Alternative High School Students Research Articles

Generational Immigration Status Modifies the Association Between Psychosocial Distress and Substance Use Among Alternative High School Students

PurposeAlternative high schools (AHS) are designed to provide individualized education, more flexible scheduling, and smaller class sizes for students referred out of traditional high school. AHS students report higher levels of substance use (SU) and face disproportionately higher levels of trauma and toxic stress than their traditional high school peers. We sought to examine whether generational immigration (GenIm) status modifies the association of mental health and SU among AHS students using a longitudinal study of 1,060 Southern California AHS students. MethodsSubscales from the 21-item Depression Anxiety Stress Scale were administered. Effect modification was examined by GenIm status defined as first generation (born outside of the United States), second generation (born in the United States with a parent born outside the United States), or third generation (born in the United States with US-born parent(s)). Main outcomes included the number of times different substances were used in the past year over a 3-year period. ResultsMultilevel, negative binomial, covariate-adjusted latent growth curve models generated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of the time-varying association between depression, anxiety, or stress and the use of cigarettes, e-cigarettes, cigars, alcohol, or marijuana. Multiple-group models examined effect modification by GenIm status. DiscussionThe link between mental health and SU was stronger among first- and second-generation students than third-generation students. For example, a one-unit increase in stress relative to the average stress of students from the same school was associated with an increase in the rate of e-cigarette use among first-generation (IRR = 2.03, 95% CI = 1.07–3.85), second-generation (IRR = 2.25, 95% CI = 1.86–2.72), and third-generation (IRR = 1.68, 95% CI = 1.31–2.16) students. Effective strategies tailored to subgroups of AHS students are needed to counter disparities between traditional and alternative school systems that may contribute to long-term trajectories of SU.

Adolescent’s explicit and implicit cigarette cognitions predict experimentation with both cigarettes and e-cigarettes

ABSTRACT Background: Past year, month, and lifetime adolescent e-cigarette use rates remain persistently high, despite falling cigarette use rates. Previous investigations have noted a strong relationship between an individual’s positive and negative cognitions related to a behavior, and subsequent initiation of that behavior. Objective: This investigation was conducted to determine the impact positive and negative explicit and implicit cigarette-related cognitions may have on the use of cigarettes and e-cigarettes among at-risk, cigarette-naive adolescents. Methods: A three-year longitudinal investigation evaluated the relationship between cigarette-related cognitions and subsequent cigarette and e-cigarette use among 586 alternative high school students (female: 50.8%; mean age: 17.4 years; Hispanic/Latino: 75.0%) who had never smoked cigarettes at the baseline assessment. Multilevel logistic regression models were used to generate demographics-adjusted odds ratios (OR) and 95% confidence intervals (95% CI). Results: Students with higher positive explicit cigarette cognitions at the baseline had greater odds of subsequent cigarette use (OR = 1.72, 95% CI 1.11–2.68). If students also reported an increase over time in positive (OR = 3.45, 95% CI 2.10–5.68) or negative (OR = 1.93, 95% CI 1.03–3.61) explicit cigarette cognitions, the odds of cigarette use increased. The odds of dual use of cigarettes and e-cigarettes were greater among students who had higher negative implicit cigarette cognitions at the baseline (OR = 2.07, 95% CI 1.03–4.17) compared to those with lower levels of negative implicit cognitions. Conclusion: Prevention programming that focuses on decreasing positive cognitions related to nicotine and tobacco use may have greater overall effect on decreasing use compared to programs that only focus on increasing negative cognitions individuals form surrounding cigarette or e-cigarettes.

“They come here for sanctuary”: educator perspectives on trauma engaged alternative education

Alaska’s alternative high schools use trauma-engaged practices in their education model. Thirteen focus groups with 100 alternative high school educators, staff and administrators were conducted. The study sought to describe the Alaska alternative high school staffs’ perspectives on effective practices and impact of alternative education on drug and alcohol use, suicide ideation, feelings of hopelessness, and community support of alternative high school students. Seven overarching themes related to trauma-engaged education and a focus on social-emotional learning were described by educators. The Alaska alternative education model addresses the root causes of youth engagement in health risk factors.

