Abstract
Research on cultural factors and substance use among Hispanic adolescents has focused primarily on acculturation, while specific core Hispanic values and attributes have received minimal attention. The objective of the current study was to examine the relationship between traditional Hispanic cultural assets and substance use among adolescents. A purposive sample of 225 Hispanic adolescents (47% male) aged 13 to 16 years were recruited from community venues (e.g., park, school, mall) in a predominately Hispanic neighborhood. Participants completed a survey to assess cultural factors (familism, simpatía, respeto, and ethnic pride) and substance use in the past 3 months (alcohol and drug). Point-biserial correlations revealed significant associations of alcohol and drug use with greater familism (family connectedness), simpatía (interpersonal relationship harmony), and respeto (respect). Two stepwise binary logistic regressions were performed to evaluate the independent association between the cultural factors and substance use. The interaction of gender with each cultural factor was examined in both analyses. Simpatía emerged as the only cultural factor independently associated with alcohol use. Greater simpatía was related to abstention from alcohol. Both simpatía and familism independently correlated with drug use. Stronger endorsements of simpatía and familism were associated with absence from drug use. Interactions between cultural factors and gender were not observed. Simpatía emerged as the strongest cultural asset that may confer protection against substance use. If replicated, our results suggest substance prevention programs targeting Hispanic adolescents may benefit from the inclusion of cultural assets in the intervention paradigm.
Substance use generally begins or peaks during the adolescent years (Kroutil, Colliver, & Gfroerer, 2010), and focusing on drug prevention among Hispanic adolescents is an important public health initiative. Hispanics are the fastest growing segment of the population in the United States, and recent data indicate significantly higher lifetime marijuana, cocaine, ecstasy, and injected illegal drug use among Hispanic adolescents relative to their non-Hispanic White counterparts (Centers for Disease Control and Prevention, 2011; Substance Abuse and Mental Health Services Administration [SAMHSA], 2011). Increases in the rates of marijuana and nonmedical use of prescription-type drugs have been observed among Hispanic adolescents in recent years (SAMHSA, 2011). To address substance use, Healthy People 2020 (2013) highlights cultural responsiveness and positive youth development as promising approaches to adolescent health promotion. Emergent literature has begun to evaluate cultural factors as protective assets that confer protection against substance use among Hispanic adolescents.
Much of the literature on culture and substance use has focused on acculturation. Overall, studies suggest a positive association between acculturation and substance use. For example, U.S.-born Hispanic adolescents had higher rates of past month cigarette, alcohol, and marijuana use compared to their foreign-born peers (SAMHSA, 2011). Moreover, greater acculturation has been correlated with more cigarette and alcohol use among Hispanic girls (Castro, Stein, & Bentler, 2009). Existing data indicate that the relationship between acculturation and substance use may be mediated by core Hispanic values and attributes. A study of Latino adolescents demonstrated that acculturation influences alcohol use through the deterioration of traditional Hispanic values of family connectedness and parental respect (Gil, Wagner, & Vega, 2000). In another study, selective acculturation, the process of retaining certain cultural traditions, has been associated with a reduction in alcohol use and binge drinking (Wahl & Eitle, 2010). These findings underscore the need to examine core Hispanic cultural values and attributes as protective factors against substance use among adolescents.
Findings in the existing literature are supported by the segmented assimilation theory, suggesting that retention of selected cultural variables may buffer youth from negative influences of the host culture (Eitle, Wahl, & Aranda, 2009). Initially developed by Portes and Zhou (1993), the segmented assimilation framework is built on the premise that the host society is diverse and multiple assimilation pathways are available to the immigrants. The theory delineates three discrete trajectories of adaptation (1) upward mobility and integration into middle class, (2) downward assimilation into the urban underclass, and (3) selective acculturation with economic integration while preserving the culture and values of one’s country of origin. Factors that influence the path of assimilation include economic and human capital and family structure (Portes & Rumbaut, 2001). Immigrants settling in a new country often lack the economic capital for upward mobility into the middle class, resulting in the tendency to reside in poor inner-city neighborhoods (Basolo & Nguyen, 2009). When navigating in a high-risk environment, the segmented assimilation theory asserts that selective acculturation such as cultural preservation and family solidarity may serve as protective mechanisms for immigrant children. The retention of cultural norms and values promotes positive family and community influences and provides adolescents with the social capital to avoid the negative impact of poor neighborhoods.
