DRUG ABUSE IN AFRICAN AMERICAN AND HISPANIC ADOLESCENTS: CULTURE, DEVELOPMENT, AND BEHAVIORJose 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-
year-olds are associated with drug use More specifically, minority adolescent
drug use is also associated with:Dropping out of schoolDelinquencyRisky 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 TheoryConsiders 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 emotionalsocial 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