Underage Alcohol Use by Intersectional Identity Among Alternative High School Students

PurposeTo examine alcohol use (AU) among intersectional subgroups within a longitudinal cohort of predominantly Hispanic/Latino alternative high school (AHS) students in southern California. MethodsPast month AU was measured over a period of three years among 1,029 students (mean age 17.5 years, 49.7% female, 76.1% Hispanic/Latino) from 29 AHSs. Multilevel models that adjusted for age, socioeconomic status, parental education, weekly income, sensation seeking, depression, anxiety, and stress estimated trends in AU over time among intersectional subgroups defined by gender, ethnicity, and generational immigration. ResultsStudents with parents born in the United States had high rates of AU at the baseline that remained stable over time. In contrast, first-generation Hispanic/Latino students had lower levels of AU at the baseline that increased over time. First-generation, female, Hispanic/Latino students exhibited one of the lowest probabilities of AU at the baseline (28.6%, confidence interval [CI]: 15.9%–41.3%) but at the two-year follow-up had one of the highest probabilities (47.4%, CI: 29.3%–65.5%). A similar trend was observed among first-generation, male, Hispanic/Latino students whose probability of past month AU rose between the baseline (23.1%, CI: 12.4%–33.8%) and two-year follow-up (36.0%, CI: 19.2%–52.7%). DiscussionFindings underscore the heterogeneity of AHS students, showing a more nuanced picture of AU by the intersection of gender, ethnicity, and generational immigration. Underage AU prevention efforts among AHS students must provide targeted messages to intersectional identities.

A Mixed Methods Exploration of Texas School Nurses' Involvement in Addressing Substance Use and Sexual/Reproductive Health Among Students in Alternative High Schools.

Students in alternative high schools (AHSs) have higher levels of substance use and risky sexual behaviors than students in traditional high schools. In this mixed methods study, we examine school nurses' efforts in Texas AHSs to address substance use and sexual/reproductive health. The nurses addressed substance use and sexual reproductive health mostly at the individual level, after students initiated risky behaviors. Nurses' efforts were influenced by district, school, and community factors (e.g., understaffing, outdated programs that weren't evidence-based or tailored to AHS students' behaviors, and family involvement). Usually, nurses were not practicing to their full scope as outlined by the National Association of School Nurses Framework. Substance use was a common reason for AHS placement and could contribute to the school-to-prison pipeline, and AHSs did not always have Narcan on campus to address drug overdoses. Our findings suggest implications for providing equitable health services to this underserved, understudied student population.

Reading on the Ropes: A Pilot Study of an Accelerated Remediation Program with Alternative High School Students

Reading on the Ropes: A Pilot Study of an Accelerated Remediation Program with Alternative High School Students

Socioemotional health, trauma exposure, and internalizing symptoms in students attending an alternative high school.

Students attending alternative schools often present with internalizing symptoms, likely related to high rates of trauma. Little is known about factors that buffer the relationship between trauma exposure and internalizing symptoms in this population. The present study examined the role of internal (i.e., self-efficacy, self-awareness, persistence) and external resources (i.e., peer support, family coherence, school support) as buffers in the association between trauma exposure and symptoms of depression and anxiety in 113 students (55% female, 91% Black, 8% Hispanic or Latinx, Mage = 18.0, SD = 1.5) attending an alternative school in a large, southeastern city. Results showed that trauma exposure was positively associated with depression and anxiety symptoms, while self-awareness and family coherence were negatively associated with depression and anxiety symptoms. Additionally, significant interactions revealed that trauma exposure was associated with depression symptoms at low but not high levels of self-awareness, and at low but not high levels of family coherence. Understanding strengths to support alternative high school students exposed to trauma is a valuable component of mental health intervention. Future research should investigate ways to cultivate self-awareness and enhance family coherence to address the complex needs of alternative school students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Using marketing frameworks to predict the effects of e-cigarette commercials on youth

