Effect of housing relocation and neighborhood environment on adolescent mental and behavioral health.

PubMed

Byck, Gayle R; Bolland, John; Dick, Danielle; Swann, Gregory; Henry, David; Mustanski, Brian

2015-11-01

This study examined whether relocating from a high-poverty neighborhood to a lower poverty neighborhood as part of a federal housing relocation program (HOPE VI; Housing Opportunities for People Everywhere) had effects on adolescent mental and behavioral health compared to adolescents consistently living in lower poverty neighborhoods. Sociodemographic, risk behavior, and neighborhood data were collected from 592 low-income, primarily African-American adolescents and their primary caregivers. Structured psychiatric interviews were conducted with adolescents. Prerelocation neighborhood, demographic, and risk behavior data were also included. Hierarchical Linear Modeling (HLM) was used to test associations between neighborhood variables and risk outcomes. HLM was used to test whether the effect of neighborhood relocation and neighborhood characteristics might explain differences in sexual risk taking, substance use, and mental health outcomes. Adolescents who relocated of HOPE VI neighborhoods (n = 158) fared worse than control group participants (n = 429) on most self-reported mental health outcomes. The addition of subjective neighborhood measures generally did not substantively change these results. Our findings suggest that moving from a high-poverty neighborhood to a somewhat lower poverty neighborhood is not associated with better mental health and risk behavior outcomes in adolescents. The continued effects of having grown up in a high-poverty neighborhood, the small improvements in their new neighborhoods, the comparatively short length of time they lived in their new neighborhood, and/or the stress of moving appears to worsen most of the mental health outcomes of HOPE VI compared to control group participants who consistently lived in the lower poverty neighborhoods. © 2015 Association for Child and Adolescent Mental Health.

Pathways From Family Disadvantage via Abusive Parenting and Caregiver Mental Health to Adolescent Health Risks in South Africa.

PubMed

Meinck, Franziska; Cluver, Lucie Dale; Orkin, Frederick Mark; Kuo, Caroline; Sharma, Amogh Dhar; Hensels, Imca Sifra; Sherr, Lorraine

2017-01-01

Adolescent health is a major concern in low- and middle-income countries, but little is known about its predictors. Family disadvantage and abusive parenting may be important factors associated with adolescent psychological, behavioral, and physical health outcomes. This study, based in South Africa, aimed to develop an empirically based theoretical model of relationships between family factors such as deprivation, illness, parenting, and adolescent health outcomes. Cross-sectional data were collected in 2009-2010 from 2,477 adolescents (aged 10-17) and their caregivers using stratified random sampling in KwaZulu-Natal, South Africa. Participants reported on sociodemographics, psychological symptoms, parenting, and physical health. Multivariate regressions were conducted, confirmatory factor analysis employed to identify measurement models, and a structural equation model developed. The final model demonstrated that family disadvantage (caregiver AIDS illness and poverty) was associated with increased abusive parenting. Abusive parenting was in turn associated with higher adolescent health risks. Additionally, family disadvantage was directly associated with caregiver mental health distress which increased adolescent health risks. There was no direct effect of family disadvantage on adolescent health risks but indirect effects through caregiver mental health distress and abusive parenting were found. Reducing family disadvantage and abusive parenting is essential in improving adolescent health in South Africa. Combination interventions could include poverty and violence reduction, access to health care, mental health services for caregivers and adolescents, and positive parenting support. Such combination packages can improve caregiver and child outcomes by reducing disadvantage and mitigating negative pathways from disadvantage among highly vulnerable families. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

How adolescent health influences education and employment: investigating longitudinal associations and mechanisms

PubMed Central

Hale, Daniel R; Viner, Russell M

2018-01-01

Background Education is recognised as a strong determinant of health. Yet there is increasing concern that health in adolescence may also influence educational attainments and future life chances. We examined associations between health in early adolescence and subsequent academic and employment outcomes, exploring potential mediators of these relationships to inform intervention strategies. Methods We used data from the Longitudinal Study of Young People in England. Adolescent health was measured at waves 1 and 2. Outcomes included educational attainment at age 16 years and being NEET (not in education, employment or training) at age 19 years. Associations were adjusted for ethnicity, area-level deprivation and early adolescent academic attainment. Where significant associations were identified, we examined the role of hypothesised mediators including attendance and truancy, classroom behaviour, substance use and psychological distress. Results Health conditions in early adolescence predicted poor subsequent education and employment outcomes (ORs ranged from 1.25 to 1.72) with the exception of long-term chronic conditions and NEET status, which were unassociated. The most consistent mediating variable was social exclusion. School behaviour, truancy and substance use were significant mediators for mental health. Long-term absences mediated associations between mental health and physical health and later outcomes. Conclusions Health is a key component of academic and vocational achievement. Investment in health is a way of improving life chances. The identification of key mediators such as social exclusion and truancy indicate areas where screening for health conditions and provision of targeted support could improve educational, employment and health outcomes. PMID:29615474

Community, Family, and Subjective Socioeconomic Status: Relative Status and Adolescent Health

PubMed Central

Quon, Elizabeth C.; McGrath, Jennifer J.

2017-01-01

Objective Relative socioeconomic status (SES) may be an important social determinant of health. The current study aimed to examine how relative SES, as measured by subjective SES, income inequality, and individual SES relative to others in the community, is associated with a wide range of adolescent health outcomes, after controlling for objective family SES. Method Adolescents (13–16 years; N = 2,199) from the Quebec Child and Adolescent Health and Social Survey were included. Socioeconomic measures included adolescents’ subjective SES; parental education and household income; community education/employment, income, and poverty rate; and community income inequality. Health outcomes included self-rated health, mental health problems, dietary and exercise health behaviors, substance-related health behaviors, reported physical health, and biomarkers of health. Best-fitting multilevel regression models (participants nested within schools) were used to test associations. Results Findings indicated that lower subjective SES was associated with poorer health outcomes. After accounting for family SES, lower community education/employment had an additional negative effect on health, while lower community income had a protective effect for certain health outcomes. There was less evidence for an independent effect of income inequality. Conclusions Findings highlight the importance of measures of relative SES that span across a number of levels and contexts, and provide further understanding into the socioeconomic gradient in adolescence. PMID:25222085

Adolescent health and adult labor market outcomes.

PubMed

Lundborg, Petter; Nilsson, Anton; Rooth, Dan-Olof

2014-09-01

Whereas a large literature has shown the importance of early life health for adult socioeconomic outcomes, there is little evidence on the importance of adolescent health. We contribute to the literature by studying the impact of adolescent health status on adult labor market outcomes using a unique and large-scale dataset covering almost the entire population of Swedish males. We show that most types of major conditions have long-run effects on future outcomes, and that the strongest effects result from mental conditions. Including sibling fixed effects or twin pair fixed effects reduces the magnitudes of the estimates, but they remain substantial. Copyright © 2014 Elsevier B.V. All rights reserved.

A global study on the influence of neighborhood contextual factors on adolescent health.

PubMed

Mmari, Kristin; Lantos, Hannah; Blum, Robert W; Brahmbhatt, Heena; Sangowawa, Adesola; Yu, Chunyan; Delany-Moretlwe, Sinead

2014-12-01

This study uses data collected as part of the Well-Being of Adolescents in Vulnerable Environments study to (1) compare the perceptions of neighborhood-level factors among adolescents across five different urban sites; (2) examine the associations between factors within the physical and social environments; and (3) examine the influence of neighborhood-level factors on two different health outcomes-violence victimization in the past 12 months and ever smoked. Across five urban sites (Baltimore, New Delhi, Johannesburg, Ibadan, and Shanghai), 2,320 adolescents aged 15-19 years completed a survey using audio computer-assisted self-interview technology. To recruit adolescents, each site used a respondent-driven sampling method, which consisted of selecting adolescents as "seeds" to serve as the initial contacts for recruiting the entire adolescent sample. All analyses were conducted with Stata 13.1 statistical software, using complex survey design procedures. To examine associations between neighborhood-level factors and among our two outcomes, violence victimization and ever smoked, bivariate and multivariate analyses were conducted. Across sites, there was great variability in how adolescents perceived their neighborhoods. Overall, adolescents from Ibadan and Shanghai held the most positive perceptions about their neighborhoods, whereas adolescents from Baltimore and Johannesburg held the poorest. In New Delhi, despite females having positive perceptions about their safety and sense of social cohesion, they had the highest sense of fear and the poorest perceptions about their physical environment. The study also found that one of the most consistent neighborhood-level factors across sites and outcomes was witnessing community violence, which was significantly associated with smoking among adolescents in New Delhi and Johannesburg and with violence victimization across nearly every site except Baltimore. No other neighborhood-level factor exerted greater influence. This study confirms the important associations between perceptions of a neighborhood and adolescent health. At the same time, it demonstrates that not all neighborhood-level factors are associated with adolescent health outcomes in the same way across different urban contexts. Further longitudinal research is needed to examine the direction of causation between adolescent health neighborhood contexts and health outcomes and the reasons for why different urban contexts may exert varying levels of influence on the health of adolescents. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study.

PubMed

Ganchimeg, T; Ota, E; Morisaki, N; Laopaiboon, M; Lumbiganon, P; Zhang, J; Yamdamsuren, B; Temmerman, M; Say, L; Tunçalp, Ö; Vogel, J P; Souza, J P; Mori, R

2014-03-01

To investigate the risk of adverse pregnancy outcomes among adolescents in 29 countries. Secondary analysis using facility-based cross-sectional data of the World Health Organization Multicountry Survey on Maternal and Newborn Health. Twenty-nine countries in Africa, Latin America, Asia and the Middle East. Women admitted for delivery in 359 health facilities during 2-4 months between 2010 and 2011. Multilevel logistic regression models were used to estimate the association between young maternal age and adverse pregnancy outcomes. Risk of adverse pregnancy outcomes among adolescent mothers. A total of 124 446 mothers aged ≤24 years and their infants were analysed. Compared with mothers aged 20-24 years, adolescent mothers aged 10-19 years had higher risks of eclampsia, puerperal endometritis, systemic infections, low birthweight, preterm delivery and severe neonatal conditions. The increased risk of intra-hospital early neonatal death among infants born to adolescent mothers was reduced and statistically insignificant after adjustment for gestational age and birthweight, in addition to maternal characteristics, mode of delivery and congenital malformation. The coverage of prophylactic uterotonics, prophylactic antibiotics for caesarean section and antenatal corticosteroids for preterm delivery at 26-34 weeks was significantly lower among adolescent mothers. Adolescent pregnancy was associated with higher risks of adverse pregnancy outcomes. Pregnancy prevention strategies and the improvement of healthcare interventions are crucial to reduce adverse pregnancy outcomes among adolescent women in low- and middle-income countries. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study.

PubMed

Busch, Vincent; Van Stel, Henk F; Schrijvers, Augustinus J P; de Leeuw, Johannes R J

2013-12-04

Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial and physical health. These findings have significant meaning for future public health programs, which should be more tailored with use of such knowledge on behavioral clustering via e.g. Transfer Learning.

Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study

PubMed Central

2013-01-01

Background Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Methods Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Results Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. Conclusions The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial and physical health. These findings have significant meaning for future public health programs, which should be more tailored with use of such knowledge on behavioral clustering via e.g. Transfer Learning. PMID:24305509

The influence of caregiver depression on adolescent mental health outcomes: findings from refugee settlements in Uganda.

PubMed

Meyer, Sarah R; Steinhaus, Mara; Bangirana, Clare; Onyango-Mangen, Patrick; Stark, Lindsay

2017-12-19

Family-level predictors, including caregiver depression, are considered important influences on adolescent mental health. Adolescent depression and anxiety in refugee settings is known to be a significant public health concern, yet there is very limited literature from humanitarian settings focusing on the relationship between caregiver mental health and adolescent mental health. In the context of a larger study on child protection outcomes in refugee settings, researchers explored the relationship between caregiver depression and adolescent mental health in two refugee settlements, Kiryandongo and Adjumani, in Uganda. Adolescents between 13 and 17 and their caregivers participated in a household survey, which included measures of adolescent anxiety and depression, and caregiver depression. Analysis was conducted using multiple logistic regression models, and results were reported for the full sample and for each site separately. In Kiryandongo, a one-unit increase in a caregiver's depression score tripled the odds that the adolescent would have high levels of anxiety symptoms (AOR: 3.0, 95% CI: 1.4, 6.1), while in Adjumani, caregiver depression did not remain significant in the final model. Caregiver depression, gender and exposure to violence were all associated with higher symptoms of adolescent depression in both sites and the full sample, for example, a one unit increase in caregiver depression more than tripled the odds of higher levels of symptoms of adolescent depression (AOR: 3.6, 95% CI: 2.0, 6.2). Caregiver depression is a consistently significantly associated with adverse mental health outcomes for adolescents in this study. Adolescent well-being is significantly affected by caregiver mental health in this refugee context. Child protection interventions in humanitarian contexts do not adequately address the influence of caregivers' mental health, and there are opportunities to integrate child protection programming with prevention and treatment of caregivers' mental health symptoms.

Systematic review of mental health and well-being outcomes following community-based obesity prevention interventions among adolescents.

PubMed

Hoare, Erin; Fuller-Tyszkiewicz, Matthew; Skouteris, Helen; Millar, Lynne; Nichols, Melanie; Allender, Steven

2015-01-05

This paper aimed to systematically evaluate the mental health and well-being outcomes observed in previous community-based obesity prevention interventions in adolescent populations. Systematic review of literature from database inception to October 2014. Articles were sourced from CINAHL, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsycARTICLES and PsycINFO, all of which were accessed through EBSCOhost. The Cochrane Database was also searched to identify all eligible articles. PRISMA guidelines were followed and search terms and search strategy ensured all possible studies were identified for review. Intervention studies were eligible for inclusion if they were: focused on overweight or obesity prevention, community-based, targeted adolescents (aged 10-19 years), reported a mental health or well-being measure, and included a comparison or control group. Studies that focused on specific adolescent groups or were treatment interventions were excluded from review. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. Primary outcomes were measures of mental health and well-being, including diagnostic and symptomatic measures. Secondary outcomes included adiposity or weight-related measures. Seven studies met the inclusion criteria; one reported anxiety/depressive outcomes, two reported on self-perception well-being measures such as self-esteem and self-efficacy, and four studies reported outcomes of quality of life. Positive mental health outcomes demonstrated that following obesity prevention, interventions included a decrease in anxiety and improved health-related quality of life. Quality of evidence was graded as very low. Although positive outcomes for mental health and well-being do exist, controlled evaluations of community-based obesity prevention interventions have not often included mental health measures (n=7). It is recommended that future interventions incorporate mental health and well-being measures to identify any potential mechanisms influencing adolescent weight-related outcomes, and equally to ensure interventions are not causing harm to adolescent mental health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Disparities in Access to Healthcare Transition Services for Adolescents with Down Syndrome.

PubMed

Nugent, James; Gorman, Gregory; Erdie-Lalena, Christine R

2018-06-01

To compare healthcare transition planning in adolescents with Down syndrome with adolescents with other special healthcare needs. Data were drawn from the 2009-2010 National Survey of Children with Special Health Care Needs, a nationally representative sample with 17 114 adolescents aged 12-17 years. Parents were asked whether providers and the study child had discussed shifting to an adult provider, changing healthcare needs, maintaining health insurance coverage, and taking responsibility for self-care. The transition core outcome was a composite measure based on the results of these 4 questions. Multivariable logistic regression determined the association between Down syndrome and the transition core outcome as well as each of the 4 individual component measures. Although 40% of adolescents with other special healthcare needs met the transition core outcome, 11.0% of adolescents with Down syndrome met this outcome. Adolescents with Down syndrome were less likely to be encouraged to take responsibility for their health (32.2% vs 78.4%). After adjustment for demographic, socioeconomic, and health-related factors, adolescents with Down syndrome had 4 times the odds of not meeting the transition core outcome. For the component measures, Down syndrome adolescents had 4 times the odds of not being encouraged to take responsibility for self-care. Medical home access increased the odds of transition preparation. Adolescents with Down syndrome experience disparities in access to transition services. Provider goals for adolescents with Down syndrome should encourage as much independence as possible in their personal care and social lives. Copyright © 2018 Elsevier Inc. All rights reserved.

A Systematic Review of Oral Health Behavior Research in American Adolescents

ERIC Educational Resources Information Center

Calderon, Susana J.; Mallory, Caroline

2014-01-01

Despite improvements in prevention, oral diseases are a problem among adolescents, linked to poor health outcomes and poor school performance. Little is known about adolescent oral health behavior. This systematic review describes factors that influence oral health behavior in adolescents. Inclusion criteria for the literature search were American…

How adolescent health influences education and employment: investigating longitudinal associations and mechanisms.

PubMed

Hale, Daniel R; Viner, Russell M

2018-06-01

Education is recognised as a strong determinant of health. Yet there is increasing concern that health in adolescence may also influence educational attainments and future life chances. We examined associations between health in early adolescence and subsequent academic and employment outcomes, exploring potential mediators of these relationships to inform intervention strategies. We used data from the Longitudinal Study of Young People in England. Adolescent health was measured at waves 1 and 2. Outcomes included educational attainment at age 16 years and being NEET (not in education, employment or training) at age 19 years. Associations were adjusted for ethnicity, area-level deprivation and early adolescent academic attainment. Where significant associations were identified, we examined the role of hypothesised mediators including attendance and truancy, classroom behaviour, substance use and psychological distress. Health conditions in early adolescence predicted poor subsequent education and employment outcomes (ORs ranged from 1.25 to 1.72) with the exception of long-term chronic conditions and NEET status, which were unassociated. The most consistent mediating variable was social exclusion. School behaviour, truancy and substance use were significant mediators for mental health. Long-term absences mediated associations between mental health and physical health and later outcomes. Health is a key component of academic and vocational achievement. Investment in health is a way of improving life chances. The identification of key mediators such as social exclusion and truancy indicate areas where screening for health conditions and provision of targeted support could improve educational, employment and health outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Improving mental health of adolescents with Type 1 diabetes: protocol for a randomized controlled trial of the Nothing Ventured Nothing Gained online adolescent and parenting support intervention

PubMed Central

2013-01-01

Background Management of Type 1 diabetes comes with substantial personal and psychological demands particularly during adolescence, placing young people at significant risk for mental health problems. Supportive parenting can mitigate these risks, however the challenges associated with parenting a child with a chronic illness can interfere with a parent’s capacity to parent effectively. Interventions that provide support for both the adolescent and their parents are needed to prevent mental health problems in adolescents; to support positive parent-adolescent relationships; and to empower young people to better self-manage their illness. This paper presents the research protocol for a study evaluating the efficacy of the Nothing Ventured Nothing Gained online adolescent and parenting intervention which aims to improve the mental health outcomes of adolescents with Type 1 diabetes. Method/Design A randomized controlled trial using repeated measures with two arms (intervention and wait-list control) will be used to evaluate the efficacy and acceptability of the online intervention. Approximately 120 adolescents with Type 1 diabetes, aged 13–18 years and one of their parents/guardians will be recruited from pediatric diabetes clinics across Victoria, Australia. Participants will be randomized to receive the intervention immediately or to wait 6 months before accessing the intervention. Adolescent, parent and family outcomes will be assessed via self-report questionnaires at three time points (baseline, 6 weeks and 6 months). The primary outcome is improved adolescent mental health (depression and anxiety). Secondary outcomes include adolescent behavioral (diabetes self-management and risk taking behavior), psychosocial (diabetes relevant quality of life, parent reported child well-being, self-efficacy, resilience, and perceived illness benefits and burdens); metabolic (HbA1c) outcomes; parent psychosocial outcomes (negative affect and fatigue, self-efficacy, and parent experience of child illness); and family outcomes (parent and adolescent reported parent-adolescent communication, responsibility for diabetes care, diabetes related conflict). Process variables including recruitment, retention, intervention completion and intervention satisfaction will also be assessed. Discussion The results of this study will provide valuable information about the efficacy, acceptability and therefore the viability of delivering online interventions to families affected by chronic illnesses such as Type 1 diabetes. Trial registration Australian New Zealand clinical trials registry (ANZCTR); ACTRN12610000170022 PMID:24341465

Contextual and intrapersonal predictors of adolescent risky sexual behavior and outcomes.

PubMed

Shneyderman, Yuliya; Schwartz, Seth J

2013-08-01

The present study was designed to test a model of contextual and intrapersonal predictors of adolescent risky sexual behaviors and of sexually transmitted infection diagnoses. Using Waves I and II from the National Longitudinal Study of Adolescent Health, the authors estimated a structural model in which intrapersonal factors such as adolescents' attitudes about sex, perceived parental norms, knowledge about sexual health, and birth-control self-efficacy partially mediated the effects of contextual factors such as parent-adolescent relationship quality, school connectedness, and exposure to AIDS and pregnancy education on a number of risky sexual behaviors and outcomes: early sex initiation, sex under the influence of substances, condom use at last intercourse, and having been diagnosed with a sexually transmitted infection. Different patterns of direct and mediated effects emerged for each sexual outcome. Results are discussed in terms of the complex interplay between environment and individual and in terms of how, when, and with whom to intervene in order to improve adolescent sexual health outcomes.

Adolescents' Right to Participate: Opportunities and Challenges for Health Care Professionals.

