This study examined whether the efficacy of keepin’ it REAL, a model program for substance use prevention in schools, was moderated by gender, ethnicity, and acculturation. Gender differences in program efficacy may arise through boys’ higher risk of drug use, inadequate attention to girls’ developmental issues, or cultural factors like polarized gender expectations. Data came from a randomized trial in 35 Phoenix, Arizona, middle schools involving 4,622 mostly Latino 7th graders. Using multi-level mixed models and multiple imputation missing techniques, results for the total sample showed no gender differences in program effects on recent substance use, but the program was more effective in fostering boys’ than girls’ anti-drug norms. Subgroup analyses demonstrated several more beneficial program effects for boys than girls (less alcohol and cigarette use and stronger anti-drug norms), but only among less acculturated Latinos. There were no gender differences in program effects among more acculturated Latinos, nor among non-Latino whites.
This article reports the results of research exploring how ethnicity and ethnic identity may “protect” adolescents against drug use and help them form antidrug use norms. This study was conducted in 1998 and is based on a sample of 4364 mostly Mexican American seventh graders residing in a large southwestern city of diverse acculturation statuses. It aims at testing existing findings by conducting the research within the unique geographic and ethnic context of the Southwest region of the United States. This research examines how strength of ethnic identity plays a distinctive role in drug use behavior among the various ethnic groups represented in the sample: Mexican Americans, other Latinos, American Indians, African Americans, non-Hispanic Whites, and those of mixed ethnic backgrounds. Positive ethnic identity (i.e., strong ethnic affiliation, attachment, and pride) was associated with less substance use and stronger antidrug norms in the sample overall. Unexpectedly, the apparently protective effects of positive ethnic identity were generally stronger for non-Hispanic White respondents (a numerical minority group in this sample) than for members of ethnic minority groups. Implications for prevention programs tailored for Mexican/Mexican American students are discussed.
Mexican American; Ethnic identity; Ethnicity; Drug use; Acculturation; Adolescents; Baffer effect; Ethic labels
This study examined the variations in drug resistance strategies endorsed by community members for rural Native Hawaiian youth in drug-related problem situations. Community stakeholders completed a Web-based survey focused on drug-related problem scenarios and their matched set of responses developed by middle/intermediate school youth in prior research. Mean differences were examined based on drug offerers described in the scenarios (i.e., peers/friends, cousins, and parents) and the substances offered in the scenarios (i.e., marijuana and alcohol). Compared with other strategies, Refuse had the highest mean scores within two offerer subgroups (peers/friends and cousins) and within both substances (alcohol and marijuana). Leave had the highest mean score within scenarios describing drug offers from parents. The endorsement of different resistance strategies varied based on drug offerers and substances offered in the selected scenarios. This study suggests that resistance skills in prevention should be tailored to youths’ social context in rural Hawai‘i.
Hawaiian youth; drug prevention; stakeholder analysis; resistance skills
Background and objective
This article explores the aspects of spirituality and religious involvement that may be the protective factors against substance use among urban American Indian (AI) youth.
Data come from AI youth (N = 123) in five urban middle schools in a southwestern metropolis.
Ordinary least squares regression analyses indicated that following Christian beliefs and belonging to the Native American Church were associated with lower levels of substance use.
Conclusions and Scientific Significance
Following AI traditional spiritual beliefs was associated with antidrug attitudes, norms, and expectancies. Having a sense of belonging to traditions from both AI cultures and Christianity may foster integration of the two worlds in which urban AI youth live.
urban American Indian; substance use; youth; spirituality; religion; Native American
This article presents the findings of a study examining acculturation differences between adolescents and their mothers within Mexican immigrant families in the border region of the Southwest U.S. The main hypotheses of the study was that youth in mother-child dyads with mismatched acculturation strategies would report higher levels of externalizing problem behaviors than other adolescents, and that this relationship would be mediated by family conflict, acculturation conflict, family cohesion, and sense of familism.
