Drug Abuse in African American and Hispanic Adolescents: Culture, Development, and Behavior

1. 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

2. 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 school • Delinquency • Risky sexual behavior

3. Adolescent Development • How may culture affect development of adolescents? • Culture is learned so socialization into the identified culture is key

4. 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

5. 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?

6. 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

7. 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

8. 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?

9. ¿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)

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. Minority Interventions • Most interventions target much more than drug use • Family functioning is correlated to child behavior • Brief Strategic Family Theory

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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