Sunder Punita K, Grady James J, Wu Z Helen
Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
Am J Community Psychol. 2007 Dec;40(3-4):167-80. doi: 10.1007/s10464-007-9135-y.
Few studies have systematically evaluated whether contextual variables differ in their ability to explain the use of different drugs in the same sample. Our objective was to examine correlates of use for different illicit drugs at the individual and neighborhood level in a tri-ethnic sample of low-income women, an underrepresented sample in drug research. Women 18-31 were recruited from a low-cost family planning clinic in southeast Texas from December 2001 to May 2003. Neighborhood level indicators of disadvantage, family structure, and nativity status from U.S. Census 2000 were linked with individual survey data. Multilevel logistic regression was used to examine the effect of individual and neighborhood level measures on lifetime use of marijuana only and of other illicit drugs in 594 women. Only individual level variables (younger age, non-Hispanic White ethnicity, not being married, greater peer acceptance of substance use) increased odds of exclusive marijuana use, controlling for neighborhood level factors. However, both neighborhood and individual level variables significantly predicted other illicit drug use. Residence in less disadvantaged neighborhoods, non-Hispanic White ethnicity, higher levels of education, greater acceptance of substance use by peers, and a larger number of perceived neighborhood problems increased odds of illicit drug use. Use of other illicit drugs with or without marijuana may be more closely tied to area level factors whereas factors driving exclusive marijuana use may not rely on localized structures to the same extent. Thus, community-level interventions may need to customize their approaches according to the type of drug use targeted. The implication of using neighborhood level variables in substance use research is also discussed.
很少有研究系统地评估情境变量在解释同一样本中不同药物使用情况时的能力是否存在差异。我们的目标是在低收入女性的三族裔样本(药物研究中代表性不足的样本)中,考察个体和社区层面不同非法药物使用的相关因素。2001年12月至2003年5月期间,从得克萨斯州东南部一家低成本计划生育诊所招募了18 - 31岁的女性。2000年美国人口普查中的社区层面劣势指标、家庭结构和出生状态指标与个体调查数据相关联。采用多水平逻辑回归分析来考察个体和社区层面指标对594名女性终生仅使用大麻及使用其他非法药物情况的影响。仅个体层面变量(年龄较小、非西班牙裔白人种族、未婚、同伴对物质使用的接受程度更高)在控制社区层面因素后增加了仅使用大麻的几率。然而,社区和个体层面变量均显著预测了其他非法药物的使用。居住在劣势程度较低的社区、非西班牙裔白人种族、教育水平较高、同伴对物质使用的接受程度更高以及感知到的社区问题较多,均增加了非法药物使用的几率。使用其他非法药物(无论是否同时使用大麻)可能与地区层面因素联系更紧密,而导致仅使用大麻的因素可能在相同程度上不太依赖局部结构。因此,社区层面的干预措施可能需要根据所针对的药物使用类型来定制其方法。本文还讨论了在物质使用研究中使用社区层面变量的意义。