PubMed

Todres, Jonathan; Diaz, Angela

Health care professionals and patients are partners in health care delivery, and this partnership is critical in the treatment of adolescents. International children's rights law establishes that all children have a right to participate in decisions that affect their lives. Fulfillment of that right is as critical in health care settings as any other area of children's lives. In this article we examine the right to participate under international children's rights law, its relevance to health care settings, and how health care professionals can foster adolescents' participation to fulfill children's rights and improve health care outcomes. The Convention on the Rights of the Child establishes a legal mandate-where ratified-that adolescents have the right to express their views in health care settings and that such views must be given due consideration. In many health care settings, adolescents are not adequately consulted or have limited opportunities to express their views. A review of research finds that both processes and outcomes can improve when youth participation is cultivated. Health care providers and organizations have numerous opportunities to cultivate adolescent's participation rights and in doing so improve health care delivery and outcomes. Health care providers and organizations should further develop structures and processes to ensure opportunities for children and adolescents to be heard on matters relevant to their health care and health status. Creating opportunities for adolescents to realize their right to participate means engaging youth at every stage in the process, beginning with the design of such opportunities. It also means addressing all aspects of health care, from the built environment to patient-provider communication to follow-up services, so that the entire process fosters an environment conductive to meaningful participation by adolescents. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

Healthy sex and sexual health: new directions for studying outcomes of sexual health.

PubMed

Lefkowitz, Eva S; Vasilenko, Sara A

2014-01-01

Sexual behavior is an important aspect of adolescent development with implications for well-being. These chapters highlight important perspectives on studying sexual health from a normative, developmental perspective, such as viewing a range of sexual behaviors as life events; considering potentially positive physical health, mental health, social health, and identity outcomes; examining both intraindividual and interindividual differences in outcomes; recognizing the romantic relationship context of sexual behavior; and understanding how sexual media may impact sexual health outcomes. We suggest new directions for studying sexual health outcomes, such as studying behaviors beyond vaginal sex and condom use, new methodologies such as latent class analysis, sophisticated longitudinal designs, and collection and analysis of dyadic data. We recommend research on populations underrepresented in sexual health research such as late adolescents who do not attend traditional universities and adolescents from ethnic/racial minorities. Finally, we consider future directions for sexuality education and prevention efforts. © 2014 Wiley Periodicals, Inc.

Immigration, citizenship, and the mental health of adolescents

PubMed Central

Fenelon, Andrew; Boudreaux, Michel

2018-01-01

Purpose To examine the reported mental health outcomes of adolescent foreign-born non-citizens and adolescent foreign-born U.S. citizens compared to adolescent U.S.-born citizens. Methods Using the Strengths and Difficulties Questionnaire in the National Health Interview Survey, we compared mental health status of U.S.-born adolescent citizens to foreign-born citizens and non-citizens in the years 2010–2015, and examined how differences in emotional difficulty changed based on time spent in the U.S. Results Results suggest that non-citizen adolescents experience better mental health outcomes than U.S.-born citizens. However, the mental health status of foreign-born citizens is indistinguishable from that of the U.S.-born, after accounting for basic socio-demographic characteristics. The prevalence of emotional difficulty experienced by immigrant adolescents increased with a family’s duration in the U.S. Conclusion Our findings are consistent with a broader health advantage for the foreign-born, but we present new evidence that the mental health advantage of foreign-born adolescents exists only for non-citizens. PMID:29723297

Ethnic and racial identity in adolescence: implications for psychosocial, academic, and health outcomes.

PubMed

Rivas-Drake, Deborah; Seaton, Eleanor K; Markstrom, Carol; Quintana, Stephen; Syed, Moin; Lee, Richard M; Schwartz, Seth J; Umaña-Taylor, Adriana J; French, Sabine; Yip, Tiffany

2014-01-01

The construction of an ethnic or racial identity is considered an important developmental milestone for youth of color. This review summarizes research on links between ethnic and racial identity (ERI) with psychosocial, academic, and health risk outcomes among ethnic minority adolescents. With notable exceptions, aspects of ERI are generally associated with adaptive outcomes. ERI are generally beneficial for African American adolescents' adjustment across all three domains, whereas the evidence is somewhat mixed for Latino and American Indian youth. There is a dearth of research for academic and health risk outcomes among Asian American and Pacific Islander adolescents. The review concludes with suggestions for future research on ERI among minority youth. © 2013 The Authors. Child Development © 2013 Society for Research in Child Development, Inc.

Behavior problems in adolescence and subsequent mental health in early adulthood: results from the World Trade Center Health Registry Cohort.

PubMed

Gargano, Lisa M; Locke, Sean; Li, Jiehui; Farfel, Mark R

2018-06-15

The present study examined the association between 9/11-related adolescent behavioral problems on mental health outcomes in early adulthood. Data from enrollees of the World Trade Center Health Registry, who completed at least one adolescent (2006-2007 or 2011-2012) and adult survey (2011-2012 or 2015-2016), were analyzed. Adolescent behavioral difficulties were assessed using the adolescent-reported Strengths and Difficulties Questionnaire (SDQ). Adult mental health outcomes included binge drinking, smoking status history, 9/11-related post-traumatic stress disorder (PTSD), depression, and the self-reported number of physician mental health diagnoses. Multivariable regression was used to estimate associations of SDQ scores with mental health outcomes. Of the 297 enrollees, 16.8% (n = 50) had abnormal/borderline SDQ scores as an adolescent. Binge drinking was not associated with adolescent SDQ scores. Enrollees with abnormal/borderline SDQ scores as an adolescent were more likely to be a consistent smoker (odds ratio (OR): 5.6, 95% confidence interval (CI): 1.2-25.2), have probable PTSD (OR: 3.5, 95% CI: 1.3-9.8), depression (OR: 6.2, 95% CI: 2.7-13.9), and to have two or more self-reported physician-diagnosed mental health conditions as an adult (OR 5.6, 95% CI: 2.0-12.5). The findings of this study underscore the need to intervene early with children exposed to traumatic events so as to avert later adolescent and adult problem behaviors.

Does Adolescent Affect Impact Adult Social Integration? Evidence from the British 1946 Birth Cohort

PubMed Central

Hatch, Stephani L.; Wadsworth, Michael EJ

2012-01-01

Using data from the MRC National Survey of Health and Development (the British 1946 birth cohort), we take a life course approach with a sociology of mental health framework to examine the relationship between adolescent affect and adult social integration. The results suggest that being observed as anxious or sad in adolescence has long-term effect on adult social integration. These associations are not explained by adult mental health or socioeconomic status, for the most part. The results demonstrate support for social selection processes between adolescent mental health and adult social outcomes and suggest a disparate effect of type of adolescent affect on adult social outcomes. PMID:22723717

Adolescent health, stress and life satisfaction: the paradox of indulgent parenting.

PubMed

Coccia, Catherine; Darling, Carol A; Rehm, Marsha; Cui, Ming; Sathe, Shridhar K

2012-08-01

A survey of adolescents aged 15 to 16 years was used to examine the relationship between their perceptions of indulgent parenting and adolescent weight status to overall satisfaction with life, as associated with adolescent perceptions of body image, health and stress. In addition, perceptions of parental indulgence were examined in terms of their association with adolescent eating behaviours and health. The results revealed a paradox related to indulgent parenting, with both positive and negative outcomes for adolescents. Structural equation analyses showed that parental indulgence was not only related to lower stress and higher life satisfaction, but also to unhealthy eating behaviours. Path analysis indicated that both positive and negative eating outcomes for adolescents were related to parental indulgence. This research has many implications for both parent and adolescent health education, focusing on parenting styles, stress and healthy lifestyles. Copyright © 2011 John Wiley & Sons, Ltd.

Positive self-beliefs as a mediator of the relationship between adolescents' sports participation and health in young adulthood.

PubMed

Dodge, Tonya; Lambert, Sharon F

2009-07-01

The present study examined the relationship between participation in sports during adolescence and physical activity and subjective health in young adulthood. A sample of 8,152 (males = 50.8%, females = 49.2%) adolescents from the National Longitudinal Study of Adolescent Health were used. Results of the study showed that participating in an organized sport during adolescence was associated with higher levels of physical activity and better subjective health during young adulthood after controlling for participation in general physical activities (e.g., jogging, biking, skateboarding) during adolescence. Participation in sports during adolescence was associated with more positive self-beliefs 1 year later that, in turn, were associated with higher levels of moderate to vigorous physical activity and better subjective health 6 years later. Results suggest that positive self-beliefs partially mediate the relationship between adolescents' participation in sports and two health outcomes in young adulthood: moderate to vigorous physical activity and subjective health. Findings highlight the utility of youths' participation in organized sports for promoting healthy outcomes. Implications for policy and practice are discussed.

Rural Adolescent Health: The Importance of Prevention Services in the Rural Community

ERIC Educational Resources Information Center

Curtis, Alexa C.; Waters, Catherine M.; Brindis, Claire

2011-01-01

Context: Adolescence is a pivotal developmental period for the establishment of positive health and health practices. However, developmentally propelled risk behaviors coinciding with barriers to health services may increase the propensity for untoward health outcomes in adolescence. In addition, the sociocultural context of the rural environment…

Acculturation and Adjustment in Latino Adolescents: How Cultural Risk Factors and Assets Influence Multiple Domains of Adolescent Mental Health

ERIC Educational Resources Information Center

Smokowski, Paul; Buchanan, Rachel L.; Bacallao, Martica L.

2009-01-01

The purpose of this study was to examine the relationships among risk factors, cultural assets, and Latino adolescent mental health outcomes. We extend past research by using a longitudinal design and evaluating direct and moderated acculturation effects across a range of internalizing, externalizing, and academic engagement outcomes. The sample…

A meta-analysis of active video games on health outcomes among children and adolescents.

PubMed

Gao, Z; Chen, S; Pasco, D; Pope, Z

2015-09-01

This meta-analysis synthesizes current literature concerning the effects of active video games (AVGs) on children/adolescents' health-related outcomes. A total of 512 published studies on AVGs were located, and 35 articles were included based on the following criteria: (i) data-based research articles published in English between 1985 and 2015; (ii) studied some types of AVGs and related outcomes among children/adolescents and (iii) had at least one comparison within each study. Data were extracted to conduct comparisons for outcome measures in three separate categories: AVGs and sedentary behaviours, AVGs and laboratory-based exercise, and AVGs and field-based physical activity. Effect size for each entry was calculated with the Comprehensive Meta-Analysis software in 2015. Mean effect size (Hedge's g) and standard deviation were calculated for each comparison. Compared with sedentary behaviours, AVGs had a large effect on health outcomes. The effect sizes for physiological outcomes were marginal when comparing AVGs with laboratory-based exercises. The comparison between AVGs and field-based physical activity had null to moderate effect sizes. AVGs could yield equivalent health benefits to children/adolescents as laboratory-based exercise or field-based physical activity. Therefore, AVGs can be a good alternative for sedentary behaviour and addition to traditional physical activity and sports in children/adolescents. © 2015 World Obesity.

Can organized leisure-time activities buffer the negative outcomes of unstructured activities for adolescents' health?

PubMed

Badura, Petr; Madarasova Geckova, Andrea; Sigmundova, Dagmar; Sigmund, Erik; van Dijk, Jitse P; Reijneveld, Sijmen A

2018-06-02

We aimed to assess the associations of involvement in selected unstructured activities (UA) with health-risk behaviours and academic achievement and the degree to which the participation in organized leisure-time activities (OLTA) changes these associations. Using a sample of 6935 Czech adolescents aged 13 and 15 years, we investigated adolescents' weekly involvement in hanging out, visiting shopping malls for fun and meeting friends after 8 p.m., OLTA and engagement in three health-risk behaviours and academic achievement. Weekly involvement in the selected UA was associated with higher odds for regular smoking, being drunk, having early sexual intercourse and low academic achievement. Concurrent participation in OLTA did not buffer these negative outcomes, except for sexual experience. However, those highly engaged only in UA were more likely to participate in the health-risk behaviours and report worse academic achievement than those participating in any OLTA concurrently. The selected UA are strongly associated with an increased occurrence of adolescents' health-risk behaviours and low academic achievement. Concurrent participation in OLTA does not buffer these negative outcomes significantly, but adolescents engaged only in UA consistently report the least favourable outcomes.

Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting.

PubMed

Dray, Julia; Bowman, Jenny; Campbell, Elizabeth; Freund, Megan; Wolfenden, Luke; Hodder, Rebecca K; McElwaine, Kathleen; Tremain, Danika; Bartlem, Kate; Bailey, Jacqueline; Small, Tameka; Palazzi, Kerrin; Oldmeadow, Christopher; Wiggers, John

2017-10-01

To examine the effect of universal, school-based, resilience-focused interventions on mental health problems in children and adolescents. Eligible studies were randomized controlled trials (RCTs) of universal, school-based interventions that included strategies to strengthen a minimum of 3 internal resilience protective factors, and included an outcome measure of mental health problems in children and adolescents aged 5 to 18 years. Six databases were searched from 1995 to 2015. Results were pooled in meta-analyses by mental health outcome (anxiety symptoms, depressive symptoms, hyperactivity, conduct problems, internalizing problems, externalizing problems, and general psychological distress), for all trials (5-18 years). Subgroup analyses were conducted by age (child: 5-10 years; adolescent: 11-18 years), length of follow-up (short: post-≤12 months; long: >12 months), and gender (narrative). A total of 57 included trials were identified from 5,984 records, with 49 contributing to meta-analyses. For all trials, resilience-focused interventions were effective relative to a control in reducing 4 of 7 outcomes: depressive symptoms, internalizing problems, externalizing problems, and general psychological distress. For child trials (meta-analyses for 6 outcomes), interventions were effective for anxiety symptoms and general psychological distress. For adolescent trials (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. For short-term follow-up, interventions were effective for 2 of 7 outcomes: depressive symptoms and anxiety symptoms. For long-term follow-up (meta-analyses for 5 outcomes), interventions were effective for internalizing problems. The findings may suggest most promise for using universal resilience-focused interventions at least for short-term reductions in depressive and anxiety symptoms for children and adolescents, particularly if a cognitive-behavioral therapy-based approach is used. The limited number of trials providing data amenable for meta-analysis for some outcomes and subgroups, the variability of interventions, study quality, and bias mean that it is not possible to draw more specific conclusions. Identifying what intervention qualities (such as number and type of protective factor) achieve the greatest positive effect per mental health problem outcome remains an important area for future research. Systematic Review of Universal Resilience Interventions Targeting Child and Adolescent Mental Health in the School Setting; http://dx.doi.org/10.1186/s13643-015-0172-6; PROSPERO CRD42015025908. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Prevalence and Mental Health Outcomes of Homicide Survivors in a Representative US Sample of Adolescents: Data from the 2005 National Survey of Adolescents

ERIC Educational Resources Information Center

Rheingold, Alyssa A.; Zinzow, Heidi; Hawkins, Alesia; Saunders, Benjamin E.; Kilpatrick, Dean G.

2012-01-01

Background: Each homicide leaves behind several friends and family members, or homicide survivors. However, limited information is available on the impact of homicide on adolescent survivors. The purpose of the current study was to identify the prevalence of homicide survivorship and to determine mental health outcomes within a sample of US…

Improving the Mental Health, Healthy Lifestyle Choices, and Physical Health of Hispanic Adolescents: A Randomized Controlled Pilot Study

ERIC Educational Resources Information Center

Melnyk, Bernadette M.; Jacobson, Diana; Kelly, Stephanie; O'Haver, Judith; Small, Leigh; Mays, Mary Z.

2009-01-01

Background: Obesity and mental health disorders are 2 major public health problems in American adolescents, with prevalence even higher in Hispanic teens. Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems, very few intervention studies have been conducted with adolescents to…

Latent Classes of Adolescent Sexual and Romantic Relationship Experiences: Implications for Adult Sexual Health and Relationship Outcomes

PubMed Central

Vasilenko, Sara A.; Kugler, Kari C.; Lanza, Stephanie T.

2015-01-01

Adolescents’ sexual and romantic relationship experiences are multidimensional, but often studied as single constructs. Thus, it is not clear how different patterns of sexual and relationship experience may interact to differentially predict later outcomes. In this study we used latent class analysis to model patterns (latent classes) of adolescent sexual and romantic experiences, and then examined how these classes are associated with young adult sexual health and relationship outcomes in data from the National Longitudinal Study of Adolescent to Adult Health. We identified six adolescent relationship classes: No Relationship (33%), Waiting (22%), Intimate (38%), Private (3%), Low Involvement (3%), and Physical (2%). Adolescents in the Waiting and Intimate classes were more likely to have married by young adulthood than those in other classes, and those in the Physical class had a greater number of sexual partners and higher rates of STIs. Some gender differences were found; for example, women in the Low-involvement and Physical classes in adolescence had average or high odds of marriage, whereas men in these classes had relatively low odds of marriage. Our findings identify more and less normative patterns of romantic and sexual experiences in late adolescence, and elucidate associations between adolescent experiences and adult outcomes. PMID:26445133

Early Self-Regulation, Early Self-Regulatory Change, and Their Longitudinal Relations to Adolescents' Academic, Health, and Mental Well-Being Outcomes.

PubMed

Howard, Steven J; Williams, Kate E

2018-05-16

To evaluate the extent to which early self-regulation and early changes in self-regulation are associated with adolescents' academic, health, and mental well-being outcomes. Data were collected from 1 of the cohorts in a large dual-cohort cross-sequential study of Australian children. This cohort consisted of a nationally representative data set of 4983 Australian children assessed at 4 to 5 years of age, who were followed longitudinally to 14 to 15 years of age. Using regression within a path analysis framework, we first sought to investigate associations of early self-regulation (at 4-5 years and 6-7 years of age) with a broad range of academic, health, and mental well-being outcomes in adolescence (at 14-15 years). We next investigated the extent to which an early change in self-regulation (from 4 to 7 years of age) predicted these adolescents' outcomes. Early self-regulation predicted the full range of adolescents' outcomes considered such that a 1-SD increase in self-regulation problems was associated with a 1.5- to 2.5-times greater risk of more-negative outcomes. An early positive change in self-regulation was associated with a reduced risk of these negative outcomes for 11 of the 13 outcomes considered. These results suggest the potential of early self-regulation interventions, in particular, in influencing long-term academic, health, and well-being trajectories.

A Community-Based Intervention Designed to Increase Preventive Health Care Seeking Among Adolescents: The Gonorrhea Community Action Project

PubMed Central

VanDevanter, Nancy L.; Messeri, Peter; Middlestadt, Susan E.; Bleakley, Amy; Merzel, Cheryl R.; Hogben, Matthew; Ledsky, Rebecca; Malotte, C. Kevin; Cohall, Renee M.; Gift, Thomas L.; St. Lawrence, Janet S.

2005-01-01

Objectives. We evaluated the effectiveness of an intervention designed to increase preventive health care seeking among adolescents. Methods. Adolescents and young adults aged 12 to 21 years, recruited from community-based organizations in 2 different communities, were randomized into either a 3-session intervention or a control condition. We estimated outcomes from 3-month follow-up data using logistic and ordinary least squares regression. Results. Female intervention participants were significantly more likely than female control participants to have scheduled a health care appointment (odds ratio [OR]=3.04), undergone a checkup (OR=2.87), and discussed with friends or family members the importance of undergoing a checkup (OR=4.5). There were no differences between male intervention and male control participants in terms of outcomes. Conclusions. This theory-driven, community-based group intervention significantly increased preventive health care seeking among female adolescents. Further research is needed, however, to identify interventions that will produce successful outcomes among male adolescents. PMID:15671472

Effects of Timing of Adversity on Adolescent and Young Adult Adjustment

ERIC Educational Resources Information Center

Kiff, Cara J.; Cortes, Rebecca C.; Lengua, Liliana J.; Kosterman, Rick; Hawkins, J. David; Mason, W. Alex

2012-01-01

Exposure to adversity during childhood and adolescence predicts adjustment across development. Furthermore, adolescent adjustment problems persist into young adulthood. This study examined relations of contextual adversity with concurrent adolescent adjustment and prospective mental health and health outcomes in young adulthood. A longitudinal…

A Rights-Based Sexuality Education Curriculum for Adolescents: 1-Year Outcomes From a Cluster-Randomized Trial.

PubMed

Rohrbach, Louise A; Berglas, Nancy F; Jerman, Petra; Angulo-Olaiz, Francisca; Chou, Chih-Ping; Constantine, Norman A

2015-10-01

The purpose of this study was to evaluate the impact of a rights-based sexuality education curriculum on adolescents' sexual health behaviors and psychosocial outcomes 1 year after participation. Within 10 urban high schools, ninth-grade classrooms were randomized to receive a rights-based curriculum or a basic sex education (control) curriculum. The intervention was delivered across two school years (2011-2012, 2012-2013). Surveys were completed by 1,447 students at pretest and 1-year follow-up. Multilevel analyses examined curriculum effects on behavioral and psychosocial outcomes, including four primary outcomes: pregnancy risk, sexually transmitted infection risk, multiple sexual partners, and use of sexual health services. Students receiving the rights-based curriculum had higher scores than control curriculum students on six of nine psychosocial outcomes, including sexual health knowledge, attitudes about relationship rights, partner communication, protection self-efficacy, access to health information, and awareness of sexual health services. These students also were more likely to report use of sexual health services (odds ratio, 1.37; 95% confidence interval, 1.05-1.78) and more likely to be carrying a condom (odds ratio, 1.97; 95% confidence interval, 1.39-2.80) relative to those receiving the control curriculum. No effects were found for other sexual health behaviors, possibly because of low prevalence of sexual activity in the sample. The curriculum had significant, positive effects on psychosocial and some behavioral outcomes 1 year later, but it might not be sufficient to change future sexual behaviors among younger adolescents, most of whom are not yet sexually active. Booster education sessions might be required throughout adolescence as youth initiate sexual relationships. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Adolescent Mental Health Consumers' Self-Stigma: Associations with Parents' and Adolescents' Illness Perceptions and Parental Stigma

ERIC Educational Resources Information Center

Moses, Tally

2010-01-01

Currently, little is known about adolescents' self-stigma experiences as mental health (MH) treatment recipients. Hence, this study addresses the following two questions: (a) what are adolescents' and parents' perceptions of stigma and perceptions of the cause, controllability, and anticipated outcome (illness perceptions) of adolescents' MH…

Do Savings Mediate Changes in Adolescents' Future Orientation and Health-Related Outcomes? Findings From Randomized Experiment in Uganda.

