From the macro to the micro: a geographic examination of the community context and early adolescent problem behaviors.

This study examined how multiple dimensions and levels of the community context associated with early adolescent problem behaviors in rural communities. Four thousand, five hundred and nine eighth-grade students in 28 rural and small town school districts in two states participated in surveys regarding substance use and delinquency in 2005. Locations of alcohol retailers, tobacco retailers, youth-serving organizations, and student residences were geocoded. Associations of the number of proximal alcohol and tobacco retailers, and youth-serving organizations with an early-adolescent problem behavior index were tested in Nonlinear Mixed Models that controlled for multiple district-level and individual characteristics. Multi-level model results demonstrated that the number of alcohol and tobacco retail locations within a one-mile radius of each adolescent's home positively associated with student-reported problem behaviors above and beyond the influence of school district and individual characteristics. Results suggest that the proximal community context added significantly to the district context when understanding the occurrence of early adolescent problem behaviors. Recognizing this variability in geographically determined risk within a community will likely enhance the effectiveness of community prevention activities.