Effects of youth assets on adolescent alcohol, tobacco, marijuana use, and sexual behavior.
Alcoholism (Health aspects)
Drinking of alcoholic beverages (Health aspects)
Infection control (Health aspects)
Marijuana (Health aspects)
Cigarettes (Health aspects)
Drugs and youth (Risk factors)
Drugs and youth (Health aspects)
Teenage girls (Surveys)
Teenage girls (Sexual behavior)
Teenage girls (Health aspects)
Parenting (Health aspects)
Native Americans (Surveys)
Native Americans (Sexual behavior)
Native Americans (Health aspects)
Teenagers (Sexual behavior)
Teenagers (Health aspects)
Workers (Beliefs, opinions and attitudes)
Workers (Health aspects)
Dunn, Michael S.
Scherzer, Gary D.
|Publication:||Name: Journal of Alcohol & Drug Education Publisher: American Alcohol & Drug Information Foundation Audience: Academic; Professional Format: Magazine/Journal Subject: Health; Psychology and mental health; Social sciences Copyright: COPYRIGHT 2011 American Alcohol & Drug Information Foundation ISSN: 0090-1482|
|Issue:||Date: Dec, 2011 Source Volume: 55 Source Issue: 3|
|Topic:||Canadian Subject Form: Teenage sexual behaviour|
|Product:||Product Code: 7754001 Marijuana; 2111000 Cigarettes NAICS Code: 312221 Cigarette Manufacturing SIC Code: 2111 Cigarettes|
BACKGROUND: Alcohol, tobacco, marijuana use, and sexual behaviors are consistently reported by high school students in the United States and can contribute to reduced quality of life. Empirical research finds that many assets may act as a protective factor for adolescent risk behaviors. As such, the purpose of this study was to examine the associations of youth assets and adolescent engagement in alcohol, cigarette, marijuana use, and sexual behavior among students 14-18 years in a rural state.
METHODS: Participants consisted of a random sample of 834 students aged 14-18 years attending two public school districts in rural Tennessee. A survey that assessed behaviors, knowledge, and youth assets was administered to these students during the spring of the school year.
RESULTS: Analysis found that a large percentage of students had engaged in alcohol, tobacco, marijuana use, and sexual behaviors. Additionally, it was discovered that some youth assets such as future aspirations, parental expectations, and positive peer influence were associated with a lower prevalence of adolescent substance use and sexual behavior. Furthermore, assets seem to be more protective in this sample of 14-18 year olds for past 30 days behavior compared to ever having used a substance (i.e., alcohol, tobacco, marijuana) or ever having had sexual intercourse.
CONCLUSIONS: The results suggest that substance use and sexual behaviors among adolescents vary by youth asset. As such, it is important to realize that interventions designed to reduce alcohol, tobacco, marijuana use, and sexual behavior using an asset development framework needs to be tailored.
Keywords: ATOD; sexual behavior; youth assets; adolescents; rural
Adolescent risk behaviors are a significant issue that can contribute to reduced quality of life. Alcohol, tobacco, marijuana use, and sexual behaviors are consistently reported by high school student in the United States. Results from the Centers for Disease Control and Prevention (CDC) 2009 Youth Risk Behavior Survey (YRBS), found that 72.5% of high school students had at least one drink of alcohol during their lifetime, and 41.8% had at least one drink in the past 30 days. Additionally, this study found that 46.3% of students had tried cigarettes, and 19.5% had smoked in the past 30 days. Also, 36.8% of students had used marijuana in their lifetime, and 20.8% had used it in the past 30 days. Furthermore, this study found that 46% of students had sexual intercourse in their lifetime. (2009 National Youth Risk Behaviro Survey Overview) Differences have been observed on substance use and sexual behaviors by males and females. For example, in a 2009 CDC study it was reported that females were more likely to have had at least one drink of alcohol in their lifetime, whereas males were more likely to have used marijuana and used in the past 30 days. No differences were observed for ever having sexual intercourse or past 30 days sexual intercourse. (National YRBS 2009)
Research has found that the more risk factors an adolescent has (e.g., poor family communication, peer pressure, lack of family support) the likelihood increases of being involved in risk behaviors such as substance use and sexual behaviors. (Schinke, Fang, Cole, 2008) (Cleveland, Feinberg, Bontempo, Greenberg, 2008) Substance use and abuse can lead to many negative consequences including death, disability and poor judgment. For example, adolescents who begin using substances at an early age are more likely to experience dependency later in life. (Chen, Storr, Anthony, 2008) (Brook, Brook, Zhang, 2002) As such, prevention and early intervention are key to reducing the harm that may result from adolescent substance use. Enhancing adolescent youth assets has been suggested as an important way to intervene in the health risk behaviors of adolescents. A youth asset model emphasizes socialization and support from sources such as family, peers, and school. The Search Institute's Developmental Asset Framework suggests 40 assets that can be enhanced or established that are thought to reduce risky behavior. (Scales, Leffert, 1999) (Scales, 1999)
