Patterns and Predictors of Viewing Pro- Versus AntiProAntidrug Websites: Effects on Marijuana Intentions, Perceived Risk, and Initiation

Steven Belenko, Ph.D.

Temple University and Treatment Research Institute at the University of Pennsylvania

Acknowledgments
National Institute on Drug Abuse Westat, Inc.

Karen Dugosh, Ph.D.

Treatment Research Institute at the University of Pennsylvania Presented at:

First Annual Meeting, NSPY Users Group

May 14, 2007 Bethesda, MD Temple University Department of Criminal Justice Temple University Department of Criminal Justice

Project Goals
 Compare

Exploratory Hypotheses
1.

youth who view antidrug, prodrug, and neither type of website

Analyze the relationship between exposure to antidrug and prodrug websites and
  Intention

Youth who view antidrug or prodrug websites will be distinguished by significant differences in level of risk, peer norms, parental behaviors, prior drug use, and exposure to other types of media messages

to use marijuana risk of marijuana use

 Perceived  Initiation

of marijuana use

2. Exposure to internet drug websites affects initiation of marijuana use and attitudes toward marijuana use.

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Overview of Presentation
 Background  Samples 

Background
Youth marijuana use associated with other problem behaviors Need to understand individual, peer, family, and community/contextual factors that affect:  Initiation  perceived risks  escalation from experimental use to regular use  desistance from use Internet effects an unexplored area of research

and Methods

 Measures  Drug

Website Viewing Correlates & Predictors on intention to use marijuana on perceived risk of marijuana use on marijuana initiation


 Effects  Effects  Effects

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Background


Background


81% of youth aged 12-17 go online, 61% on typical day (Lenhart et al., 2001) 48 minutes/day online outside of schoolwork
(Rideout et al., 2005)

45% of parents worry that internet can lead youth to do dangerous or harmful things (Lenhart et al.,
2001)

 

Recent growth in websites advertising the sale of illegal drugs, or promoting illegal drug use and intoxication (Forman, 2003; ONDCP, 2004; Volkov, 2004) Googling the term marijuana yields more promarijuana than anti-marijuana websites (Forman,
unpublished data)

61% of parents have rules about kids internet use 41% of families have installed website filters on their home computers Among 15-17 y/o, 76% went online to research health topics (Kaiser Family Foundation, 2001)
   

HIV/AIDS (31%) Drug/alcohol abuse (25%) Other STIs (24%) Smoking (23%)

 Temple University Department of Criminal Justice

41% changed their behavior because of online information

Temple University Department of Criminal Justice

Sample Hypothesis 1
 

Sample Hypothesis 2
Selected youth with at least 2 consecutive Rounds, aged 12-18, non-missing internet use data N = 4,983 with two consecutive Rounds
 

Selected youth who were asked about internet use past 6 months, and answered Yes NSPY Rounds 1 3, focus on most recent data (one observation per unique youth) If no Round 3 data, use Round 2 data If no Round 2 data, use Round 1 data Total N = 6,460
  

N = 3,862 Rounds 1 and 2 N = 1,121 Rounds 2 and 3

  

  

Used Round 2 & 3 data for youth with 3 Rounds MJ initiation : select if never used MJ T1 Perceived MJ intention: select if definitely/probably will not use MJ T1 Perceived MJ risk: select if perceived no/slight risk in using MJ occasionally T1

N = 4,799 Round 3 data N = 719 Round 2 data N = 942 Round 1 data

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Key Measures
 Four-level variable for website viewing
    Visited prodrug websites only Antidrug websites only Both types of websites Neither type

Specific Hypotheses
Hypothesis 2a.1: Exposure to prodrug websites in T1 increases probability of moving from no MJ use to MJ use in T2. Hypothesis 2a.2: Exposure to prodrug websites in T1 increases probability of moving from definitely/probably will not use MJ in T1 to definitely/probably will use MJ in T2. Hypothesis 2a.3: Exposure to prodrug websites in T1 decreases probability of moving from perceiving no/slight risk in using MJ in T1 to moderate/great risk of using MJ in T2. Hypothesis 2b.1: Exposure to antidrug website in T1 decreases probability of moving from no MJ use in T1 to MJ use in T2. Hypothesis 2b.2: Exposure to antidrug websites in T1 decreases probability of moving from definitely/probably will not use MJ in T1 to definitely/probably will use MJ in T2. Hypothesis 2b.3: Exposure to antidrug websites in T1 increases probability of moving from perceiving no/slight risk in using MJ in T1 to moderate/great risk of using MJ in T2.

