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. Author manuscript; available in PMC: 2015 Jul 20.
Published in final edited form as: J Child Adolesc Subst Abuse. 2015 Mar 26;24(4):220–227. doi: 10.1080/1067828X.2013.812529

The Relationship Between Peer, Parent, and Grandparent Norms and Intentions to Use Substances for Urban American Indian Youth

Marcos J Martinez 1, Stephanie L Ayers 2, Stephen Kulis 3, Eddie Brown 4
PMCID: PMC4507275  NIHMSID: NIHMS660508  PMID: 26203212

Abstract

Peer, parent, and grandparent norms may be a protective factor for American Indian (AI) youth intentions to use substances, but little research has explored these influences on urban AI youth. Using OLS regression, a secondary data analysis examined the relationship between peer, parent and grandparent substance use norms, and intentions to use substances (N = 148). Findings indicated that grandparent and peer norms were the strongest predictors of intentions to use substances. Implications of these results include the need for concerted, culturally focused efforts that address AI youth substance use by targeting AI peer and family networks.

Keywords: American Indian adolescents, substance use, parental drug norms, peer drug norms

Introduction

In 2010, 67 percent of individuals identifying themselves only as American Indian (AI) and Alaska Native (AN) lived away from AI or AN areas/reservations (U.S. Census Bureau, 2012). With a majority of AIs living outside of tribal land, it may be more difficult for AI adolescents to maintain a connection to their community where traditional beliefs, values, and social norms are developed and communicated to them by elders and family members (Hawkins, Cummins, & Marlot, 2004). This is important, considering that, within AI communities, youth are traditionally shown appropriate social behaviors by their elders (Red Horse, 1997). The difficulty in maintaining connections to the AI community may make it harder for families to communicate their roles in providing guidance for AI youth, and play a role in the debilitating health, social, and economic consequences of substance use among AI youth (Rutman, Park, Castor, Taualii, Forquera, 2008; SAMHSA, 2004; Schinke, Tepavac, & Cole, 2000). For example, in comparison with other ethnic minority peers, AI youth not only begin using substances at an earlier age (Moncher, Holden, & Trimble, 1990; SAMHSA, 2004), but they have the highest substance use and overall dependence rate (CDC, 2011; SAMHSA, 2010). Due to the unique cultural and familial processes that AI's experience, and given the greater role that peers have in youths' lives beginning in adolescence, examining the significance that these processes have on intentions to use substances is necessary in understanding how to protect AI youth. However, research exploring these influences on AI youth, particularly those living in urban areas, remains limited.

Parent and Grandparent Familial Roles

Within AI families, parent and grandparent roles in the child rearing process are considered to be very important because they play an integral part in teaching and modeling cultural traditions as well as guiding youth behavior (Weaver & White, 1997). While parents are the primary socializing agent in the dominant mainstream society, in AI culture grandparents and extended family assume the role of teaching the child in “morality, values, and ethics” and serve to “protect children from dangerous or risky” behavior (Machamer & Gruber, 1998, p. 367). The parents' role is primarily to give encouragement, affection, and economic support to their children (Machamer & Gruber, 1998; Garrett & Garrett, 1994). Thus, grandparents play an active role in their grandchildren's lives (Silverstein & Marenco, 2001), “typically fill[ing] leadership positions within families” (Weaver & White, 1997, p. 72). The emphasis on extended family in the raising of children is essential to their physical, mental, and emotional well-being (Red Horse, 1997; Tomlin, 1998). This collectivist approach in decision-making is recognized and valued as a more holistic, rather than an individualistic, approach to family life.

This community-centered approach that incorporates extended family in daily activities is integral in fostering a strong sense of interconnectedness and identification with the family and tribal group among AI youth (Weaver & White, 1997). This concerted, holistic familial effort in child rearing is a cultural strength (Goodluck 2002 as cited in House, Stiffman, & Brown, 2006; LaFromboise & Dizon, 2003), which “can play a pivotal role in the social ecology of substance use” (LaFromboise, Hoyt, Oliver, & Whitbeck, 2006, p. 196). Although research has typically looked at parental influence on substance use, examining the influence of grandparents can provide further insight into the potential underlying protective familial mechanisms on AI youth intentions to use substances.

