Ashley Brooks-Russell

University of Colorado, Anschutz Medical Campus · Community and Behavioral Health, Colorado School of Public Health

Due to long-standing federal restrictions on cannabis-related research, the implications of cannabis legalization on traffic and occupational safety are understudied. Accordingly, there is a need for objective and validated measures of acute cannabis impairment that may be applied in public safety and occupational settings. Pupillary response to li...

Introduction: The determination of recent cannabis use is of forensic interest in the investigation of automotive crashes, workplace incidents and other mishaps. Because Δ9-tetrahydrocannabinol may persist in blood after psychoactive effects of intoxication resolve, particularly in regular users, short-lived minor cannabinoids such as cannabigerol...

Background: In 2020, schools shifted to remote learning in response to mitigating COVID-19. Since then, students have fluctuated between in-person and remote learning environments. Changes to instructional models raise questions about the impact on health. Methods: This study leveraged a statewide surveillance system (Healthy Kids Colorado Surve...

Postpartum depression (PPD) affects a notable number of women. While many of the risk and protective factors for PPD are specific to the mother, there are also factors that are related to the partner. However, the partner is often overlooked when assessing the landscape of PPD and potential treatment programs. This study sought to expand the knowle...

This review examines the challenges of measuring the effect of acute cannabis use as it relates to injury risk. This is relevant for researchers, particularly those studying drug-impaired driving, and practitioners such as those measuring impairment in workplaces or at the roadside. Emerging research clarifies the challenges of linking drug levels...

Objective The objectives of the current study were to (1) characterize predictors of perceived risk of driving within 2 h of cannabis use and driving after cannabis use in a sample of adults who have used cannabis in the past year and (2) determine whether the influence of these predictors vary by state legalizations status. Methods Data for this...

Rates of depression and suicide are rising in adolescents, with lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth experiencing higher rates. We examined the relationship between team sports participation, depression, and suicidal ideation among a representative sample of adolescents (n = 46,537) in the Healthy Kids Colorado Survey....

Driving is a complex neurobehavioural task necessitating the rapid selection, uptake, and processing of visual information. Eye movements that are critical for the execution of visually guided behaviour such as driving are also sensitive to the effects of psychotropic substances. The Embase (via Ovid), EBSCOHost, Psynet, Pubmed, Scopus and Web of S...

Background. The general use of cannabis in adolescence is associated with various sleep deficits. While traditional smoking remains the most common form of cannabis consumption amongst adolescents, novel methods of administration are becoming more popular and available due to legalization. The association of these novel methods of use with sleep in...

Objective: This research explores the driving performance of people who use cannabis daily or occasionally during distraction tasks performed following acute cannabis use. Methods: Healthy adults aged 25 to 45 years with different cannabis usage histories were recruited to participate in a within-subjects controlled experiment using a car-based dri...

Due to the high prevalence of postpartum depression (PPD) and the far-reaching negative outcomes for both the mother and her family, pregnancy is a critical time for intervention and prevention efforts. The risk factors for PPD include both individual factors and joint couple/dyadic factors, and both should be addressed by prevention programs. The...

Purpose The economic downturn due to the Coronavirus Disease 2019 (COVID-19) pandemic initially led to a large increase in the US unemployment rate. Being laid-off or losing a job could cause financial stress and have an impact on the relationship between parents or other adults in the home and children. We aimed to assess the effect of household u...

Statement of Purpose Youth suicide is a major cause of premature death in the US; it was the second leading cause of death for youth aged 10–24 in 2018. From 2007 to 2018, the rate of suicide increased nearly 60% for this age group. This study examined suicide rates at the county-level and how county context was related to these differences. Metho...

Objective Marijuana policies in the United States have become more permissive, motivating research on demographic and policy-based differences in behaviors and attitudes towards driving after marijuana use. The Traffic Safety Culture Index is an annual survey with national scope and multiple measures relevant to driving after marijuana use. We tabu...

