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Factors associated with externalized anger among early adolescents in rural Appalachia : A conceptual proposition with implications for violence prevention
(2026-02) Mills, Rosalina; Lilly, Christa L.; Pollini, Robin A.; Zullig, Keith J.; Jarrett, Traci; Tebes, Jacob K.; Kristjansson, Alfgeir L.; Department of Psychology
Adolescent violence is understudied as a public health challenge for rural adolescents. Anger expression, also referred to as externalized anger, is a risk factor for adolescent violent behavior. Survey data from 1649 early adolescents in the Young Mountaineer Health Study (YMHS) cohort were used to identify correlates of externalized anger drawing on an adapted socioecological model. Correlates examined included: Relative family income; family affluence; neighborhood characteristics (safety, ties, collective efficacy); family living arrangements; social support from adults at home and school; and harsh parenting. Gender was utilized as an effect modifier. We employed two Poisson regression models for main effects and gender interaction effects. Parameter estimates were exponentiated and interpreted as Rate Ratios (RR). Significant main effects included perceived neighborhood safety (RR = 0.98, 95 % CI = 0.97–0.99), support from adults at home (RR = 0.98, 95 % CI = 0.97–0.99) and school (RR = 0.99, 95 % CI = 0.98–0.99), and harsh parenting (RR = 1.06, 95 % CI = 1.05–1.07). Several gender differences emerged in the interaction model. Boys reported significantly lower anger compared to girls (RR = 0.90, 95 % CI = 0.86–0.94). In the gender-based interaction model harsh parenting was more strongly associated with externalized anger among boys (RR = 1.03, 95 % CI = 1.01–1.06). Implications are discussed for future research on the relationship between externalized anger and violence prevention among rural adolescents.
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Processes of development related with the implementation of the Icelandic prevention model in a rural Canadian community
(2025-12) Halsall, Tanya; Mahmoud, Kianna; Drabenstott, Matt; Orpana, Heather; Iyer, Srividya N.; Kristjansson, Alfgeir; Matheson, Kimberly; Department of Psychology
The Icelandic Prevention Model (IPM) is a sequential 10-step community-driven collaborative intervention that is designed to support the prevention of substance use in youth by establishing healthy developmental contexts. The IPM has been implemented across Iceland for over 20 years and is now being implemented in other countries. Recognizing the need to explore how to adapt the IPM to new contexts and document the implementation of the model, this paper describes a process evaluation of the first three steps of the IPM within a Canadian rural community to capture experiences during the early development. Specifically, this study addresses the following research questions: (1) What are the processes of development and contextual features that influence the implementation of the IPM within Lanark County, Ontario? and (2) What adaptations are needed to successfully implement the IPM in Canada? Semi-structured interviews were conducted to examine experiences and lessons learned through the implementation of the model. Thematic analyses were completed using QSR NVivo. A deductive and inductive approach was applied, whereby some interview guide questions were derived from the IPM implementation steps and others were more exploratory, examining context and processes of development. Nine interviews were conducted with key partners who were leading the implementation of the IPM. Themes highlighting cultural factors that influence implementation, processes of development related to community engagement, and themes relating to youth participation, fidelity issues, fundraising, health equity and challenges related to the COVID-19 pandemic were identified. This paper contributes new scientific knowledge related to implementation processes within upstream prevention of substance use and practical information that is useful for communities interested in implementing the IPM.
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Parenting through the eyes of mothers with substance use disorder : Implications for treatment and related services
(2025-09-01) Smith, Brittany T.; Davidov, Danielle D.; Gannon, Meghan; Groth, Caroline P.; Kristjansson, Alfgeir L.; Department of Psychology
Background: Maternal substance use can negatively impact parenting. However, most research on this topic come from epidemiological studies. Thus, the purpose of this study is to qualitatively explore how mothers receiving substance misuse treatment feel their substance use disorder (SUD) has influenced their experiences of motherhood and parenting while also exploring their perception of how their children may have been impacted by their SUD Methods: 35 one-on-one semi-structured interviews with mothers receiving substance use treatment were conducted and analyzed using thematic analysis. Results: Four themes emerged from the analysis: 1) Battle between recovery and motherhood, 2) Challenges being fully present as a parent, 3) Parenting within government and legal systems, and 4) Impacts on children. Mothers mostly reported that their SUD did negatively impact their children in numerous ways. However, their SUD was also reported to be a barrier to parenting that brought unique challenges. Conclusion: Parenting and SUD are interrelated and can influence one another. To best serve mothers with SUD and their children this interconnectedness must be considered.
