Dangerous JourneysDangerous JourneysA metaphor for passage through the teen A metaphor for passage through the teen

yearsyears

Marvin KrankMarvin Krank

How can we help youth get How can we help youth get through these perilous timesthrough these perilous times

Mixed messagesMixed messages

Project on Adolescent Trajectories and Health (PATH): social context, cognition, risk-taking behaviour, and health outcomes

• Three-year Three-year longitudinal longitudinal studystudy

• Funded by Funded by the SSHRC the SSHRC and CIHRand CIHR

• Partnership Partnership with SD#23with SD#23

SocialContext

Cognition BehaviorHealth

Outcome

Overview of theoretical Overview of theoretical approachapproach

Social factors modify cognitions about risky behaviorsCognitions affect transitions to risk-taking behaviorRisk-taking behaviors impact on health outcomes

Life style choices begin in Life style choices begin in adolescenceadolescence

• Drug and alcohol use Drug and alcohol use begin in the early teensbegin in the early teens– Many smokers begin before Many smokers begin before

age 14age 14

• Risky choices have long-Risky choices have long-term consequences for term consequences for youthyouth– early pregnancyearly pregnancy– accidentsaccidents– unhealthy lifestylesunhealthy lifestyles– lost opportunitieslost opportunities

Grades 7-10 are a time of significant transitions in drug and Grades 7-10 are a time of significant transitions in drug and alcohol usealcohol use

Drug and alcohol use

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Seven Eight Nine Ten

Grade

Per

cent

use

d in

pas

t yea

r Alcohol

Drunkenness

Tobacco

Marijuana

Stimulants

Opiates

Club Drugs

Hallucinogens

A small, but significant percentage of A small, but significant percentage of these youth used drugs and alcohol in these youth used drugs and alcohol in the past weekthe past week

Male Female

Eight Nine Ten Eight Nine Ten

Alcohol 20% 33% 36% 18% 25% 29%

Drunkenness 10% 16% 21% 8% 19% 20%

Cigarettes 4% 4% 9% 5% 12% 13%

Marijuana 7% 13% 20% 7% 17% 20%

Hallucinogens 4% 2% 2% 3% 3% 3%

Inhalants 5% 4% 4% 4% 5% 2%

High risk behaviours tend High risk behaviours tend to co-existto co-exist

• Drug and alcohol use, Drug and alcohol use, early and unsafe early and unsafe sexual activity, and sexual activity, and violence tend to co-violence tend to co-occuroccur

• For example, heavier For example, heavier drug and alcohol use drug and alcohol use is linked to being is linked to being both a victim and a both a victim and a perpetrator of sexual perpetrator of sexual assault.assault.

Drug and alcohol use are Drug and alcohol use are highly correlatedhighly correlated

Used alcoholUsed alcohol Percent used Percent used marijuanamarijuana

NoNo 2.8%2.8%

YesYes 44.9%44.9%

Are aboriginal youth at greater Are aboriginal youth at greater risk?risk?

• Nine out of twelve comparison Nine out of twelve comparison measures show higher levels of usemeasures show higher levels of use

• May mask levels of use as we have a May mask levels of use as we have a lower level of participation and lower level of participation and higher drop out rate (50% versus higher drop out rate (50% versus 20%)20%)

• School drop outs have much higher School drop outs have much higher levels of use!levels of use!

Culturally Specific Risk Factors Culturally Specific Risk Factors

• Ethnic Dislocation Ethnic Dislocation (May, 1982; Oetting, Beauvais (May, 1982; Oetting, Beauvais

&Velarde, 1982; Trimble Padilla, & Bell, 1987)&Velarde, 1982; Trimble Padilla, & Bell, 1987)

• Acculturation Stress Acculturation Stress (LaFromboise, 1988)(LaFromboise, 1988)

• Alienation from the Larger Culture Alienation from the Larger Culture (Moncher et al., 1990)(Moncher et al., 1990)

• Unstructured time on reservations, Unstructured time on reservations, during which drinking is also a during which drinking is also a response to boredom response to boredom (Edwards & Edwards, 1988)(Edwards & Edwards, 1988)

Why weWhy weshould careshould care

Adolescent risk is based on Adolescent risk is based on what they dowhat they do

• Unsafe sex in youth Unsafe sex in youth leads to teen leads to teen pregnancy, low birth pregnancy, low birth weight babies, and weight babies, and STDs including HIVSTDs including HIV

• Drug and alcohol use Drug and alcohol use increase increase unintentional unintentional injuries, the leading injuries, the leading cause of death in cause of death in youthyouth

Early and heavy alcohol use is Early and heavy alcohol use is correlated with many negative correlated with many negative outcomesoutcomes• HealthHealth

– Aches and painsAches and pains– Accidents Accidents – HospitalizationHospitalization

• ViolenceViolence– VictimVictim– Perpetrator Perpetrator – Various kindsVarious kinds

• BullyingBullying• Assault Assault

• SexSex– Early sexEarly sex– Regretted sex Regretted sex – Sexual assaultSexual assault

• Problem behaviours

• Skipped school• Stayed out all night without

parent permission• Damaged property• Warned or detained by police• School detention• Stole something outside of home• Stole at home• Suspended out of school• Suspended in school• Ran away from home• Carrying weapons

Modern Risk Modern Risk Prevention ProgramsPrevention Programs

• Deal with social and cultural Deal with social and cultural influencesinfluences

• Encourage alternative activitiesEncourage alternative activities

• Correct misconceptions about drug Correct misconceptions about drug and alcohol useand alcohol use

Contemporary Evidence-Contemporary Evidence-based Methodsbased Methods• Less confrontational Less confrontational • Motivate changeMotivate change• Meet individuals where they are Meet individuals where they are

– Age and Stage appropriateAge and Stage appropriate

• Culturally responsiveCulturally responsive– Community participationCommunity participation

• Can be brief interventionsCan be brief interventions

Canoe Journey, Life’s JourneyCanoe Journey, Life’s Journey

• Development of Culturally Relevant Life Development of Culturally Relevant Life Skills ManualSkills Manual

• Canoe Journey as a metaphor for life’s Canoe Journey as a metaphor for life’s journeyjourney

• Use of other traditionally Native symbols, Use of other traditionally Native symbols, particularly the Medicine Wheel particularly the Medicine Wheel

• Medicine Wheel generally understood to Medicine Wheel generally understood to have similar meaning across tribal have similar meaning across tribal boundariesboundaries

ConclusionConclusion

• The real war on drugs is the battle for the The real war on drugs is the battle for the hearts and minds of our youthhearts and minds of our youth

• We don’t want to prevent them from We don’t want to prevent them from taking the journey, but we do want them taking the journey, but we do want them prepared for challenges along the way.prepared for challenges along the way.