Project Northland Research Articles

Cross-Gender Social Normative Effects for Violence in Middle School: Do Girls Carry a Social Multiplier Effect for At-Risk Boys?

A social multiplier effect is a social interaction in which the behavior of a person in a social network varies with the normative behavior of others in the network, also known as an endogenous interaction. Policies and intervention efforts can harness social multiplier effects because, in theory, interventions on a subset of individuals will have "spillover effects" on other individuals in the network. This study investigates potential social multiplier effects for violence in middle schools, and whether there is evidence for a social multiplier effect transmitted from girls to boys. Three years of longitudinal data (2003-2005) from Project Northland Chicago were used to investigate this question, with a sample consisting of youth in Grades 6 through 8 in 61 Chicago Public Schools (N = 4,233 at Grade 6, N = 3,771 at Grade 7, and N = 3,793 at Grade 8). The sample was 49.3% female, and primarily African American (41.9%) and Latino/a (28.7%), with smaller proportions of whites (12.9%), Asians (5.2%) and other ethnicities. Results from two sets of regression models estimating the effects of 20th (low), 50th (average), and 80th (high) percentile scores for girls and boys on levels of violence in each gender group revealed evidence for social multiplier effects. Specifically, boys and girls were both influenced by social multiplier effects within their own gender group, and boys were also affected by normative violence scores among girls, typically those of the best-behaved (20th percentile) girls. The finding that girls may have positive social influence on boys' levels of violent behavior extends prior findings of beneficial social effects of girls on boys in the domains of education and risky driving. Further, this social normative effect presents a potential opportunity to improve school-based intervention efforts for reducing violence among youth by leveraging girls as carriers of a social multiplier effect for reduced violence in the middle school environmental context, particularly among boys, who are at greater risk.

The Substance-Related Etiology of Teen Dating Violence Victimization: Does Gender Matter?

The purpose of this study was to examine gender differences in the substance-related etiology of teen dating violence using a high-risk sample of urban youth. Data were obtained from 2,991 students in grade 12 who participated in Project Northland Chicago, a group-randomized alcohol prevention intervention implemented in Chicago schools. Typologies of dating violence and physical aggression were created, and hierarchical multinomial regression procedures were used to examine risk and protective factors for membership in each group. The results suggested that there were no quantifiable gender differences in dating violence victimization; however, there were substantial differences in aggression and in the reporting of both dating violence victimization and physical aggression. Furthermore, substance use (alcohol, tobacco, and marijuana) was identified as a robust risk factor for each of the typologies for women. Among men, marijuana use was associated with only the most at-risk group (e.g., the victim-offender overlap group), whereas alcohol and marijuana use predicted membership in each typology among women. Study limitations and implications are also discussed.

P4.075 The Importance of Alcohol and Peers in Risky Sexual Partner Selection

BackgroundWhen sexual partners have risky context characteristics (i.e., partner drinking alcohol within two hours before sex, ≥ 3 age discordant, or met in public), adolescents are particularly vulnerable to having...

A Case-Control Study of Risk and Protective Factors for Incarceration Among Urban Youth

Each day in the United States, approximately 100,000 youth are under correctional supervision. The purpose of this study is to examine the early risk and protective factors for incarceration using a high-risk sample of urban youth. Data were obtained from 2,165 (54 who were incarcerated) youth who participated in Project Northland Chicago. Participants were matched exactly on gender, race/ethnicity, and aggressive behavior in sixth grade. Bivariate and multivariate conditional logistic regression analyses were used to examine the risk and protective factors present at sixth grade that increased the odds of incarceration at 12th grade. The early risk factors for incarceration were age (odds ratio [OR]= 2.51; 95% confidence interval [CI] 1.71-3.69), having been sent to detention (1-3 times: OR= 2.24; 95% CI 1.15-4.37; 4+ times: OR= 3.49; 95% CI 1.40-8.72), and the number of hours spent participating in a sport (OR= 1.11; 95% CI 1.03-1.20). Substance use was not significantly related to incarceration after adjusting for other behavioral and contextual risk factors. General problem behaviors (nonaggressive) strongly predict incarceration among at-risk youth. Implications for prevention programs are discussed.