PubMed

Karimli, Leyla; Ssewamala, Fred M

2015-10-01

This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset accumulation (in this case, by increasing family savings). Using longitudinal data from the cluster-randomized experiment, we ran generalized estimating equation models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents' future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping-to address the assumption of normal distribution. Results indicate that participation in a matched Child Savings Account (CSA) program improved adolescents' future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents' confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched CSA program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings. Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched CSAs, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how? Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Images of sexual stereotypes in rap videos and the health of African American female adolescents.

PubMed

Peterson, Shani H; Wingood, Gina M; DiClemente, Ralph J; Harrington, Kathy; Davies, Susan

2007-10-01

This study sought to determine whether perceiving portrayals of sexual stereotypes in rap music videos was associated with adverse health outcomes among African American adolescent females. African American female adolescents (n = 522) were recruited from community venues. Adolescents completed a survey consisting of questions on sociodemographic characteristics, rap music video viewing habits, and a scale that assessed the primary predictor variable, portrayal of sexual stereotypes in rap music videos. Adolescents also completed an interview that assessed the health outcomes and provided urine for a marijuana screen. In logistic regression analyses, adolescents who perceived more portrayals of sexual stereotypes in rap music videos were more likely to engage in binge drinking (OR 3.8, 95% CI 1.32-11.04, p = 0.01), test positive for marijuana (OR 3.4, 95% CI 1.19-9.85, p = 0.02), have multiple sexual partners (OR 1.9, 95% CI 1.01-3.71, p = 0.04), and have a negative body image (OR 1.5, 95% CI 1.02-2.26, p = 0.04). This is one of the first studies quantitatively examining the relationship between cultural images of sexual stereotypes in rap music videos and a spectrum of adverse health outcomes in African American female adolescents. Greater attention to this social issue may improve the health of all adolescent females.

Academic performance, educational aspiration and birth outcomes among adolescent mothers: a national longitudinal study

PubMed Central

2014-01-01

Background Maternal educational attainment has been associated with birth outcomes among adult mothers. However, limited research explores whether academic performance and educational aspiration influence birth outcomes among adolescent mothers. Methods Data from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) were used. Adolescent girls whose first pregnancy occurred after Wave I, during their adolescence, and ended with a singleton live birth were included. Adolescents’ grade point average (GPA), experience of ever skipping a grade and ever repeating a grade, and their aspiration to attend college were examined as predictors of birth outcomes (birthweight and gestational age; n = 763). Univariate statistics, bivariate analyses and multivariable models were run stratified on race using survey procedures. Results Among Black adolescents, those who ever skipped a grade had higher offspring’s birthweight. Among non-Black adolescents, ever skipping a grade and higher educational aspiration were associated with higher offspring’s birthweight; ever skipping a grade was also associated with higher gestational age. GPA was not statistically significantly associated with either birth outcome. The addition of smoking during pregnancy and prenatal care visit into the multivariable models did not change these associations. Conclusions Some indicators of higher academic performance and aspiration are associated with better birth outcomes among adolescents. Investing in improving educational opportunities may improve birth outcomes among teenage mothers. PMID:24422664

Project SHINE: Effects of Parent–Adolescent Communication on Sedentary Behavior in African American Adolescents

PubMed Central

Wilson, Dawn K.; Schneider, Elizabeth M.; Alia, Kassandra A.

2013-01-01

Objective This study examined parenting variables (communication, monitoring) as moderators of a family-based intervention for reducing sedentary behavior (SB) in African American adolescents. As a secondary aim, a similar model was tested using adolescent weight status as the outcome. Methods African American adolescents (n = 73; 12.45 ± 1.45 years; 60% girls; 63% overweight/obese) and caregivers were randomized to a 6-week interactive, parent-based intervention or general health condition. Parent–adolescent communication and monitoring of health behaviors were self-reported by parents. Adolescent SB was self-reported by youth. Results There was a significant intervention by communication interaction, such that intervention families with more positive communication showed lower adolescent SB than those with less positive communication or those in the comparison condition. No effects were found for monitoring on SB or for the model with weight status as the outcome. Conclusions Parent–adolescent communication may be an effective component to integrate into health promotion programs for African American adolescents. PMID:23685450

Systematic review of universal resilience interventions targeting child and adolescent mental health in the school setting: review protocol.

PubMed

Dray, Julia; Bowman, Jenny; Wolfenden, Luke; Campbell, Elizabeth; Freund, Megan; Hodder, Rebecca; Wiggers, John

2015-12-29

The mental health of children and adolescents is a key area of health concern internationally. Previous empirical studies suggest that resilience may act as a protective mechanism towards the development of mental health problems. Resilience refers to the ability to employ a collection of protective factors to return to or maintain positive mental health following disadvantage or adversity. Schools represent a potential setting within which protective factors of all children and adolescents may be fostered through resilience-focussed interventions. Despite this potential, limited research has investigated the effectiveness of universal school-based resilience-focussed interventions on mental health outcomes in children and adolescents. The objective of the present review is to assess the effects of universal school-based resilience-focussed interventions, relative to a comparison group, on mental health outcomes in children and adolescents. Eligible studies will be randomised (including cluster-randomised) controlled trials of universal interventions explicitly described as resilience-focussed or comprising strategies to strengthen a minimum of three internal protective factors, targeting children aged 5 to 18 years, implemented within schools, and reporting a mental health outcome. Screening for studies will be conducted across six electronic databases: MEDLINE, PsycINFO, Educational Resources Information Center (ERIC), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Central Register of Controlled Trials (CENTRAL). Two reviewers will retrieve eligible articles, assess risk of bias, and extract data. Where studies are sufficiently homogenous and reported outcomes are amenable for pooled synthesis, meta-analysis will be performed. Narrative description will be used to synthesise trial outcome data where data cannot be combined or heterogeneity exists. This review will aid in building an evidence base for the effectiveness of universal school-based resilience-focussed interventions and in doing so provide an opportunity to better inform the development of interventions to potentially prevent mental health problems in child and adolescent populations. PROSPERO CRD42015025908.

Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls.

PubMed

Kazak, Anne E; Derosa, Branlyn Werba; Schwartz, Lisa A; Hobbie, Wendy; Carlson, Claire; Ittenbach, Richard F; Mao, Jun J; Ginsberg, Jill P

2010-04-20

PURPOSE The purpose of this study was to compare adolescent and young adult (AYA) pediatric cancer survivors and peers without a history of serious illness on psychological distress, health-related quality of life (HRQOL), health beliefs; examine age at diagnosis and cancer treatment intensity on these outcomes; and examine relationships between number of health problems and the outcomes. PATIENTS AND METHODS AYA cancer survivors (n = 167) and controls (n = 170), recruited during visits to a cancer survivorship clinic and primary care, completed self-report questionnaires of distress, health problems, and health beliefs. For survivors, providers rated treatment intensity and health problems. Results There were no statistically significant differences between survivors and controls in psychological distress or HRQOL. Cancer survivors had less positive health beliefs. Survivors diagnosed as adolescents had significantly greater psychological distress and fewer positive health beliefs than those diagnosed earlier. Survivors with the highest level of treatment intensity had greater anxiety and fewer positive health beliefs than those with less intense treatments. Provider report of current health problems related to survivors' beliefs and mental HRQOL only, whereas patient report of health problems correlated significantly with most psychosocial outcomes and beliefs. CONCLUSION AYA cancer survivors did not differ from peers in psychological adjustment but did endorse less adaptive health beliefs. Survivors diagnosed during adolescence and who had more intensive cancer treatments evidenced poorer psychosocial outcomes. Beliefs about health may be identified and targeted for intervention to improve quality of life, particularly when patient perceptions of current health problems are considered.

Is sexual behavior healthy for adolescents? A conceptual framework for research on adolescent sexual behavior and physical, mental, and social health.

PubMed

Vasilenko, Sara A; Lefkowitz, Eva S; Welsh, Deborah P

2014-01-01

Although research has increasingly emphasized how adolescent sexual behavior may be associated with aspects of health beyond unwanted pregnancy and sexually transmitted infections, no current theoretical or conceptual model fully explains associations between sexual behavior and multiple facets of health. We provide a conceptual model that explicates possible processes of how adolescent sexual behavior may influence physical, mental, and social health. Next, we review the current literature consistent with this conceptual model, demonstrating that although early sexual behavior can be associated with some negative outcomes, sex may be, on average, a positive experience in late adolescence. Finally, we discuss important future directions for research in these areas, including how individuals' attitudes about and perceptions of sexual behavior influence outcomes of sex. © 2014 Wiley Periodicals, Inc.

Feasibility and Preliminary Outcomes From a Pilot Study of an Integrated Health-Mental Health Promotion Program in School Mental Health Services

PubMed Central

George, Melissa W.; Trumpeter, Nevelyn N.; Wilson, Dawn K.; McDaniel, Heather L.; Schiele, Bryn; Prinz, Ron; Weist, Mark D.

2014-01-01

The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integrated health-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, health behaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program. PMID:24297005

Elements for Successful Collaboration between K-8 School, Community Agency, and University Partners: The Lead Peace Partnership

ERIC Educational Resources Information Center

Bosma, Linda M.; Sieving, Renee E.; Ericson, Annie; Russ, Pamela; Cavender, Laura; Bonine, Mark

2010-01-01

Background: Researchers, schools, and community organizations are increasingly interested in forming partnerships to improve health and learning outcomes for adolescents. School-based service learning programs with young adolescents have been shown to improve students' health and educational outcomes. Quality school-based service learning practice…

Mental Health and Educational Experiences Among Black Youth: A Latent Class Analysis.

PubMed

Rose, Theda; Lindsey, Michael A; Xiao, Yunyu; Finigan-Carr, Nadine M; Joe, Sean

2017-11-01

Disproportionately lower educational achievement, coupled with higher grade retention, suspensions, expulsions, and lower school bonding make educational success among Black adolescents a major public health concern. Mental health is a key developmental factor related to educational outcomes among adolescents; however, traditional models of mental health focus on absence of dysfunction as a way to conceptualize mental health. The dual-factor model of mental health incorporates indicators of both subjective wellbeing and psychopathology, supporting more recent research that both are needed to comprehensively assess mental health. This study applied the dual-factor model to measure mental health using the National Survey of American Life-Adolescent Supplement (NSAL-A), a representative cross-sectional survey. The sample included 1170 Black adolescents (52% female; mean age 15). Latent class analysis was conducted with positive indicators of subjective wellbeing (emotional, psychological, and social) as well as measures of psychopathology. Four mental health groups were identified, based on having high or low subjective wellbeing and high or low psychopathology. Accordingly, associations between mental health groups and educational outcomes were investigated. Significant associations were observed in school bonding, suspensions, and grade retention, with the positive mental health group (high subjective wellbeing, low psychopathology) experiencing more beneficial outcomes. The results support a strong association between school bonding and better mental health and have implications for a more comprehensive view of mental health in interventions targeting improved educational experiences and mental health among Black adolescents.

Agentic and Communal Traits and Health: Adolescents with and without Diabetes

PubMed Central

Helgeson, Vicki S.; Palladino, Dianne K.

2013-01-01

We examined whether agentic and communal traits are associated with relationship and health outcomes among adolescents with and without diabetes. We interviewed 263 teens (average age 12; 132 type 1 diabetes; 131 healthy) on an annual basis for five years. We measured agency, communion, unmitigated agency, unmitigated communion as well as parent and peer relationship quality, psychological distress, and diabetes health. In concurrent and lagged multi-level models, unmitigated communion and unmitigated agency were associated with poor relationship outcomes and greater psychological distress for those with and without diabetes. In lagged analyses, unmitigated communion predicted deterioration in diabetes health. Communion and agency were associated with positive relationship and health outcomes, with the former being stronger than the latter. These results underscore the need to focus on unmitigated agency and unmitigated communion when studying the implications of personality for health during adolescence. PMID:22146673

The effect of neighborhood socioeconomic status on education and health outcomes for children living in social housing.

PubMed

Martens, Patricia J; Chateau, Daniel G; Burland, Elaine M J; Finlayson, Gregory S; Smith, Mark J; Taylor, Carole R; Brownell, Marni D; Nickel, Nathan C; Katz, Alan; Bolton, James M

2014-11-01

We explored differences in health and education outcomes between children living in social housing and not, and effects of social housing's neighborhood socioeconomic status. In this cohort study, we used the population-based repository of administrative data at the Manitoba Centre for Health Policy. We included children aged 0 to 19 years in Winnipeg, Manitoba, in fiscal years 2006-2007 to 2008-2009 (n = 13,238 social housing; n = 174,017 others). We examined 5 outcomes: age-2 complete immunization, a school-readiness measure, adolescent pregnancy (ages 15-19 years), grade-9 completion, and high-school completion. Logistic regression and generalized estimating equation modeling generated rates. We derived neighborhood income quintiles (Q1 lowest, Q5 highest) from average household income census data. Children in social housing fared worse than comparative children within each neighborhood income quintile. When we compared children in social housing by quintile, preschool indicators (immunization and school readiness) were similar, but adolescent outcomes (grade-9 and high-school completion, adolescent pregnancy) were better in Q3 to Q5. Children in social housing had poorer health and education outcomes than all others, but living in social housing in wealthier areas was associated with better adolescent outcomes.

The Effect of Neighborhood Socioeconomic Status on Education and Health Outcomes for Children Living in Social Housing

PubMed Central

Burland, Elaine M. J.; Finlayson, Gregory S.; Smith, Mark J.; Taylor, Carole R.; Brownell, Marni D.; Nickel, Nathan C.; Katz, Alan; Bolton, James M.

2014-01-01

Objectives. We explored differences in health and education outcomes between children living in social housing and not, and effects of social housing’s neighborhood socioeconomic status. Methods. In this cohort study, we used the population-based repository of administrative data at the Manitoba Centre for Health Policy. We included children aged 0 to 19 years in Winnipeg, Manitoba, in fiscal years 2006–2007 to 2008–2009 (n = 13 238 social housing; n = 174 017 others). We examined 5 outcomes: age-2 complete immunization, a school-readiness measure, adolescent pregnancy (ages 15–19 years), grade-9 completion, and high-school completion. Logistic regression and generalized estimating equation modeling generated rates. We derived neighborhood income quintiles (Q1 lowest, Q5 highest) from average household income census data. Results. Children in social housing fared worse than comparative children within each neighborhood income quintile. When we compared children in social housing by quintile, preschool indicators (immunization and school readiness) were similar, but adolescent outcomes (grade-9 and high-school completion, adolescent pregnancy) were better in Q3 to Q5. Conclusions. Children in social housing had poorer health and education outcomes than all others, but living in social housing in wealthier areas was associated with better adolescent outcomes. PMID:25211758

The Effect of Early Noncognitive Skills on Social Outcomes in Adolescence

ERIC Educational Resources Information Center

Coneus, Katja; Laucht, Manfred

2014-01-01

This paper investigates the impact of early noncognitive skills on social outcomes in adolescence. The child's attention span, approach, prevailing mood and distractibility in early childhood may be crucial predictors for school achievements, health risk behavior, delinquency and autonomy as adolescent. We investigate this issue using a…

Paternal Involvement in Multisystemic Therapy: Effects on Adolescent Outcomes and Maternal Depression

ERIC Educational Resources Information Center

Gervan, Shannon; Granic, Isabela; Solomon, Tracy; Blokland, Kirsten; Ferguson, Bruce

2012-01-01

The association between paternal involvement in therapy, adolescent outcomes and maternal depression was examined within the context of Multisystemic Therapy (MST), an empirically supported, family- and community-based treatment for antisocial adolescents. Ninety-nine families were recruited from five mental health agencies providing MST. We…

Birth Characteristics and Developmental Outcomes of Infants of Mexican-Origin Adolescent Mothers: Risk and Promotive Factors

ERIC Educational Resources Information Center

Jahromi, Laudan B.; Umana-Taylor, Adriana J.; Updegraff, Kimberly A.; Lara, Ethelyn E.

2012-01-01

Infants of adolescent mothers are at increased risk for negative developmental outcomes. Given the high rate of pregnancy among Mexican-origin adolescent females in the US, the present study examined health characteristics at birth and developmental functioning at 10 months of age in a sample of 205 infants of Mexican-origin adolescent mothers.…

Improving adolescent pregnancy outcomes and maternal health:a case study of comprehensive case managed services.

PubMed

Bowman, Elizabeth K; Palley, Howard A

2003-01-01

Our findings indicate how health outcomes regarding adolescent pregnancy and maternal and infant health care are intertwined with a case management process that fosters measures that are social in nature-the provision of direct services, as well as the encouragement of informal social supports systems. They also show how case managed services in a small, nongovernmental organization (NGO) with a strong commitment to its clients may provide the spontaneity and caring which results in a "match" between client needs and the delivery of services-and positive outcomes for pregnant women, early maternal health and infant health. The delivery of such case managed services in a manner which is intensive, comprehensive, flexible and integrated contributes significantly to such improved health outcomes.

Screening for Adolescent Idiopathic Scoliosis: US Preventive Services Task Force Recommendation Statement.

PubMed

Grossman, David C; Curry, Susan J; Owens, Douglas K; Barry, Michael J; Davidson, Karina W; Doubeni, Chyke A; Epling, John W; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phipps, Maureen G; Silverstein, Michael; Simon, Melissa A; Tseng, Chien-Wen

2018-01-09

Adolescent idiopathic scoliosis, a lateral curvature of the spine of unknown cause with a Cobb angle of at least 10°, occurs in children and adolescents aged 10 to 18 years. Idiopathic scoliosis is the most common form and usually worsens during adolescence before skeletal maturity. Severe spinal curvature may be associated with adverse long-term health outcomes (eg, pulmonary disorders, disability, back pain, psychological effects, cosmetic issues, and reduced quality of life). Early identification and effective treatment of mild scoliosis could slow or stop curvature progression before skeletal maturity, thereby improving long-term outcomes in adulthood. To update the 2004 US Preventive Services Task Force (USPSTF) recommendation on screening for idiopathic scoliosis in asymptomatic adolescents. The USPSTF reviewed the evidence on the benefits and harms of screening for and treatment of adolescent idiopathic scoliosis. The USPSTF found no direct evidence on screening for adolescent idiopathic scoliosis and health outcomes and no evidence on the harms of screening. The USPSTF found inadequate evidence on treatment with exercise and surgery. It found adequate evidence that treatment with bracing may slow curvature progression in adolescents with mild or moderate curvature severity (Cobb angle <40° to 50°); however, evidence on the association between reduction in spinal curvature in adolescence and long-term health outcomes in adulthood is inadequate. The USPSTF found inadequate evidence on the harms of treatment. Therefore, the USPSTF concludes that the current evidence is insufficient and that the balance of benefits and harms of screening for adolescent idiopathic scoliosis cannot be determined. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for adolescent idiopathic scoliosis in children and adolescents aged 10 to 18 years. (I statement).

An unfinished agenda on adolescent health: Opportunities for interventions.

PubMed

Lassi, Zohra S; Salam, Rehana A; Das, Jai K; Wazny, Kerri; Bhutta, Zulfiqar A

2015-08-01

The Millennium Development Goal era has resulted in improvements in maternal and child health worldwide. As more children are surviving past their fifth birthday, the population of adolescents is increasing. Adolescence is a time of significant developmental transition; adolescence sets the stage for adult health through risks taken and beneficial and detrimental habits that are formed and it is thus an optimal time to target health interventions. Beginning interventions in adolescence or even earlier in childhood maximizes the impact on the individual's health in adult life. Evidence suggests that interventions to promote sexual and reproductive health, physical activity and healthy lifestyle, mental health and wellbeing, safe and hazard-free environment, improving access to nutritious and healthy foods, and minimizing exposure to substance abuse can improve health outcomes in young adolescents. School-based delivery strategies appear to be the most highly evaluated for improving adolescent health; they have been used to deliver interventions such as sexual health, substance abuse prevention, and nutritional interventions. Use of social media and information technologies, cash transfers, social protection, and micro-finance initiatives are promising strategies; however, given the lack of rigorous evaluations, there is a need for further research. Additional research is also warranted to strengthen the evidence base by establishing causality, understanding the differential impacts of adolescent health in different contexts particularly in low- and middle-income countries. In addition, research and evaluation in the domain of adolescent health must focus on how to implement interventions effectively at-scale, sustain the impacts over time and ensure equitable outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Characteristics of adolescents with poor mental health after bariatric surgery.