Empirical research finds that many assets may act as a protective factor for adolescent risk behavior with respect to alcohol, tobacco, and other drug use (ATOD). (Beebe, Vesely, Oman, Tolma, Aspy, Rodine, 2008). In a study of 1350 urban adolescents, it was found that there were significant relationships between several assets, such as peer models and family communication, and nonuse of alcohol and other drugs, (Oman, Vesely, Aspy, McLeroy, Rodine, Marshall, 2004), thus indicating that certain assets can play a valuable role in preventing alcohol and other drug use. Another study assessing ATOD use among adolescents found that having positive adult role models was a protective asset and was associated with the nonuse of alcohol, tobacco, and other drugs. Additionally, this study found that strong family communication was associated with non-use of other drugs. (Beebe, Vesely, Oman, Tolma, Aspy, Rodine, 2008) These studies suggest that youth assets can play an important role in the prevention of ATOD.
Most studies to date have focused on the relationship of youth assets and behaviors among students in urban or suburban regions. Few have focused on these relationships in rural regions in the South. The purpose of this study was to examine the associations of youth assets and adolescent engagement in alcohol, cigarette, marijuana use, and sexual behavior among students 14-18 years in a rural state.
Participants consisted of a convenient sample of 834 students aged 14-18 years attending two public school districts in rural Tennessee. The students were participating in a larger study designed to increase sexual abstinence in high school students. The majority of the sample were 14 years of age (40.9%) followed by those 15 years of age (30.5%). Mean ages for females and males were 15.0 and 15.1 years. Of the sample, over 51% were female with whites being the largest racial group (68.4%), followed by Hispanics (14.4%) and mixed race (7%).
In order to collect information on adolescent health risk behaviors, youth assets, and knowledge, a survey was conducted. The survey instrument was developed from a series of previously validated instruments that included selected questions from a variety of widely used sources such as the Youth Risk Behavior Survey, the Middle School Risk Behavior Survey, Michigan Abstinence Program, and the California Healthy Kids Survey. The questions selected were reliable with a Cronbach's alpha of .80 or higher and developed for specific age groups and by other characteristics such as race and ethnicity. Data collection took place during the spring of 2009. All data were collected on site at the participating school. Prior to administering the survey, an active parental consent protocol was implemented. Parents were sent consent forms from the schools, and a follow-up letter was sent out after a specified two weeks time period. Parents were asked to return consent forms to a respective school administrative designee who forwarded the consent to the research staff.
Research staff were responsible for administering the survey to students. The data was collected in the classroom during a particular time in the school day. Students who did not have parental approval or chose not to participate remained in the classroom. Research staff were instructed on how to administer the survey by a protocol designed for the study. Upon completion, students returned their surveys to the research staff. Completed surveys were not viewed by anyone associated with the schools. Names were not recorded on the survey in order to protect student identity. The response rate was 85% and was based on the number of students who did not complete the survey due to not having parental permission, refusing to participate on the day the survey was administered, or were absent from school on the day the survey was administered.
Alcohol and drug use. Six items measured if the student had ever tried and if the students had in the past 30-days used alcohol, cigarette, and marijuana. Example of questions includes "Have you ever tried cigarette smoking, even one or two puffs?" "During the last 30 days, on how many days did you smoke cigarettes?" Past 30 day uses of alcohol, tobacco, and marijuana were dichotomized into yes/no response with yes indicating use.
