Covariates of substance-use initiation for Venezuelan youth: using a multilevel approach to guide prevention programs.

OBJECTIVE: Illicit drug use in Latin America is on the rise. This study contributes to the literature by examining the extent five factors related to adolescent substance use among U.S. populations covary with age at first use in a sample of Venezuelan inner-city youth. METHOD: Anonymous self-administered questionnaires on drug involvement and related behaviors were administered to a cross-sectional sample of students, ages 11 to 18, drawn from 14 schools in two school districts in Caracas, Venezuela. A multilevel modeling approach investigated the relationship between age at first drug use reported by 1,514 students and three covariates (family attention, externalizing behavior, and peer drug use) and two control variables (gender and socioeconomic status). RESULTS: For the Level 1 within-schools covariates, family attention (t = 5.14, 1440 df, p < .001), and externalizing behavior (t = -4.61, 1440 df, p < .001) were significantly related to age at first use, and females initiated use later than did males (t = 2.51, 1440 df,p < .001). Peer drug use and socioeconomic status did not significantly covary with age at first use. At Level 2, the family attention slope varied across schools, chi(2)(13) = 24.14,p = .03. Additionally, mean school-level socioeconomic status (t = -7.22, 13 df, p < .001) explained most of the variance in average age at first use between schools and exerted a much stronger influence on age at first use than did family attention, externalizing behavior, or gender. CONCLUSIONS: Factors influencing substance initiation vary from the United States to Venezuela. Specific school cultures are stronger predictors of initiation than more proximal influences.