The participants formed 142 dyads (N=284) of Mexican heritage mothers and their adolescent children. Regression analysis indicated that a gap or mismatch in acculturation strategies was associated with more externalizing youth problem behaviors.
Compared to the dyads where both mother and child were bicultural, only youth with more acculturated mothers demonstrated increased rates of externalizing problem behaviors. Family conflict and acculturation conflict mediated the relationship between acculturation gaps and externalizing behaviors. Implications for family-centered interventions as well as future research and policy implications are discussed.
Adolescent and parent communication; Ethnic minority families; Latino families; Acculturation gap; Familism
This study examined interactive relationships among ethnic identity, gender, time in the US, and changes in substance use outcomes among a school-based sample of 1,731 Mexican-heritage preadolescents (ages 9–13). Residual change multilevel models adjusting for school clustering and using multiply imputed data assessed changes from beginning to end of fifth grade in use of alcohol, cigarettes, marijuana and inhalants, and four substance use antecedents. Effects of ethnic identity were conditional on time in the US, and in opposite directions by gender. Among males living longer in the US, stronger ethnic identity predicted desirable changes in all but one outcome (substance offers). Among females living longer in the US, stronger ethnic identity predicted undesirable changes in alcohol use, pro-drug norms, and peer substance use. Interpretations focus on differential exposure to substance use opportunities and the erosion of traditional gender role socialization among Mexican-heritage youth having lived longer in the US.
ethnic identity; substance use; Mexican-heritage; preadolescence
This research assesses the effects of adaptive/maladaptive gender roles and acculturation in predicting substance use in a 2007 sample of 1466 Mexican American seventh-grade adolescents from Phoenix, Arizona, USA. Multiple regression analyses found significant effects for both adaptive and maladaptive gender roles, as well as several gender-specific interactions between gender roles and linguistic acculturation that predicted substance use. Limitations of the research are noted, as well as implications for understanding the impact of acculturation on how gender roles differentially affect substance use in Mexican American boys versus girls.
gender roles; gender; acculturation; substance use; Mexican American adolescents
This study applies advanced conceptualization and measurement to an analysis of acculturation among 1,632 Mexican-heritage preadolescents. We assessed whether – and how – multiple measures combine to form a latent acculturation construct that groups individuals into classes; and determine how many and what classes (or types) of acculturation are experienced by this sample of 5th graders. Measures included attitudinal, behavioral, and linguistic acculturation, generation status, time in the U.S., ethnic identification, and contact with the culture of origin. The analysis identified five classes of acculturation, differing in size and characterized by specific measures of acculturation: less acculturated, moderately bicultural, strongly bicultural, highly acculturated, and marginalized. Although most youths fell into the first four classes, consonant with their exposure to American society, a small minority of youths fell into the last class. Despite substantial exposure to U.S. culture and recent exposure to Mexican culture, these youth showed little affinity for either culture.
acculturation; preadolescents; Mexican
This article examined the impact of linguistic acculturation and gender on the substance use initiation of a sample of 1,473 Mexican heritage preadolescents attending 30 public schools in Phoenix, Arizona. It was hypothesized that linguistic acculturation operates differently as a risk or protective factor for young children than for older youth. The study used discrete-time event history methods to model the rate at which nonusing children initiate substance use. Alcohol, cigarettes, marijuana, and inhalants were studied separately while inhalant use was examined more closely. Results suggested that while linguistic acculturation is a risk factor for Mexican heritage preadolescents, this association depended on gender, the linguistic acculturation context (family, friends, or media), and the type of substance. For inhalants, higher linguistic acculturation with friends was inversely associated with drug initiation both for boys and girls. Implications for preventive science and future intervention research are discussed.
