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CORK Bibliography: Accuulturation and Substance Use

27 citations. January 2009 to present

Prepared: March 2011

Bakhireva LN; Young BN; Dalen J; Phelan ST; Rayburn WF. Periconceptional binge drinking and acculturation among pregnant Latinas in New Mexico. Alcohol 43(6): 475-481, 2009. (38 refs.)

Binge drinking during pregnancy might lead to the development of Fetal Alcohol Spectrum Disorders in the offspring. Latinas are often considered a low-risk group for alcohol abuse, although recent reports indicate that the prevalence of alcohol consumption in this group is increasing due to changing cultural norms. The predictors of alcohol consumption during pregnancy among Latinas are largely unknown. We explored predictors of periconceptional drinking among Latinas (n = 155) recruited into an ongoing cohort study at the University of New Mexico. Women were interviewed by a bilingual trained interviewer about any episodes of binge drinking (>= 4 drinks/occasion) a month around their last menstrual period (LMP) and were administered a TWEAK questionnaire. Sociodemographic, lifestyle, and reproductive health characteristics were also ascertained. Predictors of binge drinking were identified by Chi-square test and logistic regression in univariate and multivariable analyses, respectively. Backward selection procedure was used to identify covariates that were independently associated with binge drinking in the final model. The mean age of participants was 27.0 +/- 5.8 years and 69% were foreign born. In the entire sample, 17.4% of pregnant Latinas admitted at least one binge-drinking episode in the month around their LMP. Results of multivariate analysis indicate that Latinas born in the United States have a much greater risk of binge drinking in the periconceptional period (odds ratio [OR] = 3.2; 95% confidence interval [CI]: 1.2, 8.9) compared with foreign-born Latinas. Similarly, Latinas who primarily speak English at home were at much greater risk (OR = 3.6; 95% CI: 1.3, 10.5) compared with primarily Spanish-speaking women. No other variables were identified as significant predictors in multivariable models. Our results indicate that more acculturated Latinas are at much greater risk of binge drinking before conception and in early pregnancy compared with less acculturated Latinas. Culturally sensitive interventions should be developed to address risky alcohol consumption among Latinas of reproductive age.

Buchanan RL; Smokowski PR. Pathways from acculturation stress to substance use among Latino adolescents. Substance Use & Misuse 44(5): 740-762, 2009. (81 refs.)

The purpose of this study was to examine the link between acculturation stress and substance use among Latino adolescents. In-home interviews were completed with the participants at four time-points between 2005 and 2007. Path analysis was completed using longitudinal data from 286 Latino adolescents living in North Carolina and Arizona (65% foreign-born). Results indicate that acculturation stress influences family and friend relationships, which in turn affect adolescent mental health problems, and finally, substance use. Key mediators in the pathway from acculturation stress to substance use were parent-adolescent conflict, internalizing, and externalizing problems. Implications for practice and research have been discussed here.

Caetano R; Ramisetty-Mikler S; Rodriguez LA. The Hispanic Americans Baseline Alcohol Survey (HABLAS): The association between birthplace, acculturation and alcohol abuse and dependence across Hispanic national groups. Drug and Alcohol Dependence 99(1-3): 215-221, 2009. (39 refs.)

Hispanics are heterogeneous in national origin, evidenced by wide ranges of alcohol abuse and dependence rates across different Hispanic national groups. This paper examines associations between 12-month rates of DSM-IV alcohol abuse and dependence with birthplace and acculturation. The 2006 Hispanic Americans Baseline Alcohol Survey, using a multistage Cluster sample design, interviewed 5224 adults (18+ years) in five selected U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles. Comprehensive data on drinking behavior were collected and the analyses include bivariate and multivariate regression techniques. Alcohol abuse and dependence rates were higher among U.S.-born Puerto Ricans and South/Central Americans compared to their foreign-born counterparts, while no such differences were found for Cuban and Mexican Americans. Overall, those with higher acculturation report higher rates of abuse and dependence (statistically significant only for abuse among Puerto Ricans). Risk factors for abuse include being male and being in the high acculturation group. Risk factors for dependence include being male, being Puerto Rican or Mexican American, having less thin a college education, and being U.S.-born. Hispanics Were found to share several common risk factors with the larger U.S. population for abuse and dependence, such as male gender, lower education, and lower income.

Castro FG; Stein JA; Bentler PM. Ethnic pride, traditional family values, and acculturation in early cigarette and alcohol use among Latino adolescents. Journal of Primary Prevention 30(3-4, special issue): 265-292, 2009 , 2009. (78 refs.)

