Modeling initiation into drug injection among street youth

This study aimed at examining the predictors of initiation into drug injection among street youth using social cognitive theory framework. A prospective cohort study based on semi-annual interviews was carried out. Psychosocial determinants referred to avoidance of initiation. Other potential predictors were: sociodemographic characteristics, relationships with injectors, parent's substance misuse, drug use patterns, homelessness, survival sex, sexual abuse. Independent predictors were identified using Cox proportional hazards regression models. Among the 352 participants, high control beliefs about avoidance of initiation was protective while younger age, daily alcohol consumption, heroin use, cocaine use, and survival sex all increased risk of initiation. Preventive strategies targeting street youth should both enhance youth's control beliefs and actual control over their substance use and improve their life conditions.     

An empirical assessment of the Above the Influence advertising campaign

This study evaluated the efficacy of Above the Influence (ATI), a national media-based health persuasion campaign to deter youth drug use. The campaign uses public service anti-drug prevention messages and targets youth between the ages of 14 and 16, a period of heightened susceptibility to peer influences. The evaluation utilized mall intercepts from geographically dispersed regions of the country. Theoretical impetus for the campaign combines elements of the theory of reasoned action (TRA), persuasion theory, and the health belief model. A series of structural equation models were tested with four randomly drawn cross-validation samples (N = 3,000). Findings suggest that awareness of ATI is associated with greater anti-drug beliefs, fewer drug use intentions, and less marijuana use. Congruent with the TRA, changes in beliefs and intentions are intermediate steps linking campaign awareness with behavior. This study provides further evidence of positive campaign effects and may strengthen reliance on mass media health persuasion campaigns as a useful adjunct to other programs targeting youth.     

Perception of Substance Use Problems in Asian American Communities by Chinese,Indian, and Vietnamese American Youth

SUMMARY

The study was a cross-sectional survey using a convenience sample of 87 Asian American youth respondents to examine their perceptions of substance use problems in the Asian American community. The authors examined respondents' perceptions of the severity of substance use problems in the Asian American community, perceived characteristics of persons with problems of substance use, perceived etiology of substance use problems, beliefs about treatment, perceived help-seeking preferences and helpful services. The youth demonstrated an increased awareness of the severity of substance use problems in the community, although such awareness was more prominent for drinking problems than drug use problems. Respondents showed a positive attitude toward treatment, although such an attitudinal change was not yet accompanied by a change in their behavioral preferences. Findings suggested a tendency for Asian American youth respondents to utilize personal resources rather than professional help or formal treatment programs in response to substance use problems. In addition, respondents shared similar “myths” of Asian problem drinkers and drug users. Implications for developing culturally relevant interventions for prevention and treatment as well as future research are discussed.     

Foster youth and drug use: Exploring risk and protective factors

Substance use and misuse experiences of foster youth remain an under-researched area. Given that early use of drugs is said to be a common factor among 90% of those who develop substance misuse problems in their lifetime, this is an important area of academic study (Dennis, White, & Ives, 2009). By drawing upon primary empirical data from a mixed-methods study, this paper addresses an important gap in the literature and seeks to provide an improved understanding of foster youth, drug use and vulnerability. A total of 261 foster youth, who had exited care, contributed to a quantitative survey, and a further 35 provided qualitative narratives of their lived experience. Key risk factors including experience of homelessness, school exclusion and living setting are identified as strong influences that predict high levels of drug use among foster youth. Targeted social support and interventions in the form of pre-leaving care in the context of a strong practitioner/youth relationship are suggested to help ameliorate poor outcomes to obviate the problem of substance misuse among foster youth.     

Stress and tobacco use among African-American adolescents: the buffering effect of cultural factors

Tobacco is a leading contributor to morbidity and mortality and a primary reason for health disparities among African Americans. In this study we explore the role of stress in smoking and cultural factors that protect against stress among African-American adolescents. Our sample consisted of 239 youth who were recruited into the study while enrolled in 8th and 12th grade. Measures of risk factors (stress, school transition stress, and community disorganization), moderator or protective factors (religious support and intergenerational connections), and 30-day tobacco use were collected. Hierarchical multiple regression analyses were conducted. Intergenerational connections moderated the effect of stress on past 30-day tobacco use. Religious support moderated the effect of neighborhood disorganization on past 30-day tobacco use. Religious support also moderated the effect of stress on past 30-day tobacco use. The findings have implications for prevention efforts to consider religious beliefs and practices and also to link youth with supportive adults in their community.     

