Substance Misuse Prevention Research Articles

Interventions integrating health and academic education in schools to prevent substance misuse and violence: a systematic review

Background Schools struggle to timetable health education. Interventions integrating academic and health education to reduce substance use and violence offer promise. No current systematic reviews examine such interventions. Objectives To review evidence to explore the following questions: (1) what types of interventions integrating health and academic education in schools serving those aged 4–18 years have been evaluated? (2) What theories of change inform these interventions? (3) What factors facilitate or limit the successful implementation and receipt of such interventions, and what are the implications for the delivery of such implementations in the UK? (4) How effective are such interventions in reducing smoking and violence and the use of alcohol and drugs, and at increasing attainment? Does this vary by students’ sociodemographic characteristics? (5) What factors appear to influence the effectiveness of such interventions? Data sources In total, 19 databases were searched from 18 November to 22 December 2015, updating searches for outcome evaluations for violence on 28 February 2018 and for substance use on 14 May 2018. References were extracted from included studies and authors contacted. Review methods Included studies reported on theories of change, and process or outcome evaluations of interventions that integrated academic and health education to reduce substance use and/or violence. References were screened on the title/abstract and then on the full report. Data extraction and appraisal used Cochrane, Evidence for Policy and Practice Information Centre and other established tools. Theories of change and process data were qualitatively synthesised. Outcome evaluations were synthesised narratively and meta-analytically. Results In total, 78,451 unique references were originally identified and 62 reports included. Search updates on 28 February and 14 May 2018 retrieved a further 2355 and 1945 references, respectively, resulting in the inclusion of six additional reports. Thirty-nine reports described theories, 16 reports (15 studies) evaluated process and 41 reports (16 studies) evaluated outcomes. Multicomponent interventions are theorised to erode ‘boundaries’ (strengthen relationships) between academic and health education, teachers and students, behaviour in classrooms and in the wider school, and schools and families. Teachers, pro-social peers and parents are theorised to act as role models and reinforcers of healthy behaviours learnt in lessons. There was clear evidence that interventions are facilitated by supportive senior management and alignment with the schools’ ethos, collaborative and supportive teaching environments, and positive pre-existing student, teacher and parent attitudes towards interventions. The barriers were overburdened teachers who had little time to both learn and implement integrated curricula. The strongest evidence for effectiveness was found for the reduction of substance use in school key stages (KSs) 2 and 3. For example, a meta-analysis for substance use at KS3 reported a mean difference of –0.09 (95% confidence interval –0.17 to –0.01). A meta-analysis for effectiveness in reducing violence victimisation in KS2 found no effect. There was mixed evidence for effects on academic outcomes, with meta-analysis precluded by methodological heterogeneity. Limitations Study quality was variable. Integration was sometimes not emphasised in theories of change. Conclusions These interventions are undertheorised but involve multiple forms of boundary erosion. There is clear evidence of characteristics affecting implementation. Interventions are likely to have the greatest impact on substance use. These programmes may be effective in reducing substance use but do not appear to reduce violence and findings on educational impacts are mixed. Future work Future evaluations should assess interventions with clearer theories of change and examine academic outcomes alongside violence and substance use outcomes. Study registration This study is registered as PROSPERO CRD42015026464. Funding The National Institute for Health Research Public Health Research programme.

Transitional Stress Influences Problem Alcohol Use and Emotion Regulation in Late Adolescence: A Mixed-Methods Study

Rates of alcohol use peak during the transition from adolescence to young adulthood, a developmental phase that encompasses heightened stress and emotion regulation demands. This mixed methods study examines the influence of a critical developmental transition, high school graduation, on the relationship between problem alcohol use and emotion regulation. High school seniors (N = 117) were surveyed within three months of graduation. Quantitative analyses show that transition stress, but not emotion regulation, predicts alcohol-related problems. Qualitative analyses reveal that adolescent high-risk drinkers engage in a variety of strategies to regulate distress. Implications for adolescent substance misuse prevention programs are discussed.

