Gender and acculturation in relation to alcohol use among Hispanic (Latino) adults in two areas of the northeastern United States

The Interactive Effect of Goal Attainment and Goal Importance on Acculturation and Well-Being

The purpose of the present research is to shed light on whether and when migrants’ goal pursuit relates to their acculturation and well-being. Previous research has demonstrated the beneficial role of striving for and attaining intrinsic goals on well-being. Yet, the relationship between the pursuit of intrinsic goals and acculturation has hardly been addressed. To fill this void, we investigated whether migrants’ acculturation and well-being can be seen as a function of their pursuit of intrinsic goals. We posited that the attainment of intrinsic goals would positively predict migrants’ level of acculturation and subsequent well-being, particularly when migrants deemed these goals to be important. We tested our hypotheses in two scenario studies and two surveys. In all four studies we confirmed our hypothesis that migrants’ intrinsic goal attainment and well-being is mediated by their acculturation level. However, in only two of the four studies did we find support for our hypothesis that the relationship between intrinsic goal attainment and acculturation is moderated by intrinsic goal importance. We discuss the theoretical implications and the practical consequences of our findings. Furthermore, we outline future research directions that could deepen our understanding of the relationship between migrants’ goal pursuit and their acculturation.

Affective decision-making moderates the effects of automatic associations on alcohol use among drug offenders

BACKGROUND

This study used a dual-process model of cognition in order to investigate the possible influence of automatic and deliberative processes on lifetime alcohol use in a sample of drug offenders.

OBJECTIVE

The objective was to determine if automatic/implicit associations in memory can exert an influence over an individual's alcohol use and if decision-making ability could potentially modify the influence of these associations.

METHODS

168 participants completed a battery of cognitive tests measuring implicit alcohol associations in memory (verb generation) as well as their affective decision-making ability (Iowa Gambling Task). Structural equation modeling procedures were used to test the relationship between implicit associations, decision-making, and lifetime alcohol use.

RESULTS

Results revealed that among participants with lower levels of decision-making, implicit alcohol associations more strongly predicted higher lifetime alcohol use.

CONCLUSION

These findings provide further support for the interaction between a specific decision function and its influence over automatic processes in regulating alcohol use behavior in a risky population. Understanding the interaction between automatic associations and decision processes may aid in developing more effective intervention components.

A Quantitative Analysis of Latino Acculturation and Alcohol Use: Myth Versus Reality

Research on health among Latinos often focuses on acculturation processes and the associated stressors that influence drinking behavior. Given the common use of acculturation measures and the state of the knowledge on alcohol-related health among Latino populations, the current analyses tested the efficacy of acculturation measures to predict various indicators of alcohol consumption. Specifically, this quantitative review assessed the predictive utility of acculturation on alcohol consumption behaviors (frequency, volume, and quantity). Two main analyses were conducted-a p-curve analysis and a meta-analysis of the observed associations between acculturation and drinking behavior. Results demonstrated that current measures of acculturation are a statistically significant predictor of alcohol use (Z = -20.75, p < 0.0001). The meta-analysis included a cumulative sample size of 29,589 Latino participants across 31 studies. A random-effects model yielded a weighted average correlation of 0.16 (95% confidence interval = 0.12, 0.19). Additional subgroup analyses examined the effects of gender and using different scales to measure acculturation. Altogether, results demonstrated that acculturation is a useful predictor of alcohol use. In addition, the meta-analysis revealed that a small positive correlation exists between acculturation and alcohol use in Latinos with a between-study variance of only 1.5% (τ²  = 0.015). Our analyses reveal that the association between current measures of acculturation and alcohol use is relatively small.

