J. David Hawkins

Objective Considering the interplay between normative and legal aspects of young adults’ cannabis environments may help improve cannabis use and misuse prevention and harm reduction among young people. Method Data came from 3,818 US young adults (average age 23 years, SD=. 49) living in diverse legal cannabis contexts (54.8% illegal, 17.7% medical legal; 27.8% non-medical legal). Cannabis norms were measured by young adults’ perceptions of cannabis use and approval by parents, peers, spouse/partner, and community members. Logistic regressions estimated the separate, additive, and interactive associations of cannabis norms and legal permissiveness with young adults’ past-year cannabis use and misuse, adjusting for past cannabis use and norms and other covariates. Results Legal and normative permissiveness were highly correlated. However, only norms were independently …

This study tested whether effects of a preventive intervention delivered in elementary school showed benefits for the young adult offspring of intervention recipients over 20 years later. The Raising Healthy Children (RHC) intervention, trialed in 18 public schools in Seattle, Washington, from 1980–1986 (grades 1–6), sought to build strong bonds to family and school to promote school success and avoidance of substance use and illegal behavior. Four intervention groups were constituted: full, late, parent training only, and control. Participants were followed through 2014 (age 39 years). Those who became parents were enrolled in an intergenerational study along with their oldest offspring (10 assessments between 2002 and 2018). This study includes young adult offspring (ages 18–25 years; n = 169; 52% female; 4% Asian, 25% Black, 40% multiracial, 4% Native American, 2% Native Hawaiian/Pacific Islander, 25 …

Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease (ESKD). Prognostic biomarkers reflective of underlying molecular mechanisms are critically needed for effective management of DKD. A three-marker panel was derived from a proteomics analysis of plasma samples by an unbiased machine learning approach from participants (N = 58) in the Clinical Phenotyping and Resource Biobank study. In combination with standard clinical parameters, this panel improved prediction of the composite outcome of ESKD or a 40% decline in glomerular filtration rate. The panel was validated in an independent group (N = 68), who also had kidney transcriptomic profiles. One marker, plasma angiopoietin 2 (ANGPT2), was significantly associated with outcomes in cohorts from the Cardiovascular Health Study (N = 3,183) and the Chinese Cohort Study of Chronic Kidney Disease (N = 210). Glomerular …

IntroductionMany adult smokers have tried electronic cigarettes (e-cigarettes) as a less harmful alternative to combustible cigarettes. There is limited evidence, however, for the extent to which switching to e-cigarettes is associated with better health and functioning among nicotine users approaching their 40s—the beginning of midlife—when many health issues become more evident. This study examined the adoption of e-cigarette use (“vaping”) among smokers in their 30s, and its association with diverse measures of healthy and successful aging at age 39.MethodsData were from the Seattle Social Development Project, a panel study of 808 diverse participants with high retention (88%−91%). A subsample of 156 who used combustible cigarettes (smoked) at age 30 and smoked or vaped at age 39 was selected for analysis. A measure of vaping frequency, relative to combustible cigarette use, was computed from …

With changes to drug-related policies and increased availability of many drugs, we currently face a public health crisis related to substance use and associated health consequences. Substance use and substance use disorders (SU/SUDs) are complex developmental disorders with etiologies that emerge through the intergenerational transmission of biological, familial, and environmental factors. The family ecosystem both influences and is influenced by SU/SUDs, particularly in children and adolescents. Family dynamics and parent functioning and behaviors can represent either risk or protective factors for the development of SU/SUDs in children. Primary care providers who provide care for children, adolescents, and families are in an ideal position to deliver prevention messages and to intervene early in the development of substance misuse and SUD among their patients. Despite recommendations from …

Evidence-based parenting interventions play a crucial role in the sustained reduction of adolescent behavioral health concerns. Guiding Good Choices (GGC) is a 5-session universal anticipatory guidance curriculum for parents of early adolescents that has been shown to reduce substance use, depression symptoms, and delinquent behavior. Although prior research has demonstrated the effectiveness of evidence-based parenting interventions at achieving sustained reductions in adolescent behavioral health concerns, public health impact has been limited by low rates of uptake in community and agency settings. Pediatric primary care is an ideal setting for implementing and scaling parent-focused prevention programs as these settings have a broad reach, and prevention programs implemented within them have the potential to achieve population-level impact. The current investigation, Guiding Good Choices …

