Individual and Social Environmental Predictors (ISFs) of Illicit Drug Use Among Asian American and Native Hawaii Youths

Background: Although Asian Americans (AA) have been viewed as a model minority group in US, there are increased substance abuse among AA, particularly in young population. Moreover, possible differences among sub-ethnic groups among AAs in substance use problems have not been well researched. Native Hawaiians (NH) have been identified as a high risk population. Nevertheless, little information is available regarding the similarity and difference in drug use predictors between NH and other AAs. Due to limited sample size in most datasets, drug problems could among NH youths were often not investigated separately from AAs. This knowledge gap impede the identification of unique and malleable factors for interventions in this population. Based on the socialization perspective, this study used a large representative sample to examine the association between individual and environmental factors (IE) and drug use among AA and NH youths.

Objective: We examined 1) the prevalence rate of illicit drug use in AA and NH; 2) associations of IE with drug use among AA and NH; 3) similarities and differences in the impacts of IE measures on drug use between these two groups.

Methods: Data from 2006 to 2009 for the National Survey on Drug Use and Health (NSDUH) were combined. This produced a large representative sample of AA (n = 2,320) and NH (n = 322) youths.

Analysis:

The complex sample module in SAS 9.2 was used for the data analyses. Weighted cross-tabulations for prevalence rates of drug use were conducted. Logistic regressions with adjusted standard errors for the estimates of the survey design were applied to examine the associations of IE with drug use. Two-sample Z-tests was applied to compare the regression coefficients on predictors from logistic regression results to test differences in the effects of these variables between AA and NH.

Result:

Prevalence of past-year illicit drug use was higher among NH than AA (20.59 % vs. 11.79 %). Risk and protective factors are similar between these two groups. For AA and NH, negative views of drug use operate as protective factor (OR = .19, .21 respectively); friendship with delinquent peer (1.51, 1.60) and delinquent behaviors (2.68, 3.99) operated as risk factors.

The protective effect from school against drug use was only found in AA (OR= .77) whereas the protective effects of community engagement was only found in NH (OR=.60).  Two sample Z-tests yielded one significant difference between AA and NH youths. The effects of community engagement were significantly greater in the NH than the AA model (z = 2.20, p = .03).

Conclusion:

Although NH reported higher level of drug use rate, they share similar risk and protective factors with AAs. Intervening on these risks can help reduce drug use problems: educating youths understanding the negative consequences of drug use, providing training in drug refusal skills and handle delinquent peers‘ influence, and preventing youths from developing delinquency. Moreover, community engagement, that united members through common interests and activities, could be a key culturally relevant protection for NH and requires further investigations.