The Development and Validation of the Hawaiian Youth Drug Offers Survey (HYDOS)

Purpose: Compared with various ethnic groups, Native Hawaiian youth have been found to have some of the highest alcohol, tobacco, and other drug use rates (Kim, Ziedonis, & Chen, 2007; Wong, Klingle, & Price, 2004). Further, there are no existing measures examining the etiology of drug use for Native Hawaiian youth. Therefore, the purpose of this study was to develop and validate a survey focused on the most salient drug offer situations involving Native Hawaiian youth in rural communities.

Method: One hundred twenty four survey items were extracted from 14 gender-specific focus groups of middle school aged youth (N = 47). These items were edited and reduced to 62 drug offer situations that were selected for inclusion in the survey. Respondents were asked to indicate the lifetime frequency of experiencing the situation, ranging from 0 (“never”) to 4 (“more than 10 times”). The 62 items were administered to 249 youth (194 Hawaiian youth) from 7 middle or intermediate schools on the Big Island of Hawai‘i. A correlation matrix of questionnaire items was completed to examine relationships among items. Principal axis factoring with promax rotation was conducted with the subsample of Hawaiian/Part Hawaiian youth in order to identify and validate latent constructs. The number of retained factors was determined using a scree plot (Nunnally & Bernstein, 1994). Internal consistency was assessed with Cronbach's alphas for each of the subscales derived from the factor analysis. The mean frequency of exposure to drug offer situations for Hawaiian youth was compared to non-Hawaiian youth, in order to test the cultural specificity of the items.

Results: Correlations were moderate to high between all items for both the full sample and the Hawaiian/Part Hawaiian subsample (.70-.80). The scree plot for the Hawaiian/Part Hawaiian subsample indicated a 2-, 3-, 4-, or 5-factor solution, with the 3-factor solution being the most interpretable. Factor 1 (23% of the variance) was comprised of 9 items that focused on peer pressure to use drugs and alcohol. Factor 2 (21% of the variance) was comprised of 9 items that focused on family drug offers or context. Factor 3 (19% of the variance) was comprised of 6 items that focused on unanticipated drug offers. These were offers that appeared sudden or unexpected, and had marijuana as the drug primarily offered in the situation. Reliability coefficients were .93, .90, and .91 for Factors 1 through 3, respectively. Hawaiian/Part Hawaiian participants were exposed significantly more to items on Factor 1 (Peer Pressure), t(226) = 3.45, p < .01, Factor 2 (Family), t(239) = 4.14, p < .001, and Factor 3 (Unanticipated Drug Offers), t(244) = 3.37, p < .01, compared to their non-Hawaiian counterparts.

Conclusions: The findings validate prior research focused on drug offers and indigenous youth populations (e.g., Kulis, Okamoto, Dixon-Rayle, & Sen, 2006), and suggest that interventions for Hawaiian youth should address the core areas of peer pressure, family drug offers and context, and unanticipated drug offers in the school and community. Future research should further address the construct validity of the measure.