Using Prevention Science To Guide Community Action: Page 1 Using Prevention Science To Guide Community Action: Long-term Effects of Communities That Care on Positive Youth Development Margaret Kuklinski, PhD J. David Hawkins, PhD University of Washington Singapore Ministry of Social and Family Development, Conversations on Youth Symposium, Moving Upstream – Early Prevention of Youth Offending September 9, 2021 Page 2 Too Many Young People Don’t Reach Their Potential Anxiety Depression Alcohol, tobacco, other drug use Risky driving Aggressive behavior and conduct problems Delinquent behavior Violence Selfinflicted injury Risky sexual behavior School dropout Page 3 Early Efforts to Prevent Delinquency & Drug Abuse Lesson: Untested good ideas can make things worse. Strategies • Information • Just say “No” • Fear arousal – “Scared Straight” Outcomes • No decreases in drug use …

This study estimated sustained impacts and long-term benefits and costs of the Communities That Care (CTC) prevention system, implemented and evaluated in a longitudinal cluster-randomized trial involving 24 communities in seven states. Analyses utilized reports from a longitudinal panel of 4407 participants, followed since the study’s baseline in grade 5, with most recent follow-up 12 years later at age 23. Impacts on lifetime abstinence from primary outcomes of substance use and antisocial behavior were estimated using generalized linear mixed Poisson regression analysis, adjusted for individual and community-level covariates. Possible cascading effects on 4-year college completion, major depressive disorder, and generalized anxiety disorder through age 23 were evaluated as secondary outcomes. CTC had a statistically significant global effect on primary outcomes and also on combined …

Purpose This paper describes the origins and application of a theory, the social development model (SDM), that seeks to explain causal processes that lead to the development of prosocial and problem behaviors. The SDM was used to guide the development of a multicomponent intervention in middle childhood called Raising Healthy Children (RHC) that seeks to promote prosocial development and prevent problem behaviors. This paper reviews and integrates the tests of the SDM and the impact of RHC. While the original results of both model and intervention tests have been published elsewhere, this paper provides a comprehensive review of these tests. As such, this integrative paper provides one of the few examples of the power of theory-driven developmental preventive intervention to understand impact across generations and the power of embedding controlled tests of …

Introduction Reducing cigarette use is a major public health goal in the United States. Questions remain, however, about the potential for the social environment in the adult years—particularly in the 30s and beyond—to influence cigarette use. This study tested pathways hypothesized by the social development model to understand the extent to which social environmental factors at age 33 (eg, involvement with smokers or with physically active people) contribute to changes in cigarette use from age 30 to age 39. Both combustible and electronic cigarette use were investigated. Methods Data were from the Seattle Social Development Project, a longitudinal study of 808 diverse participants with high retention. Self-reports assessed social developmental constructs, combustible and electronic cigarette use, and demographic measures across survey waves. Results …

Rates of youth drug use are substantial. In the 2007 Monitoring the Future study (Johnston et al. 2008), 46 percent of 12th-grade students reported smoking cigarettes at least once in their lifetime, 72 percent reported lifetime alcohol use, 26 percent reported binge drinking (ie, having five or more drinks on one occasion), and 42 percent reported lifetime marijuana use. While numerous prevention programs have been found to reduce alcohol use among minors (Spoth, Greenberg, and Turrisi 2008), the impact of an intervention is likely to be compromised if the environments in which youth live are unfavorable to or do not support program goals and activities (Wagenaar and Perry 1994; Flay 2000). Community-based efforts offer much potential for impacting rates of youth substance use because, in contrast to single prevention programs operating in a single context, they typically utilize multicomponent strategies that seek to change a variety of factors that place youth at risk for substance use (Wandersman and Florin 2003). They attempt to alter not only the immediate or situational risk factors but also the long-term, structural, and environmental influences that are associated with drug use and abuse (Wagenaar and Perry 1994). By targeting multiple risks faced in multiple contexts and saturating the environment with prevention strategies and messages, community-based efforts have the potential to achieve population-level reductions in youth substance use. Another advantage of community-based strategies is their reliance on members of the local community to plan, implement, and monitor prevention activities,