Sexual behavior. Sexual behavior was assessed with two questions, specifically, "have you ever had sexual intercourse" and "in the last year, with how many people have you had sexual intercourse." This question was dichotomized into yes/no response with yes indicating students having had sexual intercourse in the past year.
Youth Assets. Eight types of youth assets were constructed by the researchers for this analysis. Factor analysis was used to determine the reliability of each subscale. The 10 assets examined (listed with the number of items for each asset, Cronbach's a, and a sample item) were (a) Future Aspiration (5 items, [alpha]=.76, "I plan to go to college after high school," (b) Internal Control (4 items, [alpha]=.71, "I can work out my problems," (c) Empathy (4 items, [alpha]=.79, "I feel bad when someone gets their feelings hurt," (d) Parental Expectation (4 items, [alpha] = .81, "A parent or other adult in my house believes I will be successful," (e) Parental Support (4 items, [alpha] = .83, "A parent or other adult in my home talks to me about my problems," (f) Self-confidence (2 items, [alpha] = .70, "There are many things I do well," (g) Positive Peer Influence (2 items, [alpha] = .74, "My friends try to do what is right," (h) Peer Help (3 items, [alpha] = .83, "I have a friend about my age who helps me when I have a hard time."
Assets were indicated as either being present or absent based on the mean response to variable included in the asset. Items that comprised each asset were scored from 1 to 4 with 4 being the most positive response. An individual was said to have the asset if the mean score were 3 or higher. This indicated that the asset was reported as "pretty much" or "very much."
PASW, Release 18 was used for all data analysis. Chi-square analysis was used to examine the variables related to differences between males and females in regard to alcohol, tobacco, marijuana use, and sexual behavior. Logistic regression models were used to examine the relationship between alcohol, tobacco, marijuana use, and sexual behavior, and the 8 youth assets. The dependent variables consisted of these four behaviors. Independent variables included the 8 youth assets. Regression models were run separately for each dependent variable. Odds ratios, 95% confidence intervals, and variance were calculated for each model, controlling for sex.
The percentage of students participating in alcohol, tobacco, marijuana use, and sexual behavior is reported in Table 1. Almost 43% of males and 40.4% of females had tried alcohol, and 35.3% of females and 34.3% of males had tried cigarettes. Additionally, 19.4% of males and 15.9% of females had tried marijuana. Almost a quarter of the students (23.0% of males and 22.7% of females) indicated they had sexual intercourse in their lifetime. Past 30 day alcohol use was reported by 20.7% of males and 19.4% of females, and 14.9% and 16.6% of males and females reported past 30 day use of cigarettes. Also, 12.5% and 8.7% of males and females, respectively, indicated past 30 day use of marijuana. Finally, past year sexual intercourse was reported by 18.8% of males and 20.0% of females.
Table 2 shows odds ratios and 95% confidence intervals for youth assets by alcohol use. There was a significant relationship between the asset peer help and having ever tried alcohol among males and females. Males who had the asset were 1.94 times more likely to report noninitiation of alcohol compared to those males who did not report the asset, and females who had the asset were 1.20 times more likely to report noninitiation of alcohol compared to those females without the asset. The assets parental expectations (OR = 3.35, OR = 2.46) and positive peer influence (OR = 2.25, OR = 3.48) were found to be protective factors among both males and females for past 30 day alcohol use. The future aspiration asset appeared to serve as a protective factor from past 30 day alcohol use for males (OR = 2.57).
Table 3 shows odds ratios and 95% confidence intervals for youth assets by cigarette use. There was a significant relationship between the asset peer help and having ever tried cigarettes among males. Males who had the asset remained more than 2 times more likely to report noninitiation of cigarettes compared to those males who did not report the asset. No asset was found to be a protective factor for females and the initiation of cigarettes. The parental expectations (OR = 3.57) and peer influence (OR = 2.48) assets were found to be protective factors for past 30 day cigarette use among males compared to those males who did not report the assets. Finally, the parental support asset (OR = 2.43) was found to be a protective factor for females.
Table 4 shows odds ratios and 95% confidence intervals for youth assets by marijuana use. There was a significant relationship between the asset positive peer influence and past 30 day marijuana use. Males who had the asset were 2.43 times more likely to report non past 30 day use of marijuana compared to those males who did not report the asset, and females who had the asset were 3.10 times more likely to report non past 30 day use compared to those females who did not report the asset. The asset future aspiration (OR=2.53) was found to be a protective factor among females for past 30 day marijuana use. Finally, females who had the parental support asset were 3.10 times more likely to have not used marijuana in the past 30 days compared to females without the asset.