Neurocognitive Precursors of Substance Misuse Corresponding to Risk, Resistance, and Resilience Pathways: Implications for Prevention Science.

Studies of substance misuse prevention generally focus on characteristics that typify risk, with the assumption that the prevalence of the problem will be optimally reduced by identifying, targeting, and reducing or eliminating risk factors. However, this risk-centered approach neglects variations in individual-level and environmental characteristics that portend differential pathways that are distinguishable by timing of substance use initiation (e.g., early versus delayed), the likelihood of use escalation versus eventual desistance, and enduring abstinence, despite exposure to significant risk factors. Considering the various underpinnings of these distinct substance use trajectories is critical to a more nuanced understanding of the effects, potency, and malleability of factors that are known to increase risk or confer protection. Here, we discuss three pathways relative to substance use patterns and predictors in the context of adversity, a well-known, highly significant influence on propensity for substance misuse. The first pathway is designated as “high risk” based on early onset of substance use, rapid escalation, and proneness to substance use disorders. Individuals who defy all odds and eventually exhibit adaptive developmental outcomes despite an initial maladaptive reaction to adversity, are referred to as “resilient.” However, another categorization that has not been adequately characterized is “resistant.” Resistant individuals include those who do not exhibit problematic substance use behaviors (e.g., early onset and escalation) and do not develop substance use disorders or other forms of psychopathology, despite significant exposure to factors that normally increase the propensity for such outcomes (e.g. trauma and/or adversity). In this paper, we apply this conceptualization of risk, resistance, and resilience for substance misuse to a more fine-grained analysis of substance use pathways and their corresponding patterns (e.g., non-use, initiation, escalation, desistance). The significance of the progression of neurocognitive functioning over the course of development is discussed as well as how this knowledge may be translated to make a science-based determination of intervention targets. This more encompassing theoretical model has direct implications for primary prevention and clinical approaches to disrupt risk pathways and to optimize long-term outcomes.

Predictors of Hospitalization of Individuals With First-Episode Psychosis: Data From a 2-Year Follow-Up of the RAISE-ETP.

Despite treatment advances in other domains, inpatient psychiatric hospitalization rates for individuals with first-episode psychosis remain high. Even with early intervention services, a third or more of individuals are hospitalized over the first 2 years of treatment. Reducing hospitalization is desirable from the individual's perspective and for public health reasons because hospitalization costs are a major component of treatment costs. Univariate and multivariate baseline and time-varying covariate analyses were conducted to identify predictors of hospitalization in the Recovery After an Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study, a 2-year cluster randomized trial for participants experiencing a first episode of psychosis who were outpatients at study entry. The trial compared an early intervention treatment model (NAVIGATE) with usual community care at 34 clinics across the United States. RAISE-ETP enrolled 404 participants of whom 382 had one or more postbaseline assessments that included hospitalization data. Thirty-four percent of NAVIGATE and 37% of usual-care participants were hospitalized during the trial. Risk analyses revealed significant predictors of hospitalization to be the number of hospitalizations before study entry; duration of untreated psychosis; and time-varying days of substance misuse, presence of positive symptoms, and beliefs about the value of medication. These results indicate that hospital use may be decreased by reducing the duration of untreated psychosis and prior hospitalizations, minimizing residual symptoms, preventing substance misuse, and facilitating adherence to medication taking. Addressing these factors could enhance the impact of first-episode early intervention treatment models and also enhance outcomes of people with first-episode psychosis treated using other models.