acculturation; bilingual/bicultural; Hispanic/Latino/Latina; substance use/alcohol and drug use
Research is limited or absent on Mexican adolescents’ exposure to substance offers, ways of dealing with these offers, and possible gender differences in responses to offers. Extending U.S.-based research, this study examines how youth living in the Mexican state of Guanajuato employ the four drug resistance strategies—refuse, explain, avoid, and leave—that are part of the Keepin’ It REAL evidence-based drug prevention intervention. The analysis uses cross-sectional survey data from 702 students enrolled in eight alternative secondary education sites in 2007. Participants reported the drug resistance behaviors they used to deal with offers of alcohol, cigarettes, and marijuana. Using multivariate regression, findings indicate most youth had developed repertoires of drug resistance strategies that involved multiple REAL strategies and some other strategy as well. For those receiving offers, the most common strategy was to refuse the offer with a simple ‘‘no.’’ However, males used all the strategies significantly more often than females for situations involving cigarettes and marijuana as well as when using refuse and non-REAL strategies for alcohol. Possible reasons for the gender difference in use of strategies are discussed. The findings can help inform effective prevention programs based on teaching culturally appropriate drug resistance and communication skills.
Adolescents; Substance use; Substance use offers; Mexican youth; Drug resistance
This article presents the findings of a study exploring two questions: What age is most efficacious to expose Mexican heritage youth to drug abuse prevention interventions, and what dosage of the prevention intervention is needed? These issues are relevant to Mexican heritage youth—many from immigrant families—in particular ways due to the acculturation process and other contextual factors. The study utilized growth curve modeling to investigate the trajectory of recent substance use (alcohol, cigarettes, marijuana, inhalants) among Mexican heritage students (N = 1,670) participating in the keepin’ it REAL drug prevention program at different developmental periods: the elementary school (5th grade), middle school (7th grade), or both. The findings provide no evidence that intervening only in elementary school was effective in altering substance use trajectories from 5th to 8th grade, either for licit nor illicit substances. Implementing keepin’ it REAL in middle school alone altered the trajectories of use of all four substances for Mexican heritage youth. A double dose of prevention, in elementary and middle school proved to be equally as effective as intervening in 7th grade only, and only for marijuana and inhalants. The decrease in use of marijuana and inhalants among students in the 7th-grade-only or the 5th- and 7th-grade interventions occurred just after students received the curriculum intervention in 7th grade. These results are interpreted from an ecodevelopmental and culturally specific perspective and recommendations for prevention and future research are discussed.
Substance use prevention; Early intervention; Mexican Americans; Preadolescents; Adolescents
This study explores the drug resistance strategies of urban American Indian adolescents when they encounter people offering them alcohol, cigarettes, and marijuana. Data were collected in 2005 from 11 female and 9 male adolescents who self-identified as American Indian and attended two urban middle schools in the southwestern United States. In two focus groups—one at each school site—the youth described their reactions to 25 hypothetical substance offer scenarios drawn from real-life narratives of similar youth. Qualitative analysis of their 552 responses to the scenarios generated 14 categories. Half of the responses were strategies reported most often by nonnative youth (refuse, explain, leave, and avoid). Using ecodevelopmental theory, the responses were analyzed for indications of culturally specific ways of resisting substance offers, such as variation by specific substance and relationship to the person offering. Study limitations are noted along with suggestive implications for future research on culturally appropriate prevention approaches for urban American Indian youth.
urban American Indian youth; drug resistance strategies; substance offers; resiliency
This study explored the drug resistance strategies that urban American Indian adolescents consider the best and worst ways to respond to offers of alcohol, cigarettes, and marijuana. Focus group data were collected from 11 female and 9 male American Indian adolescents attending urban middle schools in the southwest. The youth were presented with hypothetical substance offer scenarios and alternative ways of responding, based on real-life narratives of similar youth. They were asked to choose a preferred strategy, one that would work every time, and a rejected strategy, one they would never use. Using eco-developmental theory, patterns in the preferred and rejected strategies were analyzed to identify culturally specific and socially competent ways of resisting substance offers. The youth preferred strategies that included passive, non-verbal strategies like pretending to use the substance, as well as assertive strategies like destroying the substance. The strategies they rejected were mostly socially non-competent ones like accepting the substance or responding angrily. Patterns of preferred and rejected strategies varied depending on whether the offer came from a family member or non-relative. These patterns have suggestive implications for designing more effective prevention programs for the growing yet under-served urban American Indian youth population.
