Amid a proliferation of highly potent opioids, school systems have sought to invest in programs for preventing substance misuse. School teams often prioritize early screening and intervention to prevent student substance misuse; however, given the limited resources of many schools, it is crucial to understand the extent to which commonly available data and existing frameworks are relevant for prevention efforts. In this study, we examined (a) how commonly available data on substance misuse (office discipline referrals [ODRs]) relate to self-reported substance misuse and (b) how positive behavioral interventions and supports (PBIS) implementation across tiers relates to these substance-related outcomes. We found that self-reported substance misuse is significantly related to substance-related ODRs, but that self-report rates are much higher than ODR rates. We also found that Tier 2 PBIS implementation was associated with significantly lower rates of both self-reported substance misuse and substance-related ODRs. These findings suggest that aspects of PBIS implementation could be beneficial in preventing substance misuse, but more research is needed to understand what specific school-based practices best address these student behavioral health needs.
AlgozzineR. F.BarrettS.EberL.GeorgeH.HornerR. H.LewisT. J.PutnamR. F.Swain-BradwayJ.McIntoshK.SugaiG. (2014). SWPBIS Tiered Fidelity Inventory. OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports. http://www.pbis.org
2.
AllenK.-A.JamshidiN.BergerE.ReupertA.WurfG.MayF. (2022). Impact of school-based interventions for building school belonging in adolescence: A systematic review. Educational Psychology Review, 34, 229–257.
3.
American Academy of Pediatrics Council on School Health. (2013). Policy statement: Out-of-school suspension and expulsion. Pediatrics, 131, e1000–e1007. https://doi.org/10.1542/peds.2012-3932
4.
AustinS. C.AndersonD.SeeleyJ. R.McGovernS. (2024). Substance possession and school discipline: How substance type and student race/ethnicity affect decisions to suspend [Under review].
5.
AustinS. C.CioffiC. C.StorieS.BromleyK. W.LissmanD. C.RochelleJ. L.MengP.SeeleyJ. R. (2020). Using the PBIS framework to address the opioid crisis in schools. Center on PBIS, University of Oregon. www.pbis.org
6.
AustinS. C.SmallJ. W.SeeleyJ. R. (2023, March). School-based screening for student substance misuse. Center on PBIS, University of Oregon. www.pbis.org
7.
BakerJ. A.GrantS.MorlockL. (2008). The teacher-student relationship as a developmental context for children with internalizing or externalizing behavior problems. School Psychology Quarterly, 23(1), 3–15.
8.
BarrettS.EberL.McIntoshK.PeralesK.RomerN. (Eds.). (2018). Teaching social-emotional competencies within a PBIS framework [PBIS evaluation brief]. OSEP TA Center on Positive Behavioral Interventions and Supports.
9.
BarrettS.EberL.WeistM. (Eds.). (2013). Advancing education effectiveness: Interconnecting school mental health and school-wide positive behavior support. OSEP Center for Positive Behavioral Interventions and Supports.
10.
BastableE.KittelmanA.McIntoshK.HoseltonR. (Eds.). (2015). Do high schools implementing SWPBIS have lower rates of illegal drug and alcohol use? [PBIS evaluation brief]. OSEP TA Center on Positive Behavioral Interventions and Supports.
11.
BatesD.MächlerM.BolkerB.WalkerS. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 1–48. https://doi.org/10.18637/jss.v067.i01
12.
BennerG. J.BeaudoinK. M.ChenP.-Y.DavisC.RalstonN. C. (2010). The impact of intensive positive behavioral supports on the behavioral functioning of students with emotional disturbance: How much does fidelity matter?Journal of Behavior Assessment and Intervention in Children, 1(1), 85–100.
13.
BotvinG. J.GriffinK. W. (2004). Life skills training: Empirical findings and future directions. Journal of Primary Prevention, 25(2), 211–232.
14.
BozziniA. B.BauerA.MaruyamaJ.SimõesR.MatijasevichA. (2020). Factors associated with risk behaviors in adolescence: A systematic review. Brazilian Journal of Psychiatry, 43, 210–221.
15.
BradshawC. P.MitchellM. M.LeafP. J. (2010). Examining the effects of schoolwide positive behavioral interventions and supports on student outcomes: Results from a randomized controlled effectiveness trial in elementary schools. Journal of Positive Behavior Interventions, 12, 133–148. https://doi.org/10.1177/1098300709334798
16.
BryanJ.WilliamsJ. M.GriffinD. (2020). Fostering educational resilience and opportunities in urban schools through equity-focused school–family–community partnerships. Professional School Counseling, 23(1_part_2), 2156759X19899179.
17.