Study Sheds Light on Trajectory of Developing Bipolar Disorder

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessStudy Sheds Light on Trajectory of Developing Bipolar DisorderLinda M. RichmondLinda M. RichmondSearch for more papers by this authorPublished Online:28 Feb 2019https://doi.org/10.1176/appi.pn.2019.2a11AbstractAnxiety, sleep disorders, and/or major depression in young people whose parents have bipolar disorder may complicate early recognition and treatment. As many as 1 in 4 children who has a parent with bipolar disorder may go on to develop the disorder. A large prospective study published in AJP in Advance suggests that childhood sleep and anxiety disorders may be important predictors of the illness.Anne Duffy, M.D., and colleagues found that bipolar spectrum disorders developed in 25 percent of children who had one parent with bipolar disorder and that childhood sleep or anxiety disorders were more likely among those who developed it.“For clinicians, in order to accurately diagnose emerging psychiatric disorders, we need to take into account the developmental trajectory of emerging psychopathology as well as the family history of psychiatric illness,” lead study author Anne Duffy, M.D., a professor in the Department of Psychiatry at Queen’s University in Canada, told Psychiatric News. “Symptoms alone are not sufficient information to make a stable and accurate diagnosis.”The study included 279 “high-risk” participants (aged 5 to 25 years) who had one parent diagnosed with bipolar I or bipolar II disorder. The researchers categorized the high-risk participants into two groups, according to how their parents responded to lithium. Parents of the participants were considered to be “responsive to lithium” if they had no new recurrences over at least three years while on the medication; all others were considered nonresponsive to the medication. Also included in the study were 87 “comparison” participants—those with similar socioeconomic backgrounds from Ottawa schools whose parents had had no history of major psychiatric disorder.Participants were followed for up to 21 years, about 8 years on average for the high-risk group. All participants completed research assessments administered by a psychiatrist at baseline and about every year thereafter.The researchers observed bipolar spectrum disorders in 25 percent of the “high-risk” offspring, with an average age of onset of 21 years old, while about 11 percent of the group were diagnosed with psychotic spectrum disorders. Neither disorder was observed in the comparison group. The researchers found evidence that earlier age of onset of parental bipolar disorder was associated with an increased risk of mood disorder, including bipolar disorder and depression, in the offspring.The researchers found no difference in the prevalence of bipolar disorder among participants based on whether their parent responded to lithium; however, psychotic disorders manifested almost exclusively among the offspring of lithium-nonresponsive parents (20 percent compared with 1 percent).Individuals with childhood anxiety disorder or a sleep disorder were nearly twice as likely to develop a mood disorder, Duffy and colleagues found. Subthreshold depressive or manic symptoms were even more telling, and participants with such symptoms were 2.7 times more likely and 2.3 times more likely, respectively, to develop a mood disorder.“The implication is that clinically significant anxiety, mood, and sleep symptoms in children at confirmed familial risk for bipolar disorder identify an ultra-high-risk group that likely warrants closer surveillance and support,” the researchers wrote.The researchers diagnosed major depressive disorder almost exclusively among the high-risk offspring (33 percent of the high-risk group versus 5 percent of the comparison group). A similar pattern emerged for sleep disorders (23 percent of high-risk group versus none of the comparison group). Bipolar disorder typically unfolded in a progressive clinical sequence in individuals with familial risk, Duffy said. Depressive episodes were predominant early in the illness, especially among the offspring of individuals who responded to lithium.This study did not, however, find evidence to support a proposed pediatric bipolar subtype of illness in childhood characterized by chronic rapid fluctuating moodiness, irritability, neurodevelopmental disorder, and explosive temper. “This suggests this phenotype has nothing to do with bipolar disorder that persists into adulthood,” Duffy said.Overall the findings indicate the role that anxiety, sleep disorders, and major depression—especially with psychotic symptoms—may play in the development of bipolar disorder in young people with a familial risk. “Early clinical intervention and prevention efforts,” the researchers wrote, “should emphasize low-risk interventions addressing mood symptoms, anxiety and sleep disorders, and prevention of substance misuse.”The study was supported by a grant from the Canadian Institutes of Health Research. ■“The Emergent Course of Bipolar Disorder: Observations Over Two Decades From the Canadian High-Risk Offspring Cohort” can be accessed here. 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Injury Occurrence and Return to Dance in Professional Ballet: Prospective Analysis of Specific Correlates.