Substance use and treatment outcomes among Spanish-speaking Latino/as from four acculturation types

The purpose of this study was to examine the association of acculturation with substance use treatment outcomes in a sample of treatment-seeking Latino/as (N = 405). The study used data from a multisite randomized controlled trial of a culturally adapted version of Motivational Enhancement Therapy delivered in Spanish. Berry, Kim, Minde, and Mok's (1987) acculturation model was used to divide the sample into 4 types (integrated, assimilated, separated, marginalized), based on Bicultural Involvement Questionnaire scores. One-way analyses of variance, chi-squared tests, and repeated-measures regression were used to examine baseline acculturation, posttreatment outcomes, and follow-up outcomes. All participants were of Latino/a background, and 88.4% of the sample was male. Participants with greater acculturation to American culture (i.e., integrated and assimilated acculturation types) reported more substance use and associated problems at baseline, χ²(3) = 20.5, p < .001, with the integrated type reporting the highest percentage of substance use disorder symptoms and problems (67.6%). No significant differences in substance use were detected among acculturation types posttreatment or at follow-up. Although the integrated and assimilated acculturation types were associated at baseline with more substance use and associated problems, all acculturation types seemed to benefit at posttreatment from an evidence-based culturally adapted treatment. (PsycINFO Database Record

Analysis of Acculturation, Sex, and Heavy Alcohol use in Latino College Students

24% of 917 students at California State University Long Beach who completed an alcohol use survey in 2002 (73% response) identified themselves as Latino. Because measures of acculturation reported in most adult studies positively correlated with alcohol use and sex, it was hypothesized that these associations might also apply to Latino college students. With increasing levels of acculturation, women but not men in this Latino college sample reported significantly greater occurrence of heavy drinking, positive attitudes about drinking, and perception that most of their friends use alcoholic beverages.

Alcohol Use and Problem Drinking Among Male Mexican and Central American Im/migrant Laborers

This review addresses a growing concern regarding alcohol use in adult male Latino im/migrant laborers in the United States. The review draws from alcohol studies focusing on “Hispanic” populations, and from health behavior studies of Latino im/migrant laborers, research that includes alcohol use. Specifically, this review addresses (a) alcohol consumption and drinking patterns among Mexican and Central American im/migrant laborers, and (b) health and social consequences of alcohol use. After reviewing more than 200 articles, 30 studies meeting key criteria were selected for review. Survey data show lower alcohol use in Latino im/migrants as compared with U.S. Latino and non-Latino populations, but also a relation between problem drinking and acculturation. Ethnographic research reveals heavy drinking and negative health and social consequences in a significant number of Latino im/migrant laborers. How structural-environmental and culture-based factors combine to influence problem drinking in the United States is discussed along with recommendations for future research.

Strength Factors Among Women of Mexican Descent

Whereas few studies with Latina samples include strength factors (resilience, mastery, life satisfaction, and perceived energy level) as variables, even fewer include strength factors together with acculturation in the same study. As part of a larger study, the purpose of this analysis is to describe and examine the relationships between strength factors, risk factors such as acculturation and substance use, resource factors including financial adequacy and education, and the health and illness factor of perceived health status among a convenience sample of 315 lowincome women of Mexican descent, ages 21 to 40. Cross-sectional survey data were collected and analyzed. Results show intragroup differences related to the well-being of women of Mexican descent living with low incomes in urban settings.

Epidemiology of substance abuse among Latinos

The importance of conducting substance abuse research among ethnic minorities is underscored by findings that members of many ethnic minorities in the United States report higher rates of heavy drinking and alcohol-related problems than do Whites and have increased rates of illicit drug use, abuse, and dependence. It is important to better understand ethnic-specific substance use from a public health perspective. Recent data suggest that the prevalence of past month alcohol use and heavy alcohol use among Hispanics is lower than and the prevalence of binge drinking and alcohol abuse or dependence is comparable to that of non-Hispanic Whites. These estimates vary among Hispanic subgroups and across gender and age groups. The prevalence of past month illicit drug use is also lower among Hispanics than that of several other groups, including non-Hispanic Whites. These trends are consistent among both men and women, although the prevalence for men is nearly twice that of women in nearly all subgroups. Conversely, the prevalence of illicit drug abuse or dependence among Hispanics is slightly higher than that of non-Hispanic Whites. This article describes national level epidemiological data on the prevalence of alcohol and illicit drug use, abuse, and dependence among Latinos/Hispanics in the United States in comparison to other race and ethnic groups. Previous findings in the literature will be reviewed and new analyses using the 2002 National Survey on Drug Use and Health will be presented. Given the heterogeneity of Hispanics in the United States, data for Hispanics will be broken down by national groups whenever possible.

