Debra Furr-Holden
Debra Furr-Holden
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Professor of Epidemiology
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Professional overview
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Debra M. Furr-Holden is an epidemiologist and passionate advocate for health equity. A public health professional with broad expertise in health disparities and policy-level interventions toward health equity, her scholarship encompasses a range of topics including drug and alcohol dependence epidemiology, psychiatric epidemiology, and prevention science.
Dean Furr-Holden hails from Michigan State University, where she was the C.S. Mott Endowed Professor of Public Health and associate dean for public health integration. In announcing her appointment, effective July 2022, NYU President Andrew Hamilton noted Dr. Furr-Holden’s extensive experience working with local and national policymakers, her skill at team-building and success as a mentor, and her exceptional talent as a communicator on public health and health equity issues.
Indeed, it is Dean Furr-Holden’s action-oriented research and commitment to training the next generation of public health practitioners that dovetails perfectly with GPH’s mission to use data-driven interventions and cutting-edge innovation to identify and implement equitable solutions to both domestic and international public health challenges.
In addition to her endowed professorship at MSU, Dr. Furr-Holden served as director of the NIH-funded Flint Center for Health Equity Solutions at the College of Human Medicine. During the Covid-19 pandemic she was appointed to the Michigan Coronavirus Task Force on Racial Disparities, the Greater Flint Coronavirus Task Force on Racial Inequity, and the New York City African American Covid-19 Task Force. Most notably, in Michigan and Flint the racial disparity in Covid-19 cases and deaths among African Americans was eliminated.
Prior to her appointments at MSU Dr. Furr-Holden was an assistant (2007) and later associate (2011) professor at Johns Hopkins’ Bloomberg School of Public Health, where she retains an appointment as an adjunct professor. Before Johns Hopkins, she was a research scientist at the Pacific Institute for Research and Evaluation and a faculty member at Morgan State University.
Dean Furr-Holden is a widely published scholar whose writings include more than 120 peer-reviewed papers in high impact journals. In 2021 she published a seminal article in Addiction that highlighted racial disparities in opioid overdose deaths over the past two decades, and she was recently quoted in an exclusive article in The New York Times examining the demography of deaths nationwide from Covid-19.
Dean Furr-Holden is the recipient of numerous awards and honors, including the White House Presidential Early Career Award for Scientists and Engineers; the Michigan State University College of Human Medicine Junior Faculty Mentoring Award; and the Meeting the Moment for Public Health Award, recognizing the Michigan Coronavirus Task Force on Racial Disparities, of which she is a founding member.
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Education
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BA, Johns Hopkins University Krieger School of Arts & Sciences, Baltimore, MAPhD, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MA
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Publications
Publications
Past 15-year trends in adolescent marijuana use: Differences by race/ethnicity and sex
AbstractJohnson, R. M., Fairman, B., Gilreath, T., Xuan, Z., Rothman, E. F., Parnham, T., & Furr-Holden, C. D. M. (n.d.).Publication year
2015Journal title
Drug and alcohol dependenceVolume
155Page(s)
8-15AbstractBackground: The potential for increases in adolescent marijuana use is an important concern given recent changes in marijuana policy. The purpose of this study was to estimate trends in marijuana use from 1999 to 2013 among a national sample of US high school students. We examine changes over time by race/ethnicity and sex. Methods: Data are from the National Youth Risk Behavior Survey (YRBS), which involves biennial, school-based surveys that generate nationally representative data about 9th-12th grade students in the United States. Students self-reported sex, race/ethnicity, and marijuana use (i.e., lifetime use, past 30-day use, any use before age 13). We generated national estimates of the prevalence of marijuana use for the time period, and also tested for linear and quadratic trends (. n=. 115,379). Results: The prevalence of lifetime marijuana use decreased modestly from 1999 to 2009 (44% to 37%), and has increased slightly since 2009 (41%). Other marijuana use variables (e.g., past 30-day use) followed a similar pattern over time. The prevalence of past 30-day use from 1999 to 2013 for all groups and both sexes was 22.5%, and it was lowest among Asians and highest among American Indian/Alaska Natives. Although boys have historically had a higher prevalence of marijuana use, results indicate that male-female differences in marijuana use decreased over time. Conclusion: Despite considerable changes in state marijuana policies over the past 15 years, marijuana use among high school students has largely declined. Continued surveillance is needed to assess the impact of policy changes on adolescent marijuana use.The role of neighborhood in urban black adolescent marijuana use
AbstractReboussin, B. A., Green, K. M., Milam, A. J., Furr-Holden, D. M., Johnson, R. M., & Ialongo, N. S. (n.d.).Publication year
2015Journal title
Drug and alcohol dependenceVolume
154Page(s)
