Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health



First Committee Member

Lynette Smith


The study selected for replication is “Prescription Opioid Misuse and Use of Alcohol and Other Substances Among High School Students” by Christopher Jones and colleagues published in the Morbidity and Mortality Weekly Report Supplement in August 2020. The original report used data from the Centers for Disease Control’s 2009-2019 Youth Risk Behavior Survey (YRBS), which is a cross-sectional survey administered every two years to a sample of public- and private-school students in 9th–12th grade in the United States. Researchers from the original report aimed to use the 2009-2019 YRBS data to examine substance use among high school students, characterize the frequency of specific substances used among high school students, evaluate concurrent substance use and prescription opioid use among high school students and examine correlations of prescription opioid misuse among high school students. The first objective of this study is to conduct a pure replication and attempt to reproduce the original report’s findings. There were differences identified from the original report, and all of the results could not be replicated. A second objective in this study is to evaluate the robustness of the results by using alternative analytical methods, and it was found that the adjusted prevalence ratios were sensitive to the modeling technique and the original report underestimated the adjusted prevalence ratios by including marijuana use and grade level in the model despite these variables not being significantly associated with previous 30-day prescription opioid misuse. Finally, a theory of change analysis was conducted to evaluate the relationship between bullying (on school property and electronically) and current and lifetime use of different substances used in 2019. Results indicate that bullying, both electronically and on school property, are significantly associated with all current and lifetime substance use behaviors evaluated.

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Public Health Commons