Association between Community Attachment and Prescription Drug Misuse among American Indian Adolescents in Arizona

Prescription drug misuse (PDM) has become a major health issue in the U.S. over past decade. PDM affects all ethnic and racial groups; however, there is higher prevalence among American Indian (AI) youths, scarce information on risk protective factors driving this behavior. Using Arizona Youth Survey 2018, we analyzed data from 2494 students who self-identified as AI (aged 13–18 years, 47.31% male). Logistic regression models were used to examine association between community attachment with lifetime past-30-days PDM. Community was negatively associated youths’ (OR = 0.78, 95% CI [0.65, 0.92]); it not significant for users 0.91, [0.72, 1.15]). For both users, common factor close friends’ negative perceptions of PDM, while included siblings’ prescription use ease access substances. Lifetime users’ drug-free closest friends also protective. The findings support similar community-oriented approaches showing cumulative rather than immediate effect, PMD youths strongly influenced by peers family. can advance knowledge about social cultural determinants influence future prevention interventions.