Intergenerational transmission of the effects of acculturation on health in Hispanic Americans: a fetal programming perspective

We propose a transdisciplinary, life span framework for examining the underlying cause of the observed intergenerational decline in health among Hispanic Americans. We focus on acculturation, and we posit that acculturation-related processes in first-generation Hispanic immigrant mothers may affect the intrauterine development of an unborn child, via the process of fetal programming, to produce phenotypic effects that may alter the susceptibility for noncommunicable chronic diseases. In this manner, an intergenerational cascade of perpetuation may become established. Our framework may shed light on the biological, behavioral, and social causes of intergenerational cycles of vulnerability among immigrant minority groups, with public health and policy implications for primary prevention and intervention.

The relation between acculturation and alcohol consumption patterns among older Asian and Hispanic immigrants

This study examines the relation between acculturation and alcohol consumption patterns among older Asian and Hispanic immigrants in the state of California. Data were obtained from the 2009 California Health Interview Survey and included Asian (n = 1264) and Hispanic (n = 571) adults aged 60 and older who were born outside of the US. Outcome variables included presence of past year alcohol consumption, past year binge drinking, and number of binge drinking days. Acculturation was measured with items pertaining to English use and proficiency. Hierarchical multiple or logistic regression analyses were conducted separately for each racial/ethnic group and each dependent variable. Alcohol consumption was found in less than half of the sample for both Asians (43.2%) and Hispanics (39.2%). Binge drinking was found in 3.1% of Asians and 8.4% of Hispanics. Acculturation was significantly related to past year alcohol consumption for Hispanics, past year binge drinking for Asians, and binge drinking days for Asians, such that higher level of acculturation predicted a greater likelihood of alcohol consumption but decreased likelihood of binge drinking and fewer binge drinking days. The results indicate that acculturation may be related to alcohol consumption patterns for older immigrants. This suggests future needs to develop an in-depth understanding of the health behaviors of these immigrant elderly groups.

Acculturation stress, anxiety disorders, and alcohol dependence in a select population of young adult Mexican Americans

OBJECTIVES

Mexican Americans comprise one of the most rapidly growing populations in the U.S. and within this population the process of acculturation has been suggested to be associated with some mental health problems. This study sought to ascertain quantitative information indexing acculturation stress and its association with mental health disorders in a select community sample of Mexican Americans.

METHODS

Demographic information, DSM-III-R diagnoses, and information on cultural identity and acculturation stress were obtained from 240 Mexican American young adults that were recruited by fliers and were residing in selected areas of San Diego.

RESULTS

No associations were found between measures of cultural identification and lifetime diagnoses of drug or alcohol dependence, major depressive disorder, anxiety disorders or antisocial personality disorder/conduct disorder in this sample of Mexican American young adults. However, lifetime diagnoses of alcohol dependence, substance dependence, and anxiety disorders were associated with elevations in acculturation stress.

CONCLUSION

Quantitative measures of acculturation stress, but not cultural identity per se, were found to be significantly associated with substance dependence and anxiety disorders in this select population of Mexican American young adults. These data may be helpful in designing prevention and intervention programs for this high risk population.

Language use and adherence to multiple cancer preventive health behaviors among Hispanics

Hispanics have lower cancer mortality rates than non-Hispanic Whites and Blacks, despite demographic profiles previously associated with higher cancer mortality. Differences in adherence to multiple cancer-preventive behaviors by acculturation may offer one explanation for this "Hispanic paradox," but the relationship is not well understood. We examined this relationship using the 2000 National Health Interview Survey, which provides cross-sectional data on a nationally representative sample of US Hispanics. Multinomial logistic regression models estimated relationships between language use (a measure of acculturation) and patterns of adherence, by gender, to multiple cancer-preventive health behaviors using adherence scores. Hispanics had greater odds of adherence to multiple behaviors compared to Non-Hispanics (OR = 2.76 [2.27, 3.36]). Hispanics with greater English language use had lower odds of adherence (OR = 0.45 [0.29, 0.69]). Women were more adherent than men (P < 0.01) and their language use was associated with patterns of behavioral adherence more so than among men. Differences by gender and language use were identified in patterns of adherence to behavioral recommendations among the Hispanic population. Greater English language use was negatively associated with tobacco, alcohol, fruit and vegetable recommendation adherence but not with exercise. Study findings support evidence behaviors occur in combination and contributes to understanding of the role of language use in patterns of behavioral adherence.

