Substance use among youth is a significant health concern in the rural United States, particularly among at-risk students. While evidence-based programs are available, literature suggests that an underdeveloped rural health prevention workforce often limits the adoption of such programs. Additionally, population-size restrictions of national…

Purpose: Addressing substance abuse in rural America requires extending our understanding beyond urban-rural comparisons to how substance abuse varies across rural communities of different sizes. We address this gap by examining substance abuse prevalence across 4 geographic levels, focusing on youth (age 12-17 years) and young adults (age 18-25…

Compared substance use perceptions and behavior using a sample of 3,009 African American youth. Overall, substance abuse is perceived as a serious problem at school. Early substance use and peer influence are major determinants of later substance use, although important differences exist in the prediction of alcohol and marijuana use. (RJM)