PubMed

Järvholm, Kajsa; Karlsson, Jan; Olbers, Torsten; Peltonen, Markku; Marcus, Claude; Dahlgren, Jovanna; Gronowitz, Eva; Johnsson, Per; Flodmark, Carl-Erik

2016-05-01

About 20% of adolescents experience substantial mental health problems after bariatric surgery. The aim of this study was to explore differences between adolescents with poor mental health (PMH) 2 years after surgery and those with average/good mental health. Three university hospitals in Sweden. Mental health and health-related quality of life were assessed in 82 of 88 adolescents (mean age: 16.8 yr, 67% female) at baseline and 1 and 2 years after laparoscopic gastric bypass. Possible associations among mental health, weight, and biochemical outcomes were explored. Two years after surgery 16 (20%) adolescents were identified as having PMH. More symptoms of anxiety and depression and worse mental health at baseline significantly predicted PMH 2 years later. The decline in mental health for the PMH group happened mainly during the second year after surgery. Suicidal ideation was reported in 14% of the total sample 2 years postsurgery and was more frequent in the PMH group. Weight outcomes between groups were comparable at all time points, and physical health was equally improved 2 years after surgery. Although adolescents with PMH after surgery lose as much weight and have similar improvements in physical health compared with other adolescents, special attention should be given to adolescents who report mental health problems at baseline and follow-up, especially during the second year after gastric bypass. The high prevalence of suicidal ideation in adolescents 2 years after bariatric surgery is another indication that longer follow-up is necessary. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Parent-child Relationships, Parental Attitudes towards Sex, and Birth Outcomes among Adolescents

PubMed Central

Harville, Emily W.; Madkour, Aubrey Spriggs; Xie, Yiqiong

2014-01-01

Study objective To examine how parent-child relationships, parental control, and parental attitudes towards sex were related to pregnancy outcomes among adolescent mothers. Design Prospective cohort study. Parental report of relationship satisfaction, disapproval of adolescent having sex, discussion around sexual health, and sexual communication attitudes, and adolescent report of relationship satisfaction, parental control, and parental disapproval of sex were examined as predictors of self-reported birth outcomes. Weighted multivariable linear regression models were run incorporating interactions by race. Setting United States Participants 632 females who participated in Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health), a nationally-representative sample of students enrolled in grades 7–12 in 1994–95 and followed up in 2007–2008 Main Outcome Measures birthweight and gestational age Results For Black adolescents, better parent-child relationship was associated with higher birthweight (0.14 kg, p<0.05) and gestational age (0.75 weeks, p<0.01), while higher parental disapproval of having sex (adjusted beta 0.15 kg, p<0.05) were associated with higher birthweight. For non-Black adolescents, a moderate amount of discussion of birth control was associated with higher birthweight (0.19 kg, p<0.01 and lower child-perceived parental disapproval of having sex was associated with higher birthweight (0.08 kg, p<0.05) and gestational age (0.37 weeks, p<0.05). Higher parental control was associated with a reduced likelihood of smoking during pregnancy and a greater likelihood of early prenatal care. Conclusion Parent-child relationships and attitudes about sex affect outcomes of pregnant adolescents. PMID:25023982

Applying Self-Determination Theory to Adolescent Sexual-Risk Behavior and Knowledge: A Structural Equation Model [Formula: see text].

PubMed

Riley, Bettina H; McDermott, Ryon C

2018-05-01

National health priorities identify adolescent sexual-risk behavior outcomes as research and intervention targets for mental health. Reduce sexual-risk behavioral outcomes by applying self-determination theory to focus on decision-making autonomy. This study examined late adolescents' recollections of parental autonomy support/sexual-risk communication experiences and autonomy motivation as predictors of sexual-risk behaviors/knowledge. A convenience sample ( N = 249) of 19- and 20-year-old university students completed self-report questionnaires. Structural equation modeling with latent variables examined direct/indirect effects in the hypothesized model. Parents contributed uniquely through sexual-risk communication and/or autonomy support to late adolescents' autonomous motivation. The final model evidenced acceptable fit and explained 12% of the variation in adolescent sexual-risk behavior, 7% in adolescent autonomous motivation, and 2% in adolescent sexual-risk knowledge. Psychiatric mental health nurses should conduct further research and design interventions promoting parent autonomy support and adolescent autonomous motivation to reduce sexual risk-behavior and increase sexual-risk knowledge.

Preparing Student Nurses as Parent-based Adolescent Sexual Health Educators: Results of a Pilot Study.

PubMed

Santa Maria, Diane; Markham, Christine; Crandall, Stacy; Guilamo-Ramos, Vincent

2017-03-01

While health promotion and patient education are central to the scope of practice of professional nurses, they often feel ill-equipped to assume the role of sexual health educator and lack adequate knowledge and skills to effectively engage parents in adolescent sexual and reproductive health efforts. Employing a mixed-methods study consisting of both pre- and post-test survey and exit interviews, a pilot study was conducted to assess the impact of implementing a parent-based adolescent sexual health intervention on baccalaureate nursing student outcomes (N = 31). We found statistically significant improvements in student outcome expectancies of parenting strategies, barriers to sexual health communication, self-efficacy, and sexual health counseling experience. Using thematic content analysis of exit interview content, emerging themes were (1) need for increased sexual and reproductive health (SRH) preparation, (2) wanting greater experience and opportunity for involvement in nursing research, and (3) educational gaps in family-focused community public health. Incorporating adolescent sexual health education into public health nursing clinical training can prepare nurses as parent-based adolescent sexual health educators, a core competency for nurses working with families in communities and across all health care delivery settings. © 2016 Wiley Periodicals, Inc.

Innovations in adolescent reproductive and sexual health education in Santiago de Chile: effects of physician leadership and direct service.

PubMed

Grizzard, Tarayn; González, Electra; Sandoval, Jorge; Molina, Ramiro

2004-01-01

Reproductive and sexual health (RSH) education is a key component of most family planning programs around the world and is particularly important for adolescents, for whom parenthood is more likely to have difficult or dangerous health outcomes. A lack of comprehensive RSH education targeted at adolescents may augment the poor outcomes associated with early pregnancy by creating barriers to optimal care. This article discusses the creation of the Centro de Medicina Reproductiva y Desarrollo Integral de la Adolescencia clinic, a comprehensive adolescent reproductive health center in Santiago de Chile, and its RSH education programs. In particular, the role of the physician in originating and leading the RSH education efforts, the controversy associated with RSH education in Chile, and the effects of comprehensive RHS education on the local and regional adolescent populations are discussed.

Improving adolescent health policy: incorporating a framework for assessing state-level policies.

PubMed

Brindis, Claire D; Moore, Kristin

2014-01-01

Many US policies that affect health are made at the state, not the federal, level. Identifying state-level policies and data to analyze how different policies affect outcomes may help policy makers ascertain the usefulness of their public policies and funding decisions in improving the health of adolescent populations. A framework for describing and assessing the role of federal and state policies on adolescent health and well-being is proposed; an example of how the framework might be applied to the issue of teen childbearing is included. Such a framework can also help inform analyses of whether and how state and federal policies contribute to the variation across states in meeting adolescent health needs. A database on state policies, contextual variables, and health outcomes data can further enable researchers and policy makers to examine how these factors are associated with behaviors they aim to impact.

Parent and Adolescent Distribution of Responsibility for Diabetes Self-care: Links to Health Outcomes

PubMed Central

Reynolds, Kerry A.; Siminerio, Linda; Escobar, Oscar; Becker, Dorothy

2008-01-01

Objective To examine the relation of adolescent and parent responsibility distribution for diabetes self-care to psychological and physical health. Methods We interviewed children (mean age 12 years) annually for 3 years and asked parents to complete a questionnaire. Both reported how diabetes self-care was distributed in the family. Amount of responsibility held by the child only, the parent only, and shared between child and parent was calculated. Psychological distress, competence, and diabetes outcomes were assessed at each wave. Results In both cross-sectional and longitudinal (lagged) analyses, multilevel modeling showed that shared responsibility was consistently associated with better psychological health, good self-care behavior, and good metabolic control, whereas child and parent responsibility were not. In some cases, links of shared responsibility to health outcomes were stronger among older adolescents. Conclusions These findings highlight the importance of shared responsibility for diabetes self-care through early to middle adolescence. PMID:17848390

Does neighbourhood social capital aid in levelling the social gradient in the health and well-being of children and adolescents? A literature review

PubMed Central

2013-01-01

Background Although most countries in the European Union are richer and healthier than ever, health inequalities remain an important public health challenge. Health-related problems and premature death have disproportionately been reported in disadvantaged neighbourhoods. Neighbourhood social capital is believed to influence the association between neighbourhood deprivation and health in children and adolescents, making it a potentially interesting concept for policymakers. Methods This study aims to review the role of social capital in health inequalities and the social gradient in health and well-being of children and adolescents. A systematic review of published quantitative literature was conducted, focussing on (1) the mediating role of neighbourhood social capital in the relationship between socio-economic status (SES) and health-related outcomes in children and adolescents and (2) the interaction between neighbourhood social capital and socio-economic characteristics in relation to health-related outcomes in children and adolescents. Three electronic databases were searched. Studies executed between 1 January 1990 and 1 September 2011 in Western countries (USA, New Zealand, Australia and Europe) that included a health-related outcome in children or adolescents and a variable that measured neighbourhood social capital were included. Results Eight studies met the inclusion criteria for the review. The findings are mixed. Only two of five studies confirmed that neighbourhood social capital mediates the association between neighbourhood deprivation and health and well-being in adolescents. Furthermore, two studies found a significant interaction between neighbourhood socio-economic factors and neighbourhood social capital, which indicates that neighbourhood social capital is especially beneficial for children who reside in deprived neighbourhoods. However, two other studies did not find a significant interaction between SES and neighbourhood social capital. Due to the broad range of studied health-related outcomes, the different operationalisations of neighbourhood social capital and the conceptual overlap between measures of SES and social capital in some studies, the factors that explain these differences in findings remain unclear. Conclusions Although the findings of this study should be interpreted with caution, the results suggest that neighbourhood social capital might play a role in the health gradient among children and adolescents. However, only two of the included studies were conducted in Europe. Furthermore, some studies focussed on specific populations and minority groups. To formulate relevant European policy recommendations, further European-focussed research on this issue is needed. PMID:23339776

Does neighbourhood social capital aid in levelling the social gradient in the health and well-being of children and adolescents? A literature review.

PubMed

Vyncke, Veerle; De Clercq, Bart; Stevens, Veerle; Costongs, Caroline; Barbareschi, Giorgio; Jónsson, Stefán Hrafn; Curvo, Sara Darias; Kebza, Vladimir; Currie, Candace; Maes, Lea

2013-01-23

Although most countries in the European Union are richer and healthier than ever, health inequalities remain an important public health challenge. Health-related problems and premature death have disproportionately been reported in disadvantaged neighbourhoods. Neighbourhood social capital is believed to influence the association between neighbourhood deprivation and health in children and adolescents, making it a potentially interesting concept for policymakers. This study aims to review the role of social capital in health inequalities and the social gradient in health and well-being of children and adolescents. A systematic review of published quantitative literature was conducted, focussing on (1) the mediating role of neighbourhood social capital in the relationship between socio-economic status (SES) and health-related outcomes in children and adolescents and (2) the interaction between neighbourhood social capital and socio-economic characteristics in relation to health-related outcomes in children and adolescents. Three electronic databases were searched. Studies executed between 1 January 1990 and 1 September 2011 in Western countries (USA, New Zealand, Australia and Europe) that included a health-related outcome in children or adolescents and a variable that measured neighbourhood social capital were included. Eight studies met the inclusion criteria for the review. The findings are mixed. Only two of five studies confirmed that neighbourhood social capital mediates the association between neighbourhood deprivation and health and well-being in adolescents. Furthermore, two studies found a significant interaction between neighbourhood socio-economic factors and neighbourhood social capital, which indicates that neighbourhood social capital is especially beneficial for children who reside in deprived neighbourhoods. However, two other studies did not find a significant interaction between SES and neighbourhood social capital. Due to the broad range of studied health-related outcomes, the different operationalisations of neighbourhood social capital and the conceptual overlap between measures of SES and social capital in some studies, the factors that explain these differences in findings remain unclear. Although the findings of this study should be interpreted with caution, the results suggest that neighbourhood social capital might play a role in the health gradient among children and adolescents. However, only two of the included studies were conducted in Europe. Furthermore, some studies focussed on specific populations and minority groups. To formulate relevant European policy recommendations, further European-focussed research on this issue is needed.

Predictors and Health-Related Outcomes of Positive Body Image in Adolescent Girls: A Prospective Study

ERIC Educational Resources Information Center

Andrew, Rachel; Tiggemann, Marika; Clark, Levina

2016-01-01

This study aimed to investigate prospective predictors and health-related outcomes of positive body image in adolescent girls. In so doing, the modified acceptance model of intuitive eating was also examined longitudinally. A sample of 298 girls aged 12 to 16 years completed a questionnaire containing measures of body appreciation, potential…

Influence of Mental Health and Substance Use Problems and Criminogenic Risk on Outcomes in Serious Juvenile Offenders

ERIC Educational Resources Information Center

Schubert, Carol A.; Mulvey, Edward P.; Glasheen, Cristie

2011-01-01

Objective: To investigate the relations among certain mental health problems (MHPs; affective, anxiety, attention-deficit/hyperactivity disorder [ADHD], and substance use disorders), criminogenic risk, and outcomes in a sample of serious adolescent offenders. Method: Using data from a longitudinal study of serious adolescent offenders (N = 949;…

What Older Adolescents Expect from Physical Activity: Implicit Cognitions Regarding Health and Appearance Outcomes

ERIC Educational Resources Information Center

McFadden, K.; Berry, T. R.; McHugh, T. F.; Rodgers, W. M.

2018-01-01

Objective: To explore older adolescents' reflective and impulsive thoughts about health- and social/appearance-related physical activity (PA) outcomes and investigate how those thoughts relate to their PA behavior. Participants: One hundred and forty-four undergraduate students (109 women; 35 men) aged 17-19 years (M = 18.11, SD = 0.65)…

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature

ERIC Educational Resources Information Center

Wheaton, Anne G.; Chapman, Daniel P.; Croft, Janet B.

2016-01-01

Background: Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy…

Health, Functioning, and Participation of Adolescents and Adults with Cerebral Palsy: A Review of Outcomes Research

ERIC Educational Resources Information Center

Frisch, Dana; Msall, Michael E.

2013-01-01

With medical advances, more individuals with cerebral palsy (CP) syndromes who reside in developed countries are surviving to adolescence and adulthood. However, there continues to be a paucity of research examining long-term health, functional activities, and participatory outcomes over their life-course. This article reviews the current…

Poor adherence to US Dietary Guidelines for children and adolescents in the National Health and Nutrition Examination Survey population

USDA-ARS?s Scientific Manuscript database

Poor diet quality in childhood and adolescence is associated with adverse health outcomes throughout life, yet the dietary habits of American children and how they change across childhood and adolescence are unknown. This study sought to describe diet quality among children and adolescents by assess...

Adolescent Tobacco and Cannabis Use: Young Adult Outcomes from the Ontario Child Health Study

ERIC Educational Resources Information Center

Georgiades, Katholiki; Boyle, Michael H.

2007-01-01

Background: This study examines the longitudinal associations between adolescent tobacco and cannabis use and young adult functioning. Methods: Data for analysis come from the Ontario Child Health Study (OCHS), a prospective study of child health, psychiatric disorder and adolescent substance use in a general population sample that began in 1983,…

Physical activity and sedentary behavior patterns are associated with selected adolescent health risk behaviors.

PubMed

Nelson, Melissa C; Gordon-Larsen, Penny

2006-04-01

Little is known about how physical activity (PA), sedentary behavior, and various adolescent health risk behaviors are associated. The objective of this study was to examine relationships between PA and sedentary behavior patterns and an array of risk behaviors, including leading causes of adolescent morbidity/mortality. Nationally representative self-reported data were collected (National Longitudinal Study of Adolescent Health; wave I: 1994-1995; II: 1996; N = 11957). Previously developed and validated cluster analyses identified 7 homogeneous groups of adolescents sharing PA and sedentary behaviors. Poisson regression predicted the relative risk of health risk behaviors, other weekly activities, and self-esteem across the 7 PA/sedentary behavior clusters controlling for demographics and socioeconomic status. Main outcome measures were adolescent risk behaviors (eg, truancy, cigarette smoking, sexual intercourse, delinquency), other weekly activities (eg, work, academic performance, sleep), self-esteem. Relative to high television (TV) and video viewers, adolescents in clusters characterized by skating and video gaming, high overall sports and sports participation with parents, using neighborhood recreation center, strict parental control of TV, reporting few activities overall, and being active in school were less likely to participate in a range of risky behaviors, ranging from an adjusted risk ratio (ARR) of 0.42 (outcome: illegal drug use, cluster: strict parental control of TV) to 0.88 (outcome: violence, cluster: sports with parents). Active teens were less likely to have low self-esteem (eg, adolescents engaging in sports with parents, ARR: 0.73) and more likely to have higher grades (eg, active in school, ARR: 1.20). Participation in a range of PA-related behaviors, particularly those characterized by high parental sports/exercise involvement, was associated with favorable adolescent risk profiles. Adolescents with high TV/video viewership were less likely to have positive risk behavior outcomes. Enhancing opportunities for PA and sport may have a beneficial effect on leading adolescent risk behaviors.

Effects of eHealth physical activity encouragement in adolescents with complex congenital heart disease: The PReVaiL randomized clinical trial.

PubMed

Klausen, Susanne Hwiid; Andersen, Lars L; Søndergaard, Lars; Jakobsen, Janus Christian; Zoffmann, Vibeke; Dideriksen, Kasper; Kruse, Anne; Mikkelsen, Ulla Ramer; Wetterslev, Jørn

2016-10-15

To assess benefit and harms of adding an eHealth intervention to health education and individual counseling in adolescents with congenital heart disease. Randomized clinical trial. Denmark. A total of 158 adolescents aged 13-16years with no physical activity restrictions after repaired complex congenital heart disease. PReVaiL consisted of individually tailored eHealth encouragement physical activity for 52weeks. All patients received 45min of group-based health education and 15min of individual counseling involving patients' parents. The primary outcome was maximal oxygen uptake (VO2 peak) at 52weeks after randomization. The secondary outcome was physical activity. Exploratory outcomes were generic and disease-specific questionnaires. In the intervention group, 58 patients (72%) completed the final test, but of those, only 46 (57%) fulfilled the compliance criteria of using the eHealth application for at least 2 consecutive weeks. In the control group, 61 patients (79%) completed both exercise tests. Adjusted for baseline values, the difference between the intervention group and the control group in mean VO2 peak at 1year was -0.65ml·kg(-1)·min(-1) (95% CI -2.66 to 1.36). Between-group differences at 1year in physical activity, generic health-related quality of life, and disease-specific quality of life were not statistically significant. Adding a tailored eHealth intervention to health education and individual counseling did not affect outcomes among adolescents with congenital heart disease. Our results do not support the use of this eHealth intervention in adolescents with complex congenital heart disease. Clinical trials.gov identifier: NCT01189981. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Latino Adolescent Reproductive and Sexual Health Behaviors and Outcomes: Research Informed Guidance for Agency-based Practitioners

PubMed Central

Guilamo-Ramos, Vincent; Goldberg, Vincent; Lee, Jane; McCarthy, Katherine; Leavitt, Sarah

2011-01-01

Latinos are the largest and fastest growing minority youth group in the United States. Currently, Latino adolescents experience higher rates of teen pregnancy compared to any other racial or ethnic group and have disproportionately high levels of sexually transmitted infections and HIV. Latino teens are also affected by a number of social problems such as school dropout, poverty, depression and limited access to healthcare, which contributes to disparities in reproductive health outcomes for this population. Relatively few intervention research studies and programs have been dedicated to reducing sexual risk among Latino youth, despite their particular vulnerabilities in experiencing negative reproductive health outcomes. We provide recommendations for identifying the unique reproductive health needs of Latino youth and specific applied strategies so that agency-based social workers and other providers can develop family-based interventions that improve adolescent Latino sexual and reproductive health. PMID:23279981

The mental health consequences of nonmedical prescription drug use among adolescents.

PubMed

Ali, Mir M; Dean, David; Lipari, Rachel; Dowd, William N; Aldridge, Arnie P; Novak, Scott P

2015-03-01

Nonmedical prescription drug use is estimated to be the second most abused category of drugs after marijuana among adolescents. Prescription drugs can be highly addictive and prolonged use can produce neurological changes and physiological dependence and could result in adverse mental health outcomes. This topic is largely unexplored, as current knowledge of possible mechanisms of the linkage between adverse mental health consequences and prescription drug misuse is limited. This study explores the relationship between nonmedical use of prescription drugs and depression outcomes among adolescents. Given their complex and confounded relationship, our purpose is to better understand the extent to which nonmedical use of prescription drugs is an antecedent of depressive episodes. Using data from the 2008-2012 National Survey on Drug Use and Health, the study employs a propensity score matching methodology to ascertain whether nonmedical use of prescription drugs is linked to major depressive episodes among adolescents. The results document a positive relationship between nonmedical prescription drug use and major depressive episodes among adolescents. Specifically, the results indicate that adolescents who used prescription drugs non-medically are 33% to 35% more likely to experience major depressive episodes compared to their non-abusing counterparts. This provides additional evidence about the potential public health consequences of misuse of prescription drugs on adverse mental health outcomes. Given the significant increased risk of major depressive episode among adolescents who use prescription drugs nonmedically, it seems that the prevention of nonmedical prescription drug use warrants the utilization of both educational and public health resources. An important area for future research is to understand how any policy initiatives in this area must strike a balance between the need to minimize the misuse of prescription drugs and the need to ensure access for their legitimate health care use.

Adolescent Sexuality and Parent-Adolescent Processes: Promoting Healthy Teen Choices.

ERIC Educational Resources Information Center

Meschke, Laurie L.; Bartholomae, Suzanne; Zentall, Shannon R.

2000-01-01

Reports on trends in adolescent sexual health, the relation between parenting and adolescent sexual outcomes, and adolescent sexuality interventions. Discusses parenting efforts related to adolescent sexual behavior. Examines adolescent sexuality programs with a parent component. Review of 19 programs supports the incorporation of theory and the…

Effect of life skills building education and micronutrient supplements provided from preconception versus the standard of care on low birth weight births among adolescent and young Pakistani women (15-24 years): a prospective, population-based cluster-randomized trial.

