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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 DRUG USE AS A PUBLIC HEALTH PROBLEM… 74.5% of all deaths among 15 to 24-yearolds are associated with drug use More specifically, minority adolescent drug use is also associated with: Dropping out of school Delinquency Risky 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 Theory Considers 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 emotional social 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