title: Descriptive and injunctive network norms associated with nonmedical use of prescription drugs among homeless youth.
abstract: Nonmedical use of prescription drugs (NMUPD) among youth and young adults is being increasingly recognized as a significant public health problem. Homeless youth in particular are more likely to engage in NMUPD compared to housed youth. Studies suggest that network norms are strongly associated with a range of substance use behaviors. However, evidence regarding the association between network norms and NMUPD is scarce. We sought to understand whether social network norms of NMUPD are associated with engagement in NMUPD among homeless youth.
  
  
  
  1046 homeless youth were recruited from three drop-in centers in Los Angeles, CA and were interviewed regarding their individual and social network characteristics. Multivariate logistic regression was employed to evaluate the significance of associations between social norms (descriptive and injunctive) and self-reported NMUPD.
  
  
  
  Approximately 25% of youth reported past 30-day NMUPD. However, more youth (32.28%) of youth believed that their network members engage in NMUPD, perhaps suggesting some pluralistic ignorance bias. Both descriptive and injunctive norms were associated with self-reported NMUPD among homeless youth. However, these varied by network type, with presence of NMUPD engaged street-based and home-based peers (descriptive norm) increasing the likelihood of NMUPD, while objections from family-members (injunctive norm) decreasing that likelihood.
  
  
  
  Our findings suggest that, like other substance use behaviors, NMUPD is also influenced by youths' perceptions of the behaviors of their social network members. Therefore, prevention and interventions programs designed to influence NMUPD might benefit from taking a social network norms approach.
authors: Graduate School of Social Work, University of Denver, Denver, CO, USA. Electronic address: anamika.barmanadhikari@du.edu.
authors: Anamika
authors: A
authors: Barman-Adhikari
authors: Denver Public Health, Denver Health and Hospital Authority, Denver, CO, USA; Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
authors: Alia
authors: A
authors: Al Tayyib
authors: Graduate School of Social Work, University of Denver, Denver, CO, USA.
authors: Stephanie
authors: S
authors: Begun
authors: School of Social Work, State University of New York, Buffalo, NY, USA.
authors: Elizabeth
authors: E
authors: Bowen
authors: School of Social Work, University of Southern California, Los Angeles, CA, USA.
authors: Eric
authors: E
authors: Rice
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D018453:Homeless Youth / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles; D008297:Male; D063487:Prescription Drug Misuse / Q000523:psychology* / Q000706:statistics & numerical data*; D012309:Risk-Taking; D066262:Social Norms; D012944:Social Support; D035862:Vulnerable Populations / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Homeless youth; Nonmedical use of prescription drugs; Social network norms; Substance use