BurnhamK. P.AndersonD. R. (2002). Model selection and multi-model inference: A practical information theoretical approach (2nd ed.). Springer-Verlag.
CirankaS.van den BosW. (2021). Adolescent risk-taking in the context of exploration and social influence. Developmental Review, 61, 100979.
20.
ClevelandM. J.FeinbergM. E.BontempoD. E.GreenbergM. T. (2008). The role of risk and protective factors in substance use across adolescence. Journal of Adolescent Health, 43(2), 157–164.
21.
CliffordM. E.NguyenA. J.BradshawC. P. (2020). Both/and: Tier 2 interventions with transdiagnostic utility in addressing emotional and behavioral disorders in youth. Journal of Applied School Psychology, 36(2), 173–197.
22.
CohenJ. (1983). The cost of dichotomization. Applied Psychological Measurement, 7(3), 249–253.
23.
CollinsD. A.JohnsonK. W.ShamblenS. R. (2012). Examining a home environmental strategy to reduce availability of legal products that can be misused by youth. Substance Use & Misuse, 47(12), 1339–1348.
24.
ComptonW. M.JonesC. M.BaldwinG. T.HardingF. M.BlancoC.WargoE. M. (2019). Targeting youth to prevent later substance use disorder: An underutilized response to the US opioid crisis. American Journal of Public Health, 109(Suppl. 3), S185–S189.
25.
CroneD. A.HornerR. H.HawkenL. S. (2003). Responding to problem behavior in schools: The behavior education program. Guilford.
26.
CurtisB. L.McLellanA. T.GabelliniB. N. (2014). Translating SBIRT to public school settings: An initial test of feasibility. Journal of Substance Abuse Treatment, 46(1), 15–21.
27.
DishionT. J.NelsonS. E.KavanaghK. (2003). The family check-up with high-risk young adolescents: Preventing early-onset substance use by parent monitoring. Behavior Therapy, 34(4), 553–571.
28.
DongB.KrohnM. D. (2020). Sent home versus being arrested: The relative influence of school and police intervention on drug use. Justice Quarterly, 37(6), 985–1011.
29.
DowdyE.FurlongM.RainesT. C.BoveryB.KauffmanB.KamphausR. W.DeverB. V.PriceM.MurdockJ. (2015). Enhancing school-based mental health services with a preventive and promotive approach to universal screening for complete mental health. Journal of Educational and Psychological Consultation, 25(2–3), 178–197.
30.
DrevonD. D.HixsonM. D.WyseR. D.RigneyA. M. (2019). A meta-analytic review of the evidence for check-in check-out. Psychology in the Schools, 56(3), 393–412.
31.
EnnettS. T.RingwaltC. L.ThorneJ.RohrbachL. A.VincusA.Simons-RudolphA.JonesS. (2003). A comparison of current practice in school-based substance use prevention programs with meta-analysis findings. Prevention Science, 4, 1–14.
32.
FabeloT.ThompsonM. D.PlotkinM.CarmichaelD.MarchbanksM. P.BoothE. A. (2011). Breaking schools’ rules: A statewide study of how school discipline relates to students’ success and juvenile justice involvement. Council of State Governments Justice Center.
33.
FaggianoF.Vigna-TagliantiF. D.VersinoE.ZambonA.BorraccinoA.LemmaP. (2008). School-based prevention for illicit drugs use: A systematic review. Preventive Medicine, 46(5), 385–396.
34.
FletcherA.BonellC.HargreavesJ. (2008). School effects on young people’s drug use: A systematic review of intervention and observational studies. Journal of Adolescent Health, 42(3), 209–220.
35.
FolkJ. B.HirschtrittM. E.McCraryQ. D.KalapatapuR. K. (2022). Agreement between youth self-report and biospecimen-confirmed substance use: A systematic review. Substance Use & Misuse, 57(4), 531–538.
36.
GageN. A.Grasley-BoyN.LombardoM.AndersonL. (2020). The effect of school-wide positive behavior interventions and supports on disciplinary exclusions: A conceptual replication. Behavioral Disorders, 46(1), 42–53.
37.
GageN. A.WhitfordD. K.KatsiyannisA. (2018). A review of schoolwide positive behavior interventions and supports as a framework for reducing disciplinary exclusions. Journal of Special Education, 52(3), 142–151.
38.
Grasley-BoyN. M.GageN. A.LombardoM.AndersonL. (2022). The additive effects of implementing advanced tiers of SWPBIS with fidelity on disciplinary exclusions. Journal of Positive Behavior Interventions, 24(3), 183–195.
39.
