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Protective factors, or factors that promote resiliency, have also been identified in these various domains.

Among those most frequently cited are religiosity or spirituality, commitment to academic achievement, strong life skills, social competencies, and belief in self-efficacy.

It is known that even the most effective and comprehensive school-based strategies, and even those that reinforce their messages across multiple grade levels, are only slightly more effective than school-based programs that are generally discredited in the early twenty-first century. In the YRBS data, about 16 percent of high school students report having had sex with four or more partners; 48 percent of adolescent African-American males report four or more sexual partners.

There has evolved a consensus among both practitioners and researchers that school-based programs, by themselves, are insufficient. 2000 Annual Summary: Effective Prevention Principles and Programs. "Implementing a Comprehensive Drug Abuse Prevention Strategy." In Increasing Prevention Effectiveness, ed. Forty-two percent of sexually active respondents did not use a condom at last intercourse.

In the family domain, ATOD use has been associated with familial substance use, poor parenting practices including harsh or inconsistent discipline, poor intrafamilial communication, and inadequate supervision and monitoring of children's behaviors and peer associations.

Youth under the age of twenty-five account for two-thirds of the total number of cases of STIs diagnosed annually.A variety of strategies have demonstrated effectiveness in preventing or reducing ATOD use.Project Alert, described by Phyllis Ellickson and colleagues in a 1993 article, and Life Skills Training Program, described by Gill Botvin and colleagues in 1995, are the two most-prevalent effective classroom-based-curricula.Rates of chlamydia, gonorrhea, and human papillomavirus are particularly high among sexually active female teens.An individual's risk is affected by STI prevalence among the pool of potential sex partners.

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Key trends in substance use by twelfth graders are displayed in Table 1.

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