Latent class analysis of substance use among adolescents presenting to urban primary care clinics

Am J Drug Alcohol Abuse. 2014 Jan;40(1):44-50. doi: 10.3109/00952990.2013.844821. Epub 2013 Nov 12.


Background: Polysubstance use during adolescence is a significant public health concern. However, few studies have investigated patterns of substance use during this developmental window within the primary care setting.

Objectives: This study used an empirical method to classify adolescents into substance use groups, and examines correlates of the empirically defined groups.

Methods: Data came from patients, ages 12-18 years, presenting to an urban, primary care community health clinics (Federally Qualified Health Centers) in two cities in the Midwestern United States (n = 1664). Latent class analysis (LCA) was used to identify classes of substance users. Multinomial logistic regression was used to examine variables associated with class membership.

Results: LCA identified three classes: class 1 (64.5%) exhibited low probabilities of all types of substance use; class 2 (24.6%) was characterized by high probabilities of cannabis use and consequences; and class 3 (10.9%) had the highest probabilities of substance use, including heavy episodic drinking and misuse of prescription drugs. Those in class 2 and class 3 were more likely to be older and have poorer grades, poorer health, higher levels of psychological distress and more sexual partners than those in class 1. Individuals in class 3 were also less likely to be African-American than those in class 1.

Conclusion: Findings provide novel insight into the patterns of substance use among adolescents presenting to low-income urban primary care clinics. Future research should examine the efficacy of interventions that address the complex patterns of substance use and concomitant health concerns among adolescents.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Midwestern United States / epidemiology
  • Models, Statistical
  • Poverty
  • Primary Health Care*
  • Risk Factors
  • Substance-Related Disorders / epidemiology*
  • Urban Health Services*
  • Urban Population