Substance Use Behaviors As Predictor of Critical Consciousness Among African American Men with History of Incarceration and Substance Abuse Disorder

Background: A Brazilian philosopher, Paulo Freire, defined critical consciousness (CC) as the ability to analyze, navigate, and challenge the oppressive social forces determining one’s life and community. In support of the CC theory, a growing body of research has found that CC is associated with important outcomes among marginalized populations that are impacted by health inequalities. Some of the reported predictive outcomes include resilience (Romero, 2011), academic engagement (Ramos-Zayas, 2003), professional aspirations (Diemer and Hsieh, 2008), and civic and political engagement (Diemer and Li, 2011). To join the discourse on CC and cultivate innovative evidence, we investigated whether substance misuse frequency among formerly incarcerated men with a history of substance use disorder is a significant predictor of CC controlling for demographic variables. 

Methods: Baseline data from a larger longitudinal study titled Community Wise Optimization (R01 MD010629-04, PI Windsor and Benoit) was used in the analysis. Study participants were recruited from Newark, NJ using a mixture of strategies including indigenous field worker sampling, facility-based sampling, community advertisement, and street outreach. Eligibility criteria included: over 18 years of age; history of substance use disorder; released from incarceration in the past 4 years; English-speaker; and people identifying themselves as African American male. CC was measured by the CC scale developed by Community Wise Optimization project team and baseline instruments were administered to participants directly via a tablet. A convenience community dwelling sample of 408 were included in the analysis.

Results: Participants in the sample ranged in age from 19-67 (M=44.9); 100% identified as African American; and 91.2% identified as current substance users with average CC score of 4.36. The majority were single (83.3%), and the average annual household income was $13,570. A reduced linear regression model with 2-way interaction on CC score with demographic statistics and substance use frequency was run to predict CC score from income; housing and employment status; alcohol, heroin, cocaine, cannabis, and hallucinogen use. Data was imported into SPSS from Redcap and assessed for missing values, data entry errors, and distribution.  The regression model predicted CC score, F(4, 398) = 32.393, p < .001, adj. R² = .662. All of the substance use variables included in the model were negative predictors and statistically significant (p < .05) including cannabis (B = -.310), heroin (B = -.272), alcohol (B = -.231), and cocaine (B = -.144).  

Conclusions and Implications: Utilizing primary data from Community Wise Optimization, this study fills an important gap in the literature examining predictors of CC. Tested model indicates that high frequency of drug use have negative effect on CC. CC is a construct that has important scholarly, practice and policy implications. Future studies for marginalized populations noting the relevance and application of CC to current social problems will foster development of the CC Theory.