PubMed

Baxter, Jo-Anna B; Wasan, Yaqub; Soofi, Sajid B; Suhag, Zamir; Bhutta, Zulfiqar A

2018-05-31

Risk factors known to impact maternal and newborn nutrition and health can exist from adolescence. If an undernourished adolescent girl becomes pregnant, her own health and pregnancy are at an increased risk for adverse outcomes. Offering preconception care from adolescence could provide an opportunity for health and nutrition promotion to improve one's own well-being, as well as future pregnancy outcomes and the health of the next generation. The Matiari emPowerment and Preconception Supplementation (MaPPS) Trial is a population-based two-arm, cluster-randomized, controlled trial of life skills building education and multiple micronutrient supplementation provided in a programmatic context to evaluate the impact on pre-identified nutrition and health outcomes among adolescent and young women (15-24 years) in Matiari district Pakistan, and the infants born to them within the context of the trial. The primary aim is to assess the effect of the intervention on the prevalence of low birth weight births (< 2500 g). The intervention includes bi-monthly life skills building education provided from preconception, and supplementation with multiple micronutrients during preconception (twice-weekly), pregnancy (daily), and post-partum (daily to 6 months). The standard of care includes non-regulated community-based health sessions and daily iron and folic acid supplementation during pregnancy. Additional outcome information will also be collected at set time periods. Among participants, these relate to nutrition (anthropometry, nutritional status), morbidity, and mortality. Among infants, these include birth outcomes (stillbirth, preterm birth, length of gestation, small for gestational age, birth defects), anthropometry, morbidity, and mortality. Preconception care from adolescence that includes interventions targeting life skills development and nutrition is suggested to be important to improving the health and nutrition of adolescent and young women and their future offspring. This study is expected to offer insight into providing such an intervention both within a programmatic context and with an extended exposure period prior to conception. The MaPPS Trial was registered retrospectively on clinicaltrials.gov (Identifier: NCT03287882 ) on September 19, 2017.

Consumer satisfaction with the Child and Adolescent Mental Health Service and its association with treatment outcome: a 3-4-year follow-up study.

PubMed

Solberg, Cathrine; Larsson, Bo; Jozefiak, Thomas

2015-04-01

Consumer satisfaction studies with the Child and Adolescent Mental Health Service (CAMHS) have mainly assessed evaluations in a short-term follow-up perspective. Adolescent reports with CAMHS have not been included nationally. The purposes of this study were to explore adolescent and parental satisfaction with the CAMHS in a 3-4-year follow-up perspective, and to examine the relationships between reported consumer satisfaction and clinical parameters such as reason for adolescent referral, emotional/behavioral symptoms and treatment outcome. Of 190 adolescent-parent pairs in a sample of CAMHS outpatients, 120 completed a Consumer Satisfaction Questionnaire. Parents assessed adolescent emotional/behavior problems both at baseline and at follow-up by completing the Child Behavior Checklist (CBCL). Correlations were examined between adolescent and parental evaluations. The relationships between service satisfaction and symptom load at baseline and follow-up and treatment outcome at follow-up were explored. Overall, adolescents and parents were satisfied with the services received from the CAMHS. The correlations between adolescent and parent consumer satisfaction ratings were low to moderate. Consumer satisfaction was significantly and negatively correlated with symptom load on the CBCL Total Problems scores at baseline, but not at follow-up. There was no difference in satisfaction levels between those who improved after treatment and those who did not. Given the differences in informant ratings of consumer satisfaction, it is important to include both adolescent and parental perceptions in evaluations of CAMHS services and treatment outcomes. Consumer satisfaction should serve as a supplement to established standardized outcome measures.

Parent-child relationships, parental attitudes towards sex, and birth outcomes among adolescents.

PubMed

Harville, Emily W; Madkour, Aubrey Spriggs; Xie, Yiqiong

2014-10-01

To examine how parent-child relationships, parental control, and parental attitudes towards sex were related to pregnancy outcomes among adolescent mothers. Prospective cohort study. Parental report of relationship satisfaction, disapproval of adolescent having sex, discussion around sexual health, and sexual communication attitudes, and adolescent report of relationship satisfaction, parental control, and parental disapproval of sex were examined as predictors of self-reported birth outcomes. Weighted multivariable linear regression models were run incorporating interactions by race. United States. 632 females who participated in Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health), a nationally-representative sample of students enrolled in grades 7-12 in 1994-95 and followed up in 2007-2008. Birthweight and gestational age. For Black adolescents, better parent-child relationship was associated with higher birthweight (0.14 kg, P < .05) and gestational age (0.75 weeks, P < .01), while higher parental disapproval of having sex (adjusted beta 0.15 kg, P < .05) were associated with higher birthweight. For non-Black adolescents, a moderate amount of discussion of birth control was associated with higher birthweight (0.19 kg, P < .01 and lower child-perceived parental disapproval of having sex was associated with higher birthweight (0.08 kg, P < .05) and gestational age (0.37 weeks, P < .05). Higher parental control was associated with a reduced likelihood of smoking during pregnancy and a greater likelihood of early prenatal care. Parent-child relationships and attitudes about sex affect outcomes of pregnant adolescents. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Adolescents with congenital heart disease: the importance of perceived parenting for psychosocial and health outcomes.

PubMed

Luyckx, Koen; Goossens, Eva; Missotten, Lies; Moons, Philip

2011-11-01

: Little is known about how parenting relates to psychosocial functioning and health behavior in adolescents with congenital heart disease (CHD). Different parenting styles were identified through relying on adolescent perceptions of multiple dimensions (regulation, responsiveness, and psychological control). The degree to which parents were perceived as consistent in their rearing style was assessed. : Adolescents with CHD were selected from the database of pediatric and congenital cardiology of the University Hospitals Leuven; control individuals were recruited at secondary schools. A total of 429 adolescents (14-18 years) with CHD participated; 403 were matched on gender and age with control individuals. Adolescents completed questionnaires on maternal and paternal regulation, psychological control, and responsiveness. Main outcome measures were depressive symptoms, loneliness, quality of life, health status, alcohol, cigarette, and drug use. : No significant differences emerged between adolescents with CHD and controls in perceived parenting styles. Democratic parenting was accompanied by the most optimal pattern of outcomes in adolescents with CHD, whereas psychologically controlling parenting by the least optimal pattern. Overprotective parenting was related to high patient substance use. Perceiving both parents as democratic turned out most favorably for psychosocial functioning and quality of life, whereas parental consistency was unrelated to substance use in adolescents with CHD. : By building bridges between the fields of adolescent medicine and family studies, the present study generated important information on the role of parents in psychosocial and behavioral functioning of adolescents with CHD. Future longitudinal studies could inform family-based interventions for this population.

Inter-personal violence and abuse in adolescent intimate relationships: mental health impact and implications for practice.

PubMed

Barter, Christine; Stanley, Nicky

2016-10-01

This paper provides a narrative review of the knowledge on inter-personal violence and abuse (IPVA) in adolescents' intimate relationships. It draws on the authors' own research, published reviews, and a rapid review on IPVA victimization and mental health outcomes for adolescents. The research reviewed identified associations between adolescent IPVA and substance misuse, depressive symptoms and PTSD, eating disorders and suicidal thinking, and behaviour in young people. Generally, girls appeared more likely to report severe mental health outcomes than boys. Adolescents rarely disclose IPVA to adults and delivering preventative programmes that promote knowledge and help seeking may offer a means of building on young people's tendency to seek help from friends. These preventative interventions, usually delivered in schools, need to be closely linked to support services for adolescents who disclose abuse. While there are some practice examples of emerging interventions for both victims and perpetrators of adolescent IPVA, there is as yet little robust evidence regarding their effectiveness.

A Review of Psychotherapy Outcome Research: Considerations for School-Based Mental Health Providers

ERIC Educational Resources Information Center

Zirkelback, Emily A.; Reese, Robert J.

2010-01-01

Evaluating psychotherapeutic outcome is an important endeavor given psychology's focus on identifying effective treatments. There is ample evidence to suggest that psychotherapy interventions for children and adolescents are effective. Unfortunately, the child and adolescent psychotherapy outcome literature lags behind the adult-focused outcome…

Developmental Cascade Models of a Parenting-focused Program for Divorced Families on Mental Health Problems and Substance Use in Emerging Adulthood

PubMed Central

Wolchik, Sharlene A.; Tein, Jenn-Yun; Sandler, Irwin N.; Kim, Han-Joe

2017-01-01

A developmental cascade model from functioning in adolescence to emerging adulthood was tested using data from a 15-year longitudinal follow-up of 240 emerging adults whose families participated in a randomized, experimental trial of a preventive program for divorced families. Families participated in the program or literature control condition when the offspring were ages 9 – 12. Short-term follow-ups were conducted 3 months and 6 months following completion of the program when the offspring were in middle to late adolescence. Long-term follow-ups were conducted 6 years and 15 years after program completion when the offspring were in emerging adulthood. It was hypothesized that the impact of the program on mental health and substance use outcomes in emerging adulthood would be explained by developmental cascade effects of program effects in adolescence. The results provided support for a cascade effects model. Specifically, academic competence in adolescence had spillover effects on internalizing problems and externalizing problems in emerging adulthood. Also, adaptive coping in adolescence was significantly, negatively related to binge drinking. Unexpectedly, internalizing symptoms in adolescence were significantly negatively related to marijuana use and alcohol use. Gender differences occurred in the links between mental health and substance use outcomes in adolescence and mental health and substance use outcomes in emerging adulthood. PMID:27427811

Adolescents' Perceptions of Alcohol

ERIC Educational Resources Information Center

Roy, Amit; Ikonen, Risto; Keinonen, Tuula; Kumar, Kuldeep

2017-01-01

Purpose: Rising trends in alcohol consumption and early drinking initiation pose serious health risks especially for adolescents. Learner's prior knowledge about alcohol gained from the social surroundings and the media are important sources that can impact the learning outcomes in health education. The purpose of this paper is to map adolescents'…

Dental enamel defects predict adolescent health indicators: A cohort study among the Tsimane' of Bolivia.

PubMed

Masterson, Erin E; Fitzpatrick, Annette L; Enquobahrie, Daniel A; Mancl, Lloyd A; Eisenberg, Dan T A; Conde, Esther; Hujoel, Philippe P

2018-05-01

Bioarchaeological findings have linked defective enamel formation in preadulthood with adult mortality. We investigated how defective enamel formation in infancy and childhood is associated with risk factors for adult morbidity and mortality in adolescents. This cohort study of 349 Amerindian adolescents (10-17 years of age) related extent of enamel defects on the central maxillary incisors (none, less than 1/3, 1/3 to 2/3, more than 2/3) to adolescent anthropometrics (height, weight) and biomarkers (hemoglobin, glycated hemoglobin, white blood cell count, and blood pressure). Risk differences and 95% confidence intervals were estimated using multiple linear regression. Enamel defects and stunted growth were compared in their ability to predict adolescent health indicators using log-binomial regression and receiver operating characteristics (ROCs). Greater extent of defective enamel formation on the tooth surface was associated with shorter height (-1.35 cm, 95% CI: -2.17, -0.53), lower weight (-0.98 kg, 95% CI: -1.70, -0.26), lower hemoglobin (-0.36 g/dL, 95% CI: -0.59, -0.13), lower glycated hemoglobin (-0.04 %A 1c , 95% CI: -0.08, -0.00008), and higher white blood cell count (0.74 10 9 /L, 95% CI: 0.35, 1.14) in adolescence. Extent of enamel defects and stunted growth independently performed similarly as risk factors for adverse adolescent outcomes, including anemia, prediabetes/type II diabetes, elevated WBC count, prehypertension/hypertension, and metabolic health. Defective enamel formation in infancy and childhood predicted adolescent health outcomes and may be primarily associated with infection. Extent of enamel defects and stunted growth may be equally predictive of adverse adolescent health outcomes. © 2018 Wiley Periodicals, Inc.

Association between child marriage and reproductive health outcomes and service utilization: a multi-country study from South Asia.

PubMed

Godha, Deepali; Hotchkiss, David R; Gage, Anastasia J

2013-05-01

Despite the pervasiveness of child marriage and its potentially adverse consequences on reproductive health outcomes, there is relatively little empirical evidence available on this issue, which has hindered efforts to improve the targeting of adolescent health programs. The purpose of this study was to assess the association of child marriage with fertility, fertility control, and maternal health care use outcomes in four South Asian countries: India, Bangladesh, Nepal, and Pakistan. Data for the study come from the most recent Demographic and Health Surveys conducted in the study countries; we used a subsample of women aged 20-24 years. Child marriage, defined as first marriage before 18 years of age, is categorized into two groups: first married at ages 15-17 years and first married at age ≤14 years. We used multivariate logistic regression models. The results of the study suggest that child marriage is significantly associated with a history of rapid repeat childbirth, current modern contraceptive use, female sterilization, not using contraception before first childbirth, pregnancy termination, unintended pregnancy, and inadequate use of maternal health services, although the associations are not always consistent across countries. Furthermore, women who married in early adolescence or childhood show a higher propensity toward most of the negative outcomes, compared with women who married in middle adolescence. Child marriage adds a layer of vulnerability to women that leads to poor fertility control and fertility-related outcomes, and low maternal health care use. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Patterns of Self-Reported Alcohol Use, Depressive Symptoms, and Body Mass Index in a Family Sample: The Buffering Effects of Parentification

ERIC Educational Resources Information Center

Hooper, Lisa M.; Doehler, Kirsten; Jankowski, Peter J.; Tomek, Sara E.

2012-01-01

Although the impact of parentification on children and adolescents' psychological health and outcomes has long been studied and well documented, little is known about the impact of parentification on children and adolescents' physical health and medical outcomes. Moreover, the potential buffering effects of parentification have been examined very…

Sex differences in adult outcomes by changes in weight status from adolescence to adulthood: results from Add Health.

PubMed

Chung, Arlene E; Skinner, Asheley Cockrell; Maslow, Gary R; Halpern, Carolyn T; Perrin, Eliana M

2014-01-01

Changes in weight status from adolescence to adulthood may be associated with varying social, vocational, economic, and educational outcomes, which may differ by sex. We studied whether there are differences in adult outcomes by sex for different weight status changes in the transition to adulthood. Using data from the National Longitudinal Study of Adolescent Health, participants were categorized by weight status from adolescence into adulthood. We examined self-reported outcomes in adulthood for living with parents, being married, being a parent, employment, receipt of public assistance, income, and college graduation by weight groupings (healthy-healthy, healthy-overweight/obese, overweight/obese-overweight/obese, overweight/obese-healthy). The effect of changes in weight status on the adult outcomes was modeled, controlling for sex, age, parental education, and race/ethnicity. There were differences by sex for many of the self-reported outcomes, especially educational and economic outcomes. Female subjects who became overweight/obese between adolescence and adulthood or remained so had worse economic and educational findings as adults compared to male subjects. Overall, for female subjects, becoming and remaining overweight/obese was associated with worse outcomes, while for male subjects, adolescent obesity was more important than isolated adult obesity. The relationship between obesity and life situations may be more negative for female subjects in the transition to adulthood. The findings emphasize that adolescent obesity, and not just obesity isolated in adulthood, is important for characteristics achieved in adulthood. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Dairy product intake in children and adolescents in developed countries: trends, nutritional contribution, and a review of association with health outcomes.

PubMed

Dror, Daphna K; Allen, Lindsay H

2014-02-01

Despite its contribution to nutrient intake and status, consumption of milk and dairy products by children and adolescents in many countries has waned in recent decades, with a substantial proportion of youth failing to meet intake recommendations. Dairy products remain an important dietary source of multiple micronutrients, including calcium, phosphorus, magnesium, zinc, iodine, potassium, vitamin A, vitamin D, vitamin B12 , and riboflavin (vitamin B2 ). In addition, dairy products provide children with energy, high-quality protein, and essential and nonessential fatty acids. A review of evidence was conducted to evaluate associations between milk or dairy product intake and health outcomes in children and adolescents. Results suggest a neutral or inverse association between consumption of milk and dairy products in children and adolescents and indicators of adiposity, incidence of dental caries, and hypertension. Available data indicate that dairy products are important for linear growth and bone health during childhood. Additional research--in particular, controlled intervention trials and long-term prospective cohort studies--is warranted to better understand how dairy intake affects health outcomes in children and adolescents. © 2013 International Life Sciences Institute.

Where do HIV-infected adolescents go after transfer? - Tracking transition/transfer of HIV-infected adolescents using linkage of cohort data to a health information system platform.

PubMed

Davies, Mary-Ann; Tsondai, Priscilla; Tiffin, Nicki; Eley, Brian; Rabie, Helena; Euvrard, Jonathan; Orrell, Catherine; Prozesky, Hans; Wood, Robin; Cogill, Dolphina; Haas, Andreas D; Sohn, Annette H; Boulle, Andrew

2017-05-16

To evaluate long-term outcomes in HIV-infected adolescents, it is important to identify ways of tracking outcomes after transfer to a different health facility. The Department of Health (DoH) in the Western Cape Province (WCP) of South Africa uses a single unique identifier for all patients across the health service platform. We examined adolescent outcomes after transfer by linking data from four International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) cohorts in the WCP with DoH data. We included adolescents on antiretroviral therapy who transferred out of their original cohort from 10 to 19 years of age between 2004 and 2014. The DoH conducted the linkage separately for each cohort and linked anonymized data were then combined. The primary outcome was successful transfer defined as having a patient record at a facility other than the original facility after the transfer date. Secondary outcomes included the proportion of patients retained, with HIV-RNA <400 copies/ml and CD4 > 500 cells/µl at 1, 2 and 3 years post-transfer. Of 460 adolescents transferred out (53% female), 72% transferred at 10-14 years old, and 79% transferred out of tertiary facilities. Overall, 81% of patients transferred successfully at a median (interquartile range) of 56 (27-134) days following transfer date; 95% reached the transfer site <18 months after transfer out. Among those transferring successfully, the proportion retained decreased from 1 to 3 years post-transfer (90-84%). There was no significant difference between transfer and 1-3 years post-transfer in the proportion of retained adolescents with HIV-RNA <400 copies/ml and CD4 > 500 cells/µl except for HIV-RNA <400 copies/ml at 3 years (86% vs. 75%; p  = 0.007). The proportion virologically suppressed and with CD4 > 500 cells/µl was significantly lower at 1 and 2 years post-transfer in those transferring at 15-19 vs. 10-14 years of age. Using laboratory data alone over-estimated time to successful transfer. Linking cohort data to health information system data allowed efficient assessment of post-transfer outcomes. Although >80% of adolescents transferred successfully with nearly 85% of them retained for 3 years post-transfer, the decline in the proportion virologically suppressed and poorer outcomes in older adolescents are concerns.​.

Examining Relationships between Ethnic Identity, Family Environment, and Psychological Outcomes for African American Adolescents

ERIC Educational Resources Information Center

Street, Jalika; Harris-Britt, April; Walker-Barnes, Chanequa

2009-01-01

Ethnic identity has been linked to a number of healthy psychological outcomes for African American adolescents. The levels of conflict and cohesion in the family environment have also been found to be predictive of adolescent mental health. This study examined whether the ethnic identity and levels of conflict and cohesion in the family…

The Longitudinal Impact of Adolescent Drug Use on Socioeconomic Outcomes in Young Adulthood

ERIC Educational Resources Information Center

Broman, Clifford L.

2009-01-01

This study investigates how drug use in adolescence contributes to socioeconomic outcomes in young adulthood. Several studies have investigated whether drug problems alter the life course in ways that are detrimental to young adult achievement, but findings are inconsistent. We use data from the National Longitudinal Study of Adolescent Health to…

Personality and adolescent pregnancy outcomes

PubMed Central

Harville, Emily W.; Madkour, Aubrey Spriggs; Xie, Yiqiong

2014-01-01

Aims To examine the relationship between personality, pregnancy and birth outcomes in adolescents Background Personality has been shown to be a strong predictor of many health outcomes. Adolescents who become pregnant have worse birth outcomes than adults. Design Cross-sectional study using data from the National Longitudinal Study of Adolescent Health (baseline, 1994-1995; follow-up, 2007-2008). Methods The study sample was 6529 girls, 820 of whom reported on pregnancy outcomes for a teenage birth. Personality data was taken from the Mini International Personality Item Pool personality tool, which measures the five-factor personality traits of neuroticism, conscientiousness, intellect/imagination, extraversion and agreeableness. Logistic regression was used to predict teen pregnancy and linear regression was used to predict birth weight and gestational age with adjustment for confounders and stratification by race. Results Agreeableness and intellect/imagination were associated with a reduced likelihood of becoming pregnant as an adolescent, while neuroticism, conscientiousness and extraversion were all associated with an increased likelihood of becoming pregnant. Higher neuroticism was associated with lower birth weight and gestational age among Black girls, but not non-Black. Conscientiousness was associated with lower gestational age among non-Black girls. No relationships were found with extraversion or agreeableness and birth outcomes. Receiving late or no prenatal care was associated with higher intellect/imagination. Conclusions Personality is understudied with respect to pregnancy and birth outcomes compared with other health outcomes. Such research could help professionals and clinicians design and target programs that best fit the characteristics of the population most likely to need them, such as those with high neuroticism. PMID:25040691

Linking Caregiver Strain to Diabetes Illness Management and Health Outcomes in a Sample of Adolescents in Chronically Poor Metabolic Control

PubMed Central

Carcone, April Idalski; Ellis, Deborah A.; Naar-King, Sylvie

2012-01-01

Objective This study examined a multivariate model of the relationship between caregiver strain and adolescent diabetes illness outcomes in a sample of caregivers of adolescents in chronically poor metabolic control (Hba1c ≥ 8.0% at enrollment and for previous 12 months). Caregiver mental health symptoms were hypothesized to mediate the relationship between caregiver strain and adolescent illness management behavior and metabolic control. Caregivers’ perceptions of social support and their level of responsibility for diabetes care tasks were hypothesized to be directly related to caregiver strain and indirectly to caregiver mental health symptoms. Method One hundred forty-six caregiver-adolescent dyads completed baseline measures of caregiver strain, responsibility for diabetes care, social support, mental health symptoms, and illness management behavior. Adolescent metabolic control was also assessed. Results Findings from structural equation modeling suggested that caregiver strain was directly and positively associated with caregiver mental health symptoms which mediated the relationship to adolescent diabetes management behavior and metabolic control. Caregivers’ responsibility for diabetes care tasks was directly related to caregiver strain and indirectly to caregiver mental health, but caregiver perceptions of social support was not. Conclusions These findings suggest that caregiver strain is an important dimension of the caregiving context of diabetes. Clinicians and researchers should consider how caregiving strain, responsibility for illness management, and mental health symptoms might be impacting children’s diabetes care behavior and diabetes health when working with and designing interventions for adolescents with diabetes. PMID:22566030

Victimization among Peruvian adolescents: insights into mental/emotional health from the Young Lives study.

