Gender Differences In Preferred Drug Resistance Strategies of Rural Hawaiian Youth

Purpose: Compared with their male counterparts, research has indicated significantly higher rates of substance use for Native girls (Wallace et al., 2003), including Native Hawaiian girls (Glanz, Maskarinec, & Carlin, 2005; Mayeda, Hishinuma, Nishimura, Garcia-Santiago, & Mark, 2006). Despite these findings, there is a lack of empirically based gender-specific content in prevention programs for these youth (Edwards, Giroux, & Okamoto, 2010). Therefore, the purpose of this study was to examine gender differences in preferred drug resistance strategies of rural Hawaiian youth. Examining these differences in resistance strategies has implications to promote developmentally and culturally appropriate, gender-specific resistance skills training for rural Hawaiian youth, thereby informing ecologically focused substance abuse prevention for these youth.

Methods: Data from this study came from a NIDA-funded pilot/feasibility drug prevention study, in which youth participants were asked to adapt and/or validate narrative scripts to be used to create culturally grounded drug prevention videos. Seventy-four youth (60% female) within eight middle/intermediate or high schools on Hawai‘i Island participated in this study. Youth participated in 15 gender-specific focus groups (2-10 youth per group; M = 4.63, SD= 2.33). Focus group discussions were transcribed verbatim, and systematically checked for data quality. Intercoder reliability and validity was established through the use of coding “teams”, and grounded theory coding procedures were conducted to examine patterns in suggested changes to each narrative script. Particular attention was paid to gender differences within each of the codes, including differences in content and the manner in which youth participants discussed the drug-related problem situations depicted in each of the scripts.

Results: The primary gender differences for the youth participants were evident in the discussion and/or modification of responses to drug offers described in each of the scripts. Male participants tended to endorse responses that “disconnected” the protagonist in the script from the drug offerer more abruptly (e.g., “I would leave the situation”, “I would tell him, ‘no, I cannot.’”). Female participants tended to endorse methods to stay relationally “connected” in the situation, despite the drug offer occurring (e.g., “I would tell him, ‘not now, maybe later’”). Data further suggested that female participants were more aware and/or concerned of the longer-term ramifications of interactions during drug refusal, and how the youth protagonist’s responses to drug offers would be contingent on specific contextual circumstances (e.g., the degree of intoxication of the drug offerer in the script).

Conclusions: This study suggests that, even within risky situations, rural Hawaiian girls may perceive a need to maintain relational and social harmony within their communities. These findings are consistent with gender/feminist theories (i.e., Relational-Cultural Theory), and inform recent empirical research which has described the perceived difficulty that these girls experience in dealing with drug offers. Results from this study may also elucidate similar findings in research with American Indian girls (Dixon Rayle et al., 2006). As such, this study may have implications for the development of gender-specific content in drug prevention programs for indigenous youth, including ongoing NIDA-funded culturally grounded drug prevention research in rural Hawai‘i.