The research to date has offered minimal insight into the influence of traditional Hispanic cultural values and attributes on substance use. The limited evidence suggests that cultural assets may strengthen resiliency and empower adolescents to resist the pressure to experiment with tobacco, alcohol, and other illegal drugs. A strong sense of familism, that is, connectedness and identification with one’s family, has been linked to a reduction in alcohol use (Sale et al., 2005). Greater ethnic pride, a strong affiliation with one’s ethnic or cultural group, has been associated with less cigarette and alcohol use (Castro et al., 2009). Simpatía, a focus on interpersonal relationship harmony, and respeto, an emphasis on respect toward authority figures, have been demonstrated to buffer against the risk of lifetime smoking (Unger et al., 2006). In light of these promising results, the protective impact of traditional Hispanic cultural assets warrants further investigation. The current study expands on prior research by examining the association between a set of core Hispanic cultural values and attributes (familism, simpatía, respeto, and ethnic pride) on alcohol and drug use.
Method
Participants
The participants were 225 adolescents (47% male) aged 13 to 16 years (M ± SD = 14.42 ± 1.08) from a southeast region of the United States. All participants self-identified as Hispanic, and 77.8% of the adolescents were born in the United States. Purposive sampling was employed to recruit participants from a city where 94.7% of the residents were Hispanics and the median income was $29,959 (U.S. Census Bureau, 2015). Targeted venues for recruitment included a city parks and recreation system, a private school, an after-school program, a city library, a shopping mall, and a youth intervention and prevention program. In addition to the distribution of flyers at the recruitment sites, adolescents and/or their parents were approached by research assistants to invite study participation. At venues with organized programs (e.g., private school, after-school program), recruitment was facilitated by program staff with an introduction of the study to adolescents. For adolescents who were approached without their parents, parental contact information was collected, and contact was made with all parents prior to study initiation. Informed assent and consent were obtained from participants and their parent/guardian. The study was conducted in accordance with the U.S. Department of Health guidelines for human subjects and approved by the university institutional review board.
Procedure
Participants completed a survey on demographic variables, Hispanic cultural values and attributes, and risk behaviors. The survey was conducted on a tablet computer using an audio computer-assisted self-interview program. After a brief orientation to the computer program, participants completed the survey in private with a research assistant available for questions. Following the computer screen with a headset, participants listened to a recording delivering the content of the survey. Responses were made by selecting an option on the touch screen. On completion of the survey, adolescents received an honorarium of a $15 gift card.
Measures
The independent variables consisted of the following cultural assets: (1) Familism was measured with a seven-item scale to assess adherence to the Hispanic value of family solidarity and connectedness. Participants endorsed how much they agreed with each statement on a 5-point Likert-type scale (1 = strongly agree to 5 = strongly disagree). The instrument has documented reliability with Cronbach’s alphas ranging from .87 to .91 (Gil et al., 2000). The internal consistency reliability for the current study was .84 (representative item: We share similar values and beliefs as a family). (2) Simpatía was assessed using a four-item scale designed to measure interpersonal harmony with a reported internal consistency reliability of .62 (Unger et al., 2006). For the present study, Cronbach’s alpha of the measure was .64 (representative item: I try not to get into an argument, even if someone makes me really mad). The instrument uses a 5-point Likert-type scale ranging from strongly agree to strongly disagree. (3) Respeto was evaluated with a seven-item scale designed to assess respect for parents and authority figures. The scale employs a 5-point Likert-type scale (1 = strongly agree to 5 = strongly disagree) and has a documented internal consistency reliability of .76 (Unger et al., 2006). Cronbach’s alpha for the current study sample was .74 (representative item: I must always respect my parents, even if I don’t agree with them). (4) Ethnic pride was measured with a three-item scale to assess the adolescent’s orientation and pride toward his or her own culture (representative item: How do you feel about your cultural/ethnic background). The scale has a published internal consistency reliability of .74 (Castro et al., 2009) and a .70 for the present study. All the items were measured using 5-point Likert-type scales. The responses consisted of “not proud” to “very proud,” “I don’t like it” to “I like it a lot,” and “I don’t want to learn more” to “I want to learn a lot.” The dependent variables (response as yes or no) consisted of past 3-month alcohol use and drug use (recreational drugs and prescription drug abuse). An endorsement of alcohol consumption in the past 3 months was coded as “yes” for alcohol use. The use of marijuana, cocaine, injected needle, and/or prescription medication not prescribed to the participant was coded as “yes” for past 3-month drug use.