This study examines the drug resistance strategies described by Native Hawaiian youth residing in rural communities. Sixty-four youth from 7 middle and intermediate schools on the Island of Hawai‘i participated in a series of gender-specific focus groups. Youth responded to 15 drug-related problem situations developed and validated from prior research. A total of 509 responses reflecting primary or secondary drug resistance strategies were identified by the youth, which were qualitatively collapsed into 16 different categories. Primary drug resistance strategies were those that participants listed as a single response, or the first part of a two-part response, while secondary drug resistance strategies were those that were used in tandem with primary drug resistance strategies. Over half of the responses reflecting primary drug resistance strategies fell into three different categories (“refuse,” “explain,” or “angry refusal”), whereas over half of the responses reflecting secondary drug resistance strategies represented one category (“explain”). Significant gender differences were found in the frequency of using different strategies as well as variations in the frequency of using different strategies based on the type of drug offerer (family versus friends/peers). Implications for prevention practice are discussed.
Drug; Native Hawaiian; Culture; Prevention; Youth
The family is one of the most important contexts for children’s development and well-being. Parents play a central role in the family, and the degree to which parents monitor their children’s behaviors has been shown to be associated with fewer risky behaviors, especially substance use. Prior research on parental monitoring and substance use, however, has several limitations. Most studies have focused on older adolescents, as well as adolescents from primarily White, Euro-American heritage. Prior studies largely have been cross-sectional and unable to test if parental monitoring decreases substance use over time. This article explicitly addresses these limitations by examining a longitudinal sample of primarily Latino youth in pre-adolescence (5th grade). Using an Ecodevelopmental framework, we hypothesized that parental monitoring will be associated with lower levels of youth substance use and more beneficial substance use intentions, norms, and attitudes. We further hypothesized that the effects of parental monitoring may differ by gender and between Latino and non-Latino youth. The data came from a school-based randomized trial of a substance use prevention program in Phoenix, AZ. To test our hypotheses, we use regression models, with adjustments for clustering and multiple imputation of missing data. The results show that parental monitoring has significant beneficial and longitudinal effects on youth’s substance use and related substance use intentions, norms, and attitudes. These beneficial effects of parental monitoring are invariant to the youth’s gender or Latino ethnicity, except in the case of marijuana use: parental monitoring is significantly more effective in reducing girls’ marijuana use.
parental monitoring; Latino/a; pre-adolescence
This study explored intentions to emigrate and substance use among youth (ages 14–24) from a central Mexico state with high emigration rates. Questionnaires were completed in 2007 by 702 students attending a probability sample of alternative secondary schools serving remote or poor communities. Linear and logistic regression analyses indicated that stronger intentions to emigrate predicted greater access to drugs, drug offers, and use of illicit drugs (marijuana, cocaine, inhalants), but not alcohol or cigarettes. Results are related to the healthy migrant theory and its applicability to youth with limited educational opportunities. The study’s limitations are noted.
Mexico; migration; drugs; alcohol adolescents
This study examined the gender differences in drug-offer situations of Native Hawaiian youths in rural communities. Youths from seven middle or intermediate schools (N 194) on the Big Island of Hawai'i completed a survey that focused on the drug offers they had received. Multivariate and bivariate analyses indicated that the girls received significantly more drug offers than did the boys in the sample and found it more difficult to refuse drugs in such situations. Qualitative data gathered from communities in the survey's sampling frame elucidated the quantitative findings. Limitations of the study and implications for prevention practice are discussed.