 Intention to use
 definitely/probably will not use MJ in T1  definitely/probably will use MJ in T1

 Perceived risk
 No/slight risk of using marijuana at T1  Moderate/great risk at T2

 MJ Initiation
 Never used at T1  Used at T2

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Drug Website Viewing X Demographics

Anti-Drug Sites Only TOTAL SAMPLE Male Female 5.1% 4.0 6.3 4.9 6.0 4.7 5.7 5.4 6.1 4.5 Pro-Drug Sites Only 1.7% 2.5 0.8 2.0 1.0 1.0 2.2 0.6 1.9 2.1 Both Pro- & Anti-Drug Sites 3.4% 3.3 3.5 3.4 3.1 3.4 5.1 1.6 3.0 4.4

Drug Website Viewing

White NonHispanic Black NonHispanic Hispanic Other 12-13 Years 14-15 Years 16-18 Years

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Prevention Exposure
Anti-Drug Sites Pro-Drug Sites Both Pro & AntiDrug Sites

Risk Behaviors
Anti-Drug Ever Alcohol: Yes No 4.3% 5.9 3.7 5.6 4.0 5.1 Pro-Drug 2.9% 0.3 4.1 0.7 9.2 1.3 Both Pro & AntiDrug 4.7% 2.0 5.9 2.4 8.0 3.2

Drug Prevention Classes Yes No Drug Education Films/Lectures Yes No Anti-Drug TV Ads <1Time Per Month 1-3 X Per Month 4+ X Per Month 4.6 3.3 7.1 1.6 1.9 2.0 2.5 4.3 3.9 6.7 3.2 1.8 1.5 3.9 2.9 6.2% 4.2 1.7% 1.7 4.4% 2.7

Ever Marijuana: Yes No Ever Inhalants: Yes No Offered Marijuana Yes No Close Friends Use Yes No

4.8 5.5

2.9 0.3

5.0 1.6

4.8 5.3

3.4 0.5

5.6 1.8

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Parents
Anti-Drug Sites Parents Aware of Activities Yes No Talked w/Parents Rules About Drugs Yes No Talked w/Parents How to Avoid Drugs Yes No 7.1 3.8 1.4 1.9 4.0 3.0 6.6 3.8 1.8 1.6 4.2 2.7 5.5% 4.6 0.8% 2.5 2.1% 4.6 Pro-Drug Sites Anti & ProDrug Sites

Peers
Anti-Drug Sites Hang w/ Friends w/o Parents There Never Seldom About Time Often Always/Almost Always Talked w/Friends How to Avoid Drugs Yes No 7.8 4.0 1.0 1.9 4.6 3.0 5.1 5.8 5.0 4.7 4.5 0.3 0.9 1.1 2.6 3.1 1.3 2.4 3.5 3.7 5.4 Pro-Drug Sites Anti & ProDrug Sites

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Viewing of Websites Past 6 Months by Youth aged 12-18 By Likelihood of Using Marijuana Occasionally in the Next 12 Months
Vie ing of Websites Past 6 Months by Youth aged 12-18 y Likelihood of sing Marijuana ccasionally in the ext 12 Months (Weighted ata)

Viewing Websites Past 6 Months by Youth aged 12-18 By Perceived Risk of Using Marijuana Once or Twice
V ie ing of W e bsite s P ast 6 M onths by Y outh age d 12-18 y P e rce i e d isk of sing M arijuana nce or ice (W e ighte d ata)
    

14.00

8 .0 0
12.00

.0 0

10.00

Visited AntiDrugs Sites

6 .0 0

.0 0

Visite d AntiD rug s Site s



8.00

4 .0 0
6.00 Visited ProDrugs Sites

.0 0

Visite d Pro D rug s Site s

4.00

2 .0 0
Visited both Pro- and AntiDrugs Sites

2.00

1 .0 0

Visite d b o th Pro - a nd AntiD rug s Site s No Risk Slig htly Mo d e ra te Risk re a t Risk

0.00

0 .0 0
I Definitely Will Not I Probably Will Not I Probably Will I Definitely Will

 

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Viewing of Websites Past 6 Months by Youth Aged 1218 By Youth Monitoring Behavior Score
V ie in g o f We b s ite s P a s t 6 M o n th s b y Y o u th a g e d 1 2 -1 8 M o n ito rin g e h a io r c o re (We ig h te d a ta )
! " # $

Predictors of Vie ing Pro- rug ites Pro% & '

Predictor Parents kno hat kid doing hen a ay from home

1 1 1 1

Estimate
(

.E.

. .
0

Wald 4.33*

-0.18

0.09

0.70

y Y o u th

.0 0

6 .0 0

Attended drug education classes Ever offered MJ

V i si te d A nti D rug s S i te s

0.16 0.29 0.31

Moderate (v. Great) o risk (v. Great) light (v. Great)
2

0.08 0.11 0.09

0.17 0.14 0.13

1.37 1.79 1.85

1.01 2.31 1.27

3.48 6.86* 10.72* 16.09* 7.72* 16.36*

4 .0 0

2 .0 0

1 .0 0

0 .0 0

Temple University Department of Criminal Justice

Predictors of Vie ing Anti- rug ites Anti% & '

Predictor Female Income V hrs per eek

7

  

 

.0 0

Any close friends use drugs Marijuana risk behavior score Ever used inhalants

.0 0

V i si te d P ro D rug s S i te s


-0.26 0.57 -0.03

0.36
Probably/ efinitely Will (vs. Prob/ ef ill not)
$ $

0.13 0.10

2.04 2.15

V i si te d b o th P ro - a nd A nti D rug s S i te s L o w M o ni to ri ng M e d i um -L o w M o ni to ri ng M e d i um -Hi g h M o ni to ri ng Hi g h M o ni to ri ng

 

Likelihood to use marijuana

0.38

Temple University Department of Criminal Justice

Estimate
3

.E.