BackgroundEvidence for use of electronic cigarettes (e-cigs) as a potential aid in quitting or reducing combustible cigarette (c-cig) use is mixed. This study examined the extent to which e-cig initiation among smokers in their 30 s predicted quitting or reducing smoking or nicotine dependence symptoms by age 39, and whether the role of e-cigs in quitting differed by prospectively assessed moderators.MethodsData were from the Seattle Social Development Project (SSDP), a panel study of 808 diverse participants with high retention. A subsample of 221 smokers at age 33 was selected for analysis. Self-reports of c-cig use and dependence were assessed longitudinally at ages 33 and 39. Sixteen potential moderators were examined, including social demographics, smoking attitudes and desire to quit, other health behaviors and status, and adolescent and early adult assessments of smoking history.ResultsThe use …

There are stable between-person differences in an internalizing “trait,” or the propensity to experience symptoms of internalizing disorders, such as social anxiety, generalized anxiety disorder, and depression. Trait internalizing may serve as a marker of heightened risk for problem alcohol outcomes (such as heavier drinking, binge drinking, or alcohol dependence). However, prior research on the association between internalizing symptoms and alcohol outcomes has been largely mixed in adolescence, with more consistent support for an association during adulthood. It may be that trait internalizing is only associated with problem alcohol outcomes in adulthood, after individuals have gained experience with alcohol. Some evidence suggested that these effects may be stronger for women than men. We used data from a community sample (n= 790) interviewed during adolescence (ages 14–16) and again at ages 21 …

ImportanceTrials of preventive interventions for children that were implemented in the 1980s have reported sustained positive outcomes on behavioral and health outcomes into adulthood, years after the end of the intervention. This present study examines whether intervention in childhood may show sustained benefits across generations.ObjectiveTo examine possible intervention outcomes on the offspring of individuals (now parents) who participated in the Raising Healthy Children preventive intervention as children in the elementary grades.Design, Setting, and ParticipantsThis nonrandomized controlled trial was conducted in public elementary schools serving high-crime areas in Seattle, Washington. The panel originated in Seattle but was followed up locally and in out-of-state locations over time. Data analyzed in this study were collected from September 1980 to June 2011, with follow-up of the firstborn …

Few longitudinal studies are capable of identifying criminal career profiles using both self‐report and official court data beyond the 30s. The current study aims to identify criminal career profiles across three developmental periods using self‐report data, validate these profiles with official court records and determine early childhood predictors. Data came from the Seattle Social Development Project (n = 808). Latent Class Analysis was used to examine criminal careers from self‐reported data during adolescence (aged 14–18), early adulthood (aged 21–27) and middle adulthood (aged 30–39). Official court records were used to validate the classes. Childhood risk and promotive factors measured at ages 11–12 were used to predict classes. Findings revealed four career classes: non‐offending (35.6%), adolescence‐limited (33.2%), adult desister (18.3%) and life‐course/persistent (12.9%). Official court records are …

This study examined associations of neighborhood structural factors (census-based measures, socioeconomic disadvantage, and residential stability); self-reported measures of general and substance use-specific risk factors across neighborhood, school, peer, and family domains; and sociodemographic factors with substance use among 9th grade students. Data drawn from the Seattle Social Development Project, a theory-driven longitudinal study originating in Seattle, WA, were used to estimate associations between risk factors and past month cigarette smoking, binge drinking, marijuana use, and polysubstance use among students (N = 766). Results of logistic regression models adjusting for neighborhood clustering and including all domains of risk factors simultaneously indicated that neighborhood socioeconomic disadvantage was associated with a significantly higher likelihood of cigarette …

The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

There is growing critical commentary and debate about the relative effectiveness of individual program and generic practice approaches to identifying evidence‐based interventions and their impact on the operation of the juvenile justice system. The central issue is whether both of these approaches to identifying evidence‐based interventions provide a valid and reliable guide to improving juvenile justice programming and, if so, what are the relative advantages and disadvantages of each? From a public policy perspective, should we be investing more heavily in one or the other, or treating them as effective complementary approaches and encourage both? We address each of these questions and offer some suggestions for improving the effectiveness of each approach.