Table 5 shows odds ratios and 95% confidence intervals for youth assets by sexual behavior. There was a significant relationship between the asset parental support and positive peer influence among females and past year sexual intercourse. Female who had the asset remained more than 2 times more likely to report nonsexual behavior in the past year compared to those females without the asset. No asset was found to be a protective factor for males or females who ever had sexual intercourse.
The purpose of this study was to examine the associations of youth assets and adolescent engagement in alcohol, cigarette, marijuana use, and sexual behavior among high school students in a rural state. Analysis found that a large percentage of students had engaged in alcohol, tobacco, and marijuana use. For example, over 40% of males and females had tried alcohol in their lifetime and over 34% of both sexes had tried cigarettes. Additionally, about 20% of students had engaged in sexual intercourse in the past year. The results of this study suggest that some youth assets are associated with a lower prevalence of adolescent substance use and sexual behavior. Furthermore, assets seems to be more protective in this sample of 14-18 year olds for past 30 days behavior compared to having ever used a substance (i.e., alcohol, tobacco, marijuana) or ever having had sexual intercourse.
Significant relationships were found between nonuse of alcohol and the availability of peer help, parental expectations, and positive peer influence. An adolescent who had any 1 of the assets was approximately 1.2 to 3.5 times less likely to have used alcohol than an adolescent who did not have any of the assets. These results are indicative of previous research that found that positive peer relationships and parental expectations are protective factors for alcohol use. (Nash, McQueen, Bray, 2005) (Padilla, Carlo, 2007) The relationship between assets and alcohol use varied by sex. For example, future aspiration was found to be a protective factor for past 30 day alcohol use for males, whereas having deviant friends was a risk factor for females. Of interest is the fact that assets were more protective of past 30 day alcohol use as compared to those students never trying alcohol. This may be a result of the age of the sample (14-18 years), and the fact that 37% of adolescents try alcohol before the age of 14. (Johnston, O'Malley, Bachman, Schulenberg, 2010)
There were significant relationships between four of the assets and past 30 day cigarette use. Males who perceived strong parental expectations and positive peer influence were found to be less likely to be engaging in past 30 day cigarette use. The youth asset parental support was found to be a protective factor for females, whereas deviant friends was a risk factor for past 30 day cigarette use. These results suggest assets differ by sex, and program planners need to take this into account when designing preventive interventions.
No youth asset was found to be significant for ever having tried marijuana. Parental support and positive peer influence were found to be significant for both males and females during the past 30 days. An adolescent who had any 1 of these assets was approximately 1.5 to 3.0 times less likely to have used marijuana in the past 30 days than adolescents without the asset. These results support previous research that found that parental and positive peer influence are protective for various health risk behaviors. For example, Padilla-Walker and Bean (2009) found that positive peer influence had a direct effect on positive behaviors including the use of marijuana. Specifically, this study found that positive relationships resulted in less likely involvement with marijuana use.
Lastly, it was observed that the assets of parental support and positive peer influence were protective factors for females for having had sexual intercourse in the past year. Females who had the asset were over 2 times less likely to have had sexual intercourse in the past year. Also, peer deviance was a risk factor among both males and females. Males and females who possessed this risk factor were over 2 times and 5 times, respectively, more likely to have had sexual intercourse in the past year. Research has found a strong relationship between deviant peer influence and sexual intercourse among adolescents. (20)
The findings of this study must be considered in light of several limitations. First, the sample was one of convenience and cross sectional. Thus, the generalization of the finding must be done with caution. Second, the survey was self-reported behaviors and perceptions of youth assets. This may have resulted in some response bias by the students. There is no way to ensure the accuracy of the responses. However, steps were taken to ensure the reliability of the measures by assuring the subjects that the survey was completely anonymous and by requesting honest responses. Third, the students were from a rural setting, limiting the generalizability of the findings.