69-75AbstractBackground: The present study examined the influence of neighborhood factors on transitions in marijuana involvement during adolescence in a sample of primarily low-income, urban Black youth. Methods: 556 Black adolescents were interviewed annually beginning in first grade as part of a longitudinal study. Latent class analysis (LCA) was used to examine stages of marijuana involvement from 6th to 9th grades. The influence of neighborhood disorder, drug activity, violent crime, safety and disadvantage on transitions in marijuana involvement was tested using latent transition analysis (LTA). Results: There was evidence for three stages of involvement: no involvement, offered, and use and problems. Involvement increased steadily during adolescence with a slightly greater risk to transition from offers to use between 6th and 7th grades. Neighborhood disorder (AOR = 1.04, CI = 1.00, 1.08), drug activity (AOR = 1.12, CI = 1.02, 1.22) and disadvantage (AOR = 1.44, CI = 1.10, 1.92) were associated with the transition from marijuana offers to use and problems. Neighborhood disorder (AOR = 1.07, CI = 1.02, 1.11), drug activity (AOR = 1.19, CI = 1.10, 1.29) and violent crime (AOR = 1.17, CI = 1.03, 1.32) were associated with transitioning rapidly from no involvement to use and problems. Conclusions: Understanding how neighborhoods could be organized and provided with supports to discourage marijuana use and promote non-drug using behaviors should be an important goal of any prevention program in low-income, urban Black neighborhoods. Enhancing citizen participation and mobilization to address the social processes of neighborhood disorder has the potential to reduce marijuana involvement in these neighborhoods.The School Assessment for Environmental Typology (SAfETy): An Observational Measure of the School Environment
AbstractBradshaw, C. P., Milam, A. J., Furr-Holden, C. D. M., & Lindstrom Johnson, S. (n.d.).Publication year
2015Journal title
American journal of community psychologyVolume
56Issue
3Page(s)
280-292AbstractSchool safety is of great concern for prevention researchers, school officials, parents, and students, yet there are a dearth of assessments that have operationalized school safety from an organizational framework using objective tools and measures. Such a tool would be important for deriving unbiased assessments of the school environment, which in turn could be used as an evaluative tool for school violence prevention efforts. The current paper presents a framework for conceptualizing school safety consistent with Crime Prevention through Environmental Design (CPTED) model and social disorganization theory, both of which highlight the importance of context as a driver for adolescents’ risk for involvement in substance use and violence. This paper describes the development of a novel observational measure, called the School Assessment for Environmental Typology (SAfETy), which applies CPTED and social disorganizational frameworks to schools to measure eight indicators of school physical and social environment (i.e., disorder, trash, graffiti/vandalism, appearance, illumination, surveillance, ownership, and positive behavioral expectations). Drawing upon data from 58 high schools, we provide preliminary data regarding the validity and reliability of the SAfETy and describe patterns of the school safety indicators. Findings demonstrate the reliability and validity of the SAfETy and are discussed with regard to the prevention of violence in schools.Neighborhood alcohol outlets and the association with violent crime in one mid-Atlantic City: The implications for zoning policy
AbstractJennings, J. M., Milam, A. J., Greiner, A., Furr-Holden, C. D. M., Curriero, F. C., & Thornton, R. J. (n.d.).Publication year
2014Journal title
Journal of Urban HealthVolume
91Issue
1Page(s)
62-71AbstractViolent crime such as homicide causes significant excess morbidity and mortality in US urban areas. A health impact assessment (HIA) identified zoning policy related to alcohol outlets as one way to decrease violent crime. The objectives were to determine the relationship between alcohol outlets including off-premise alcohol outlets and violent crime in one urban area to provide local public health evidence to inform a zoning code rewrite. An ecologic analysis of census tracts in Baltimore City was conducted from 2011 to 2012. The data included violent crimes (n = 51,942) from 2006 to 2010, licensed alcohol outlets establishments (n = 1,327) from 2005 to 2006, and data on neighborhood disadvantage, percent minority, percent occupancy, and drug arrests from 2005 to 2009. Negative binomial regression models were used to determine the relationship between the counts of alcohol outlets and violent crimes controlling for other factors. Spatial correlation was assessed and regression inference adjusted accordingly. Each one-unit increase in the number of alcohol outlets was associated with a 2.2 % increase in the count of violent crimes adjusting for neighborhood disadvantage, percent minority, percent occupancy, drug arrests, and spatial dependence (IRR = 1.022, 95 % CI = 1.015, 1.028). Off-premise alcohol outlets were significantly associated with violent crime in the adjusted model (IRR = 1.048, 95 % CI = 1.035, 1.061). Generating Baltimore-specific estimates of the relationship between alcohol outlets and violent crime has been central to supporting the incorporation of alcohol outlet policies in the zoning code rewrite being conducted in Baltimore City.Neighborhood Environment and Marijuana Use in Urban Young Adults
AbstractFurr-Holden, C. D. M., Lee, M. H., Johnson, R., Milam, A. J., Duncan, A., Reboussin, B. A., Leaf, P. J., & Ialongo, N. S. (n.d.).Publication year
2014Journal title
Prevention ScienceVolume
16Issue
2Page(s)
268-278AbstractRisk factors for marijuana use in older adolescents and young adults have focused primarily on family environment and peer affiliation. A growing body of work has examined the relationship between environmental context and young adult substance use. This study builds on previous research linking neighborhood environment to young adult marijuana use by exploring two distinct features of neighborhoods, namely the physical (e.g., broken windows) and social environment (e.g., adults watching youth). Data were obtained from a longitudinal sample of 398 predominately African American young adults living in an urban environment. The data also included observational measures of physical and social order and disorder collected on the young adult’s residential block. Exploratory structural equation modeling (ESEM) was utilized to test hypothesized relationships between these two features of the neighborhood environment and past year young adult marijuana use. A two-factor model of neighborhood environment with good fit indices was selected (CFI = 0.97, RMSEA = 0.037). There was a positive and significant direct effect from neighborhood physical disorder to marijuana use (0.219, p < 0.05) controlling for gender, race, and free and reduced price meal (FARPM) status. The direct effect from neighborhood social environment to marijuana use was not significant. These results converge with previous research linking vacant housing with young adult marijuana use but do not provide empirical support for the neighborhood social environment as a determinant of drug taking. Better explication of the social environment is needed to understand its relationship to drug use.Neighborhood Environment and Urban African American Marijuana Use during High School
