Abstract of Distinction & EPCN Student Poster Contestant: Concurrent Validity of Adolescent Risk and Protective Factors for Substance Use in Colombia

Introduction: Communities That Care (CTC) is a prevention system aimed at reducing antisocial behaviors in adolescents. In Colombia, this system has been developed and adapted under the name of Comunidades Que se Cuidan (CQC). Successful implementation of CQC depends on valid associations between measured risk and protective factors (RPFs) for substance use and substance use outcomes. This study assessed these associations using large-scale, school-based surveys of Colombian youth. Significant associations between RPFs and outcomes in Colombia support the use of the CQC as a prevention planning system and highlight the focus on RPFs as targets for universal preventive intervention, planning, and evaluation.

Methods: A cross-sectional analysis of the CQC Youth Survey was performed. Data from 23 communities in Colombia were collected between 2012 and 2016 from youth (N = 50,946) aged 10 to 19 years. RPFs measured were dichotomized using specific grade-normed CQC cut-points based on distributions of RPFs from the Colombian data. Dichotomous alcohol, cigarette, cannabis, and other illegal drug use outcomes were assessed for past 30-day, past-year, and lifetime use. Logistic regression analyses, adjusting for age, gender, and age by RPF, and gender by RPF interactions, were performed for each RPF.

Results: We evaluated the association of 11 risk factors and 3 protective factors with the 12 outcomes. A total of 168 associations were examined and tabulated. All associations were statistically significant (p < .001) across all substance use outcomes and temporal categories. About observed size effects, 3.0% were considered very small (0.70 ≥ OR ≤ 1.43), 51.7% small (0.70 ≥ OR ≥ 1.43), 42.6% medium (0.40 ≥ OR ≥ 2.48) and 7.1% large (0.23 ≥ OR ≥ 4.27). Significant main effects for age and gender, and their interactions with RPFs were found for most RPFs. The domain with the most elevated likelihood for any substance use was the peer-individual, followed by family, school, and community domains. Significant main effects for age and gender, and their interactions with RPFs were found for most RPFs with older students, male students, older-high risk students, and male-high risk students being more likely to engage in drug use.

Conclusion: Findings from this study demonstrate the viability of RPFs for adolescent substance use as focal points for intervention planning, development, and evaluation in Colombia. This study also highlights the international importance of validly measuring RPFs and identifying the appropriate cut-points for assessment of risk and protection in communities. Additionally, this study supports the use of community-based prevention systems like CQC that rely on epidemiologic data from students for local decision making.