Risk and protective factors for adolescent substance use: Findings from a study in selected Central American countries

Purpose: To identify the prevalence of substance use and problems with use, and risk and protective factors at different levels of the adolescent's ecology associated with substance use among adolescents in selected Central American countries. Methods: Results of a survey of 17,215 students from Panama, Costa Rica, and Guatemala conducted in 2000-2001 served as the basis for the analyses. Lifetime use of alcohol, tobacco, marijuana, and five other drugs (inhalants, tranquilizers, cocaine, crack, and ecstasy), and problems with drugs and alcohol were the outcome variables. Risk factors included dysregulation, family problems with drugs/alcohol, negative family interactions, school disengagement, peer deviance, and exposure to community violence. Protective factors included a personal belief in God, positive family interactions, parent religiosity, and positive student-teacher interaction. Both hierarchical linear regression and logistic regression analyses were used to model main and interaction effects of risk and protective factors. Results: There was a linear association between number of risk and protective factors and substance use, however, risk factors were more strongly associated with substance use than were protective factors. There were significant risk-by-protective-factor interactions for alcohol and marijuana use, and for problems with drugs and alcohol. Risk interacted most consistently with a personal belief in God, but also with parent religiosity and with student-teacher communication. Conclusions: It is important to consider risk and protective factors at different levels of an adolescent's ecology. Prevention and intervention efforts should focus on interactions adolescents have in different microsystems (e.g., with parents, teachers, and peers). (c) 2007 Society for Adolescent Medicine. All rights reserved.