Assessment for general functions, among others. The results showed significant differences in executive functions, attentional processes, memory and language. These difficulties can be key to school performance, therefore, educational interventions adapted to these adolescents are suggested.

The COVID-19 pandemic has had a profound impact on the education sector worldwide, and on undergraduate students in particular. This Scoping Review seeks to unearth research examining the psychosocial impact of the pandemic on undergraduate students in the regions of North America, Latin America, and the Caribbean. Additionally, this review explores students' coping mechanisms as a means to guide researchers in conducting informed investigations and to allow institutions in making meaningful decisions to combat the effects of the pandemic and future disruptions. Despite the wealth of research on COVID-19, findings from this review show a notable scarcity of literature specifically focused on undergraduate students. Findings reveal a consensus among studies regarding increased stress, anxiety, and depression among undergraduate students. Coping strategies employed by students highlight possible challenges such as overuse of social media and substance use, but they also shed light on potential interventions including physical activities, emotional strategies, and social supports. Future research should focus on filling the gaps in the existing literature and assessing the efficacy of targeted interventions. By gaining a deeper understanding of undergraduate student experiences and identifying effective support mechanisms, we can enhance the overall well-being and academic success of students.

It is important to prioritize intersectoral action at schools to prevent the use of alcohol and other drugs. This strategic act should be organized with multidisciplinary learning characteristics and with the involvement of different stakeholders. The aim of a recent scoping review was to identify the factors that benefit and hinder intersectoral actions at school resulting from the elaboration of policies to prevent drug use. It seems like the research study was a scoping review that used the P-population, C-context, and C-concept structure. The study searched for information in various databases like Embase, Proquest, Lilacs, Medline via Pubmed, PsycInfo, WHO-Iris, and PAHO-Iris on April 17, 2023. According to the results, there were 5 studies that were eligible to answer the research question. One of the advantages of intersectoral actions is the role of schools in creating a support network with different social actors, particularly with family involvement. On the other hand, one of the challenges is inconsistencies in legal regulations, which do not provide enough guidance to schools on how to prevent alcohol and drug use. While public and private schools may be affected differently by social and economic factors, it is essential to invest in developing policies that focus on drug prevention for children and adolescents who are learning in schools.

Objective: Our study examined the impact of sex, ADHD subtype, and comorbid illnesses (depression/anxiety) on the timing of diagnosis and treatment for ADHD. Method: To analyze ADHD patients, four health databases were used to assess subtype, comorbid mood, and antidepressant or anxiolytic drug exposure. Analyses were stratified by sex and age. Standardized mean differences measured intergroup differences. Results: Females with ADHD were identified at older ages and had higher rates of depression and anxiety diagnoses and treatments before and after their initial ADHD diagnosis. Predominantly inattentive ADHD patients were diagnosed later and more likely to receive mood disorder diagnosis and treatment than hyperactive impulsive ADHD patients. Conclusions: Results suggest a more complex ADHD presentation in females, potentially causing late diagnosis and delayed treatment.

Objective: Crack cocaine use has increased rapidly throughout Mexico, along with rising HIV and hepatitis C virus (HCV) infections among vulnerable groups. The Tirando Esquina: Interviniendo Muros de Salud (TE:IMS) project uses projection-mapping technology and is the first of its kind to reach and provide health education at an individual and community level to at-risk crack smoking populations in Mexico City. Setting: This intervention project took place in Mexico City. Design: A single-arm design was utilised. Method: The TE:IMS intervention used projection mapping, a community-based art form wherein 3-dimensional (3-D) images, videos and graphics are projected onto buildings in the community. A total of nine projection mapping episodes were projected and health promoters engaged individuals on the street to reinforce messaging and distribute safer crack kits. A sample of persons who use crack (n = 58) were recruited prior to the intervention to complete pretest-posttest evaluation questionnaires. Results: Findings provide evidence of initial effectiveness. Decreases pre- to posttest were found in weekly crack use (p < 0.05), sharing of paraphernalia (p = 0.002) and use of cans as pipes (p = 0.008), while increases were observed in the usage of Pyrex pipes (p = 0.002). While quantitative HIV knowledge assessments did not increase significantly, qualitative data suggest the intervention made a substantial impact on perceptions and knowledge of HIV among those who interacted with the health promoters and saw the projections. Conclusions: TE: IMS was successful in providing health education and harm reduction strategies at a community level to at-risk crack smoking populations in Mexico City. These findings provide evidence for the initial effectiveness of innovative education and harm reduction efforts in this population.