A structural equations model examined the influence of three cultural variables of ethnic pride, traditional family values and acculturation, along with the mediating variables of avoidance self-efficacy and perceptions of the "benefits'' of cigarette smoking, on cigarette and alcohol use in a sample of Latino middle school students in the Southwest. Girls (N = 585) and boys (N = 360) were analyzed separately. In both groups, higher ethnic pride and traditional family values exerted indirect effects on less cigarette smoking and alcohol use when mediated through greater self-efficacy and less endorsement of the "benefits'' of cigarette smoking. Among the girls, greater ethnic pride also had a direct effect on less cigarette and alcohol use. Also, greater acculturation directly predicted more cigarette and alcohol use among the girls, but not among the boys. However, differences between the boys and girls were generally nonsignificant as revealed by multiple group latent variable models. These results offer implications for incorporating cultural variables into the design of culturally relevant prevention interventions that discourage cigarette and alcohol use among Latino adolescents.

Chedebois L; Regner I; van Leeuwen N; Chauchard E; Sejourne N; Rodgers R et al. Relative contributions of acculturation and psychopathological factors to cannabis use among adolescents from migrant parents. Addictive Behaviors 34(12): 1023-1028, 2009. (61 refs.)

Immigrant adolescents and adolescents born of immigrant parents are at increased risk of substance use which has been linked to difficulties in acculturation processes. However very few studies have examined the role of the different acculturation strategies and none of them have controlled for relevant psychopathological and socio-familial factors. The aim of this study was to investigate the role of acculturation in cannabis use in a sample of adolescents born of immigrant parents taking into account potential confounding variables. A sample of 292 high school Students born in France from at least one foreign parent completed a questionnaire assessing cannabis use, acculturation orientations, ethnic identity and the most relevant potential confounders (depressive symptoms, sensation seeking, borderline and psychopathic traits, alcohol and tobacco use, parental attachment, life events, socioeconomic status and academic achievement). A regression analysis showed that acculturation orientations and ethnic identity explained a significant part of the variance in the frequency of cannabis use. Individualism, integration and assimilation were negatively associated with the frequency of cannabis use suggesting they might serve as protective factors.

Constantine ML; Rockwood TH; Schillo BA; Alesci N; Foldes SS; Phan T et al. Exploring the relationship between acculturation and smoking behavior within four Southeast Asian communities of Minnesota. Nicotine & Tobacco Research 12(7): 715-723, 2010. (29 refs.)

This study sought to measure the prevalence of smoking among the Hmong, Vietnamese, Lao, and Cambodian communities of Minnesota and explore the relationship between smoking and acculturation within these communities. A community-based participatory research framework was used through all phases of this study. Standard as well as community-developed measures of acculturation were used. Data were obtained by face-to-face and telephone interviews with 1,628 respondents from July 2006 to March 2007. Vietnamese and Cambodian men smoke at higher rates than men in the U.S. general population (35% and 58% compared with 20%, respectively). Most men across the Vietnamese, Cambodian, and Lao populations started smoking prior to immigration to the United States, although most former smokers quit smoking after immigration to the United States. Most male Hmong respondents started smoking after immigration. Education was predictive of smoking status across genders, with less education associated with greater odds of being a smoker. Logistic regression found some acculturation measures to be predictive of smoking status across both genders: Less acculturated male respondents and more acculturated female respondents are more likely to be smokers. Results of this study suggest that the role of acculturation in tobacco use may not be straightforward as has been presented previously. Other factors, such as social norms and cultural or linguistic isolation, may also be playing a role in tobacco use patterns and may play different roles for different subgroups. Further research is needed within each population and subgroups within those populations to understand these relationships and how they affect smoking behavior.

Constantine ML; Rockwood TH; Schillo BA; Castellanos JW; Foldes SS; Saul JE. The relationship between acculturation and knowledge of health harms and benefits associated with smoking in the Latino population of Minnesota. Addictive Behaviors 34(11): 980-983, 2009. (16 refs.)