Results
The past 3-month alcohol and drug use were 15.1% and 11.6%, respectively. The influences of age, gender, country of birth, and household composition (single vs. dual parents) on alcohol and drug use were evaluated using t tests and chi-square tests. Adolescents who reported alcohol, t(223) = −2.94, p < .01, and drug use t(223) = −2.74, p < .01, were significantly older than those who abstained from substances (Table 1).
Substance Use by Age, Gender, Birthplace, and Household Composition.
Note. OR = odds ratio; CI = confidence interval.
p = .06 for drug use. **p < .01 for alcohol and drug use.
Point-biserial correlations between each cultural factor and each dependent variable were conducted. Significant correlations of greater familism, simpatía, and respeto with abstinence from alcohol and drug use were observed. Pearson correlations were also performed to evaluate the relationships among the cultural factors. Significant low to medium associations (range r = .16-.45) were observed between most cultural factors (Table 2).
Correlations Among Cultural Factors and Substance Use.
p < .05. **p < .01. ***p < .001.
Stepwise binary logistic regressions were used to assess the relationships of the cultural measures with each outcome variable independent of the shared variance between the cultural factors. Age was entered as a control variable. The interaction of gender with each cultural variable was examined by entering each gender interaction term into the regression model. Results indicated simpatía (odds ratio [OR] = 0.78, confidence interval [CI; 0.68, 0.89], p < .001) was independently associated with alcohol use. Participants who abstained from recent alcohol use scored higher on simpatía. Both simpatía (OR = 0.76, CI [0.66, 0.88], p < .001) and familism (OR = 0.92 CI [0.82, 1.00], p < .05) were associated with drug use. Greater levels of simpatía and familism were correlated with abstinence from recent drug use (Table 3). Gender by predictor interactions were not detected.
Stepwise Binary Logistic Regression Analyses With Cultural Factors.
Note. OR = odds ratio; CI = confidence interval.
p < .05. ***p < .001.
Discussion
Results of the current study augment the limited body of research on the protective benefits of core Hispanic cultural assets. To our knowledge, this is the first study to examine simpatía and respeto as potential cultural strengths against alcohol and drug use. The identification of cultural assets supports the recent focus on promoting human strengths and resiliency to enhance adolescent health (Healthy People, 2013). The pattern of results is consistent with some aspects of the segmented assimilation theory, which suggests that the welfare of minority children may be influenced by the acculturation path experienced by the children and their family. Selective acculturation with retention of cultural values may insulate adolescents from the high-risk environment. Based on the segmented assimilation framework, minority adolescents in an economically disadvantaged context may be at risk of experiencing downward assimilation (e.g., substance use) without the protective benefit of cultural resources (Portes & Rumbaut, 2001).
Simpatía emerged as the cultural asset that most strongly predicted alcohol as well as drug use. Simpatía, a construct that encourages respectful, smooth, and pleasant interpersonal relationships, is inconsistent with deviant behaviors. Adolescents who embody this concept are likely to emphasize positive social behaviors and deemphasize negative behaviors (i.e., substance use) in an effort to avoid family conflict and confrontation (Triandis, Marin, Lisansky, & Betancourt, 1984). To this end, simpatía may serve to maintain interpersonal harmony and protect against adolescent alcohol and drug use.
Familism also emerged as a potential cultural asset. The close bonds to the nuclear and extended family network may buffer against substance use by providing emotional and instrumental support that promote the necessary self-efficacy to resist peer pressure to engage in deviant behaviors. Adolescents with strong familism sentiment may view delinquent activities as negative reflections on the family unit, leading them to abstain from illegal substances due to familial obligations (German, Gonzales, & Dumka, 2009). Additionally, high levels of familism may be related to greater parental monitoring, involvement, and parent–child communication, factors that have been documented to be negatively associated with substance use (Elder et al., 2000; Miller & Volk, 2002; Yabiku et al., 2010).