Importance: Suicide is the second leading cause of death in adolescents, with firearms the most common method, especially in rural communities. Identifying where to target lethal means safety interventions could better leverage limited resources. Objectives: To understand the associations of rurality, school-level prevalence of easy handgun acce...

Capturing the voices of both parents regarding perinatal mental health is imperative. This qualitative study employed a purposive sampling technique to interview 23 individuals, including mothers, partners, and perinatal practitioners/educators. Qualitative data analysis utilized an inductive, data-driven approach. Four themes emerged. First, mothe...

Objective Daily cannabis users develop tolerance to some drug effects, but the extent to which this diminishes driving impairment is uncertain. This study compared the impact of acute cannabis use on driving performance in occasional and daily cannabis users using a driving simulator. Methods We used a within-subjects design to observe driving per...

Collaboration across sectors is needed to improve community health, but little is known about collaborative activities among public health prevention programs. Using the Nurse‐Family Partnership® (NFP) home visiting program as context, this qualitative study aimed to describe effective collaboration among nurse home visitors, healthcare providers a...

Background Syringe services programs provide sterile injection supplies and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who use drugs, aiming to prevent the transmission of infectious diseases. Methods We performed a qualitative needs...

Background: In recent years, use of the herbal supplement kratom has increased in the United States. The reasons for use include pain relief, particularly as a substitute for opioids. Objectives: To describe epidemiologic trends in kratom-related exposures among older adults reported to U.S. poison centers. Design: Retrospective analysis of Am...

This cross-sectional study utilized responses from 46,537 students enrolled in grades 9 through 12 in 166 high schools across the state of Colorado via the 2019 Healthy Kids Colorado Survey to: (1) quantify the association between high school start times and student sleep duration and (2) investigate the associations between school start times and...

This cross-sectional study examines reports of cannabis exposure at US poison control centers for trends in patient and product characteristics, stratified by manufactured cannabis products and plant materials.

Objective: To evaluate prescribers' reactions and self-reported intentions to change prescribing behavior in response to opioid-prescribing report cards. Design: We surveyed a sample of licensed prescribers in the state of Colorado registered with the state's prescription drug monitoring program (PDMP). Setting: In 2018, Colorado disseminated...

Objectives: Access to firearms among youth can increase the risk of suicide or other injury. In this study, we sought to estimate the population prevalence of adolescent perception of firearm access by demographic, geographic, and other individual health characteristics. Methods: The 2019 Healthy Kids Colorado Survey was an anonymous survey admi...

Objective To assess the degree to which nurses in a national public health home visiting program collaborate with interprofessional providers to serve families experiencing adversity. Design A descriptive, cross‐sectional survey measured collaborative practices between nurse home visitors, health care, and social service providers. A census of 263...

Syringe Services Programs (SSPs) provide sterile needles and a range of health services (e.g., HIV and HEP-C testing, overdose prevention education, provision of naloxone) to a hard-to-reach population, including people who inject drugs (PWID), aiming to prevent the transmission of infectious diseases. We performed a qualitative needs assessment of...

Background A common concern surrounding increasingly permissive marijuana policies in the US is that they will lead to more dangerous behavior, including driving after marijuana use. Although there is considerable research on the effects of marijuana policies on behaviours, few studies have examined self-reported driving after marijuana use. In thi...

Purpose The prevalence of adolescent risk behaviors varies by age and grade level in school, both of which are proxies for physical and social development. Adjusting for both age and grade would be ideal but is ill advised because of collinearity. We developed a variable to assess “relative age” (i.e., old for grade vs. age normative) and estimated...

Background: Recently increased access to cannabis products in the United States has been associated with increased rates of driving after cannabis use. Although numerous studies indicate that cannabis impairs psychomotor and neurocognitive functions that can affect driving ability, the determination of cannabis-impaired driving risk is complicated...

Context: The decision to initiate a syringe service program or expand to a supervised use site is often influenced by local public support or opposition. Objective: The purpose of this study was to better understand public attitudes to local syringe service programs to inform the possibility of expanding services. Design, setting, and participa...