PurposeThis paper aims to apply the Product Life Cycle (PLC) and Product Evolutionary Cycle (PEC) frameworks to the nicotine and tobacco market to predict the impact of television commercials for electronic cigarettes (e-cigarettes) on youth.Design/methodology/approachSurveys were administered over a three-year period to 417 alternative high school students from Southern California who had never used e-cigarettes, cigarettes or cigars at the baseline. Covariate-adjusted logistic regression causal mediation models were used to test competing hypotheses from the PLC and PEC frameworks.FindingsResults support a refined version of the PEC framework where e-cigarette commercials increase the odds of e-cigarette use, which leads to subsequent use of competing products including cigarettes and cigars.Practical implicationsThis investigation demonstrates the utility of frameworks that conceptualize youth-oriented marketing as a two-part process in which potential customers are first convinced to adopt a behavior and then enticed to use a specific product to enact the behavior.Social implicationsRising rates of nicotine and tobacco product use among youth may be partially attributable to e-cigarette commercials.Originality/valueRegulations in the USA that permit television commercials for e-cigarettes but restrict the promotion of cigarettes and cigars have created an opportunity to study product adoption among youth consumers when one product has a strategic marketing advantage.

Opening up Neat New Things: Exploring Understandings and Experiences of Social and Emotional Learning and Meaningful Physical Education Utilizing Democratic and Reflective Pedagogies.

When it comes to teaching social and affective outcomes pertaining to health and physical activity within Physical Education (PE) settings, such learning historically has been observed as manifesting itself as hoped-for-by-products rather than intentionally-taught-for curricular outcomes. The purpose of this study was to explore understandings and experiences of Social and Emotional Learning (SEL) and Meaningful Physical Education (MPE) utilizing democratic and reflective pedagogies. A qualitative case study design was implemented in an alternative high school setting in the USA across 10 months. Participants included the Teacher–Researcher (TR), one Physical Education (PE) teacher, a critical friend, two teaching assistants, and 16 ninth-grade alternative high school students aged 14–15 (eight girls/eight boys). Methods involved a TR journal, post–lesson teaching reflections, interviews, and focus groups, with inductive and deductive analysis applied. The following themes were constructed: It really made you think; making movement meaningful; being a better classmate; and doing things differently. Results demonstrate how utilizing democratic and reflective approaches grounded in social constructivist learning theory innovatively promoted SEL and MPE. It allowed students to reflect, interrogate and discuss how movement experiences inside and outside of PE influenced their pursuit of a physically active life. Participants articulated experiencing a more inclusive learning experience that challenged the purpose and subject matter of previous PE and physical activity. Teaching for SEL and MPE using common language and terminology around pre–identified and defined competencies, skills, and features drawn from these conceptual frameworks as demonstrated here, can help contribute to more concrete and uniform learning experiences within and across settings. Doing so led participants to demonstrate more holistic and broader understandings of what constituted participation in PE and physical activity, as well as how to promote and participate in meaningful movement and physical activity within and outside of school to promote healthy living. We call for further embedding of democratic and reflective pedagogies in PE teacher education and professional development that provides teachers and students with the opportunity to do so going forward.

NARRATIVES OF SUICIDALITY, ALTERNATIVE EDUCATION, AND RESILIENCY: IMPLICATIONS FOR SOCIAL WORK PRACTICE AND RESEARCH.

Suicidal behaviors and academic difficulties are characteristics that stigmatize youth as "bad" or "troubled" students. Alternative school programs aim to help students struggling with mental health and academic issues. This study explores how high school students make meaning of experiences of suicidality and resilience with respect to mainstream constructs of mental health, education, and identity. Three cases were selected from a sample of 44 interviews with alternative high school students: an 18-year-old White cisgender hetero-sexual male, a 17-year-old White transgender male (sexuality unspecified), and an 18-year-old Latina cisgender bisexual woman. A preliminary analysis of participant interviews with histories of severe suicidality informed this case selection. Using narrative analysis, common themes emerged: contamination versus redemption, the importance of having space, the physical experience of suicidality, and critical turning points in rejecting stigmatized identities. The findings have implications for practice and research focused on building student resiliency against suicidality.

