Effects of Culture and Family Involvement on Substance Use Among Native American Adolescents

Background and Purpose: Previous research has urged for culturally tailored prevention and intervention strategies for substance use among Native Americans. These preventions and interventions stress the importance of incorporating Native American culture and traditions as a way to meaningfully reduce substance abuse. Native American adolescents use alcohol and drugs earlier, at higher rates, and with more acute health, social, and economic consequences than their non-Native American counterparts (Schinke et al., 2000). Even when compared with other minority groups, Native Americans still experience notable health disparities (Kenyon & Hanson, 2012). The present study aimed to investigate whether cultural identity and family involvement predicted substance use among Native American adolescents. The present study also aimed to address whether gender differences exist in the hypothesized relationships among the variables.

Method: The current study utilized data from The Drug Use Among Young American Indians: Epidemiology and Prediction, 1993-2006 and 2009-2013 study. The current research is a cross-sectional study of survey data collected in the years 2009-2013 from a sample of N=5,744 participants (49.5% males). Study participates were adolescents in 7^th-12^th grade attending schools on or near reservations with at least 20 percent Native American students. Alcohol, marijuana, and inhalants use were assessed by frequency of use, user level, and age of first use rated on a 6 point scale. Then, a composite score of the 3 measures was calculated for each type of substance. Family involvement assessed communication about substance use, family caring, and sanctions against substance use. Each category included 5 questions rated on a 4 point scale. Cultural identity addressed the importance of culture, traditions, and way of life. Each category included 5 questions rated on a 4 point scale. Response categories consisted of “yes/no,” marked/not marked, four or five point categorical scales, and categorized numbers to show frequency.  A series of multiple linear regression were conducted for male and female participants separately to identify whether cultural identity and family involvement predicted substance use among adolescents.       

Results: Overall, the results indicated gender difference in the effect of cultural identity and family involvement on substance use. Among both males and females, family sanctions predicted less substance use for all substances. Family communication predicted only marijuana use among males, while family communication and family caring predicted alcohol, marijuana and inhalant use among females. Among males, participants who identified themselves more with Native American culture used less alcohol and inhalants. In contrast among females, participants who identified themselves more with Native American culture used more alcohol, marijuana, and inhalants.

Conclusion: Findings from this study address the importance of family as a prevention and intervention among male and female Native American adolescents. Findings suggest that the meaning of substance use may differ between male and females in context of cultural identity. These findings assert the need for culturally informed prevention and intervention strategies for the Native American population. Implementation of these strategies should be tailored to the needs of male and female adolescents.