Reservation-dwelling American Indian adolescents are at exceedingly high risk for cannabis use. Prevention initiatives to delay the onset and escalation of use are needed. The risk and promotive factors approach to substance use prevention is a well-established framework for identifying the timing and targets for prevention initiatives. This study aimed to develop predictive models for the usage of cannabis using 22 salient risk and promotive factors. Models were developed using data from a cross-sectional study and further validated using data from a separate longitudinal study with three measurement occasions (baseline, 6-month follow-up, 1-year follow-up). Application of the model to longitudinal data showed an acceptable performance contemporaneously but waning prospective predictive utility over time. Despite the model's high specificity, the sensitivity was low, indicating an effective prediction of non-users but poor performance in correctly identifying users, particularly at the 1-year follow-up. This divergence can have significant implications. For example, a model that misclassifies future adolescent cannabis use could fail to provide necessary intervention for those at risk, leading to negative health and social consequences. Moreover, supplementary analysis points to the importance of considering change in risk and promotive factors over time.

An important public concern about the impact of recreational cannabis legalization is how it may affect adolescent cannabis use. Prior research on this issue has primarily focused on the implications of "medical" cannabis legalization for adolescents and used data that cover a relatively short post-legalization period. This study extends this line of research by examining the relationship between "recreational" cannabis legalization and adolescent cannabis use in Washington State, using the National Survey of Drug Use and Health (NSDHU) data from 2005 to 2019. Based on a quasi-experimental research design, this study found some evidence suggesting a positive effect of recreational legalization on the prevalence of adolescent cannabis use and cannabis initiation. Findings suggest the need to create a cannabis regulatory environment that minimizes adolescent access to this drug.

Prenatal cannabis use and maternal stress have been proposed as risk factors for autism spectrum disorder (ASD). Black mothers and mothers of lower socioeconomic status (SES) may be especially likely to experience high levels of stress. This study examined the impact of prenatal cannabis use and maternal stress (i.e., prenatal distress, racial discrimination, and lower SES) on child ASD-related behaviors in a sample of 172 Black mother-child pairs. We found that prenatal stress was significantly associated with ASD-related behaviors. Prenatal cannabis use did not predict ASD-related behaviors and did not interact with maternal stress to predict ASD-related behaviors. These findings replicate previous work on prenatal stress-ASD associations and add to the limited literature on prenatal cannabis-ASD associations in Black samples.

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.

Background: In people with intellectual disabilities and mental disorders and/or challenging behaviours, rates of psychotropic drug prescription are high. In clinical treatments and evaluations, all stakeholders should be involved in a process of shared decision-making (SDM). We aimed to investigate the perspectives of clients and their carers on clients' treatments with psychotropic drugs. Methods: We conducted a survey among adults with intellectual disabilities in a Dutch mental healthcare centre providing community, outpatient and inpatient care. Data were collected between January and June 2022. Questions focused on experiences with the provision of information, treatment involvement and SDM and participants' wishes in this regard. Findings: Respondents (57 clients and 21 carers) were largely satisfied with the overall care from their clinicians, and with how information on the pharmacological treatment was provided verbally, but written information was insufficient or not provided. Seventy per cent of clients and 60% of carers reported being involved in medication decision-making. However, over 75% of participants desired greater involvement in SDM and over 60% in medication reviews. Conclusions: Service users and representatives were satisfied about the treatment and verbal information on their psychotropic drug use. The provision of written information, the SDM process and ongoing evaluation of psychotropic medication use could be improved.

