1. SWL 579: Session 3 10/17/09

2. EPIDEMIOLOGY ETIOLOGY EFFICACY EFFECTIVENESS DISSEMINATION 1. Identify problem or disorder(s) and review information to determine its extent 2. With an emphasis on risk and protective factors, review relevant information- both from fields outside prevention and from existing preventive intervention research programs 3. Design, conduct, and analyze pilot studies and confirmatory and replication trials of the preventive intervention program 4. Design, conduct, and analyze large- scale field trials of the preventive intervention program 5. Facilitate large-scale implementation and ongoing evaluation of the preventive intervention program in the community. The preventive intervention research cycle. Preventive intervention research is represented in boxes three and four. Note that although information from many different fields in health research, represented in the first and second boxes, is necessary to the cycle depicted here, it is the review of the information, rather than the original studies, that is considered to be part of the preventive intervention research cycle. Likewise, for the fifth box, it is the facilitation by the investigator of the shift from research project to community service program with ongoing evaluation, rather than the service program itself, that is part of the preventive intervention research cycle. Although only one feedback loop is represented here, the exchange of knowledge among researchers and between researchers and community practitioners occurs throughout the cycle.

3. Generalizations About Risk and Protective Factors v Risk & protective factors are found in many domains v The more risk factors present, the greater likelihood of problem behaviors, and the less likelihood of successful outcomes v Protective factors reduce effects of exposure to risk -- the greater the level of protection, the less likelihood of problem behaviors v Common risk & protective factors predict diverse behavior outcomes v Risk & protective factors show much consistency in effects across different races & cultures

4. Unger, Yan, Shakib, et al. (2002). Peer Influences and Access to Cigarettes as Correlates of Adolescent Smoking: A Cross-Cultural Comparison of Wuhan, China and California. Prevention Medicine 34, 476-484.

5. Results of regression analysis estimating the association between childhood maltreatment (between the ages of 3 and 11 years) and adult depression (ages 18 to 26), as a function of 5-HTT genotype. Among the 147s/s homozygotes, 92 (63%), 39 (27%), and 16 (11%) study members were in the no maltreatment, probable maltreatment, and severe maltreatment groups, respectively. Among the 435 s/l heterozygotes, 286 (66%), 116 (27%), and 33 (8%) were in the no, probable, and severe maltreatment groups. Among the 265 l/l homozygotes, 172 (65%), 69 (26%), and 24 (9%) were in the no, probable, and severe maltreatment groups. The main effect of 5-HTTLPR was not significant (b _ –0.14, SE _ 0.11, z _ 1.33, P _ 0.19), the main effect of childhood maltreatment was significant (b _ 0.30, SE _ 0.10, z _ 3.04, P _ 0.002), and the G _ E interaction was in the predicted direction (b _ –0.33, SE _ 0.16, z _ 2.01, P _ 0.05). The interaction showed that childhood stress predicted adult depression only among individuals carrying an s allele (b _ 0.60, SE _ 0.26, z _ 2.31, P _ 0.02 among s/s homozygotes, and b _ 0.45, SE _ 0.16, z _ 2.83, P _ 0.01 among s/l heterozyotes) and not among l/l homozygotes Caspi, et. al. (2003) p. 388

6. Social Development Model Prosocial opportunities Prosocial involvement Prosocial rewards Bonding to prosocial others Belief in the moral order Position in the social structure: race, SES, age, gender External constraints: Norms Family & Classroom Management Individual constitutional factors Problem Behavior Belief in antisocial values Bonding to antisocial others Antisocial rewards Antisocial involvement Antisocial opportunities Skills for interaction ( + ) ( - ) ( +, - Positive Behavior PROSOCIAL PATH ANTISOCIAL PATH SSDP Intervention

7. SSDP: Intervention Components Component One: Teacher Training in Classroom Instruction and Management Component One: Teacher Training in Classroom Instruction and Management Component Two: Parent Training in Behavior Management and Academic Support Component Two: Parent Training in Behavior Management and Academic Support Component Three: Child Social and Emotional Skill Development Component Three: Child Social and Emotional Skill Development

