Stephen Kulis

Culturally Grounded Substance Use Prevention: An Evaluation of the keepin' it R.E.A.L. Curriculum

This paper reports on the evaluation of a culturally grounded prevention intervention targeting substance use among urban middle-school students. The curriculum consists of 10 lessons promoting antidrug norms and teaching resistance and other social skills, reinforced by booster activities and a media campaign. Three versions were delivered: Mexican American, combined African American and European American, and Multicultural. Thirty-five middle schools were randomly assigned to 1 of the 3 versions or the control. Students completed baseline and follow-up questionnaires over a 2-year period (total 6,035 respondents). Analyses utilizing a generalized estimating equations approach assessed the overall effectiveness of cultural grounding and the cultural matching hypothesis. Support was found for the interventions overall effectiveness, with statistically significant effects on gateway drug use as well as norms, attitudes, and resistance strategies but with little support for the cultural matching hypothesis. Specific contrasts found the Mexican American and Multicultural versions impacted the most outcomes.

Technology, Proximity, and Measures of Kin Support.

The proposition is advanced that many current measures of kinship strength may paradoxically indicate inadequate or weakened kinship structures. That is so because they rely on measures that emphasize continuous proximity. This curious paradox is a consequence of inattention to the relationship between technology, services, and proximity. This article presents nonproximity indicators of kinship contact and service delivery that can measure strength of kinship bonds, and states the principles for assessing at what distances kin can deliver which services.

Ethnic Labels and Ethnic Identity as Predictors of Drug Use among Middle School Students in the Southwest

This article explores differences in the self-reported drug use and exposure to drugs of an ethnically diverse group of 408 seventh-grade students from a large city in the southwest. We contrast the explanatory power of ethnic labels (African American, non-Hispanic White, Mexican American, and mixed ethnicity) and two dimensions of ethnic identity in predicting drug use. One dimension focuses on perceived ethnically consistent behavior, speech, and looks, while the other gauges a sense of ethnic pride. Ethnic labels were found to be somewhat useful in identifying differences in drug use, but the two ethnic identity measures, by themselves, did not generally help to explain differences in drug use. In conjunction, however, ethnic labels and ethnic identity measures explained far more of the differences in drug use than either did alone. The findings indicate that the two dimensions of ethnic identity predict drug outcomes in opposite ways, and these relations are different for minority students and non-Hispanic White students. Generally, African American, Mexican American, and mixed-ethnicity students with a strong sense of ethnic pride reported less drug use and exposure, while ethnically proud White students reported more. Ethnic minority students who viewed their behavior, speech, and looks as consistent with their ethnic group reported more drug use and exposure, while their White counterparts reported less. These findings are discussed, and recommendations for future research are provided.

God Forbid! Substance Use Among Religious and Nonreligious Youth

Among a predominantly Mexican and Mexican American sample of preadolescents, religiosity protected against lifetime alcohol, cigarette, and marijuana use and recent alcohol and cigarette use when religious affiliation was controlled. When religiosity was controlled, however, adolescents with no religious affiliation and adolescents who were religiously affiliated reported similar substance use outcomes. Interaction effects demonstrated that the protective effect of greater religiosity operated more strongly in some religions than in others for selected outcomes. Overall, the impact of religiosity on reported drug use did not differ significantly for more and less acculturated Latino youth.

Ethnicity and Ethnic Identity as Predictors of Drug Norms and Drug Use Among Preadolescents in the US Southwest

This article reports the results of research exploring how ethnicity and ethnic identity may “protect” adolescents against drug use and help them form antidrug use norms. This study was conducted in 1998 and is based on a sample of 4364 mostly Mexican American seventh graders residing in a large southwestern city of diverse acculturation statuses. It aims at testing existing findings by conducting the research within the unique geographic and ethnic context of the Southwest region of the United States. This research examines how strength of ethnic identity plays a distinctive role in drug use behavior among the various ethnic groups represented in the sample: Mexican Americans, other Latinos, American Indians, African Americans, non-Hispanic Whites, and those of mixed ethnic backgrounds. Positive ethnic identity (i.e., strong ethnic affiliation, attachment, and pride) was associated with less substance use and stronger antidrug norms in the sample overall. Unexpectedly, the apparently protective effects of positive ethnic identity were generally stronger for non-Hispanic White respondents (a numerical minority group in this sample) than for members of ethnic minority groups. Implications for prevention programs tailored for Mexican/Mexican American students are discussed.