AbstractReboussin, B. A., Green, K. M., Milam, A. J., Furr-Holden, C. D. M., & Ialongo, N. S. (n.d.).Publication year
2014Journal title
Journal of Urban HealthVolume
91Issue
6Page(s)
1189-1201AbstractAfrican American male high school students have the highest rates of marijuana use among all racial, ethnic, and gender groups, yet there is limited research examining contextual factors salient to the African American community. The purpose of this study was to examine how neighborhood environment measured in 8th grade is related to longitudinal transitions in marijuana use during high school (9th to 12th grades) in a sample of urban African Americans. Four hundred and fifty-two African American children were interviewed annually beginning in 1st grade as part of a longitudinal field study in Baltimore city. Latent transition analysis indicated early in high school posed the greatest risk for initiation and progression of marijuana use. Community violence exposure was associated with an increased likelihood of transitioning from no marijuana use to infrequent use (adjusted odds ratios (AOR) = 2.40, p < 0.001). Higher perceived neighborhood disorder (AOR = 3.20, p = 0.004), drug activity and sales in the neighborhood (AOR = 2.28, p = 0.028), and community violence exposure (AOR = 4.54, p < 0.001) were associated with an increased risk of transitioning from no use to frequent/problematic marijuana use. There was evidence for partial mediation of these associations by perceptions of harm and depressed mood. Drug activity and sales was associated with progression from infrequent to frequent and problematic use (AOR = 2.87, p = 0.029). African American youth living in urban environments with exposure to drug activity, violence, and neighborhood disorder are at increased risk for both initiation and progression to more frequent and problematic marijuana use during high school. These findings highlight the need to develop interventions for African American youth that are mindful of the impact of the additional stressors of living in a high-risk urban environment during a critical developmental transition period. Reducing exposure to drug activity and violence in high-risk urban neighborhoods may be the first step to potentially halt increasing rates of marijuana use among African Americans.Objective and perceived neighborhood characteristics and tobacco use among young adults
AbstractBrown, Q. L., Milam, A. J., Smart, M. J., Johnson, R. M., Linton, S. L., Furr-Holden, C. D. M., & Ialongo, N. S. (n.d.).Publication year
2014Journal title
Drug and alcohol dependenceVolume
134Issue
1Page(s)
370-375AbstractBackground: In the US, past month tobacco use is higher among young adults aged 18-25 years than among any other age group. Neighborhood disorder may be a malleable environmental determinant of tobacco use among young adults; its correlation with tobacco use is understudied. The purpose of this study is to examine whether perceived and objectively measured neighborhood factors are associated with tobacco use among young adults in Baltimore City. Methods: This cross-sectional study of predominately African American young adults (n= 359) used logistic regression models via generalized estimating equations (GEE) to estimate the association of perceived and objective neighborhood disorder with past month tobacco use, adjusting for race, age, sex, income, and other substance use. Two measures of perceived neighborhood environment - neighborhood drug involvement, and neighborhood social cohesion - were derived from the Neighborhood Environment Scale (NES). Objective neighborhood disorder was measured via trained field raters using the Neighborhood Inventory for Environmental Typology (NIfETy) instrument. Results: Sex modified the relationship between perceived neighborhood drug involvement and past month tobacco use, and the association was significant among women only (aOR = 1.49; 95% CI = 1.19-1.88). Perceptions of neighborhood social cohesion (aOR = 0.97; 95% CI = 0.83-1.13), and objective neighborhood disorder (aOR = 1.17; 95% CI = 0.98-1.38) were not significantly associated with past month tobacco use. Conclusion: Understanding the correlation between perceived and objective neighborhood disorder, and their independent association with tobacco use can potentially lead to environmentally based interventions aimed at reducing tobacco use among young adults who live in urban environments.Off-premise alcohol outlets and substance use in young and emerging adults
AbstractMilam, A. J., Furr-Holden, C. D. M., Harrell, P., Ialongo, N., & Leaf, P. J. (n.d.).Publication year
2014Journal title
Substance Use and MisuseVolume
49Issue
1Page(s)
22-29AbstractThis investigation examined the association between alcohol outlets and substance use during young adulthood in Baltimore, MD. Geospatial methods were used to determine the number of outlets within walking distance of the participant's home and distance to nearest outlet. Logistic regression models found that distance to the nearest alcohol outlet was associated with past year marijuana use after adjusting for community disadvantage and sociodemographic characteristics (OR = 0.77, p = .03); specifically, as distance to the nearest outlet increased the likelihood of marijuana use decreased. Findings suggest that distance to the nearest alcohol outlet was a better predictor of marijuana use than the density of alcohol outlets.Posttreatment drug use abstinence: Does the majority program clientele matter?