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COVID-19 Pandemic, Parental Protective Factors, and Substance Use Onset Among Early Adolescents in Appalachia
(2025-10) Layman, Hannah M.; Lilly, Christa L.; Dino, Geri A.; Jarrett, Traci D.; Rishel, Carrie W.; Kristjansson, Alfgeir L.; Department of Psychology
Introduction: During the pandemic, adolescents spent significantly more time at home with their families than during nonpandemic eras. This change could be beneficial because time spent with family has been linked to positive health outcomes; however, given the stress and strains accompanied by COVID-19, research has yet to assess the potential effect that increased family time may have had on youth substance use onset and development during this strenuous period. Methods: School-based survey data from 2,322 students in the Young Mountaineer Health Study were collected during the fall of 2020 (Wave 1), spring of 2021 (Wave 2), and fall of 2021 (Wave3) and were used to create logistic regression models to identify variables at Wave 1 that related to 3 types of substance use onset in the sample at Wave 2 and Wave 3. The study's primary independent variable was COVID-19–related emotional impact (scale range: 5–25). Results: Average age of participants at Wave 1 was 11.50 years (males=42.9%). COVID-19–related emotional impact was positively associated with an increase in cigarette (AOR=1.06, p=0.008) and E-cigarette use onset (AOR=1.06, p<0.001). Parental monitoring (AOR=0.89, p=0.013) and parental social support (AOR=0.93, p=0.026) were associated with a decreased initiation of cigarette use, respectively. Conclusions: The authors found that higher levels of COVID-19–related emotional impact were predictive of increased cigarette and E-cigarette onset but were only marginally related to alcohol use onset. The authors also identified that increased parental monitoring and parental social support might decrease the onset risks for cigarette and alcohol use among early adolescents.
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Building on West Virginia's innovative COVID-19 public health communication : associations between vaccination beliefs and vaccination messaging, partisanship, and social vulnerability
(2025-07-11) Totzkay, Dan; Fraustino, Julia Daisy; Costello, Lisa M.; Jarrett, Traci; Kristjansson, Alfgeir L.; Department of Psychology
Background: Building on our previous theory-guided research findings, this study investigated differences in COVID-19 vaccination-related beliefs across a number of relevant types of communication such as provider recommendations and aided recall of various vaccination campaign assets. We also explored the potential roles of political affiliation and social vulnerability in vaccination beliefs. Methods: A cross-sectional survey of West Virginia residents was administered in January 2022 online and via phone interview by Research America, Inc. (N = 756). Results: About 71 % of respondents had received at least one COVID-19 vaccine dose at the time of the survey. Two-thirds of the sample reported having a healthcare provider recommend vaccination, and around two-thirds reported seeing a vaccination TV advertisement. Despite varying strength of beliefs across political groups, there was a general openness to choosing to vaccinate against the virus that causes COVID-19, which reflects a social landscape conducive to vaccination communication and points toward the importance of understanding unique population segment needs, wants, and reservations, as well as the messengers from whom they trust to receive such information. Healthcare provider recommendation was consistently associated with stronger vaccination-related intentions and beliefs. Most observed differences in vaccine-related beliefs were between those who reported being politically liberal compared to both those who reported being politically moderate and politically conservative. Politically moderate and conservative participants, however, did not vary from one another. Social vulnerability index was mostly unrelated to vaccination beliefs. Conclusion: Participants had overall relatively supportive vaccination-related beliefs. While partisanship played some role surrounding vaccination-related beliefs, even politically conservative groups still exhibited positive attitudes and intentions toward vaccination– albeit to a lesser degree than their liberal counterparts. The social landscape was at least conducive to vaccination communication. Findings build on previous theory-driven communication science scholarship and hold practical implications for communication messengers and channels for ongoing health communication in a rural Appalachia.

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