Correlates of mental health problems among students in Texas alternative high schools and school-level efforts to address mental health.

Students in alternative high schools (AHSs) are an understudied population who experience disproportionate levels of risk factors that contribute to mental health problems. Using logistic regression, we explored associations between mental health problems and risk and protective factors among students in Texas AHSs (n = 515; mean age 17.1 years; 51% female, 78% youth of color, 64% eligible for free/reduced lunch). Principals (n = 14) and lead health educators (n = 14) reported on school-level efforts to address mental health. Students reported, on average, 1.55 of 4 mental health problems in the past year. Logistic regression indicated that greater number of adverse childhood experiences, lower self-esteem, female gender, and sleep disruption (getting <8 h of sleep per night) were common contributors to symptoms of depression, anxiety, suicidal ideation, and PTSD with models showing medium-to-large effects (AUC: 0.73-0.81). We assessed school-level efforts to address mental health using descriptive statistics. At the school level, most (>50%) principals reported having policies and services to support student mental health, with the exception of having mental health/social services staff represented on school health councils (36%) and having Gay-Straight Alliances (21%). Most lead health educators (86%) reported educating AHS students about mental health, and many (57%) reported receiving professional development in mental health. Future research with a larger number of schools is needed to analyze whether school policies are statistically associated with student-level mental health outcomes. Such multi-level research can inform policies and practices for AHS student mental health.

"This Is Not Gym": Enacting Student Voice Pedagogies to Promote Social and Emotional Learning and Meaningful Physical Education.

The purpose of this study was to explore learners' experiences enacting youth/student voice pedagogies (SVP) to promote Social and Emotional Learning (SEL) and meaningful physical education (MPE) in an alternative education setting. Drawing on social constructivist learning theory in understanding and implementing a MPE approach, and a systemic framework for SEL, two research questions guided the research process: (1) How did students interpret and enact these pedagogies? (2) What contribution did the enactment of these pedagogies have in promoting SEL and MPE? This study implemented a qualitative case study design framed by a participatory action research (PAR) approach spanning 12 weeks from February to May 2021. Participants in this study included 16 ninth grade alternative high school students (eight girls/eight boys) aged 14–15 who had just returned to face-to-face learning in January 2021 for the first time following COVID-19. A range of traditional and innovative participatory qualitative research methods including focus group interviews, students' personal biographies, timelines, digital and written reflections, photovoice, and class artifacts were utilized. The Miles, Huberman, and Saldana Framework for Qualitative Data Analysis was implemented involving both deductive and inductive combinations of comparative and thematic analysis. The following themes were constructed: Making responsible decisions; unearthing and sharing mixed emotions; picturing physical activity beyond the classroom; recognizing the role of relationships; considering challenge and competence; and, pursuing meaning. Findings demonstrate how enacting SVP can lead to the development of students' SEL and MPE experiences complimenting multiple learning domains. We call for further embedding of SVP capturing students' physical activity and movement experiences inside and outside of PE in teacher education and professional development that helps teachers and their students make sense of, shape, influence, and enact more MPE and physical activity learning experiences.

Care Matters: Student Perspectives of Mental Health Determinants in an Alternative High School.

Public alternative schools in the United States are multifaceted educational entities that often serve students marginalized from traditional spaces, yet little research exists highlighting the perceptions of alternative school students regarding mental health-promoting school practices. In this qualitative study, the voices of seven alternative high school students (four female and three male) are presented through the use of a targeted focus group. The following two research questions guided this study: What aspects of the public alternative school environment do students perceive to facilitate their mental health? What aspects of public alternative school environments do students perceive as barriers to mental health? Using qualitative descriptive methods, findings suggested that for these students the alternative school is a unique institution, designed for them, in which they can thrive due to the caring nature of the professionals they encounter. Implications for practitioners dedicated to producing mental health-promoting, inclusive school spaces for marginalized youth are presented.

