Cultural/Interpersonal Values and Smoking in an Ethnically Diverse Sample of Southern California Adolescents

In ethnically diverse school contexts, values from multiple cultures might influence adolescents\u27 attitudes and behaviors. This study developed scales to assess cultural values among Southern California 6- grade adolescents (N=2281) and evaluated the associations between values and smoking. The scales assessed values salient in many Hispanic and Asian cultures: Respect for Adults (e.g., filial piety, respeto). Interpersonal Harmony (e.g., saving face, simpatia), and Differentiated Gender Roles (e.g., machismo). In cross-sectional and one-year longitudinal models. Respect for Adults and Interpersonal Harmony were associated with a lower risk of lifetime smoking. The associations were significant even after controlling for demographic characteristics, friends\u27 smoking, and parents\u27 smoking, indicating that values influence adolescents\u27 behavior over and above the effects of modeling and peer influence. Increased understanding of adolescents\u27 values could inform the creation of smoking prevention programs for ethnically diverse adolescents

Multiple Peer Group Self-identification and Adolescent Tobacco Use

Associations between peer group self-identification and smoking were examined among 2,698 ethnically diverse middle school students in Los Angeles who self-identified with groups such as Rockers, Skaters, and Gamers. The sample was 47.1% male, 54.7% Latino, 25.4% Asian, 10.8% White, 9.1% Other ethnicity, and 59.3% children of immigrant parents. Multiple group self identification was common: 84% identified with two or more groups and 65% identified with three or more groups. Logistic regression analyses indicated that as students endorsed more high risk groups, the greater their risk of tobacco use. A classification tree analysis identified risk groups based on interactions among ethnicity, gender, and group self-identification. Psychographic targeting based on group self-identification could be useful to design more relevant smoking prevention messages for adolescents who identify with high-risk peer groups

Internet Accessibility and Usage among Urban Adolescents in Southern California: Implications for Web-Based Health Research

The World Wide Web (WWW) poses a distinct capability to offer interventions tailored to the individual’s characteristics. To fine tune the tailoring process, studies are needed to explore how Internet accessibility and usage are related to demographic, psychosocial, behavioral, and other health related characteristics. This study was based on a cross-sectional survey conducted on 2373 7th grade students of various ethnic groups in Southern California. Measures of Internet use included Internet use at school or at home, Email use, chat-room use, and Internet favoring. Logistic regressions were conducted to assess the associations between Internet uses with selected demographic, psychosocial, behavioral variables and self-reported health statuses. The proportion of students who could access the Internet at school or home was 90% and 40%, separately. Nearly all (99%) of the respondents could access the Internet either at school or at home. Higher SES and Asian ethnicity were associated with higher internet use. Among those who could access the Internet and after adjusting for the selected demographic and psychosocial variables, depression was positively related with chat-room use and using the Internet longer than 1 hour per day at home, and hostility was positively related with Internet favoring (All ORs = 1.2 for +1 STD, p \u3c 0.05). Less parental monitoring and more unsupervised time were positively related to email use, chat-room use, and at home Internet use (ORs for +1 STD ranged from 1.2 to 2.0, all p \u3c 0.05), but not related to at school Internet use. Substance use was positively related to email use, chat-room use, and at home Internet use (OR for “used” vs. “not used” ranged from 1.2 to 4.0, p \u3c 0.05). Self-reported health problems were associated with higher levels of Internet use at home but lower levels of Internet use at school. More physical activity was related to more email use (OR = 1.3 for +1 STD), chat room use (OR = 1.2 for +1 STD), and at school ever Internet use (OR = 1.2 for +1 STD, all p \u3c 0.05). Body mass index was not related to any of the Internet use-related measures. In this ethnically diverse sample of Southern California 7th grade students, 99% could access the Internet at school and/or at home. This suggests that the Internet is already a potential venue for large scale health communication studies. Adolescents with more psychosocial risk factors or detrimental health behaviors were more likely to use the Internet. Therefore, if used properly, Internet interventions could effectively address the high risk populations. Additional research is needed to gain a more complete understanding of the positive and negative consequences of Internet use among adolescents

