Trends were also observed for older adolescents toward lower GEC ratings at 6 months ( = -0.40 ; P = .05 ) , lower BRI ratings at 12 ( = -0.40 ; P = .06 ) and 18 ( = -0.47 ; P = .04 ) months , and lower MI ratings at 6 ( = -0.41 ; P = .05 ) , 12 ( = -0.46 ; P = .03 ) , and 18 ( = -0.50 ; P = .03 ) months .