School Protective Factors and Substance Use Among Lesbian, Gay, and Bisexual Adolescents in California Public Schools

Purpose: The majority of studies examining substance use among lesbian, gay, and bisexual (LGB) youth have focused on a wide array of risk factors (e.g., victimization). Few studies have explored the protective role of schools. This study aims to fill this gap in the literature and inform programs aimed at reducing substance use among LGB youth. More specifically, this study explores the extent to which school connectedness and support from teachers and other adults at school are associated with substance use among LGB youth in school and within the past 30 days. Methods: A secondary analysis of the 2013-2015 California Healthy Kids Survey (CHKS) was conducted to examine associations between school protective factors (i.e., school connectedness and adult support) and substance use among LGB youth, above and beyond a key risk factor, school victimization. The study outcomes were past 30-day and in-school use of cigarettes, alcohol, marijuana, inhalants, prescription pain medication, and other illegal drugs. Results: Overall, school connectedness and school adult support were associated with lower odds of substance use. For example, higher levels of school connectedness were associated with 22% decreased odds of past 30-day inhalant use (adjusted odds ratio [AOR] = 0.78; 95% confidence interval [CI] = 0.72-0.86), and 25% decreased odds of past 30-day prescription pain medication use (AOR = 0.75; 95% CI = 0.69-0.82). Higher levels of adult support in school were also associated with 17% decreased odds of marijuana use on school property in the past 30 days (AOR = 0.83; 95% CI = 0.77-0.91). Conclusion: The results indicate a need for substance use prevention programs that integrate school connectedness and adult support in school.