Assessing Risk and Protective Factors for Adolescent Drug Use and Problem Behaviors: Comparing Youth in Chile and the United States

Introduction: Obtaining accurate measures of community-level risk and protection is a critical part of science-based approaches to prevention. The Communities that Care Youth Survey (CTCYS) is a brief, reliable, and valid self-report instrument, used widely in the U.S. and internationally to measure risk, protection and problem behaviors among adolescents. Data from the CTCYS is used by communities to prioritize risk and protective factors for intervention, and to target prevention programming to actual local need. This study reports on the first large-scale application of the CTCYS in Chile, and compares results with U.S. data.

Methods: We compare levels of drug use and associated risk and protective factors between youth in Chile and the United States, for adolescents in grades 6, 8, and 10. Chilean data were collected from over 2,000 adolescents in 2014, as part of a broader study to adapt and implement the Communities that Care (CTC) prevention system in three low-income communities in Chile. Data were collected using a Spanish language version of the CTCYS, which was reviewed and adapted for cultural relevance with minimal modifications to the original English version. U.S. data were collected in 2010 from over 5,000 students in ten communities that are part of the control group of the Community Youth Development Study—a randomized controlled trial of CTC. Additional U.S. data were provided by Bach Harrison Survey Research and Evaluation Services, collected from close to 400,000 students in 9 states between 2008 and 2010. Cut-points for identifying the percentages at elevated risk and depressed protection were calculated using the Arthur et al., 2007 methodology.

Results: Results show the utility of risk and protective factor data to determine priorities for prevention planning. Levels of risk and protection in the community, school, family and individual/peer domains—by country—indicate that some factors are more elevated in comparison with others and that profiles vary by country. Prevalence of drug use and antisocial behavior outcomes also differ between the Chilean and U.S. adolescents.

Conclusions: Findings have significant implications for prevention efforts in Chile, as they will be used in the larger context of targeting preventive interventions to those risk/protective factors that are most elevated/depressed in each community. The availability of local data represents a major step towards helping shape local decisions and broader policy in the country. In the international context, the study contributes to examining the cross-national utility of risk/protective factor measures, especially for middle income countries.