BACKGROUND The adoption of a shortened school week from the traditional 5 to 4 days is increasing nationwide. Budgetary and staffing needs are driving the change, yet research on the effects on students is lacking, especially regarding student health. Our study examined student health in 4 vs 5‐day schools in Colorado, a state with one of the highe...

Home‐visiting prevention programs must coordinate with other community providers to be most effective. However, the associations between collaboration and program outcomes are not well understood. This study aimed to examine the associations between cross‐sector collaboration in Nurse‐Family Partnership (NFP), a model home‐visiting program, and cli...

Background The decision to initiate a syringe service program or expand to a supervised use site is often influenced by local public support or opposition. The purpose of this study was to better understand public attitudes to local syringe service programs to inform the possibility of expanding services.Methods.We surveyed a sample of registered v...

Large-scale population surveillance systems may fall short in capturing localized data specifically from rural communities. A three-tiered engagement approach is implemented by survey administrators that focuses on supporting communities and schools to better understand the health of youth locally and identify the most effective interventions. This...

Smoking is the most prevalent mode of marijuana consumption among adolescents, but nonsmoking modes, including ingesting, vaporizing, and dabbing, have expanded in the context of legalization.¹,2 Each mode of consumption has different effects that may be associated with distinct health consequences.³ Previous research in Colorado identified smoking...

Our objective was to examine the prevalence of cannabis in homes with children and temporal trends in storage practices among caregivers. Caregivers of children ages 1–14 in Colorado, identified through a representative population-based telephone survey, participated in a repeated telephone survey from 2014 to 2017. Representing 79 805 households i...

Background: Schools struggle to support health needs of students with diabetes due to limited funding/resources. A competency framework can help individual schools clarify the knowledge and skills required for school-based diabetes care within their unique context, and inform the development of standardized diabetes education for health staff. Me...

Purpose The purpose of the study was to describe associations between employment and marijuana use among adolescents 2 years before passage of 2012 ballot initiative and 2 years after the implementation of retail recreational marijuana sales took place in Washington. Methods We used 2010 and 2016 data from Washington's statewide school-based Healt...

Purpose: The purpose of the study was to understand how adolescents concurrently use different modes of marijuana consumption. Methods: Using data from the 2017 Healthy Kids Colorado Survey, we examined how modes of marijuana use (smoking/ingesting/vaping/dabbing/other) co-occur. We estimated the prevalence of all combinations of these modes amo...

Objective: As marijuana use becomes more available to college students through increasing legal reform, this paper seeks to examine intentions for driving under the influence of cannabis (DUIC) and riding with a high driver (RWHD) through the lens of the theory of planned behavior (TPB) and assess potential interactions between personal attitudes,...

Objectives: We examined factors grounded in the theory of planned behavior that influence gun retailers' willingness to provide temporary, voluntary firearm storage for suicide prevention. Methods: We conducted a cross-sectional survey of gun retailers in the US mountain west. Analyses included descriptive statistics and ordered logistic regression...

Objective: This study aimed to estimate the prevalence of different modes of marijuana consumption (e.g., smoking, ingesting) overall and by sociodemographic factors, marijuana-related perceptions, and other substance use among adolescents, as well as to characterize differences in the usual mode of consumption before and after the initiation of r...

Objectives: To examine the perceived benefits of and barriers to law enforcement agencies providing increased access to voluntary and temporary firearm storage. Methods: We surveyed 448 police chiefs and sheriffs in 8 US Mountain West states about firearm storage practices, benefits of and barriers to storage, and related attitudes and beliefs....

Cannabis is the most commonly used psychoactive substance in the United States, and recent estimates of the prevalence of cannabis use among pregnant women in the United States range between 3% and 16%. Population-based surveillance data from the National Survey on Drug Use and Health suggests that cannabis use among pregnant women in the United St...

Due to the recentness of changes to marijuana policies in a number of states, the effect on adolescent use and perceptions is not yet well understood. This study examines change in adolescent marijuana use and related perceptions in Colorado, before and after the implementation of legal commercial sale of recreational marijuana for adults starting...