Do hotspots improve student performance? Evidence from a small-scale randomized controlled trial

Much has been made about the “homework gap” that exists between students who have access to the Internet and those that do not. Policy-makers increasingly recognize the connectivity aspect of this issue but typically fail to acknowledge the importance of computer ownership. We use a small-scale randomized controlled trial (n=18) to test whether the provision of Internet access by itself — or in conjunction with a laptop computer — improves educational outcomes of alternative high-school students in the U.S. Our results suggest that the combination of Internet access and computer ownership is more effective than Internet access alone for positive educational outcomes.

Reducing smoking in youth by a smoke-free school environment: A stratified cluster randomized controlled trial of Focus, a multicomponent program for alternative high schools.

Youth smoking remains a major challenge for public health. Socioeconomic position influences the initiation and maintenance of smoking, and alternative high school students are at particularly high risk. The school environment is an important setting to promote health, however there is a lack of evidence-based school intervention programs. This article presents the Focus study, which aims to test the implementation and effectiveness of a school-based intervention integrating1 a comprehensive school smoking policy [i.e. smoke-free school hours (SFSH)]2, a course for school staff in short motivational conversations3, school class-based teaching material4, an edutainment session5, a class-based competition, and6 access to smoking cessation support. Together these intervention components address students’ acceptability of smoking, social influences, attitudes, motivation, and opportunities for smoking. The setting is alternative high schools across Denmark, and the evaluation design is based on a stratified cluster randomized controlled trial comparing the intervention group to a control group. Outcome data is collected at baseline, midway, and at the end of the intervention period. Moreover, a detailed process evaluation, using qualitative and quantitative methods, is conducted among students, teachers, and school principals. The results from this trial will provide important knowledge on the effectiveness of a smoke-free school environment. The findings will lead to a better understanding of which policies, environments, and cognitions, contribute to preventing and reducing cigarette use among young people in a diverse and high-risk school setting, and illuminate which complementary factors are significant to achieve success when implementing SFSH.

Acceptance of Drug Use Mediates Future Hard Drug Use Among At-Risk Adolescent Marijuana, Tobacco, and Alcohol Users.

Alternative high school (AHS) students typically report higher levels of alcohol and other drug use compared to students attending traditional high schools. Greater use of such drugs as heroin, methamphetamines, and cocaine in this at-risk population may be driven, in part, by a greater latitude of acceptance toward substance use in general, which may accelerate the transition from gateway drugs to hard drugs. Seven hundred seventy-seven adolescents (mean age 16.6; 56% female) were recruited from alternative high schools throughout Southern California. To understand the factors that may lead AHS students to use hard drugs, a model was tested in order to determine if AHS students' latitude of acceptance toward substance use was a mediator between the relationship of past use of gateway drugs and future use of hard drugs. Latitude of acceptance was found to be a statistically significant mediator of future hard drug use (b = 0.03, 95% confidence intervals = 0.01 to 0.05) among gateway drug users. An individual's latitude of acceptance to various drug use behaviors may be consistent with societal norms. However, after exposure to, or use of, gateway drugs, attitudes that are more permissive toward hard drug use may be encountered, the acceptance of hard drugs may expand, and the use of hard drugs may escalate. Interventions designed to reduce the use of hard drugs among at-risk youth may be more persuasive by crafting messages that are within the latitude of acceptance of the target population and prevent the acceptance of hard drug use.

School-Level Efforts to Address Sexual Health and Risky Sexual Behavior Among Students in Texas Alternative High Schools

We compared sexual/reproductive health services and sexuality education topics provided in Texas alternative high schools (AHSs) with the prevalence of sexual risk behaviors among students in AHS. Using cross-sectional data from convenience samples of 14 principals, 14 lead health educators, and 515 students, we calculated descriptive statistics for 20 services and 15 sexuality education topics provided by AHSs and seven sexual risk behaviors among students in AHS. AHSs provided few sexual/reproductive health services and limited educational content, despite high levels of sexual risk taking among students. For example, no AHSs taught students about proper condom use, yet 84% of students have had sex. Findings provide preliminary evidence of unmet needs for school-based sexual/reproductive health services and comprehensive sexuality education in AHS settings. Future investigation with larger, representative samples is needed to assess the provision of sexual/reproductive health services and sexuality education in AHSs and monitor sexual risk behaviors in the AHS population.