AbstractDuncan, A., Melnick, G., Ahmed, R., & Furr-Holden, C. D. (n.d.).Publication year
2014Journal title
Journal of Ethnicity in Substance AbuseVolume
13Issue
3Page(s)
185-208AbstractThe current study examines differences in organizational characteristics and client posttreatment drug use abstinence in residential substance abuse treatment programs serving clients with high or low levels of legal coercion to participate in treatment. The findings show that low legal coercion programs have higher counselor caseloads (Z = 59, p <.05) than high coercion programs. Although the results showed that programs with a large proportion of African American clients (β = 14.26, p <.0001) and high legal coercion programs (β = 19.99, p <.05) predicted longer abstinence posttreatment, the final models suggest organizational factors are the key predictors of client posttreatment abstinence.Real-time tracking of neighborhood surroundings and mood in urban drug misusers: Application of a new method to study behavior in its geographical context
AbstractEpstein, D. H., Tyburski, M., Craig, I. M., Phillips, K. A., Jobes, M. L., Vahabzadeh, M., Mezghanni, M., Lin, J. L., Furr-Holden, C. D. M., & Preston, K. L. (n.d.).Publication year
2014Journal title
Drug and alcohol dependenceVolume
134Issue
1Page(s)
22-29AbstractBackground: Maladaptive behaviors may be more fully understood and efficiently prevented by ambulatory tools that assess people's ongoing experience in the context of their environment. Methods: To demonstrate new field-deployable methods for assessing mood and behavior as a function of neighborhood surroundings (geographical momentary assessment; GMA), we collected time-stamped GPS data and ecological momentary assessment (EMA) ratings of mood, stress, and drug craving over 16 weeks at randomly prompted times during the waking hours of opioid-dependent polydrug users receiving methadone maintenance. Locations of EMA entries and participants' travel tracks calculated for the 12 before each EMA entry were mapped. Associations between subjective ratings and objective environmental ratings were evaluated at the whole neighborhood and 12-h track levels. Results: Participants (N= 27) were compliant with GMA data collection; 3711 randomly prompted EMA entries were matched to specific locations. At the neighborhood level, physical disorder was negatively correlated with negative mood, stress, and heroin and cocaine craving (ps. <. .0001-0335); drug activity was negatively correlated with stress, heroin and cocaine craving (ps .0009-0134). Similar relationships were found for the environments around respondents' tracks in the 12. h preceding EMA entries. Conclusions: The results support the feasibility of GMA. The relationships between neighborhood characteristics and participants' reports were counterintuitive and counter-hypothesized, and challenge some assumptions about how ostensibly stressful environments are associated with lived experience and how such environments ultimately impair health. GMA methodology may have applications for development of individual- or neighborhood-level interventions.Risk for Exposure to Alcohol, Tobacco, and Other Drugs on the Route to and from School: The Role of Alcohol Outlets
AbstractMilam, A. J., Furr-Holden, C. D., Cooley-Strickland, M. C., Bradshaw, C. P., & Leaf, P. J. (n.d.).Publication year
2014Journal title
Prevention ScienceVolume
15Issue
1Page(s)
12-21AbstractDespite the national push encouraging children to walk to school, little work has been done to examine what hazards children encounter on the route to school. This study examined the association between the presence of alcohol outlets on children’s route to school and perceived safety on the route to school as well as exposure to alcohol, tobacco, and other drugs (ATOD). Data come from a community-based epidemiological study of 394 urban elementary school students. Participants’ residential address, school location, and alcohol outlet data were geocoded and the route to school was mapped. The route to school layer and the geocoded alcohol outlet data were joined to determine the number of alcohol outlets children pass on the route to school. Logistic regression models estimated the association between the presence of alcohol outlets on the route to school, alcohol and drug exposure, and self-reported safety. Children with an alcohol outlet on the route to school were more likely to be offered ATOD (OR = 2.20, p = 0.02) as well as be exposed to drug selling (OR = 1.72, p = 0.02) and seeing people using drugs (OR = 1.93, p = 0.02). After adjusting for individual-level variables, the relationship between presence of alcohol outlets and being offered ATOD and seeing people using drugs remained significant. However, after adjusting for individual-level control variables and a proxy for the larger neighborhood context, the association between the presence of alcohol outlets and exposure to ATOD was no longer significant. As national campaigns are encouraging children to walk to school, it is essential to consider what children are exposed to on the route to school.The role of substance use in adherence to HIV medication and medical appointments
Duncan, A., VanDevanter, N., Ahmed, R., Burrell-Piggott, T., & Furr-Holden, C. D. (n.d.).Publication year
2014Journal title
Journal of the Association of Nurses in AIDS CareVolume
25Issue
3Page(s)
262-268Use of mobile phones, computers and internet among clients of an inner-city community psychiatric clinic