Objectives: This study sought to examine the relationship between acculturation and the knowledge of smoking and health and perception of benefits associated with smoking within the Latino population of Minnesota. In addition to standard acculturation measures. this study employed a multidimensional model and measures of acculturation. Methods: A telephone and in-person administered survey was conducted across the state of Minnesota with Latino men and women. Results: A total of 804 participants completed the survey, 54% were men. The average age of respondents was 37 years; 81% were foreign born and 68% completed the interview in Spanish. Knowledge of the relationship between smoking and lung cancer (99%) and heart disease (93%) was high. Acculturated respondents indicate a more refined knowledge of the relationship between smoking and health conditions not related to smoking (poor vision and arthritis). Smokers identify more benefits associated with smoking than do nonsmokers, with gender (male), education (less than high school) and greater acculturation being significant predictors of perceiving benefits.

Everhart J; Ferketich AK; Browning K; Wewers ME. Acculturation and misclassification of tobacco use status among Hispanic men and women in the United States. Nicotine & Tobacco Research 11(3): 240-247, 2009. (30 refs.)

This study sought to determine the relationship between acculturation and misclassification of tobacco use among Hispanic Americans. The dataset was limited to respondents from the 1999-2002 National Health and Nutrition Examination Surveys who self-reported as "Mexican American" or "other Hispanic" and were at least 20 years old. Acculturation was measured with a short language scale, and self-reported tobacco use was verified with serum cotinine. Misclassified tobacco users were individuals who self-reported as never or former users but had a cotinine concentration of 15 ng/ml or higher. A gender-specific association between misclassification and acculturation was found. Among males (n = 1,175), the prevalence estimates of misclassification were 4.8%, 1.8%, and 2.2% for low, medium, and highly acculturated males, respectively (p < .02). Among females (n = 1,345), the prevalence estimates of misclassification were 0.8%, 2.0%, and 4.9% for low, medium, and highly acculturated females, respectively (p < .03). The findings of this study support the notion that the association between tobacco use and acculturation among Hispanics is gender specific. Several possible barriers to accurate self-report of tobacco use among Hispanics may include (a) the misconception among Hispanic men that infrequent tobacco use does not qualify one as a current user, (b) increasing desire among acculturated Hispanic women to conform to the tobacco use behaviors of non-Hispanic White women, and (c) the perceived acceptability of tobacco among Hispanic women in the United States. Finally, these trends support the use of early tobacco prevention efforts among Hispanic women and especially among those with low levels of acculturation.

Garcia JIR; Manongdo JA; Cruz-Santiago M. The family as mediator of the impact of parent youth acculturation/enculturation and inner-city stressors on Mexican American youth substance use. Cultural Diversity & Ethnic Minority Psychology 16(3): 404-412, 2010 , 2010. (57 refs.)

Youth substance use was investigated in a sample of Mexican-origin mothers and youth (93 dyads totaling 186 individuals). We tested the hypotheses that both acculturation and inner-city risk factors impact substance use largely because they undermine family relationships. Mothers and youth completed self-report measures of acculturation and enculturation. Youth completed questionnaires of family relationships, inner-city risk factors, and substance use. Youth substance use was measured with an index of lifetime alcohol, tobacco, and marijuana use based on the Youth Risk Behavior Survey. As predicted, mother youth (dyadic) acculturation/enculturation, as well as exposure to violence, were significantly associated with substance use. Family cohesion mediated the impact of violence exposure on substance use. However, both cohesion and violence had unique and significant associations with substance use. Furthermore, family relationships did not mediate the link between substance use and mother youth acculturation or mother youth enculturation. Results underscore the need to develop and test hypotheses that link Latino youth substance use with both acculturation and inner-city contexts that do not solely rely on family relationships as mediators.

Garcia GM; Romero RA; Maxwell AE. Correlates of smoking cessation among Filipino immigrant men. Journal of Immigrant and Minority Health 12(2): 259-262, 2010 , 2010. (9 refs.)

A survey on tobacco use among 318 Filipino immigrant men aged 40-75 years was conducted in Los Angeles, California. Those who reported more English language use with their family, friends and neighbors (OR = 1.31) and who lived in households with complete smoking prohibition (OR = 3.82) were more likely to be successful in quitting smoking. Those who endorsed more positive beliefs on physical and social consequences of smoking (OR = 0.69) and who had mostly smoking friends (OR = 0.37) were less likely to be successful in quitting smoking. Our findings suggest that prohibiting smoking in households, creating social networks of nonsmokers, and education or counseling are important components of a smoking cessation intervention for Filipino immigrant men.

Kang SY; Deren S; Mino M; Cortes DE. Biculturality and HIV-risk behaviors among Puerto Rican drug users in New York City. Substance Use & Misuse 44(4): 578-592, 2009. (28 refs.)