ethnic issues; family relationships; gender; peers and friends; substance use
A sample of 60 male and 91 female Mexican-American adolescents (age 13–18) were administered measures of positive (i.e., assertive masculinity, affective femininity) and negative (i.e., aggressive masculinity, submissive femininity) gender roles, internalizing and externalizing problem behaviors, peer substance use, and own substance use (alcohol, cigarettes, marijuana). Negative gender roles were significantly correlated with internalizing and externalizing problems for both boys and girls, with aggressive masculinity also predicting peer substance use for both genders. Assertive masculinity significantly predicted lower alcohol use in boys, and this effect was not mediated by internalizing problems, externalizing problems, or peer substance use. Negative gender roles significantly predicted higher alcohol use in girls, but this effect was almost completely mediated by internalizing problems, externalizing problems, and peer substance use. Results are discussed in terms of gender role socialization among Mexican Americans.
externalizing/internalizing; gender roles; Mexican-American adolescents; substance use
This article examines key aspects of the school environment — its composition by ethnicity and acculturation — as important social contexts for understanding Mexican immigrant and Mexican American adolescents' drug use norms and behaviors. Results are presented based on surveys completed by Mexican-background students from 35 Phoenix. Arizona middle schools, whose enrollment ranged from a numerical minority to an overwhelming majority. Multivariate mixed models tested for the influence of school ethnic composition measures on substance use outcomes, while accounting for individual level predictors and for the nesting of data at the school level. The proportional representation of Latinos in the school was not a factor in an individual's drug use norms or drug use for the sample overall. Once students were broken down by acculturation status, however, ethnic composition had an effect. Less acculturated Mexican heritage students in schools with higher proportions of Latino students reported less substance use and less adherence to pro-drug norms. Further investigation using other measures of ethnic composition suggested that these effects were attributable to the larger presence of less acculturated Latinos in the school rather than more acculturated Latino students. These school-level effects support the individual-level results indicating that less acculturated Mexican American students face less daunting substance use risks. The results suggest that ethnic group size, but not necessarily numerical predominance, matters and that within-group differences influence the effect of a particular ethnic group's presence in the school. In other words, the majority does not always rule. These findings are interpreted using the concepts of segmented assimilation and school level social capital.
This study examined whether language preference, as an indicator of acculturation, moderated the effects of a culturally grounded substance use prevention intervention for Mexican and Mexican American middle school students (N = 2,146) in Phoenix, Arizona. The main hypothesis was that levels of program effectiveness would vary based on the language preference of the students and the specific culturally grounded version of the intervention they were assigned. Findings show that matching language preference to particular versions of the intervention did not influence substance use related program outcomes, but that overall program effects (intervention versus control) did vary by language preference. English-language dominant participants, the most at risk sub-group, responded more positively to the intervention, while Spanish dominant, who had low substance use rates at baseline, and bilingual participants did not demonstrate significant differences between the intervention and control groups. Implications for school social work prevention interventions and prevention science in general, are discussed.
Acculturation; substance abuse; protective factors; Mexican; Latino; youth; prevention
This study describes the development and preliminary validation of a survey focused on the most salient situations where drugs and/or alcohol are offered to Native Hawaiian youth in rural communities. The study used a 5-phase approach to test development and validation. In Phase 1 (Item Generation), survey items were created from a series of focus groups with middle school aged youth (N = 47). In Phase 2 (Item Refinement and Selection), items were edited and reduced to 62 drug offer situations that were selected for inclusion in the survey. In Phase 3 (Item Reduction), items were administered to 249 youth from 7 middle or intermediate schools in Hawai‘i. Exploratory factor analysis of the Native Hawaiian subsample (n = 194) indicated the presence of three factors accounting for 63% of the variance: Peer Pressure (23%), Family Offers and Context (21%), and Unanticipated Drug Offers (19%). The survey items differentiated between Hawaiian and non-Hawaiian youth respondents, supporting the validity of the questionnaire. The hypothesized relationship between cultural connectedness and drug offer exposure was not confirmed. Internal consistency of the measure was high.
