Alternative high schools (AHS) are designed to provide individualized education, more flexible scheduling, and smaller class sizes for students referred out of traditional high school. AHS students report higher levels of substance use (SU) and face disproportionately higher levels of trauma and toxic stress than their traditional high school peers. We sought to examine whether generational immigration (GenIm) status modifies the association of mental health and SU among AHS students using a longitudinal study of 1,060 Southern California AHS students. Subscales from the 21-item Depression Anxiety Stress Scale were administered. Effect modification was examined by GenIm status defined as first generation (born outside of the United States), second generation (born in the United States with a parent born outside the United States), or third generation (born in the United States with US-born parent(s)). Main outcomes included the number of times different substances were used in the past year over a 3-year period. Multilevel, negative binomial, covariate-adjusted latent growth curve models generated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of the time-varying association between depression, anxiety, or stress and the use of cigarettes, e-cigarettes, cigars, alcohol, or marijuana. Multiple-group models examined effect modification by GenIm status. The link between mental health and SU was stronger among first- and second-generation students than third-generation students. For example, a one-unit increase in stress relative to the average stress of students from the same school was associated with an increase in the rate of e-cigarette use among first-generation (IRR = 2.03, 95% CI = 1.07–3.85), second-generation (IRR = 2.25, 95% CI = 1.86–2.72), and third-generation (IRR = 1.68, 95% CI = 1.31–2.16) students. Effective strategies tailored to subgroups of AHS students are needed to counter disparities between traditional and alternative school systems that may contribute to long-term trajectories of SU.

中文翻译：

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代际移民身份改变了另类高中生心理社会困扰与药物使用之间的关联


另类高中 (AHS) 旨在为传统高中转出的学生提供个性化教育、更灵活的日程安排和较小的班级规模。与传统高中同龄人相比，AHS 学生的物质使用 (SU) 水平更高，并且面临的创伤和毒性压力水平更高。我们试图通过对 1,060 名南加州 AHS 学生的纵向研究来检验代际移民 (GenIm) 身份是否会改变 AHS 学生心理健康与 SU 的关联。使用 21 项抑郁焦虑压力量表的子量表。效果修改通过 GenIm 状态进行检查，GenIm 状态定义为第一代（在美国境外出生）、第二代（在美国出生且父母在美国境外出生）或第三代（在美国出生且父母在美国境外出生）亲生父母）。主要结果包括过去一年三年内使用不同物质的次数。多水平、负二项式、协变量调整的潜在增长曲线模型生成了抑郁、焦虑或压力与香烟、电子烟的使用之间随时间变化的关联的发生率比 (IRR) 和 95% 置信区间 (CI)。雪茄、酒精或大麻。多组模型检查了 GenIm 状态的影响修改。第一代和第二代学生的心理健康与 SU 之间的联系比第三代学生更强。例如，相对于同一学校学生的平均压力，压力增加一个单位与第一代电子烟使用率的增加相关（IRR = 2.03，95% CI = 1.07–3.85 ），第二代（IRR = 2.25，95% CI = 1.86–2。72）和第三代（IRR = 1.68，95% CI = 1.31–2.16）学生。需要针对 AHS 学生亚群体制定有效的策略，以消除传统学校系统和替代学校系统之间的差异，这可能有助于 SU 的长期发展轨迹。