Native Hawaiian risky behavior : the role of individual, social, and cultural factors in predicting substance use and violence

Abstract

This study examined alcohol use, drug use, and violence experience among Native Hawaiians living in four communities using both qualitative and quantitative methods to understand the factors that predict these behaviors. The methods employed were designed to be culturally appropriate to the communities being surveyed in terms of the recruitment and engagement strategies employed, an equal representation of both problem behaviors and well being in the instruments that were used, and the use of Hawaiian thought in interpreting results. Qualitative data derived from focus group sessions in each community centered around themes such as community-specific strengths and weaknesses, typical substance use and violence patterns, and the role of Hawaiian identity and culture in definitions of health. Quantitative data on demographic characteristics, alcohol and substance use practices, and violence were collected from 405 Native Hawaiians living in four geographically and economically diverse communities including Hilo, Hawai'i, Papakolea, O'ahu, Waimanalo, O'ahu, and Phoenix, Arizona. The representativeness of the survey sample was examined using Census 2000 data for each of the areas sampled. In addition, a smaller subset of the sample participated in test-retest reliability and cross-informant reliability analyses. The instrument was found to be reliable across time and reporters. By community analyses suggested that the groups were overall more similar than different in their substance use and experience with violence. Hierarchical regression analyses using gender, religious practice, network density of use, age at first use, reasons for use, and negative thoughts about use predicted 19.5% of the variance in 30-day alcohol use and 25.2% of the variance in 30-day binge drinking. Seventeen percent of the variance in 30- day marijuana use was explained by age, income, network density of use, age at first use, and negative thoughts about use. Network density witnessing, perpetrating, and being a victim of violence explained between 15.8 and 57.8% of the variance in 30-day experience of these same behaviors. Although depression, hopelessness, and own-group ethnic identity were tested, they were not significant predictors of substance use or violence experience.