Abstract:
Background: Adverse Childhood Experiences (ACEs) increase the risk of adolescent substance abuse. Positive
youth connections may mitigate these negative effects. We test whether and how home and school
connectedness influences adolescent substance use.
Methods: Youth (N=1651 6
th
to 8
th graders, N=565, 10
th graders) from a rural, Midwestern low to middle income
school district completed a baseline questionnaire prior to a health education program. The outcome, substance
use, was a mean index of eight reported substance use behaviors (tobacco, electronic vapor, alcohol, any
marijuana [organic or synthetic], prescription pills, inhalants, IV injection; all 6 categories: never to 40+ times).
Structural equation modeling (SEM) was used to evaluate both the direct and indirect relationships between
ACEs (middle school (MS), α =.700; high school (HS), α=.740), school- (MS α =.805; HS α=.833) and parent-
connectedness (MS α =.923; HS α=.942) and substance use (Stata, 15.1).
Results: Higher ACEs was directly associated with lower school connectedness (MS: B=-0.29, p<.000; HS: B=-
0.27, p<.000) and lower parent connectedness (MS: B=-0.16, p<.000; HS: B=-0.23, p<.000). Higher school
connectedness (MS: B=-0.19; p<.000; HS: B=-0.14, p<.000), higher parent connectedness (MS: B=-0.09; p<.000;
HS: B=-0.209, p<.000) and lower ACEs (MS: B=0.27; p<.000; HS: B=-.17, p<000) all directly associated with lower
substance use. The impact of ACEs on substance use was mitigated indirectly through higher school
connectedness (MS: B=0.01, p<.000; HS: B=0.03, p<.000) and parent connectedness (MS: B=0.03, p<.000; HS:
B=-=0.01, p<.000).
Conclusion: Prevention programs should be trauma-informed and incorporate parent-youth and teacher-student
components.