Although significant correlations were observed between respeto and alcohol consumption as well as drug use, the construct did not independently associate with substance use beyond the shared variances with simpatía and familism. In the current study, respeto was significantly correlated with simpatía (r = .39) and familism (r = .45). The emphasis on positive interpersonal relations, a key concept of simpatía, is based on the value of respeto (Triandis et al., 1984). Similarly, respeto is subsumed under familism, a value that promotes commitment and connection to family members. Respeto serves as a means to maintain harmony within the family and other interpersonal relationships (Marin & Marin, 1991). Results of the current study highlight the importance of examining a set of individual values and attributes to identify cultural assets with unique contribution in promoting positive behavioral choices among adolescents.
Associations between ethnic pride and substance use were not observed in the current study. Although these results are inconsistent with Castro et al.’s (2009) findings of negative relationships between ethnic pride and cigarette/alcohol use, a study of Mexican American adults suggests a lack of association between ethnic pride and smoking status (de Heer, Balcazar, Cardenas, Rosenthal, & Schulz, 2011). The inconsistent results may be a function of the study samples and restricted range of the cultural variable. Our study sample was recruited from a city where 94.7% of the residents were Hispanics (U.S. Census Bureau, 2015). Similarly, de Heer et al. (2011) sampled Hispanic Americans residing along the U.S.–Mexico Border. As a consequence of sampling from predominately Hispanic neighborhoods, the score on ethnic pride for both studies were positively skewed with a restricted range. For example, over 90% of the participants in the de Heer et al. study reported they were proud or very proud of their ethnic heritage. In the current study, although the possible scores for ethnic pride ranged from 0 to 12, 80% of the participants scored from 9 to 12. Using the same measure to assess ethnic pride, participants in the current study had a higher mean score, with a lower standard deviation, compared to adolescents in the Castro et al. (2009) study. Participants in the Castro et al. (2009) study were recruited from 14 middle schools with large proportions of Latino youth. However, the ethnic compositions of those schools were not reported. Taken together, the pattern of observations suggest the impact of ethnic pride on risk-taking behaviors may be masked by the elevated pride among participants residing in predominately Hispanic neighborhoods. Ethnic pride has been documented to be a separate construct that may not be associated with other cultural variables (Keefe & Padilla, 1987). Consequently, the restricted range observed in ethnic pride is not evident with the other cultural constructs in the current study.
Limitations and Implications for Practice
The limitations to this study include the cross-sectional design, which limits our ability to make causal inferences. Also, the self-report nature of the assessment may be subject to social desirability and shared-reporter variance. Additionally, the purposive sampling and restricted geographic region precludes widely generalizing these results beyond the study sample. Future research using probability sampling and a nationally representative sample of Hispanic adolescents could improve the generalizability of our findings. We did not collect data on the enrollment and refusal rate of adolescents who were offered participation. Such data could address potential self-selection bias and would be a good component to assess in future studies. Despite these limitations, our results provide further evidence that traditional Hispanic cultural factors may serve as assets to promote a positive developmental trajectory among Hispanic adolescents. If replicated by future studies, our findings suggest that substance use prevention programs targeting Hispanic adolescents could benefit from the inclusion of a component to strengthen the traditional values of simpatía and familism. Such strategies would likely enhance intervention effectiveness and acceptability for Hispanic adolescents and their families.
Footnotes
Acknowledgements
The authors would like to thank Vera Klinoff, Lissette Cortes, Elisa Leeder, Sohani Barrientos, Christina Allen, and Danille Wright for their work on data collection. We are grateful to the following community leaders for their assistance with participant recruitment: William Sanchez and Jeorge Vega from the City of Hialeah Parks and Recreation and Early Prevention/Intervention Program, Sharon Dziedzic from the City of Hialeah Young Leaders With Character Program, Lilah Ross from Masters Preparatory School, and Julia Hidalgo from John F. Kennedy Library.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Nova Southeastern University President’s Faculty Research and Development Grant.