Peer Influences

According to Erikson (1968), youth are in a stage of exploration during adolescence where they are developing their identity, and the peer group is a central facet in that process. This developmental period for youth is fraught with a variety of physical and cognitive changes, including shifts in the relationships with parents and peers (Dekovic, 1999; Smetana, Campione-Narr, & Metzger, 2006), which results in an increased reliance on peers for support and acceptance (Feldman, 2008) and in greater autonomy and independence (Dekovic, 1999; McKenzie, 2008).

Peers have an important influence on youth attitudes and behavior (Okamoto et al., 2004). With the increased credence placed on peers and the desire to be accepted by them, youth may act in certain ways to fit into their peers' perceived behavioral or attitudinal norms in order to gain acceptance (Newman, Lohman, & Newman, 2007). Youth may change their behavior based on their perception of how their peers behave and of what they think their peers would approve. The magnitude of this influence was evident in Okamoto and colleagues' (2004) finding that the decision to use substances among AI youth was impacted more by their peers than their parents. Accounting for situational factors is also important in this decision to use substances, since AI youth are typically offered substances from their peers, which directly influences their own use (Kulis, Okamoto, & Rayle, 2006). Peer influences, however, can also serve as a protective force against risky behavior. Positive peer relationships can foster pro-social behavior through the social support function they can provide in emotional encouragement as well as the modeling they can do for each other by not engaging in risky behavior (Dekovic, 1999; Feldman, 2008).

Theoretical Approach

Social Norms

Cialdini, Kallgren, and Reno's (1991) theory of social norms, which builds from earlier social norms theory, posits that there are different kinds of norms that influence human behavior. Those norms include injunctive and descriptive norms. Descriptive norms relate to what most people perceive to happen in certain social situations, which can motivate people to act in a certain way because they think that behavior is the “norm” (Cialdini et al., 1991; Kulis et al., 2001). For example, an individual who believes that his/her peers' heavy drinking or smoking on the weekend is normal, regardless if the belief is true or accurate, may then act in a way that they believe is normative to their peer group. Descriptive norms could influence that individual to engage in the smoking or drinking behavior based on that misperceived norm.

Injunctive norms, the focus of this study, are based on what an individual thinks “ought” to be done in a social situation (Cialdini et al., 1991). Specifically, injunctive norms are the anticipated approval or disapproval of a behavior. For example, a youth might base his/her decision to drink or smoke based on whether or not they think that his/her parents or peers would condone or object to that behavior. Therefore, if AI youth anticipate their peers, parents, or grandparents reacting negatively (e.g. disappointment or anger) to substance use, they may be less likely to engage in substance use. Currently, there is little research that has examined the impact of both parent and grandparent injunctive norms on AI youth substance use, which is essential considering the crucial yet distinct roles that parents and grandparents play in child rearing in AI culture. Although there is research that has examined the impact of peer injunctive norms (Elek, Miller-Day, & Hecht, 2006; Olds & Thombs, 2001; Simons-Morton, Haynie, Crump, Eitel, & Saylor, 2001), this area is also limited among samples of AI youth.

Studies that have examined parental influence on substance use have found that youth who had parents who would be upset if they used substances, or if parents disapproved of use, were less likely to use substances (Barkin, Smith, & Durant, 2002; Beal, Ausellio, & Perrin, 2001; Beck & Treinman, 1996; Jackson, Henriksen, Dickinson, & Levine, 1997; Olds & Thombs, 2001; Simons-Morton et al., 2001). Kegler and colleagues (2002) found that AI youth were more likely to talk about the effect that their parents' smoking attitudes had on their own decision to smoke compared to other groups, and in turn, were less likely to smoke when their parents and grandparents voiced anti-smoking messages (Kegler, Cleaver, & Yazzie-Valencia, 2000). These findings indicate that parental articulation of expectations and feelings toward substance use may help deter it, which highlights the influence that parental attitudes have on youth substance use.

