1
|
Marshall SM, Saladino PA, An KJ, Song SD, Stephens TA, Carson AB, Chin SK, Okamura KH, Subica AM, Pokhrel P, Kaholokula JK, Okamoto SK. Adult Familial Influences on Rural Native Hawaiian and Pacific Islander Youths' E-Cigarette Use. Subst Use Misuse 2024:1-8. [PMID: 39164965 DOI: 10.1080/10826084.2024.2392540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
Background: Over the past decade, youth e-cigarette use has grown into a national epidemic, with Native Hawaiian and Pacific Islander (NHPI) youths' rates among some of the highest in the nation. Family factors significantly contribute to NHPI youths' decisions to engage in or resist substance use, yet few studies have specifically examined familial influences on NHPI youths' substance use decision-making and behaviors. Objective: The objective of this study is to examine adult familial influences on rural NHPI youths' decisions to engage in e-cigarette use. Method: Seventeen gender-specific focus groups with NHPI youths (N = 69) from eight public schools on Hawai'i Island were conducted. Results: Two family-related themes emerged from the data: 1) parental substance use permissiveness, and 2) family normalization of e-cigarette use. Conclusions: Examining adult familial contributors to NHPI youths' e-cigarette use needs to be part of a comprehensive effort to address NHPI health and substance use disparities. Prevention interventions should be explicit in addressing the family and relational context of NHPI youths' substance use.
Collapse
Affiliation(s)
- Sarah Momilani Marshall
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Paula Angela Saladino
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | - Katlyn J An
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | - Sarah D Song
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | - Tea A Stephens
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | - Adabelle B Carson
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | - Steven Keone Chin
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | - Kelsie H Okamura
- The Baker Center for Children and Families, Roxbury Crossing, Massachusetts, USA
| | - Andrew M Subica
- School of Medicine, University of California Riverside, Riverside, California, USA
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| | | | - Scott K Okamoto
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, Hawai'i, USA
| |
Collapse
|
2
|
Marshall SM, Lau S. Native Hawaiian and Pacific Islander Youth Substance Use Prevention in Rural Hawai'i. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2024; 83:144-146. [PMID: 38716140 PMCID: PMC11070780 DOI: 10.62547/duas8087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Affiliation(s)
- Sarah Momilani Marshall
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| | - Sophia Lau
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| |
Collapse
|
3
|
Swaminath M, Clayton HB, Lowry R, Hertz MF, Underwood JM. Health-Risk Behaviors and Experiences Among Asian American and Native Hawaiian/Pacific Islander Adolescents in the United States, 2011-2019. Public Health Rep 2023; 138:925-935. [PMID: 36633365 PMCID: PMC10576474 DOI: 10.1177/00333549221137325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Understanding the health-risk behaviors of racial and ethnic groups when disaggregated is an important step in improving the health outcomes of racial and ethnic minority groups. We compared national prevalence estimates for selected health-risk behaviors and experiences of Asian American and Native Hawaiian/Pacific Islander (NHPI) students with those of non-Hispanic White, non-Hispanic Black, and Hispanic students. METHODS We analyzed data from the Youth Risk Behavior Survey, a nationally representative survey of US high school students. To generate a sufficient sample of Asian American and NHPI students for analyses, we combined data from 5 survey administrations, conducted in 2011, 2013, 2015, 2017, and 2019 (N = 73 074). We calculated the prevalence and 95% CIs; we analyzed data on Asian American and NHPI adolescents separately to unmask important differences. RESULTS Compared with students of other races and ethnicities, Asian American students had the lowest prevalence of alcohol use (16.7%) and marijuana use (10.3%). In contrast, NHPI students were more likely than Asian American students to participate in several health-risk behaviors and experiences, such as substance use (ranging from 4.8% for ever injecting an illegal drug to 31.5% for current alcohol use), having been in a physical fight (15.4%), and having been threatened or injured with a weapon (11.6%). Differential patterns in the prevalence of ever having missed school due to feeling unsafe among NHPI and Asian American students were observed among male and female students. CONCLUSION Further disaggregating racial subgroups within broad categories of Asian American and NHPI populations may reveal differences from overall group prevalence, and additional strategies to identify these differences should be investigated.
