Family beliefs shape substance use patterns in sexual minority youth

Sexual minority young adults (SMYAs) display elevated rates of mental health symptoms and substance use relative to their heterosexual peers. This study examined associations of parental beliefs with SMYAs' critical consciousness and health outcomes. We analyzed data among 548 US SMYAs (ages 18-25) residing in Oklahoma and surrounding states who participated in a 2-wave online observational survey study. Multivariable regressions conducted separately for each outcome examined associations of 1) parental beliefs (i.e., political beliefs and religious importance) with SMYAs' critical consciousness (i.e., inequality, egalitarianism, and critical action) and health outcomes (mental health symptoms, past-month tobacco use, cannabis use, alcohol use, and polysubstance use); and 2) critical consciousness with health outcomes, controlling for sociodemographic covariates. Within our sample of SMYAs (Mage = 21.75[SD = 2.11]), parental liberal (31.2%) and conservative (46.5%) (vs. moderate [22.3%]) beliefs were associated with higher egalitarianism beliefs. Parental religious importance was associated with lower egalitarianism beliefs, which were associated with lower odds of tobacco use. Parental conservative (vs. moderate) beliefs were also associated with lower critical action, which was associated with higher odds of mental health symptoms and tobacco use and lower odds of no substance use (vs. polysubstance use). Findings provide preliminary evidence for the potential importance of incorporating SMYAs' egalitarianism beliefs into mental health and substance use prevention and intervention efforts, particularly for SMYAs' from families with more moderate political beliefs and greater religious beliefs. Findings also highlight the need to identify factors that protect SMYAs engaging in activism from mental health symptoms and substance use.