Studies examining peer normative perceptions found that youth perceived their peers to be using substances at higher rates than what their actual use was (Durant, 2002; Thombs, Wolcott, & Farkash, 2007; Henry, Kobus, & Schoeny, 2011). Other studies found peer normative perceptions, positive attitudes towards substance use, and peer approval of substance use to be predictors of substance use (Barkin, Smith, & Durant, 2002; Beal, Ausellio, & Perrin, 2001; Beck & Treinman, 1996; Elek et al., 2006; Olds & Thombs, 2001).

Purpose

While studies have consistently found that peers are highly influential in intentions to use substances, it is unknown how AI parents and grandparents protect against intentions to use alcohol, cigarette, and marijuana above and beyond the effects of peers. The main research question guiding this exploratory study is: (1) are parent and grandparent injunctive norms protective against intentions to use alcohol, cigarettes, and marijuana for urban AI youth, after controlling for the effect of their peers? We hypothesize that, given the uniqueness of familial roles in AI cultures, with grandparents and extended family assigned to provide guidance on morality and protect against risky behaviors, both parent and grandparent injunctive norms will act as a protective factor for urban AI youth in their intentions to use alcohol, cigarettes, and marijuana.

Methods

Data

The data for this study came from a longitudinal randomized controlled trial to test the efficacy of a culturally grounded substance use prevention program for urban AI 7th and 8th grade students. The substance use prevention program was incorporated in the schools' educational and cultural enrichment programs for AI students, an elective class led by a native instructor during regular school hours. The youth were identified to the school as AI by their parents at the time of school enrollment. Official school district reports indicate that youth of AI background account for between 5 and 11 percent of enrolled students.

The study followed policies for protecting human subjects in accordance with the researchers' university IRB, of the students' schools and school districts, and of the social service agency sponsoring the academic enrichment program. Active parental consents and student assents were obtained in a non-coercive manner. University-trained survey proctors administered a one-hour written questionnaire in the classrooms. Students were informed that the survey was part of a university research project, participation was voluntary, and answers were confidential.

The current analysis is based on self-administered post-test questionnaires (N = 155 students) from the Spring 2010 semester immediately after the prevention curriculum was delivered. All participants were AI, with students coming from both the treatment (n = 73) and control (n = 82) conditions. Students self-identified as AI and were enrolled in five middle schools in a large southwestern city (86% of students in 7th or 8th grade).

Measures

Substance use intentions

This study examines the intent to use substances if given an opportunity. Students were asked separate questions for alcohol, cigarettes, and marijuana in the format: “If you had the chance this weekend, would you use (a) alcohol?; (b) cigarettes?; (c) marijuana?” Responses were Likert scaled from (1) ‘Definitely No’ to (4) ‘Definitely Yes.’ In addition to examining each intention to use substance question separately, a three item mean-scale overall intention to use substances (alcohol, cigarettes, and marijuana), was created with good reliability (α = .81).

Injunctive norms

Familial injunctive norms were measured for both parents and grandparents for alcohol, cigarettes, and marijuana. Students were asked, “How angry would your parents [grandparents] be if they found out you: (a) drank alcohol?; (b) smoked cigarettes?; (c) smoked marijuana?” Response categories ranged from (1) ‘Not at all angry’ to (4) ‘Very angry.’ Peer injunctive norms were also measured for alcohol, cigarettes, and marijuana. Students were asked, “How would your best friends react if you (a) got drunk?; (b) smoked cigarettes?; (c) smoked marijuana?” Response categories ranged from (1) ‘Very positively’ to (5) ‘Very negatively’, with (3) being ‘No reaction.’ In addition to each intention to use substance being examined separately, three mean-scaled variables were created with good reliability: overall parental injunctive norms (M = 3.69, SD = .72) for alcohol, cigarettes, and marijuana (α = .91); overall grandparent injunctive norms (M = 3.61, SD = .68) for alcohol, cigarettes, and marijuana (α = .96); and overall peer injunctive norms (M = 3.65, SD = 1.17) for alcohol, cigarettes, and marijuana (α = .90).

