Examining the Moderating Effects of Ecodevelopmental Influences on Substance Use for Urban American Indian Adolescents

PURPOSE:  Most American Indian (AI) families now live in urban areas, but rigorous research is lacking on the social determinants of their health. Urban AI youth report higher rates, earlier initiation, and more severe consequences of substance use than their non-Native counterparts. Family disruption and substance abuse, stresses related to the move to urban settings, and difficulties in establishing and sustaining social and cultural connections are frequently mentioned as contributing to adverse health outcomes for urban AI youth.   This paper examines (1) how ecodevelopmental influences operate in distinctive ways at the peer, family, school, and neighborhood levels among urban AI youth to influence substance use, and (2) how positive familial influences can moderate the risky influences at the peer, school, and neighborhood levels.

METHODS:  Data come from the 2012 Arizona Youth Survey, a state-wide self-report survey of 8^th, 10^th, and 12^th grade students, which includes 2,407 AI youth living in metropolitan urban areas. Using confirmatory factor analysis, latent variables were constructed to represent risk and protective factors within each of the four ecodevelopmental realms. Structural equation modeling tested the direct and moderated effects of seven substance use measures (last 30-day use) on the four ecodevelopmental realms.

RESULTS: The overall ecodevelopmental measurement model comprised seven latent variables (RMSEA=.048; CFI=.91),  a positive family environment, substance users in the family, associations with anti-social peers and with pro-social peers, overall positive school environment, and negative and positive neighborhood environmental influences. In the structural equation model,  the two latent constructs that produced significantly consistent results across the seven substance use outcomes were (1) having high levels of substance use within the family and (2) having numerous associations with anti-social peers. Moderated effects tested if a positive family, school, and neighborhood environment dampens these negative direct effects.

CONCLUSION: The emerging patterns of ecodevelopmental latent factors and direct effects on substance use help to identify issues that urban AI youth face when navigating within larger socio-environmental contexts that influence the youth’s vulnerability to health disparities. Understanding possible moderators can be used to design and deliver strengths-based prevention programs that enhance health and wellbeing of AI youth in the face of myriad challenges they face in urban social environments.