GregoryC.GraybillE. C.BargerB.RoachA. T.LaneK. (2021). Predictive validity of the student risk screening scale-internalizing and externalizing (SRSS-IE) scores. Journal of Emotional and Behavioral Disorders, 29(2), 105–112.
40.
GubbelsJ.van der PutC. E.AssinkM. (2019). Risk factors for school absenteeism and dropout: A meta-analytic review. Journal of Youth and Adolescence, 48, 1637–1667.
HawkenL. S. (2006). School psychologists as leaders in the implementation of a targeted intervention: The behavior education program. School Psychology Quarterly, 21, 91–111.
43.
HornerR. H.SugaiG. (2015). School-wide PBIS: An example of applied behavior analysis implemented at a scale of social importance. Behavior Analysis in Practice, 8, 80–85. https://doi.org/10.1007/s40617-015-0045-4
44.
HornerR. H.SugaiG.SmolkowskiK.EberL.NakasatoJ.ToddA. W.EsparanzaJ. (2009). A randomized, wait-list controlled effectiveness trial assessing school-wide positive behavior support in elementary schools. Journal of Positive Behavior Interventions, 11, 133–144.
45.
HornerR. H.ToddA. W.Lewis-PalmerT.IrvinL. K.SugaiG.BolandJ. B. (2004). The school-wide evaluation tool (SET): A research instrument for assessing school-wide positive behavior support. Journal of Positive Behavior Interventions, 6, 3–12.
46.
JordanC. J.AndersenS. L. (2017). Sensitive periods of substance abuse: Early risk for the transition to dependence. Developmental Cognitive Neuroscience, 25, 29–44.
47.
KnightJ. R.SherrittL.ShrierL. A.HarrisS. K.ChangG. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of Pediatrics & Adolescent Medicine, 156, 607–614.
48.
KimberB.SandellR. (2009). Prevention of substance use among adolescents through social and emotional training in school: A latent-class analysis of a five-year intervention in Sweden. Journal of Adolescence, 32(6), 1403–1413.
49.
KittelmanA.Cohen LissmanD.Strickland-CohenM. K.McGrath KatoM.FlanneryK. B.HornerR. H.IzzardS.St. JosephS.MoweryA. (2023). CICO-secondary: A single-case experimental study in high school. Journal of Positive Behavior Interventions, 10983007231200542.
50.
KittelmanA.McIntoshK.HoseltonR. (2019). Adoption of PBIS within school districts. Journal of School Psychology, 76, 159–167.
51.
KittelmanA.MonzalveM.FlanneryK. B.HershfeldtP. A. (2018). Adaptations of check-in/check-out to meet the needs of high school students. The High School Journal, 102(1), 4–17.
52.
LeeA.GageN. A. (2020). Updating and expanding systematic reviews and meta-analyses on the effects of school-wide positive behavior interventions and supports. Psychology in the Schools, 57(5), 783–804.
53.
LewisK. M.BavarianN.SnyderF. J.AcockA.DayJ.DuBoisD. L.JiP.SchureM. B.SilverthornN.VuchinichS. (2012). Direct and mediated effects of a social-emotional and character development program on adolescent substance use. The International Journal of Emotional Education, 4(1), 56–78.
54.
LipscombS.HamisonJ.BurghardtJ.JohnsonD. R.ThurlowM. (2017). Preparing for life after high school: The characteristics and experiences of youth in special education. Findings from the National Longitudinal Transition Study 2012. Volume 2: Comparisons across Disability Groups: Full Report. NCEE 2017-4018. National Center for Education Evaluation and Regional Assistance.
55.
LochmanJ. E.WellsK. C. (2003). Effectiveness of the coping power program and of classroom intervention with aggressive children: Outcomes at a 1-year follow-up. Behavior Therapy, 34(4), 493–515.
56.
MagginD. M.ZurheideJ.PickettK. C.BaillieS. J. (2015). A systematic evidence review of the check-in/check-out program for reducing student challenging behaviors. Journal of Positive Behavior Interventions, 17, 197–208.
57.
ManikandanS. (2010). Data transformation. Journal of Pharma-cology and Pharmacotherapeutics, 1(2), 126–127.
58.
MayS. L.ArdW. I.ToddA. W.HornerR. H.GlasgowA.SugaiG.SpragueJ. R. (2013). School-wide information system. https://www.pbisapps.org/
59.
McDanielS. C.WatkinsL.ChowJ. C.FedewaM.NemerS. (2023). Systematic literature review and meta-analysis of coping power: Effects and implications for implementation. Journal of Applied School Psychology, 39(4), 350–374.
60.
McIntoshK.MassarM.AlgozzineR. F.GeorgeH. P.HornerR. H.LewisT. J.Swain-BradwayJ. (2017). Technical adequacy of the SWPBIS Tiered Fidelity Inventory. Journal of Positive Behavior Interventions, 19, 3–13.