Medical students face challenging but important topics they must learn in short periods of time, such as autonomic pharmacology. Autonomic pharmacology is difficult in that it requires students to synthesize detailed anatomy, physiology, clinical reasoning, and pharmacology. The subject poses a challenge to learn as it is often introduced early in medical school curricula. To ease the difficulty of learning autonomic pharmacology, we created a free web application, PharmaMemory (www.pharmamemory.com), that interactively depicts the effects of high-yield autonomic drugs on the human body. PharmaMemory provides users with the opportunity to read and quiz themselves on the mechanisms, side effects, indications, and contraindications of these drugs while interacting with the application. We provided PharmaMemory to first-year medical students for three consecutive years of quality improvement and assessed the application's perceived effects on learning via user surveys. Survey feedback showed that users viewed PharmaMemory favorably and self-reported increased knowledge and confidence in the subject of autonomic pharmacology. Comments revealed that users liked the website's visuals, opportunity for challenged recall, and conciseness. PharmaMemory utilizes challenged recall, visual stimulation, and interactive learning to provide users with a multifaceted learning tool. Preliminary data suggest that students find this method of learning beneficial. Further studies are needed to assess PharmaMemory compared with more traditional learning methods such as PowerPoint or text-based learning. Additionally, further research is needed to quantitatively assess reduction in cognitive load.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent patterns of inattention, hyperactivity, and impulsiveness. Among US children and adolescents aged 3-17 years, 9.4% have a diagnosis of ADHD. Previous research suggests possible links between parental substance use and ADHD among children. We conducted a systematic review and meta-analysis of 86 longitudinal or retrospective studies of prenatal or postnatal alcohol, tobacco, or other parental substance use and substance use disorders and childhood ADHD and its related behavioral dimensions of inattention and hyperactivity-impulsivity. Meta-analyses were grouped by drug class and pre- and postnatal periods with combined sample sizes ranging from 789 to 135,732. Prenatal exposure to alcohol or tobacco and parent substance use disorders were consistently and significantly associated with ADHD among children. Other parental drug use exposures resulted in inconsistent or non-significant findings. Prevention and treatment of parental substance use may have potential for impacts on childhood ADHD.

Background: Knowledge of specific health-related events encountered by students studying abroad and the availability and use of pre-travel healthcare for these students is lacking. Methods: Anonymous web-based questionnaires were sent to study abroad offices, student health centers, and undergraduate students after studying abroad at eight institutions of higher education in the United States and Ireland from 2018-2021. Analyses were descriptive; relative risks and 95% confidence intervals were calculated for health-related events. Results: One study abroad office required a pre-travel consultation. All student health centers had pre-travel counseling available. Among 686 students, there were 307 infectious and 1,588 non-infectious health-related issues; 12 students (2%) were hospitalized. Duration of travel and timing of a pre-travel consultation impacted the risk of health-related events. Certain mental health conditions were associated with increased risk of alcohol and drug use. Conclusion: Future studies should address the optimal timing and best practices to optimize health for students studying abroad.

Medication for attention-deficit/hyperactivity disorder (ADHD) is frequently abused and misused alongside alcohol on college campuses. The aim of the study was to assess the relationship between participants' alcohol use, mental distress, and academic performance in relation to their illicit use of ADHD medication. An anonymous cross-sectional survey administered online using Google Forms compiled 702 U.S. college students' responses evaluating their drug usage, academic performance, and mental health. ADHD medication use had a positive association (p < 0.05) (p < 0.01) with hallmarks of mental distress and perceived stress. There was a negative association (p < 0.05) (p < 0.01) between alcohol use in the last 12 months and feelings of mental distress and perceived stress. There were negative associations (p < 0.05) (p < 0.01) found between illicit ADHD medication use and hallmarks of GPA. A positive association (p < 0.05) was also found between alcohol use in the last 4 weeks and students' positive perceptions of the effectiveness of illicit ADHD medication. These findings on the relationships between illicit usage of ADHD medication and usage of alcohol as it relates to mental health are important in broadening our understanding of some of the most important risk factors that illicit use of ADHD medication and alcohol usage can have on college students.

The COVID-19 pandemic resulted in increased parenting stress and substance use. At the same time that mental health and social service needs increased, access to services, including among those receiving treatment, decreased due to stay-at-home orders. Few programs were equipped or prepared to translate their interventions to a virtual format at the start of the pandemic. There is a critical need to identify effective adaptations to substance use and family-focused treatment during the COVID-19 pandemic. Effective program adaptations have continued relevance for the expansion of access to family-focused addiction services beyond the pandemic itself, particularly for rural or other hard to reach populations. Seventy-three semi-structured interviews were conducted with the five agencies participating in the implementation of the In-Home Recovery Program (IHRP), an in-home, substance use disorder (SUD) treatment program. Using a rapid analysis approach two coders analyzed interviews for recurring concepts and themes. Facilitators for adapting services included: (1) the introduction of virtual toxicology screens, (2) helping parents access technology, (3) assisting parents with non-identified children to decrease their stress, and (4) anticipating reoccurrences of substances during the pandemic. Barriers to adapting services included: (1) engaging young children in virtual treatment, (2) privacy, and (3) engaging in telehealth with parents experiencing domestic violence or reoccurrence of substances. Findings reveal virtual substance use treatment is possible. Facilitators to adaptation such as providing access to technology and virtual toxicology screens demonstrate the feasibility and acceptability of utilizing telehealth interventions for substance use. Barriers to adaptations were primarily related to the infant mental health component. Telehealth is likely not appropriate for children below the age of five. Individual sessions focusing on caregiving, rather than dyadic treatment may be more suitable to virtual formats.

