261557 Role of social network position and norms on substance use among homeless youth in Los Angeles, California

Monday, October 29, 2012

Anamika Barman-Adhikari, MA, MSW, PhD Student , School of Social Work, University of Southern California, Los Angeles, CA
Eric Rice, PhD , School of Social Work, University of Southern California, Los Angeles, CA
Harmony Rhoades, PhD , School of Social Work, University of California, Los Angeles, CA
Hailey Winetrobe, MPH , School of Social Work, University of Southern California, Los Angeles, CA
Background: Studies have demonstrated that drug use does not typically happen in isolation, but is initiated and reinforced through social-interactions and influence. Conceptually, network-structure and ensuing norms are especially salient in explaining drug use. Work on homeless youth, however, has focused almost exclusively on dyadic or egocentric influences. We examined how drug use norms and position in a large network of homeless youth reinforced heroin, cocaine, and methamphetamine using behaviors.

Methods: Using Freeman's Event Based Approach, 136 adolescents were recruited in 2008 at one drop-in agency serving homeless youth in Los Angeles, California. Participants provided self-reports of heroin, cocaine, and methamphetamine use. Youth nominated a full spectrum of network ties, including other youth at the agency. The structure of nominations among the 136 sampled youth were assessed with UCINET and visualized with Net-Draw. Logistic-regressions were used to assess associations among, substance use, adjacent peer substance use, and network position.

Results: Youth connected to more methamphetamine- or heroin-using peers were significantly more likely to use methamphetamine (OR=5.9) and heroin (OR=26.8). Youth in the core or center of the network (Kcore7) were significantly more likely to use methamphetamine (OR=5.32), while youth who affiliated with larger networks were significantly less likely to use heroin (OR=0.34).

Implications: Youth's position in the network exposed them to norms supportive of specific illicit drugs. These results underscore the importance of tailoring interventions to reduce drug use at the network level and of recognizing drug use as not only a clinical problem but also a public health problem.

Learning Areas:
Program planning
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe how one's position in the larger social network might influence methamphetamine, heroin, and cocaine use among homeless youth. Assess the relative influence of network position and network norms on methamphetamine, heroin, and cocaine use among homeless youth. Discuss the importance of tailoring interventions to reduce drug use at the network level.

Keywords: Network Analysis, Drug Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD student whose research focuses on understanding the social-contextual determinants of sexual and drug use behaviors among vulnerable youth populations such as homeless and minority youth.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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