The social contextual approach and rural adolescent substance use: implications for prevention in rural settings.

Adolescents in rural areas use substances at rates comparable to urban adolescents; understanding causes of rural adolescent substance use is critical if prevention efforts are to succeed. The present review has three primary goals: (1) to define rural, (2) to evaluate the empirical evidence regarding correlates and causes of rural adolescent substance use from a social contextual framework (L. V. Scaramella, R. D. Conger, R. Spoth, & R. L. Simons, in press), and (3) to discuss the malleability of theoretically based risk or protective factors in rural settings. The review concludes with a discussion of the difficulties and challenges of implementing prevention programs in rural areas.