AbstractCarras, M. C., Mojtabai, R., Furr-Holden, C. D., Eaton, W., & Cullen, B. A. (n.d.).Publication year
2014Journal title
Journal of Psychiatric PracticeVolume
20Issue
2Page(s)
94-103AbstractObjective. Recent years have witnessed an expansion of Internet- and mobile-phone-based interventions for health promotion, yet few studies have focused on the use of technology by individuals with mental illness. This study examined the extent to which patients at an inner-city community psychiatry clinic had access to information and communications technology (ICT) and how they used those resources. Methods. Patients of an outpatient, inner-city community psychiatry program (N=189) completed a survey that included questions about demographics and ICT use which were adapted from an existing local population-based health survey (community sample, N=968). Frequencies of ICT use were assessed for the clinic sample and questions common to both the surveys completed by the clinic and community samples were compared using logistic regression. Results. Among clinic cases, 105 (55.6%) reported owning or using a computer, 162 (85.7%) reported owning or using a mobile phone, and 112 (59.3%) reportedf using the Internet. Among those who used mobile phones, the majority reported using them daily; 42% of those who used the Internet reported using it several times per day. Differences in frequency of Internet use between samples were not significant, but clinic participants used the Internet more intensively to email, instant message, access health information, and use social media sites. Conclusions. A majority of patients in this community psychiatry clinic sample use ICT. Greater access to and use of the Internet by those with mental illness has important implications for the feasibility and impact of technology-based interventions.Alcohol environment, perceived safety, and exposure to alcohol, tobacco, and other drugs in early adolescence
AbstractMilam, A. J., Furr-Holden, C. D., Bradshaw, C. P., Webster, D. W., Cooley-Strickland, M. C., & Leaf, P. J. (n.d.).Publication year
2013Journal title
Journal of Community PsychologyVolume
41Issue
7Page(s)
867-883AbstractThis study examined the association between the count of alcohol outlets around children's homes and opportunities to use alcohol, tobacco, and other drugs (ATOD) during preadolescence. Data were collected in 2007 from 394 Baltimore City children aged 8-13 years (86% African American). Participants' residential address and alcohol outlet data were geocoded with quarter mile (i.e., walking distance) buffers placed around each participant's home to determine the number of outlets within walking distance. The unadjusted logistic regression models revealed that each unit increase in the number of alcohol outlets was associated with a 14% increase in the likelihood of children seeing people selling drugs (odds ratio [OR] = 1.14, p = .04) and a 15% increase in the likelihood of seeing people smoking marijuana (OR = 1.15, p < .01). After adjusting for neighborhood physical disorder, the relationship between alcohol outlets and seeing people selling drugs and seeing people smoking marijuana was fully attenuated. These results suggest that alcohol outlets are one aspect of the larger environmental context that is related to ATOD exposure in children. Future studies should examine the complex relationship between neighborhood physical disorder and the presence of alcohol outlets.Cigarillo use among high-risk urban young adults
AbstractMilam, A. J., Bone, L. R., Byron, M. J., Hoke, K., Williams, C. D., Furr-Holden, C. D., & Stillman, F. A. (n.d.).Publication year
2013Journal title
Journal of health care for the poor and underservedVolume
24Issue
4Page(s)
1657-1665AbstractIn the U.S., cigar use doubled from 5.0 to 10.6 billion cigars consumed annually between 1997 and 2007, driven in large part by increased sales of cigarette-sized "little cigars" and narrow, mid-sized "cigarillos." The present study examined prevalence of cigarillo use as well as attitudes, knowledge and behaviors related to cigarillo use among a sample of predominantly urban African American young adults 18-24 not in school and not employed. Survey data were collected from 131 young adults attending education and job training centers in Baltimore, Maryland and from 78 young adults attending education, job training, or recreational programs in Washington, D.C. In Baltimore, 22% of young adults had smoked a cigarillo in the past 30 days, compared with nearly 63% in D.C. Both populations were heavily exposed to cigarillo advertising and marketing. Cigarillo use in this urban young adult population is a growing public health problem and undermines the progress made in decreasing cigarette use.Drug Use Disorder (DUD) Questionnaire: Scale Development and Validation
AbstractScherer, M., Furr-Holden, C. D., & Voas, R. B. (n.d.).Publication year
2013Journal title
Evaluation ReviewVolume
37Issue
1Page(s)
