Gender identity and substance use among students in two high schools in Monterrey, Mexico

Avanzando Caminos (Leading Pathways): design and procedures of the Hispanic/Latino Cancer Survivorship Study

Avanzando Caminos (Leading Pathways): The Hispanic/Latino Cancer Survivorship Cohort Study aims to examine the influence of sociocultural, medical, stress-related, psychosocial, lifestyle, behavioral, and biological factors on symptom burden, health-related quality of life, and clinical outcomes among Hispanics/Latinos who have been previously treated for cancer. Avanzando Caminos is a prospective, cohort-based study of 3000 Hispanics/Latinos who completed primary cancer treatment within the past 5 years that is representative of the general Hispanic/Latino population in the United States. Participants will complete self-report measures at baseline (time [T] 1), 6 months (T2), 1 year (T3), 2 years (T4), 3 years (T5), 4 years (T6), and 5 years (T7). Blood samples drawn for assessment of leukocyte gene expression, cardiometabolic markers, and genetic admixture will be collected at baseline (T1), 1 year (T3), 3 years (T5), and 5 years (T7). Medical and cancer characteristics and clinical outcomes will be extracted from the electronic medical record and/or state cancer registry at each time point. Data analysis will include general latent variable modeling and latent growth modeling. Avanzando Caminos will fill critical gaps in knowledge in order to guide future secondary and tertiary prevention efforts to mitigate cancer disparities and optimize health-related quality of life among Hispanic/Latino cancer survivors.

At-Risk Drinking and Workplace Conditions among Latino Day Laborers

Background: Latino Day Laborers (LDL) face a variety of factors which have been associated with at-risk drinking. The objective of this study was to assess the association of at-risk drinking with measures of work site conditions. Methods: Data from surveys conducted with 307 LDL in Houston, TX in 2015 were analyzed. Sociodemographic information and measures of exposures to hazardous products at the worksite, adverse working conditions, and work stressors were collected. Measures of positive working climate at the jobsite and a climate that promoted jobsite safety were also included. Participants were administered the Hazardous Use items from the Alcohol Use Disorders Identification Test of Consumption (AUDIT-C). Participants were classified as low-risk or at-risk drinkers based on AUDIT-C score. Logistic regression models were run to assess the associations of the sociodemographic and worksite related variables with drinking status. Results: One-hundred-five (34.2%) participants were classified as at-risk drinkers. At-risk drinking was associated with past-month income, being formerly married (compared to having never married), and lack of housing. At-risk drinking was also associated with measures of a positive working climate and a climate that promoted jobsite safety. Conclusions: One-third of our participants were classified as at-risk drinkers. At-risk drinking was associated with stressors in the form of lack of housing and no longer having a spouse but was also associated with increased income and with positive workplace factors. At-risk drinking was thus a function of both stressors and positive factors, including a positive work site.

Impacts of recreational cannabis legalization on use and harms: A narrative review of sex/gender differences

Legalization of cannabis use for non-medical (recreational) purposes is changing the global cannabis landscape. As attitudes toward cannabis use become more positive and prevalence of use increases in complex ways, concerns emerge about the potential for increased cannabis-attributable harms. Understanding the who, why, and when of this likely increase in cannabis-attributable harms is thus an important public health priority. Both sex and gender contribute to variability in the use, effects, and harms of cannabis and thus sex/gender considerations are important when evaluating the impacts of cannabis legalization. The goal of this narrative review is to broadly discuss sex/gender differences in attitudes toward and prevalence of cannabis use, whether there are sex/gender differences in the impacts of cannabis legalization, and why these sex/gender differences might exist. One of our strongest conclusions is that men have always been more likely to use cannabis than women, yet the sex/gender gap in prevalence of cannabis use has narrowed over time, and this might be partly due to cannabis legalization. The existing evidence suggests that there have also been sex/gender differences in the impacts of legalization on cannabis-attributable harms such as cannabis-involved motor vehicle collisions and hospitalizations, though these results are more variable. The body of literature reviewed has focused almost exclusively on samples of cisgender research participants, and thus future research should encourage inclusion of transgender and gender-diverse participants. More consideration of sex- and gender-based analysis in research evaluating long-term impacts of cannabis legalization is a clear research priority.

Associations between parental and adolescent alcohol use: The role of gender and familism support

INTRODUCTION

This study examined the role of gender and familism support in the associations between parental and adolescent drinking behaviors in a sample of Mexican adolescents.

METHOD

Mexican adolescents (49% girls; N = 724) aged 12-19 completed measures assessing familism support, self-reported drinking behaviors, and perceptions of parental drinking behaviors.

RESULTS AND CONCLUSION

Findings suggest that both gender and familism support moderate the relationship between parental drinking behaviors and adolescent drinking behaviors. For instance, the association between mothers' alcohol use frequency and adolescent binge drinking was stronger for girls. In contrast, the association between fathers' amount per drinking day and adolescent binge drinking was stronger for boys. Mother's amount per drinking day was associated with less alcohol use per drinking day among adolescents reporting high familism support. The current study expands our understanding of parental modeling on Mexican adolescent drinking behavior.