8. Perceived opportunities for prosocial interaction/involvement with prosocial family, classmates, teachers and classroom activities Interaction/involvement with prosocial family, caregivers, teachers, classmates, and classroom activities Perceived rewards for interaction/involvement with prosocial family, caregivers, teachers, classmates and classroom activities Family management Classroom management School policies Position in the social structure Perceived opportunities for interaction with antisocial family and caregivers, and/or involvement in aggressive and other problem behaviors Interaction with antisocial family and caregivers, and/or involvement in aggressive and other problem behaviors Perceived rewards for interaction with antisocial family and caregivers, and/or involvement in aggressive and other problem behaviors Skills for interaction/ involvement Home-based services Preparing for the Drug Free Years Respect & Responsibility Proactive Family Management Newsletters ANTISOCIAL PATH PROSOCIAL PATH (+) (-) (+,-) Attachment and commitment to prosocial family, caregivers, teachers, classmates and classroom activities Proactive Classroom Management Teacher Instructional Skills Constitutional factors Interpersonal and problem solving skills training and summer camp How to Help your Child Succeed in School After school study clubs Belief in prosocial family, caregivers, and school values Belief in antisocial family and caregivers’ values Attachment and commitment to antisocial family and caregivers Drug and delinquency initiation Note: Interaction or moderating effects are indicated by an arrowhead pointing to a structural path rather than a construct. Shaded circles indicate program interventions The Social Development Model: Elementary School Period

9. Prevention Principles Include those at greatest risk, lowest protection –Target individuals exposed to high levels of risk, low levels of protection –Target community areas exposed to high levels of risk, low levels of protection Use data to prioritize risk and protective factors Use approaches that demonstrate effects on prioritized factors –Address risk and protective factors at appropriate developmental stage –Intervene early –Address the racial, cultural, and economic diversity of your community

10. Total Aggregated Risk Factors Perspective

11. Principles for Culturally Competent Prevention Science Include multiple groups in studies.

12. SSDP Demographics SES Eligible for free/reduced lunch (5 th,6 th or 7 th ) 423 52% Ethnic Group European-American38147% African-American20726% Asian-American 17722% Native-American435% of these445% were Hispanic Gender Female396 49% Male 412 51%

13. Principles for Culturally Competent Prevention Science Include multiple groups in studies. Compare prevalences and rates of positive and problem behaviors and outcomes.

14. Are there differences in high school drug use by ethnicity?

15. Seattle Social Development Project. African American and European American Proportions Initiating Alcohol Use by Age Age 12-13 Age 13-14 Age 14-15 Percent current Users 14-15 African American 56.3%**65.5%*73.2%56.6% European American71.8%76.7%79.6%67.2%

16. Principles for Culturally Competent Prevention Science Include multiple groups in studies. Compare prevalences and rates of positive and problem behaviors and outcomes. Include measures of ethnic identify or acculturation to understand degree to which group differences reflect culture. Examine levels of risk and protection exposure in different groups.

17. Principles for Culturally Competent Prevention Science Examine the strength of risk and protective factors in different groups after controlling for socioeconomic status.

18. Peterson, et. al. (1994) p. 216

19. Hierarchical Logistic Regression: Parent Drinking, Family Management, and Parental Alcohol Attitudes and Norms Predicting Current Alcohol Use, With Demographic Variable Controlled Step Model df -2 log likelihood Chi-Squarep Step df ImprovementChi-Squarep Demographics246321.30.00135.41.15 Youth’s Race (percent Black) 245316.52.00214.78.03 Parental Drinking 244310.06.00316.46.02 Family Management 243275.81.08134.25.001 Parental Alcohol Attitudes and Norms 239271.12.0844.69.33 Child’s Involvement 238263.38.1317.74.006 Interactions: Race x Parental Drinking, Family Management, Parental Alcohol Attitudes and Norms 231249.25.23716.13.03 Peterson, et. al. (1994) p. 216

20. Hierarchical Logistic Regression: Parent Drinking, Family Management, and Parental Alcohol Attitudes and Norms Predicting Current Alcohol Use, With Demographic Variable Controlled Peterson, et. al. (1994) p. 216

21. Etiology – Parent Drinking and Child Age 15 Alcohol use (odd ratios) Child’s Alcohol Use Age 15 Parent Drinking 1.4 ** Peterson et al. (1994)

22. Etiology – Parent Drinking and Child Age 15 Alcohol use (odd ratios) Child’s Alcohol Use Age 15 Parent Drinking Good Family Management 1.4**.36*** Peterson et al. (1994)