Counseling about reducing access to lethal means of suicide, especially firearms, is a recommended practice in emergency departments (EDs) but does not occur routinely. Understanding influencers of decisions makers in health care (ED nurse leaders, mental health providers) and temporary firearm storage (law enforcement and gun retailers) could enha...

Introduction: For ED patients at risk of suicide, counseling to reduce access to lethal means (including firearms) is recommended yet not routine. To enhance practice uptake, we sought to examine the attitudes and beliefs of emergency nurse leaders concerning the acceptability and effectiveness of lethal-means counseling. Methods: We invited a n...

Objectives: To evaluate state-level prevalence estimates of prenatal and early postnatal cannabis use in a state with legalized medical and recreational marijuana and the association with adverse neonatal outcomes. Study design: We conducted a cross-sectional study on 3,207 respondents from the 2014-2015 Colorado Pregnancy Risk Assessment Monito...

Introduction Safe storage of guns outside the household while someone is at risk for suicide is important for suicide prevention. Some gun retailers offer temporary firearm storage as a community resource. Others may be willing if perceived barriers can be addressed. Methods We invited all gun retailers in eight Mountain West states to respond to...

This study examines the extent to which knowledge of recreational marijuana laws, health effects, and perceptions of risk for marijuana use differ between Spanish- and English-speaking Latino survey respondents from a registry of Colorado adults. Spanish-speaking Latino respondents (n = 47) had less accurate knowledge of laws permitting use of mari...

Introduction: Lethal means counseling of suicidal individuals in emergency departments has the potential to reduce suicide. This study examines the provision of lethal means counseling and the presence of written protocols in a region with high rates of both firearm ownership and suicide. Methods: In 2015-2016, emergency department nurse manager...

Objectives: To examine the extent to which law enforcement agencies (LEAs) and gun retailers are willing to offer voluntary, temporary storage as a part of an overall suicide prevention effort. Methods: We invited all LEAs and gun retailers in 8 US states to respond to questionnaires asking about their willingness to offer temporary gun storage...

Purpose Safe storage of guns is critical to suicide prevention. This study examines the extent to which law enforcement agencies (LEAs) and gun retailers (GRs) are willing to offer safe gun storage in a variety of circumstances, including mental health crises. Methods We invited, with two follow-up reminders, all LEAs and GRs with storefronts in t...

Background: As of January 1, 2017, eight states have approved laws for recreational marijuana use. While the social impacts of these changes remain under debate, the influence on adolescent marijuana use is a key policy and health issue across the U.S. Objective: To examine changes in adolescent marijuana-use behaviors in the first year after re...

Youth marijuana use is a growing concern with increasingly permissive views towards marijuana use. Little is known about attitudes and beliefs toward marijuana use among youth in the context of legalization. This study describes youth attitudes and beliefs about health risks associated with marijuana use, social norms of peer use, conversations wit...

Introduction: Passage of voter-driven marijuana reform laws signals a shift in public attitudes for marijuana use. For providers, legalization may necessitate practice modifications, particularly regarding patient-provider conversations about use and risk. We examined healthcare providers' knowledge of marijuana laws and health implications, profe...

Background: Colorado is among the first states to legalize the recreational sale of marijuana and therefore among the first to develop regulations outlining the purchase, possession, consumption, and enforcement, and penalties. Colorado legislators set aside funds for a statewide informational media campaign to educate Colorado residents on legal...

Objective: The purpose of this study was to assess the prevalence of modes of marijuana consumption among Colorado youth and explore variation by demographics, access, substance use, and risk perceptions. Method: Data are from a 2013 survey of Colorado high school students (N = 25,197; 50.5% female). The outcome variable was usual mode of mariju...

Objective: Use of tobacco, alcohol, marijuana, and other drugs increases during the high school years, yet little is known about individual patterns over time, particularly patterns of contemporaneous multiple-substance use. This study examined trajectories of contemporaneous substance use and how individual and social factors differentially predi...