Biculturality refers to two independent processes of acculturation, one to the host society's culture and another to the culture of origin. This study examined the relationship between biculturality and HIV-related risk behaviors in a sample of injecting and noninjecting Puerto Rican drug users (N = 259), recruited in New York City in 2005-2006. Biculturality was measured by two scales: involvement in (i) American culture (AMBIC) and (ii) Puerto Rican culture Biculturality (PRBIC). The majority (78%) of the participants were males, with a mean age of 42 years. About half were born in Puerto Rico, and the average length of stay in the United States was 26 years. In multiple logistic-regression analysis, AMBIC was significantly related to lower injection risk after controlling for other factors including gender, age, and MMTP enrollment, while PRBIC was a significant predictor of higher sex risk. Involvement in the host culture and the culture of origin differed in their relationship to risk behaviors, indicating that incorporating assessments of biculturality may be useful in assessing and addressing migrants' behaviors, including HIV-risk behaviors. The study's limitations have been noted.

Kimbro RT. Acculturation in context: Gender, age at migration, neighborhood ethnicity, and health behaviors. Social Science Quarterly 90(5, Special Issue): 1145-1166, 2009. (67 refs.)

Objectives: This article investigates differences in smoking and binge-drinking for Latinos by nativity, stratified by their age at immigration, and tests individual- and neighborhood-level acculturation measures as determinants of those differences. Methods: Data are from the Los Angeles Families and Neighborhoods Study (N=2,023) and analyses use multilevel logistic regression. Results: The article finds that Latino immigrants are less likely to smoke or binge drink, compared to their U.S.-born peers, and that acculturation measures account for some of the immigrant gaps in health behaviors, although results differ by gender and age at migration. Additionally, living in a neighborhood with a high foreign-born concentration is associated with lower odds of binge-drinking. Conclusions: Findings suggest that both individual- and neighborhood-level measures of acculturation may contribute to immigrant health behavior advantages, and that it is important to consider these relationships within the context of gender and age at migration.

Kulis S; Marsiglia FF; Nieri T. Perceived ethnic discrimination versus acculturation stress: Influences on substance use among Latino youth in the Southwest. Journal of Health and Social Behavior 50(4): 443-459, 2009. (65 refs.)

Using a predominately Mexican-origin Latino sample of 5th grade students from the Southwestern United States, this study examined the relative effects of perceived discrimination and acculturation stress on substance use, and it assessed whether these effects were moderated by linguistic acculturation or time in the United States. Although rates of substance use were generally low in the sample, given the young age of the participants, over half (59%) of the sample perceived some discrimination, and almost half (47%) experienced some acculturation stress. Spanish-dominant and bilingual youth perceived more discrimination than English-dominant youth, whereas youth who have been in the United States five or fewer years perceived more discrimination than youth with more time in the United States. Youth who were Spanish-dominant or were recent arrivals experienced the most acculturation stress, with levels declining as linguistic acculturation and time in the United States increased. Multiple regression estimates indicated that perceived discrimination was associated with larger amounts and higher frequency of recent substance use and an array of substance use attitudes, such as stronger intentions to use substances, espousal of pro-drug norms, more positive substance use expectancies, and peer approval of substance use. Although acculturation stress was not associated with substance use, it was positively associated with several substance use attitudes, which are known antecedents of actual use. With a few exceptions, linguistic acculturation and time in the United States did not moderate the effects of perceived discrimination or acculturation stress.

LaFromboise TD; Albright K; Harris A. Patterns of hopelessness among American Indian adolescents: Relationships by levels of acculturation and residence. Cultural Diversity & Ethnic Minority Psychology 16(1): 68-76, 2010. (86 refs.)

Poor mental health among American Indian adolescents has been a matter of significant concern for the past two decades. This study extends the literature on acculturation within this population by investigating the relationship between hopelessness, levels of acculturation, and residence among American Indian adolescents. Utilizing data drawn from 438 adolescents across 67 American Indian tribes, our analyses show that American Indian adolescents who have bicultural competence (i.e., those who are adept in both Indian and White cultures) have significantly less hopelessness than do those with adeptness in only one culture or in neither culture. Our findings also show a significant difference by residence, with American Indians who live on reservations indicating less hopelessness than those living in urban or rural/nonreservation areas. Analysis of interaction effects suggests that the beneficial effect of adeptness in White culture is particularly true for American Indians living in urban areas.