Collapse
Affiliation(s)
- Meera Swaminath
- Department of Family Medicine and Public Health, University of California–San Diego, La Jolla, CA, USA
- Public Health Leader Fellowship Program, Morehouse College, Atlanta, GA, USA
| | - Heather B. Clayton
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard Lowry
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marci F. Hertz
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J. Michael Underwood
- Division of Adolescent and School Health, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
4
|
Lam EL, Kandula NR, Shah NS. The Role of Family Social Networks in Cardiovascular Health Behaviors Among Asian Americans, Native Hawaiians, and Pacific Islanders. J Racial Ethn Health Disparities 2023; 10:2588-2599. [PMID: 36329308 PMCID: PMC10154436 DOI: 10.1007/s40615-022-01438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Asian American, Native Hawaiians, and Other Pacific Islander (AANHPI) populations experience significant disparities in cardiovascular health. AANHPI populations also have strong, family-centered social relationships and networks. Since social networks may influence health behaviors, this review aimed to summarize research on the relationship between family social networks and cardiovascular health behaviors among AANHPI individuals. Current evidence suggests that family social network structures may play a particularly important role in smoking, dietary pattern, and physical activity behaviors among AANHPI individuals. Family networks may hinder or promote healthy behaviors through several social network mechanisms including social support, social influence, and social control. These effects vary across different AANHPI subgroups. Recommendations for future research on the role of social networks in health behaviors among AANHPI individuals are provided. Drawing on methodological advances and interventions that leverage social networks in AANHPI populations may be an avenue to improve health and reduce disparities.
Collapse
Affiliation(s)
- Emily L Lam
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, IL, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Namratha R Kandula
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Nilay S Shah
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| |
Collapse
|
5
|
Wills TA, Kaholokula JK, Pokhrel P, Pagano I. Ethnic differences in respiratory disease for Native Hawaiians and Pacific Islanders: Analysis of mediation processes in two community samples. PLoS One 2023; 18:e0290794. [PMID: 37624834 PMCID: PMC10456168 DOI: 10.1371/journal.pone.0290794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE The prevalence of asthma and chronic obstructive pulmonary disorder (COPD) is elevated for Native Hawaiians but the basis for this differential is not well understood. We analyze data on asthma and COPD in two samples including Native Hawaiians Pacific Islanders, and Filipinos to determine how ethnicity is related to respiratory disease outcomes. METHODS We analyzed the 2016 and 2018 Behavioral Risk Factor Surveillance Survey (BRFSS), a telephone survey of participants ages 18 and over in the State of Hawaii. Criterion variables were a diagnosis of asthma or COPD by a health professional. Structural equation modeling tested how five hypothesized risk factors (cigarette smoking, e-cigarette use, second-hand smoke exposure, obesity, and financial stress) mediated the ethnic differential in the likelihood of disease. Age, sex, and education were included as covariates. RESULTS Structural modeling with 2016 data showed that Native Hawaiian ethnicity was related to higher levels of the five risk factors and each risk factor was related to a higher likelihood of respiratory disease. Indirect effects were statistically significant in almost all cases, with direct effects to asthma and COPD also observed. Mediation effects through comparable pathways were also noted for Pacific Islanders and Filipinos. These findings were replicated with data from the 2018 survey. CONCLUSIONS Native Hawaiian and Pacific Islander ethnicity is associated with greater exposure to five risk factors and this accounts in part for the ethnic differential in respiratory disease outcomes. The results support a social-ecological model of health disparities in this population. Implications of the findings for preventive interventions are discussed.
Collapse
Affiliation(s)
- Thomas A. Wills
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| | - Joseph Keawe’aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, United States of America
| | - Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| | - Ian Pagano
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii, United States of America
| |
Collapse
|
6
|
Spencer SD, Pokhrel P, Helm S, Wilczek K, Galimov A, Sussman S. Emerging Adulthood Attributes, Discrimination, Mental Health, and Substance Use in a Sample of Asian, Native Hawaiian/Pacific Islander, and White College Students. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2023; 14:51-62. [PMID: 37362322 PMCID: PMC10289252 DOI: 10.1037/aap0000254] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Although Asian/Pacific Islanders are considered a single ethnic/racial category in national studies, Native Hawaiians/other Pacific Islanders (NHOPIs) and Asians show marked disparities in health outcomes and risk behaviors, including substance use. Currently, knowledge regarding the psychosocial mechanisms by which NHOPI ethnicity is associated with increased substance use, compared with Asian or White, is limited, especially among emerging adults. The present study tested a model in which the relationship between NHOPI ethnicity and higher substance use (i.e., current tobacco, alcohol, marijuana, and illicit drug use) was hypothesized to be mediated through higher emerging adulthood stress (e.g., feeling "in-between," instability), higher self-reported racial/ethnic discrimination, substance use in one's social networks, and poorer mental health symptomology (i.e., depression, anxiety). Data collected at a single time-point from 2,344 college students (M age = 21.2 [SD = 2.1]; 54% Women; 24% NHOPI, 49% Asian, 27% White) were analyzed by employing structural equation modeling. NHOPI and Asian ethnicity were dummy coded with reference to White, and separate analyses were run for NHOPI and Asian groups, with White as the reference group. Results indicated that the association between NHOPI ethnicity and higher substance use was mediated in two steps, via higher racial/ethnic discrimination and poorer mental health symptomatology. NHOPI ethnicity, but not Asian, was associated with higher identification with emerging adulthood attributes, which in turn was associated with increased substance use. Implications are discussed in the context of reducing health disparities faced by NHOPIs.
