Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA, USA.
BMC Public Health. 2024 Aug 22;24(1):2291. doi: 10.1186/s12889-024-19720-2.
Identifying factors associated with post-disaster youth substance use is a crucial element of developing evidence-based prevention and intervention efforts. Hurricane María struck Puerto Rico in September of 2017 and the wide-spread impact from this disaster, including exposure to trauma, displacement, and disrupted social supports had the potential to negatively impact levels of substance use among youth across the archipelago. However, post-disaster substance use remains under-investigated in this context. The current study sought to identify risk and protective factors associated with substance use among Puerto Rican youth in the aftermath of Hurricane Maria.
Cross-sectional, secondary data analyses were conducted using school-based survey data collected at all schools in Puerto Rico between February 1 and June 29, 2018 (5-9 months after Hurricane María). Social supports, substance use, and trauma symptoms were assessed. An ordinal regression analysis was conducted to identify student factors associated with greater likelihood of post-disaster substance use.
A total of 36,485 participants (50.7% female, grades 7-12), were included in an ordinal regression analysis that compared the likelihood of respondents endorsing high, low, or no substance use after Hurricane María based on reported adult social support, counselor/teacher social support, peer social support, ptsd symptomatology, and gender. Findings showed that, when compared to students that endorsed low or no substance use, those who reported having adult social support demonstrated a 58% reduction in odds (OR = 0.42, 95% CI: 0.34-0.53) of reporting high substance use after Hurricane María, while students who reported having teacher/counselor social support demonstrated a 21% reduction in odds (OR = 0.79, 95% CI: 0.69-0.89) of reporting high substance use. Additionally, those that reported having peer social support demonstrated a 31% increase in odds (OR = 1.31, 95% CI: 1.10 to 1.58) of reporting higher substance use, compared to those that reported low or no substance use.
While social support was generally protective, prevention efforts to build positive family and community connections may be indicated. Evidence-based school screenings of substance use and trauma may help direct intervention to those most at risk for co-occurring issues.
识别与灾后青少年物质使用相关的因素是制定基于证据的预防和干预措施的关键要素。2017 年 9 月，飓风玛丽亚袭击了波多黎各，这场灾害的广泛影响，包括接触创伤、流离失所和社会支持中断，有可能对该群岛青少年的物质使用水平产生负面影响。然而，灾后物质使用在这方面的研究仍然不足。本研究旨在确定与玛丽亚飓风后波多黎各青少年物质使用相关的风险和保护因素。
使用 2018 年 2 月 1 日至 6 月 29 日（飓风玛丽亚后 5-9 个月）在波多黎各所有学校收集的基于学校的调查数据进行横断面、二次数据分析。评估社会支持、物质使用和创伤症状。进行有序回归分析，以确定与灾后物质使用可能性更高相关的学生因素。
共有 36485 名参与者（50.7%为女性，7-12 年级）被纳入有序回归分析，该分析比较了根据报告的成人社会支持、辅导员/教师社会支持、同伴社会支持、创伤后应激症状和性别，报告飓风玛丽亚后高、低或无物质使用的受访者的可能性。研究结果表明，与报告低或无物质使用的学生相比，报告有成人社会支持的学生报告飓风玛丽亚后高物质使用的可能性降低了 58%（OR=0.42，95%CI：0.34-0.53），而报告有教师/辅导员社会支持的学生报告高物质使用的可能性降低了 21%（OR=0.79，95%CI：0.69-0.89）。此外，与报告低或无物质使用的学生相比，报告有同伴社会支持的学生报告更高物质使用的可能性增加了 31%（OR=1.31，95%CI：1.10-1.58）。
虽然社会支持总体上是保护性的，但可能需要加强建立积极的家庭和社区联系的预防工作。基于证据的学校物质使用和创伤筛查可能有助于将干预措施指向最有可能同时出现问题的人。