Mills BA; Caetano R. The Hispanic Americans Baseline Alcohol Survey (HABLAS): Predictors of alcohol attitudes and expectancies in Hispanic national groups. Alcoholism: Clinical and Experimental Research 34(5): 790-799, 2010. (59 refs.)

Background: Multiple theoretical frameworks identify attitudes and expectancies as important predictors of alcohol behavior. Few studies have examined demographic predictors of these evaluative and belief-based cognitive mediators in the general population, and none have examined them in large-scale studies of Hispanics, a group at higher risk for drinking behavior and problems. This study probes the extent to which dimensions of attitudes and expectancies share common demographic predictors in a large sample of Puerto Ricans, Cuban-Americans, Mexican-Americans, and South/Central Americans. Methods: The 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS) used a multistage cluster sample design to interview 5,224 individuals randomly selected from households in Miami, New York, Philadelphia, Houston, and Los Angeles. This study focused on 2,773 respondents self-identified as current drinkers. Multiple linear regression was used to identify predictors of positive and negative dimensions of attitudes and expectancies, controlling for various background variables. Results: Religious affiliation selectively predicted alcohol attitudes, with Catholics having more positive and fewer negative attitudes than other religious groups. Hispanic group selectively predicted alcohol expectancies, with Cuban-Americans having less positive and less negative expectancies than other groups. Being U.S.-born or male predicted more positive attitudes and expectancies, but birthplace and gender did not predict negative dimensions of attitudes or expectancies. Higher acculturation and more education were linked to a decreased tendency to agree with any item. Age was positively and negatively associated with negative expectancies and positive attitudes, respectively, and having never been married, higher income, and unemployment were each linked to fewer negative attitudes. Conclusions: Although there is some overlap, attitudes and expectancies are influenced by different sociodemographic variables. Positive and negative dimensions of those constructs also show distinct patterns of relations. Prevention and treatment programs targeting cognitive mediators of behavior should be mindful of these differential determinants and future modeling endeavors should incorporate them.

Myers R; Chou CP; Sussman S; Baezconde-Garbanati L; Pachon H; Valente TW. Acculturation and substance use: Social influence as a mediator among Hispanic alternative high school youth. (review). Journal of Health and Social Behavior 50(2): 164-179, 2009. (116 refs.)

Research suggests that acculturation increases the risk of substance use among Hispanic youth. However this process is not well understood. This study examined associations between acculturation and several substance use indicators among a sample of 714 Hispanic youth attending alternative high schools in southern California. Peer social influence was assessed as a potential mediator. Acculturation, measured by language use, was associated with increased risk of lifetime alcohol, marijuana, and current alcohol, cigarettes, marijuana, and hard drug use, controlling for age, socioeconomic status, and gender Results of mediation analyses indicate that peer social influence mediated the relationship between acculturation and lifetime alcohol, and current alcohol, cigarettes, and hard drug use. Evidence for partial mediation was observed with lifetime and current marijuana use. These results provide evidence that peer social influence is an important mediating variable that should be considered when examining the relationship between acculturation and substance use.

Ndiaye K; Hecht ML; Wagstaff DA; Elek E. Mexican-heritage preadolescents' ethnic identification and perceptions of substance use. Substance Use & Misuse 44(8): 1160-1182, 2009. (79 refs.)

This paper examines the relationship between ethnic identification and substance use for 1,346 Mexican-heritage preadolescents in a National Institute on Drug Abuse-funded study in Phoenix, A rizona (2004-2005). Participants ranged from 9 to 13 years old, 49% reported their gender as male, 33% self-identified as Mexican, and 67% as Mexican American, and 91% (if the students reported taking part in the free or reduced-price lunch program. Questionnaire responses were analyzed by fitting regression models. Analyses showed that ethnic identification may play a protective role, with stronger ethnic identification related to more antidrug norms, less positive drug expectations, stronger refusal efficacy, and less intent to use substances. While gender did not significantly moderate the relationships, ethnic identification appears more broadly related to antisubstance-use norms for Mexican-born than U.S.-born participants. This study presents important implications for substance-use prevention research among Mexican heritage preadolescents. Finally, limitations of the study are noted.

Paljarvi T; Suominen S; Koskenvuo M; Winter T; Kauhanen J. The differences in drinking patterns between Finnish-speaking majority and Swedish-speaking minority in Finland. European Journal of Public Health 19(3): 278-284, 2009. (41 refs.)