35-58AbstractBackground: Despite the ample interest in the measurement of substance abuse and dependence, obtaining biological samples from participants as a means to validate a scale is considered time and cost intensive and is, subsequently, largely overlooked. Objectives: To report the psychometric properties of the drug use disorder (DUD) questionnaire including oral fluid and blood sample screening indicators measuring the three most commonly used illicit substances-marijuana, cocaine, and extramedicinal painkillers. Subjects: Participants were a subset (N = 2,702) of the 2007 U.S. National Roadside Survey that was administered to daytime and nighttime weekend drivers in the 48 contiguous states to examine the prevalence of substance use and misuse. Measures: Participants completed demographic and substance use questions as well as the DUD-a 12-item measure assessing substance abuse and dependence. Participants could potentially have completed the DUD three times for each of the three substances. Subscales of abuse and dependence were created using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition Text Revision [DSM-IV-TR]) criteria of these diagnoses. Results: The DUD displayed adequate internal consistency on both subscales of substance abuse and dependence (Cronbach's a ranging from .71 to .84 and .83 to .92, respectively). The DUD also demonstrated construct validity in comparison to biological markers of each substance. Conclusions: The DUD is a biologically validated instrument that is both easy to utilize and may have valuable implications as a research tool among both clinical and nonclinical populations.Exploring walking path quality as a factor for urban elementary school children's active transport to school
AbstractCurriero, F. C., James, N. T., Shields, T. M., Roman, C. G., Furr-Holden, C. D. M., Cooley-Strickland, M., & Pollack, K. M. (n.d.).Publication year
2013Journal title
Journal of Physical Activity and HealthVolume
10Issue
3Page(s)
323-334AbstractBackground: Path quality has not been well studied as a correlate of active transport to school. We hypothesize that for urban-dwelling children the environment between home and school is at least as important as the environment immediately surrounding their homes and/or schools when exploring walking to school behavior. Methods: Tools from spatial statistics and geographic information systems (GIS) were applied to an assessment of street blocks to create a walking path quality measure based on physical and social disorder (termed "incivilities") for each child. Path quality was included in a multivariate regression analysis of walking to school status for a sample of 362 children. Results: The odds of walking to school for path quality was 0.88 (95% CI: 0.72-1.07), which although not statistically significant is in the direction supporting our hypothesis. The odds of walking to school for home street block incivility suggests the counter intuitive effect (OR = 1.10, 95% CI: 1.08-1.19). Conclusions: Results suggest that urban children living in communities characterized by higher incivilities are more likely to walk to school, potentially placing them at risk for adverse health outcomes because of exposure to high incivility areas along their route. Results also support the importance of including path quality when exploring the influence of the environment on walking to school behavior.Marijuana as a Predictor of Concurrent Substance Use Among Motor Vehicle Operators
AbstractScherer, M., Voas, R. B., & Furr-Holden, D. (n.d.).Publication year
2013Journal title
Journal of Psychoactive DrugsVolume
45Issue
3Page(s)
211-217AbstractDespite the adverse effects associated with marijuana abuse and dependence, marijuana is becoming more common-place in activities such as driving. Previous literature has discussed the high rates of cocaine, opioid and benzodiazepine use among users of marijuana, but no research has addressed the rates of concurrent use among drivers meeting abuse or dependence criteria. Each of these substances may produce effects detrimental to driving safety which may be compounded by concurrent substance use. This research examines rates of marijuana use, abuse, and dependence among an active sample of drivers (N = 7,734) in the 2007 National Roadside Survey. Mean age of participants was 36.89 years, and the majority were male (60.1%) and identified as White (59.2%). Participants who used marijuana but did not meet diagnostic criteria for abuse (n = 165) or dependence (n = 112) were significantly more likely to test positive for all substances than were those who did not use marijuana. Further, those that met criteria for marijuana abuse or dependence were more likely than those who did not meet criteria to test positive for THC, cocaine, and benzodiazepines and THC, cocaine, and opioids, respectively. The current research has implications for policy development and drugged driving interventions.Neighborhood environment and urban schoolchildren's risk for being overweight
AbstractWhitaker, D., Milam, A. J., Graham, C. M., Cooley-Strickland, M., Belcher, H. M., & Debra Furr-Holden, C. (n.d.).Publication year
2013Journal title
American Journal of Health PromotionVolume
27Issue
6Page(s)
