title: Disparities in drinking patterns and risks among ethnic majority and minority groups in China: The roles of acculturation, religion, family and friends.
abstract: OBJECTIVE
  Studies investigating alcohol consumption related factors have rarely focused on the relationship between acculturation, religion and drinking patterns. The objective of this study is to explore the predictors of drinking patterns and their mutual relationships, especially acculturation, ethnicity and religion.
  
  
  METHODS
  A cross-sectional household survey using a multistage systematic sampling technique was conducted in Yunnan Province of China. A revised Vancouver Index of Acculturation (VIA) and Alcohol Use Disorder Identification Test (AUDIT) Chinese version were used to measure acculturation and drinking patterns. Structural equation modeling (SEM) was used to explore the structures of how predictors affect drinking patterns.
  
  
  RESULTS
  A total of 977 subjects aged 12-35 years were surveyed. A higher percentage of binge drinking was found among Lisu people. However, the proportion of drinking until intoxication was highest among Han. Gender and enculturation had both direct (standardized β=-0.193, -0.079) and indirect effects (standardized β=-0.126, 0.033) on risky drinking pattern; perceived risk of alcohol consumption (-0.065), family drinking environment (0.061), and friend drinking environment (0.352) affected risky drinking pattern directly, while education level (0.066), ethnicity (-0.038), acculturation (0.012), religious belief (-0.038), and age group (0.088) had indirect effects.
  
  
  CONCLUSIONS
  Risky drinking pattern was associated with gender and aboriginal culture enculturation both directly and indirectly, and related to mainstream culture acculturation and religious belief indirectly. Other demographic (such as education level) and social family factors (friend drinking environment for example) also had effects on risky drinking pattern.
authors.affiliation: Department of Health Economics and Health Management, School of Public Health, Kunming Medical University, Chun Rong West Road 1168, Yu Hua Street, Chenggong New City, Kunming, Yunnan Province, PR China. Electronic address: hejianhui9804012@163.com.
authors.forename: Jianhui
authors.initials: J
authors.lastname: He
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanich Road, Hat Yai, Songkhla 90110, Thailand. Electronic address: savitree.a@psu.ac.th.
authors.forename: Sawitri
authors.initials: S
authors.lastname: Assanangkornchai
authors.affiliation: School of Public Health, Kunming Medical University, Chun Rong West Road 1168, Yu Hua Street, Chenggong New City, Kunming, Yunnan Province, PR China. Electronic address: caile002@hotmail.com.
authors.forename: Le
authors.initials: L
authors.lastname: Cai
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, 15 Kanjanavanich Road, Hat Yai, Songkhla 90110, Thailand. Electronic address: edward.m@psu.ac.th.
authors.forename: Edward
authors.initials: E
authors.lastname: McNeil
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D033062:Friends; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012067:Religion; D012309:Risk-Taking; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Acculturation; Ethnic groups; Religion; Risky drinking; Social drinking environment