SWL 579: Session 3

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

2. EPIDEMIOLOGY ETIOLOGY EFFICACY EFFECTIVENESS DISSEMINATION 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. 1. Identify problem or disorder(s) and review information to determine its extent 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 AboutRisk and Protective Factors • Risk & protective factors are found in many domains • The more risk factors present, the greater likelihood of problem behaviors, and the less likelihood of successful outcomes • Protective factors reduce effects of exposure to risk -- the greater the level of protection, the less likelihood of problem behaviors • Common risk & protective factors predict diverse behavior outcomes • 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. SSDP Intervention ( +, - ( - ) ( + ) Social Development Model PROSOCIAL PATH Prosocial opportunities Prosocial involvement Prosocial rewards Bonding to prosocial others Belief in the moral order External constraints:Norms Family & Classroom Management Positive Behavior Skills for interaction Position in the social structure: race, SES, age, gender Problem Behavior Individual constitutional factors Antisocial opportunities Antisocial involvement Antisocial rewards Bonding to antisocial others Belief in antisocial values ANTISOCIAL PATH

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

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

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 Ethnic Group European-American 381 47% African-American 207 26% Asian-American 177 22% Native-American 43 5% of these 44 5% were Hispanic • Gender • Female 396 49% Male 412 51% • SES • Eligible for free/reduced lunch (5th,6th or 7th) 423 52%

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?

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 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) ParentDrinking Child’s Alcohol Use Age 15 1.4 ** Peterson et al. (1994)

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

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

24. Etiology – Parent Drinking and Child Age 15 Alcohol use (odd ratios) ParentDrinking Child’s Alcohol Use Age 15 .33*** Good FamilyManagement Parental Anti- Alc. Norms .38*** Chld’s Non-Invl in Parent’s Alc Use 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 binge tobacco pot hard highest degree by age 24 years of education 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 High School Drug Use -.49 AcademicAttainment by Age 24 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.

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

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

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. SSDP Panel Ages and Retention Middle High Elementary Adult Panel retention has been high. Longitudinal data have been collected on these Seattle youths and their parents from 1985 to 2002 (age 27). MEANAGE G2 10 11 12 13 14 15 16 (17) 18 21 24 27 % 87% 69% 81% 96% 97% 95% -- 94% 95% 93% 92%

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 & 6 grades 9, 10 & 12 age 24

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

38. Multiple Group SEM: Caucasian-African American-Asian American gender (female) poverty Caucasian High School Drug Use -.39 AcademicAttainment by Age 24 .39 prior schoolgrades -.21 High SchoolDelinquency

39. Multiple Group SEM: Caucasian-African American-Asian American gender (female) poverty African American High School Drug Use -.77 AcademicAttainment by Age 24 prior schoolgrades High SchoolDelinquency

40. Multiple Group SEM: Caucasian-African American-Asian American gender (female) poverty Asian American High School Drug Use -.13, ns AcademicAttainment by Age 24 .39 prior schoolgrades -.20 High SchoolDelinquency

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.