Background: This study aims to examine whether the Swedish-speaking minority in Finland differ from the Finnish-speaking majority in respect to alcohol consumption and, whether such differences could be explained by aspects of social capital measured by both individual and area level variables. Methods: This cross-sectional dataset consisted of 17,352 Finnish speakers (baseline response rate 40) and 2,018 Swedish speakers (baseline response rate 37), aged 25-59 years. Multilevel logistic regression models were used to analyse the differences in alcohol consumption between the language groups, and to adjust for several potential individual and area level confounders. Results: Finnish-speaking men and women reported more frequent drunkenness, suffered more frequent hangovers, and had alcohol-induced pass-outs significantly more often than men and women in the Swedish-speaking population. Demographic, social, or environmental factors did not explain the observed differences in drinking patterns between these groups. Active social participation, social engagement, and trust in others were significantly related to drinking patterns only among Finnish speakers, but not among Swedish speakers. Conclusions: Drinking patterns are likely to have a direct impact on the health differences between the two populations, especially in relation to alcohol-related acute harm. It seems unlikely that the effect of social capital on the health differences between the two populations would be mediated through drinking patterns.

Resor MR; Cooper TV. Club drug use in Hispanic college students. American Journal on Addictions 19(4): 319-324, 2010. (51 refs.)

Club drug use and correlates were examined among 251 Hispanic college students on the Texas-Mexico border. Participants completed questionnaires on substance use, club drug attitudes and beliefs, sexual risk-taking behaviors, depressive symptoms, and acculturation. One-quarter of participants reported club drug use. Regression analyses demonstrated that frequency and history of lifetime use were consistently associated with more permissive drug attitudes and other substance use but not sexual risk-taking, depression symptoms, or acculturation. Acculturation was negatively associated with frequency of club drug use, yet positively associated with use of other illicit substances. Avenues for future studies are suggested.

Rosario-Sim MG; O'Connell KA. Depression and language acculturation correlate with smoking among older Asian American adolescents in New York City. Public Health Nursing 26(6): 532-542, 2009. (45 refs.)

Objective: To explore the correlates of smoking status among a sample of Asian American adolescents in New York City (NYC). Design and Sample: This descriptive, correlational study compared current smokers and current nonsmokers in terms of age, gender, ethnicity, academic performance, acculturation, depressive symptoms, smoking history, and parental, sibling, and peer smoking. The convenience sample included 328 Asian American adolescents, ages 16-19, who lived in NYC, and were recruited from members, friends, and affiliates of 6 organizational sources. Measures: The study used demographic, depression (Center for Epidemiological Studies Depression scale), English language acculturation, and smoking opportunity survey questionnaires. Results: Statistical analyses revealed that being older, being more English-language acculturated, having poor academic performance, increased depressive symptoms, and having siblings and peers who smoked were significantly associated with current smoking. Conclusions: Asian American adolescents initiate smoking later than other groups. Depressive symptoms were at high levels in the sample and were correlated with smoking. Thus, for Asian American adolescents, smoking prevention programs should be extended to later grades, with particular attention to low-performing students and those who are more acculturated. Likewise, programs that identify and assist adolescents with depressive symptoms may be useful in smoking prevention.

Saint-Jean G. Gender differences in the salience of psychosocial mediators of the impact of acculturation on substance abuse among Hispanic youth in Florida. Journal of Immigrant and Minority Health 12(2): 166-172, 2010 , 2010. (25 refs.)

Objectives: A number of psychosocial factors have been identified as mediators of the impact that acculturation exerts on adolescent drug use. We sought to evaluate gender differences in mediators of the impact of acculturation on substance abuse. Methods: We used t-test and logistic regression to analyze data collected from 8,200 adolescent students who self-identified as Hispanic during the 2004 Florida Youth Substance Abuse. The dependent variable was past 30 day use of marijuana and the key independent variable was language spoken at home. The covariates were 32 risk and protective (R/P) factors for drug use as defined by the Social Development Strategy framework. Results: For boys, the ORs associated with language changed significantly with the addition of any of the R/P factors to their basic model, while for girls only the addition of the Individual domain factors significantly changed the ORs. Discussion and conclusion These findings suggest that among boys the interventions that target any or all of the R/P factors may be able to positively alter the drug using behaviors among boys. In contrast, only the interventions that reinforce girls' innate strengths may succeed in dissuading them from initiating and perpetuating drug use. This information can be used to develop policies and interventions geared toward preventing drug problems among the growing group of adolescent of immigrant descent.