Professional ballet is a highly challenging art, but studies have rarely examined factors associated with injury status in ballet professionals. This study aimed to prospectively examine gender-specific correlates of injury occurrence and time-off from injury in professional ballet dancers over a one-year period. The participants were 99 professional ballet dancers (41 males and 58 females). Variables included: (i) predictors: sociodemographic data (age, educational status), ballet-related factors (i.e., experience in ballet, ballet status), cigarette smoking, alcohol drinking, and consumption of illicit drugs; and (ii) outcomes: injury occurrence and time-off from injury. Participants were questioned on predictors at the beginning of the season, while data on outcomes were collected continuously once per month over the study period. Dancers reported total of 196 injuries (1.9 injuries (95% CI: 1.6–2.3) per dancer in average), corresponding to 1.4 injuries per 1000 dance-hours (95% CI: 1.1–1.7). In females, cigarette smoking was a predictor of injury occurrence in females (OR: 4.33, 95% CI: 1.05–17.85). Alcohol drinking was a risk factor for absence from dance in females (OR: 1.29, 95% CI: 1.01–4.21) and males (OR: 1.21, 95% CI: 1.05–3.41). Less experienced dancers were more absent from dance as a result of injury than their more experienced peers (Mann-Whitney Z: 2.02, p < 0.04). Ballet dancers and their managers should be aware of the findings of this study to make informed decisions on their behavior (dancers) or to initiate specific programs aimed at the prevention of substance use and misuse in this profession (managers).

A Review of Personality-Targeted Interventions for Prevention of Substance Misuse and Related Harm in Community Samples of Adolescents.

Several school-based prevention programmes have been developed and used to prevent, delay, or reduce substance misuse, and related problems among community samples of adolescents. However, findings indicate that many of these interventions are associated with null, small, or mixed effects in reducing adolescent substance misuse, in particular for those mostly at risk of transitioning to substance use disorders. These findings highlight the need to shift the focus of substance use prevention efforts toward intervention strategies which directly target high-risk adolescents. The Preventure programme was designed to target four personality risk factors for substance misuse: hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. This article reviews findings from the previous trials of personality-targeted interventions (i.e., Preventure programme) with adolescents and discuss the promises and benefits of these interventions for targeting community samples of high-risk adolescents at school level for reducing substance misuse and related mental health problems. Findings indicated that this programme has been successful in reducing the rates of alcohol and illicit drug use and substance-related harms by ~50% in high-risk adolescents with the effects last for up to 3 years. These interventions were also associated with a 25% reduction in likelihood of transitioning to mental health problems, such as anxiety, depression, suicidal ideation, and conduct problems. The programme is particularly beneficial for youth with more significant risk profiles, such as youth reporting clinically significant levels of externalizing problems, and victimized adolescents. A key strength of the Preventure programme is that it is embedded in the community and provides substance use intervention at school level to the general samples of high-risk adolescents who might not otherwise have access to those programmes.

2017 ASTHO President's Challenge: Public Health Approaches to Preventing Substance Misuse and Addiction.

2017 ASTHO President's Challenge: Public Health Approaches to Preventing Substance Misuse and Addiction.

Risk Competence in Dealing With Alcohol and Other Drugs in Adolescence

ABSTRACTBackground: Adolescence is a critical phase for the development substance use patterns. We propose that individual competence in dealing with psychoactive substances is crucial for the development of healthy substance use behavior and prevention of substance misuse or addiction. Objectives: We present a new concept of health related skills in dealing with alcohol and other drugs in adolescence, its operationalization and validation. Our conception of risk competence (RICO) consists of the four major factors being Reflective, Informed, Self-Controlled and Life-Oriented, and their sub-facets. Methods: Based on a sample of N = 753 adolescents we used classical test theory as well as item response theory to create a new measure of RICO. Validity was investigated in a new sample of N = 229 with regard to substance use, risk perception, and measures of personality (Big Five, sense of coherence, general self-efficacy). Results: RICO contains 7 scales with 28 items that measure independent aspects of risk competence. Cross-sectional criterion validity for most of the scales could be shown. Conclusions/Importance: The new RICO scales are a valid measure of different aspects of risk competence in dealing with psychoactive substances. The questionnaire can be used in general research settings, but may also be applied to assess the effects of interventions.