61.
McLellanA. T. (2017). Substance misuse and substance use disorders: Why do they matter in healthcare?Transactions of the American Clinical and Climatological Association, 128, 112–130.
62.
MeehanB. T.HughesJ. N.CavellT. A. (2003). Teacher–student relationships as compensatory resources for aggressive children. Child Development, 74(4), 1145–1157.
63.
MolloyL. E.MooreJ. E.TrailJ.Van EppsJ. J.HopferS. (2013). Understanding real-world implementation quality and “active ingredients” of PBIS. Prevention Science, 14, 593–605.
64.
NelsonS. E.Van RyzinM. J.DishionT. J. (2015). Alcohol, marijuana, and tobacco use trajectories from age 12 to 24 years: Demographic correlates and young adult substance use problems. Development and Psychopathology, 27(1), 253–277.
65.
NoltemeyerA. L.WardR. M.McloughlinC. S. (2015). Relationship between school suspension and student outcomes: A meta-analysis. School Psychology Review, 44, 224–240.
66.
PoudelA.GautamS. (2017). Age of onset of substance use and psychosocial problems among individuals with substance use disorders. BMC Psychiatry, 17, 1–7.
67.
Rimm-KaufmanS. E.La ParoK. M.DownerJ. T.PiantaR. C. (2005). The contribution of classroom setting and quality of instruction to children’s behavior in kindergarten classrooms. The Elementary School Journal, 105(4), 377–394.
68.
RomerN.von der EmbseN.EklundK.KilgusS.PeralesK.SplettJ. W.SuldoS.WheelerD. W. (2020). Best practices in universal screening for social, emotional, and behavioral outcomes: An implementation guide (Version 2.0). https://smhcollaborative.org/universalscreening/
69.
RusbyJ. C.LightJ. M.CrowleyR.WestlingE. (2018). Influence of parent–youth relationship, parental monitoring, and parent substance use on adolescent substance use onset. Journal of Family Psychology, 32(3), 310–320.
70.
SeoY. S.ChangY.-P. (2022). Racial and ethnic differences in e-cigarette and cigarette use among adolescents. Journal of Immigrant and Minority Health, 24(3), 713–720.
71.
SimonsenB.MyersD.BriereD. E.III (2011). Comparing a behavioral check-in/check-out (CICO) intervention to standard practice in an urban middle school setting using an experimental group design. Journal of Positive Behavior Interventions, 13(1), 31–48.
72.
SkibaR. J.HornerR. H.ChungC.RauschM. K.MayS. L.TobinT. (2011). Race is not neutral: A national investigation of African American and Latino disproportionality in school discipline. School Psychology Review, 40, 85–107.
73.
SplettJ. W.PeralesK.Al-KhatibA. M.RabornA.WeistM. D. (2020). Preliminary development and validation of the interconnected systems framework-implementation inventory (ISF-II). School Psychology, 35(4), 255.
74.
SplettJ. W.TrainorK. M.RabornA.Halliday-BoykinsC. A.GarzonaM. E.DongoM. D.WeistM. D. (2018). Comparison of universal mental health screening to students already receiving intervention in a multitiered system of support. Behavioral Disorders, 43(3), 344–356.
75.
TremblayM.BaydalaL.KhanM.CurrieC.MorleyK.BurkholderC.DavidsonR.StillarA. (2020). Primary substance use prevention programs for children and youth: A systematic review. Pediatrics, 146(3), Article e20192747.
76.
van AmsterdamJ.PenningsE.BruntT.van den BrinkW. (2013). Physical harm due to chronic substance use. Regulatory Toxicology and Pharmacology, 66(1), 83–87.
77.
von der EmbseN.KimE. S.KilgusS.DedrickR.SanchezA. (2019). Multi-informant universal screening: Evaluation of rater, item, and construct variance using a trifactor model. Journal of School Psychology, 77, 52–66.
78.
WeinbergN. Z. (2001). Risk factors for adolescent substance abuse. Journal of Learning Disabilities, 34(4), 343–351.
79.
WeistM. D.EberL.HornerR.SplettJ.PutnamR.BarrettS.PeralesK.FairchildA. J.HooverS. (2018). Improving multitiered systems of support for students with “internalizing” emotional/behavioral problems. Journal of Positive Behavior Interventions, 20(3), 172–184.
80.
WolfeK.PyleD.CharltonC. T.SabeyC. V.LundE. M.RossS. W. (2016). A systematic review of the empirical support for check-in check-out. Journal of Positive Behavior Interventions, 18(2), 74–88.