. .
5

Wald 3.39 5.37 5.62 6.79* 3.06 11.50* 38.85* 9.47* 15.97* 4.33*

0.11
35,000-74,999 75,000+

0.06 0.08 0.09 0.09 0.08 0.06 0.07 0.07 <0.01 0.07 0.06 0.10

1.26 0.73 0.81 1.41 1.08 0.73 1.30 1.56 1.01 1.52 1.67 1.53

-0.14 -0.04 0.21 -0.07 -0.16 0.13 0.22 0.01 0.21 0.25

1 or fe er 2 -3 (vs. 4+)
7

hat kid doing Parents kno a ay from home

7 7

alked ith parents about avoiding drugs Attended drug education films or lectures General Exposure Index core Any close friends use drugs alked ith friends about avoiding drugs Likelihood to use marijuana
6 7 3 6 7

6 7

Intention to se Marijuana

Probably/ efinitely Will (vs. Probably/ efinitely ill not)

$ $

0.21

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Intention to MJ Use at T2 x Website Type at T1

Total N % (unweighted) Intending to Use Pro-Drug Site Only Both Pro & Anti-Drug Sites Anti-Drug Site Only Neither Total 44 99 30.8 14.5 SE of % 95% CI

Modeling Increased Intention to Use at T2

Predictor Estimate S.E. O.R. P Type 3 Wald ChiSquare 94.78 <.0001

8.15 4.22

14.8 46.7 Risk 6.2 22.8 High Risk 1.43 0.10 4.16

305 3976 4424

10.9 8.1 8.7

2.12 0.55 0.53

6.7 15.1 7.0 9.2 7.7 9.7

Viewing (reference group=no drug sites)

Pro & Anti- 0.51 Drug Sites Anti-Drug Pro-Drug 0.52 0.89

0.15

1.66

8.90

0.03

0.25 0.46

1.68 2.43

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Change from Perceiving No/Slight Risk at T1 to Moderate/Great Risk at T2

Total N (unweighted) Pro-Drug Site Only 54 73 % Changing Perceived Risk 21.3 20.1 SE of % 95% CI

7.71 5.64

6.2 36.4 9.1 31.1

Perceived Risk of Using Marijuana

Both Pro & Anti-Drug Sites Anti-Drug Site Only Neither Total

97 1443 1667

30.7 29.8 29.0

5.56 1.51 1.38

19.8 41.6 26.8 32.8 26.3 31.7

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Modeling Increased Perceived Risk at T2

Predictor Estimate S.E. O.R. P Type 3 Wald ChiSquare 34.96 4.53 <0.0001 0.21

Risk Viewing (reference group=no drug sites)

High Risk

-0.93

0.16 0.42 0.27 0.52

0.39 0.41 0.91 1.08

Initiation into Marijuana Use

Pro & Anti- -0.88 Drug Sites Anti-Drug -0.09 Pro-Drug 0.08

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Initiation of MJ Use at T2 x Website Type at T1

Total N % (unweighted) Initiating Use Pro-Drug Site Only Both Pro and AntiDrug Sites Anti-Drug Site Only Neither Total 30 95 27.9 11.6 SE of % 95% CI Predictor

Modeling MJ Initiation at T2
Estimate S.E. O.R. Type 3 Wald ChiSquare 91.30 2.74 P

9.27 3.79

9.7 - 46.1 Risk 4.2 - 19.0 Viewing (reference group=no drug sites) Pro & AntiDrug Sites Anti-Drug Sites Pro-Drug Sites 0.21 0.02 0.99 0.41 0.26 0.62 1.23 1.03 2.68 0.43 High Risk 1.51 0.16 4.54 <.0001

298 3783 4206

8.3 8.6 8.8

1.73 0.58 0.55

4.9 11.7 7.5 9.7 7.7 9.9

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice

Conclusions



Future Research
More detailed interviews of patterns and sequence of drug website utilization
 Salience, influence, and content recall of drug website messages  Effects on intention, perceived risks, and initiation with larger samples of drug website viewers  

Nearly 4.5 million teens view pro-drug websites Prodrug viewing linked to higher risk profile Antidrug viewing linked to other prevention exposure

  

Exposure to drug prevention messages may increase viewing of all types of drug websites


Causal models of drug website effects Role of other web-based information exchange


Prodrug viewing may increase future risk of MJ initiation



Only for low risk youth?



PDA Cell phone Myspace

Prodrug viewing increased intention to use



Moderated by risk level

 

Antidrug viewing increased perceived risk of using MJ?



Only among low-risk youth?

Unanticipated consequences of drug prevention exposure

Temple University Department of Criminal Justice

Temple University Department of Criminal Justice