Test development; validity; Native Hawaiian; youth; drugs
This study examined drug resistance strategies and substance use among adolescents from Monterrey, Mexico. The focus was strategies that U.S. adolescents use most often to resist using substances, including refuse (saying no), explain (declining with an explanation), avoid (staying away from situations where drugs are offered), and leave (exiting situations where drugs are offered). Using self-administered questionnaire data from a convenience sample of 327 Mexican students enrolled at two secondary schools (preparatorias), we tested whether frequent use of particular drug resistance strategies predicted actual substance use. Multiple regression results showed that different strategies were effective for different substances, that some effects were mediated by number of offers received, and that certain effects were stronger for females than for males. Students using the refuse strategy reported less cigarette use and less binge drinking; those using the avoid strategy reported less alcohol and cigarette use; and those using the leave strategy reported less binge drinking and, for females only, less marijuana use. Use of the explain strategy was not significantly related to substance use after controlling for use of other strategies. Findings are discussed in terms of Mexican cultural values and their implications for the design of prevention programs for Mexican youth.
Adolescents; Substance use; Substance use offers; Mexican youth; Drug resistance
This article reports on the findings of a study conducted with a sample of 136 Mexican-heritage mothers residing in a large southwestern metropolitan area. From a risk-and-resiliency perspective, hopelessness was approached as a culturally specific response to family stress and other challenges encountered by Mexican immigrants. Although Mexican-heritage women and other Latinas have higher prevalence rates of psychiatric disorders than their male counterparts, they experience disparity in accessing mental health services. Multiple regression analysis was used to explore the relationships among hopelessness, depression, social support, and other variables. Culturally rooted resiliency and a sense of optimism connected to immigration appear to shelter Mexican-heritage mothers from hopelessness and depression. A very large households and nonworking status were found to elevate the risk of hopelessness. Because poverty and acculturation levels were not related to hopelessness or depression, further culturally specific research distinguishing hopelessness from depression is recommended. Given that hopelessness sometimes presents itself independently from depression, implications for practice include the need to refine mental health assessment tools to capitalize on the resiliency among immigrant mothers and avoid misdiagnosis.
depression; hopelessness; Latina mothers; women’s health
Efforts to address youth substance use have focused on prevention among non-users and treatment among severe users with less attention given to youth occupying the middle ground who have used substances but not yet progressed to serious abuse or addiction. Using a sample from 35 middle schools of 1,364 youth who reported using substances, this study examined the effectiveness of a universal youth substance use prevention program, the SAMHSA Model Program keepin’ it REAL, in promoting reduced or recently discontinued alcohol, cigarette, and marijuana use. Discrete-time event history methods modeled the rates of reduced and recently discontinued use across four waves of data. Each substance (alcohol, cigarettes, and marijuana) was modeled separately. Beginning at the second wave, participants who reported use at wave 1 were considered at risk of reducing or discontinuing use. Since the data sampled students in schools, multi-level models accounted for the nesting of data at the school level. Results indicated that prevention program participation influenced the rates of reduced and recently discontinued use only for alcohol, controlling for baseline use severity, age, grades, socioeconomic status, ethnicity and gender. Among youth who reported use of alcohol in wave 1 (N= 1,028), the rate of reducing use for program participants was 72% higher than the rate for control students. The rate of discontinuing use was 66% higher than the rate for control students. Among youth who reported use of one or more of the three substances in wave 1 (N = 1,364), the rate of discontinuing all use was 61% higher for program participants than for control students. Limitations and implications of these findings and plans for further research are discussed.
Universal prevention; Substance use reduction; substance users; Adolescents
This study examines how strength of ethnic identity, multiethnic identity, and other indicators of biculturalism relate to the drug use norms of urban American Indian middle school students. The article distinguishes categories of norms that may affect drug use. Regression analysis of self-reports by 434 American Indian seventh graders attending middle schools in a large southwestern U.S. city indicated that students who had a more intense sense of ethnic pride adhered more strongly to certain antidrug norms than those who did not. Whereas American Indian students with better grades in school held consistently stronger antidrug norms, there were few differences by gender, socioeconomic status, or age. These results have implications in social work practice for better understanding and strengthening the protective aspects of American Indian culture in drug prevention efforts.
adolescents; American Indians; biculturalism; drug use