CONTEXT: Parenting interventions may prevent adolescent substance use; however, questions remain regarding the effectiveness of interventions across substances and delivery qualities contributing to successful intervention outcomes. OBJECTIVE:To describe the effectiveness of parent-focused interventions in reducing or preventing adolescent tobacco, alcohol, and illicit substance use and to identify optimal intervention targeted participants, dosage, settings, and delivery methods.DATA SOURCES: PubMed, PsycINFO, ERIC, and CINAHL.STUDY SELECTION: Randomized controlled trials reporting adolescent substance use outcomes, focusing on imparting parenting knowledge, skills, practices, or behaviors. DATA EXTRACTION:Trained researchers extracted data from each article using a standardized, prepiloted form. Because of study heterogeneity, a qualitative technique known as harvest plots was used to summarize findings. RESULTS:A total of 42 studies represented by 66 articles met inclusion criteria. Results indicate that parenting interventions are effective at preventing and decreasing adolescent tobacco, alcohol, and illicit substance use over the short and long term. The majority of effective interventions required ≤12 contact hours and were implemented through in-person sessions including parents and youth. Evidence for computer-based delivery was strong only for alcohol use prevention. Few interventions were delivered outside of school or home settings. LIMITATIONS: Overall risk of bias is high.CONCLUSIONS: This review suggests that relatively low-intensity group parenting interventions are effective at reducing or preventing adolescent substance use and that protection may persist for multiple years. There is a need for additional evidence in clinical and other community settings using an expanded set of delivery methods.

Research has demonstrated significantly higher rates of sexual assault victimization among lesbian, gay, bisexual and queer (LGBQ) students than heterosexual students, and the overwhelming majority of assaults are not reported to any official system. Given the potential for support services to provide valuable assistance and promote well-being after an assault, the present study explores whether LGBQ students report assaults at similar rates to heterosexual students. As part of the 2015 College Student Health Survey, 10,646 male and female college students at 2- and 4-year colleges in Minnesota provided data regarding sexual assault victimization; reporting to a health care provider, campus authority, police, or social contact; and sexual orientation (two items, including write-in). Chi-square tests were used to detect associations between sexual assault victimization and five sexual orientation groups; and between sexual orientation and assault reporting (for 523 assault incidents). Almost 6% of students reported that they had experienced sexual assault in the previous 12 months. Significant differences in assault experience were seen by sexual orientation groups, for both males and females. For example, rates of sexual assault were 2.5 to over 5 times higher among bisexual and queer/pansexual/other females than among heterosexual females. Reporting of sexual assault to health care providers, campus authorities or police was rare for both heterosexual and sexual minority students, and there were no significant differences in reporting across sexual orientation. LGBQ students and heterosexual students appear to be similarly comfortable accessing health care providers, police, and campus resources, suggesting that these services are not overtly biased or unwelcoming to sexual minorities. However, rates of sexual assault were considerably higher among sexual minority groups, suggesting a need for primary prevention that is appropriate and sensitive to the experiences of LGBQ students.

Attention toward who can use which gender binary, multi-stall bathroom has brought to the forefront, once again, the ways in which youth are supported or marginalized. No study has documented sexual and gender minority youths’ experiences with and perspectives about bathrooms. We collected qualitative data in 2014-2015. Participants were 25 lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth, aged 14-19, in the United States and Canada. Their comments describe first- and second-hand bathroom experiences, identify advocacy efforts, and highlight the roles of peers and adults in making bathrooms safe (or not). Youth emphasized the importance of gender-neutral bathrooms in fostering a sense of safety and inclusivity. Adult support and gay-straight alliances (GSAs) were important contributors to a welcoming environment and fostered advocacy efforts for gender-neutral bathrooms. We encourage purposeful inclusivity of youths’ voices when enacting bathroom-specific policies and legislation that directly influence their health and well-being.

Background and Aims Although sexual-orientation-related alcohol use disparities are well established, researchers have not identified whether disparities are diminishing as societal attitudes towards lesbian/gay and bisexual (LGB) people become more accepting. We examined changes in four alcohol-related disparities between heterosexual and LGB youth from 1998–2013 by (1) estimating the prevalence of these behaviors; (2) estimating disparities in alcohol-related outcomes between heterosexual and LGB youth within each wave year; and (3) testing whether the degree of difference in alcohol-related disparities between heterosexual and LGB youth has changed. Design Logistic regression models and year-by-sexual-orientation interactions with repeated, cross-sectional, provincially-representative data. Setting British Columbia, Canada. Participants Students (ages 12–19) from the 1998 (n = 22,858), 2003 (n = 29,323), 2008 (n = 25,254), and 2013 (n = 21,938) British Columbia Adolescent Health Survey (total N = 99,373, 48.7% male, M ®age = 14.84). Measurements We modeled age-adjusted differences in lifetime alcohol use, age of onset, past 30-day drinking, and past 30-day heavy episodic drinking between heterosexual and three subgroups of sexual minority youth (i.e., mostly heterosexual, bisexual, and lesbian/gay). Findings Generally, alcohol use declined for all youth, although less so among LGB youth (average aOR = .58 and aOR = .53 for heterosexual males and females and aOR = .71 and aOR = .57 for sexual minority males and females, respectively). Within-year comparisons demonstrated elevated rates of alcohol use among LGB compared with heterosexual youth for each of the four survey years, especially among females. Findings indicate few changes over time; however, results show an increase in risky alcohol use from 1998 to 2013 among mostly heterosexual (aOR = 1.58 for lifetime alcohol use, aOR = 1.58 for 30-day alcohol use, and aOR = 1.34 for 30-day heavy episodic drinking), and bisexual (aOR = 1.95 for lifetime alcohol use) females. Conclusion Despite the general decline in the prevalence of alcohol use among young people in Canada since 1998, lesbian/gay and bisexual youth in Canada continue to show elevated rates of alcohol use compared with heterosexual youth.

BACKGROUND Gay-Straight Alliances (GSAs) are school-based clubs that can contribute to a healthy school climate for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. While positive associations between health behaviors and GSAs have been documented, less is known about how youth perceive GSAs. METHODS Fifty-eight LGBTQ youth (14–19 years old) mentioned GSAs during go-along interviews in three states/provinces in North America. These 446 comments about GSAs were thematically coded and organized using Atlas.ti software by a multi-disciplinary research team. RESULTS Three themes describe youth-perceived attributes of GSAs. First, youth identified GSAs as an opportunity to be members of a community, evidenced by their sense of emotional connection, support and belonging, opportunities for leadership, and fulfillment of needs. Second, GSAs served as a gateway to resources outside of the GSA, such as supportive adults and informal social locations. Third, GSAs represented safety. CONCLUSIONS GSAs positively influence the physical, social, emotional, and academic well-being of LGBTQ young people and their allies. School administrators and staff are positioned to advocate for comprehensive GSAs. Study findings offer insights about the mechanisms by which GSAs benefit youth health and well-being.