23. Etiology – Parent Drinking and Child Age 15 Alcohol use (odd ratios) Child’s Alcohol Use Age 15 Parent Drinking Good Family Management Parental Anti- Alc. Norms 1.3+.35*** Peterson et al. (1994)

24. Etiology – Parent Drinking and Child Age 15 Alcohol use (odd ratios) Child’s Alcohol Use Age 15 Parent Drinking Good Family Management Parental Anti- Alc. Norms Chld’s Non- Invl in Parent’s Alc Use.33***.38*** Peterson et al. (1994)

25. Principles for Culturally Competent Prevention Science Examine the strength of risk and protective factors in different groups after controlling for socioeconomic status. Use engagement approaches that effectively involve the focal audience. Use communication strategies that effectively communicate with the focal audience.

26. Academic Attainment by Ethnicity

27. Ethnic disparities in educational attainment Persistent disparity in educational attainment between African Americans and European Americans (Jencks & Phillips, 1998) African Americans are about 50% less likely to earn a bachelor’s degree by age twenty- nine compared to White individuals (Haycock, 2001; US Census data)

28. Explanations for the existence of this inequality – Socioeconomic Status differences in family socioeconomic status (Bond, 1981; Tate, 1997) while differences in SES seem to account for a proportion of the gap… large racial differences remain even after standard measures of family background are controlled (Wilson, 1998) other factors may be contributing to ethnic differences in academic attainment

29. Consequences of Drug Use on Attainment High School Drug Use Academic Attainment by Age 24 bingetobaccopothard highest degree by age 24 years of education Prior work in SSDP and other studies (Ellickson, et al. 1998; Newcomb & Bentler, 1988) has shown that high school substance use predicts reduced academic attainment. -.49 7 Doctoral Degree 6 Master Degree 5 Bachelor Degree 4 Associate Degree 3 H.S. Diploma or Voc-tech 2 GED 1 Elementary or Junior High

30. Controls for delinquency, gender, prior academic achievement and poverty High School Drug Use Academic Attainment by Age 24 gender (female) poverty High School Delinquency prior school grades grades 5 & 6grades 9, 10 & 12age 24

31. Controls for delinquency, gender, prior academic achievement and poverty High School Drug Use Academic Attainment by Age 24 gender (female) poverty High School Delinquency prior school grades High school drug use predicts reduced academic attainment after controlling for delinquency, gender, prior academic achievement and poverty -.44 +.60 +.37 -.12 -.23 -.15 -.10 p <.05 not sig.

32. Research Question Do the consequences of adolescent drug use on academic attainment differ for African American, Asian American and European Americans in the SSDP study?

33. Longitudinal data have been collected on these Seattle youths and their parents from 1985 to 2002 (age 27). SSDP Panel Ages and Retention MEAN AGE G210111213141516(17)1821 2427 %87%69%81%96%97%95% --94%95% 93% 92% ElementaryMiddleHighAdult Panel retention has been high.

34. Are national differences in academic attainment reflected in the SSDP Sample?

35. Are the consequences of high school drug use different for Caucasians, African Americans and Asian Americans?

36. Model tested grades 5 & 6grades 9, 10 & 12age 24

37. Multiple Group SEM: Caucasian-African American-Asian American Caucasian African American Asian American AMOS Model Fit: CFI:.981 TLI:.962 RMSEA:.051 Fixed the measurement model to be the same across groups.

38. Multiple Group SEM: Caucasian-African American-Asian American High School Drug Use High School Delinquency prior school grades Academic Attainment by Age 24 gender (female) poverty -.39.39 -.21 Caucasian

39. Multiple Group SEM: Caucasian-African American-Asian American High School Drug Use High School Delinquency prior school grades Academic Attainment by Age 24 gender (female) poverty -.77 African American

40. High School Drug Use High School Delinquency prior school grades Academic Attainment by Age 24 gender (female) poverty -.13, ns.39 Asian American -.20 Multiple Group SEM: Caucasian-African American-Asian American

41. The consequences of high school drug use on academic attainment were worse for African Americans. The consequences of high school drug use on academic attainment were not significant for Asian Americans.

42. Prevention Implications Preventive interventions reducing adolescent drug use may have long-term benefits of greater educational attainment in adulthood. These benefits may be especially strong for African Americans.