Substance Use Among Rural African American Adolescents: Identifying Risk and Protective Factors

Substance use continues to be a significant problem among youth in our society, particularly in rural communities. The purpose of the current study was to identify the possible risk and protective factors that may be affecting the rates of alcohol and illegal drug use among a population of African American adolescents living in a rural, southern community. The following were identified as possible risk factors: (1) Being an older adolescent (15 years of age or older); (2) Spending afternoons after school with friends; (3) Having friends or family members who use alcohol or illegal drugs; (4) Being raised by non-family members; and (5) Having plans to enter military after high school. The following characteristics were associated with less alcohol and illegal drug use, and were identified as possible protective factors: (1) Being raised by parent(s) or other family members; (2) Spending afternoons after school with parents; (3) Having parents who talk to youth about dangers of drug and alcohol use; (4) Having parents who disapprove of their child using drugs or alcohol; (5) Being involved in extra-curricular church-related activities; and (6) Having plans to work, or attend college or technical school after high school. Characteristics that have been associated with drug and alcohol in previous research that were not associated with use in the current study include: (1) Being male; (2) Peer pressure to use alcohol or illegal drugs; (3) Grades in school; and (4) Involvement in extra-curricular activities. Implications for developing effective community programs aimed at reducing substance use among our youth are discussed.     

THEORY OF SEGMENTED ASSIMILATION AND THE ADOPTION OF MARIJUANA USE AND DELINQUENT BEHAVIOR BY ASIAN PACIFIC YOUTH

This article examines the adoption of behaviors of the teen drug and delinquent subcultures among Asian Pacific youth within the framework of the theory of segmented assimilation. Alejandro Portes and Min Zhou's theory offers a new perspective to the question: Under what conditions are youth susceptible to marijuana use and delinquent behavior? In contrast to Milton Gordon's classic one‐path theory, segmented assimilation theory looks to the immigrant culture and social capital (e.g., social solidarity) as critical factors in the assimilation process. The theory suggests several different types of adaptation by immigrant youth and Asian youth born in the United States. The data from the Asian Student Drug Survey were used to analyze the patterns of marijuana use and delinquent behavior among Japanese. Chinese, Filipino. Korean, Southeast Asian, Asian Indian, and Pacific Islander youth, controlling for human capital and social capital, as well as other relevant factors. Logistic regression analysis was used to determine the factors that affect the odds of marijuana use and delinquent behavior for the seven ethnic groups in this study. The likelihood of marijuana use differed significantly among the ethnic groups. For example, Pacific Islander and Filipino youth were much more likely than Japanese youth to use marijuana. Korean, Southeast Asian, and Asian Indian youth did not differ significantly from the Japanese youth in marijuana use. Like the model that predicted marijuana use, the Chinese youth were least likely to engage in delinquent behavior, while Filipino and Pacific Islander youth were most likely. Segmented assimilation theory points to the importance of the human and social capital that serve to insulate youth from the influence of the teen drug and delinquent cultures.     

Comparison of Treatment Response among GLB and non-GLB Street Living Youth

Researchers have found that adolescents who identify as gay, lesbian, or bisexual (GLB) are at a higher risk for increased substance use and mental health symptoms. The current study is a secondary analysis of two clinical trials for street-living youth. This analysis examines self-identification as GLB as a moderator of treatment effects and addresses whether street-living GLB youth respond differently to a therapeutic intervention than non-GLB street-living youth. Comparisons were made of treatment outcomes on two categories of variables (drug use and mental health symptoms) among 244 homeless GLB and non-GLB identified adolescents. Overall, GLB and non-GLB adolescents showed similar reductions in drug use and mental health symptoms. However, compared to non-GLB adolescents, GLB adolescents showed greater improvement in reduction of drug use and internalizing and depressive symptom scores. While both groups reported less drug use and fewer mental health symptoms from baseline to post-intervention, GLB youth's scores improved more drastically. Implications of using the identified treatment intervention are discussed.     

"I No Like Get Caught Using Drugs": Explanations for Refusal as a Drug Resistance Strategy for Rural Native Hawaiian Youth

This exploratory study examined the use of explanations for refusal as a drug resistance strategy for rural Native Hawaiian youth. Fourteen gender-specific focus groups were conducted within seven middle or intermediate schools on the Island of Hawai'i (N = 64). Participants were asked to describe drug resistance strategies in response to 15 hypothetical culturally specific drug-related problem scenarios developed from earlier research. The findings indicate that variations in the types of explanations used for refusal were based on the type of drug offerer in the associated scenario (i.e., peer/friend, cousin, or parent). Participants also described the rationales for the use of different explanations with different drug offerers. The findings suggest that culturally grounded drug prevention programs for Hawaiian youth should incorporate the use of specific types of explanations for refusal, depending on the youths' relationship to the drug offerer.     

An Ecological Assessment of Drug-Related Problem Situations for American Indian Adolescents of the Southwest

This study examined difficult situations related to drug and alcohol use as identified by American Indian youth in the South-west. Sixty-two contextually based items were developed from focus group data, and were administered to 71 American Indian youth. The items measured the frequency in which youth experienced specific drug-related situations, as well as the perceived difficulty in resisting drug use offers in those situations: The results indicated that the most frequent and difficult drug and alcohol situations occurred primarily with friends or cousins at their homes or after school. Implications for culturally specific assessment, prevention, and treatment are discussed.     