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.

Introduction: As little is known about who uses specialty mental health clinics for persons with intellectual disabilities, this study aimed to identified caregiver concerns, clinical characteristics, and the relationship between these two constructs for referrals to such a clinic. Methods: Qualitative and quantitative analyses were applied to data derived from an intake questionnaire of all individuals referred to a specialty clinic in Canada over one year. Results: The dataset consisted of 149 persons (55.7% male; 37.6% with autism; mean age: 28.8 years [SD: 13.2]). The two overarching categories of caregiver concerns were about: (1) aspects of clinic service, especially medication questions; and (2) specific emotional, behavioral, and diagnostic concerns, especially regarding emotional states. Caregivers of persons with autism had higher odds of medication concerns, but few other significant relationships were found. Conclusions: Further investigations about emotional difficulties and medication concerns, inclusive of perspectives of persons with intellectual disabilities, are needed.

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.

Objective: Among two-year college students, alcohol and marijuana use, related consequences, and risk factors for use are not well understood. We examined differences between two- and four-year students in alcohol and marijuana use, consequences, and perceived descriptive norms, and explored whether two-year status moderated associations between norms and use. Participants: Data were drawn from a cross-sectional subsample of two- and four-year students aged 18-23 (n = 517) participating in a longitudinal study on alcohol use. Results: Four-year students reported greater alcohol use and consequences than two-year students; two-year students reported greater marijuana use than four-year students. Perceived alcohol and marijuana norms were positively related with use; two-year status did not moderate these associations. Conclusions: Perceived alcohol and marijuana norms function similarly for two- and four-year students in terms of associations to actual use. Adapting normative interventions for two-year students may be an effective strategy for reducing high-risk use among this underserved population.

Objective: To evaluate the association between health behaviors with academic performance among tertiary education students. Methods: Six databases were searched until July 2020 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and academic performance. Results: Thirty-four studies were included (18 assessed sleep, 16 alcohol intake, 12 illicit drug use, 10 physical activity, 8 diet, 4 smoking, 2 sedentary behavior). A consistent negative association with academic performance was demonstrated for sleep (12/18 studies), alcohol intake (13/16) and illicit drug use (9/12). Most (7/10) studies found no association between physical activity and academic performance. Conclusion: Findings suggest interventions to mitigate the influence of poor sleep, high alcohol intake, and illicit drug use on academic performance may be needed. Further research of other health behaviors, along with their co-occurrence, with academic performance, is required.

Objective: Around 40% of US university students use cannabis, 25% of whom present with cannabis use disorder, which endangers health. We investigated the concurrent contribution of reflective processes, which generate action via conscious deliberation, and non-reflective processes, which prompt behavior automatically, to undergraduates' cannabis consumption. Participants: Eighteen UK undergraduates who regularly consume cannabis (11 female, 7 male; mean age 20 y). Methods: Semi-structured interviews explored cannabis motives, routines, cues, and decision points. Thematic analysis identified themes, in each of which reflective and non-reflective dimensions were coded. Results: Four themes were identified: cannabis use for relaxation, social bonding, and symbolic-affective significance, and contexts and triggers. Some influences guided cannabis use reflectively in some settings, and non-reflectively in others. Even when cannabis use was consciously driven, non-reflective processes were deployed to execute subservient acts, such as rolling joints. Conclusions: Findings highlight specific processes and pathways that might be targeted to reduce cannabis-related harm.

