Primary Socialization Theory and American Indian Adolescents' Intentions to Use Substances.

Intentions to use substances are a robust risk factor for future substance use. Primary Socialization Theory (PST), with its focus on relational factors, is well-suited to provide insight into American Indian adolescents' intentions to use substances given the importance of relationships in American Indian communities. The goal of the present study was to examine the role of PST-related factors (i.e., parental monitoring, peer pressure, attitudes toward school) on likelihood of intending to use substances (i.e., alcohol, cigarettes, cannabis, other drugs) among American Indian adolescents. American Indian participants ( = 8,950, 50.7% females) were recruited as a part of the Our Youth, Our Future survey, an ongoing surveillance of substance use among 7th-12th graders attending school on or near reservations. Parental monitoring was found to be associated with decreased likelihood of intending to use alcohol (aOR = 0.97, 95% [0.96, 0.99]), cigarettes (aOR = 0.96, 95% [0.94, 0.98]), cannabis (aOR = 0.95, 95% [0.94, 0.96]), and other drugs (aOR = 0.94, 95% [0.92, 0.96]). Peer pressure was associated with increased likelihood of intending to use alcohol (aOR = 1.68, 95% [1.59, 1.78]), cigarettes (aOR = 1.73, 95% [1.60, 1.86]), cannabis (aOR = 1.81, 95% [1.71, 1.92]), and other drugs (aOR = 1.40, 95% [1.26, 1.56]). More positive attitudes toward school were associated with decreased likelihood of intending to use alcohol (aOR = 0.93, 95% [0.91, 0.94]), cigarettes (aOR = 0.92, 95% [0.90, 0.94]), cannabis (aOR = 0.90, 95% [0.88, 0.91]), and other drugs (aOR = 0.96, 95% [0.93, 0.99]). Results support incorporating social relationships into interventions aiming to prevent substance use initiation, including promoting positive parental monitoring, peer interactions, and school attitudes.