Heterogeneity in etiological factors for substance use among low-income African American adolescents.

Abstract

Impoverished African American adolescents comprise a subgroup of individuals who are at a uniquely increased risk for substance use, making early identification of African American adolescents who are most likely to engage in substance use a relevant public health issue. While much research has explored a variety of risk and protective factors for substance use, complementary approaches may uncover distinct subgroups of individuals with homogeneous patterns of risk and/or protective factors which may discriminate among those who are more or less likely to use substances across adolescence. The present study draws on the Social Development Model and holistic-interactionism to identify unique prototypical patterns of risk and protective factors and assess the extent to which these patterns are predictive of alcohol, cigarette, and marijuana use across adolescence. Using data from the Mobile Youth Survey, (n = 1,576, 100% African American, 45.5% female), we identified three discrete patterns of protective factors, characterized by high, average, and low levels of parental knowledge; six patterns of protective factors characterized by sequentially increasing levels of delinquency, exposure to violence, and peer pressure; and six patterns of etiological factors characterized by sequentially increasing levels of delinquency, exposure to violence, accompanied by concurrently decreasing levels consisting of parental knowledge and self-worth. While there was no evidence of heterogeneity in cigarette or marijuana use trajectories, we identified high use and average use alcohol trajectories. Patterns characterized by high levels of delinquency, exposure to violence, and peer pressure as well as either low or average levels of parental knowledge were associated with increased odds of demonstrating either the high use alcohol trajectory or higher initial levels of cigarette or marijuana use. The results indicate that risk and protection are two discrete, yet interactive, dimensions, wherein greater predictive specificity may be attained through examining risk and protective factors separately. While no factors emerged as strong protective factors, protection may have a discrete and specific function in the context of certain patterns of risk factors; which factors provide the most protection against substance use among members of this population should be investigated in future research.