Beliefs of older Mexican American women about alcohol and alcohol use

This exploratory study assessed the belief system regarding alcohol use in a non-clinical population of Mexican American women age 55 and older drawn from a potential population of 1,000 older adults who attend nine senior centers. The overriding research question was: What are the normative attitudes, knowledge, and behavior regarding alcohol in this population of older Mexican American women? Findings from this study can serve as a baseline for comparison for future studies of older Mexican American who are more acculturated or who are second- and third-generation Mexican Americans.

Gender, acculturation and alcohol use among Latina/o adolescents: a multi-ethnic comparison

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.

Acculturation, coping styles, and health risk behaviors among HIV positive Latinas

This study examined the relationships among acculturation, coping styles, substance use, sexual risk behavior, and medication non-adherence among 219 Latinas living with HIV/AIDS in Los Angeles, CA. Coping styles were hypothesized to mediate the link between acculturation and health risk behaviors for HIV positive Latinas. Structural equation modeling revealed that greater acculturation was related to less positive coping and more negative coping. In turn, negative coping was associated with more health risk behaviors and more non-adherence. Positive coping was associated with less substance use as reflected in use of cigarettes and alcohol and less non-adherence. Coping styles mediated the relationship between acculturation and health risk behaviors. Findings echo previous works examining the Hispanic Health Paradox wherein more acculturated Latinos exhibit increased risk behavior and maladaptive coping styles. HIV/AIDS interventions need to be mindful of cultural differences within Hispanic populations and be tailored to address these differences.

Associations between acculturation and alcohol consumption of Latino men in the United States

OBJECTIVE

This study examined the relationship between acculturation and six distinct drinking outcomes. We expected high levels of acculturation to be associated with higher odds of being a drinker and, among drinkers, with lower frequency of drinking, less alcohol consumption per year, less heavy drinking, fewer episodes of drunkenness, and fewer dependence symptoms.

METHOD

The data consisted of a nationally representative sample of Latino men ages 18 and older (N = 784) from the 2005 National Alcohol Survey. The men were predominantly Mexican and Mexican American (64%), and most were born outside the United States (68%). Analyses included both bivariate and multivariate regression models using weights to adjust for sampling and nonresponse.

RESULTS

The hypotheses were partially supported. Men at high levels of acculturation were more likely than their peers at low levels of acculturation to be drinkers but only if they had above-average incomes. Counter to expectations, among drinkers there was a protective effect of medium, rather than high, levels of acculturation on frequency of drinking, volume of alcohol consumed, drinking to drunkenness, and dependence symptoms, with a protective effect approaching significance for heavy drinking.

CONCLUSIONS

The findings have implications for future research and public health programs designed to reach Latino men in the United States.

Effects of parental monitoring, parent-child communication, and parents' expectation of the child's acculturation on the substance use behaviors of urban, Hispanic adolescents

This cross-sectional study was conducted on 1,936 Hispanic adolescents of mean age 14.0 years (standard deviation= 0.4) from seven Los Angeles area schools. The effects of perceived parental monitoring and parent-child communication on the adolescents' self-reported past thirty day cigarette smoking and alcohol and marijuana use behaviors were analyzed. In addition, the relationships between parents' expectations of the child's acculturation and adolescents' drug use behaviors were examined. Parental monitoring and parent-child communication were found to have statistically significant inverse associations with all three drug types when controlling for one another and the demographic variables assessed in the study. Parents' expectation of the child's acculturation to the U.S. was found to be inversely related with alcohol use. Parental monitoring and parent-child communication were not found to mediate the relationship between parents' expectation of the child's acculturation and alcohol use.

Acculturation and alcohol among Latino adults in the United States: a comprehensive review

BACKGROUND

In light of the inconsistent evidence associating acculturation with drinking outcomes among Latinos in the United States, the current paper comprehensively reviews the literature on this topic.