Controls

Response categories for typical school grades were coded from to (1) Mostly F's to (9) Mostly A's. Federal school lunch participation, a proxy for socioeconomic status, was coded as (1) free lunch or (0) not free. Gender was coded as female (0) and male (1). Treatment condition was coded as (0) control group and (1) treatment group. Because of the small sample size of the data, initial bivariate statistics were analyzed to determine if demographic variables were significantly associated with intentions to use substances. Of the demographic variables examined (gender, free lunch status, grades in school, and receipt of a substance use prevention program during 7th grade), only gender was significantly associated with intentions to use substances. Multivariate models included gender, free lunch status, grades, and treatment condition.

Analysis Strategy

Descriptive statistics were employed to first examine the distributions and the characteristics of the sample. Second, the relationship of intentions to use substances to injunctive norms was analyzed using OLS regression. Multiple outcomes were examined in the analyses: each of the substance-specific intentions plus the composite scale of those items. For each substance-specific outcome, only the peer, parent, and grandparent injunctive norm corresponding to that substance are included as predictors.

Results

The descriptive characteristics of the sample are presented in Table 1. Demographically, the sample was almost evenly split between males (49%) and females (51%). The mean age of participants was 12.4 years (SD = 1.25) and the grades on average were between Bs and Cs (M = 6.35, SD = 2.07). Sixty four percent of participants received free lunch (SD = .48), and 47% percent of participants were in the treatment condition (M = .47, SD = .50).

Table 1. Descriptive Statistics for Variables in the Analysis.

Variables Range
Mean (SD) Min Max N
Dependent Variables
  Use Intentions Scale (Alcohol, Cigarettes, and Marijuana) 1.45 (.81) 1 4 148
  Use Intentions - Alcohol 1.46 (.81) 1 4 147
  Use Intentions - Cigarettes 1.35 (.68) 1 4 148
  Use Intentions - Marijuana 1.54 (.90) 1 4 149
Independent Variables
 Peer Injunctive Norms
  Injunctive Norms - Scale (Alcohol, Cigarettes, and Marijuana) 3.65 (1.17) 1 5 149
  Injunctive Norms- Alcohol 3.64 (1.21) 1 5 149
  Injunctive Norms- Cigarettes 3.79 (1.13) 1 5 149
  Injunctive Norms- Marijuana 3.52 (1.40) 1 5 149
 Parent Injunctive Norms
  Injunctive Norms - Scale (Alcohol, Cigarettes, and Marijuana) 3.69 (.72) 1 4 148
  Injunctive Norms- Alcohol 3.66 (.79) 1 4 148
  Injunctive Norms- Cigarettes 3.64 (.87) 1 4 148
  Injunctive Norms- Marijuana 3.76 (.68) 1 4 148
 Grandparent Injunctive Norms
  Injunctive Norms - Scale (Alcohol, Cigarettes, and Marijuana) 3.61 (.68) 1 4 148
  Injunctive Norms- Alcohol 3.58 (.75) 1 4 148
  Injunctive Norms- Cigarettes 3.59 (.80) 1 4 148
  Injunctive Norms- Marijuana 3.65 (.80) 1 4 148
 Controls
  Gender: Male=1 Female=0 0.49 0 1 155
  Age 12.4 (1.21) 9 17 183
  School Lunch 0.64 (.48) 0 1 172
  Grades 6.35 (2.06) 1 9 178
  Treatment Condition .47 (.50) 0 1 155
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Overall, AI youth in the sample had very low substance use intentions. The intentions to use substances scale (alcohol, cigarettes, and marijuana) (M = 1.45, SD = .81) and intentions to use alcohol (M = 1.46, SD = .81) were very similar with the average AI youth reporting they would “not” or “definitely not” use if given the chance to during the next weekend. While the lowest intentions to use substances were for cigarettes (M = 1.35, SD = .68) and the highest were for marijuana (M = 1.54, SD = .90), the means were still low and remained between “definitely not” and “not.” Additionally, both parent and grandparent injunctive norms, overall, were very strongly discouraging of substance use. A typical AI youth reported that both the parents (M = 3.69, SD = .69) and grandparents (M = 3.61, SD = .75) would be “pretty angry” to “very angry” if they drank alcohol, smoked cigarettes, or smoked marijuana, with mean scores less than a standard deviation below the range maximum. Overall, peer injunctive norms were typically somewhat discouraging of substance use (M = 3.65, SD = 1.17) but not as strongly as parent and grandparent injunctive norms, once the wider range of the peer measure is considered. The mean for the peer measure fell between “no reaction” and a “negative” reaction from peers if the respondent drank alcohol, smoked cigarettes, or smoked marijuana.