Does Family Structure Matter in the Relationships Between Youth Assets and Youth Alcohol,Drug and Tobacco Use?

This study investigated significant relationships between youth assets and youth alcohol, tobacco, and drug use that differ according to family structure (one- or two-parent households). Data were collected from a randomly sampled inner-city population (n=1,256 teenagers and 1,256 parents of the teenagers) using in-home, in-person interviews. Logistic regression analyses, stratifying by one- and two-parent household status, were conducted with nine youth assets as the independent variables and youth alcohol, tobacco, and drug use as the dependent variables. Results indicated that the associations between assets and risk behaviors varied depending upon whether the youth lived in one- or two-parent households. Continued research is warranted to further investigate associations among family structure, youth assets, and youth risk behaviors.     

An Ecological Assessment of Drug-Related Problem Situations for American Indian Adolescents of the Southwest

ABSTRACT

This study examined difficult situations related to drug and alcohol use as identified by American Indian youth in the Southwest. Sixty-two contextually based items were developed from focus group data, and were administered to 71 American Indian youth. The items measured the frequency in which youth experienced specific drug-related situations, as well as the perceived difficulty in resisting drug use offers in those situations. The results indicated that the most frequent and difficult drug and alcohol situations occurred primarily with friends or cousins at their homes or after school. Implications for culturally specific assessment, prevention, and treatment are discussed.     

Chapter 10: Issues in HIV/AIDS Service Delivery to High Risk Youth

Homeless and runaway youth engage in behavior that puts them at risk for infection with HIV, the virus that causes AIDS. Prevalence of HIV disease in homeless and runaway youth is higher than it is among other adolescents. In addition, homeless and runaway youth are often forced to engage in sex as a means of survival. Although they engage in high risk behavior, AIDS education programs have neglected them as a target group for education. To some extent, they have been included in other more general categories of persons with AIDS risk behaviors, such as men who have sex with men or intravenous drug users. However, the number of adolescents receiving age-specific HIV/AIDS information is far below the number infected (Hein et al., 1992). Often high risk youth are disenfranchised, having been forced from home by their families after disclosing their gay or lesbian identities. Lacking a political voice and having no spokesperson, they represent a group with complex unmet needs. These youth typically have immediate needs for food, shelter, and clothing. In addition, they often need medical management, mental health and drug counseling, crisis management, and HIV/AIDS information. These needs are often overwhelming to the agencies that serve youth. This article examines the barriers and issues that exist in providing services to high risk youth. Then, suggsetions for removing those barriers by empowering both service providers and youth are offered. Some of the suggestions are based upon the authors' own experience in providing HIV/AIDS in-service training to service providers to high risk youth. The article makes recommendations for policy on youth and HIV/AIDS.     

Exposure to Parent and Peer Alcohol Use and the Risk of Drinking Onset and Escalation Among Adolescents

Although the rate of alcohol use among adolescents has declined, it remains their drug of choice. Parent and peer alcohol use are powerful risk factors for youth alcohol use. However, questions remain about how these factors influence underage drinking. The present study investigates the relationship between exposure to parent or peer alcohol use and two stages of adolescent drinking—onset and escalation—overall and at five age points during adolescence. Participants were 9348 adolescents in Waves I (WI) and II (WII) of the National Longitudinal Study of Adolescent Health, whose parents completed interviews at WI, and who identified themselves as either non-drinkers or experimental drinkers at WI. Reports of WII alcohol use were used to measure onset among WI non-drinkers and escalation among WI experimenters. Risk ratios were calculated to assess the overall impact of exposure to parent or peer alcohol use on onset and escalation, and at five age points (i.e., ≤?13, 14, 15, 16, and ≥?17). Findings show that exposure to either parent or friend alcohol use increased the risk of onset and escalation. Age-based analyses reveal a more nuanced relationship, showing variability in the nature and strength of influence by stage of drinking and by age. This study highlights the relevance of both parent and peer modeling on youth drinking throughout adolescence. Implications in advancing prevention and treatment include parental education about the impact of their own behaviors and the importance of monitoring teens’ friendships.     

