DRUG ABUSE IN AFRICAN AMERICAN AND HISPANIC ADOLESCENTS: CULTURE, DEVELOPMENT, AND BEHAVIORJose Szapocznik, Guillermo Prado, Ann Kathleen Burlew, Robert A. Williams, and Daniel SantistebanPresented 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 HISPANICSDevelop 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