410-416AbstractPurpose. Child and adolescent obesity is increasingly prevalent and predisposes risk for poor physical and psychosocial health. Physical and social factors in the environment, such as neighborhood disorder, may be associated with childhood obesity. This study examines the association between living in a disordered neighborhood and being overweight among a sample of urban schoolchildren. Design. Baseline interview data, including height, weight, and hip circumference, were obtained from 313 elementary school-aged participants in a community-based epidemiologic study. Setting. The setting was Baltimore, MD, a large metropolitan city. Subjects. Subjects were elementary school students ages 8 to 12 years. Measures. To assess neighborhood characteristics, independent evaluators conducted objective environmental assessments using the Neighborhood Inventory for Environmental Typology instrument on the block faces (defined as one side of a city block between two intersections) where the children resided. Analysis. Logistic regression models with generalized estimating equations were used to examine the association between neighborhood disorder and children being overweight. Results. Neighborhood disorder showed a trend toward a statistically significant association with being overweight during childhood (odds ratio [OR], 1.03; confidence interval [CI], .99-1.07; p = .07) in the unadjusted model. Gender was significantly associated with being overweight, with female gender increasing the odds of being overweight by 50%in the sample (OR, 1.50; CI, 1.18-1.92; p < .01). After controlling for race, age, and comparative time spent on a sport, multivariable analyses revealed that gender (adjusted odds ratio [AOR], 2.42; CI, 1.63-3.59; p < .01) and neighborhood disorder (AOR, 1.09; CI, 1.03-1.15; p < .01) were associated with being overweight. Further, an examination of interactions revealed girls (AOR, 2.40; CI, 1.65-3.49; p < .01) were more likely to be overweight compared with boys (AOR, 2.20; CI, 1.57-3.11; p < .01) living in neighborhoods with the same level of neighborhood disorder. Conclusion. Results suggest neighborhood hazards warrant additional consideration for their potential as obesogenic elements affecting gender-based disparities in weight among urban schoolchildren. Future studies in this area should include longitudinal examinations."Unplugged": A school-based randomized control trial to prevent and reduce adolescent substance use in the Czech Republic
AbstractGabrhelik, R., Duncan, A., Miovsky, M., Furr-Holden, C. D. M., Stastna, L., & Jurystova, L. (n.d.).Publication year
2012Journal title
Drug and alcohol dependenceVolume
124Issue
1Page(s)
79-87AbstractBackground: The Czech Unplugged Study, inspired by the European Drug Addiction Prevention Trial, is a prospective, school-based, randomized controlled prevention trial designed to reduce the risk of alcohol, tobacco, inhalant, and illegal drug use in 6th graders in the Czech Republic. The intervention uses the comprehensive social influence model to affect alcohol and drug using norms among primary school students. Methods: Descriptive statistics and chi-square analyses were used to assess differences between the experimental and control groups on demographic characteristics and study outcomes. Multilevel techniques were used to take the hierarchical structure of the data into account. Prevalence odds ratios using the Bonferroni correction were calculated to assess the differences between the experimental (n=914) and control (n=839) groups on each outcome 1, 3, 12, 15, and 24 months after the end of the intervention. Results: Multilevel analysis using the Bonferroni correction showed statistically significant intervention effects at the final follow-up for any smoking (OR = 0.75, 99.2% CI 0.65-0.87), daily smoking (OR = 0.62, 99.2% CI 0.48-0.79), heavy smoking (OR = 0.48, 99.2% CI 0.28-0.81), any cannabis use (OR = 0.57 99.2% CI 0.42-0.77), frequent cannabis use (OR = 0.57, 99.2% CI 0.36-0.89), and any drug use (OR = 0.78, 99.2% CI 0.65-0.94). Conclusions: This study adds new evidence on the effectiveness of the Unplugged school-based prevention program for primary school students in the Czech Republic.Disordered neighborhood environments and risk-taking propensity in late childhood through adolescence
AbstractFurr-Holden, C. D. M., Milam, A. J., Reynolds, E. K., MacPherson, L., & Lejuez, C. W. (n.d.).Publication year
2012Journal title
Journal of Adolescent HealthVolume
50Issue
1Page(s)
100-102AbstractTo investigate the relationship between childhood neighborhood environment and risk-taking propensity in adolescence by using an objective environmental measure and a laboratory-based risk-taking propensity measure. Childhood neighborhood disorder predicted risk-taking propensity on a behavioral measure during early adolescence (β = 1.8, p <.01). Early toxic environments affect laboratory-based behavioral manifestations of risk.Mobilizing for policy: Using community-based participatory research to impose minimum packaging requirements on small cigars
AbstractMilam, A. J., Bone, L., Furr-Holden, D., Coylewright, M., Dachille, K., Owings, K., Clay, E., Holmes, W., Lambropoulos, S., & Stillman, F. (n.d.).Publication year
2012Journal title
Progress in Community Health Partnerships: Research, Education, and ActionVolume
6Issue
2Page(s)
205-212AbstractThe Problem: Cigarette sales have declined in the United States over the past decade; however, small cigar sales have been rapidly increasing. In most urban areas, small cigars are inexpensive and are sold as singles without health warnings. Purpose of Article: This paper describes a community- academic-practice partnership's (CAPP) efforts to decrease small cigar use in young adults living in Baltimore, Maryland, through legislative strategies. Key Points: Survey data among young adults not in school indicated that 20% of individuals reported current small cigar use, often in combination with cigarettes. The community- academic partnership engaged the community in discussion about small cigar use in the fall of 2007. In collaboration with partners, bills were submitted to the legislative bodies for the city and state to impose minimum packaging requirements on small cigars. Conclusion: Collaborative partnerships between communitybased organizations, public health agencies, and academic institutions can lead to policy initiatives with the potential to improve public health.Neighborhood & Family Effects on Learning Motivation among Urban African American Middle School Youth
