Background: To determine if school engagement is a viable target for early prevention of adolescent substance use, this study investigated whether school engagement in early adolescence (ages 12-14) is a cause of alcohol and cannabis use during middle to late adolescence (ages 15-19). Methods: To facilitate causal inference, inverse probability of…

Background: School-based substance use prevention is important, yet many educators are not trained in the curriculums. The purpose of this study was to assess changes in educators' knowledge about substances and confidence in delivering drug education before and after participating in educator trainings, as well as overall perceptions of the…

Background: Comprehensive health education in schools can effectively prevent drug use and related outcomes, but successful implementation remains challenging. Contextual determinants, including intervention-setting compatibility, focus on the intervention, available resources, and leadership support, influence implementation success. This study…

Background: Boys use cannabis at a younger age and more frequently than girls. It has been suggested these sex differences might vary according to students' relationship to school. We explored whether the association between sex and adolescents' cannabis use varies among schools and according to students' school connectedness. Methods: The study…

Background: We assessed whether self-descriptions, self-perceptions, perceived substance use of friends, and actual substance use were associated with high school girls' frequency of making social comparisons to peers. Methods: We analyzed data from the Adolescent Health Risk Behavior Survey data for 357 high school girls using multinomial…

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…

Background: The conceptual framework for "School as a Protective Factor" approach was presented in a companion article in this issue of the journal. The current article describes the validation of the "School as a Protective Factor-Brief (SPF-Brief)," a 13-item survey measuring the 3 core constructs and 13 defining…

Background: Four-day school week (FDSW) use has increased substantially among US districts in recent years, but limited data exist on health impacts of this school schedule. This study examined associations of reduced school exposure via FDSWs with adolescent health and risk behaviors, obesity, and food security. Methods: Self-report data from…

Background: Among adolescents, the pathway from being offered drugs to engaging in drug use has been established. The prevalence of drug transactions specifically in schools is less understood. The purpose of this study was to identify the prevalence of adolescents who have reported drug transaction experiences (being offered, sold, or given an…

Background: More than half of US states have legalized medical marijuana. Several states have also legalized it for recreational use. In spite of states' actions, marijuana remains illegal under federal law. It remains to be seen, however, if the Trump administration will enforce federal law in states that have legalized marijuana. For now, it…

Background: The Pennsylvania Youth Survey (PAYS) is administered biennially to adolescents; it covers knowledge, attitudes, and behaviors about risk and protective factors. Purpose: This study explored 8th, 10th, and 12th grade students' attitudes and beliefs about current trends regarding drugs, alcohol, and mental health. Methods: We asked…

Background: Substance use is prevalent and is associated with academic performance among adolescents. Few studies have examined the association between abstinence from all substances and academic achievement. Methods: Data from a nationally representative sample of 9578 12th graders from the 2015 Monitoring the Future survey were analyzed to…

Background: Given ever-reducing budgets of community and school substance use prevention programs, there is a call for identifying the first substance in the sequence leading to polydrug use. Methods: Examining data from a nationally representative sample of 2835 United States 12th graders, we sought to determine (1) the first substance…

Background: Despite previous research indicating an adolescents' alcohol, tobacco, and other drug (ATOD) use is dependent upon their sex and the sex composition of their social network, few social network studies consider sex differences and network sex composition as a determinant of adolescents' ATOD use behavior. Methods: This systematic…

Background: Much etiologic research has focused on individual-level risk factors for teen dating violence (TDV); therefore, less is known about school-level and neighborhood-level risk factors. We examined the association between alcohol outlet density around high schools and TDV victimization and the association between markers of physical…