A Technical Assistance Tool for Helping Youth Navigate Peer Influence

Part of: A Technical Assistance Tool for Helping Youth Navigate Peer Influence

Peer influence plays a critical role in shaping youth’s^a experiences and behaviors. Peer influence can include direct pressure from peers, perceived peer norms about what “everyone” is doing, digital influences, and the influence of close friends’ attitudes and behaviors—influences that can be both positive and negative. Peer influence is particularly important in relation to substance use and risky sexual activity, which can increase the risk of unintended teen pregnancy.^1,2,3 Youth-supporting professionals can help youth develop positive peer networks that support healthier decisions about substance use, sexual activity, and contraception use.^4,5,6

This tool provides practical, research-informed strategies that youth-supporting professionals can use to help youth recognize and respond to negative peer influence, strengthen positive peer connections, and make safe decisions related to substance use and sexual activity. This resource builds on previous Activate resources^7,8 that focus on helping youth-supporting professionals build trust and rapport with youth before engaging in difficult conversations, such as conversations about substance use and risky sexual activity.

Why Peer Influence, Substance Use, and Risky Sexual Activity Can Be Addressed Together

Substance use is linked to risky sexual activity, including engaging in sexual activity when judgement and decision-making are impaired,^9,10 sexual initiation before age 14,¹¹ inconsistent contraceptive use,¹² coercive sexual encounters,¹³ and sex with multiple partners.¹⁴ These sexual activities increase the risk of unintended teen pregnancy and sexually transmitted infections (STIs).¹⁵

Research shows that peer influence can shape both substance use and risky sexual activity. For example, when asked about their peers broadly, youth often overestimate alcohol use among their peers, which can make alcohol use^b seem more normative.^16,17,18 Research further shows that close friends shape norms through everyday interactions and shared expectations.¹⁹ For example, youth may be less likely to try substances when their close friends do not use them. Peers can also shape norms and behaviors related to sexual activity and contraception use.²⁰ Youth who perceive that their peers are sexually active or approve of sexual activity are more likely to engage in sexual activity than those who do not share these perceptions.²¹ Peer influence on substance use and sexual activity may be particularly important for youth experiencing the child welfare system, juvenile justice system, or homelessness. Young people in these settings are more likely to experience disruptions in their connections to stable, supportive adults, due in part to placement instability, and may consequently rely on peers for emotional support and guidance.^{22,23,24,25,26,27} Together, this research suggests that youth-supporting professionals can help youth recognize and respond to peer influence and build peer relationships that support safer decisions.

Strategies for Helping Youth Address Peer Influence Related to Substance Use and Risky Sexual Activity

Below we describe four strategies that youth-supporting professionals can use to help youth resist negative peer influences (i.e., peer pressure) and strengthen positive peer influences related to substance use and sexual activity. For each strategy, we include guidance on how to apply it in practice. The strategies are intended as general guidance and may need to be adapted based on the circumstances and experiences of the youth you are working with.

1. Help youth recognize and name negative peer influence

Youth may experience negative peer influence (i.e., peer pressure) from friends, romantic partners, or acquaintances to use substances or engage in risky sexual activities.^28,29 This peer pressure can occur in person or through digital communication, such as text messaging, social media, or other platforms and apps.^30,31 Youth may sense when this is happening but lack the language to describe it. Helping youth recognize and name this peer pressure is an important first step in building their ability to respond effectively. To help youth name the kinds of peer pressure they experience, youth-supporting professionals can:

• Help youth identify what negative peer influence looks like. Negative peer influence can include peer pressure, as well as peer approval of risky behaviors or peer engagement in risky behaviors without directly pressuring others to join in.
  • “Do you feel pressured to engage in certain activities when you see your peers posting on social media about those activities?”
• Ask questions to help youth identify who is pressuring them to make risky choices and/or who is encouraging them to make safer choices.
  • “Is anyone in your life pushing you to do something you don’t want to do?”
  • “Who do you look to for examples of how you want to be or things you want to do?”
• Ask questions to identify where youth are experiencing peer influence. For example, is it happening in a residential care setting, at home, or at school?
  • “Where do you feel like you have the most freedom to make your own choices?”
  • “Are there certain places where you feel you have to do what your friends expect you to do?”
• Help youth connect their experiences to their feelings and choices. Youth may not always label an experience as feeling peer pressured, but they may connect it to feelings such as nervousness, guilt, or embarrassment.
  • “How did you feel in your body when that situation happened?”
  • “What made it feel hard to do what you wanted to do?”
  • “Did you feel like you would be judged or let someone down if you didn’t do that?”