Binational Cultural Adaptation of the keepin' it REAL Substance Use Prevention Program for Adolescents in Mexico

Sharp increases in substance use rates among youth and the lack of evidence-based prevention interventions in Mexico are a major concern. A team of investigators from Mexico and the USA are actively addressing this gap by culturally adapting keepin' it REAL (kiR)-a former US SAMHSA model program-for Mexico. This paper reports on the processes and outcomes of the cultural adaptation of kiR for adolescents in Mexico. Multiple forms of data informed this cultural adaptation, including focus groups with students about gendered and violence experiences with substance use, feedback from teachers who previously implemented the original versions of kiR, lesson fidelity observations, and external expert reviews. The culturally adapted version of kiR integrates Ecological Validity and Cultural Sensitivity Models in the adaptation process. The process encompassed surface structure adaptations, like updating language, graphics, and videos, as well as deep structure adaptation components including cultural norms, attitudes, and beliefs salient among Mexican adolescents. Youth reported receiving alcohol offers from family members, links between substance use and violence, and that shifting gender norms result in more females initiating substance use offers. In adapted kiR activities, students practice navigating substance use offers in these contexts. This approach to cultural adaptation led to a true collaborative between investigators in two countries. This study advances knowledge about how to undertake cultural adaptations of efficacious US-based prevention programs in international settings.

Accounting for linguistic acculturation, coping, antisociality and depressive affect in the gender role-alcohol use relationship in Mexican American adolescents: a moderated mediation model for boys and girls

Background: Prior studies have established that gender roles are predictive of substance use for Mexican and Mexican American adolescents, both living in the U.S. and in Mexico. Objectives: The moderating effects of gender and acculturation and the mediating effects of antisociality, depressive affect, and adaptive and avoidant coping on the gender role-alcohol use relationship were examined in a sample of Mexican American adolescents.Methods: Secondary data analyses were conducted on a sample of 955 (450 boys, 505 girls) Mexican American 7th and 8th grade adolescents participating in a school-based substance use intervention.Results: For boys, path analyses yielded significant direct paths from aggressive masculinity to alcohol use. Bootstrapped mediation tests also yielded significant indirect paths through antisociality from assertive masculinity, affective femininity, aggressive masculinity, and the interaction of linguistic acculturation by affective femininity to alcohol use. For girls, the relationship between aggressive masculinity with alcohol use and the negative relationship of affective femininity with alcohol use were also mediated by adaptive coping, which is predictive of decreased substance use.Conclusion/Importance: The present analyses confirm the importance of gender roles, functional mediators, and their interaction with acculturation in predicting substance use in Mexican American adolescents, with implications for the design of interventions to reduce substance use within the Mexican American community.

Participant Satisfaction and Acceptability of a Culturally Adapted Brief Intervention to Reduce Unhealthy Alcohol Use Among Latino Immigrant Men

Latino immigrant men are at increased risk for unhealthy alcohol use, yet few interventions have been designed to meet their unique needs. The current study assessed participant satisfaction and acceptability of a culturally adapted brief intervention to reduce unhealthy alcohol use in this population. Adaptations to the brief intervention included delivering it in Spanish by promotores in a community setting. The mixed methods approach included surveys (N = 73) and in-depth interviews (N = 20) with participants in a pilot randomized controlled trial. The study drew on Sekhon's theoretical framework of acceptability to asses affective attitude, burden, and perceived effectiveness of the intervention, along with satisfaction with the content, setting, and promotor. Participants' survey responses indicated that they were highly satisfied with the content, setting, and delivery of the brief intervention. In interviews participants noted that the brief intervention helped them reflect on their drinking behaviors, that they perceived promotores to be a trusted source of health information, and that they liked receiving personalized feedback via tablets. Some participants found the feedback did not match their own perceptions of their alcohol use and wanted clearer advice on how to reduce their drinking. Men felt they would benefit from more contact with promotores. These findings suggest that Latino immigrant men in this study were receptive to the culturally adapted brief intervention. Future interventions may be more effective if they include multiple contacts with promotores and more directive guidance on strategies to reduce drinking.

Gender Norms, Roles and Relations and Cannabis-Use Patterns: A Scoping Review

Currently, boys and men use cannabis at higher rates than girls and women, but the gender gap is narrowing. With the legalization of recreational cannabis use in Canada and in multiple US states, these trends call for urgent attention to the need to consider how gender norms, roles and relations influence patterns of cannabis use to inform health promotion and prevention responses. Based on a scoping review on sex, gender and cannabis use, this article consolidates existing evidence from the academic literature on how gender norms, roles and relations impact cannabis-use patterns. Evidence is reviewed on: adherence to dominant masculine and feminine norms and cannabis-use patterns among adolescents and young adults, and how prevailing norms can be both reinstated or reimagined through cannabis use; gendered social dynamics in cannabis-use settings; and the impact of gender roles and relations on cannabis use among young adults of diverse sexual orientations and gender identities. Findings from the review are compared and contrasted with evidence on gender norms, roles and relations in the context of alcohol and tobacco use. Recommendations for integrating gender transformative principles in health promotion and prevention responses to cannabis use are provided.

Prevalence of, Factors Associated with and Level of Dependence of Psychoactive Substance Use among Mekelle University Students, Ethiopia