Results for the OLS regression of intentions to use substances on peer and familial injunctive norms are presented in Table 2. The first equation presents the results for the scaled variable of intentions to use substances. Stronger peer injunctive norms were associated with decreased intentions to use substances (β = -.19, p < .001). Similarly, as grandparent injunctive norms become stronger (e.g. less permissive), intentions to use substances decreased (β = -.21, p < .05). Although males had significantly weaker intentions to use substances than females (β = -.23, p < .05), parent injunctive norms, school lunch status, and grades in school were not significant predictors of overall intentions to use substances.

Table 2. OLS Regression Results for Intentions to Use Substances on Ethnic Identity and Injective Norms.

Model 1 Model 2 Model 3 Model 4
Use Intentions Scale (Alcohol, Cigarettes, and Marijuana) Intentions to Use - Alcohol Intentions to Use - Cigarettes Intentions to Use - Marijuana
(N=148) (N=147) (N=148) (N=149)
B SE B SE B SE B SE
Peer Injunctive Norms
 Injunctive Norms -Scale -0.19 *** 0.05
 Injunctive Norms- Alcohol -.11 † .60
 Injunctive Norms- Cigarettes -.14 * .05
 Injunctive Norms- Marijuana -.33 *** .06
Parent Injunctive Norms
 Injunctive Norms -Scale -0.07 0.11
 Injunctive Norms- Alcohol -0.10 0.13
 Injunctive Norms- Cigarettes -0.25 ** 0.09
 Injunctive Norms- Marijuana 0.08 0.16
Grandparent Injunctive Norms
 Injunctive Norms -Scale -0.21 * 0.11
 Injunctive Norms- Alcohol -0.30 * 0.12
 Injunctive Norms- Cigarettes -0.01 0.09
 Injunctive Norms- Marijuana -0.20 0.14
Controls
 Gender: Male=1 Female=0 -0.23 * 0.11 -0.25 † 0.14 -0.30 * 0.12 -0.15 0.15
 School Lunch 0.16 0.12 0.19 0.09 0.11 0.07 0.16 0.09
 Grades -0.01 0.03 0.01 0.03 -0.04 0.03 0.01 .04
 Treatment Condition 0.07 0.11 0.05 0.14 -0.02 0.11 0.14 0.15
 Constant 3.21 *** 0.40 3.26 *** 0.46 3.16 *** 0.38 3.04 *** 0.54
R2 0.20 0.17 0.19 0.25
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†

p < .10;

*

p < .05;

**

p < .01;

***

p < .001

In the second equation, intentions to use alcohol were analyzed with peer and familial injunctive norms for alcohol use as predictors. Results followed the earlier pattern observed for the composite measure of intentions to use substances. Stronger peer injunctive norms were associated with a decrease in intentions to use alcohol (β = -.11, p < .10), while grandparent injunctive norms for alcohol was associated with a decrease in intentions to use alcohol (β = -.30, p < .01). Males had significantly lower intentions to use substances than females (β = -.25, p < .10). Once again, parent injunctive norms were not a significant predictor for intentions to use alcohol.

Intentions to use cigarettes were analyzed using peer and familial injunctive norms for cigarette use in the third equation. Unlike the previous equations, students that had stronger parent injunctive norms (e.g. less permissive) had significantly lower intentions to use cigarettes (β = -.24, p < .01). Similar to the previous equations, students that had stronger peer injunctive norms had lower intentions to use cigarettes (β = -.13, p < .01). However, grandparent injunctive norms were not a significant predictor of intentions to use cigarettes. Once again, males had significantly lower intentions to use cigarettes than females (β = -.30, p < .05).