Influence of Grade-Level Drinking Norms on Individual Drinking Behavior

To investigate which points of the middle-school drinking distribution are the most influential in the social contagion of drinking across the middle-school years, in order to identify potential social multipliers. We measured drinking intentions and behaviors by gender, school, and grade among urban middle-school students who participated in Project Northland Chicago in a longitudinal cohort design. Individual drinking behaviors were consistently influenced by extreme (80(th) percentile) drinking intentions and behaviors. This effect was mediated through normal or average levels of drinking, over time. Interventions can target extreme drinkers as the influential persons in middle-school grades.

Association Between Sex Partner Meeting Venues and Sexual Risk Taking Among Urban Adolescents

To increase understanding of the association between sexual partner meeting venue types (school, through friends or family, organized groups, public places, or on the street) and sexual risk taking among urban youths. Data were from 17- to 18-year-old youths who reported having had sex (n = 1,656) by the time they participated in the 2008-2009 follow-up of a multicomponent alcohol preventive intervention, Project Northland Chicago. We used logistic regression to assess the association between partner meeting venue and sexual risk taking. Approximately 20% of Chicago adolescents met their most recent sex partner on the street or in public places. Adolescents who met their partner in a public place, rather than in school, were more likely to report having ≥ 3 years age-discordant partner (women: odds ratio [OR] = 7.7, 95% confidence interval [CI] = 3.3-17.7; men: OR = 2.7, 95% CI = 1.1-6.6], alcohol use before sex (women: OR = 3.4, 95% CI = 1.8-6.5; men: OR = 2.4, 95% CI = 1.3-4.4), casual partner (women: OR = not significant; men: OR = 2.4, 95% CI = 1.3-4.5), anal sex (women: OR = not significant; men: OR = 2.4, 95% CI = 1.2-4.9), and unprotected sex (women: OR = 1.7, 95% CI = 1.0-2.7; men: OR = 1.9, 95% CI = 1.1-3.4). Meeting partners on the street was associated with increased probability of alcohol use before sex (women: OR = 2.2, 95% CI = 1.1-4.3; men: OR = 2.1, 95% CI = 1.0-4.6), age-discordant partnerships among women (OR = 14.2, 95% CI = 6.4-31.4), and casual sex partners among men (OR = 2.5, 95% CI = 1.4-4.8). Targeting sexual risk taking with partners selected from public places or the street may improve adolescent HIV preventive interventions.

Classroom Norms and Individual Smoking Behavior in Middle School

To investigate whether smoking prevalence in grade-level networks influences individual smoking, suggesting that peers are important social multipliers in teen smoking. We measured gender-specific, grade-level recent and life-time smoking among urban middle-school students who participated in Project Northland Chicago in a longitudinal cohort design. Within schools, grade-level recent smoking had comparable effects on girls' and boys' individual-level smoking. Grade-level lifetime smoking had a greater effect on girls' smoking. Interventions can target middle school classes and schools broadly, without making the identification of friendship networks a concern.

A Multi-Level Approach to Investigating Neighborhood Effects on Physical Aggression among Urban Chicago Youth

The current study evaluates neighborhood effects, individual-level effects, and demographic characteristics that influence physically aggressive behavior among urban youth. Using data derived from 5,812 adolescents from Project Northland Chicago (PNC) and Heirarchical Linear Modeling (HLM) techniques, the results suggested that neighborhood problems significantly predicted physical aggression, before and after adjustment for individual-level risk factors (alcohol use, peer alcohol use, lack of adult supervision, and depression) and demographics. After accounting for baseline physical aggression, however, neighborhood problems were no longer a significant predictor of physical aggression. Implications for intervention at both the neighborhood and individual-level and study limitations are also discussed.

Contemporary options for longitudinal follow-up: Lessons learned from a cohort of urban adolescents

This study reports efforts to locate and survey participants in Project Northland Chicago (PNC), a longitudinal, group-randomized trial of an alcohol preventive intervention for racial/ethnic minority, urban, early-adolescents, 3–4 years following the end of the intervention. Data were collected annually among students from 6th–8th grade and then at age 17–18. Tracking procedures were used to maintain contact with participants and data collection consisted of three phases: (1) Internet- and mail-based surveys; (2) in-school survey administration; and (3) courier service delivery. Contact was lost with 11% of this urban cohort from the end of the PNC intervention activities through these longterm follow-up efforts, as indicated by returned locating postcards. Fifty-three percent of the cohort responded to the survey, the majority completing in Phase 1 of our data collection. Additional school-based and courier-delivery efforts increased our response rate by 11.5%. Costs per completed survey were $118 in Phase 1, $166 in Phase 2, and $440 in Phase 3. This study illustrates that it is possible to track and follow-up a high-risk cohort as they progress through adolescence, even with minimal efforts in intervening years. Lessons learned from this study may inform future efforts to track and collect longitudinal data among high-risk populations.

