Michele Mouttapa

Using Social Networks to Understand and Prevent Substance Use: A Transdisciplinary Perspective

We review findings from research on smoking, alcohol, and other drug use, which show that the network approach is instructive for understanding social influences on substance use. A hypothetical network is used throughout to illustrate different network findings and provide a short glossary of terms. We then describe how network analysis can be used to design more effective prevention programs and to monitor and evaluate these programs. The article closes with a discussion of the inherent transdisciplinarity of social network analysis.

PEER INFLUENCES AND SUSCEPTIBILITY TO SMOKING AMONG CALIFORNIA ADOLESCENTS

Using data from a diverse statewide sample of 10th-grade adolescents in California, in 1996–97, this study investigated the associations between peer influence variables and susceptibility to smoking. Peer influence variables included attitudes about the social consequences of smoking and subjective norms, as described by the Theory of Reasoned Action. Among never-smokers (N = 2681) and ever-smokers (N = 4248), attitudes about social consequences of smoking and subjective norms each were associated with an increased risk of susceptibility to smoking. The model explained a larger proportion of the variance in susceptibility among ever-smokers than among never-smokers. Results indicate that peer influences, including perceptions of the social consequences of smoking and perceived social norms, may make adolescents susceptible to smoking.

Longitudinal Effects of Hostility, Depression, and Bullying on Adolescent Smoking Initiation

PURPOSE The present study examined the associations between smoking initiation and, hostility, depressive symptoms, and bullying (bullies and bully-victims) among a culturally diverse sample of 1,771 adolescents who reported never having smoked at baseline. METHODS Data were obtained from a longitudinal school-based experimental trial of smoking prevention programs in Southern California. Annual survey was performed for students of the sixth, seventh, and eighth grades. All students in the 24 participating schools were invited to participate in the study during the sixth grade. RESULTS The risk of smoking initiation was significantly higher among students who scored higher on hostility and depressive symptoms, and were bully-victims. CONCLUSION The findings suggest that tobacco prevention programs should include strategies for managing hostile feelings and negative effect as part of the curriculum. In addition, it might be helpful to identify youth who score high on these psychosocial factors and teach them skills to handle interpersonal conflict and negative feelings to prevent their involvement in substance use.

Association between psychological factors and adolescent smoking in seven cities in China.

Background: Cigarette smoking is a culturally accepted behavior among adult males in China. However, there is limited information on smoking among Chinese adolescents, particularly the information on the relationship between psychological well-being and smoking behavior among this population. Purpose: This study explored associations between three psychological factors—anxiety, hostility, and depressive symptoms—and smoking behavior among Chinese adolescents. Methods: The data presented in this study are a cross-sectional slice from a longitudinal investigation of tobacco use and lifestyle carried out in China. The study population consisted of 4,724 7th and 11th grade students from seven large cities in China. Results: Odds ratios showed that anxiety, hostility, and depressive symptoms were significantly associated with a higher risk of lifetime smoking for both boys and girls. Conclusion: Much like their Western counterparts, Chinese adolescents face developmental stress. The resulting distress may increase their risk for substance use and other health-risk behaviors.

Preventing problematic Internet use through video-based interventions: a theoretical model and empirical test

This study relies on the core ideas of the health belief model and suggests that short informational videos on Internet ‘addiction’ can be an effective means towards preventing problematic use of the Internet through their ability to drive changes in viewers’ attitudes towards reducing their Internet use. Building on the heuristic-systematic model of information processing viewpoint, it is further suggested that this attitude change is guided by the information the videos provide, as well as the surprise emotion they generate. To test this model, data were collected at three points in time from 223 participants who were exposed to one of two video interventions. Partial least-square analyses indicated that the videos were efficacious in improving viewers’ attitudes towards reducing their Internet use, after accounting for viewers’ preexisting attitudes, levels of Internet ‘addiction’, demographics and social desirability bias. Consistent with the heuristic-systematic model of information-processing perspective this effect was mobilised simultaneously through the information and surprise induced by the videos.

