Family Socialization and Communication Processes As Social Determinants of Adolescent Health and Decision-Making about Drugs: Perspectives On Prevention Effectiveness Across the Lifespan

Family communication and parent-child relational quality contribute to family members’ general health and well-being, and they can be protective factors in preventing adolescents from initiating drug use at an early age, and from eventual substance abuse in adulthood. Conversely, certain family stressors can act as catalysts to adolescent use/abuse, such as parental use/abuse, which are predictive of subsequent adolescent behaviors with legal and illegal substances. Family interaction and relational quality, and parental substance use, are social determinants of adolescent health, well-being, and decision-making about drugs. Therefore, 85 in-depth, individual interviews with parents and one of their adolescent children (in 40 families) were conducted to learn more about intergenerational perceptions of family culture, the role of parental substance use in family life, parent-child communication about drugs, and perspectives on prevention effectiveness. Two theoretical perspectives guided this research: family communication patterns (FCP) and communication privacy management (CPM). Patterns of family communication help create a global family culture over time, and family members’ management of privacy boundaries provides a possible explanation for why parents and adolescent children may not openly discuss substance use in general and parental substance use in particular. Among notable findings, the primary model for “drug talks” across family communication patterns and family privacy orientations was the ongoing and relatively frequent use of “teachable moments” in the media, the community, children’s schools and distant peer groups, and in participants’ own families. Emergent technologies like smart phones and Facebook were discussed in every interview to some extent, and they seemed to be a prevalent source of prevention communication (i.e., expectations and rules for appropriate use/avoidance of negative consequences of misuse). Technology affected parental monitoring efforts, perceptions of personal and family privacy, and parent-adolescent conflict (often stemming from and resulting in “digital grounding”). Perhaps most importantly, cyber-bullying and other “horror stories” from computer-mediated communication provided many of the teachable moments talked about in these interviews. Results of this study provide a working model of modern prevention communication in families, including the prominent role of technology as a social component of family life that often necessitates communication about safe behaviors generally, and safety with technology, peer influence, and substance use/abuse specifically. These teachable moments serve as the tangible facilitators for parent-adolescent communication about substance use, and the technology itself impacts the quality of interaction and relationships. Implications for family-based interventions and initiatives to incorporate emerging technology into prevention programs are discussed.