Background: Psychoactive substance use is a major public health concern globally. Though youth attending higher education institutions are considered particularly vulnerable to psychoactive substances, there is a paucity of evidence in Ethiopia. We aimed to determine the prevalence of psychoactive substance use, factors associated with psychoactive substance use and level of dependence among Mekelle University undergraduate students in Ethiopia. Methods: An institution-based quantitative cross-sectional survey was used to randomly (using multistage sampling) invite 1220 undergraduate students in April and May 2017 to participate. Multinomial logistic regression was used to identify factors associated with psychoactive substance use. Level of dependence was determined using the WHO’s Alcohol, Smoking and Substance Involvement Screening Test classification. Results: Among the eligible students approached, 1214 participants completed the survey, which yields a 99.5% response rate. The lifetime prevalence of psychoactive substance use was 66.5% (95% Confidence Interval (CI) = 64% to 69%) while the current prevalence was 49% (95% CI = 46% to 52%). A history of, but not current, psychoactive substance use was reported by 18%, while 33.5% reported never having used psychoactive substances. The current prevalence of alcohol use was 35.5%, tobacco 7.8% and khat 5.7%. Of the current users, 17% (95% CI = 14% to 20%) were at a moderate to high risk of dependency. Being over 21 years of age (adjusted odds ratio (AOR) = 1.6, 95% CI = 1.37 to 2.25), male (AOR = 3.13; 95% CI = 2.26 to 4.34), living in urban areas (AOR = 2.39, 95% CI = 1.77 to 3.23), an Orthodox Christian (AOR = 7.55, 95% CI = 4.56 to 12.48), and being in their 3rd year (AOR = 2.3, 95% CI = 1.49 to 3.55), 4th year (AOR = 2.0, 95% CI = 1.2 to 3.51) and 5th year (AOR = 4.0, 95% CI = 2.81 to 7.67) at university were associated with currently using psychoactive substances. Being male and Orthodox Christian was associated with being an ex-smoker. Conclusions: Approximately half of Mekelle University undergraduate students were using psychoactive substances with almost one in five at risk of dependency. The likelihood of use increased with seniority. Evidence-based strategies are needed to prevent school-aged children from using psychoactive substances and university students becoming dependent on substances. Interventions designed to stop current psychoactive substance use may also have promise for reducing dependency.

Traditional gender roles and alcohol use among Latinas/os: A review of the literature

Research indicates alcohol use among Latinas/os occurs within a gendered context. Scholars surmise this is due to traditional gender roles (TGRs) of Latina/o culture, but without an analysis of the literature these assertions are unclear. Thus, this article provides a narrative review of the extant TGRs and alcohol use literature among Latinas/os. Thirteen articles met inclusion criteria. Across studies, findings were mixed, aside from those suggesting TGRs composed of hypermasculinity (i.e., traditional machismo) were robustly related to drinking. Tests of mediation and moderation indicated TGRs and alcohol use should be assessed within a multivariate framework. Future research should address these inconsistencies through methodological refinements. In addition, we suggest the integration of existing theoretical perspectives to assist with scholarly development in this area.

Factors associated with tobacco, alcohol, and other drug use among youth living in West Central Mexico

AIM

To determine the prevalence of drug and substance abuse among high school students in Jalisco and its association with the severity of health, behavior and psychosocial problems in order to provide evidence for possible prevention and treatment needs.

METHODS

A multi-stage random sample of Jalisco high school students was given a paper-and-pencil survey based upon an adapted version of the drug use screening inventory (DUSI) (n = 24699; n = 2832). The DUSI showed adequate psychometric characteristics in this population. The statistical analyses accommodated the complex survey design with attention to unequal probability of selection and clustering of participants within schools and regions.

RESULTS

An estimated 44% of the students had smoked tobacco, one in five students was a current smoker, and one in four students used to smoke but had not smoked for one year or more. By contrast, 6.8% of the students reported having used marijuana, cocaine, or both. Behavioral problems, deviant peer affiliation, and troubled families were independently associated with drug use. One in two students who used tobacco or alcohol had used these drugs in the past year (46% and 54%, respectively), and one in four students who used marijuana or cocaine in their lifetime had used those drugs in the past year (28% in both cases).

CONCLUSION

The rates of cocaine use as well as the proportion of current users were higher than expected among high school students and indicate changing patterns of drug use in Mexico. These results corroborate that the general trend of drug use by youth in Mexico is increasing. Results from this study help us better understand the needs of at-risk youth and the need for new treatment and prevention strategies.

A Tale of Two Stories: An Exploration of Identification, Message Recall, and Narrative Preferences Among Low-Income, Mexican American Women

Additional research is needed to guide the design of narratives for use in practice-oriented, naturalistic settings to maximize health behavior change, particularly among populations affected by health disparities. This mixed-methods study explored the influence of cultural tailoring and emotional arousal on identification and message recall in narratives promoting childhood obesity prevention among 40 Mexican American mothers. Participants were also asked about narrative exposure, narrative preferences, and beliefs about the purpose of a story. Participants were randomly assigned to listen to two stories: (a) a story tailored on noncultural or cultural variables, and (b) a story designed to enhance or minimize emotional arousal. Participants reported high engagement and identification with all stories. Participants generally envisioned protagonists as Latina, despite limited cues, and identified with protagonists in four ways: sharing personal characteristics; having similar thoughts and feelings; engaging in similar actions; and experiencing similar situations. Mothers were most interested in narratives that helped them to improve their lives. Findings from this study yield several hypotheses for consideration in future study, including ways in which story setting and message enactment may moderate message recall.

Depressive symptom domains and alcohol use severity among Hispanic emerging adults: Examining moderating effects of gender

OBJECTIVE

A limited amount of research has examined the effects of unique depressive symptom domains on alcohol use behavior among Hispanics of any developmental stage. This study aimed to (a) examine the respective associations between depressive symptom domains (e.g., negative affect, anhedonia, interpersonal problems, and somatic complaints) and alcohol use severity among Hispanic emerging adults, and (b) examine if gender moderates each respective association.

METHOD

181 Hispanic emerging adults (ages 18-25) completed an anonymous cross-sectional online survey. Participants completed a demographic questionnaire, the Alcohol Use Disorder Identification Test, and the Center Epidemiological Studies Depression Scale. Hierarchical multiple regression was used to estimate respective associations of negative affect, anhedonia, interpersonal problems, and somatic complaints in relation to alcohol use severity. Moderation tests were also conducted to examine if gender functioned as an effect modifier between respective depressive symptom domains and alcohol use severity.