Commentary on Vrolijk et al. (2017): The paradox of the quality control problem.

Commentary on Vrolijk et al. (2017): The paradox of the quality control problem.

Effectiveness of the strengthening families programme 10-14 in Poland: cluster randomized controlled trial.

: The Strengthening Families Programme for youth aged 10-14 and parents/carers (SFP10-14) is a family-based prevention intervention with positive results in trials in the United States. We assessed the effectiveness of SFP10-14 for preventing substance misuse in Poland. : Cluster randomized controlled trial with 20 communities (511 families; 614 young people) were allocated to SFP10-14 or a control arms. Primary outcomes were alcohol, smoking and other drug use. Secondary outcomes included parenting practices, parent-child relations, and child problem behaviour. Interview-based questionnaires were administered at baseline and at 12- and 24-months post-baseline, with respective 70.4 and 54.4%, follow-up rates. : In Bayesian regression models with complete case data we found no effects of SFP10-14 for any of the primary or secondary outcomes at either follow-up. For example at 24-months, posterior odds ratios and 95% credible intervals for past year alcohol use, past month binge drinking, past year smoking, and past year other drug use, were 0.83 (0.44-1.56), 0.83 (0.27-2.65), 1.94 (0.76-5.38) and 0.74 (0.15-3.58), respectively. Although moderate to high attrition rates, together with some evidence of systematic attrition bias according to parent education and family disposable income, could have biased the results, the results were supported in further analyses with propensity score matched data and 40 multiple imputed datasets. : We found no evidence for the effectiveness of SFP10-14 on the prevention of alcohol or tobacco use, parenting behaviour, parent-child relations or child problem behaviour at 12- or 24-month follow-up in a large cluster randomized controlled trial in Poland.

Risk Factors for Substance Misuse and Adolescents' Symptoms of Depression

PurposeDepressive symptoms during adolescence are positively associated with peer-related beliefs, perceptions, and experiences that are known risk factors for substance misuse. These same risk factors are targeted by many universal substance misuse prevention programs. This study examined whether a multicomponent universal substance misuse intervention for middle schoolers reduced the associations between depressive symptoms, these risk factors, and substance misuse. MethodsThe study used data from a place-randomized trial of the Promoting School-Community-University Partnerships to Enhance Resilience model for delivery of evidence-based substance misuse programs for middle schoolers. Three-level within-person regression models were applied to four waves of survey, and social network data from 636 adolescents followed from sixth through ninth grades. ResultsWhen adolescents in control school districts had more symptoms of depression, they believed more strongly that substance use had social benefits, perceived higher levels of substance misuse among their peers and friends, and had more friends who misused substances, although they were not more likely to use substances themselves. Many of the positive associations of depressive symptoms with peer-related risk factors were significantly weaker or not present among adolescents in intervention school districts. ConclusionsThe Promoting School-Community-University Partnerships to Enhance Resilience interventions reduced the positive associations of adolescent symptoms of depression with peer-related risk factors for substance misuse.

Selecting Communication Channels for Substance Misuse Prevention With At-Risk African-American Emerging Adults Living in the Southern United States

ABSTRACTNatural health information sources used by African-American emerging adults were investigated to identify sources associated with high and low substance-related risk. Participants (110 males, 234 females; M age = 18.9 years) were recruited using respondent-driven sampling, and structured interviews assessed substance use, sources of health information, and preferences for help. Friends and social network sites were associated with higher risk, whereas teachers/schools were associated with lower risk (ps < .025). Despite risks associated with friends, more participants preferred receiving help from friends than the other sources. The findings inform targeted prevention messages that are sensitive to contextual and audience characteristics.