Stigler M; Dhavan P; Van Dusen D; Arora M; Reddy KS; Perry CL. Westernization and tobacco use among young people in Delhi, India. Social Science & Medicine 71(5): 891-897, 2010 , 2010. (47 refs.)

Few studies have explored the relationship between acculturation and health in non-immigrant populations. The purpose of this study was to investigate the relationship between "westernization" and tobacco use among adolescents living in Delhi. India. A bi-dimensional model of acculturation was adapted for use in this study to examine (a) whether young people's identification with Western culture in this setting is related to tobacco use, and (b) whether their maintenance of more traditional Indian ways of living is related to tobacco use. Multiple types of tobacco commonly used in India (e.g., cigarettes, bidis, chewing tobacco) were considered. Socioeconomic status (SES), gender, and grade level were examined as potential effect modifiers of the relationship between "westernization" and tobacco use. The study was cross-sectional by design and included 3512 students in eighth and tenth grades who were enrolled in 14 Private (higher SES) and Government (lower SES) schools in Delhi, India. A self-report survey was used to collect information on tobacco use and "westernization." The results suggest that young people's identification with Western influences may increase their risk for tobacco use, while their maintenance of traditional Indian ways of living confers some protection. Importantly, these effects were independent of one another. Boys benefitted more from protective effects than girls, and tenth graders gained more consistent benefits than eighth graders in this regard, too. Negative effects associated with identification with Western ways of living were, in contrast, consistent across gender and grade level. The positive and negative effects of acculturation on adolescent tobacco use held for all tobacco products considered here. Future interventions designed to curb youth tobacco use in India may benefit by paying closer attention to cultural preferences of these young consumers.

Unger JB; Ritt-Olson A; Soto DW; Baezconde-Garbanati L. Parent-child acculturation discrepancies as a risk factor for substance use among Hispanic adolescents in Southern California. Journal of Immigrant and Minority Health 11(3): 149-157, 2009 , 2009. (30 refs.)

Theories of acculturation predict that discrepancies in cultural orientation between adolescents and their parents will increase the adolescents' risk for behavior problems such as substance use. This study evaluated this hypothesis in a sample of 1772 Hispanic 9th grade students in Southern California. Parent-child discrepancy in U. S. orientation (defined as the difference between the child's U.S. orientation and the child's perception of the parents' U.S. orientation) was a risk factor for past-month smoking, lifetime and past-month alcohol use, and lifetime and past-month marijuana use. Parent-child discrepancy in Hispanic orientation (defined as the difference between the child's Hispanic orientation and the child's perception of the parents' Hispanic orientation) was a risk factor for lifetime and past-month alcohol and marijuana use. The adolescents' own Hispanic orientation was protective against lifetime and past-month smoking and marijuana use, but not alcohol use. In an analysis of mediation, U. S. acculturation discrepancy was associated with lower levels of family cohesion, which in turn was associated with higher levels of substance use. Results suggest that family-based interventions for acculturating and bicultural Hispanic families may be useful in decreasing the likelihood of substance use among Hispanic adolescents.

Unger JB; Ritt-Olson A; Wagner KD; Soto DW; Baezconde-Garbanati L. Parent-child acculturation patterns and substance use among Hispanic Adolescents: A longitudinal analysis. Journal of Primary Prevention 30(3-4, special issue): 293-313, 2009 , 2009. (46 refs.)

Acculturation discrepancy theory predicts that conflicting cultural preferences between adolescents and their parents will increase the adolescents' risk for behavior problems such as substance use. This study evaluated this hypothesis in a sample of 1683 Hispanic students in Southern California who completed surveys in 9th and 10th grade. Measures included the students' own cultural orientations and their perceptions of their parents' preference for their cultural orientations ("Perceived Parental Cultural Expectations''-PPCE). Hispanic PPCE in 9th grade was a risk factor for lifetime, but not past-month, cigarette, alcohol, and marijuana use in 10th grade. The adolescents' own Hispanic orientation in 9th grade was protective against lifetime and past-month smoking and marijuana use and lifetime alcohol use in 10th grade. The effects of the acculturation variables did not vary according to generation in the U.S. Change in acculturation between 9th and 10th grade was statistically significant but small in magnitude. Increases in parent-child Hispanic acculturation discrepancy (i.e., the difference between the adolescents' own cultural orientations and their PPCE, with adolescents perceiving that their parents wanted them to be more Hispanic oriented than they actually were) from 9th to 10th grade were associated with an increased risk of substance use. Family-based interventions for acculturating Hispanic families may be useful in decreasing the likelihood of substance use among Hispanic adolescents.