RESULTS

Findings indicated higher levels of anhedonia were associated with higher alcohol use severity (β=0.20, p=0.02). Moderation analyses indicated that somatic complaints (β=-0.41, p=0.02) and interpersonal problems were associated with greater alcohol use severity among men (β=-0.60, p<0.001), but not women.

CONCLUSIONS

Findings underscore the need to examine the relationship between specific depressive symptom domains and alcohol use; and the importance of accounting for potential gender differences in these associations.

Depression in the barrio: An analysis of the risk and protective nature of cultural values among Mexican American substance users

Understanding the effect of cultural values on depression and how social networks influence these relationships may be important in the treatment of substance-using, Mexican American populations. Latino cultural values, familismo, personalismo, fatalismo, and machismo, may be associated with depression among Latinos. The current study identified the association of traditional Latino values on depressive symptomatology among a sample of Mexican American heroin injectors. A cross-sectional research design and field-intensive outreach methodology were utilized to recruit 227 Mexican American men. Participants were categorized into depressed and nondepressed groups. Relations among cultural values and depression were examined using logistic regression. Findings indicate that drug-using men with higher familismo and fatalismo scores are protected against depressive symptomatology. Relations between familismo and depression seem to be moderated by having a drug use network. In addition, findings reveal that age is inversely related to depressive symptomatology. Young Mexican American heroin users who do not ascribe to traditional Latino values may be highly associated with depression and therefore more vulnerable to riskier drug use behaviors. Moreover, drug-using social networks may affect the protective nature of certain cultural values. Further research is needed to identify whether culturally tailored treatments can cultivate these values while simultaneously undermining the effect of substance-using social networks in order to reduce depression symptoms among this group of high-risk substance users.

A systematic review of the salient role of feminine norms on substance use among women

AIMS

Substance use among women is a growing and significant public health concern. Given women's vulnerability to substance-use related consequences, it is essential to understand the factors that explain within-group variability in substance use and related problems. Feminine norms, or the beliefs and expectations of what it means to be a woman, appear to be a promising and theoretically-important social determinant of substance use. The present systematic review identifies the current trends and limitations of research examining feminine norms and substance use outcomes among women.

METHODS

A systematic review was conducted for peer-reviewed, full-text journal articles written in English published between 2000-2015. Articles that fit the following inclusion criteria: a) use of a feminine norms/ideology or feminine role conflict measure, b) sampling women with a mean age of 15 or higher, and c) quantitative, were included.

RESULTS

Twenty-three eligible studies were identified. Many women engaged in heavy episodic drinking or were classified as high-risk drinkers. Seventy-four percent of the studies detected a significant relationship between feminine norms and substance use, of which 52% of the studies reviewed reported the harmful role of feminine norms as conferring risk for alcohol use. In addition to substance use risk, women who more strongly endorsed traditional feminine norms were more likely to report concomitant chronic diseases and eating disorder behavior.

CONCLUSION

The systematic review highlights that femininity appears to play a distinct and significant role in explaining within-group differences and patterns of substance use among women.

Discrimination, Racial/Ethnic Identity, and Substance Use Among Latina/os: Are They Gendered?

BACKGROUND

Prior research suggests that stronger racial/ethnic identification offsets negative effects of discrimination on substance use. Yet research in this area and on whether gender modifies this association is limited for Latina/os.

PURPOSE

The purpose of the present study is to examine whether different sources of discrimination (everyday and racial/ethnic) are associated with substance use (alcohol use disorder, smoking), if racial/ethnic identity buffers this association, and the potential moderating role of gender among these variables.

METHODS

We present cross-sectional, US population-based data from the Latina/o adult sample (1427 females and 1127 males) of the National Latino and Asian American Study. Respondents completed self-reported measures of everyday and racial/ethnic discrimination, racial/ethnic identity, smoking status, and Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) lifetime alcohol use disorder.

RESULTS

Weighted logistic regression analyses showed that before inclusion of three-way interactions and adjusting for covariates, everyday discrimination predicted increased risk for any DSM-IV lifetime alcohol use disorders. Moderation analyses revealed that the effect of everyday discrimination on the risk of being a current smoker was strongest for Latino men with high levels of racial/ethnic identity compared to those with low racial/ethnic identity. No differences were noted among Latino women. There were no main or interaction effects of racial/ethnic discrimination for any substance use outcome.

CONCLUSIONS

Findings suggest differential associations for type of discrimination and outcome and that the role of racial/ethnic identity is gender-specific for smoking, appearing particularly detrimental for Latino men reporting high levels of racial/ethnic identity.

Patterns of Unhealthy Alcohol Use among Latino Day Laborers

OBJECTIVE

We sought to describe patterns of unhealthy alcohol use among Latino immigrant day laborers and identify correlates of these behaviors.

METHODS

Participants (N = 104) completed surveys on substance use, alcohol-related problems, mental health, and demographics. We assessed differences in unhealthy alcohol use by subject characteristic using chi-square tests of independence and 2-sample tests of proportions.

RESULTS

Unhealthy alcohol use was common with 65% having an AUDIT score of 8 or higher. Living situation and income were significantly associated with unhealthy alcohol use and high levels of depression and anxiety were associated with increased alcohol-related problems.

CONCLUSIONS

Interventions to reduce unhealthy alcohol use should consider the role of stable housing, income and mental health.

Life events, genetic susceptibility, and smoking among adolescents

Although stressful life events during adolescence are associated with the adoption of unhealthy behaviors such as smoking, both social circumstances and physical traits can moderate the relationship. This study builds on the stress paradigm and gene-environment approach to social behavior by examining how a polymorphism in the serotonin transporter gene 5-HTTLPR moderates the effect of life events on adolescent smoking. Tests of interaction hypotheses use data from the Family Transitions Project, a longitudinal study of 7th graders followed for 5years. A sibling-pair design with separate models for the gender composition of pairs (brothers, sisters, or brother/sister) controls for unmeasured family background. The results show that negative life events are significantly and positively associated with smoking. Among brother pairs but not other pairs, the results provide evidence of gene-environment interaction by showing that life events more strongly influence smoking behavior for those with more copies of the 5-HTTLPR S allele.