Collapse
Affiliation(s)
| | - Pallav Pokhrel
- University of Hawaiʻi Cancer Center, University of Hawaiʻi at Mānoa
| | - Susana Helm
- Department of Psychiatry, University of Hawaiʻi at Mānoa
| | | | - Arthur Galimov
- Department of Preventative Medicine, University of Southern California
| | - Steve Sussman
- Department of Preventative Medicine, University of Southern California
| |
Collapse
|
7
|
Mills R, Mann MJ, Smith ML, Kristjansson AL. Parental support and monitoring as associated with adolescent alcohol and tobacco use by gender and age. BMC Public Health 2021; 21:2000. [PMID: 34736436 PMCID: PMC8567647 DOI: 10.1186/s12889-021-12119-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parental support (PS) and parental monitoring (PM) are known protective factors against adolescent substance use (SU). However, little is known about whether PS and PM may affect SU outcomes differently by gender and age. This study examined the relationship between PS and PM and adolescent SU, specifically alcohol and tobacco use, stratified by gender and age group. METHODS Middle and high school students (n = 2351, 48.5% Female) completed surveys of self-reported SU, perceived PS and PM, and socioeconomic background. Age group was defined dichotomously as grade 7-8 Middle school and grade 9-10 High school students. PS and PM were each measured using previously validated tools. SU was measured by lifetime and past 30 days cigarette/alcohol use. One-way ANOVA and binary logistic regression models were completed. Odds ratios and means were reported. RESULTS PS and PM were significantly and negatively related to all outcome variables regardless of gender and age group. Mean differences in PS and PM were insignificant between age groups. Between genders, PM scores were significantly higher for girls (14.05) compared to boys (13.48) (p < 0.01). Odds Ratios of all four SU types (for alcohol and tobacco use) increased with higher age group, with ORs ranging from 1.45-2.61 (p < .05). CONCLUSIONS PS and PM were protective against SU for all participants, consistent with previous literature. Girls reported greater parental monitoring than boys, irrespective of age-group. While girls experienced higher levels of monitoring, they did not report lower SU than boys. This suggests that monitoring girls more closely than boys appears unnecessary in preventing adolescent SU. Finally, PS was a more significant factor in preventing SU for older adolescents (high school aged group) than for younger adolescents, irrespective of gender suggesting that PS may be more impactful and important as adolescents age. As children mature, particularly from middle school to high school, PS may play a larger role in preventing SU for older adolescents compared to younger ones.
Collapse
Affiliation(s)
- Rosalina Mills
- School of Public Health, West Virginia University, Morgantown, USA.
| | | | | | | |
Collapse
|
8
|
Huang CY, Nishioka SA, Zane NW, Uchigakiuchi P. Examining risk and protective predictors of substance use among low-income Native Hawaiian and Pacific Islander adolescents. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2021; 92:18-24. [PMID: 34516146 PMCID: PMC8831443 DOI: 10.1037/ort0000582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Substance use (SU) among adolescents is a critical public health concern that increases the risk for negative outcomes. Although Asian American (AA) adolescents tend to report low rates of SU, Native Hawaiian and Pacific Islander (NH/PI) adolescents often report significantly higher rates of use. Yet, NH/PI youth are seldom studied as a separate group. Consequently, little is known about the factors involved in SU among NH/PI adolescents and how to prevent it. This prospective study investigated the effect of ecological risk and protective factors at the individual, family, and school levels on SU for NH/PI adolescents. This prospective study utilized longitudinal data from 120 NH/PI adolescents who were7 part of an SU prevention program. Information was collected at two time points-Time 1 and Time 2 (32 weeks later)-and included adolescents' SU behaviors and individual, family, and school factors. The parents of these adolescents also provided data; all information was self-report. Positive academic attitudes at Time 1 were negatively associated with alcohol and other drug (e.g., marijuana) use at Time 2. Specifically, NH/PI adolescents who had more positive attitudes toward their school, peers, and teachers reported less alcohol and other SU. Prevention efforts may be most effective for NH/PI adolescents if addressed within the school context. This may include programs implemented in schools, utilizing teachers as role models, and/or promoting prosocial peer relationships to support positive behaviors. Additional implications are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
- Cindy Y. Huang
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Silvia A. Nishioka
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Nolan W. Zane
- Department of Psychology, Asian American Center on Disparities Research, University of California, Davis
| | - Patrick Uchigakiuchi
- Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa
| |
Collapse
|