METHODS

Studies were eligible for review if they (1) were published in a refereed journal, (2) were published in English, (3) sampled Latino/Hispanic adults aged 18+, (4) examined self-reported drinking behavior, alcohol-related problems, and/or alcohol abuse/dependence, and (5) reported original results or unique analyses from a larger dataset. The review includes only studies using composite scales of acculturation. Studies were identified via electronic databases (i.e., PSYCHINFO, ETOH, and PUBMED) using search terms, and combinations thereof, including "acculturat*," "alcohol*," "Latino," and "Hispanic." This search was supplemented by recursive checking and author searches. Thirty-two articles were identified and coded on methodological characteristics; results from 24 disaggregating genders and using appropriate outcomes were summarized.

RESULTS

Higher acculturation was very consistently associated with higher odds of drinking among women, even controlling for demographic covariates. The evidence for women also suggested associations between higher acculturation and heavier drinking on other outcomes, including total volume, drinking frequency, typical quantity, heavy/problem drinking, drinking problems, and abuse/dependence, despite some null results. Relationships were weaker and ambiguous among men. Some evidence suggested that highly acculturated men are (compared with peers low on acculturation) more prone to drink, and perhaps as a result, can show higher consumption and problems. However, results also implied that, among male drinkers, higher acculturation may be associated with a lighter drinking pattern. Important study limitations were identified, including low power, aggregation of nondrinkers with drinkers, restrictive sampling, measurement issues, and analytical issues.

CONCLUSIONS

The pattern of results suggests important associations between acculturation and drinking outcomes-particularly for women-but conclusions are tempered by serious methodological limitations. The review urges further research, particularly large-scale, longitudinal studies, addressing these limitations.

Alcohol use among immigrant Latino farmworkers in North Carolina

BACKGROUND

Heavy alcohol use among Latino farmworkers is believed to be common, but it remains poorly documented.

METHODS

Interviewer-administered survey questionnaires were administered to 151 Latino male farmworkers in Eastern North Carolina; topics included frequency of alcohol consumption, amount of alcohol typically consumed, frequency of consuming five or more drinks in a single setting, and signs of alcohol abuse/dependence.

RESULTS

Over one-quarter (26%) completely abstain from alcohol, but 27% report frequent heavy drinking, or drinking five or more alcoholic beverages two or more times per month. Over one-third of farmworkers (39%) may be alcohol-dependent. Frequent heavy drinking is more common among single farmworkers and among those who do not follow the crops, and dependence is more common among farmworkers living in camps comprised of both H2A and non-contract workers.

CONCLUSIONS

There is substantial variation in alcohol use among Latino farmworkers. Although a substantial proportion of farmworkers abstain from alcohol, an equally substantial proportion report alcohol use that poses significant risk for injury on and off the job. More research is needed to document the potential threat to Latino farmworkers by their alcohol use. Interventions targeting alcohol are needed to minimize the risk of injury in an already dangerous occupation.

Correlates of alcohol and tobacco use among Mexican immigrants in rural North Carolina

This study examined the relationship among sociodemographic, cultural, and psychological factors associated with alcohol and tobacco use among Mexican immigrants in the rural south. Questionnaires including sociodemographics, alcohol and tobacco use, acculturation, and stress were administered to 173 Mexican immigrants residing in rural eastern North Carolina. Gender, preimmigration use, and occupational/economic stress were significant predictors for alcohol use, with preimmigration use significant for tobacco use, suggesting that alcohol and tobacco use may be related to previous behavior, rather than acculturation to American society. Stress, setting, and preimmigration substance use would be important factors to address in the immigrant's health history.

Brief intervention for alcohol use by pregnant women

OBJECTIVES

We examined the efficacy of brief intervention as a technique to help pregnant women achieve abstinence from alcohol. A second aim was to assess newborn outcomes as a function of brief intervention.

METHODS

Two hundred fifty-five pregnant women who were participants in the Public Health Foundation Enterprises Management Solutions Special Supplemental Nutrition Program for Women, Infants, and Children and who reported drinking alcohol were assigned to an assessment-only or a brief intervention condition and followed to their third trimester of pregnancy. Brief intervention consisted of 10- to 15-minute sessions of counseling by a nutritionist, who used a scripted manual to guide the intervention. Newborn outcomes of gestation, birth-weight, birth length, and viability were assessed.