Prevalence and Factors Associated with Substance Use and Misuse among Kosovar Adolescents; Cross Sectional Study of Scholastic, Familial-, and Sports-Related Factors of Influence.

Adolescence is considered to be the most important period for the prevention of substance use and misuse (SUM). The aim of this study was to investigate the problem of SUM and to establish potentially important factors associated with SUM in Kosovar adolescents. Multi-stage simple random sampling was used to select participants. At the end of their high school education, 980 adolescents (623 females) ages 17 to 19 years old were enrolled in the study. The prevalence of smoking, alcohol consumption (measured by Alcohol Use Disorder Identification Test–AUDIT), and illegal drug use (dependent variables), as well as socio-demographic, scholastic, familial, and sports-related factors (independent variables), were assessed. Boys smoke cigarettes more often than girls with daily-smoking prevalence of 16% among boys and 9% among girls (OR = 1.85, 95% = CI 1.25–2.75). The prevalence of harmful drinking (i.e., AUDIT scores of >10) is found to be alarming (41% and 37% for boys and girls, respectively; OR = 1.13, 95% CI = 0.87–1.48), while 17% of boys and 9% of girls used illegal drugs (OR = 2.01, 95% CI = 1.35–2.95). The behavioral grade (observed as: excellent–average-poor) is the factor that was most significantly correlated with SUM both in boys and girls, with lower behavioral grades among those adolescents who consume substances. In girls, lower maternal education levels were associated with a decreased likelihood of SUM, whereas sports achievement was negatively associated with risky drinking. In boys, sports achievement decreased the likelihood of daily smoking. Information on the factors associated with SUM should be disseminated among sports and school authorities.

Attitudes of West African Immigrants in the United States toward Substance Misuse: Exploring Culturally Informed Prevention and Treatment Strategies

There is a lack of literature exploring substance misuse issues of the West African-born population in the United States. Thirty-four participants born in West Africa participated in one of three focus groups in a U.S. city to discuss their attitudes toward alcohol and drug use. Based on a qualitative analysis of the discussions, stigmatization of substance abusers and negative attitudes toward U.S. substance abuse treatment were identified as barriers to service utilization for West African immigrants. Community cohesion, importance of family, and a strong sense of spirituality were identified as essential resources to inform substance misuse prevention and treatment strategies.

Cannabis and adolescents: Exploring the substance misuse treatment provider experience in a climate of legalization

BackgroundUnderstanding consumer attitudes toward drugs is vital for the design and implementation of effective substance misuse prevention and treatment programs. Research that enhances our understanding of these perceptions is of the utmost importance in the climate of cannabis legalization. While there is a body of literature focused on the perceptions of drug use among adolescents, less attention has been paid to the experiences of health care professionals who serve this vulnerable population. Research aimed at better understanding the experiences of professionals may improve cannabis misuse prevention efforts and inform policy decisions as cannabis moves closer to legalization nationwide. MethodsThe present study applied a grounded theory qualitative methodology to interview 11 adolescent substance misuse treatment providers. Each participant had at least two years of clinical practice in Colorado before January 1, 2014, when cannabis became available for recreational sale. FindingsExtensive analysis of data obtained from participant interviews, yielded seven core concepts related to cannabis use and decriminalization: normalizing, increasing access, rising addiction potential, link to opioids and other drugs, complicating substance treatment, diversity issues, and responding to change. According to participants, legalization has contributed to the continuing normalization of cannabis, validation of its consumption, and greater access to a host of new and more potent THC products by adolescents. Providers attributed these attitudinal changes to heavier use of both cannabis and other drugs and increased resistance to treatment efforts and interventions. ConclusionsThese results support the need to expand access to a wider range of substance misuse treatment options for adolescents and to further our understanding of the impact on this population of the cannabis laws.

