Latent class analysis of substance use among adolescents presenting to urban primary care clinics

Abstract

Background: Polysubstance use during adolescence is a significant public health concern. However, few studies have investigated patterns of substance use during this developmental window within the primary care setting. Objectives: This study used an empirical method to classify adolescents into substance use groups, and examines correlates of the empirically defined groups. Methods: Data came from patients, ages 12–18 years, presenting to an urban, primary care community health clinics (Federally Qualified Health Centers) in two cities in the Midwestern United States (n = 1664). Latent class analysis (LCA) was used to identify classes of substance users. Multinomial logistic regression was used to examine variables associated with class membership. Results: LCA identified three classes: class 1 (64.5%) exhibited low probabilities of all types of substance use; class 2 (24.6%) was characterized by high probabilities of cannabis use and consequences; and class 3 (10.9%) had the highest probabilities of substance use, including heavy episodic drinking and misuse of prescription drugs. Those in class 2 and class 3 were more likely to be older and have poorer grades, poorer health, higher levels of psychological distress and more sexual partners than those in class 1. Individuals in class 3 were also less likely to be African-American than those in class 1. Conclusion: Findings provide novel insight into the patterns of substance use among adolescents presenting to low-income urban primary care clinics. Future research should examine the efficacy of interventions that address the complex patterns of substance use and concomitant health concerns among adolescents.