Resilience among students at risk of dropout: Expanding perspectives on youth suicidality in a non-clinical setting.

While research supports a strong association between risk of school dropout and suicidality, this youth population remains understudied. This qualitative study addresses this gap by examining self-reported risk and protective factors among 44 alternative high school students who endorsed varying levels of suicidal ideation. Criterion sampling of Suicidal Ideation Questionnaire-JR scores informed student selection for semi-structured interviews. Students were grouped by low, moderate, or high suicidal ideation scores. Transcribed interviews were analyzed using thematic analysis. The findings demonstrate subgroup differences of suicide risk and resiliency among students at risk of dropout and offer points for prevention and intervention. School practitioners can advocate for school-based suicide preventive interventions that are tailored for students who are both at risk of suicide and academic failure.

The role of negative affect in the persistence of nicotine dependence among alternative high school students: A latent growth curve analysis

BackgroundPrevious research has demonstrated how negative affect (i.e., depression, anxiety, stress) is often a correlate of and precursor to nicotine dependence. Although recent evidence shows a gradual decline in tobacco use in the United States, subgroups that report higher levels of negative affect may continue to be at risk of becoming dependent on nicotine. One high-risk subgroup is students who attend alternative high schools. The current longitudinal investigation examined the effect of negative affect on nicotine dependence in this youth population. Methods1060 students from 29 alternative high schools in Southern California completed a series of attitudinal and behavioral measures once per year over a three-year period. The main outcome was nicotine dependence i.e., feeling a strong urge to use nicotine products or experiencing withdrawal symptoms after a period of abstinence, measured using a version of the Fagerstrom Tolerance Questionnaire designed for adolescents. A latent growth curve model was utilized to examine the effect of negative affect on nicotine dependence during this timeframe. ResultsThe analysis revealed that negative affect had both a concurrent and prospective relationship with nicotine dependence. Moreover, the association between negative affect and nicotine dependence in the present was not statistically significant once the influence of negative affect reported one year earlier was accounted for. ConclusionsNegative affect may play a critical role in the persistence of nicotine dependence among high-risk youth. Providing resources to help manage negative affect may be critical to curtailing nicotine dependence in this population.

Age-varying associations between e-cigarette use and peer use, household use, and exposure to e-cigarette commercials among alternative high school students in Southern California.

INTRODUCTIONElectronic cigarettes (e-cigarettes) have rapidly become the most commonly used tobacco product among youth in the United States. Exposure to advertising, peer use, and household use, increases the risk of current e-cigarette use; however, the influence of these factors may be dynamic across adolescence. The aim of this study is to examine the age-varying associations between e-cigarette use and peer use, household use, and exposure to e-cigarette commercials among alternative high school students in Southern California.METHODSUsing data previously collected for a tobacco marketing study, we examine the age-varying associations of current e-cigarette use and three risk factors (peer use, exposure to commercials, and household use) across ages 15 to 20 years using time-varying effect modeling (TVEM). Analyses include three waves of data from alternative high school students (N=1060 students; 2036 observations).RESULTSThe probability of e-cigarette use gradually increased over the age of 15 years and then decreased by the age of 17 years for females and after the age of 18 years for males. Significant gender differences were observed between the ages of 17 and 19.5 years. Peer e-cigarette use was associated with higher odds of current e-cigarette use across all ages for females and after the age of 16 years for males. Exposure to e-cigarette commercials increased current use significantly for males between the ages of 16 and 18 years. Household use increased the odds of current use of e-cigarettes between the ages of 17 and 19 years for males and under 16.5 and over 18 years for females.CONCLUSIONSThe findings highlight the utility of TVEM in understanding the risk factors of e-cigarette use and suggest that these factors are dynamic across adolescence.