Meanings of Smoking and Adolescent Smoking Across Ethnicities

Purpose To develop insight into population-specific meanings of smoking in our highly multicultural middle schools in order to provide effective and appropriate tools for smoking prevention efforts. Methods We used focus group interviews to develop the Meanings of Smoking Index (MSI), a nine-item scale that uses a “mark all that apply” strategy to assess what smoking means to children who have tried smoking as well as to those who are susceptible to smoking. In 24 public and parochial middle schools in the greater Los Angeles area, 2336 7th graders (1483 Latino, 565 Asian/ Pacific Islander and 288 white, 55.2% of the sample was female) completed the MSI as part of a school-based trial of culturally-targeted smoking prevention strategies. Items were rank ordered according to salience (rate of endorsement) and relevance (strength of relationship with lifetime smoking) across the entire sample and separately for Hispanic/Latino, Asian/Asian-American and white respondents. Spearman correlation coefficient was used to compare results between ethnicities. Results The most frequently endorsed meanings were similar across ethnicities. Magnitude of associations between smoking behaviors and meanings were dissimilar across ethnicities. The meaning with the strongest relationship to lifetime smoking for whites and Latinos was “it helps me study” (OR 3.4 and 2.6 respectively), and for Asians was “don\u27t want to make another smoke alone” (OR 5.4). Conclusions We have shown previously that interventions on meanings of eating behaviors changed dietary behaviors in adolescents. The present findings suggest that meanings are powerful determinants of adolescent smoking in culturally diverse populations and could offer powerful intervention tools to prevent adolescent smoking

Unique Contributions of Meanings of Smoking and Outcome Expectancies to Understanding Smoking Initiation in Middle School

Background: Previous research has shown that meanings of smoking are highly predictive of smoking in middle school children. Three factors of meanings of smoking have been suggested in the literature: personal meanings, functional meanings, and social meanings. These conceptually derived factors of meanings of smoking have not previously been empirically studied. Purpose: This study examined the factor structure of the Meanings of Smoking Index (MSI) to determine the unique contribution of meanings of smoking and positive outcome expectancies to smoking behavior in middle school children. Methods: A multiethnic sample of 2,247 eighth-grade students enrolled in 24 middle schools in greater Los Angeles completed a paper-and-pencil survey in class. Results: Four factors of the MSI emerged (functional, personal, social image, and weight concern). Positive outcome expectancies and each of the four factors of the MSI predicted lifetime smoking in a multivariate model. Conclusions: Meanings of smoking were empirically distinct from positive outcome expectancies. Adolescents who endorsed personal and functional meanings were more likely to smoke. Social image and weight concern meanings were negatively related to smoking after controlling for all other meanings. Meanings of smoking may prove to be important and modifiable mediators of smoking and therefore useful in future prevention studies

The AHIMSA Acculturation Scale: A New Measure of Acculturation for Adolescents in a Multicultural Society

Acculturation has been associated with adolescent health-risk behaviors. Most acculturation scales are inappropriate for adolescent surveys because they are too long, are not applicable to differing ethnic groups, or are language-based only. A brief, multidimensional, multicultural acculturation measure for adolescents was developed. Sixthgrade students (N = 317) in Los Angeles completed that scale and other measures of acculturation. The Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA) generates four subscores: United States Orientation (Assimilation), Other Country Orientation (Separation), Both Countries Orientation (Integration), and Neither Country Orientation (Marginalization). Three of the subscales were correlated with the subscales of a modified Acculturation Rating Scale for Mexican-Americans-II, with English language usage, and with generation in the United States providing evidence for the validity of the scale. Research on culturally diverse adolescent samples might benefit from the inclusion of the AHIMSA

Stressful Life Events, Smoking Behavior, and Intentions to Smoke among a Multiethnic Sample of Sixth Graders.

Objectives. Adolescent smoking has been associated with stressful life events. However, few studies have examined the associations between stress, smoking intentions, and smoking behavior among a multiethnic sample of adolescents. Methods. We compiled a checklist of stressful life events relevant to multiethnic youth and administered it to 1,074 sixth-grade students in urban Los Angeles. Results. The most frequently reported stressful events were similar across ethnic groups and generations in the USA: test taking, chores, and arguments with friends. The events reported as the most severe were disturbances in family life, such as: death, arguments between parents, and illness or injury. Whites and Latinos had reported higher levels of ever smoking and intentions to smoke than Asian/Pacific Islanders (PIs). On the positive family-related events scale Latinos scored higher than did whites or Asian/PIs. Whites scored higher than Latinos or Asian/PIs on both negative peer-related and negative personal-related events. Associations were observed between total stress, stressful life events, and smoking behavior and intention to smoke. Total stress was associated with ever smokers, smoking intentions within the next year and in high school over the entire sample. Negative peer-related events were associated with intention to smoke within the next year, among Latinos. Among Asian/PIs negative peer-related events were associated with intention to smoke within the next year and in high school. Negative school-related events were significantly associated with ever smoking and intentions to smoke in the next year and marginally associated with intentions to smoke in high school among children born in the USA whose parents were also born in the USA. Negative peer-related events and positive personal-related events were significantly associated with intentions to smoke in the next year among children born in the USA whose parents were immigrants. Conclusions. Results suggest that negative peer- and school-related events may lead to increased risk of smoking behavior and intentions to smoke among multicultural adolescent