Background: Adolescent substance use is often associated with concurrent mental health problems (e.g., depression, suicide attempts, parental emotional and physical abuse, not feeling close to people at school, and lower virtual connectedness) at multiple ecological levels. Objective: This study examined whether such risk factors among adolescents were associated with the use of telemental healthcare (TMHC) and whether gender moderated these associations. Methods: Data were drawn from the Adolescent Behaviors and Experiences Survey, collected by the U.S. Centers for Disease Control and Prevention from January to June 2021. A hierarchical multiple logistic regression analysis was conducted using a national sample of 1,460 students in Grades 9-12 in the United States who reported having used more alcohol and/or drugs during the pandemic than before it started. Results: The results showed that only 15.3% of students sought TMHC. Students reporting increased substance use during the pandemic were more likely to use TMHC if they experienced more severe mental health problems (e.g., suicide attempts) compared to other ecological factors, such as issues with their family, school, or community. Analysis of the moderating effect showed that the closer male students felt to people at school, the more likely they were to seek TMHC, whereas the opposite was true for female students. Conclusions: The findings highlighted that feeling close to people at school is an important aspect of understanding the help-seeking behavior of female and male adolescent substance users.

Background: Research has demonstrated that parent-child attachment security and school connectedness (SC) are protective factors against substance use, depression, and suicidality during adolescence. However, past research has examined these factors independently, and little is known about how attachment security and SC work in conjunction to reduce risk. Objective: The present study examined the moderating role of SC on the relations between parent-adolescent attachment (security, anxiety, and avoidance) and substance use, depression, and suicidality among at-risk adolescents. Method: Using a cross-sectional design, 480 community-based adolescents (60.5% female; M[subscript age] = 14.86) aged 12-18 years self-reported parent-adolescent attachment, adolescent substance use, depression, and suicidality. Results: High levels of attachment security in conjunction with high SC predicted the lowest risk for adolescent substance use. Several sex differences were found: SC significantly moderated the relation between attachment security and depressive symptoms in female adolescents and suicidality in male adolescents. Results also revealed that the moderating of role of SC differed in relation to attachment anxiety versus attachment avoidance for female versus male adolescents. Conclusion: Findings point to the importance of testing associations between multiple dimensions of attachment and SC on several well-established mental health outcomes in a sample of high-risk adolescents.

Background: Most health and developmental issues affecting young people are interrelated. However, few interventions address multiple behavioral domains simultaneously or are based on theories that encompass a holistic perspective of youth development. Aim: The purpose of this scoping review was to identify and describe the range of theory-based, multibehavioral health interventions aimed at improving two or more of the following behavioral youth outcomes: (1) sexual and reproductive health; (2) education and employment; (3) violence; and (4) substance use. Methods: Interventions conducted worldwide and published in English or Spanish between January 2000 and July 2020 were identified using four databases: PubMed, PsycINFO, LILACS, and SciELO. Results: A total of 11,084 articles were identified, of which 477 were retrieved and assessed for eligibility. Twenty-three articles (evaluating 21 interventions) ultimately met the inclusion criteria. Most interventions were conducted in the United States and addressed two behavioral domains of interest, although seven interventions incorporated three domains, and one incorporated all four. Substance use was the most common domain (16 interventions) but only in the United States/Canada, followed by sexual and reproductive health (14 interventions). All produced significant improvement in at least one outcome or for at least one subgroup of youth. The most common theoretical foundations were positive youth development and social learning theory. Conclusion: Integrated interventions that are theory based and evidence informed can support positive development and empower youth to make healthy decisions. Further efforts are needed to address structural and policy issues that affect young people's developmental opportunities and health outcomes.

This paper aims to understand the impact on student learning of redesigning an elective substance use course with the intent of contextualizing the topic by modeling a structural critical lens. In addition, we look at how this shift impacts students' approaches to working with clients who use substances. Secondary data from student course evaluations were used to determine themes. The findings reinforce the value of a social work approach, the need to rebalance individual and society's responsibility for substance use, the necessity of a critical structural lens, new skills students learned, and the existing gaps students have identified in relation to integrated substance use practice.

Racial disparities are evident in both educational outcomes and incarceration rates when comparing African American and white youth. It is essential to understand the school-to-prison pipeline and the ways in which school discipline practices and other factors disproportionately affect African American students, limit educational attainment, and increase risk for future incarceration in order to improve students' educational and life outcomes. This study explores how marijuana, anxiety and locus of control interact with school disciplinary practices in pushing students out of schools and into the criminal justice system. Analyses utilizing data from the Woodlawn Study, a longitudinal study of African Americans followed from first grade through adolescence, young adulthood, and midlife (n = 1,242), reveal that suspension or expulsion, frequent marijuana use, and locus of control (males only) all predict criminal justice system involvement above and beyond not graduating from high school, but do not interact significantly. This study offers avenues for intervention to reduce disparities.

