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Schedule:
Tuesday, January 19, 2021
* noted as presenting author
Background/Purpose: Adolescent substance use remains a major public health concern in the United States. In 2018, 58% and 48% of late adolescents reported having ever used alcohol and illicit drugs, respectively. Especially adolescents whose families are experiencing severe economic hardships such as those on Temporary Assistance for Needy Families (TANF) or Supplemental Nutrition Assistance Program (SNAP) are at elevated risks of substance use (except alcohol). Given the detrimental effects of adolescent substance use on physical, mental, and behavioral health outcomes, prevention is critical to close health disparities between adolescents on public assistance (PA) and their non-recipient counterparts. However, at-risk adolescents’ access to prevention education opportunities and its effectiveness in substance use reduction are understudied. To fill the gaps, this study aimed to investigate the involvement in substance use prevention education among adolescents on PA in different settings (i.e., home, school, and neighborhood), and test each education source’s effects on current alcohol and illicit drug use.
Methods: Using data from the 2002-2017 National Survey on Drug Use and Health, this study’s sample included 45,916 adolescents (aged 12−17) whose families received TANF, SNAP, or both in the past year. For comparison purposes, 200,884 adolescents whose families did not receive PA were also examined. We examined binary measures of past-year involvement in three substance use prevention education sources: home (having a conversation with parent(s) about the danger of substance use), school-based (films, lectures, discussions about drugs/alcohol in class), and neighborhood (prevention messages from posters, pamphlets, radio, and TV). We also examined binary measures of past-year and current alcohol and illicit drug (marijuana, cocaine, crack, or heroin) use. Statistical analyses were conducted in two steps. We first estimated the rates of parental talk, school-based prevention class participation, and access to preventive messages while stratifying by PA receipt status. Then we conducted logistic regression analyses separately for each education source to test its effects on current substance use among adolescents on PA programs.
Results: Despite decreasing trends in substance use regardless of PA receipt status, adolescents on PA continued to report higher usage of illicit drugs. Compared to their non-PA counterparts, PA receipt was significantly associated with lower rates of involvement in all three substance use prevention education sources: home (54.6% vs. 60.1%; AOR=0.905, 95% CI=0.877-0.934), school (60.8% vs. 66.3%, AOR=0.850, 95% CI=0.821-0.879), and neighborhood (71.3% vs. 79.3%, AOR=0.739, 95% CI=0.713-0.766). While all three education sources were overall effective in reducing substance use among adolescents on PA, parental talk was associated with the largest reductions in both alcohol (AOR=0.831, 95% CI=0.758-0.910) and illicit drug use (AOR=0.826, 95% CI=0.755-0.902).
Conclusion and Implications: Despite their greater substance use risks, fewer adolescents on PA were involved in substance use prevention education at home, school, and neighborhood. Special attention needs to be paid to increase access to substance use prevention education among adolescents on PA. Such measures need to account for the importance of parent-child conversation about the danger of substance use as well as resources to increase availability of substance use prevention in schools and in neighborhoods.
Methods: Using data from the 2002-2017 National Survey on Drug Use and Health, this study’s sample included 45,916 adolescents (aged 12−17) whose families received TANF, SNAP, or both in the past year. For comparison purposes, 200,884 adolescents whose families did not receive PA were also examined. We examined binary measures of past-year involvement in three substance use prevention education sources: home (having a conversation with parent(s) about the danger of substance use), school-based (films, lectures, discussions about drugs/alcohol in class), and neighborhood (prevention messages from posters, pamphlets, radio, and TV). We also examined binary measures of past-year and current alcohol and illicit drug (marijuana, cocaine, crack, or heroin) use. Statistical analyses were conducted in two steps. We first estimated the rates of parental talk, school-based prevention class participation, and access to preventive messages while stratifying by PA receipt status. Then we conducted logistic regression analyses separately for each education source to test its effects on current substance use among adolescents on PA programs.
Results: Despite decreasing trends in substance use regardless of PA receipt status, adolescents on PA continued to report higher usage of illicit drugs. Compared to their non-PA counterparts, PA receipt was significantly associated with lower rates of involvement in all three substance use prevention education sources: home (54.6% vs. 60.1%; AOR=0.905, 95% CI=0.877-0.934), school (60.8% vs. 66.3%, AOR=0.850, 95% CI=0.821-0.879), and neighborhood (71.3% vs. 79.3%, AOR=0.739, 95% CI=0.713-0.766). While all three education sources were overall effective in reducing substance use among adolescents on PA, parental talk was associated with the largest reductions in both alcohol (AOR=0.831, 95% CI=0.758-0.910) and illicit drug use (AOR=0.826, 95% CI=0.755-0.902).
Conclusion and Implications: Despite their greater substance use risks, fewer adolescents on PA were involved in substance use prevention education at home, school, and neighborhood. Special attention needs to be paid to increase access to substance use prevention education among adolescents on PA. Such measures need to account for the importance of parent-child conversation about the danger of substance use as well as resources to increase availability of substance use prevention in schools and in neighborhoods.