Recent research has demonstrated the substantial prevalence of adolescent dating violence and the importance for public health because of the negative consequences for adolescent health and well-being. This chapter reviews the prevalence for dating violence using nationally representative studies, and the individual, family, and social factors pred...

A systematic review of the literature was conducted to appraise the evidence from epidemiological studies of crash risk in young drivers accompanied by passengers, compared with solo driving. Databases searched were the Cochrane Library, Embase, Scopus, Transportation Research Information Services, and Web of Science for studies published between J...

Purpose: A systematic review of the literature was conducted to appraise the evidence from epidemiological studies of crash risk in young drivers accompanied by passengers, compared with solo driving. Methods:Databases searched were the Cochrane Library, Embase, Scopus, Transportation Research Information Services, and Web of Science for studies pu...

This study examined the time from law enforcement dispatch to the first blood draw in cases of driving under the influence (DUI) vehicular homicide and a subset of DUI vehicular assault cases in Colorado in 2012. Laboratory toxicology results were also examined to understand the implications of delays in blood draws in cases of driving while under...

Statement of purpose Motor vehicle crashes are the leading cause of teen death in the United States. Peer passengers increase risk, in part due to how they draw the teen driver’s attention away from the roadway. The purpose of this study was to examine teens’ attitudes, perceived behavioural control, and norms related to driving inattention and pee...

There is an underappreciation among the general public and among health professionals that firearms are implicated in just over half of all suicide deaths. Suicide attempts with firearms are much more lethal than attempts using other methods, with more than 85% of individuals using a firearm dying compared to 2% for individuals using poisoning, 31%...

Dating violence is a major public health issue among youth. Overweight/obese adolescents experience peer victimization and discrimination and may be at increased risk of dating violence victimization. Furthermore, given the stigma associated with overweight/obesity, perceptions and misperceptions of overweight may be more important than actual weig...

Objectives: We examined trends from 1998 to 2010 in bullying, bullying victimization, physical fighting, and weapon carrying and variations by gender, grade level, and race/ethnicity among US adolescents. Methods: The Health Behavior in School-Aged Children surveys of nationally representative samples of students in grades 6 through 10 were comp...

Of the handful of national studies tracking trends in adolescent substance use in the United States, only the Health Behavior in School-Aged Children (HBSC) study collects data from 6th through 10th graders. The purpose of this study was to examine trends from 1998 to 2010 (four time points) in the prevalence of tobacco, alcohol, and marijuana use...

Objective: The purpose of this study was to identify the extent to which 10th-grade substance use and parenting practices predicted 11th-grade teenage driving while alcohol-/other drug-impaired (DWI) and riding with alcohol-/other drug-impaired drivers (RWI). Method: The data were from Waves 1 and 2 of the NEXT Generation study, with longitudina...

Background/Purpose: The majority of studies reporting novice drivers' secondary task engagement have focused on cell phone use while driving. However, other secondary tasks such as eating or reaching for an object, have also been shown to elevate novice teen drivers' crash risk. The purpose of this study is to describe the prevalence of a range of...

Background/Purpose. Perceived risk is frequently cited as a predictor of teenage risky driving. Theoretically, people are less likely to engage in a behavior they perceive to involve potential harm, however the extent to which adolescents' perceptions of risk are associated with objective measures of risky driving has not been established. The purp...

Novice teenage drivers have high crash rates due to inexperience; therefore, cell phone-related secondary task engagement (distracted driving) is likely to aggravate crash risk for this population. A previous study of teenage distracted driving behavior, found that 34% of 16-17-year-olds had texted, and 52% reported talking on a cell phone while dr...

Purpose: This research identified conceptually cohesive latent classes of youth dating violence (DV) and examined associations between covariates and classes by gender. Methods: A nationally representative sample of 2,203 10th grade students completed assessments of physical and verbal DV victimization and perpetration, depressive symptoms, heal...

Descriptive norms are consistently found to predict adolescent alcohol use but less is known about the factors that predict descriptive norms. The objective of this study is to test if drinking with peers predicts later alcohol consumption and if this relationship is mediated by a change in the descriptive norms of peer alcohol use. Data are from a...