The Role of Relational Harmony in the Use of Drug-Refusal Strategies of Rural Native Hawaiian Youths

Guam Adolescents' Use of Strategies to Resist Cigarette, e-Cigarette, and Betel Nut Offers: Findings from a Focus Group Study

Background: This study examined resistance strategies used by predominantly Pacific Islander young adolescents in response to offers of tobacco, e-cigarettes, and betel [areca] nuts. This study was intended to inform the development of a prevention curriculum focused on training young adolescents from the U.S.-Affiliated Pacific Islands (USAPI) on culturally appropriate strategies to resist substance use offers. Currently, very little is understood in terms of how Pacific Islander youths deal with tobacco and other substance use offers, although the use of tobacco products among Pacific Islander youths is high. Specifically, given the collectivist sociocultural orientation of the Pacific Islander communities, it is unclear whether the direct (overt) confrontational style of resistance is a viable mode of resistance for youths to practice when faced with a substance use offer. Methods: We conducted 10 focus groups with public middle school students (N = 34) from Guam, which is part of the USAPI. Results: Results suggested that, as with other communities in the U.S., the resistance strategies fall into two categories-overt/confrontational and non-confrontational resistance strategies. Overt/confrontational strategies included (a) saying "no" and (b) verbally confronting the offeror. Non-confrontational strategies included (a) avoiding or leaving the situation and (b) telling an adult. Conclusions: Our findings have implications for the development of culturally grounded interventions aimed at preventing youth tobacco and other substance use in Guam, the USAPI, and the Pacific region.

Tobacco use among native Hawaiian and Pacific Islander youth in the U.S. and USAPI: a systematic review of the literature

With rates of tobacco use among youth in the United States on the rise, further analysis of disproportionately impacted populations, like Native Hawaiian and other Pacific Islanders (NHPIs), is needed. NHPIs face a unique set of challenges compared to other ethnic minorities that contribute to their health disparities from tobacco use. This systematic literature review investigated empirical studies published between 2010-2020 on tobacco use among NHPI youth and young adults. Using comprehensive literature search engines and focused author searches of tobacco researchers in NHPI communities, 7,208 article abstracts were extracted for potential inclusion. Explicit inclusionary and exclusionary criteria were used to identify peer-reviewed articles related to tobacco use correlates and interventions for NHPI youth populations. A total of 17 articles met our criteria for inclusion in this study. Community influences, peer pressure, social status, variety of flavors, craving, and stimulation were correlates found in smoking and vaping for NHPI youth. There were also few published tobacco use prevention and intervention studies focused specifically on NHPI youth. Our study addresses the needs of an under-researched population that is heavily affected by the adverse consequences of short-term and long-term use of cigarettes and e-cigarettes. Additional research should focus on developing effective and culturally relevant interventions to reduce NHPI health disparities.

Emerging Adulthood Attributes, Discrimination, Mental Health, and Substance Use in a Sample of Asian, Native Hawaiian/Pacific Islander, and White College Students

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.

A Review of the Prevention of Drug Addiction: Specific Interventions, Effectiveness, and Important Topics

BACKGROUND

This study was a narrative review on prevention of addictive behaviors with an effort to clarify the major concepts of prevention and its dimensions.

METHODS

The PsycInfo and MedInfo databases were used to identify prevention. Α total of 65 articles were found 46 of which were included in the review. Τhe data were analyzed using content analysis.

FINDINGS

For a better understanding of the results, it was deemed advisable to categorize them into: (a) the types of major interventions and the theoretical approaches on which they were based, (b) the results of the review articles according to (1) variables and factors concerning the prevention proved important through the review and (2) a number of more general important topics which arose in the prevention of addictive behaviors.

CONCLUSION

The results highlighted the greater effectiveness of community-based programs, applied primarily in broader contexts but also secondarily in high-risk groups. Τhe results were discussed based on the combination of the emerged factors with each other and prevention experience.

Untangling the Complexities of Substance Use Initiation and Recovery: Client Reflections on Opioid Use Prevention and Recovery From a Social-Ecological Perspective

Background:

In Canada, the rate of opioid use, opioid use disorder (OUD), and associated mortality and morbidity are higher among Indigenous Peoples than the general population. Indigenous Peoples on medications for opioid use disorders (MOUD) often face distinct barriers that hinder their clinical progress, leading to treatment attrition.

Methods:

We used a social-ecological model to inquire into clients’ experiences with a history of treatment failure for OUD. We used exploratory qualitative research to engage 22 clients with a history of OUD treatment dropouts and who are currently on MOUD. In-depth, semi-structured interviews lasting an average of 30 minutes were conducted on-site.

Results:

We identified 4 themes from the study: (a) risk for substance use; (b) factors sustaining substance use; (c) factors leading to treatment, and (d) treatment failure and re-enrollment.

Conclusion:

Using a socio-ecological model helps to understand factors that influence an individual’s risk for OUD, decision to pursue treatment, and treatment outcomes. Furthermore, social ecological model also creates possibilities to develop supportive, multilevel interventions to prevent OUD risks and support for clients on MOUD. Such interventions include mitigating adverse childhood experiences, supporting families, and creating safe community environments.

Parental Support, Parent-Adolescent Conflict, and Substance Use of Native Hawaiian and Other Pacific Islander Youth: Ethnic Differences in Stress-Buffering and Vulnerability Effects

This research study examined the overall and ethnic-specific effects of parental emotional and instrumental support, parent-adolescent interpersonal conflict, and negative life events (i.e., major life stressors, such as parental job loss or school suspension) on the substance use of Caucasian, Asian-American, Filipino, and Native Hawaiian and other Pacific Islander (NHOPI) youth in Hawai'i. Adolescents (N = 3,561) from 10 public middle/intermediate schools completed paper/pencil surveys, and multiple regression and structural equation models were developed to examine overall and ethnic-specific effects. Parental support was found to buffer against the influence of negative life events on substance use in the overall sample; however, this effect was not observed for either Caucasian or NHOPI youth in ethnic-specific analyses. The impact of parent-adolescent conflict and negative life events on substance use was more pronounced for both Filipino and NHOPI youth. While the study may have had some limitations related to regional specificity and measurement, the findings nonetheless point to the differential effects of risk and protective factors for NHOPI youth, compared with other youth ethnic groups in Hawai'i. Implications of these findings for culturally specific, family-focused prevention research and practice for NHOPI youth are discussed.

The Validation of a School-Based, Culturally Grounded Drug Prevention Curriculum for Rural Hawaiian Youth

The purpose of this study was to validate a school-based, culturally grounded drug prevention curriculum for rural Native Hawaiian youth. Faculty and administrators from eight geographically dispersed middle-, intermediate-, or multilevel schools on Hawai'i island were interviewed on the cultural relevance and feasibility of implementation of the curriculum (Ho'ouna Pono). While all participants appreciated the culturally specific content interwoven throughout the curriculum's structure, several of them expressed concerns that the curriculum would compete with resources needed to implement Common Core national standards. Implications for the implementation, adoption, and sustainability of school-based prevention curricula are discussed.