Understanding Adversity and Peer Crowds to Prevent Youth Health Risks

: Objectives: Adverse childhood experiences (ACEs) and adolescent peer crowds are associated with similar health risks, and both have been leveraged to inform interventions. In this study, we examined if ACEs and peer crowds are associated with each other, and their combined effect on health risks. Methods: A cross-sectional survey of adolescents (N = 1053) measured ACEs, peer crowd identification (Mainstream, Popular, Hip Hop, Country, Alternative), and risks (current cigarette, alcohol, and marijuana use, obesity, feeling sad/hopeless, making a suicide plan). Logistic regression explored ACEs as a predictor of peer crowd, and ACEs and peer crowds separately as risk predictors. Mediation explored peer crowd as a mediator of the relationship between ACEs and risks. Results: Experiencing 2+ ACEs was associated with increased odds of Alternative (AOR=2.38, 95% CI=1.53, 3.71) and Hip Hop (AOR=2.08, 95% CI=1.24, 3.51) peer crowd identification. ACEs level and peer crowd independently predicted risks. Finally, peer crowd identification was a partial mediator of the effect of ACEs on risks. Conclusions: ACEs and peer crowds are key predictors of adolescent health risks. Peer crowd-targeted interventions may lessen the long-term effects of ACEs by utilizing values-based, trauma-informed messaging to reduce ACEs-related risks.