IMPLICATIONS FOR SCHOOL HEALTH
School health professionals and researchers may find the results of this study useful when designing preventive interventions. It should be noted that varying patterns of behaviors were identified by asset and sex. As such, it is important to realize that interventions designed to reduce alcohol, tobacco, marijuana use, and sexual behavior using an asset development framework needs to be tailored by sex. A one size fits all program will be less effective than one that targets the assets of the group under investigation. Additionally, employing a combination of assets and taking into account the roles of parents, peers, and schools, may be more effective than focusing on one or a few assets that only targets peers compared to focusing simultaneously on the three roles of parents, peers, and schools.
HUMAN SUBJECTS APPROVAL STATEMENT
The institutional review board at the State University of New York at Utica has approved the study protocol.
Data for this study was provided by the Douglas Cherokee Economic Authority, Morristown, Tennessee through a grant from the Office of Adolescent Health, U. S. Department of Health and Human Resources.
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Michael S. Dunn, PhD
Coastal Carolina University
Cathy Kitts, MS & Sandy Lewis, MBA
Douglas-Cherokee Economic Authority's Education Center
Bruce Goodrow, Ed.D, MPH
Saltfork Consulting Group
Gary D Scherzer, PhD
State University of New York at Oswego
Correspondence concerning this article should be addressed to: Michael S. Dunn, PhD, Associate Professor, Department of Health Promotion, Coastal Carolina University, P.O. Box 261954, Phone: 423-794-9530, Email: email@example.com
TABLE 1 Frequency and Percent Participating in Selected Behaviors by Sex Male Female Behavior % n % n Ever tried alcohol 42.9 170 40.4 169 Ever tried cigarettes 34.3 136 35.3 148 Ever tried marijuana 19.4 77 15.9 66 Ever had sexual intercourse 23.0 91 22.7 95 Past 30-day alcohol use 20.7 81 19.4 81 Past 30-day cigarette use 14.9 59 16.6 69 Past 30-day marijuana use 12.5 49 8.7 36 Past year sexual intercourse 18.8 74 20.0 83 TABLE 2 Odds Ratios of Non-Use of Alcohol and Youth Assets Ever tried alcohol Male Female Variable OR (95% CI) OR (95 CI) Future Aspirations 0.98 (0.47-2.03) 1.42 (0.58-3.48) Internal Control 1.00 (0.57-1.75) 1.11 (0.63-1.96) Empathy 0.67 (0.39-1.14) 0.90 (0.51-1.61) Parent Expectation 0.49 (0.25-0.96) 0.56 (0.27-1.17) Parent Support 0.86 (0.47-1.57) 0.54 (0.30-1.00) Self-Confidence 1.58 (0.71-3.51) 1.20 (0.62-2.30) Pos Peer Influence 0.76 (0.43-1.34) 0.29 (0.16-1.52) Peer Help 1.94 (1.11-3.38) * 1.20 (1.08-2.13) * Past 30-day alcohol use Variable Male Female OR (95% CI) OR (95 CI) Future Aspirations 2.57 (1.09-6.02) * 1.38 (0.54-3.49) Internal Control 0.44 (0.21-0.94) 0.55 (0.27-1.14) Empathy 0.95 (0.47-1.92) 1.21 (0.61-2.40) Parent Expectation 3.35 (1.44-7.80) * 2.46 (1.12-5.41) * Parent Support 0.65 (0.27-1.57) 1.85 (0.92-3.73) Self-Confidence 0.73 (0.28-1.90) 0.81 (0.38-1.73) Pos Peer Influence 2.25 (1.09-4.65) * 3.48 (1.76-6.84) * Peer Help 0.56 (0.28-1.13) 0.62 (0.30-1.25) TABLE 3 Odds Ratios of Non-Use of Cigarettes and Youth Assets Ever tried cigarettes Male Female Variable OR (95% CI) OR (95 CI) Future Aspiration 0.63 (0.30-1.33) 0.90 (0.37-2.19) Internal Control 0.91 (0.50-1.65) 0.73 (0.41-1.28) Empathy 0.76 (0.43-1.34) 1.11 (0.61-2.02) Parent Expectation 0.37 (0.18-0.73) 0.50 (0.24-1.04) Parent Support 1.10 (0.57-2.12) 0.72 (0.40-1.28) Self-Confidence 1.07 (0.48-2.41) 1.76 (0.88-3.49) Pos Peer Influence 0.65 (0.36-1.18) 0.32 (0.18-1.57) Peer Help 2.38 (1.32-4.30) * 0.80 (0.45-1.40) Past 30-day cigarette use Male Female Variable OR (95% CI) OR (95 CI) Future Aspiration 2.28 (0.89-5.81) 0.80 (0.31-2.05) Internal Control 0.73 (0.32-1.66) 1.36 (0.68-2.71) Empathy 0.92 (0.42-2.02) 0.93 (0.46-1.86) Parent Expectation 3.57 (1.39-9.20) * 1.87 (0.86-4.08) Parent Support 0.41 (0.14-1.14) 2.43 (1.17-5.01) * Self-Confidence 1.20 (0.45-3.21) 0.91 (0.43-1.91) Pos Peer Influence 2.48 (1.09-5.61) * 1.83 (0.91-3.68) Peer Help 0.54 (0.25-1.20) 0.97 (0.49-1.90) * = statistically significant TABLE 4 Odds Ratios of Non-Use of Marijuana and Youth Assets Ever tried marijuana Male Female Variable OR (95% CI) OR (95 CI) Future Aspiration 0.52 (0.22-1.20) 0.88 (0.32-2.37) Internal Control 0.91 (0.45-1.84) 1.66 (0.77-3.56) Empathy 1.72 (0.87-3.38) 1.07 (0.51-2.25) Parent Expectation 1.20 (0.54-2.68) 0.88 (0.37-2.10) Parent Support 1.00 (0.46-2.15) 0.42 (0.20-1.90) Self-Confidence 0.74 (0.31-1.80) 0.77 (0.35-1.68) Pos Peer Influence 0.32 (0.16-0.65) 0.46 (0.22-1.95) Peer Help 1.40 (0.71-2.74) 1.43 (0.68-3.01) Past 30-day marijuana use Male Female Variable OR (95% CI) OR (95 CI) Future Aspiration 2.53 (1.95-6.75) * 0.83 (0.27-2.60) Internal Control 0.73 (0.30-1.73) 0.47 (0.18-1.26) Empathy 0.52 (0.22-1.21) 0.96 (0.38-2.39) Parent Expectation 1.73 (0.66-4.50) 1.88 (0.70-5.01) Parent Support 0.87 (0.32-2.35) 3.01 (1.08-8.33) * Self-Confidence 0.89 (0.31-2.60) 1.95 (0.79-4.82) Pos Peer Influence 2.43 (1.02-5.76) * 3.10 (1.19-8.09) * Peer Help 0.64 (0.28-1.45) 1.14 (0.46-2.80) * = statistically significant TABLE 5 Odds Ratios of Non-Sexual Behaviors and Youth Assets Ever had sexual intercourse Male Female Variable OR (95% CI) OR (95 CI) Future Aspiration 0.93 (0.42-2.04) 1.15 (0.46-2.88) Internal Control 1.02 (0.52-1.98) 1.39 (0.72-2.70) Empathy 0.99 (0.52-1.86) 1.17 (0.61-2.27) Parent Expectation 0.51 (0.25-1.06) 0.67 (0.31-1.44) Parent Support 0.93 (0.44-1.96) 0.39 (0.20-0.75) Self- Confidence 0.68 (0.30-1.55) 0.82 (0.41-1.64) Pos Peer Influence 0.61 (0.32-1.17) 0.56 (0.29-1.05) Peer Help 1.20 (0.63-2.30) 0.93 (0.49-1.74) Past year sexual intercourse Male Female Variable OR (95% CI) OR (95 CI) Future Aspiration 1.30 (0.55-3.04) 0.93 (0.36-2.35) Internal Control 0.81 (0.39-1.68) 0.72 (0.36-1.46) Empathy 0.95 (0.47-1.91) 0.86 (0.43-1.72) Parent Expectation 1.41 (0.64-3.10) 1.59 (0.73-3.49) Parent Support 1.60 (0.71-3.58) 2.22 (1.11-4.44) * Self- Confidence 0.98 (0.40-2.43) 1.48 (0.73-3.02) Pos Peer Influence 1.64 (0.79-3.37) 2.11 (1.08-4.11) * Peer Help 0.76 (0.37-1.55) 0.88 (0.45-1.71) * = Statistically significant
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