Do High-Risk Urban Youth Also Have Older Friends?

The purpose of this study was to explore how behavioral, intrapersonal, and socio-environmental factors were associated with the likelihood of having at least one older friend. Participants included 3,709 ethnically diverse eighth grade students in the Project Northland Chicago intervention trial. Socio-demographic characteristics included gender, family composition, language spoken at home, race/ethnicity, and age. Behavioral factors included cigarette, alcohol, and marijuana use, depressed feelings, willingness to wear alcohol-branded merchandise, and violent and delinquent behavior. Intrapersonal factors included low refusal self-efficacy, and outcome expectations and expectancies. Socio-environmental factors included alcohol offers and access, normative estimates and expectations, and peer alcohol use. Having an older friend was defined as having at least one friend aged 16 years or older (students' mean age = 14.2). Logistic mixed-effects regression models were used and controlled for gender, race/ethnicity, treatment status, and age. Adolescent girls and older eighth graders were significantly more likely to have at least one older friend. Students who scored higher on all the behavioral, intrapersonal, and socio-environmental risk factors were significantly more likely to have at least one older friend. Significant gender interactions were found for several of the relationships. Overall, this study showed that multiple risk-related factors are associated with having older friends in eighth grade. Particularly important factors appear to be cigarette, marijuana and alcohol use, having friends who use alcohol, having increased alcohol offers, and being willing to wear or use alcohol-branded merchandise.

Effects of Beverage-Specific Alcohol Consumption on Drinking Behaviors among Urban Youth

Alcoholic beverage consumption among high school students has shifted from beer to liquor. The current longitudinal study examined the effects of beverage-specific alcohol use on drinking behaviors among urban youth. Data included 731 adolescents who participated in Project Northland Chicago and reported consuming alcohol in 7th grade. Logistic regression tested the effects of beverage-specific use on consequences (e.g., alcohol use in the past month, week, heavy drinking, and ever drunkenness). Compared to wine users, adolescents who reported drinking hard liquor during their last drinking occasion had increased odds of alcohol use during the past month (OR = 1.44; 95% CI = 1.01-2.05), past week (OR = 3.37; 95% CI = 1.39-8.18), and ever drunkenness (OR = 1.56; 95% CI = 1.07-2.29). Use of hard liquor was associated with increased risk of alcohol-related consequences. Early selection of certain alcoholic beverages (e.g., hard liquor) may result in negative health outcomes and problematic alcohol use over time.

Trajectories of Physical Aggression Among Hispanic Urban Adolescents and Young Adults: An Application of Latent Trajectory Modeling from Ages 12 to 18

This study sought to identify trajectories of physical aggression among urban Hispanic youth, and to examine the effects of risk and protective factors at age 11 on trajectories of physical aggression over time (ages 12-18). Relying on data from 731 urban Hispanic adolescents from Project Northland Chicago (PNC), latent trajectory modeling was used to determine the number of trajectories, and multinomial logistic regression was used to identify the predictors associated with trajectory membership. The results suggested five trajectories of physical aggression (non-aggressive, low stable, escalators, early-rapid desistors, and high aggression/moderate desistors). After adjusting for several risk and protective factors, language preference (e.g. speaking Spanish at home) was identified as a protective factor, while indirect exposure to alcohol, sadness/depression, fewer negative alcohol-related attitudes, and threatening to fight were associated with increased risk for physical aggression. Study implications indicate that early, multilevel prevention efforts are necessary to deter the initiation and promote the desistance of physical aggression over time among urban Hispanic adolescents.

Effects of alcohol on trajectories of physical aggression among urban youth: an application of latent trajectory modeling.