The last model examined peer and familial injunctive norms as predictors of intentions to use marijuana. Of the main variables of interest, only peer injunctive norms were a significant predictor, with stronger peer injunctive norms against marijuana use associated with lower intentions to use marijuana (β = -.33, p < .001). In agreement with some of the prior three equations, parent and grandparent injunctive norms were not significant predictors for intentions to use marijuana.

Discussion

This study explored how familial normative drug perceptions influence intentions to use substances for urban AI youth, after controlling for the impact of peers. Understanding the dynamic processes between peer and familial injunctive substance use norms is important when working with urban AI youth as well as when attempting to develop strategies aimed at strengthening youths' anti-drug norms. This study, to the best of the research team's knowledge, is one of few studies to integrate the cultural role of elders (grandparents) as influences on the lives of AI youth. This study is an important step towards untangling the tapestry of AI familial roles and peer interactions that can serve as protective factors that strengthen AI youth.

This paper hypothesized that both parent and grandparents injunctive norms would protect against intentions to use alcohol, cigarettes, and marijuana. Using a composite measure of intentions to use alcohol, cigarettes, and marijuana, grandparent injunctive norms, but not parent injunctive norms, were significant influences in protecting urban AI youth. There also were differences among grandparent and parent norms when substances were examined separately. Parents had a stronger influence on intentions to use cigarettes while grandparents had a stronger influence on intentions to use alcohol. This difference may be related to the parent generation being exposed to more anti-smoking rhetoric and information related to cigarette use. The overall differences in influence on individual intentions to use substances may be explained by the important role that grandparents have in child rearing. Because elders carry a lot of respect in AI culture, AI youth may feel that substance use is more disrespectful to their grandparents, and in turn feel that their grandparents would be upset with them if they were to use substances. Further, due to the leadership role that grandparents have in raising children (Weaver & White, 1997), and the influence they have on attitudes and guiding behaviors (Red Horse, 1997; Tomlin, 1997), grandparents appear to have a strong influence in helping shape anti-drug use attitudes to prevent substance use. That is however, not to say that parents do not influence youth. Integrating previous research findings into this work would seem that to protect AI youth from having intentions to use substances, both parents and grandparents must play an active role in communicating anti-drug messages (Beal et al., 2001; Kegler et al., 2000; Jackson et al., 1997; Olds & Thombs, 2001; Simons-Morton et al., 2001; Treinman, 1996)

Additionally, this paper controlled for the impact of peers on intentions to use substances, and the findings were strong and consistent. Urban AI youth that had stronger peer norms (less acceptance of use) had lower intentions to use substances, whether examining intentions to use alcohol, cigarettes, and marijuana individually or as a composite. This finding was one of the strongest findings, and may be indicative of the greater role of peer relationships during this age and the subsequent impact on behavior and attitudes. During adolescence, youth begin to develop and affirm their identity as individuals with a desire of gaining autonomy, and peers play a substantial role in that identity development (Erikson, 1968; Feldman, 2008; McKenzie, 2008). Peer acceptance and approval are important components in that process (Dekovic, 1999; Smetana, Campione-Narr, & Metzger, 2006), and these findings suggest that youth who have peers that are less accepting of substance use may be protective against intentions to use substances.

Although previous research has indicated that parent and peer substance use attitudes have an impact on youth substance use (Barkin, Smith, & Durant, 2002; Beal, Ausellio, & Perrin, 2001; Beauvais et al., 2002; Beck & Treinman, 1996; Elek, Miller-Day, & Hecht, 2006; Jackson, Henriksen, Dickinson, & Levine, 1997; Kegler et al., 2002; Olds & Thombs, 2001; Simons-Morton, Haynie, Crump, Eitel, & Saylor, 2001), this study sheds further light into the relationship between peer, parent, and grandparent norms on intentions to use substances among a sample of urban AI youth. Furthermore, these analyses showed that the impact of peer, parent, and grandparent norms were partially independent of each other, with each group (peer, parent, and grandparent) having a differential impact on each substance measured. This may be evidence of the distinct salience that specific substance use attitudes, depending on which peer, parent, or grandparent attitudes are considered, have on particular youth intentions to use substances (alcohol, cigarettes, or marijuana). Although findings from this study show that stronger peer, parent, and grandparent anti-drug norms may be protective against intentions to use substances with urban AI youth, more research is needed to further elucidate this relationship as youth mature into young adulthood.