2. Teach and practice refusal and boundary-setting kills

Youth are more likely to resist peer pressure when they have simple, prepared responses.^32,33,34,35 Teaching youth refusal skills can help them navigate situations where they feel pressured to use substances or engage in risky sexual activity by giving them strategies to avoid or exit these situations.^36,37,38 Refusal skills include being direct, giving reasons for not participating in an activity, redirecting to alternatives, using external excuses, or using humor. Youth-supporting professionals should also work with youth on respecting and responding to boundaries regarding substance use and sexual activity set by others. Boundary-respecting skills include recognizing and honoring when others express discomfort or say no and understanding that respecting others’ boundaries is as important as asserting one’s own. Youth-supporting professionals can help youth practice the S.T.O.P. approach to saying no, which includes setting boundaries and responding to peer influence with clear communication.³⁹

3. Provide accurate information about peer norms and substance use trends

Youth may underestimate or be unaware of the risks associated with substance use and unprotected sex. Youth can also hold inaccurate beliefs about how common these behaviors are among their peers, and this can influence their own choices.⁴⁰ Providing accurate, relevant information in a nonjudgmental way can help youth better understand what their peers are actually doing, what risks may be involved, and how to make safe choices.^41,42

It is important for youth-supporting professionals to stay up to date on information, including the slang or “street names”⁴³ for drugs, and to understand⁴⁴ how those drugs impact the body. In addition, information about regional and national trends on substance use among youth can be helpful. For more information on how to track trends in your community, see the list below. These resources can help professionals stay informed and discuss trends with youth in accurate, nonjudgmental ways:

• Monitoring the Future is an ongoing study at the University of Michigan that conducts annual surveys of more than 25,000 adolescents and young adults on attitudes and behaviors related to drug use. The project regularly publishes data on prevalence and emerging trends.⁴⁵
• The Youth Risk Behavior Surveillance System (YRBSS) is the largest public health monitoring system in the United States focused on high school students. YRBSS tracks and publishes health-related behaviors, including sexual behavior, substance use, and social media use.⁴⁶
• The National Survey on Drug Use and Health (NSDUH) provides nationally representative data on substance use, substance use disorders, mental health, and receipt of substance use and mental health treatment among U.S. residents age 12 and older. NSDUH data are used to generate national, regional, and state-level prevalence estimates, which can be viewed by age group on interactive maps.⁴⁷

Youth-supporting professionals do not need to present detailed data on sexual behavior and substance use to youth. Instead, they can use information to answer questions accurately, correct misperceptions about what “everyone” is doing, and connect youth to credible information when needed.

4. Encourage youth to build prosocial peer relationships

Prosocial peers are those who generally support or help others and model positive behaviors; research suggests they can help protect against substance use in their peer groups.^48,49 When youth are surrounded by prosocial peers, they may be less likely to be encouraged to use substances or to see substance use as acceptable.⁵⁰ In prosocial peer groups, youth encourage one another to make healthy, safe, and constructive choices, such as helping others, respecting boundaries, and discouraging harmful behaviors.⁵¹ Relationships with prosocial peers, such as peer-to-peer mentors, are associated with positive social, academic, and health-related behaviors.^52,53

Prosocial peer relationships can encourage youth to:^54,55,56

• Spend time with friends who respect their choices.
• Support friends who say no to substances or unsafe sex.
• Create group norms around safety and respect.

Prosocial peer relationships can also create a strong sense of belonging, which can reduce the pressure some youth may feel to seek acceptance through engaging in peer pressure (including related to substance use or sexual activity).^57,58,59,60 In this way, prosocial peer relationships serve as both a buffer against negative influences and a source of support that promotes resilience and well-being.

More background on the research behind these strategies is available in the accompanying research summary, Harnessing Positive Peer Influence to Reduce Substance Use and Unintended Teen Pregnancy.

Footnotes

1. Throughout this resource, we use youth to refer to all adolescents and young adults ages 14–24. ↩
2. Alcohol is the most commonly studied substance when examining the relationship between substance use and sexual activity. ↩