Not Just Academics: Paths of Longitudinal Effects From Parent Involvement to Substance Abuse in Emerging Adulthood

PurposeBy the 12th grade, half of American adolescents have abused an illicit drug at least once (Johnston et al., 2015). Although many substance misuse prevention programs exist, we propose an alternative mechanism for reducing substance use. There is evidence that parent involvement is related to reductions in children's behavior problems which then predict later substance abuse. We examine the Child-Parent Center (CPC) program, an early childhood intervention, as a strategy to impact substance abuse. MethodsWe conducted a path analysis from CPC to parent involvement through early adolescent problem behaviors and competencies to young adult substance abuse. Participants (N = 1,203; 51.5% female; 93.8% African-American) were assessed from age 3 to 26 years. ResultsCPC participation initiates a pathway to increased parent involvement and expectations, which positively impact adolescents' competencies and problem behaviors, lowering rates of substance abuse. ConclusionsThrough early childhood education, increasing early parental involvement and expectations can alter life-course outcomes by providing children with a foundation for positive behaviors and encouraging adaptive functioning in adolescence.

Juries

A quick journey through prevention science (e.g., substance misuse prevention) and a comparison between online and offline risks, harm, and vulnerability in children suggests that new approaches and interventions are needed to promote Internet safety and minimise the new sources of risk associated with accessing the Internet. In this paper we present a new methodological approach to promote digital literacy and positively influence the way in which young people interact with the Internet: iRights Youth Juries. These juries offer a solution for the challenge of how to engage children and young people in activities that, rather than simply promoting Internet safety, aim to provide the knowledge and the confidence required for developing healthy digital citizens. This approach thus begins to move beyond the notion of the Internet as a simple cause of social change, approaching it instead as an opportunity to engage knowledgeably with the digital world and maximise citizenship.

Everything is connected: social determinants of pediatric health and disease.

Carine Tarazi, MA, is an Assistant Editor for Pediatric Research in Boston, Massachusetts, USA. Margie Skeer, ScD, MPH, MSW, served as a Guest Editor for this special issue. Dr. Skeer is Assistant Professor of Public Health and Community Medicine at Tufts University. Her research focuses on adolescent substance misuse and sexual risk prevention, both from epidemiologic and intervention-development perspectives. Kevin Fiscella, MD, MPH, served as a Guest Editor for this special issue. Dr. Fiscella is Tenured Professor of Family Medicine, Public Health Sciences and Community Health at the University of Rochester Medical Center. Dr. Fiscella's research focuses on health and health care disparities, particularly practical strategies to improve health equity. Stephanie Dean, MBA, is Managing Editor of Pediatric Research and is based out of editorial office in The Woodlands, Texas. Olaf Dammann, MD, served as a Guest Editor for this special issue. Dr. Dammann is a Professor of Public Health and Community Medicine, Pediatrics, and Ophthalmology at Tufts University School of Medicine in Boston, Massachusetts, USA, as well as Professor of Perinatal Neuroepidemiology at Hannover Medical School, Hannover, Germany. His research interests include the elucidation of risk factors for brain damage and retinopathy in preterm newborns, the theory of risk and causation in biomedical and public health research, and the development of computational chronic disease models.

Translating Developmental Neuroscience to Substance Use Prevention.

Several preventive interventions have demonstrated efficacy in reducing substance use. However, opportunities exist to further improve prevention approaches. The application of recent advances in developmental neuroscience can inform the design, implementation, and evaluation of substance use prevention programs. This paper first briefly describes the developmental integration of the prefrontal cortex with emotion and motivation centers of the brain, and the implications of this process for substance use vulnerability. Discussed next are specific examples of how developmental neuroscience can inform prevention timing, development, and evaluation. Contextual considerations are then suggested including a critical role for schools in substance misuse prevention. Finally, current theoretical and methodological challenges to the translation of developmental neuroscience to substance use prevention are discussed.