In spite of the finding that peer and parental anti-drug attitudes are associated with lower intentions to use substances, research is needed to elucidate the content and context of anti-drug messages that AI youth receive from their peers, parents, and grandparents as well as how they are expressed. Specifically, what are the processes underlying the delivery of anti-drug messages for different substances, when do they begin to occur, and are there different ways in which AI youth receive those messages? A deeper understanding of why substance use injunctive norms resonate differently for AI youth depending on the substance and who holds those views (peer, parent, grandparent), may provide insight into ways that prevention programs can craft and deliver messages about drug use. Furthermore, given the collectivist orientation present in AI communities, examining the influence of other extended family members (e.g. aunts, uncles, cousins) and community elders' (spiritual leaders, teachers, community leaders) anti-drug attitudes on AI youth substance use may further tap into other sources of influential messaging. Although this study was a step in that direction by examining the effect of grandparents, more research investigating the interpersonal communication processes between AI youth and the aforementioned family members and elders is critical given the cultural contrasts in AI's approach to parenting versus European American approaches.

Overall, the current findings demonstrate the need to use a culturally focused approach in working with AI youth that incorporates elders and peers. This approach should be a concerted effort that includes other people, such as community leaders and teachers (Kulis, Napoli, & Marsiglia, 2002) that have a lot of contact with youth to help reinforce anti drug attitudes. Recognizing the positive and protective aspects that peer and familial norms carry may allow those working with youth to be more effective in their prevention efforts targeting adolescents and families who contend with substance use issues.

Limitations

There were several limitations to this study. Due to the large number and cultural diversity of American Indian tribes located throughout the United States, the results of this study can only be generalized to AI families present in one urban area of the Southwest. Also, although treatment condition was controlled for, generalizability may be further limited since nearly half of the participants completed surveys after taking part in a substance use prevention program. The sample size was small and the analysis was cross sectional, which limits the ability to consider causal relationships in the findings. Further, one of the limitations of self reported data is that study participants may provide socially desirable responses, which may lead to inaccurate data. Using intentions to use substances as an outcome was appropriate and necessary due to the low variability in actual substance use among a sample of early adolescents. Although research with similar samples has found that youth with more pro-drug attitudes are more likely to use substances (Kulis et al., 2002), future research is needed with older urban AI adolescents to establish how peer and family injunctive norms are associated with actual substance use.

Conclusion

In conclusion, urban AI youth with stronger peer and familial anti-drug norms—especially having strong peer and grandparent injunctive norms against substance use—appeared as protective factors against the development of intentions to use substances. Disapproval of substance use by friends and family members is an important component of urban AI youths' decisions to not engage in substance use. Therefore, targeting peer groups in substance use prevention may help urban AI youth substance use prevention efforts. Furthermore, grandparents and parents can help shape and reinforce strong anti-drug use attitudes by clearly establishing and articulating to their children how they feel about alcohol and other substance use. These findings demonstrate the importance of utilizing a strength-based, ecological approach to preventing substance use in this population; one that utilizes peer and multigenerational familial processes as integral components when working with urban AI youth. This exploratory work provides an impetus for future research that looks more at the interplay between peer and parental drug attitudes and their influence on youth substance use.

Acknowledgments

Funding: Data collection for this study was supported by the National Institute on Minority Health and Health Disparities (NIH P20MD002316, F.F. Marsiglia, PI) for the project “Culturally-Specific Substance Abuse Prevention for Urban American Indian Youth” (P20MD002316-030004, E.F. Brown, PI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center on Minority Health and Health Disparities, or the National Institutes of Health.

Contributor Information

Marcos J. Martinez, Southwest Interdisciplinary Research Center, Arizona State University

Stephanie L. Ayers, Southwest Interdisciplinary Research Center, Arizona State University

Stephen Kulis, Sociology Program, Arizona State University.

Eddie Brown, American Indian Studies, Arizona State University.

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