Short-term effects on substance use of the keepin' it real pilot prevention program: linguistically adapted for youth in Jalisco, Mexico

This article presents the short-term effects of a pilot study of keepin'it REAL (Manténte REAL) conducted in central Mexico by a binational team of investigators. This middle school-based model program for preventing substance use was adapted for Mexico linguistically but not culturally. Two Guadalajara public middle schools were recruited and randomly assigned to either implement the prevention program or serve as a control site. The program was implemented in the treatment site by the students' regular teachers, who were trained by the research team. Seventh graders in ten classrooms in the treatment and control schools (N = 432) completed a pretest and posttest survey in Spanish similar to the survey utilized in the original efficacy trial of keepin'it REAL in the US. T-tests and OLS regressions were conducted to determine the effects of the intervention on substance use outcomes. Differences between treatment and control groups in frequency of use of alcohol and tobacco, the two substances of choice in this sample, were significant and in the desired direction. Differences in amount of use were also in the preferred direction but were not significant for alcohol and only marginally significant for tobacco. When the sample was split by gender, statistically significant treatment effects remained for females but were not observed among males. Effects of the linguistically adapted version of keepin'it REAL appears to be driven by the change in female use; however, the difference in male and female outcomes was not statistically significant. Implications for cultural adaptation and prevention in Mexico are discussed from a communication competency perspective. The promising results of the pilot study suggest that the linguistic adaptation was effective, but that a comprehensive cultural adaptation of keepin'it REAL in partnership with Mexican investigators and communities may be warranted.

Blood is thicker than booze: Examining the role of familism and gender in alcohol use and related consequences among Hispanic college students

The present study evaluated cultural, ethnic, and gender differences in drinking and alcohol-related problems among Hispanic students. Familism protects against negative outcomes in Hispanic populations, thus we expected familism to buffer against alcohol problems. Participants (N = 623; 53% female) completed a battery of measures. Results suggested that familism was protective against drinking. Furthermore, alcohol use mediated the association between familism and alcohol-related problems. In sum, understanding that culture plays an important role in people's behaviors and identifying protective factors is critical to inform culturally sensitive prevention and intervention efforts.

The relationship between ethnic-racial socialization and adolescent substance use: An examination of social learning as a causal mechanism

The presence of parental socialization messages relevant to a child's race/ethnicity--ethnic-racial socialization (ERS)--have been found to be an important predictor of developmental outcomes. However, scholars have recently called for greater theoretical clarification, citing the need for better understanding of how the effects of ethnic-racial socialization messages differ by dimension and what causal mechanisms underlie this relationship. Using survey data from 269 Southern California high school students, this study tested a theoretical model examining how 3 dimensions of ERS differentially relate to adolescent substance use, and how much these links are mediated by peer substance use social learning (Akers, 2009). Using structural equation modeling, we cross-sectionally and longitudinally tested the pathways between ERS and peer substance use social learning and between peer social learning and substance use. We found that 2 of the 3 dimensions of ERS were related to substance use. Cultural socialization was associated with lower substance use, and promotion of mistrust was associated with greater substance use. Both effects were indirect and mediated by peer substance use social learning. These results were replicated in a separate analysis of the largest ethnic subsample (Latinos). Ethnic-racial socialization messages that stress pride in one's ethnic group and the development of one's ethnic identity (cultural socialization) may be a protective factor against future substance use by inhibiting the association with substance-using peers, whereas messages that stress distrust of other ethnic groups (promotion of mistrust) may be a risk factor against future substance use by promoting the association with substance-using peers.

The association between engaging in romantic relationships and Mexican adolescent substance use offers: exploring gender differences

Gender differences in alcohol, tobacco, and other drugs use in Mexico are rapidly disappearing. This study explores the possible relationship between engaging in romantic relationships on substance use offers and the moderating effects of gender among a group of adolescents (N = 432) living in Guadalajara, Jalisco, Mexico. The data used to test these relationships were collected through self-administered surveys in 2010. OLS regressions were estimated, predicting substance offers. The results demonstrate an association between having been in a relationship and receiving substance use offers in the previous 12 months. Having had a boyfriend/girlfriend had a significant influence on the offers received by adolescent females, but not for males.

Vida PURA: A Cultural Adaptation of Screening and Brief Intervention to Reduce Unhealthy Drinking Among Latino Day Laborers

BACKGROUND

Brief intervention is known to reduce drinking in primary care; however, because health care access is limited for Latino immigrants, traditional brief interventions are unlikely to reach this population.

METHODS

Using Barrera and Castro's framework, our study aims to culturally adapt a screening and brief intervention program to reduce unhealthy alcohol use among Latino day laborers, a particularly vulnerable group of Latino immigrant men. We conducted 18 interviews with Latino day laborers and 13 interviews with mental health and substance use providers that serve Latino immigrant men. Interviews were conducted until saturation of themes was reached. Themes from interviews were used to identify sources of mismatch between traditional screening and brief intervention in our target population.

RESULTS

Unhealthy alcohol use was common, culturally accepted, and helped relieve immigration-related stressors. Men had limited knowledge about how to change their behavior. Men preferred to receive information from trusted providers in Spanish. Men faced significant barriers to accessing health and social services but were open to receiving brief interventions in community settings. Findings were used to design Vida PURA, a preliminary adaptation design of brief intervention for Latino day laborers. Key adaptations include brief intervention at a day labor worker center provided by promotores trained to incorporate the social and cultural context of drinking for Latino immigrant men.

