This article examines prevalence of non-medical use of prescription drugs (NMUPD) in a sample of elementary and high school students in an Appalachian Tennessee county. We found that lifetime prevalence of NMUPD (35%) was higher than prevalence of cigarette use (28%) and marijuana use (17%), but lower than lifetime prevalence of alcohol use (46%). We examined characteristics, as well as risk and protective factors in several domains, as predictors of NMUPD. For comparison, we also examined these characteristics and factors as predictors of alcohol, cigarette, and marijuana use. Using survey data from a sample of late elementary school and high school students (grades 5, 7, 9, and 11), logistic regression analyses showed that the risk factors of friends' non-medical use and perceived availability, and the protective factors of perceived risk, parents' disapproval, school commitment, and community norms against youth NMUPD were significant predictors of lifetime prevalence of NMUPD. Implications for prevention are discussed.

This article reports results of a meta-analysis of the effects of a set of community coalitions that implemented science-based substance use prevention interventions as part of a State Incentive Grant (SIG) in Kentucky. The analysis included assessment of direct effects on prevalence of substance use among adolescents as well as assessment of what “risk” and “protective” factors mediated the coalition effects. In addition, we tested whether multiple science-based prevention interventions enhanced the effects of coalitions on youth substance use. Short-term results (using 8th-grade data) showed no significant decreases in six prevalence of substance use outcomes—and, in fact, a significant though small increase in prevalence of use of one substance (inhalants). Sustained results (using 10th-grade data), however, showed significant, though small decreases in three of six substance use outcomes—past month prevalence of cigarette use, alcohol use, and binge drinking. We found evidence that the sustained effects on these three prevalence outcomes were mediated by two posited risk factors: friends' drug use and perceived availability of drugs. Finally, we found that the number of science-based prevention interventions implemented in schools within the coalitions did not moderate the effects of the coalitions on the prevalence of drug use. Study limitations are noted.

Few studies of inhalant use have examined a large number of predictors at the individual level, including risk and protective factors and delinquent behavior, while also taking into account contextual variables (such as school size and poverty rates). This exploratory study uses 8th grade data from a large-scale survey of students in Kentucky to examine individual and contextual predictors of prevalence of inhalant use, and compares the predictors of inhalant use with factors predicting the use of marijuana and other drug use. Hierarchical Generalized Linear Modeling results using a logit link function suggest that the relationships between inhalant use and some of these factors are different than the relationships between the factors and both marijuana and other drug use. Implications for prevention of inhalant use are discussed.

Background:The purpose of this study was to determine whether a health coaching (HC) course for providers and staff in Veterans Health Affairs medical facilities resulted in increased attitudes toward, intentions to use, and actual use of HC. Methods: A Whole Health Coaching Course was developed and implemented in national sites in 2014. A pre-post intervention group only design was used to assess changes in HC outcomes, including use of HC skills. Results: There were large pre- to posttest increases in preparedness and self-efficacy that were sustained at follow-up. Initial small increases in attitudes toward patient-centered care and intentions to use HC skills were not sustained at follow-up. There was a medium-sized increase in actual use of HC skills between pre-test and follow-up. Conclusions: Findings suggest that participation in the HC course is an effective means for providers and staff to increase preparedness, self-efficacy, and actual use of health coaching skills.