School of Nursing; Faculty Research Associate, Population Research Center, The University of Texas at Austin, 1710 Red River, Austin, TX, 78712, USA.
Research Design Techniques Consulting Office, College of Education, The University of Texas at Austin, 1912 Speedway, Stop D5000, Austin, TX, 78712, USA.
J Adolesc. 2019 Aug;75:151-162. doi: 10.1016/j.adolescence.2019.07.010. Epub 2019 Aug 6.
Alternative high school (AHS) students, an understudied and underserved population, experience educational, social, and health disparities relative to students in mainstream high schools. Disparities in single types of substance use are particularly high, yet no known studies have compared patterns of substance use or relationships between these patterns and other health-risk behaviors between AHS and mainstream high schools.
Using data from the Texas Alternative School Health Survey (n = 515; mean age 17.1 years, 49% male, 59% Hispanic, 23% White, 15% Black) and the Texas Youth Risk Behavior Survey (n = 2,113; mean age 16 years, 47% male, 64% Hispanic, 22% White, 7% Black), we used latent class analyses to compare patterns of substance use in AHSs and mainstream high schools. We used latent class regression to examine relationships between patterns of substance use and involvement in other health-risk behaviors in each school setting.
Students in AHSs and mainstream high schools had similar patterns of substance use, and youth in higher risk categories engaged in higher levels of other health-risk behaviors. A substantially greater proportion of AHS students, however, fell into the moderate and high use categories, in support of continuing disparities for AHS students.
Additional support is needed in AHSs to address the prevalence of high-risk patterns of substance use and associated health-risk behaviors. For example, ongoing public health surveillance is needed in AHSs, just as is done in mainstream high schools, to monitor trends in substance use and impact of policies and interventions.
另类高中（AHS）学生是一个研究不足且服务不足的群体，与主流高中的学生相比，他们在教育、社会和健康方面存在差异。在单一类型的物质使用方面存在的差异尤其明显，但目前还没有研究比较 AHS 和主流高中学生的物质使用模式或这些模式与其他健康风险行为之间的关系。
利用来自德克萨斯州另类学校健康调查（n=515；平均年龄 17.1 岁，49%为男性，59%为西班牙裔，23%为白人，15%为黑人）和德克萨斯州青年风险行为调查（n=2113；平均年龄 16 岁，47%为男性，64%为西班牙裔，22%为白人，7%为黑人）的数据，我们使用潜在类别分析比较了 AHS 和主流高中学生的物质使用模式。我们使用潜在类别回归分析研究了在每个学校环境中，物质使用模式与参与其他健康风险行为之间的关系。
AHS 和主流高中学生的物质使用模式相似，处于高风险类别的青少年从事其他健康风险行为的程度更高。然而，AHS 学生中相当大的比例属于中高使用类别，这支持了 AHS 学生持续存在的差异。
需要在 AHS 中提供额外的支持，以解决高风险物质使用模式和相关健康风险行为的普遍性。例如，需要在 AHS 中开展持续的公共卫生监测，就像在主流高中一样，以监测物质使用趋势以及政策和干预措施的影响。