PubMed

Lister, Cameron E; Merrill, Ray M; Vance, David L; West, Joshua H; Hall, Parley C; Crookston, Benjamin T

2015-07-01

Bullying is a global problem among children and adolescents. The purpose of this study was to explore bully victimization in Peru and to identify potential adverse mental health and social outcomes resulting from bully victimization. This study analyzed data from an ongoing prospective cohort of children taking part in the Young Lives study. This study assessed bullying consequences on mental and emotional health in the 3 rounds of data collected among Peruvian adolescents at ages 8, 12, and 15. Bullying by peers was negatively related with age. A factor analysis showed that boys were significantly less likely than girls to suffer emotional and relational problems due to victimization. Additionally, bullying in rounds 2 and 3 of the cohort were significantly correlated with adverse emotional and mental health outcomes in round 3. Lastly, emotional status was positively associated with violent incidences in the schools and at home. This study shows significant problems with emotional and mental stress as early outcomes associated with victimization in Peru. The findings have implications for treating adolescent health issues like peer victimization. Steps should be taken to address bullying and mental/emotional health in Peru in order to combat subsequent mental health problems. © 2015, American School Health Association.

The Influence of Health Behaviors During Childhood on Adolescent Health Behaviors, Health Indicators, and Academic Outcomes Among Participants from Hawaii.

PubMed

Nigg, Claudio R; Amato, Katie

2015-08-01

Health behaviors during childhood may influence adolescent health behaviors and be related to other important outcomes, but no longitudinal research has examined this in a multicultural population in Hawaii to date. This study investigated if childhood moderate to vigorous physical activity (MVPA), fruit and vegetable consumption, and sedentary behavior influence adolescent (1) MVPA, fruit and vegetable consumption, and sedentary behavior; (2) body mass index (BMI) percentile, general health, and stress; and (3) school marks and school absenteeism. Three cohorts of public elementary school children (fourth to sixth graders) who participated in a state-mandated after-school program in 2004, 2005, and 2006 completed baseline (demographics, MVPA, fruit and vegetable consumption, and sedentary behavior) and 5-year follow-up surveys (demographics, MVPA, fruit and vegetable consumption, and sedentary behavior; BMI, general health, stress, school marks, and absenteeism; combined follow-up n = 334; 14.76 ± 0.87 years old; 55.1% female; 53% Asian, 19.8% Native Hawaiian/other Pacific Islander, 15.3% White, and 11.9% other). Regressions found that childhood MVPA (mean [m] = 45.42, standard deviation [SD] = 31.2 min/day) and fruit and vegetable consumption (m = 6.96, SD = 4.54 servings/day) predicted these behaviors in adolescence (m = 47.22, SD = 27.04 min/day and m = 4.63, SD = 3.03 servings/day, respectively, p < 0.05). Childhood sedentary behavior (m = 3.85, SD = 2.85 h/day)) predicted adolescent BMI percentile (m = 60.93, SD = 28.75, p < 0.05). Childhood fruit and vegetable consumption and sedentary behavior negatively predicted adolescent marks (B average, p < 0.05). Childhood health behaviors do influence adolescent health behaviors, some health outcomes, and some academic indicators in this population, especially childhood sedentary behavior, which underlines the importance of sedentary behavior interventions.

Long-term consequences of adolescent gang membership for adult functioning.

PubMed

Gilman, Amanda B; Hill, Karl G; Hawkins, J David

2014-05-01

We examined the possible public health consequences of adolescent gang membership for adult functioning. Data were drawn from the Seattle Social Development Project, a longitudinal study focusing on the development of positive and problem outcomes. Using propensity score matching and logistic regression analyses, we assessed the effects of adolescent gang membership on illegal behavior, educational and occupational attainment, and physical and mental health at the ages of 27, 30, and 33 years. In comparison with their nongang peers, who had been matched on 23 confounding risk variables known to be related to selection into gang membership, those who had joined a gang in adolescence had poorer outcomes in multiple areas of adult functioning, including higher rates of self-reported crime, receipt of illegal income, incarceration, drug abuse or dependence, poor general health, and welfare receipt and lower rates of high school graduation. The finding that adolescent gang membership has significant consequences in adulthood beyond criminal behavior indicates the public health importance of the development of effective gang prevention programs.

Associations between Adolescent Risk Behaviors and Injury: The Modifying Role of Disability

ERIC Educational Resources Information Center

Raman, Sudha R.; Boyce, William F.; Pickett, William

2009-01-01

Background: Adolescents with disabilities are at risk for poor health outcomes including injury. The objective of this study was to examine if disability status modifies the association between risk behavior and injury among adolescents. Methods: The cross-sectional Health Behavior in School-Aged Children Survey was administered to a…

MOTHERS’ UNION HISTORIES AND THE MENTAL AND PHYSICAL HEALTH OF ADOLESCENTS BORN TO UNMARRIED MOTHERS

PubMed Central

Williams, Kristi; Sassler, Sharon; Frech, Adrianne; Addo, Fenaba; Cooksey, Elizabeth

2014-01-01

As nonmarital childbearing becomes a dominant pathway to family formation, understanding its long-term consequences for children’s well-being is increasingly important. Analysis of linked mother-child data from the NLSY79 indicates a negative association of having been born to a never-married mother with adolescent self-assessed health, but not with depressive symptoms. We also consider the role of mothers’ subsequent union histories in shaping the adolescent health outcomes of youth born to unmarried mothers. With two exceptions, unmarried mothers’ subsequent unions appear to have little consequence for the health of their offspring during adolescence. Adolescents whose mothers subsequently married and remained with their biological fathers reported better health, yet adolescents whose mothers continuously cohabited with the biological father without subsequent marriage reported worse adolescent mental health when compared with adolescents whose mothers remained continually unpartnered. PMID:23956357

Health care services and the transition to young adulthood: challenges and opportunities.

PubMed

Park, M Jane; Adams, Sally H; Irwin, Charles E

2011-01-01

The aim of this study was to examine the potential role of the health care system in the successful transition to young adulthood for all adolescents, with emphasis on adolescents with special health care needs (ASHCN), and to evaluate the system's status in filling that role. Research and conceptual frameworks addressing successful transitions and functioning were reviewed. A framework describing a role for health care services in the transition was presented. The health care system's status in promoting healthy transitions was evaluated, including National Survey of Children with Special Health Care Needs 2005-2006 analyses of key outcomes for ASHCN. Although most national efforts to define skills needed for the transition have focused on career/vocational skills, a few frameworks integrate broader issues such as health, psychosocial development, and civic engagement. Adolescent transitional issues have generally received little attention; however, these have been articulated for ASHCN. Nevertheless, only 2 in 5 ASHCN receive transitional care, and ASHCN fare poorly on other core outcomes. ASHCN with mental health conditions fare worse on outcomes than those with physical health conditions. Our framework for healthy transitions includes the following: 1) adolescents can access a comprehensive health care system, 2) preventable problems are avoided, and 3) chronic problems are managed. The present health care system falls short of accomplishing these. Health care services can potentially play a role in facilitating a healthy transition to young adulthood; however, many gaps exist. Although the health care reform act addresses some gaps, efforts that integrate adolescents' developmental needs and address mental health issues are needed. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Relationships between Adolescent Sexual Outcomes and Exposure to Sex in Media: Robustness to Propensity-Based Analysis

ERIC Educational Resources Information Center

Collins, Rebecca L.; Martino, Steven C.; Elliott, Marc N.; Miu, Angela

2011-01-01

Adolescent sexual health is a substantial problem in the United States, and two recent studies have linked adolescent sexual behavior and/or outcomes to youths' exposure to sex in the media. Both studies had longitudinal survey designs and used covariate-adjusted regression analysis. Steinberg and Monahan (2011) reanalyzed data from one of these…

Nurses on the Front Lines: Improving Adolescent Sexual and Reproductive Health Across Health Care Settings.

PubMed

Santa Maria, Diane; Guilamo-Ramos, Vincent; Jemmott, Loretta Sweet; Derouin, Anne; Villarruel, Antonia

2017-01-01

: Nurses care for adolescents in a variety of settings, including communities, schools, and public health and acute care clinics, which affords them many opportunities to improve adolescents' sexual and reproductive health and reduce the rates of unplanned pregnancy and sexually transmitted infections. To ensure that adolescents have access to sexual and reproductive health care (which includes both preventive counseling and treatment) in all nursing practice sites, nurses need to gain the knowledge and hone the skills required to deliver evidence-based counseling and services to adolescents and parents. Collectively, nurses can use their unique combination of knowledge and skills to make a positive impact on adolescent sexual and reproductive outcomes. Nurses have the capacity and opportunity to disseminate information about sexual and reproductive health to adolescents and their parents in communities, schools, public health clinics, and acute care settings. This article discusses the Society for Adolescent Health and Medicine's goals and recommendations, which address adolescent sexual and reproductive health as both a health care and a human rights issue.

Mother-Adolescent Relationship Quality and Autonomy as Predictors of Psychosocial Adjustment among African American Adolescents

ERIC Educational Resources Information Center

Bynum, Mia Smith; Kotchick, Beth A.

2006-01-01

This study investigated the role of mother-adolescent relationship quality and autonomy in the psychosocial outcomes in a sample of African American adolescents drawn from the National Longitudinal Study of Adolescent Health. The results indicated that positive mother-adolescent relationship quality and greater autonomy were associated with higher…

Assessing the benefits of a rising tide: Educational attainment and increases in neighborhood socioeconomic advantage.

PubMed

Johnston, William R

2017-02-01

An emerging approach to studying associations between neighborhood contexts and educational outcomes is to estimate the outcomes of adolescents growing up in neighborhoods that are experiencing economic growth in comparison to peers that reside in economically stable or declining communities. Using data from the National Longitudinal Study of Adolescent Health (Add Health), I examine the association between education attainment and changes in socioeconomic advantage in urban neighborhoods between 1990 and 2000. I find that residing in a neighborhood that experiences economic improvements has a positive association with educational attainment for urban adolescents. Furthermore, race-based analyses suggest consistently positive associations for all race subgroups, lending support to protective models of neighborhood effects that argue high neighborhood SES supports positive outcomes for adolescents residing in these contexts. Copyright © 2016 Elsevier Inc. All rights reserved.

To tweet, or not to tweet: gender differences and potential positive and negative health outcomes of adolescents' social internet use.

PubMed

Pujazon-Zazik, Melissa; Park, M Jane

2010-03-01

Adolescents and young adults are avid Internet users. Online social media, such as social networking sites (e.g., Facebook, MySpace), blogs, status updating sites (e.g., Twitter) and chat rooms, have become integral parts of adolescents' and young adults' lives. Adolescents are even beginning to enter the world of online dating with several websites dedicated to "teenage online dating." This paper reviews recent peer-reviewed literature and national data on 1) adolescents use of online social media, 2) gender differences in online social media and 3) potential positive and negative health outcomes from adolescents' online social media use. We also examine parental monitoring of adolescents' online activities. Given that parental supervision is a key protective factor against adolescent risk-taking behavior, it is reasonable to hypothesize that unmonitored Internet use may place adolescents' at significant risk, such as cyberbullying, unwanted exposure to pornography, and potentially revealing personal information to sexual predators.

Status of adolescent pelvic inflammatory disease management in the United States.

PubMed

Trent, Maria

2013-10-01

Pelvic inflammatory disease (PID) is a common and serious reproductive health disorder and disease rates remain unacceptably high among adolescent girls and young adult women in the United States. Despite data demonstrating that women experience major adverse health outcomes after PID, national recommendations for management of adolescents have become increasingly less cautious in an era of cost-containment. In this review, we take an alternative look at published data on adolescents with PID to frame the next steps for optimizing management for this vulnerable population. Several findings emerge from review of the literature. First, there is limited evidence to guide the best practice strategies for adolescents with PID due to low enrolment of early and middle adolescents in national trials. Second, adolescents and adult women in the United States receive suboptimal treatment regimens per Centers for Disease Control and Prevention (CDC) standards. Third, available evidence suggests that adolescents are at an increased risk for poor adherence to CDC recommendations for self-care, reacquisition of sexually transmitted infections (STIs) and PID, and subsequent adverse reproductive health outcomes. Efforts to develop and integrate adolescent-focused, evidence-based strategies for PID management and prevention of subsequent STIs and recurrent PID are warranted.

Direct and indirect effects of caregiver social support on adolescent psychological outcomes in two South African AIDS-affected communities

PubMed Central

Casale, Marisa; Cluver, Lucie; Crankshaw, Tamaryn; Kuo, Caroline; Lachman, Jamie M.; Wild, Lauren G.

2015-01-01

Caregiver social support has been shown to be protective for caregiver mental health, parenting and child psychosocial outcomes. This is the first known analysis to quantitatively investigate the relationship between caregiver social support and adolescent psychosocial outcomes in HIV-endemic, resource-scarce Southern African communities. A cross-sectional household survey was conducted over 2009-2010 with 2477 South African adolescents aged 10-17 and their adult caregivers (18 years or older) in one urban and one rural community in South Africa’s KwaZulu-Natal province. Adolescent adjustment was assessed using adult caregiver reports of the Strengths and Difficulties questionnaire (SDQ), which measures peer problems, hyperactivity, conduct problems, emotional symptoms and child prosocial behavior. Hierarchical linear regressions and multiple mediation analyses, using bootstrapping procedures, were conducted to assess for: a) direct effects of more caregiver social support on better adolescent psychosocial wellbeing; and b) indirect effects mediated by better parenting and caregiver mental health. Direct associations (p<.001), and indirect associations mediated through better parenting, were found for all adolescent outcomes. Findings reinforce the importance of social support components within parenting interventions but also point to scope for positive intervention on adolescent psychosocial wellbeing through the broader family social network. PMID:25623784

Sleep Patterns and Mental Health Correlates in US Adolescents.

PubMed

Zhang, Jihui; Paksarian, Diana; Lamers, Femke; Hickie, Ian B; He, Jianping; Merikangas, Kathleen Ries

2017-03-01

To investigate systematically the associations of sleep patterns with a range of mental disorders and other outcomes among a nationally representative sample of US adolescents. Using the National Comorbidity Survey Adolescent Supplement, a nationally representative cross-sectional survey of 10 123 US adolescents 13-18 years of age, we assessed associations between adolescent-reported sleep patterns (tertiles of weeknight bedtime, weeknight sleep duration, weekend bedtime delay, and weekend oversleep) and past-year mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, smoking, injury, suicidality, and perceived mental and physical health, assessed via direct diagnostic interview. The average weeknight bedtime was at 22:37 and sleep duration was 7.72 hours. Average weekend bedtime delay was 1.81 hours and average weekend oversleep was 1.17 hours. Later weeknight bedtime, shorter weeknight sleep duration, greater weekend bedtime delay, and both short and long periods of weekend oversleep were associated with increased odds of mood, anxiety, substance use, and behavioral disorders, as well as suicidality, tobacco smoking, and poor perceived mental and physical health. ORs ranged from 1.27 to 2.15. The only outcomes not associated with any sleep patterns were past-year injury and eating disorder. Suboptimal sleep patterns were associated with an array of mental disorders and other health-related outcomes among adolescents. Abnormal sleep patterns may serve as markers of prodromal or untreated mental disorders among adolescents, and may provide opportunities for prevention and intervention in mental disorders. Copyright © 2016. Published by Elsevier Inc.

Addressing Structural and Environmental Factors for Adolescent Sexual and Reproductive Health in Low- and Middle-Income Countries

PubMed Central

Mmari, Kristin

2015-01-01

A deeper understanding of how structure and environment shape the sexual and reproductive health vulnerabilities of youths across a range of outcomes has implications for the development of successful policies and programs. We have discussed some of the key structural and environmental factors that influence the sexual and reproductive health of adolescents, particularly in low- and middle-income countries, and the importance of engaging adolescents in identifying solutions. We have highlighted 2 case studies that describe structural or environmental approaches to improving adolescent sexual and reproductive health and made recommendations to more systematically incorporate attention to structure and environment to improve global adolescent health. PMID:26270290

Addressing Structural and Environmental Factors for Adolescent Sexual and Reproductive Health in Low- and Middle-Income Countries.

PubMed

Sommer, Marni; Mmari, Kristin

2015-10-01

A deeper understanding of how structure and environment shape the sexual and reproductive health vulnerabilities of youths across a range of outcomes has implications for the development of successful policies and programs. We have discussed some of the key structural and environmental factors that influence the sexual and reproductive health of adolescents, particularly in low- and middle-income countries, and the importance of engaging adolescents in identifying solutions. We have highlighted 2 case studies that describe structural or environmental approaches to improving adolescent sexual and reproductive health and made recommendations to more systematically incorporate attention to structure and environment to improve global adolescent health.

Relationship between Frequency and Intensity of Physical Activity and Health Behaviors of Adolescents

ERIC Educational Resources Information Center

Delisle, Tony T.; Werch, Chudley E.; Wong, Alvin H.; Bian, Hui; Weiler, Robert

2010-01-01

Background: While studies have determined the importance of physical activity in advancing health outcomes, relatively few have explored the relationship between exercise and various health behaviors of adolescents. The purpose of this study is to examine the relationship between frequency and intensity of physical activity and both health risk…

The Relationship between Screen Time and Sexual Behaviors among Middle School Students

ERIC Educational Resources Information Center

Barr, Elissa M.; Moore, Michele J.; Johnson, Tammie; Merten, Julie; Stewart, William P.

2014-01-01

Reducing risky sexual behaviors and their negative health outcomes in youth remains a priority for health educators. Years of research have documented media's effect on various adolescent health risks, including sexual behaviors. As technology evolves and youth access to media increases, understanding the role of media in adolescent health risk…

Homophobic Name-Calling among Secondary School Students and Its Implications for Mental Health

ERIC Educational Resources Information Center

Collier, Kate L.; Bos, Henny M. W.; Sandfort, Theo G. M.

2013-01-01

Although homophobic verbal victimization has been associated with negative mental health outcomes, little actually is known about its general prevalence and relationship to mental health among adolescents. In addition, the relationship of homophobic name-calling to mental health in gender non-conforming adolescents is not well understood. This…

Adolescent mental health and subsequent parenting: a longitudinal birth cohort study

PubMed Central

Byford, M; Abbott, R A; Maughan, B; Richards, M; Kuh, D

2014-01-01

Background Adolescent mental health problems are associated with a range of adverse outcomes in adulthood but little is known about the effects on adult parenting practices. This study aimed to examine prospective associations between adolescent conduct and emotional problems and subsequent parenting behaviours in adulthood. Methods The study sample comprised 1110 members from the MRC National Survey of Health and Development. Prospective data were collected from teacher reports of conduct and emotional problems at age 13 and 15 years and adult outcome measures of parenting included intellectual environment, cognitive stimulation, coercive discipline, parental interest and parental aspiration. Results In regression models adjusted for the confounding effects of social background, cognition and education, adolescent conduct problems predicted coercive parenting behaviours in adulthood. The effects of adolescent emotional problems on the development of coercive discipline practices were explained by covariates. Likewise, the inability of parents who displayed conduct problems in adolescence to provide an intellectually stimulating home environment was fully explained by the adjustment for education. Conclusions Adolescents who exhibit conduct problems are more likely to develop coercive styles of parenting. PMID:24357583

Adolescent mental health and subsequent parenting: a longitudinal birth cohort study.

PubMed

Byford, M; Abbott, R A; Maughan, B; Kuh, D; Richards, M

2014-05-01

Adolescent mental health problems are associated with a range of adverse outcomes in adulthood but little is known about the effects on adult parenting practices. This study aimed to examine prospective associations between adolescent conduct and emotional problems and subsequent parenting behaviours in adulthood. The study sample comprised 1110 members from the MRC National Survey of Health and Development. Prospective data were collected from teacher reports of conduct and emotional problems at age 13 and 15 years and adult outcome measures of parenting included intellectual environment, cognitive stimulation, coercive discipline, parental interest and parental aspiration. In regression models adjusted for the confounding effects of social background, cognition and education, adolescent conduct problems predicted coercive parenting behaviours in adulthood. The effects of adolescent emotional problems on the development of coercive discipline practices were explained by covariates. Likewise, the inability of parents who displayed conduct problems in adolescence to provide an intellectually stimulating home environment was fully explained by the adjustment for education. Adolescents who exhibit conduct problems are more likely to develop coercive styles of parenting.

The association between self-rated health and social environments, health behaviors and health outcomes: a structural equation analysis.