AbstractWhitaker, D., Graham, C., Severtson, S. G., Furr-Holden, C. D., & Latimer, W. (n.d.).Publication year
2012Journal title
Journal of Child and Family StudiesVolume
21Issue
1Page(s)
131-138AbstractMotivational theorists in psychology have moved away from individual-based approaches to socio-cognitive and socio-ecological models to explain student engagement and motivation for learning. Such approaches consider, for example, the influence of family and neighborhood environments as important constructs in youth behavior. In this study, links between neighborhood condition (e. g. external appearance of the blocks nearest to the respondents' home), family dysfunction, and motivation for learning are investigated. Data were obtained from two hundred and sixteen (216) urban African American middle school children enrolled in a substance use prevention intervention. Analytic models show associations between poor neighborhood condition, and both family dysfunction and lower learning motivation, and poor neighborhood condition and lower learning motivation. Family dysfunction was also found to mediate the effect of neighborhood condition on motivated learning. Neighborhood and family characteristics are important determinants of urban schoolchildren's motivation for learning.Neighborhood disorder and juvenile drug arrests: A preliminary investigation using the NIfETy instrument
AbstractMilam, A. J., Furr-Holden, C. D. M., Harrell, P. T., Whitaker, D. E., & Leaf, P. J. (n.d.).Publication year
2012Journal title
American Journal of Drug and Alcohol AbuseVolume
38Issue
6Page(s)
598-602AbstractBackground: Disordered neighborhood environments are associated with crime, drug use, and poor health outcomes. However, research utilizing objective instruments to characterize the neighborhood environment is lacking. Objectives: This investigation examines the relationship between objective measures of neighborhood disorder and juvenile drug arrests (JDAs) in an urban locale. Methods: The neighborhood disorder scale was developed using indicators from the Neighborhood Inventory for Environmental Typology (NIfETy) instrument; a valid and reliable tool that assesses physical and social disorder. Data on 3146 JDAs from 2006 were obtained from the police department. Results: Negative binomial regression models revealed a significant association between neighborhood disorder and the count of JDAs in the neighborhood (β = .34, p < .001). The relationship between neighborhood disorder and JDAs remained significant after adjusting for percent African-Americans in the neighborhood (β = .24, p < .001). Conclusions: This preliminary investigation identified a positive and statistically significant relationship between an objective measure of neighborhood disorder and JDAs. Future investigations should examine strategies to reduce drug-related crime by addressing the larger neighborhood and social context in which drug involvement and crime occurs.Neighborhood drug markets: A risk environment for bacterial sexually transmitted infections among urban youth
AbstractJennings, J. M., Taylor, R. B., Salhi, R. A., Furr-Holden, D. C., & Ellen, J. M. (n.d.).Publication year
2012Journal title
Social Science and MedicineVolume
74Issue
8Page(s)
1240-1250AbstractWe hypothesized that neighborhoods with drug markets, as compared to those without, have a greater concentration of infected sex partners, i.e. core transmitters, and that in these areas, there is an increased risk environment for STIs. This study determined if neighborhood drug markets were associated with a high-risk sex partnership and, separately, with a current bacterial STI (chlamydia and/or gonorrhea) after controlling for individual demographic and sexual risk factors among a household sample of young people in Baltimore City, MD. Analyses also tested whether links were independent of neighborhood socioeconomic status. Data for this study were collected from a household study, systematic social observations and police arrest, public health STI surveillance and U.S. census data. Nonlinear multilevel models showed that living in neighborhoods with household survey-reported drug markets increased the likelihood of having a high-risk sex partnership after controlling for individual-level demographic factors and illicit drug use and neighborhood socioeconomic status. Further, living in neighborhoods with survey-reported drug markets increased the likelihood of having a current bacterial STI after controlling for individual-level demographic and sexual risk factors and neighborhood socioeconomic status. The results suggest that local conditions in neighborhoods with drug markets may play an important role in setting-up risk environments for high-risk sex partnerships and bacterial STIs. Patterns observed appeared dependent on the type of drug market indicator used. Future studies should explore how conditions in areas with local drug markets may alter sexual networks structures and whether specific types of drug markets are particularly important in determining STI risk.