Strategies to Resist Drug Offers Among Urban American Indian Youth of the Southwest: An Enumeration, Classification, and Analysis by Substance and Offeror

Abstract

This study explores the drug resistance strategies of urban American Indian adolescents when they encounter people offering them alcohol, cigarettes, and marijuana. Data were collected in 2005 from 11 female and 9 male adolescents who self-identified as American Indian and attended two urban middle schools in the southwestern United States. In two focus groups—one at each school site—the youth described their reactions to 25 hypothetical substance offer scenarios drawn from real-life narratives of similar youth. Qualitative analysis of their 552 responses to the scenarios generated 14 categories. Half of the responses were strategies reported most often by nonnative youth (refuse, explain, leave, and avoid). Using ecodevelopmental theory, the responses were analyzed for indications of culturally specific ways of resisting substance offers, such as variation by specific substance and relationship to the person offering. Study limitations are noted along with suggestive implications for future research on culturally appropriate prevention approaches for urban American Indian youth.

Drug Offers as a Context for Violence Perpetration and Victimization

“…Junior high school students and adult graduate students differed in their perceptions of competent refusal, with the youth endorsing strategies considered to be ineffective by adult-derived programmatic standards (Nichols, Birnel, Graber, Brooks-Gunn, & Botvin, 2010). Not only is it important to identify and include differences in developmental perspectives, culturally grounded perspectives are critical (Kulis, Jumper Reeves, Dustman, & O'Neill, 2011). While minority and indigenous youth may employ similar drug refusal strategies as majority youth in many instances, there are important nuances as suggested in the study presented here and elsewhere (Kulis & Brown, 2011; Kulis, Dustman, Brown, & Martinez, 2013; Kulis, et al, 2011).…”

Substance Use Prevention for Urban American Indian Youth: A Efficacy Trial of the Culturally Adapted Living in 2 Worlds Program

“…Further evidence of the need for program adaptation came from qualitative studies showing that UAI youth use the REAL drug resistance strategies often but employ them in distinctive ways, for example by finding a respectful way to say “no” to an offer, or combining a direct refusal with an explanation. In addition to avoiding drug offer situations, they employ passive strategies to evade using substances while remaining present when offers occur, redirecting attention from the substance offer by changing the subject or using humor (Kulis & Brown, 2011; Kulis, Reeves, Dustman, & O’Neill, 2011). Such non-confrontational approaches allow UAI youth to remain in social situations and preserve relationships in family networks where many substance offers occur (Kulis, Okamoto, Rayle, & Sen, 2006; Okamoto, LeCroy, Dustman, Hohmann-Marriott, & Kulis, 2004; Rayle et al, 2006; Waller, Okamoto, Miles, & Hurdle,2003).…”

“…AI teachers delivered each lesson over two 45-min regular classroom periods. The L2W lessons (see Table 1) incorporated culturally specific ways that UAI youth can use to resist substance offers, including distinct ways of employing the REAL strategies (Kulis & Brown, 2011; Kulis, Reeves et al, 2011; Okamoto, Hurdle, & Marsiglia, 2001). …”

Consistency in the Reporting of Sensitive Behaviors by Adolescent American Indian Women: A Comparison of Interviewing Methods

“…Qualitative studies show that, although large proportions of UAI youth use the four R-E-A-L drug resistance strategies, they employ them in distinctive ways and supplement them with other means of resisting substance use (Kulis & Brown, 2011;Kulis, Reeves, Dustman and O'Neill, 2011). For example, when utilizing the refuse strategy they emphasize respectful ways to say "no" to an offer, and often follow a direct refusal with some version of the explain strategy.…”

“…Led by Native facilitators, the students identified culturally influenced ways of responding appropriately to offers of alcohol, cigarettes, and other drugs (Kulis & Brown, 2011;Kulis, Reeves, Dustman, & O'Neill, 2011).…”