PubMed

Craig, Bevan Adrian; Morton, Darren Peter; Morey, Peter John; Kent, Lillian Marton; Gane, Alva Barry; Butler, Terry Leslie; Rankin, Paul Meredith; Price, Kevin Ross

2018-04-03

The factors shaping the health of the current generation of adolescents are multi-dimensional and complex. The purpose of this study was to explore the determinants of self-rated health (SRH) of adolescents attending a faith-based school system in Australia. A total of 788 students attending 21 Seventh-day Adventist schools in Australia responded to a health and lifestyle survey that assessed SRH as well as potential determinants of SRH including the health outcomes mental health, vitality, body mass index (BMI), select health behaviors, social factors and personal demographics. Structural equation modeling was used to analyze the data and examine the direct and indirect effects of these factors on SRH. The structural model developed was a good fit with the data. The health outcome mental health had the strongest association with SRH (β = 0.17). Several upstream variables were also associated with higher SRH ratings. The health behavior sleep hours had the strongest association with SRH (β total  = 0.178) followed by fruit/vegetable consumption (β total  = 0.144), physical activity (β total  = 0.135) and a vegetarian diet (β total  = 0.103). Of the demographic and social variables measured, adverse childhood experiences (ACEs) had the strongest association with SRH (β total  = - 0.125), negatively influencing SRH, and gender also associated with an increase in SRH (β total  = 0.092), with the influence of these factors being mediated through other variables in the model. This study presents a conceptual model that illustrates the complex network of factors concomitantly associated with SRH in adolescents. The outcomes of the study provide insights into the determinants of adolescent SRH which may inform priority areas for improving this construct.

Sexual Health Behavior Interventions for U.S. Latino Adolescents: A Systematic Review of the Literature

PubMed Central

Cardoza, Vicky J.; Documét, Patricia I.; Fryer, Craig S.; Gold, Melanie A.; Butler, James

2012-01-01

Study Objective To identify sexual health behavior interventions targeting U.S. Latino adolescents. Design A systematic literature review. Setting Peer-reviewed articles published between 1993 and 2011, conducted in any type of setting. Participants Male and female Latino adolescents ages 11–21 years. Interventions Interventions promoting sexual abstinence, pregnancy prevention, sexually transmitted infection (STI) prevention, and/or HIV/AIDS prevention. Main Outcome Measures Changes in knowledge, attitudes, engagement in risky sexual behaviors, rates of STIs, and/or pregnancy. Results Sixty-eight articles were identified. Fifteen were included in this review that specifically addressed Latino adolescent sexual health behavior. Among the reviewed interventions, most aimed to prevent or reduce STI and HIV/AIDS incidence by focusing on behavior change at two levels of the social ecological model: individual and interpersonal. Major strengths of the articles included addressing the most critical issues of sexual health; using social ecological approaches; employing different strategies to deliver sexual health messages; and employing different intervention designs in diverse geographical locations with the largest population of Latino communities. Most of the interventions targeted female adolescents, stressing the need for additional interventions that target Latino adolescent males. Conclusions Latino adolescent sexual health is a new research field with gaps that need to be addressed in reducing negative sexual health outcomes among this population. More research is needed to produce new or validate existing, age-specific, and culturally-sensitive sexual health interventions for Latino male and female adolescents. Further, this research should also be conducted in areas of the U.S. with the newest Latino migration (e.g., North Carolina). PMID:22206687

A Multilevel Model to Examine Adolescent Outcomes in Outdoor Behavioral Healthcare: The Parent Perspective

ERIC Educational Resources Information Center

Combs, Katie Massey; Hoag, Matthew J.; Roberts, Sean D.; Javorski, Stephen

2016-01-01

Background: Outdoor Behavioral Healthcare (OBH) has arisen to fill a gap in mental health treatment. While research shows large positive changes in adolescent self-reports, little is known about predictors of change, longitudinal outcomes, and parent-reports of change. Objective This study sought to identify treatment outcomes up to 18 months…

Regular energy drink consumption is associated with the risk of health and behavioural problems in adolescents.

PubMed

Holubcikova, Jana; Kolarcik, Peter; Madarasova Geckova, Andrea; Reijneveld, Sijmen A; van Dijk, Jitse P

2017-05-01

Consumption of energy drinks has become popular and frequent among adolescents across Europe. Previous research showed that regular consumption of these drinks was associated with several health and behavioural problems. The aim of the present study was to determine the socio-demographic groups at risk for regular energy drink consumption and to explore the association of regular energy drinks consumption with health and behavioural problems and negative school experiences in adolescents. Data from the Health Behaviour in School-aged Children Study conducted in 2014 in Slovakia were analysed. We assessed socio-demographic characteristics, energy drink consumption, health and behavioural problems and negative school experiences based on self-reports from 8977 adolescents aged 11-15 years (mean age/standard deviation 13/1.33; 50.0% boys). The prevalence of regular energy drink consumption in the present sample was 20.6% (95%CI: 20%-21%). Regular energy drink consumption was more frequent among boys and older adolescents. Adolescents with a medium-level family affluence were less likely to drink energy drinks regularly. Adolescents who consumed energy drinks regularly had more health and behavioural problems and negative school experiences. Adolescents drinking energy drinks are at risk of a wide range of negative outcomes and should be specifically addressed by preventive interventions. What is Known • Energy drink consumption has become popular and frequent among adolescents across Europe. • There is growing evidence that energy drink consumption is related to negative social, emotional and health outcomes, but only a few studies have explored this relationship in adolescents. What is New • Regular energy drink consumption was more frequent among boys and adolescents reporting low family affluence and increased with age. • Adolescents reporting regular energy drink consumption were in higher risk to suffer from health and behavioural problems and negative school experiences.

Social support for diabetes illness management: supporting adolescents and caregivers.

PubMed

Idalski Carcone, April; Ellis, Deborah A; Weisz, Arlene; Naar-King, Sylvie

2011-10-01

The aim of this research study was to examine the relationship between 4 sources of social support (support for the adolescent from family, support for the adolescent from friends, support for the caregiver from another adult, and support to the family from the health care provider) and adolescents' diabetes outcomes (illness management behavior and health status) using a diverse sample of urban adolescents. One hundred forty-one adolescents with insulin-managed diabetes and their primary caregivers completed questionnaires assessing social support and illness management behavior. Glucose meters were downloaded and hemoglobin A1c assays were obtained. Structural equation modeling was used to test a model social support informed by social ecological theory. The results of the structural equation modeling indicated that support for the caregiver from another adult was directly and positively related to support for the adolescent from family and indirectly related to better illness management. Support for the adolescent from family was directly related to better diabetes management and, through better management, to better diabetes health. Support to the family from the health care provider was not related to support for the adolescent and support to the adolescent from friends was not related to illness management, as hypothesized. This study identifies a novel target for social support intervention to improve adolescents' illness management behavior-the caregivers of adolescents with diabetes. By enhancing the social support caregivers receive from other adults in their lives, caregivers' ability to support their adolescent children with diabetes might also be improved which, in turn, improves adolescents' illness outcomes.

Family Rejection, Social Isolation, and Loneliness as Predictors of Negative Health Outcomes (Depression, Suicidal Ideation, and Sexual Risk Behavior) among Thai Male-to-Female Transgender Adolescents

ERIC Educational Resources Information Center

Yadegarfard, Mohammadrasool; Meinhold-Bergmann, Mallika E.; Ho, Robert

2014-01-01

This study examined the influence of family rejection, social isolation, and loneliness on negative health outcomes among Thai male-to-female transgender adolescents. The sample consisted of 260 male respondents, of whom 129 (49.6%) were self-identified as transgender and 131 (50.4%) were self-identified as cisgender (nontransgender). Initial…

Addressing the Mental Health Needs of Pregnant and Parenting Adolescents

PubMed Central

Beers, Lee; Southammakosane, Cathy; Lewin, Amy

2014-01-01

Adolescent parenthood is associated with a range of adverse outcomes for young mothers, including mental health problems such as depression, substance abuse, and posttraumatic stress disorder. Teen mothers are also more likely to be impoverished and reside in communities and families that are socially and economically disadvantaged. These circumstances can adversely affect maternal mental health, parenting, and behavior outcomes for their children. In this report, we provide an overview of the mental health challenges associated with teen parenthood, barriers that often prevent teen mothers from seeking mental health services, and interventions for this vulnerable population that can be integrated into primary care services. Pediatricians in the primary care setting are in a unique position to address the mental health needs of adolescent parents because teens often turn to them first for assistance with emotional and behavioral concerns. Consequently, pediatricians can play a pivotal role in facilitating and encouraging teen parents’ engagement in mental health treatment. PMID:24298010

Weight misperception and psychosocial health in normal weight Chinese adolescents.

PubMed

Lo, Wing-Sze; Ho, Sai-Yin; Mak, Kwok-Kei; Lai, Hak-Kan; Lai, Yuen-Kwan; Lam, Tai-Hing

2011-06-01

To investigate the association between weight misperception and psychosocial health problems among normal weight Chinese adolescent boys and girls. In the Youth Smoking Survey 2003-04, 20 677 normal weight students aged 11-18 years from 85 randomly selected schools throughout Hong Kong were analysed. Students who perceived themselves as very thin, thin, fat or very fat were classified as having weight misperception in contrast to the reference group who correctly perceived themselves as normal weight. Psychosocial health outcomes included headache, feeling stressful, feeling depressed, poorer appetite, sleepless at night, having nightmares and less confidence in getting along with friends. Logistic regression yielded adjusted odds ratios (ORs) for each outcome by weight misperception in boys and girls separately. In girls, misperceived fatness was associated with all outcomes, while misperceived thinness was associated with poorer appetite and less confidence. Boys who misperceived themselves as very thin or fat had greater odds of all outcomes except having nightmares. In general, greater ORs were observed for misperceived fatness than thinness in girls, but similar ORs were observed in boys. Misperceived thinness and fatness accounted for 0.6% to 45.1% of the psychosocial health problems in adolescents. Normal weight adolescents with weight misperception were more likely to have psychosocial health problems, and the associations were stronger for extreme misperceptions (i.e., very fat or very thin) in both boys and girls.

Adolescent to Adult HIV Health Care Transition From the Perspective of Adult Providers in the United States.

PubMed

Tanner, Amanda E; Philbin, Morgan M; Ma, Alice; Chambers, Brittany D; Nichols, Sharon; Lee, Sonia; Fortenberry, J Dennis

2017-10-01

The HIV Care Continuum highlights the need for HIV-infected youth to be tested, linked, and maintained in lifelong care. Care engagement is important for HIV-infected youth in order for them to stay healthy, maintain a low viral load, and reduce further transmission. One point of potential interruption in the care continuum is during health care transition from adolescent- to adult-centered HIV care. HIV-related health care transition research focuses mainly on youth and on adolescent clinic providers; missing is adult clinic providers' perspectives. We examined health care transition processes through semi-structured interviews with 28 adult clinic staff across Adolescent Trials Network sites. We also collected quantitative data related to clinical characteristics and transition-specific strategies. Overall, participants described health care transition as a "warm handoff" and a collaborative effort across adolescent and adult clinics. Emergent transition themes included adult clinical care culture (e.g., patient responsibility), strategies for connecting youth to adult care (e.g., adolescent clinic staff attending youth's first appointment at adult clinic), and approaches to evaluating transition outcomes (e.g., data sharing). Participants provided transition improvement recommendations (e.g., formalized protocols). Using evidence-based research and a quality improvement framework to inform comprehensive and streamlined transition protocols can help enhance the capacity of adult clinics to collaborate with adolescent clinics to provide coordinated and uninterrupted HIV-related care and to improve continuum of care outcomes. Copyright © 2017 Society for Adolescent Health and Medicine. All rights reserved.

Assessment of Evaluation Frameworks for Design of a Sexual Risk Prevention Game for Black Adolescent Girls.

PubMed

Sockolow, Paulina; Joppa, Meredith; Zhu, Jichen

2018-01-01

Adolescent sexual risk behavior (SRB), a major public health problem affects urban Black adolescent girls increasing their health disparities and risks for sexually transmitted infections. Collaborating with these adolescents, we designed a game for smartphones that incorporates elements of trauma-informed care and social cognitive theory to reduce SRB. Game researchers promote use of a comprehensive, multipurpose framework for development and evaluation of games for health applications. Our first game development step was framework selection and measurable health outcomes identification. Literature search identified two health game frameworks, both incorporating pedagogical theory, learning theory, and gaming requirements. Arnab used the IM + LM-GM framework to develop and implement a game in a school intervention program. Yusoff's framework was developed for use during game design. We investigated concordance and discordance between our SRB game design characteristics and each framework's components. Findings indicated Arnab's framework was sufficiently comprehensive to guide development of our game and outcome measure selection.

The Role of Pharmacotherapy in the Treatment of Adolescent Substance Use Disorders.

PubMed

Hammond, Christopher J

2016-10-01

Adolescent substance use disorders (SUDs) are a significant public health issue due to the associated morbidity, mortality, and societal cost. While effective for some adolescents, psychosocial interventions generally produce small-to-moderate reductions in substance use. Most youth relapse within 12 months of treatment. One approach to improve outcomes is through adjunctive pharmacotherapy. Medication assisted treatments have been shown to improve adult SUD treatment outcomes, and preliminary studies in adolescents suggest that combining medication with psychosocial interventions may also enhance SUD outcomes for youth. This article presents a comprehensive review and grading of the evidence from studies conducted in adolescents with SUDs. Copyright © 2016 Elsevier Inc. All rights reserved.

Adolescents' Mental Health Outcomes According to Different Types of Exposure to Ongoing Terror Attacks

ERIC Educational Resources Information Center

Braun-Lewensohn, Orna; Celestin-Westreich, Smadar; Celestin, Leon-Patrice; Verte, Dominique; Ponjaert-Kristoffersen, Ingrid

2009-01-01

This study investigates the impact of several types of exposure to terror attacks on adolescents' psychological outcomes in the context of ongoing terror. A total of 913 adolescents (51 girls) aged 12 to 18 years (12-13.6 = 33%; 13.7-15.6 = 38%; 15.7-18 = 28%) took part in the study. Detailed data were collected concerning objective, subjective…

Parent and Adolescent Interest in Receiving Adolescent Health Communication Information From Primary Care Clinicians.

PubMed

Ford, Carol A; Cheek, Courtney; Culhane, Jennifer; Fishman, Jessica; Mathew, Leny; Salek, Elyse C; Webb, David; Jaccard, James

2016-08-01

Patient-centered health care recognizes that adolescents and parents are stakeholders in adolescent health. We investigate adolescent and parent interest in receiving information about health topics and parent-teen communication from clinicians. Ninety-one parent-adolescent dyads in one practice completed individual interviews. Items assessed levels of interest in receiving health and health communication information from the adolescent's doctor about 18 topics, including routine, mental health, sexual health, substance use, and injury prevention issues. Analyses tested differences between parents and adolescents, within-dyad correlations, and associations with adolescent gender and age. Most parents were female (84%). Adolescents were evenly divided by gender; 36 were aged 12-13 years, 35 were aged 14-15 years, and 20 were aged 16-17 years. Adolescent race reflected the practice population (60% black; 35% white). The vast majority of parents and adolescents reported moderate or high levels of interest in receiving information about all 18 health issues and information to increase parent-teen communication about these topics. Parents' interest in receiving information varied by adolescent age when the expected salience of topics varied by age (e.g., acne, driving safety), whereas adolescents reported similar interest regardless of age. Adolescent gender influenced parent and adolescent interest. Level of interest in receiving information from doctors within adolescent-parent pairs was not significantly correlated for one-half of topics. Parents and adolescents want health care professionals to help them learn and talk about a wide range of adolescent health topics. Feasible primary care interventions that effectively improve parent-teen health communication, and specific adolescent health outcomes are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

How adolescents perceive their communities: a qualitative study that explores the relationship between health and the physical environment.

PubMed

Mmari, Kristin; Lantos, Hannah; Brahmbhatt, Heena; Delany-Moretlwe, Sinead; Lou, Chaohua; Acharya, Rajib; Sangowawa, Adesola

2014-04-12

The Well-Being of Adolescents in Vulnerable Environments (WAVE) study was conducted among adolescents aged 15-19 years in Baltimore, Ibadan, Johannesburg, New Delhi, and Shanghai to examine perceived factors related to their health. A preliminary analysis of the data, unexpectedly, revealed that the influence of the physical environment on adolescent health was a dominant theme across every site examined. To explore this further, this paper analyzed the specific components of the physical environment that were perceived to influence health, and how they contributed to various health outcomes across sites. Researchers in each site conducted in-depth interviews among adolescents; community mapping and focus groups among adolescents; a Photovoice methodology, in which adolescents were trained in photography and took photos of the meaning of 'health' in their communities; and key informant interviews among adults who work with young people. A total 529 participants from across the sites were included in the analysis. Findings showed that while there was surprising uniformity in how adolescents characterized their physical environment, perceived health outcomes related to the physical environment varied by site and gender. In Baltimore and Johannesburg, vacant homes and the lack of recreation facilities were perceived to impact on sexual and reproductive health problems for girls, while among boys they contributed to drugs and violence. In Shanghai, New Delhi, and Ibadan, garbage and trash observed in their communities were perceived to have a higher impact on infectious and chronic diseases. As the world continues to urbanize, our study points to a strong need to examine how the physical aspects of a living environment contribute to the health of adolescents. Specific aspects, such as housing, safety, garbage, and recreational spaces must all be examined as possible pathways for making improvements to health of adolescents, particularly among those living in poor urban environments.

Nurses on the Front Lines: Improving Adolescent Sexual and Reproductive Health Across Health Care Settings

PubMed Central

Maria, Diane Santa; Guilamo-Ramos, Vincent; Jemmott, Loretta Sweet; Derouin, Anne; Villarruel, Antonia

2017-01-01

Nurses care for adolescents in a variety of settings, including communities, schools, and public health and acute care clinics, which affords them many opportunities to improve adolescents’ sexual and reproductive health and reduce the rates of unplanned pregnancy and sexually transmitted infections. To ensure that adolescents have access to sexual and reproductive health care (which includes both preventive counseling and treatment) in all nursing practice sites, nurses need to gain the knowledge and hone the skills required to deliver evidence-based counseling and services to adolescents and parents. Collectively, nurses can use their unique combination of knowledge and skills to make a positive impact on adolescent sexual and reproductive outcomes. Nurses have the capacity and opportunity to disseminate information about sexual and reproductive health to adolescents and their parents in communities, schools, public health clinics, and acute care settings. This article discusses the Society for Adolescent Health and Medicine’s goals and recommendations, which address adolescent sexual and reproductive health as both a health care and a human rights issue. PMID:28030408

Physical and emotional health problems experienced by youth engaged in physical fighting and weapon carrying.

PubMed

Walsh, Sophie D; Molcho, Michal; Craig, Wendy; Harel-Fisch, Yossi; Huynh, Quynh; Kukaswadia, Atif; Aasvee, Katrin; Várnai, Dora; Ottova, Veronika; Ravens-Sieberer, Ulrike; Pickett, William

2013-01-01

Then aims of the current study were 1) to provide cross-national estimates of the prevalence of physical fighting and weapon carrying among adolescents aged 11-15 years; (2) To examine the possible effects of physical fighting and weapon carrying on the occurrence of physical (medically treated injuries) and emotional health outcomes (multiple health complaints) among adolescents within the theoretical framework of Problem Behaviour Theory. 20,125 adolescents aged 11-15 in five countries (Belgium, Israel, USA, Canada, FYR Macedonia) were surveyed via the 2006 Health Behaviour in School Aged Children survey. Prevalence was calculated for physical fighting and weapon carrying along with physical and emotional measures that potentially result from violence. Regression analyses were used to quantify associations between violence/weapon carrying and the potential health consequences within each country. Large variations in fighting and weapon carrying were observed across countries. Boys reported more frequent episodes of fighting/weapon carrying and medically attended injuries in every country, while girls reported more emotional symptoms. Although there were some notable variations in findings between different participating countries, increased weapon carrying and physical fighting were both independently and consistently associated with more frequent reports of the potential health outcomes. Adolescents engaging in fighting and weapon carrying are also at risk for physical and emotional health outcomes. Involvement in fighting and weapon carrying can be seen as part of a constellation of risk behaviours with obvious health implications. Our findings also highlight the importance of the cultural context when examining the nature of violent behaviour for adolescents.

Physical and Emotional Health Problems Experienced by Youth Engaged in Physical Fighting and Weapon Carrying

PubMed Central

Walsh, Sophie D.; Molcho, Michal; Craig, Wendy; Harel-Fisch, Yossi; Huynh, Quynh; Kukaswadia, Atif; Aasvee, Katrin; Várnai, Dora; Ottova, Veronika; Ravens-Sieberer, Ulrike; Pickett, William

2013-01-01

Then aims of the current study were 1) to provide cross-national estimates of the prevalence of physical fighting and weapon carrying among adolescents aged 11–15 years; (2) To examine the possible effects of physical fighting and weapon carrying on the occurrence of physical (medically treated injuries) and emotional health outcomes (multiple health complaints) among adolescents within the theoretical framework of Problem Behaviour Theory. 20,125 adolescents aged 11–15 in five countries (Belgium, Israel, USA, Canada, FYR Macedonia) were surveyed via the 2006 Health Behaviour in School Aged Children survey. Prevalence was calculated for physical fighting and weapon carrying along with physical and emotional measures that potentially result from violence. Regression analyses were used to quantify associations between violence/weapon carrying and the potential health consequences within each country. Large variations in fighting and weapon carrying were observed across countries. Boys reported more frequent episodes of fighting/weapon carrying and medically attended injuries in every country, while girls reported more emotional symptoms. Although there were some notable variations in findings between different participating countries, increased weapon carrying and physical fighting were both independently and consistently associated with more frequent reports of the potential health outcomes. Adolescents engaging in fighting and weapon carrying are also at risk for physical and emotional health outcomes. Involvement in fighting and weapon carrying can be seen as part of a constellation of risk behaviours with obvious health implications. Our findings also highlight the importance of the cultural context when examining the nature of violent behaviour for adolescents. PMID:23437126

Perceived Racial/Ethnic Discrimination, Problem Behaviors, and Mental Health among Minority Urban Youth

PubMed Central

Tobler, Amy L.; Maldonado-Molina, Mildred M.; Staras, Stephanie A.; O’Mara, Ryan J.; Livingston, Melvin D.; Komro, Kelli A.