More Than a Pipeline Problem: Labor Supply Constraints and Gender Stratification Across Academic Science Disciplines

Employing a nationally representative sample of science faculty in U.S. colleges, we investigate 3 explanations for persisting differences in womens faculty representation across science fields even after adjusting for womens variable representation among doctoral recipients. First, we examine labor market factors: (a) differential growth rates and “critical mass” in the supply of women doctoral recipients, (b) growth or contraction in academic and nonacademic job opportunities, and (c) presence of foreign-born scholars. Second, we control for institutional explanations such as differential rates of faculty unionization and less receptivity to women at prestigious or research-oriented universities and fields that are “applied,” “soft,” or “nonlife” sciences. Third, gender role explanations are addressed by controlling for gender differences in work experience, work interruptions, and the prestige of doctoral credentials. After finding that none of these explanations account fully for distinctive patterns among science fields in the faculty gender composition, we discuss how they may reflect differences in academic “cultures.”

The protective and risk effects of parents and peers on substance use, attitudes and behaviors of Mexican and Mexican American female and male adolescents.

This study explores the extent to which parental and peer behaviors and norms may affect substance use, personal antidrug norms, and intentions to use drugs in a group of Mexican heritage preadolescents in the Southwest United States, and whether these parental and peer influences differ according to gender. Secondary data from a randomized trial of a drug prevention program were used. The sample consisted of 2,733 adolescents. The outcomes were recent alcohol, cigarette, and marijuana use, personal antidrug norms, and intentions to use drugs. In this study, peer variables were more consistently related to the outcomes than parent variables, with the exception of parental injunctive norms, which were the most predictive parent factor. Recommendations are provided to further study the protective processes that are maintained through the transition into adolescence and acculturation as a foundation for the design of resiliency-focused prevention interventions.

Perceived Ethnic Discrimination versus Acculturation Stress: Influences on Substance Use among Latino Youth in the Southwest∗:

Using a predominately Mexican-origin Latino sample of 5th grade students from the Southwestern United States, this study examined the relative effects of perceived discrimination and acculturation stress on substance use, and it assessed whether these effects were moderated by linguistic acculturation or time in the United States. Although rates of substance use were generally low in the sample, given the young age of the participants, over half (59%) of the sample perceived some discrimination, and almost half (47%) experienced some acculturation stress. Spanish-dominant and bilingual youth perceived more discrimination than English-dominant youth, whereas youth who have been in the United States five or fewer years perceived more discrimination than youth with more time in the United States. Youth who were Spanish-dominant or were recent arrivals experienced the most acculturation stress, with levels declining as linguistic acculturation and time in the United States increased. Multiple regression estimates indicated that perceived discrimination was associated with larger amounts and higher frequency of recent substance use and an array of substance use attitudes, such as stronger intentions to use substances, espousal of pro-drug norms, more positive substance use expectancies, and peer approval of substance use. Although acculturation stress was not associated with substance use, it was positively associated with several substance use attitudes, which are known antecedents of actual use. With a few exceptions, linguistic acculturation and time in the United States did not moderate the effects of perceived discrimination or acculturation stress.

Effects of Familism and Family Cohesion on Problem Behaviors among Adolescents in Mexican Immigrant Families in the Southwest U.S

This study used baseline data from the Southwest sample of the Latino Acculturation and Health Project to examine whether familism and cohesion are related to problem behaviors in a sample of Mexican and Mexican-American adolescents in the Southwest United States. This study is important to practitioners and prevention and intervention researchers because it examines buffers to problem behaviors among an increasingly at-risk population. The results confirm that familism is a powerful protective factor against aggressive behavior, conduct problems, and rule-breaking in this sample. The results draw attention to the importance of family among Mexican and Mexican-American families. Family cohesion, however, was found to be protective against conduct problems and rule-breaking but not aggressive behavior. Possible explanations for this result are discussed. Additional findings suggest that adolescents who have the ability to navigate between culture of origin and mainstream culture are also protected against some problem behaviors.

Physician Satisfaction in a Changing Health Care Environment: The Impact of Challenges to Professional Autonomy, Authority, and Dominance

For some time, sociologists have debated whether physicians still retain dominance in the health care world, public faith in their moral and scientific authority, and the autonomy to set work conditions and make clinical decisions. Using ideas derived from this debate, we analyze the impact of changes in the health care environment on physician satisfaction. Our data come from a mailed survey of 510 Arizona physicians. Our results show that background physician attributes did not predict satisfaction, nor did most organizational attributes. However, participation in IPAs (Individual Practice Associations) predicted higher satisfaction, while payment according to a third party payers fee-for-service schedule predicted lower satisfaction. In addition, physicians were more likely to be satisfied if they wrote the orders that non-physicians had to follow, were paid what they wanted, did not need to subordinate their clinical judgment to that of non-physicians, and believed that their patients had confidence in physicians. Our conclusions discuss both theoretical and policy implications of our findings.