Everybody's talking: using entertainment–education video to reduce barriers to discussion of cervical cancer screening among Thai women

Although Southeast Asian women are at exceedingly high risk for cervical cancer, low rates of the Pap testing necessary for early detection and successful treatment continue among this group. Previous research suggests that discussions about Pap testing with important people in a womans life, particularly her doctor, may increase the likelihood of screening; therefore increasing womens discussions about cancer screenings is an important step toward behavior change. The purpose of this study was to determine the effectiveness of a culturally sensitive, seven-minute video intervention in reducing barriers to discussions about Pap tests among Thai women. This unique video presented Thai actors, speaking in Thai, in a soap opera format. Participants completed a self-report questionnaire at baseline, immediately after the intervention and at 3-month follow-up. The comparison group received an educational pamphlet. Although the results indicated that both groups experienced reductions in barriers to communicating with others about Pap tests, the intervention group had significantly stronger outcomes than the comparison group for communicating about Pap tests in general as well as to doctors. These findings suggest that intermediate communication effects such as self-efficacy, collective efficacy and perhaps interpersonal communication may reduce barriers to discussion and positive decision making regarding Pap tests.

Is Image Everything? The Role of Self-Image in the Relationship Between Family Functioning and Substance Use Among Hispanic Adolescents

This cross-sectional self-report study examined (1) whether family functioning (Family Functioning in Adolescence Questionnaire, FFAQ) and self-image (Piers–Harris Childrens Self-Concept Scale) have independent associations with smoking and alcohol use and (2) whether self-image mediates the relationship between family functioning, smoking, and alcohol use among 1,598 Hispanic males and females in grades 7 through 12 in Los Angeles County, California, in 2001. The findings supported the main effects and, to some degree, the mediational effects that were hypothesized. Limitations and implications for this study are discussed, and directions for future research are suggested. This study was funded by the California Tobacco Related Disease Research Program.

Bias-motivated bullying and psychosocial problems: Implications for HIV risk behaviors among young men who have sex with men

The present study aimed to determine whether the experience of bias-motivated bullying was associated with behaviors known to increase the risk of HIV infection among young men who have sex with men (YMSM) aged 18–29, and to assess whether the psychosocial problems moderated this relationship. Using an Internet-based direct marketing approach in sampling, we recruited 545 YMSM residing in the USA to complete an online questionnaire. Multiple linear regression analyses tested three regression models where we controlled for sociodemographics. The first model indicated that bullying during high school was associated with unprotected receptive anal intercourse within the past 12 months, while the second model indicated that bullying after high school was associated with engaging in anal intercourse while under the influence of drugs or alcohol in the past 12 months. In the final regression model, our composite measure of HIV risk behavior was found to be associated with lifetime verbal harassment. None of the psychosocial problems measured in this study – depression, low self-esteem, and internalized homonegativity – moderated any of the associations between bias-motivated bullying victimization and HIV risk behaviors in our regression models. Still, these findings provide novel evidence that bullying prevention programs in schools and communities should be included in comprehensive approaches to HIV prevention among YMSM.

Environmental influences on tobacco use among Asian American and Pacific Islander youth.

There is growing interest in understanding individual and environmental influences on youth risk behaviors, including tobacco use. The purpose of this article is to describe the processes and findings from a study that sought to increase the capacity of Asian American and Pacific Islander (AAPI) community-based organizations to understand and address the environmental influences on tobacco use among AAPI youth. Using a multimethod approach to data collection that included GIS (geographic information system) mapping, Photovoice, and individual youth surveys, a team of community and university researchers conducted a 3-year study to assess and address the environmental influences of tobacco use among youth. Community-based participatory research principles guided the study and facilitated unique capacity building and analyses throughout the study period. Results in Long Beach from all three methods highlighted the associations between youth smoking and environmental factors: GIS mapping identified at least 77 separate locations of pro-tobacco influences, photographs captured many of these locations and provided youth leaders with opportunities to identify how other influences contributed to smoking risk, and surveys of youth indicated that perceived community safety and proximity to pro-tobacco influences were associated with smoking in the past 30 days. Subsequent community-based organization activities undertaken by study partners are also discussed, and lessons learned summarized.

HIV prevention among incarcerated male adolescents in an alternative school setting.

This pilot project tested the feasibility of an evidence-based HIV Intervention Program (HIP) program among 64 male youth, most of whom were African American or Hispanic, in Los Angeles County probation camps. Comparisons were made between adolescents who participated in HIP and a control group on changes in (a) condom use, (b) sexual intercourse under the influence of drugs, (c) knowledge of HIV prevention behaviors, and (d) attitudes toward condom use. Compared to the control group, the intervention group demonstrated significant increases in condom use and significant decreases in their endorsement of the attitude, ‘‘If you want to use a condom, your boy-friend or girlfriend might think you don’t trust them.’’ These preliminary findings suggest that the HIP program influences key HIV-related constructs among male juvenile offenders.