A primary community prevention approach in Iceland was associated with strong reductions of substance use in adolescents. Two years into the implementation of this prevention model in Chile, the aim of this study was to assess changes in the prevalence of adolescent alcohol and cannabis use and to discuss the impact of the COVID-19 pandemic on the substance use outcomes. In 2018, six municipalities in Greater Santiago, Chile, implemented the Icelandic prevention model, including structured assessments of prevalence and risk factors of substance use in tenth grade high school students every 2 years. The survey allows municipalities and schools to work on prevention with prevalence data from their own community. The survey was modified from an on-site paper format in 2018 to an on-line digital format in a shortened version in 2020. Comparisons between the cross-sectional surveys in the years 2018 and 2020 were performed with multilevel logistic regressions. Totally, 7538 participants were surveyed in 2018 and 5528 in 2020, nested in 125 schools from the six municipalities. Lifetime alcohol use decreased from 79.8% in 2018 to 70.0% in 2020 (X[superscript 2] = 139.3, p < 0.01), past-month alcohol use decreased from 45.5 to 33.4% (X[superscript 2] = 171.2, p < 0.01), and lifetime cannabis use decrease from 27.9 to 18.8% (X[superscript 2] = 127.4, p < 0.01). Several risk factors improved between 2018 and 2020: staying out of home after 10 p.m. (X[superscript 2] = 105.6, p < 0.01), alcohol use in friends (X[superscript 2] = 31.8, p < 0.01), drunkenness in friends (X[superscript 2] = 251.4, p < 0.01), and cannabis use in friends (X[superscript 2] = 217.7, p < 0.01). However, other factors deteriorated in 2020: perceived parenting (X[superscript 2] = 63.8, p < 0.01), depression and anxiety symptoms (X[superscript 2] = 23.5, p < 0.01), and low parental rejection of alcohol use (X[superscript 2] = 24.9, p < 0.01). The interaction between alcohol use in friends and year was significant for lifetime alcohol use ([beta] = 0.29, p < 0.01) and past-month alcohol use ([beta]= 0.24, p < 0.01), and the interaction between depression and anxiety symptoms and year was significant for lifetime alcohol use ([beta] = 0.34, p < 0.01), past-month alcohol use ([beta] = 0.33, p < 0.01), and lifetime cannabis use ([beta] = 0.26, p = 0.016). The decrease of substance use prevalence in adolescents was attributable at least in part to a reduction of alcohol use in friends. This could be related to social distancing policies, curfews, and homeschooling during the pandemic in Chile that implied less physical interactions between adolescents. The increase of depression and anxiety symptoms may also be related to the COVID-19 pandemic. The factors rather attributable to the prevention intervention did not show substantial changes (i.e., sports activities, parenting, and extracurricular activities).

Research has linked pre- and perinatal complications (PPCs) with increased risk for autism spectrum disorder (ASD). However, PPCs are also known risk factors for other mental health disorders. This study explored which PPCs are specific risk factors for ASD, as opposed to other forms of psychopathology, among a large sample of clinically-referred youth. Archival data were used from 1177 youth who were evaluated at a hospital-based autism clinic. Results from logistic regressions indicated that use of tobacco, alcohol, or drugs, or experiencing amniocentesis predicted inclusion in the non-ASD group, while physical difficulties with delivery predicted inclusion in the ASD group. Possible explanations and implications for these findings are discussed.

Objective: To identify the lifetime prevalence and correlates of appearance- and performance-enhancing drugs and substances (APEDS) use among a national sample of US college and university students. Participants: Student participants from the 2020-2021 Healthy Minds Study (N = 7,401; ages 18-30 years). Methods: Lifetime prevalence of five forms of APEDS was estimated. Modified Poisson regression analyses were conducted to determine the sociodemographic correlates of protein and creatine supplement use. Results: Lifetime protein (23.8%) and creatine (7.7%) supplement use were most common among the sample. Older age within young adulthood, male sex, perceiving oneself to be normal weight or somewhat overweight, any athletics participation, and 2-3 or [greater than or equal to] 5 h/week of exercise were associated with greater likelihood of lifetime protein and creatine supplement use. Conclusions: Awareness and prevention efforts on the potential harms of APEDS use are needed on campuses, particularly among males and those who participate in athletics and high-frequency exercise.