Several studies have investigated factors associated with physical aggression during adolescence. Yet, little is known about the longitudinal relationship between drug use, particularly alcohol use, and physical aggression among minority youth. The present study examined the effects of alcohol and substance use at age 11 on trajectories of physical aggression over time (ages 12-14) among urban adolescents from Chicago, IL. Data from the Project Northland Chicago (n = 3038, 49.4% female) was used. The current study sample included 1,160 Black, 1,015 Hispanic and 863 White/other adolescents for a total of 3,038 adolescents. Four trajectories of physical aggression were identified: Non-aggressive (16%), Desistors (9%), Escalators (20%) and Chronic Aggressive (55%). After adjusting for physical aggression behaviors, delinquent friends, lack of supervised time, demographic variables, smoking and marijuana use, past year alcohol users at age 11 were 2.1 times more likely to be "Escalators" and 1.9 times more likely to be in the "Chronic Aggressive" group. Gender and ethnic differences were also observed in the trajectories of physical aggression. Black youth were 2.5 times more likely to be in the "Chronic Aggressive" group. Findings highlight the importance of targeting alcohol prevention to reduce physical aggression among urban young adolescents.

Relationships Between Alcohol-related Informal Social Control, Parental Monitoring and Adolescent Problem Behaviors Among Racially Diverse Urban Youth

The purpose of the present study is to investigate the relationships between alcohol-related informal social control and parental monitoring on alcohol use, behavior and intentions; violent behavior; and delinquent behavior in a racially diverse population of young urban adolescents. Baseline surveys were administered to 6th grade male and female students in 61 urban Chicago schools as part of Project Northland Chicago, a group randomized trial for the prevention/reduction of substance use. A subset of their parents (n = 3,034) was also surveyed regarding alcohol use, violence, and delinquency and related issues. Structural equation modeling was used to assess relationships between alcohol-related informal social control (as measured by parental perceptions of neighborhood action regarding youth drinking) and parental monitoring (as reported by parents), and three adolescent outcomes (alcohol use, behaviors and intentions; violent behavior; and delinquent behavior; as reported by teens). Associations between alcohol-related informal social control and parental monitoring were positive and significant (P < .001). Direct paths from parental monitoring to all three adolescent outcomes were negative and statistically significant (alcohol use, behaviors and intentions, P < .001; violent behavior, P < .001; and delinquent behavior, P < .001). Alcohol-related informal social control was not significantly associated with adolescent outcomes. Efforts to engage parents to be more active in monitoring adolescents' activities may be related to lower levels of underage drinking, violence and delinquency among both female and male urban youth. Neighborhood norms and action against teenage drinking may be too distal to adolescent outcomes to be directly associated.

Project Northland in Croatia: Results and Lessons Learned

As part of an international public health partnership formed in 2001 we assessed the impact of Project Northland in Croatia--an adolescent alcohol school-based prevention intervention implemented in Split--on students. The curriculum was implemented in 13 randomly selected schools with another 13 schools serving as controls. The evaluation included quantitative and qualitative methods, using pre/post-tests to compare intervention and controls and follow-up focus groups with parents and teachers. Quantitative data showed the intervention was more successful in changing attitudes in the first two years, but had less impact on older students. Qualitative data suggest benefits from the program overall. Given the intervention was successful in the earlier grades it should be initiated earlier to have a greater impact. Challenges and lessons learned are offered.

Sixth Grade Students Who Use Alcohol: Do We Need Primary Prevention Programs for “Tweens”?

Young adolescent alcohol users drink at higher rates than their peers throughout adolescence and appear to be less amenable to intervention. This study compares those who reported alcohol use in the past year to those who reported no use in a multiethnic, urban sample of sixth graders in 61 schools in Chicago in 2002 (N = 4,150). Demographic, behavioral, intrapersonal, and socioenvironmental factors were identified based on behavioral theories and potential mediators of the Project Northland Chicago intervention. Single and multiple regression models were created for users and nonusers to determine associations between these factors and alcohol use behavior and intentions. The multiple regression models explained 35% and 56% of the variance in alcohol use behavior and intentions between students for nonusers and users, respectively. Results suggest that primary prevention programs for alcohol use should occur prior to sixth grade, particularly for the substantial group at high risk for early use.

