Understanding Substance Use in Alaska Native Youth- A Social Network Perspective

BACKGROUND: Alaska Native (AN) youth and their communities experience many health inequities, including increased rates of substance use. AN youth have earlier initiation and heavier use of substances compared to other youth, with over half of AN youth having engaged in use by 13. While prior research has examined risk factors, few studies have evaluated how social network structures may protect against substance use in youth. This study used social network analysis to examine associations between peer ties, connections with school staff, cultural connectedness, victimization, and substance use among AN youth. METHODS: This cross-sectional study collected social network data from 7th -12th grade students (n = 109) at an urban school in Alaska using Network Canvas, a tablet-based platform. Students nominated peers, school staff, family, and non-family, non-school individuals to whom they are close. They then completed survey items assessing cultural connectedness, substance use, depression, victimization, and suicidal ideation. Multivariate logistic regression models examined associations between demographic, psychosocial, and network characteristics and alcohol, tobacco, and marijuana use in AN youth. RESULTS: The mean age of participants was 14.7 years, with youth nominating an average of 15.4 network members. Victimization was consistently associated with greater odds of alcohol, tobacco, and marijuana use. For alcohol use, contact frequency with staff was protective at higher levels, demonstrated by a negative quadratic effect, while greater emotional closeness to those in one's network had a positive linear effect. Similar patterns were observed for marijuana use, including a significant negative quadratic effect of contact frequency and a positive linear effect of closeness. Neither contact frequency nor closeness was significantly associated with tobacco use. Greater cultural connectedness was associated with greater odds of tobacco use but was not significantly associated with alcohol or marijuana use. CONCLUSION: Substance use among urban AN youth is influenced by complex social processes involving victimization, peer relationships, and connections with school staff. Frequent contact with school staff appears to play a protective role against alcohol and marijuana use. This study demonstrates how network data can identify both risk and protective factors embedded in youths' social environments and insights can be directly applied to the development of prevention strategies.