CONCLUSIONS

Culturally adapted brief intervention may help reduce unhealthy drinking in this underserved population.

The impact of religiosity on suicidal ideation among youth in central Mexico

Although over 100 years of research has been dedicated to understanding the connection between religiosity and suicide, many questions still remain. This is especially true among adolescent populations in countries outside the US. In 2008, over 700 students attending eight alternative high school centers in central Mexico completed a health survey designed to provide a comprehensive overview of their physical, mental, spiritual, and emotional health. This article reports on the findings of a secondary analysis study of those data and focuses on the protective influence of religiosity on suicidal ideation. The findings of this study are discussed in light of the network theory's assertion that there is a belonging aspect to religion, and also to the idea that in religiously homogeneous communities of Mexico, religion can have a protective effect on the suicidal ideation of its members.

Influence of gender role attitudes on smoking and drinking among girls from Jujuy, Argentina

OBJECTIVE

Evaluate effect of gender role attitudes on tobacco and alcohol use among Argentinean girls.

METHOD

Cross-sectional survey of 10th grade students attending 27 randomly selected schools in Jujuy, Argentina. Questions about tobacco and alcohol use were adapted from global youth surveys. Five items with 5-point response options of agreement-disagreement assessed attitude towards egalitarian (higher score) gender roles.

RESULTS

2133 girls, aged 13-18 years, 71% Indigenous, 22% mixed Indigenous/European, and 7% European responded. Of these, 60% had ever smoked, 32% were current smokers, 58% ever drinkers, 27% drank in previous month, and 13% had ≥5 drinks on one occasion. Mean response to the gender role scale was 3.49 (95% Confidence Intervals = 3.41-3.57) out of 5 tending toward egalitarian attitudes. Logistic regression models using the gender role scale score as the main predictor and adjusting for demographic and social confounders showed that egalitarian gender role was associated with ever smoking (Odds Ratio = 1.25; 95% Confidence Intervals 1.09-1.44), ever drinking (Odds Ratio = 1.24; 95% Confidence Intervals 1.10-1.40), drinking in prior month (Odds Ratio = 1.21; 95% Confidence Intervals 1.07-1.37) and ≥5 drinks on one occasion (Odds Ratio = 1.15; 95% Confidence Intervals 1.00-1.33), but was not significant for current smoking.

CONCLUSION

Girls in Jujuy who reported more egalitarian gender role attitudes had higher odds of smoking or drinking.

Adolescents' experiences of a strengths-based treatment program for substance abuse

Substance abuse is a growing issue among adolescents. While not every adolescent who struggles with this issue seeks treatment, those who do frequently fail to complete treatment or tend to relapse following treatment. To improve adolescent treatments for substance abuse issues it is important to understand adolescent experiences while in treatment, along with the factors that contribute to positive treatment outcomes. Qualitative methods were used to examine 52 post-treatment interviews conducted with adolescents following their completion of a five-week strengths-based residential program for substance use issues. The adolescent narratives were analyzed to answer three research questions: (1) what aspects of the treatment program were found to be most helpful by youth, (2) which specific strengths did youth identify to be the most helpful throughout the treatment process and in beginning to overcome their substance use issues, and (3) did youth begin to adopt strengths-based thinking strategies over the course of treatment? Results include descriptive answers to these questions based on common themes across participant responses. Implications for future research are discussed.

Gender differences in the relationship between discrimination and substance use disorder among Latinos

Using data from the National Latino and Asian American Study collected in 2002-2003 (N = 2,554), we assessed the adjusted odds of lifetime substance use disorder (SUD) associated with report of both unfair treatment and racial/ethnic discrimination. Among men, SUD was increased for those reporting low, moderate, and high levels of unfair treatment compared to those reporting no unfair treatment and patterns were similar for racial/ethnic discrimination. Among women, only those reporting high levels of unfair treatment were at increased risk of lifetime SUD and no associations were observed between racial/ethnic discrimination and lifetime SUD. Future research should examine the role that discrimination plays in the development of substance misuse among Latinos.

Drug resistance and substance use among male and female adolescents in alternative secondary schools in Guanajuato, Mexico

OBJECTIVE

Research is limited on the strategies that Mexican adolescents use to resist use of alcohol, cigarettes, and other drugs. Cultural norms and gender socialization patterns concerning the acceptability of use of various substances by women and men influence Mexican youths in their responses to offers of substances. This study explored the drug-resistance strategies used by youth in the central Mexican state of Guanajuato, how their use predicted patterns of substance use, and how these associations differed by gender.

METHOD

The analysis used cross-sectional survey data from 702 (60% male) students enrolled in eight alternative secondary education school sites in 2007. Participants reported the drug-resistance behaviors they used to deal with offers of alcohol, cigarettes, and marijuana. Past-12-month use of the four drug-resistance strategies employed most often by U.S. youth-refuse, explain, avoid, and leave (R.E.A.L.)-and any other strategies were measured. Composite measures of lifetime and recent use of alcohol, cigarettes, and marijuana were predicted in multivariate ordinary least squares regression analyses. Models were tested with and without controls for the frequency that respondents were offered substances and introduced gender interaction effects.

RESULTS

Controlling for substance use offers, more frequent use of a wide repertoire of R.E.A.L. strategies predicted less consumption of alcohol and cigarettes, and using non-R.E.A.L. strategies predicted less marijuana consumption. All of these relationships were either stronger for males than for females or significant for males only.

