Risk and Promotive Factors Related to Cannabis Use Among American Indian Adolescents

Reservation-dwelling American Indian adolescents are at exceedingly high risk for cannabis use. Prevention initiatives to delay the onset and escalation of use are needed. The risk and promotive factors approach to substance use prevention is a well-established framework for identifying the timing a...

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Bibliographic Details
Published in:Prevention science 2024-07, Vol.25 (5), p.734-748
Main Authors: Henry, Kimberly L., Stanley, Linda R., Swaim, Randall C.
Format: Article
Language:English
Subjects:
Adolescents
American Indians
Child and School Psychology
Cross-sectional studies
Data
Escalation
Health Psychology
High risk
Longitudinal studies
Marijuana
Measurement
Medicine
Medicine & Public Health
Prediction models
Predictions
Prevention
Prevention programs
Public Health
Risk
Substance abuse
Teenagers
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Summary:Reservation-dwelling American Indian adolescents are at exceedingly high risk for cannabis use. Prevention initiatives to delay the onset and escalation of use are needed. The risk and promotive factors approach to substance use prevention is a well-established framework for identifying the timing and targets for prevention initiatives. This study aimed to develop predictive models for the usage of cannabis using 22 salient risk and promotive factors. Models were developed using data from a cross-sectional study and further validated using data from a separate longitudinal study with three measurement occasions (baseline, 6-month follow-up, 1-year follow-up). Application of the model to longitudinal data showed an acceptable performance contemporaneously but waning prospective predictive utility over time. Despite the model’s high specificity, the sensitivity was low, indicating an effective prediction of non-users but poor performance in correctly identifying users, particularly at the 1-year follow-up. This divergence can have significant implications. For example, a model that misclassifies future adolescent cannabis use could fail to provide necessary intervention for those at risk, leading to negative health and social consequences. Moreover, supplementary analysis points to the importance of considering change in risk and promotive factors over time.
ISSN:1389-4986
1573-6695
1573-6695
DOI:10.1007/s11121-024-01649-y