Abstract Background Rural youth often begin developing polysubstance use and other risk behaviors during middle school. However. little polysubstance use research focuses on rural middle school youth. Our research uses Latent Class Analysis to understand existing patterns of rural middle school polysubstance use and risk and protective factors associated with polysubstance use. https://www.jmannino.com/super-pick-Bolso-Yerse-Rafia-Zanzibar-mega-value/