The moderating effects of culture on peer deviance and alcohol use among high-risk African-American Adolescents

African-American adolescents have lower rates of alcohol consumption than White youth. However, African-American youth suffer disproportionately more adverse social, mental, and physical health outcomes related to alcohol use. Affiliating with negative peers is a risk factor for alcohol initiation and consumption. Cultural variables have shown moderating effects against other risk factors for African-American youth and therefore were the focus of this study. Specifically, we tested whether three culturally-relevant variables, Africentric beliefs, religiosity, and ethnic identity were promotive or protective for alcohol initiation and use within the context of negative peer affiliations. The sample consisted of 114 at-risk African-American adolescents whose ages ranged from 13 to 20. Participants were administered a questionnaire with measures of alcohol initiation and use, peer risk behaviors, ethnic identity, Africentric beliefs, religiosity, and demographic items. Peer risk behaviors accounted for significant percentages of the variance in age of alcohol initiation, lifetime use, and current and heavy alcohol use after adjusting for age and gender. Cultural variables showed both promotive and protective effects. Africentric beliefs were promotive of delayed alcohol initiation, whereas both Africentrism and religiosity moderated peer risk behaviors effect on alcohol initiation. Africentric beliefs were also inversely related to lifetime alcohol use revealing a promotive effect. Moreover, there were significant protective effects of ethnic identity and religiosity on heavy alcohol consumption. One implication of these findings is that prevention programs that infuse cultural values and practices such as Africentrism, ethnic identity, and religiosity may delay alcohol initiation and reduce use especially for youth with high risk peers.     

Predictors of Frequency of Sexual Health Communication: Perceptions from Early Adolescent Youth in Rural Arkansas

Parent–child communication about sex-related themes can shape adolescents’ attitudes and beliefs, and have the potential to contribute to their decision either to engage in or abstain from sexual activity. Despite the burgeoning literature in this area, few studies have examined the issue as it pertains specifically to rural early adolescent youth. The current investigation addresses this gap by examining whether familial, situational, and sociodemographic factors were associated with youth’ perceptions of frequency of communication with parents about multiple sex-related topics among a rural population (N?=?252). Multiple regression results suggest that being a female, being a youth of color, level of closeness with father and spending enough time with one’s father predicted increased frequency of sex-related communication between parent and child. Our findings show that situational and sociodemographic differences play a significant role in predicting frequency levels of sex communication. Intervention efforts aimed at rural early adolescent youth should be planned with such differences in mind.     

Justice towards youth: Investigating the mismatch between current policy and public opinion

In this article, we present evidence that public perceptions within the United States are not as supportive of the harsh treatment afforded juveniles as public policy would suggest. Based on data from a representative state-wide survey, we used path analysis to investigate whether respondents' understanding and beliefs surrounding child and adolescent development were related to their beliefs surrounding appropriate levels of punishment towards juveniles. We estimated direct and indirect pathways whereby factors such as the age at which a respondent considers a youth responsible for his/her actions and adolescents' cognitive ability were associated with overall attitudes towards punishment. The results indicated respondents' attitudes towards punishment were associated with their beliefs and attitudes concerning different aspects of adolescent development. The results provided support for the premise that deeper knowledge and understanding of adolescent development does make a difference in terms of how individuals view appropriate punishment options. We argue that such evidence can be used as part of a broader advocacy strategy designed to develop more just programs and policies directed at children and youth involved with the justice system.     

Conventional Ties,Peer Influence,and the Fear of Apprehension: a Study of Adolescent Marijuana Use*

This study examines the relationship between a belief in the certainty of apprehension and self-reported marijuana use; the relative importance of this belief and ties to conventional others as sources of control; and the extent to which involvement with other users is related to the belief examined and use. The findings suggest that both the belief examined and conventional ties, in this case to the family and school. serve as independent sources of control among the high school youth studied. Of particular importance is involvement with other users; use is unlikely given the absence of group supports. This holds both for youth who maintain conventional ties and for those with weak ties. Further, involvement with nonusing peers is related to patterns of use as well as the belief that one will get caught should he try. The effectiveness of the law as a deterrent, then, is questionable given peer involvement and reinforcement for beliefs which effectively discount or support the certainty of apprehension as a viable reason for nonuse.     

Impact of Parenting Behaviors on Recent Alcohol Use Among African American Students

Parenting is a critical factor in substance abuse prevention. Positive parenting behaviors are identified as a protective factor for substance abuse among youth. Limited research exists that investigates the role of parenting practices on minority youth substance use. The present study seeks to examine correlates between parenting and recent alcohol use among African American youth. Specifically, to what extent do African American students report experiencing specific parenting behaviors that are measured by the National Household Survey on Drug Use and Health?, do specific parenting behaviors increase the risk of recent alcohol use among African American youth?, does the impact of parenting behaviors on recent alcohol use among African American youth differ based on sex (males and females) and age category (12–13, 14–15, and 16–17 years old) were examined in this study? Logistic regression analysis of the National Household Survey on Drug Use and Health was conducted to examine the research questions. Findings indicated that parenting behaviors was associated with recent alcohol among youth. Significant differences were found for males, females, 12–13, 14–15, and 16–17 years olds. Study findings demonstrate the importance of positive parenting behaviors in youth alcohol prevention. Program specialists may target parenting as a means of preventing and reducing youth alcohol use among African American youth.