Outcomes from a randomized controlled trial of a multi‐component alcohol use preventive intervention for urban youth: Project Northland Chicago

The goal of this group-randomized trial was to test the effectiveness of an adapted alcohol use preventive intervention for urban, low-income and multi-ethnic settings. Sixty-one public schools in Chicago were recruited to participate, were grouped into neighborhood study units and assigned randomly to intervention or 'delayed program' control condition. The study sample (n = 5812 students) was primarily African American, Hispanic and low-income. Students, beginning in sixth grade (age 12 years), received 3 years of intervention strategies (curricula, family interventions, youth-led community service projects, community organizing). Students participated in yearly classroom-based surveys to measure their alcohol use and related risk and protective factors. Additional evaluation components included a parent survey, a community leader survey and alcohol purchase attempts. Overall, the intervention, compared with a control condition receiving 'prevention as usual', was not effective in reducing alcohol use, drug use or any hypothesized mediating variables (i.e. related risk and protective factors). There was a non-significant trend (P = 0.066) that suggested the ability to purchase alcohol by young-appearing buyers was reduced in the intervention communities compared to the control communities, but this could be due to chance. Secondary outcome analyses to assess the effects of each intervention component indicated that the home-based programs were associated with reduced alcohol, marijuana and tobacco use combined (P = 0.01), with alcohol use alone approaching statistical significance (P = 0.06). Study results indicate the importance of conducting evaluations of previously validated programs in contexts that differ from the original study sample. Also, the findings highlight the need for further research with urban, low-income adolescents from different ethnic backgrounds to identify effective methods to prevent and reduce alcohol use.

The Impact of Project Northland on Selected MMPI-A Problem Behavior Scales

Project Northland was a randomized community trial to prevent or delay alcohol use among adolescents. Students in the intervention communities were exposed to a multi-component prevention program in early adolescence and high school. This paper examines the impact of Project Northland on the trajectories of four scales of the adolescent form of the Minnesota Multiphasic Personality Inventory (MMPI-A). Students in the intervention communities demonstrated lower rates of growth of family problems and alcohol/drug use proneness than students in the delayed-program control communities. The results were more robust for baseline non-drinkers. EDITORS' STRATEGIC IMPLICATIONS: This experimental study extends the scope of the impact of Project Northland, already recognized as a model substance abuse prevention program by the Substance Abuse and Mental Health Services Administration. The results suggest that focused prevention programs have the potential to impact young adolescents' lives more broadly. Replication and further examination of the mechanisms by which risk factors and outcomes are modified is necessary, but school administrators and public health officials could learn from this promising program and evaluation.

Efficacy of an American Alcohol and HIV Prevention Curriculum Adapted for Use in South Africa: Results of a Pilot Study in Five Township Schools

The high prevalence of HIV among young people in African countries underscores a pressing need for effective prevention interventions. Adapting school-based prevention programs developed in the United States for use in African schools may present an alternative to the time-consuming process of developing home-grown programs. The researchers report the results of a pretest-posttest field trial of an alcohol/HIV prevention curriculum adapted from an American model and delivered to ninth-grade students in five South African township schools. The revised intervention was based primarily on the Project Northland alcohol prevention and Reducing the Risk safer sex programs. The researchers found significant differences in change from baseline to follow-up between students in intervention and comparison groups on intentions to use a condom; drinking before or during sex; and, among females, sex refusal self-efficacy. The results of the field trial suggest that behavioral interventions developed in Western countries may be rapidly adapted to work in other cultural contexts.

Teasing Apart a Multiple Component Approach to Adolescent Alcohol Prevention: What Worked in Project Northland?

This paper presents the results of a post hoc component analysis designed to tease apart the effects of different intervention strategies used in Project Northland, a group-randomized, community-wide, multi-level intervention trial originally conducted in the 1990's to prevent and reduce alcohol use among a cohort of mainly White students in rural Minnesota. This study focuses on Phase I, when students were in 6th-8th grade. The intervention during this phase included five components: classroom curricula, peer leadership, youth-driven/led extra-curricular activities, parent involvement programs, and community activism. Student exposure to/participation in these components was followed over time using reliable process measures. These measures were used as time-varying covariates in growth curve analyses to estimate the effects of the intervention components over time. Multi-item scales from annually-administered student surveys were used to measure relevant outcome variables, like alcohol use. The impact of the components appears to have been differential. The strongest effects were documented for the planners of extra-curricular activities and parent program components. The classroom curricula proved moderately effective, but no effects were associated with differential levels of community activism. The interactions tested here did not provide support for synergistic effects between selected intervention components. Care must be taken when selecting and combining intervention strategies meant to reduce adolescent alcohol use.