Background: The Theory of Triadic Influence (TTI) provides a comprehensive framework for understanding adolescent substance use. Objectives: We examined mechanisms by which a TTI-guided social-emotional and character development program, "Positive Action" (PA), influences adolescent substance use. Study data come from the PA-Chicago, longitudinal matched-pairs cluster-randomized control trial. A diverse, dynamic cohort of approximately 1,200 students from 14 low-performing schools were assessed at eight points of time, between grades 3-8, across a six-year period. Students completed scales related to substance use, self-control, deviant peer affiliation, and school attachment, adapted from the Risk Behavior Survey, Social-Emotional and Character Development Scale, Conventional Friends Scale, and People in My Life Scale. After testing the overall effect of PA on substance use, we used latent growth modeling to assess whether effects on each outcome were mediated by longitudinal changes in three composite measures aligning with the TTIs three streams. Results: Students in PA schools reported fewer experiences with drinking, getting drunk, and overall substance use. In the multiple mediator models, significant indirect effects of PA on substance use via changes in self-control were evident. Conclusions/ Importance: Findings are consistent with theory and past research suggesting the influence of self-control on youth substance use. Future studies should include implementation in different settings and additional theory-based measures.

Drug and alcohol neonate simulators were used to highlight the effects of substance misuse on prenatal development within lifespan development modules to 61 Psychology undergraduates and 12 sixth-form Health and Social Care students. A mixed method approach was used considering both knowledge development and perceptions of experiential hands-on learning. Student knowledge of the effects of drugs and alcohol on prenatal development was assessed before and after an interactive session on teratogenesis utilising neonate simulators demonstrating these effects. With this experiential learning approach, the statistical analysis combining both groups showed increased knowledge after the interactive session, and the students perceived this enhanced understanding to be a direct result of hands-on interaction with the neonate simulators. The researchers encourage the use of neonate simulators as good practice that can be effectively incorporated into the psychology and other health-related teaching contexts to facilitate knowledge on teratogenesis.

The aim of this research was to explore the attitudes of elite athletes towards performance enhancement through banned substances. In this study, survey model, which is one of the quantitative research methods, was used. Purposive sampling method was used in the data collection process. Participants consisted of a sample group of elite athletes (n = 418: 49.3% female, 50.7% male;). Participants answered questions about sociodemographic characteristics as well as performance enhancement attitudes. A performance enhancement attitude scale was used to determine the participants' attitudes towards performance enhancement. Data were analyzed using SPSS Version 22.0 (IBM Corp., Armonk, NY, USA). Elite level athletes participating in the study were found to have low use of prohibited substances for performance enhancement. There was no difference between the attitudes of the participants to increase their performance according to their gender and educational status. Participation of the participants in individual or team sports did not lead to a difference between their performance enhancement attitudes. It was found that as the duration of being a national athlete of the participants in the study increased, their attitudes towards using prohibited substances for performance enhancement increased. From the point of view of elite athletes, the use of banned substances for performance enhancement was found to be low. However, as the duration of being an elite athlete increases, it has been found that the attitude towards the use of banned substances for performance enhancement increases. Policies should be developed to discourage elite athletes from using banned substances. Coaches and managers need to correctly manage success strategies at all levels of sports.

Students with emotional and behavioral problems have poor academic and behavioral outcomes, both short- and long-term. Psychotropic medications are commonly used as an intervention with this population and their use has increased significantly. This study investigated adolescent and family variables associated with medication use among high school students with elevated emotional and behavioral problems, including those with a label of emotional and behavioral disorders. Participants included 548 adolescents from a larger randomized controlled trial, 184 (33.6%) of whom were receiving medication. Hierarchical linear modeling revealed that special education status, externalizing and internalizing behavior symptoms and participant race were significant student predictors of medication use. Parenting stress, family structure, positive parenting, and poor monitoring were significant family predictors of participants' medication use. These findings have implications for current practices in schools pertaining to screening and access to interventions as well as future research focused on the parent and student decision making process for choice of interventions.

