Adolescent Substance Use: School and Community Perspectives on School-Based Interventions

Substance use among adolescents is a public health concern. African American youth, in particular, initiate marijuana use earlier and use more frequently than their White peers. Substance use has been linked to increased violent behavior, criminal offenses, delinquent behavior, risky sexual behavior and negative academic performance. Compared to their White counterparts, African American youth experience disparate consequences and more substance use related problems, even at equivalent or lower levels of use. Despite associated consequences, African Americans in Kentucky are half as likely (compared to generally low rates observed across the country) to seek mental health treatment. Reasons that prevent African Americans from seeking treatment include cultural factors such as fear of stigma, distrust of mental health professionals, a strong reliance on religion, and issues related to access (i.e., insurance, accessibility, transportation). Schools are promising locations to provide evidence-based substance use interventions, as 70% of children who receive any type of mental health service, receive them in schools and school-based interventions remove logistical barriers for some African American families such as lack of transportation or insurance. SBIRT (Screening, Brief Intervention, and Referral to Treatment), is an evidence-based substance use intervention with demonstrated effects in community settings. The first aim of the proposed study is to identify the characteristics of the intervention, inner and outer setting variables, and characteristics of the school-based practitioners impacting the implementation of SBIRT. The second aim is to identify characteristics of African American families and adolescents that affect use of an evidence based substance use intervention.