CONCLUSIONS

Gender differences exist in the impact of R.E.A.L. strategies on substance use among youth in Mexico. Despite a narrowing gender gap in substance use in Mexico, large exposure to and susceptibility of substance use remains. Developing effective prevention programs in Mexico based on teaching appropriate drug-resistance strategies and enhancing communication skills could aid in reducing substance use among Mexican adolescents.

Experiences of parents of substance-abusing young people attending support groups

Background

Substance abuse puts a burden on the physical and mental health and well-being of individuals and their families, particularly parents. Parents of substance-abusing young people are in need of professional or informal support and information. Potential and easy accessible sources are support groups. We explored the experiences of parents of substance-abusing young people attending support groups regarding several topics related to the substance-abuse of their son or daughter, the impact on their lives and their views on social support.

Methods

In this small-scale qualitative study based on in-depth interviews, we interviewed parents of substance-abusing young people focusing on their experiences concerning having a substance-abusing relative and attending the support group.

Results

All parents displayed feelings of stress and strain. They appeared to be highly satisfied with their participation in a support group. The expert status and knowledge of the facilitator and the provision of accurate information in the support group was also much appreciated. They were however dissatisfied by the attitude and knowledge of their GP.

Conclusions

Our findings suggest that parents benefit from joining support groups, particularly in terms of emotional and social support and the practical information they received.

Understanding the gendered patterns of substance use initiation among adolescents living in rural, central Mexico

BACKGROUND

Little is known about the age of initiation and gender differences in substance use among adolescents in rural, central Mexico.

METHODS

The cross-sectional data were collected from students enrolled in the Videobachillerato (VIBA) (video high school) programme in Guanajuato, Mexico. Questionnaires asked students about the age at which they had used alcohol, cigarettes, or cannabis for the first time. Kaplan-Meier Survival Functions were used to estimate if males and females were significantly different in their cumulative probabilities of initiating substances over time.

RESULTS

On average, alcohol is initiated at 14.7 years of age, cigarettes at 15.1 years of age, and cannabis at 16.5 years of age. Over time, males had a significantly higher probability of initiating alcohol (Kaplan-Meier Failure Curve: X(2)=26.35, p<0.001), cigarettes (Kaplan-Meier Failure Curve: X(2)=41.90, p<0.001), and cannabis (Kaplan-Meier Failure Curve: X(2)=38.01, p<0.001) compared to females.

CONCLUSIONS

These results highlight the gendered patterns of substance use initiation among adolescents in rural, central Mexico and underscore the need for gendered substance use prevention interventions with these adolescents. By putting forth efforts to understand substance use initiation patterns of adolescents living in rural, central Mexico, culturally specific and efficacious prevention efforts can be tailor-made to create lasting differences.

Religiosity and adolescent substance use in central Mexico: exploring the influence of internal and external religiosity on cigarette and alcohol use

This study explores the multidimensional nature of religiosity on substance use among adolescents living in central Mexico. From a social capital perspective, this article investigates how external church attendance and internal religious importance interact to create differential pathways for adolescents, and how these pathways exert both risk and protective influences on Mexican youth. The data come from 506 self-identified Roman Catholic youth (ages 14-17) living in a semi-rural area in the central state of Guanajuato, Mexico, and attending alternative secondary schools. Findings indicate that adolescents who have higher church attendance coupled with higher religious importance have lower odds of using alcohol, while cigarette use is lower among adolescents who have lower church attendance and lower religious importance. Adolescents are most at risk using alcohol and cigarettes when church attendance is higher but religious importance is lower. In conclusion, incongruence between internal religious beliefs and external church attendance places Mexican youth at greater risk of alcohol and cigarette use. This study not only contributes to understandings of the impact of religiosity on substance use in Mexico, but highlights the importance of understanding religiosity as a multidimensional phenomenon which can lead to differential substance use patterns.

Gender roles and substance use among Mexican American adolescents: a relationship moderated by acculturation?

This research assesses the effects of adaptive/ maladaptive gender roles and acculturation in predicting substance use in a 2007 sample of 1466 Mexican American seventh-grade adolescents from Phoenix, Arizona, U.S.A. Multiple regression analyses found significant effects for both adaptive and maladaptive gender roles, as well as several gender-specific interactions between gender roles and linguistic acculturation that predicted substance use. Limitations of the research are noted, as well as implications for understanding the impact of acculturation on how gender roles differentially affect substance use in Mexican American boys versus girls.

Direct and mediated effects of nativity and other indicators of acculturation on Hispanic mothers' use of physical aggression

This study used data from 845 foreign-born (n = 328) and native-U.S. born (n = 517) Hispanic mothers who participated in the Fragile Families and Child Wellbeing Study (FFCWS) to examine four indicators of acculturation--nativity, years lived in the United States, religious attendance, and endorsement of traditional gender norms--as predictors of maternal physical aggression directed toward young children. The authors also examined whether psychosocial risk factors associated with child maltreatment and acculturation--maternal alcohol use, depression, parenting stress, and intimate partner aggression and violence--mediate relationships between acculturation and maternal aggression. Foreign-born Hispanic mothers had significantly lower rates of physical aggression than native-born Hispanic mothers. In path modeling results, U.S. nativity, along with maternal alcohol use, parenting stress, and child aggressive behavior, emerged as the strongest risk factors for maternal physical aggression. Among the four acculturation indicators, only foreign birth was directly associated with lower maternal aggression. Study findings suggest immigrant status is a unique protective factor that contributes to lower levels of physical aggression among Hispanic mothers.

