Transcript Drug Abuse in African American and Hispanic Adolescents

DRUG ABUSE IN AFRICAN
AMERICAN AND HISPANIC
ADOLESCENTS: CULTURE,
DEVELOPMENT, AND
BEHAVIOR
Jose Szapocznik, Guillermo Prado, Ann Kathleen
Burlew, Robert A. Williams, and Daniel
Santisteban
Presented by: Jennifer Allen
DRUG USE AS A PUBLIC
HEALTH PROBLEM…
 74.5%
of all deaths among 15 to 24-yearolds are associated with drug use
 More specifically, minority adolescent
drug use is also associated with:



Dropping out of school
Delinquency
Risky sexual behavior
ADOLESCENT DEVELOPMENT
 How
may culture
affect development
of adolescents?
 Culture
is learned
so socialization
into the identified
culture is key
PROS AND CONS OF BROAD
TERMS
 By
using a broad term such as “Hispanic,”
researchers can gain information
regarding common linguistic and value
orientations
 Looking
at culture more specifically may
expose other cultural differences within
groups that are over looked
CONTRARY TO POPULAR
BELIEF…
 8th,
10th and 12th grade African
American adolescents report less use of
most illicit drugs than non-Hispanic and
Hispanic same-aged peers
 What
may be accounting for this cultural
difference in adolescent drug use?
MONITORING THE FUTURE
 Series
of independent surveys of 8th, 10th,
and 12th graders across America’s youth
 Since 2001, overall use of adolescents has
decreased by 21%
 Ages when adolescents are particularly
vulnerable for drug experimentation
 Prescription pain killers (such as Vicodin)
usage has increased
 Monitoring the Future
AFRICAN AMERICAN
PREVALENCE
 Most
recently, African American adolescents
trend towards higher rates of cigarette and
illicit drug use amongst 8th graders, which is
now slightly higher than non-Hispanic whites
HISPANIC PREVALENCE
 8th
and 10th graders
report highest lifetime,
annual, and 30-day
prevalence rates of
alcohol, cigarette, and
any legal or illicit drug
use
 Prescription drug
abuse affects 21% of
Hispanic adolescents

What may lead a culture
to favor certain kinds of
drugs?
¿DE DÓNDE ERES?
 U.S.-born
Hispanic adolescents report
higher rates of drug use than foreign-born
Hispanics
 Developmental differences?
 So, being foreign or not would moderate
prevalence of drug use

Ethnicity (Hispanic)

Drug Use
Place of Birth (Foreign)
PROTECTION AND RISKS
 Problem
Behavior Syndrome
 Risk and Protective Factors Paradigm

Organizes contexts that predispose adolescents
of all ethnic groups to experiment with drug
use or not
 Ecodevelopmental

Theory
Considers not only the contexts of
predisposition, but also their interaction and
the developmental course of these processes
RACIAL IDENTITY AND
SOCIALIZATION
 Racial
Identity has been found to be a
protective factor for African Americans
 African
Americans that endorse positive
attitudes about being African American
report more antidrug attitudes and in
turn less substance use
 Racial
Socialization can increase racial
identity
ACCULTURATION AND THE
IMMIGRANT PARADOX
 Acculturation
is a process that occurs
when an individual interacts within a
host cultural-social context
 Immigrant
Paradox refers to foreign-born
Hispanics being expected to have lower
levels of health care and poorer health
PREVENTION AND
TREATMENT: FAMILY
 Nine
of the twelve treatment models included
aspects of the family
 Familias
Unidas and Nuestras Familias
discovered that improvement in Hispanic
adolescent outcomes can be made by working
primarily with the parent
 Familism
– use of family
network as a source of emotional
social support
PREVENTION AND
TREATMENT: CULTURE
 Culturally
specific
interventions identify that
differences in the type of
exposure to risk and
protection do exist between
ethnic groups
 Specific groups may
respond better to
interventions that are
tailored to their preferred
views, morals, attitudes,
customs and/or needs
ADAPTING GENERIC TO
CULTURE-SPECIFIC
 Surface
Modification: change an
intervention to match the race/culture
 Deep
Structure: modify the actual content
and process of the intervention to include
culture norms and social realities of the
ethnic group
MINORITY INTERVENTIONS
 Most
interventions target much more
than drug use
 Family
functioning is correlated to child
behavior
 Brief
Strategic Family Theory
MEDIATORS/MODERATORS
 Mediation
provides guidance on how
interventions can be streamlined and
strengthened
 Moderators


Intervention effects varied between U.S.-born
and foreign-born participants and levels of
behavioral problems
Gender differences
COMMITMENT AND
RETENTION TO THERAPY
 Prevention
and treatment interventions
assume that clients receive an
intervention
 Difficult

to get consistent participation
Cultural factors?
 Group
leadership cohesiveness is
positively correlated to (and significantly
predicts) retention
TREATMENT OUTCOME
 Research
studies highlight the importance
of parent-interventionist relationship and
interventionists’ skills
 It is imperative that facilitators develop a
good rapport with the client at initial
contact
 Changes in interventionist behaviors have
significant prospective implications for
success
TAKE HOME POINTS
 Racial/ethnic
culture influences
adolescent development
 Racial
identity, racial socialization, and
acculturation are key factors
 Context
influences development and
development influences adolescent
behavior
CONCLUSIONS
 Cannot
study the human condition
without studying the variability of
genetic, historical, social and cultural
variables
 However,
studying a specific ethnic/racial
group is incomplete without studying the
variability of these variables within the
specific group
RESEARCH PRIORITIES FOR
AFRICAN AMERICANS
 Lower
prevalence rates but more severe
consequences
 Cannot
fully prevent drug use therefore
prevention and intervention are key
 Increase
knowledge of racial identity and
racial socialization
RESEARCH PRIORITIES FOR
HISPANICS
 Develop
prevention interventions for U.S.born Hispanics
 Investigate
mechanisms through which
drug use is increased in these adolescents
 Prevention
efforts should be targeted
earlier than 8th grade
 Structural
interventions are encouraged
TREATMENT PLAN
Eduardo is a 13 year old U.S.-born Hispanic
 His family is Puerto Rican and his parents speak
broken English
 Most of Eduardo’s friends are American,
however, he is close with his same-aged cousins
 His mother has recently noticed that she needs to
refill her prescriptions more often
 Eduardo’s parents cannot find good employment
because they barely speak English
 Eduardo’s father is an alcoholic
