Scale validation of Filipino cultural values and its associations with depressive symptoms and substance use in Filipino Americans.

Cultural values influence health beliefs, attitudes, and behaviors. Given the history of pre-colonial Philippines and under Spanish, American, and Japanese colonization, Filipinos have unique cultural values that are understudied in relation to health outcomes. The objectives of this study are to (1) create and validate measurement scales of surface level Filipino cultural values and (2) examine its associations with depressive symptoms and substance use in a sample of Filipino Americans. We analyzed data from the Midwest Longitudinal Studies of Asian American Families (MLSAAF) collected in 2013 of Filipino American parents (n=376). We implemented factor analyses to create and validate the scales and ordinary least squares and logistic regressions to examine the associations between Filipino cultural values and depressive symptoms and substance use. Factor analyses produced five scales: hiya (dignity or shame) from parent, hiya in general, utang na loob (gratitude or solidarity), pakikisama (companionship), and bahala na (determination). Hiya from parent was positively associated with depressive symptoms and hiya in general was negatively associated with depressive symptoms and alcohol use until passing out. The findings demonstrate the nuanced and complex means that Filipino cultural values have influenced health outcomes in Filipino Americans. This study is the first of its kind to quantitatively measure surface level Filipino cultural values. Future studies should consider using the measurement scales to better understand how intergenerational trauma and resilience through cultural values influence other health beliefs, behaviors, and outcomes in Filipinos in the Philippines and in the diaspora.