THE MODERATING EFFECTS OF ETHNIC IDENTIFICATION ON THE RELATIONSHIP BETWEEN PARENTAL MONITORING AND SUBSTANCE USE IN MEXICAN HERITAGE ADOLESCENTS IN THE SOUTHWEST UNITED STATES

The purpose of this study was to assess the combined effects of ethnic identification and perceived parental monitoring on the substance use of a sample of 162 male and 192 female Mexican heritage seventh grade adolescents. Parental monitoring predicted lower risk for substance use. An interaction of ethnic identification by parental monitoring was observed with parental monitoring exhibiting stronger effects in decreasing use of alcohol use among boys who scored low on ethnic identification. For girls, decreased substance use was predicted by stronger parental monitoring coupled with high ethnic identification. Results are discussed in terms of how the youth's ethnic identification is a distinct process from acculturation, and how ethnic identification may operate as an added protective factor in conjunction with parental monitoring, as protective factors against adolescent substance abuse.

Gender differences in drug resistance skills of youth in Guanajuato, Mexico

Research is limited or absent on Mexican adolescents' exposure to substance offers, ways of dealing with these offers, and possible gender differences in responses to offers. Extending U.S.-based research, this study examines how youth living in the Mexican state of Guanajuato employ the four drug resistance strategies-refuse, explain, avoid, and leave-that are part of the Keepin' It REAL evidence-based drug prevention intervention. The analysis uses cross-sectional survey data from 702 students enrolled in eight alternative secondary education sites in 2007. Participants reported the drug resistance behaviors they used to deal with offers of alcohol, cigarettes, and marijuana. Using multivariate regression, findings indicate most youth had developed repertoires of drug resistance strategies that involved multiple REAL strategies and some other strategy as well. For those receiving offers, the most common strategy was to refuse the offer with a simple "no." However, males used all the strategies significantly more often than females for situations involving cigarettes and marijuana as well as when using refuse and non-REAL strategies for alcohol. Possible reasons for the gender difference in use of strategies are discussed. The findings can help inform effective prevention programs based on teaching culturally appropriate drug resistance and communication skills.

The Influence of Linguistic Acculturation and Gender on the Initiation of Substance Use Among Mexican Heritage Preadolescents in the Borderlands

This article examined the impact of linguistic acculturation and gender on the substance use initiation of a sample of 1,473 Mexican heritage preadolescents attending 30 public schools in Phoenix, Arizona. It was hypothesized that linguistic acculturation operates differently as a risk or protective factor for young children than for older youth. The study used discrete-time event history methods to model the rate at which nonusing children initiate substance use. Alcohol, cigarettes, marijuana, and inhalants were studied separately while inhalant use was examined more closely. Results suggested that while linguistic acculturation is a risk factor for Mexican heritage preadolescents, this association depended on gender, the linguistic acculturation context (family, friends, or media), and the type of substance. For inhalants, higher linguistic acculturation with friends was inversely associated with drug initiation both for boys and girls. Implications for preventive science and future intervention research are discussed.

Cultural values associated with substance use among Hispanic adolescents in southern California

Cultural values can shape people's attitudes toward substance use and influence their risk of experimentation with drugs. This article examines the relationships between cultural values (familism, respeto, and machismo), fatalism (a culturally encouraged personality disposition), and substance use among Hispanic adolescents. In 2005, cross-sectional data were collected from 1,616 Hispanic ninth grade students in Los Angeles. Each cultural value was associated with lifetime substance use; however, these relationships depended on the type of substance and gender. Our findings suggest that it might be useful to incorporate the cultural values and address the personality trait of fatalism in prevention programs for Hispanic adolescents. The study's limitations are noted.

Survey Response Styles, Acculturation, and Culture Among a Sample of Mexican American Adults

A number of studies have investigated use of extreme (ERS) and acquiescent (ARS) response styles across cultural groups. However, due to within-group heterogeneity, it is important to also examine use of response styles, acculturation, and endorsement of cultural variables at the individual level. This study explores relationships between acculturation, six Mexican cultural factors, ERS, and ARS among a sample of 288 Mexican American telephone survey respondents. Three aspects of acculturation were assessed: Spanish use, the importance of preserving Mexican culture, and interaction with Mexican Americans versus Anglos. These variables were hypothesized to positively associate with ERS and ARS. Participants with higher Spanish use did utilize more ERS and ARS; however, value for preserving Mexican culture and interaction with Mexican Americans were not associated with response style use. In analyses of cultural factors, endorsement of familismo and simpatia were related to more frequent ERS and ARS, machismo was associated with lower ERS among men, and la mujer was related to higher ERS among women. Caballerismo was marginally associated with utilization of ERS among men. No association was found between la mujer abnegada and ERS among women. Relationships between male gender roles and ARS were nonsignificant. Relationships between female gender roles and ARS were mixed but trended in the positive direction. Overall, these findings suggest that Mexican American respondents vary in their use of response styles by acculturation and cultural factors. This usage may be specifically influenced by participants' valuing of and engagement with constructs directly associated with social behavior.

Gender Roles, Externalizing Behaviors, and Substance Use Among Mexican-American Adolescents

A sample of 60 male and 91 female Mexican-American adolescents (age 13-18) were administered measures of positive (i.e., assertive masculinity, affective femininity) and negative (i.e., aggressive masculinity, submissive femininity) gender roles, internalizing and externalizing problem behaviors, peer substance use, and own substance use (alcohol, cigarettes, marijuana). Negative gender roles were significantly correlated with internalizing and externalizing problems for both boys and girls, with aggressive masculinity also predicting peer substance use for both genders. Assertive masculinity significantly predicted lower alcohol use in boys, and this effect was not mediated by internalizing problems, externalizing problems, or peer substance use. Negative gender roles significantly predicted higher alcohol use in girls, but this effect was almost completely mediated by internalizing problems, externalizing problems, and peer substance use. Results are discussed in terms of gender role socialization among Mexican Americans.