RESULTS

Women in the brief intervention condition were 5 times more likely to report abstinence after intervention compared with women in the assessment-only condition. Newborns whose mothers received brief intervention had higher birthweights and birth lengths, and fetal mortality rates were 3 times lower (0.9%) compared with newborns in the assessment-only (2.9%) condition.

CONCLUSIONS

The success of brief intervention conducted in a community setting by nonmedical professionals has significant implications for national public health policies.

Acculturation status and heavy alcohol use among Mexican American college students: investigating the moderating role of gender

We examined whether gender moderates the association between acculturation and heavy alcohol use. The sample consisted of 126 Mexican American college students (Mean age=24.7 years; 57% female) who completed self-report measures of heavy alcohol use, acculturation status (global acculturation and ethnic identity), and relevant control variables (age, peer alcohol use). Multivariable regression revealed that higher levels of ethnic identity were associated with greater frequency of heavy alcohol among men. Conversely, neither measure of acculturation was associated with heavy alcohol use among women. These findings suggest that interventions for Latino/a students should consider the role of culturally relevant variables in heavy alcohol use, particularly for men. They also have implications regarding how acculturation is operationalized in alcohol studies, and suggest directions for future research.

Drinking pattern among adolescents with immigrant and Norwegian backgrounds: a two-way influence?

AIMS

To assess the association between drinking behaviour among adolescents with both immigrant and native backgrounds with aspects of acculturation.

DESIGN

Cross-sectional school survey among 15-16 year olds.

SETTING AND PARTICIPANTS

All students, a total of 8361, in 10th grade during spring 2000 and 2001 in Oslo, Norway with response rate 88.3%. The sample consisted of 1213 students with an immigrant background and 4627 students with a Norwegian background.

MEASUREMENTS

Indicators of the length of the acculturation process were assessed as first versus second generation and in terms of length of stay in Norway. The proportion of Muslim students in school was an indicator of social environment 'dryness'. Drinking behaviour was assessed as drinking alcohol ever, drinking frequency and intoxication frequency.

FINDINGS

A smaller proportion of immigrant students were current drinkers, frequent drinkers and drank to intoxication compared with adolescents with a Norwegian background. Adjusted two-level analyses showed that alcohol drinking was less common among immigrant students with a short stay in Norway and with a large proportion of Muslim students in school. In those with a Norwegian background there was a larger proportion of abstainers, and those who drank did so less frequently and were less frequently intoxicated the larger the proportion of Muslim students there was in their school.

CONCLUSION

Drinking behaviour among adolescents in a multicultural and heterogeneous society seems to reflect a bi-directional acculturation process where the majority population tend to adapt to the behaviours of the immigrant population which in turn, to a varying degree, tends to adapt to the behaviour of the majority population.

Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context

This chapter provides an overview of the concept of acculturation and reviews existing evidence about the possible relationships between acculturation and selected health and behavioral outcomes among Latinos. The effect of acculturation on Latino health is complex and not well understood. In certain areas-substance abuse, dietary practices, and birth outcomes-there is evidence that acculturation has a negative effect and that it is associated with worse health outcomes, behaviors, or perceptions. In others-health care use and self-perceptions of health-the effect is mostly in the positive direction. Although the literature, to date, on acculturation lacks some breadth and methodological rigor, the public health significance of findings in areas in which there is enough evidence justifies public health action. We conclude with a set of general recommendations in two areas-public health practice and research-targeted to public health personnel in academia, community-based settings, and government agencies.

Culture Change and Ethnic-Minority Health Behavior: An Operant Theory of Acculturation

Data on acculturation and ethnic-minority health indicate that acculturation has opposite effects on the same health behavior among different ethnic groups; opposite effects on different health behaviors within an ethnic group; opposite effects on the same health behavior for the women vs. the men of most ethnic groups; and no effect whatsoever on some health behaviors for some ethnic groups. This evidence is so incoherent that it is unintelligible, and hence it continues to be largely useless to health psychology and behavioral medicine. This paper presents a new theory of acculturation that renders these confusing data coherent by predicting such changes in minority health behavior a priori. By so doing, the operant model of acculturation has the potential to improve health promotion and disease prevention and thereby reduce ethnic health disparities.

