racial discrimination and its effects on adolescent substance abuse

racial discrimination and its effects on adolescent substance abuse

1. Racial Discrimination and its Effect on Adolescent Substance Use

2. Background Racism and racial discrimination have been recognized as important risk factors that affect most minority populations and may contribute to elevated health risks (NIDA, 1998). It has also been estimated from the National Household Survey on Drug Abuse (NHSDA) that prevalence of drug use among high school students is higher in urban areas. High-school students are at high risk for drug abuse (Borrell , 2007).

3. Background The data and research concerning the possible correlation and/or causal relationship between racial discrimination and drug abuse is sparse. The purpose of this report is to afford policymakers, educators, and concerned community members with a firm understanding and awareness of the nature of drug abuse with respect to racial discrimination among minority high school students in the Washington D.C. area.

4. Specific Aims/Hypot hesis Specific Aims : To determine the prevalence of substance abuse in adolescents who have experienced racial discrimination. To analyze the effect of co-mediators; self-esteem, cultural identity, acculturation and peer pressure, on the interplay between racism and substance abuse. To provide a treatment outlet for identified adolescents via structured focus programs. Hypotheses: Experiences of racial discrimination positively correlate to future substance abuse, specifically alcohol, tobacco and marijuana use. Positive self-esteem and strong cultural identity buffer against substance abuse, despite experiences of racial discrimination. Acculturation and peer pressure exacerbate the progression to substance abuse following episodes of racism.

5. Methods Design : Two year cross sectional study Population : DC public school students ages 14-18 All ethnic groups are observed in the study Minority groups in this study are defined as African Americans, Hispanic Americans, Asian Americans, and Native Americans. Setting : The respondents in this study will be 9th, 10th and 11th grade students attending 32 schools in the District of Columbia.

6. Methods Cultural and Ethical considerations : Linguistic competency- survey language will be set to minority preference. Survey will be distributed to high school students. Survey will be written in a 5-6 th grade reading level to improve comprehension. Using a Flesch/Flesch-Kincaid readability test (MS word to measure readability)

7. Methods - Procedures Gain approval from: D C Board of Education IRB School principals District superintendents Parent Consent- issued to students on the first day of class along with heath forms for parents to sign. Student assent - issued during homeroom along with survey To maximize the response rate and encourage participation an incentive will be offered (iPad raffle and Pizza Party upon completion of survey).

8. Survey to be conducted in September 2012 by trained research assistants in students' classrooms. A total of 1500 students will be included in the study. Each student will be assigned a random ID number to protect their privacy and identifiable information. 10% of the total population will participate in local focus groups. Focus group sessions will be taped and discarded after analysis (participants will be informed of this as to avoid ethical complications) Methods - Procedures

9. Methods - Focus Groups Recruitment Included in the assent form and will be an attached leaflet regarding voluntary involvement in a focus group Over recruit for 10-25% but at least 10% percent of the total study population will be in the focus group 8-10 participants per session, 15 sessions, each session 1-2 hrs. Sessions will be held from September 2013 to January 2014.

10. Instrumentation/Tools Demographic Variables Schedule of Racist Events (Racism) Youth behavior risk Surveillance system (YBRSS) Rosenberg Multi-ethnic Identity measurement (MEIM) General ethnicity questionnaire (GEQ) (acculturation) Peer Influence

11. Data analysis Demographics: Distribution of gender (male versus female) Distribution of race (number of students that identify as White/Caucasian, Black/African American, Hispanic, Asian, Native American, Middle Eastern, Pacific Islander) Distribution of age Data Analysis of First Hypothesis: We will quantitatively assess the degree of racial discrimination among our adolescent population, as outlined in instrumentation/tools, to compare those who have engaged in substance use versus those who have not engaged in substance use. Achieve mean values Compare two groups using a t-test for each of our substances (alcohol, tobacco, and marijuana) C ategorize adolescents into use versus non-use C ompare SRE scores using t-test

12. Data analysis Data Analysis of Second Hypothesis: Co-mediators play a role in buffering for/against the effect of racial discrimination on adolescent substance use. Quantify co-mediators: self-esteem, cultural identity, peer pressure, and acculturation Use logistic regression to yield an odds ratio for each substance Data Analysis of Focus Group: We will explore the complexity of how mediators impact adolescent substance users. Qualitatively assess data Transcribe and review transcripts of recorded sessions using Kreuger framework of analysis Develop, evaluate and execute school programs based on results

13. Innovation & Impact Innovation: Studies surrounding specific minorities and substance abuse have been done, n o study has provided an encompassing view of minority populations in inner urban school populations and fall short in addressing the relationship between racial discrimination and substance abuse. Such a study can provide vital data to school boards to add/modify culture competency and/or drug abuse programs. Impact: The study will provide insight and help contribute to the development of improved alcohol and substance abuse treatment programs in high schools.

14. Acknowledgements We would like to acknowledge School board of Washington, DC Dr. Tywanda McLaurin-Jones Group 3C Howard University College of Medicine Sources: Borrell, L. N., D. R. Jacobs, D. R. Williams, M. J. Pletcher, T. K. Houston, and C. I. Kiefe. (2007). "Self-reported Racial Discrimination and Substance Use in the Coronary Artery Risk Development in Adults Study." American Journal of Epidemiology 166.9: 1068-079. Print. (1998). “Drug Use Among Racial/Ethnic Minorities.” National Institute on Drug Abuse: 98-3888 Fatemeh Rabiee, (2004) Focus-group interview and data analysis. Proceedings of the Nutrition Society 63, 655–660 DOI:10.1079/PNS2004399 Okamoto, J., MPH, Ritt-Olson, A., PhD, Soto. D., Baezconde-Garbanati, L. PhD, Unger, B., PhD (2009) Perceived Discrimination and Substance Use among Latino Adolescents Am J Health Behav.: 33(6):718-727 Whitesell NR, Mitchell CM, Spicer P & The Voices of Indian Teens Project Team. "A Longitudinal Study of Self Esteem, Cultural Identity, and Academic Success Among American Indian Adolescents". (2009, January). C ultural Diversity Ethnic Minority Psychology. 15(1): 38-50. Print.