Session: Individual-, Family-, and Community-Level Pathways to Adolescent Substance Use (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Background and purpose:
Adolescent substance use continues to be a major social problem that threatens healthy development. Despite the growing body of research investigating risk factors for adolescent substance use, key gaps in our knowledge remain in two areas: 1) risk factors for substance use in vulnerable youth (i.e., those at risk for maltreatment and/or involved in social welfare systems); and 2) risk factors across the multiple levels of the social ecology. We address the first gap by focusing on three distinct populations of vulnerable youth: child welfare-involved youth (paper 1), youth at-risk of maltreatment (paper 2), and low-income ethnic minority youth (paper 3). We address the second gap by focusing on risk factors at multiple levels, including individual-level (paper 1: initial substance use), family-level (paper 1: ongoing physical abuse; paper 2: child neglect, poor caregiver-child relationships), and community-level (paper 3: neighborhood social disorder, neighborhood violent/property crime rates). This symposium seeks to contribute to the social work research and practice knowledge base by providing directions for effective prevention and intervention strategies to prevent and reduce substance use among high-risk youth.

Methods:
The first paper conducts path analysis, using data from the National Survey of Child and Adolescent Well-Being (NSCAW-I), to examine the effects of physical abuse on adolescent substance use as well as indirect effects through ongoing physical abuse and initial substance use. The second paper conducts structural equation modeling, using the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) data, to examine the direct and indirect (via caregiver-child relationship quality) effects of child neglect on adolescent substance use. The third paper uses a Cox Proportional Hazard Cause-Specific model and the Denver Child Study data to examine the effects of cumulative exposure to neighborhood risk factors during preadolescence on the likelihood of initiating alcohol, cigarette and marijuana use during adolescence.

Results:
The first paper found that lack of safety from ongoing physical abuse (i.e., reoccurrence of physical abuse after CPS investigation) and earlier substance use were related to increased risk of adolescent substance use. The second paper found that child neglect had an indirect effect on adolescent substance use through poor quality of the caregiver-child relationship. The third paper found that greater exposure to neighborhood social disorder during preadolescence was associated with a higher hazard of initiation of cigarette use during adolescence particularly among Latino youth.

Conclusion and implication:
Collectively, the findings highlight the importance of examining and targeting risk factors across the multiple levels of the social ecology when working with vulnerable youth. These youth experience accumulating risk factors (e.g., ongoing physical abuse exposure, cumulative neighborhood risk) at multiple ecological levels (e.g. initial substance use, caregiver-child relationship quality, neighborhood disorder). Because of the chronic and concentrated individual, family, and community risk factors surrounding them, interventions focusing only on a single level may not be effective in addressing substance use risk in vulnerable youth. Moving forward, future research needs to examine how multi-level protective factors as well as their interactions with multi-level risk factors shape adolescent substance use pathways.