Should "acculturation" be a variable in health research? A critical review of research on US Hispanics

Acculturation has become a popular variable in research on health disparities among certain ethnic minorities, in the absence of serious reflection about its central concepts and assumptions. Key constructs such as what constitutes a culture, which traits pertain to the ethnic versus "mainstream" culture, and what cultural adaptation entails have not been carefully defined. Using examples from a systematic review of recent articles, this paper critically reviews the development and application of the concept of acculturation in US health research on Hispanics. Multiple misconceptions and errors in the central assumptions underlying the concept of acculturation are examined, and it is concluded that acculturation as a variable in health research may be based more on ethnic stereotyping than on objective representations of cultural difference.

The use of the Puerto Rican Biculturality Scale with Puerto Rican drug users in New York and Puerto Rico

This study examines the psychometric properties of an acculturation scale specifically developed for Puerto Ricans with a sample of substance abusers residing in Puerto Rico and New York. In line with current conceptual models of acculturation, this instrument departs from a mutually exclusive or zero-sum conceptualization of acculturation by assessing involvement in both American and Puerto Rican cultures independently of each other. Findings from this study permitted comparisons of acculturation as experienced by Puerto Rican injection drug users in Puerto Rico and New York. Results supported the notion of independence of individuals' involvement in American and Puerto Rican cultures, thus confirming the complex nature of biculturalism. This article also examines the relevance of the study of acculturation scales that can assist in identifying the influences of the cultures of origin and destination on substance abuse and HIV risk behaviors.

Prior cigarette smoking initiation predicting current alcohol use: evidence for a gateway drug effect among California adolescents from eleven ethnic groups

Gateway drug theory provides a useful framework for understanding drug use among adolescent populations. Studies have reported a gateway effect of cigarette smoking on alcohol use among adolescents; but there is a lack of knowledge regarding ethnic differences in this effect. Using data from a cross-sectional survey in California, 11,239 subjects (46.3% male) from 31 high schools with at least 25% of total enrollment of Asian and at least 200 students with Asian ancestry entered the analysis. Among them, 6016 were ninth graders (mean age=14.3, S.D.=0.49) and 5223 were twelfth graders (mean age=17.3, S.D.=0.54). After controlling for seven variables, the risk ratio of last 30-day alcohol use among prior smoking initiators vs. noninitiators was 5.82 for non-Hispanic Whites, 4.25 for Blacks, 8.37 for Asian Indians, 3.99 for Chinese, 3.45 for Filipinos, 3.48 for Japanese, 5.41 for Koreans, 7.57 for Vietnamese, 4.02 for Mexicans, 2.64 for South/Central Americans, and 5.95 for adolescents with multiethnic background. Comparison of the 11 ethnic groups indicated that adolescents from different ethnic groups but with similar cultural background had a similar risk level; such pattern existed after controlling for acculturation, parents' monitoring, and school performance. The risk ratio did not differ by gender and grade. There is an association between prior cigarette smoking initiation and current alcohol use among adolescents from different ethnic backgrounds, including those of multiethnicity, which supports the generalizability of gateway drug effect of cigarette smoking on alcohol use. Studies should be conducted to investigate factors attributable to the ethnic variations of this association.

Linguistic acculturation associated with higher marijuana and polydrug use among Hispanic adolescents

Hispanic sixth and seventh graders in 22 New York City middle schools (mean age: 12.66 years) completed self-report questionnaires with items related to drug use (cigarette smoking, alcohol use, and marijuana) use and linguistic acculturation at two assessments (N = 1299 at baseline; N = 1038 at 1-year follow-up). Adolescents who spoke English with their parents smoked marijuana more frequently than those who spoke Spanish with their parents at both surveys. By the 1-year follow-up, students who spoke English with their parents and bilingual students who spoke English and Spanish with their parents engaged in greater polydrug use than those who spoke Spanish with their parents.