This study is a secondary data analysis that extends knowledge about the effects of the early childhood Family Check-Up (FCU) intervention to trajectories of general psychopathology problems (p factor) across early and middle childhood, and effects on adolescent psychopathology and polydrug use. The Early Steps Multisite study (ClinicalTrials.gov Identifier NCT00538252) is a randomized controlled trial of the FCU and consists of a large, racially and ethnically diverse sample of children who grew up in low-income households in Pittsburgh, Pennsylvania; Eugene, Oregon; and Charlottesville, Virginia (n = 731; 49% female; 27.6% African American, 46.7% European American, 13.3% Hispanic/Latinx). To represent a comorbid presentation of internalizing and externalizing problems, we fit a bifactor model that included a general psychopathology (p) factor at eight ages in early childhood (ages 2-4), middle childhood (ages 7.5-10.5), and adolescence (age 14). Latent growth curve modeling was conducted to examine trajectories of the p factor across ages within the developmental periods of early and middle childhood. The effects of FCU on the reductions in growth in the childhood p factor had cascading effects on adolescent p factor (i.e., within-domain effect) and polydrug use (i.e., across-domain effect). Findings underscore the utility of the early FCU in preventing a host of maladaptive adolescent outcomes across diverse settings and populations.

Background: Schools have become a primary access point for mental health services to cover the gap between need and service utilization that has long existed, particularly among vulnerable populations. This study aims to identify the profiles of comprehensive school mental and behavioral health system (CSMBHS) needs and examine related characteristics. Methods: We used the 2019 National Survey of Drug Use and Health (NSDUH) collected from a nationally representative sample in the United States. The sample included 6th through 12th-grade adolescents who had received CSMBHS services in the last 12 months (N = 1346). The study conducted latent class analysis and multinomial logistic regression using Vermunt's 3-step approach. Results: The analysis identified 3 profiles of student CSMBHS service need: depression needs (42%), multiple endorsements in most needs (depressed, friend, and school problems; 6.5%), and low endorsement (51.4%). Findings suggest that the profiles differed by age, a lifetime major depressive episode, family income, and use of other mental health services. Implications for School Health, Policy, Practice, and Equity: Emphasis should be placed on proactively identifying student needs and advocating for appropriate interventions based on student needs. Conclusions: The study reveals important information regarding how schools best support students in need and in seeking services.

Volunteering can serve as a protective factor against substance abuse. Yet, it is unclear whether volunteering in specific community organizations, such as emergency services, promotes or protects against substance use. We aimed to (1) describe community volunteering characteristics among adolescents; (2) investigate differences in the prevalence of substance use according to community volunteering type; and (3) determine whether volunteering type was a predictor of substance use. We analyzed data from the 2018-2019 Health Behavior in School-aged Children survey among Israeli adolescents aged 11-17 years (N = 3972). Most participants (N = 2452; 61.7%) did not volunteer at all, 27.1% (N = 1077) volunteered in youth movements/councils, and 11.2% (N = 443) volunteered in community emergency services. In comparison to the emergency services group, there was a higher volunteering frequency among the youth movements/councils group. Of the three groups (nonvolunteering, volunteering in youth movements/councils, and volunteering in community emergency services), those in the community emergency services group reported a significantly higher prevalence of weekly alcohol use, lifetime cannabis use, and new psychoactive drug use, while no significant between-group differences were observed in smoking tobacco prevalence. Volunteering in the community emergency services has been linked to substance use, requiring the development of intervention programs by the school staff, before their active volunteering (e.g., guidance on emotional stress and substance abuse). Also, teachers can act as a protective factor for students, and identify emotional distress and anxiety in their students to prevent substance abuse. Furthermore, emergency services workers and instructors should also be aware of the higher risk of substance use among volunteering youth and should be given tools to better collaborate with parents and teachers in dealing with it.

Despite growing evidence to the contrary, researchers continue to posit causal links between cannabis, crime, psychosis, and violence. These spurious connections are rooted in history and fueled decades of structural limitations that shaped how researchers studied cannabis. Until recently, research in this area was explicitly funded to link cannabis use and harm and ignore any potential benefits. Post-prohibition cannabis research has failed to replicate the dire findings of the past. This article outlines how the history of controlling cannabis research has led to various harms, injustices, and ethical complications. We compare commonly cited research from both the prohibition and post-prohibition eras and argue that many popular claims about the dangers of cannabis are the result of ethical lapses by researchers, journals, and funders. We propose researchers in this area adopt a duty of care in cannabis research going forward. This would oblige individual researchers to establish robust research designs, employ careful analytic strategies, and acknowledge limitations in more detail. This duty involves the institutional recognition by funders, journals, and others that cannabis research has been deliberately misconstrued to criminalize, stigmatize, and pathologize.