Examining risk and protective predictors of substance use among low-income Native Hawaiian and Pacific Islander adolescents.

Abstract

Substance use (SU) among adolescents is a critical public health concern that increases the risk for negative outcomes. Although Asian American (AA) adolescents tend to report low rates of SU, Native Hawaiian and Pacific Islander (NH/PI) adolescents often report significantly higher rates of use. Yet, NH/PI youth are seldom studied as a separate group. Consequently, little is known about the factors involved in SU among NH/PI adolescents and how to prevent it. This prospective study investigated the effect of ecological risk and protective factors at the individual, family, and school levels on SU for NH/PI adolescents. This prospective study utilized longitudinal data from 120 NH/PI adolescents who were7 part of an SU prevention program. Information was collected at two time points-Time 1 and Time 2 (32 weeks later)and included adolescents' SU behaviors and individual, family, and school factors. The parents of these adolescents also provided data; all information was self-report. Positive academic attitudes at Time 1 were negatively associated with alcohol and other drug (e.g., marijuana) use at Time 2. Specifically, NH/PI adolescents who had more positive attitudes toward their school, peers, and teachers reported less alcohol and other SU. Prevention efforts may be most effective for NH/PI adolescents if addressed within the school context. This may include programs implemented in schools, utilizing teachers as role models, and/or promoting prosocial peer relationships to support positive behaviors. Additional implications are discussed. Public Policy Relevance StatementNative Hawaiian/Pacific Islander (NH/PI) adolescents have some of the highest rates of substance use (SU). Yet, they are regularly combined with Asian American adolescents in research, which deflates their actual rates of SU. By identifying risk and protective factors in SU for NH/PI adolescents, SU intervention and prevention strategies can be tailored specifically for this high-risk, underserved population. aaa A dolescent substance use (SU) remains a serious health concern in the United States (U.S.), with clear racial/ ethnic group differences in rates and trends of SU (Hall et al., 2016; Substance Abuse and Mental Health Services Administration [SAMHSA], 2013). Within SU research, Native Hawaiian/Pacific Islander (NH/PI) and other Asian American(AA) adolescents are often aggregated into one group due to their relative smaller sample size in the U.S. Collectively, AA and NH/PI adolescents appear to have the lowest rates of SU compared to other racial/ethnic groups-rates as low as 3.7% were found for these adolescents, compared to 9.2% for White adolescents (SAMHSA, 2013). Yet, these findings are misleading, since NH/PI adolescents This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Health-Risk Behaviors and Experiences Among Asian American and Native Hawaiian/Pacific Islander Adolescents in the United States, 2011-2019

“…Studies have suggested differences in protective factors for substance use between NHPI and Asian American adolescents—with parental support acting as a positive buffer against engaging in substance use among Asian American adolescents but with conflicting evidence for such protection among NHPI adolescents. 5,15,16 Wills et al noted that their measurement model narrowly defined a nuclear NHPI parental system and could be improved by including extended family members given the potential influence of other family members on the social environment of NHPI adolescents and their decisions on substance use. 16 Substance use among Asian American students may be explained by acculturative stress, correlated with differential rates of alcohol use; acculturation has been associated with increased alcohol consumption among Asian American students.…”

“…21-23 One study of NHPI adolescents identified several significant protective factors for substance use among NHPI adolescents in the school context, such as school-based programs, teachers as role models, and peer relationships. 5…”

“…[21][22][23] One study of NHPI adolescents identified several significant protective factors for substance use among NHPI adolescents in the school context, such as school-based programs, teachers as role models, and peer relationships. 5 Studies have demonstrated that violence-related experiences are a growing concern for Asian American and NHPI adolescents. 21,24 For Asian American adolescents, low levels of acculturation and cultural marginality are risk factors for fear, victimization, and bullying, but the impact of acculturation on adolescent aggression and violence can be mediated by family dynamics.…”

“…3 When data are disaggregated, there are significant differences in health-risk behaviors between Asian American and NHPI students. 4,5 The objective of this study was to provide updated national prevalence estimates for 2011 through 2019 of health-risk behaviors and experiences among Asian American and NHPI high school students in behavioral and experiential domains that may increase the risk for transmission of HIV, viral hepatitis, and sexually transmitted diseases, including substance use, sexual risk behaviors, violence-related experiences, and suicidal behaviors. We also compared the prevalence of each risk behavior and experience among Asian American and NHPI students with the prevalence among non-Hispanic White, non-Hispanic Black, and Hispanic students.…”

“…3 When data are disaggregated, there are significant differences in health-risk behaviors between Asian American and NHPI students. 4,5…”