Why Smoking Prevention Programs Sometimes Fail. Does Effectiveness Depend on Sociocultural Context and Individual Characteristics?

Background: School-based smoking prevention programs sometimes fail in unexpected ways. This study tests the hypotheses that both social/cultural contexts and individual dispositional characteristics may interact with program content to produce effects that are variable in potentially predictable ways. Methods: Students in 24 culturally heterogeneous or primarily Hispanic/Latino middle schools (N = 3,157 6th graders) received a multicultural collectivist-framed social influences (SI) program, an individualist-framed SI program, or a control condition. Three-way linear and nonlinear interactions, program frame × social context × dispositional phenotype, were tested. Results: Three-way interactions were found for the dispositional phenotypes of depression and hostility with social context and program content/frame. In predominantly Hispanic/Latino schools, larger program effects were observed for high depressed and high hostile youth in both the collectivist and individualist framed programs. In culturally mixed schools, prevention effects were greatest for low depressed and low hostile youth, especially in the individualist framed program. In culturally mixed schools, there may have been a negative treatment effect for both programs among adolescents scoring high on depression and hostility. Discussion: Prevention program effects can vary by combination of program content, social setting, and individual dispositional characteristics. The results suggest that prevention program design and implementation should be sensitive to population characteristics at both the individual and sociocultural levels

No News is Bad News: Characteristics of Adolescents Who Provide Neither Parental Consent Nor Refusal for Participation in School-Based Survey Research

Schools offer a convenient setting for research on adolescents.However, obtaining active written parental consent is difficult. In a 6th-grade smoking study, students were recruited with two consent procedures: active consent (parents must provide written consent for their children to participate) and implied consent (children may participate unless their parents provide written refusal). Of 4,427 invited students, 3,358 (76%) provided active parental consent, 420 (9%) provided active parental refusal, and 649 (15%) provided implied consent (parental nonresponse). The implied consent procedure recruited more boys, African Americans, students with poor grades, and smokers. This dual-consent procedure is useful for collecting some limited data from students who do not provide active consent or refusal

Ethnic Variation in Parenting Characteristics and Adolescent Smoking

Purpose To examine ethnic variation in parenting characteristics and in associations among parenting characteristics and adolescent smoking, and to assess the strength of those associations separately by ethnic subgroup. Methods Data were collected from a diverse sample (48.4% Hispanic/Latino, 22.9% Asian, 12.1% Non-Hispanic white, and 16.6% Multiethnic) of 1846 Southern California 6th-graders (mean age 11.3 years). Lifetime smoking and parenting characteristics (parental smoking status, adolescents’ perceptions of parent–child communication, and parental monitoring) were assessed. Across ethnic groups, descriptive statistics for parenting and smoking variables were calculated and compared. Logistic regression analyses controlled for demographics (socioeconomic status, generation status, family structure, age, and gender) and interaction terms (parenting characteristics × ethnicity), and were also run separately by ethnicity. Results Asian adolescents reported less parental monitoring than Latino/Hispanics and less parental communication than other ethnic subgroups. Odds ratios indicated parental monitoring (OR = .63; CI = .53-.74; p \u3c .001) and parental communication (OR = .73; CI = .62–.86; p \u3c .001) were protective whereas parental smoking (OR = 1.48; CI = 1.18–1.87; p \u3c .01) was a risk factor for smoking. Relative to Latinos, parental monitoring (OR = .50; CI = .26–.95; p \u3c .05) was more protective, and parental communication (OR = 2.44; CI = 1.15–5.17; p \u3c .05) less protective for white adolescents. All parental characteristics were significantly associated with Latino/Hispanics smoking. Parental monitoring was significantly associated with Multiethnic and white smoking. No parenting characteristics were significant for Asians. Conclusion Ethnic differences in parenting characteristics and adolescent smoking should be considered when designing prevention curriculum. Future research should investigate the nature of parent–child communication among Asian immigrant populations