Wahl AMG; Eitle TM. Gender, acculturation and alcohol use among Latina/o Adolescents: A multi-ethnic comparison. Journal of Immigrant and Minority Health 12(2): 153-165, 2010 , 2010. (52 refs.)

This is the first study to examine the relationship between acculturation and alcohol use by gender and ethnicity using a nationally representative sample of Hispanic and non-Hispanic white adolescents. Specifically, we use data from the National Longitudinal Study of Adolescent Health (Add Health) to explore alcohol use and binge drinking for a sample that includes 6792 non-Hispanic whites, 910 Mexican Americans, 290 Cuban Americans, and 336 Puerto Ricans. Bivariate results reveal significant gender differences in alcohol use among first generation Mexican American, first generation Puerto Rican, and second generation Cuban American adolescents. In addition, these results indicate binge drinking differs significantly by gender among first generation Mexican American, first generation Cuban American, third plus generation Puerto Rican, and third plus generation non-Hispanic white adolescents. Multivariate logistic regression reveals that gender also moderates the effect of acculturation as well as ethnicity on alcohol use and abuse. Among both males and females, first generation immigrants are significantly less likely than third plus generation immigrants to use alcohol and binge drink while selective acculturation significantly reduces the odds of both behaviors. However, the effects of immigrant generation and selective acculturation on binge drinking are larger for females. Further, the trajectories that alcohol use and binge drinking follow with acculturation differ significantly by gender and ethnicity. These results reaffirm the need to further develop theoretical models and intervention strategies that are both gender-specific and culturally-specific, targeting high risk groups in particular in these efforts.

Wilkinson AV; Shete S; Spitz MR; Swann AC. Sensation seeking, risk behaviors, and alcohol consumption among Mexican origin youth. Journal of Adolescent Health 48(1): 65-72, 2011. (39 refs.)

Purpose: To examine factors associated with ever use of alcohol among Mexican origin youth. Methods: Using a prospective study design, we followed 1,053 Mexican origin adolescents. Participants completed two surveys in their homes and three follow-up telephone interviews, every 6-8 months, in between. The second home survey was completed 30 months (SD = 4.8 months) after baseline. Acculturation, subjective social status, and family cohesion were assessed at baseline and final home visit. Ever drinking, risk behaviors, and sensation-seeking tendencies were assessed at the final home visit only. Results: Overall, 30% of the study participants reported ever drinking alcohol. Multivariate models revealed that being female, increasing age, lower levels of acculturation, family cohesion and subjective social status, higher sensation-seeking tendencies, and concomitantly engaging in three or four other risk behaviors were associated with ever drinking. Also, social disinhibition, an aspect of sensation seeking, mediated the relationship between engaging in other risk behaviors and alcohol use. This is consistent with previous research, suggesting that social disinhibition is a common factor that underlies the use of alcohol, tobacco, illicit drugs, and other problem behaviors. Conclusions: The results of this study support taking a family-based approach to prevention that includes discussion of other risk behaviors, especially smoking, among Mexican origin youth. In addition, tailoring programs by gender, directly addressing how changes in social norms resulting from acculturation can affect a youth's decision to drink alcohol and underlying gender-based differences in why youth drink could improve the efficacy of preventive interventions.

Zamboanga BL; Schwartz SJ; Jarvis LH; Van Tyne K. Acculturation and substance use among Hispanic early adolescents: Investigating the mediating roles of acculturative stress and self-esteem. Journal of Primary Prevention 30(3-4, special issue): 315-333, 2009. (64 refs.)

We examined the extent to which Hispanic orientation and American orientation are associated with substance use (cigarette, alcohol, and marijuana) both directly and indirectly through acculturative stress and self-esteem. Participants were 347 Hispanic early adolescents (50.7% male; mean age = 12.57, SD = 0.92, range 11-15) from two middle schools in western Michigan. Findings showed that self-esteem emerged as the most consistent predictor of likelihood and extent of substance use. Ethnic identity was positively related to risk for substance use, and acculturative stress and self-esteem mediated the relationships of Hispanic cultural orientation to alcohol use. Self-esteem was the most important protective factor against substance use, and as such, we conclude that prevention programs designed to address precocious substance use that incorporate a self-esteem building component could prove useful among Hispanic early adolescents residing in monocultural contexts within the United States.