2013-01-01

Objectives We examined perceived frequency and intensity of racial/ethnic discrimination and associations with high-risk behaviors/conditions among adolescents. Design With surveys from 2,490 primarily low socioeconomic status, racial/ethnic minority adolescents, we used regression analysis to examine associations between racial/ethnic discrimination and behavioral health outcomes (alcohol use, marijuana use, physical aggression, delinquency, victimization, depression, suicidal ideation, and sexual behaviors). Results Most adolescents (73%) experienced racial/ethnic discrimination and 42% of experiences were “somewhat-” or “very disturbing.” Adolescents reporting frequent and disturbing racial/ethnic discrimination were at increased risk of all measured behaviors, except alcohol and marijuana use. Adolescents who experienced any racial/ethnic discrimination were at increased risk for victimization and depression. Regardless of intensity, adolescents who experienced racial/ethnic discrimination at least occasionally were more likely to report greater physical aggression, delinquency, suicidal ideation, younger age at first oral sex, unprotected sex during last intercourse, and more lifetime sexual partners. Conclusion Most adolescents had experienced racial/ethnic discrimination due to their race/ethnicity. Even occasional experiences of racial/ethnic discrimination likely contribute to maladaptive behavioral and mental health outcomes among adolescents. Prevention and coping strategies are important targets for intervention. PMID:23043428

Perceived racial/ethnic discrimination, problem behaviors, and mental health among minority urban youth.

PubMed

Tobler, Amy L; Maldonado-Molina, Mildred M; Staras, Stephanie A S; O'Mara, Ryan J; Livingston, Melvin D; Komro, Kelli A

2013-01-01

We examined perceived frequency and intensity of racial/ethnic discrimination and associations with high-risk behaviors/conditions among adolescents. With surveys from 2490 racial/ethnic minority adolescents primarily with low socioeconomic status, we used regression analysis to examine associations between racial/ethnic discrimination and behavioral health outcomes (alcohol use, marijuana use, physical aggression, delinquency, victimization, depression, suicidal ideation, and sexual behaviors). Most adolescents (73%) experienced racial/ethnic discrimination and 42% of experiences were 'somewhat-' or 'very disturbing.' Adolescents reporting frequent and disturbing racial/ethnic discrimination were at increased risk of all measured behaviors, except alcohol and marijuana use. Adolescents who experienced any racial/ethnic discrimination were at increased risk for victimization and depression. Regardless of intensity, adolescents who experienced racial/ethnic discrimination at least occasionally were more likely to report greater physical aggression, delinquency, suicidal ideation, younger age at first oral sex, unprotected sex during last intercourse, and more lifetime sexual partners. Most adolescents had experienced racial/ethnic discrimination due to their race/ethnicity. Even occasional experiences of racial/ethnic discrimination likely contribute to maladaptive behavioral and mental health outcomes among adolescents. Prevention and coping strategies are important targets for intervention.

Early Adolescent Relationship Predictors of Emerging Adult Outcomes: Youth with and without Type 1 Diabetes

PubMed Central

Helgeson, Vicki S.; Palladino, Dianne K.; Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

2013-01-01

Background Emerging adulthood is a high-risk period for mental health problems and risk behaviors for youth generally and for physical health problems among those with type 1 diabetes. Purpose To examine whether adolescents’ relationships with parents and friends predict health and risk behaviors during emerging adulthood. Method Youth with and without diabetes were enrolled at average age 12 and followed for 7 years. Parent and friend relationship variables, measured during adolescence, were used to predict emerging adulthood outcomes: depression, risk behavior, and, for those with diabetes, diabetes outcomes. Results Parent relationship quality predicted decreased depressive symptoms and, for those with diabetes, decreased alcohol use. Parent control predicted increased smoking, reduced college attendance, and, for control participants, increased depressive symptoms. For those with diabetes, parent control predicted decreased depressive symptoms and better self-care. Friend relationship variables predicted few outcomes. Conclusions Adolescent parent relationships remain an important influence on emerging adults’ lives. PMID:24178509

Family leadership styles and adolescent dietary and physical activity behaviors: a cross-sectional study.

PubMed

Morton, Katie L; Wilson, Alexandra H; Perlmutter, Lisa S; Beauchamp, Mark R

2012-04-30

Transformational leadership is conceptualized as a set of behaviors designed to inspire, energize and motivate others to achieve higher levels of functioning, and is associated with salient health-related outcomes in organizational settings. Given (a) the similarities that exist between leadership within organizational settings and parenting within families, and (b) the importance of the family environment in the promotion of adolescent health-enhancing behaviors, the purpose of this exploratory study was to examine the cross-sectional relationships between parents' transformational leadership behaviors and adolescent dietary and physical activity behaviors. 857 adolescents (aged 13-15, mean age = 14.70 yrs) completed measures of transformational parenting behaviors, healthful dietary intake and leisure-time physical activity. Regression analyses were conducted to examine relationships between family transformational leadership and adolescent health outcomes. A further 'extreme group analysis' was conducted by clustering families based on quartile splits. A MANCOVA (controlling for child gender) was conducted to examine differences between families displaying (a) HIGH levels of transformational parenting (consistent HIGH TP), (b) LOW levels of transformational parenting (consistent LOW TP), and (c) inconsistent levels of transformational parenting (inconsistent HIGH-LOW TP). Results revealed that adolescents' perceptions of family transformational parenting were associated with both healthy dietary intake and physical activity. Adolescents who perceived their families to display the highest levels of transformational parenting (HIGH TP group) displayed greater healthy eating and physical activity behaviors than adolescents who perceived their families to display the lowest levels of transformational parenting behaviors (LOW TP group). Adolescents who perceived their families to display inconsistent levels of transformational parenting behaviors (HIGH-LOW TP group) displayed the same levels of healthy eating behaviors as those adolescents from the LOW TP group. For physical activity behaviors, adolescents who perceived their families to display inconsistent levels of transformational parenting behaviors (HIGH-LOW TP group) did not differ in terms of physical activity than those in either the HIGH TP or LOW TP group. Family transformational parenting behaviors were positively associated with both healthful dietary intake and leisure-time physical activity levels amongst adolescents. The findings suggest that transformational leadership theory is a useful framework for understanding the relationship between family leadership behaviors and adolescent health outcomes.

Physical Activity and Screen-based Activity in Healthy Development of School-aged Children.

PubMed

Hamřík, Zdeněk; Bobáková, Daniela; Kalman, Michal; Veselská, Zuzana Dankulincová; Klein, Daniel; Gecková, Andrea Madarasová

2015-11-01

Physical and screen-based activity in adolescents plays a crucial role in future health outcomes. Therefore, the aim of the study was to examine the associations of physical activity and screen-based activity with behavioural and psychosocial characteristics of school-aged children. Data on 11, 13 and 15 years old elementary school pupils (N=9,014; mean age=13.59) who participated in the cross-sectional Health Behaviour in School-aged Children 2009/2010 study in the Czech Republic and the Slovak Republic were analyzed. The associations of vigorous physical activity and screen-based activity with substance use, violent behaviour, eating habits and school-related outcomes adjusted for age were explored using logistic regression. Vigorous physical activity was positively associated with some of the health-related behaviours (smoking, breakfast consumption, vegetable and fruit consumption) and school related outcomes (perceived school achievement and school pressure), with gender and country based differences. Screen-based activity was significantly associated with all examined health-related behaviours and school related outcomes with only some country and gender based differences. Vigorous physical activity is positively associated with healthy development of adolescents. Screen-based behaviour shows an inverse relationship with adolescents' healthy development, especially in the group of 11 and 13 years old children. Supporting physical activity conducive environments might lead to a reduction in screen-based behaviour in adolescents and should be highlighted in health-promoting strategies. Copyright© by the National Institute of Public Health, Prague 2015.

Examining the Efficacy of an mHealth Media Literacy Education Program for Sexual Health Promotion in Older Adolescents Attending Community College

ERIC Educational Resources Information Center

Scull, Tracy Marie; Kupersmidt, Janis Beth; Malik, Christina Valerie; Keefe, Elyse Mallory

2018-01-01

Objective: To determine the feasibility of a mobile health (mHealth), media literacy education program, "Media Aware", for improving sexual health outcomes in older adolescent community college students. Participants: 184 community college students (ages 18-19) participated in the study from April-December 2015. Methods: Eight community…

Body weight, self-perception and mental health outcomes among adolescents.

PubMed

Ali, Mir M; Fang, Hai; Rizzo, John A

2010-06-01

The prevalence of childhood obesity in the United States has increased three-fold over the last thirty years. During the same period, the prevalence of depressive symptoms in children also rose significantly. Previous literature suggests an association between actual body weight and mental health, but there is little evidence on self-perception of weight and mental health status. To examine the relationship between actual body weight, self-perception of body weight and mental health outcomes among adolescents. Using data for a nationally-representative sample of adolescents in the United States, we ascertain the effect of body weight status on depressive symptoms by estimating endogeneity-corrected models including school-level fixed effects to account for bi-directionality and unobserved confounders. Actual body weight status was calculated using interviewer-measured height and weight. We also used a measure of self-perceived weight status to compare how actual versus self-perceived weight status affects mental health. The Rosenberg Self-Esteem (RSE) Scale, Center for Epidemiologic Studies Depression (CES-D) Scale, and a dichotomous version of self-reported indicator for depression were utilized as mental health indicators. Potential mediators between mental health and weight status such as levels of physical activity, participation in risky health behaviors and parental characteristics were also controlled for in the analysis. The analytical sample consisted of 13,454 adolescents aged 11 to 18. After accounting for a wide array of relevant characteristics, we did not find a direct and significant association between actual weight status and mental health outcomes. Instead, our analysis revealed a strongly negative and significant relationship between self-perceived weight status and mental health. The negative relationship between self-perceived weight and depressive symptoms was more pronounced among females. The RSE scale was particularly correlated with body weight perceptions, suggesting a potentially important link between weight perception and self esteem. While the data set has rich detail on body weight and mental health outcomes, it lacks information on weight stigmatization. The complex relationships between actual body weight, self-perception of weight and weight stigmatization also limit determination of causality. The results from this study highlight the role of body weight perceptions in influencing mental health outcomes independent of actual weight status, especially among female adolescents. This suggests that policies aimed at improving mental health outcomes among adolescents might benefit from a focus on increasing awareness about healthy attitudes towards weight. Recent studies have found evidence that weight stigmatization and body dissatisfaction are predictors of depressive symptoms. It may be that the causal pathway between perceived weight status and depression occurs through weight stigmatization and body dissatisfaction. Future studies should investigate this causal mechanism further.

Can Social Support Protect Bullied Adolescents from Adverse Outcomes? A Prospective Study on the Effects of Bullying on the Educational Achievement and Mental Health of Adolescents at Secondary Schools in East London

ERIC Educational Resources Information Center

Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen

2011-01-01

This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to…

Perceived financial status, health, and maladjustment in adolescence.

PubMed

Hamilton, Hayley A; Noh, Samuel; Adlaf, Edward M

2009-04-01

This study examines the relationship between adolescent perception of family financial status and diverse aspects of health and maladjustment. Data were derived from the 2005 Ontario Student Drug Use Survey of 7th-12th grade students in ontario, Canada. This biennial survey monitors mental and physical health, substance use, and delinquent behavior in adolescent students. Results indicate that the significance of perceived financial status varies across adolescent outcomes. Greater emotional distress and lower self-rated health are associated with a perception of below average financial status. The associations of illicit drug use and hazardous and harmful drinking with perceived financial status vary for younger and older adolescents. Adjustments for parental education highlight differences in the influences of perceived financial status and parental education on health and behavior. Results highlight the utility of perceived family financial status in examinations of adolescent health and behavior, and the importance of examining diverse aspects of health and maladjustment.

A systematic review of the association between family meals and adolescent risk outcomes.

PubMed

Goldfarb, Samantha S; Tarver, Will L; Locher, Julie L; Preskitt, Julie; Sen, Bisakha

2015-10-01

To conduct a systematic review of the literature examining the relationship between family meals and adolescent health risk outcomes. We performed a systematic search of original empirical studies published between January 1990 and September 2013. Based on data from selected studies, we conducted logistic regression models to examine the correlates of reporting a protective association between frequent family meals and adolescent outcomes. Of the 254 analyses from 26 selected studies, most reported a significant association between family meals and the adolescent risk outcome-of-interest. However, model analyses which controlled for family connectedness variables, or used advanced empirical methods to account for family-level confounders, were less likely than unadjusted models to report significant relationships. The type of analysis conducted was significantly associated with the likelihood of finding a protective relationship between family meals and the adolescent outcome-of-interest, yet very few studies are using such methods in the literature. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Perspectives on high-intensity interval exercise for health promotion in children and adolescents

PubMed Central

Bond, Bert; Weston, Kathryn L; Williams, Craig A; Barker, Alan R

2017-01-01

Physical activity lowers future cardiovascular disease (CVD) risk; however, few children and adolescents achieve the recommended minimum amount of daily activity. Accordingly, there is virtue in identifying the efficacy of small volumes of high-intensity exercise for health benefits in children and adolescents for the primary prevention of CVD risk. The purpose of this narrative review is to provide a novel overview of the available literature concerning high-intensity interval-exercise (HIIE) interventions in children and adolescents. Specifically, the following areas are addressed: 1) outlining the health benefits observed following a single bout of HIIE, 2) reviewing the role of HIIE training in the management of pediatric obesity, and 3) discussing the effectiveness of school-based HIIE training. In total, 39 HIIE intervention studies were included in this review. Based upon the available data, a single bout of high-intensity exercise provides a potent stimulus for favorable, acute changes across a range of cardiometabolic outcomes that are often superior to a comparative bout of moderate-intensity exercise (14 studies reviewed). HIIE also promotes improvements in cardiorespiratory fitness and cardiometabolic health status in overweight and obese children and adolescents (10 studies reviewed) and when delivered in the school setting (15 studies reviewed). We thus conclude that high-intensity exercise is a feasible and potent method of improving a range of cardiometabolic outcomes in children and adolescents. However, further work is needed to optimize the delivery of HIIE interventions in terms of participant enjoyment and acceptability, to include a wider range of health outcomes, and to control for important confounding variables (eg, changes in diet and habitual physical activity). Finally, research into the application of HIIE training interventions to children and adolescents of different ages, sexes, pubertal status, and sociocultural backgrounds is required. PMID:29225481

Does sex education affect adolescent sexual behaviors and health?

PubMed

Sabia, Joseph J

2006-01-01

This study examines whether offering sex education to young teenagers affects several measures of adolescent sexual behavior and health: virginity status, contraceptive use, frequency of intercourse, likelihood of pregnancy, and probability of contracting a sexually transmitted disease. Using data from the National Longitudinal Study of Adolescent Health, I find that while sex education is associated with adverse health outcomes, there is little evidence of a causal link after controlling for unobserved heterogeneity via fixed effects and instrumental variables. These findings suggest that those on each side of the ideological debate over sex education are, in a sense, both correct and mistaken. Opponents are correct in observing that sex education is associated with adverse health outcomes, but are generally incorrect in interpreting this relationship causally. Proponents are generally correct in claiming that sex education does not encourage risky sexual activity, but are incorrect in asserting that investments in typical school-based sex education programs produce measurable health benefits.

How adolescents perceive their communities: a qualitative study that explores the relationship between health and the physical environment

PubMed Central

2014-01-01

Background The Well-Being of Adolescents in Vulnerable Environments (WAVE) study was conducted among adolescents aged 15-19 years in Baltimore, Ibadan, Johannesburg, New Delhi, and Shanghai to examine perceived factors related to their health. A preliminary analysis of the data, unexpectedly, revealed that the influence of the physical environment on adolescent health was a dominant theme across every site examined. To explore this further, this paper analyzed the specific components of the physical environment that were perceived to influence health, and how they contributed to various health outcomes across sites. Methods Researchers in each site conducted in-depth interviews among adolescents; community mapping and focus groups among adolescents; a Photovoice methodology, in which adolescents were trained in photography and took photos of the meaning of ‘health’ in their communities; and key informant interviews among adults who work with young people. A total 529 participants from across the sites were included in the analysis. Results Findings showed that while there was surprising uniformity in how adolescents characterized their physical environment, perceived health outcomes related to the physical environment varied by site and gender. In Baltimore and Johannesburg, vacant homes and the lack of recreation facilities were perceived to impact on sexual and reproductive health problems for girls, while among boys they contributed to drugs and violence. In Shanghai, New Delhi, and Ibadan, garbage and trash observed in their communities were perceived to have a higher impact on infectious and chronic diseases. Conclusions As the world continues to urbanize, our study points to a strong need to examine how the physical aspects of a living environment contribute to the health of adolescents. Specific aspects, such as housing, safety, garbage, and recreational spaces must all be examined as possible pathways for making improvements to health of adolescents, particularly among those living in poor urban environments. PMID:24726018

Using a Framework to Explore Associations between Parental Substance Use and the Health Outcomes of Their Adolescent Children

ERIC Educational Resources Information Center

Francis, Shelley A.

2011-01-01

Risk-taking behavior plays a significant role in the lives of adolescents. Adolescents engaging in risk behaviors such as substance use and risky sexual activity are at increased risk for contracting STDs, unplanned pregnancy, and other health problems. Consequently, children of substance abusers are at even greater risk for engaging in…

Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster-Randomized Trial in Ghana.

PubMed

Rokicki, Slawa; Cohen, Jessica; Salomon, Joshua A; Fink, Günther

2017-02-01

To evaluate whether text-messaging programs can improve reproductive health among adolescent girls in low- and middle-income countries. We conducted a cluster-randomized controlled trial among 756 female students aged 14 to 24 years in Accra, Ghana, in 2014. We randomized 38 schools to unidirectional intervention (n = 12), interactive intervention (n = 12), and control (n = 14). The unidirectional intervention sent participants text messages with reproductive health information. The interactive intervention engaged adolescents in text-messaging reproductive health quizzes. The primary study outcome was reproductive health knowledge at 3 and 15 months. Additional outcomes included self-reported pregnancy and sexual behavior. Analysis was by intent-to-treat. From baseline to 3 months, the unidirectional intervention increased knowledge by 11 percentage points (95% confidence interval [CI] = 7, 15) and the interactive intervention by 24 percentage points (95% CI = 19, 28), from a control baseline of 26%. Although we found no changes in reproductive health outcomes overall, both unidirectional (odds ratio [OR] = 0.14; 95% CI = 0.03, 0.71) and interactive interventions (OR = 0.15; 95% CI = 0.03, 0.86) lowered odds of self-reported pregnancy for sexually active participants. Text-messaging programs can lead to large improvements in reproductive health knowledge and have the potential to lower pregnancy risk for sexually active adolescent girls.

Advancing adolescent sexual and reproductive health by promoting healthy relationships.

PubMed

Tharp, Andra Teten; Carter, Marion; Fasula, Amy M; Hatfield-Timajchy, Kendra; Jayne, Paula E; Latzman, Natasha E; Kinsey, Jennine

2013-11-01

The field of public health faces a challenge in preventing adverse sexual and reproductive health outcomes such as sexually transmitted diseases, unintended pregnancy, and dating and sexual violence among adolescents. Innovative approaches are needed to better address these issues. Focusing on healthy relationships is an emerging approach that may be used to promote adolescent sexual and reproductive health. In this report, we discuss the need for innovative and efficient strategies for adolescent sexual and reproductive health, the benefits of a healthy relationships approach, describe the need for a science-based conceptual framework on healthy relationships, and provide some considerations for developing a conceptual framework of healthy relationships in order to move the field of public health forward.

Youth Psychotherapy Change Trajectories and Outcomes in Usual Care: Community Mental Health versus Managed Care Settings

ERIC Educational Resources Information Center

Warren, Jared S.; Nelson, Philip L.; Mondragon, Sasha A.; Baldwin, Scott A.; Burlingame, Gary M.

2010-01-01

Objective: The authors compared symptom change trajectories and treatment outcome categories in children and adolescents receiving routine outpatient mental health services in a public community mental health system and a private managed care organization. Method: Archival longitudinal outcome data from parents completing the Youth Outcome…

Parent-adolescent communication and diabetes: an integrative review.

PubMed

Dashiff, Carol; Hardeman, Traci; McLain, Rhonda

2008-04-01

This paper presents a synthesis of findings from empirical studies about communication and interaction between parents and their adolescents with diabetes. Communication between parent and adolescent is essential in transitioning the adolescent to increased responsibility for diabetes self-management. Nurses are in a pivotal position to enhance the type of parent-adolescent communication that facilitates this transition. A search of published studies from 1985 to 2006 featuring communication or interaction between parents and adolescents with type 1 diabetes was implemented through a computerized search. Papers were organized by type of evidence and were analysed sequentially. Sources were described based on data elements which were extracted. Findings in the areas of productive and problematic parent-adolescent communications were included. Data elements were compared and critiqued, noting consistencies, and findings were summarized and evaluated. Studies across several countries indicate that maternal support, conflict, control, involvement and emotional expression are important communication concepts that are linked to diabetes outcomes in adolescents. The influences of different family structures and cultural and socioeconomic circumstances, as well as developmental status and gender of adolescents on these types of communication, have not been systematically studied. Nurses caring for adolescents with type 1 diabetes need to consider family relationships and communication patterns in achieving health outcomes. Studies of communication, including perspectives of mothers and fathers, and the influence of family structure, economics and culture are needed to build a framework of parent-adolescent interaction and health outcomes for adolescents with type 1 diabetes.

Sexual orientation, parental support, and health during the transition to young adulthood.

PubMed

Needham, Belinda L; Austin, Erika L

2010-10-01

Some recent studies suggest that sexual minorities may have worse health-related outcomes during adolescence because they report lower levels of family connectedness, a key protective resource. Using data from wave 3 of the National Longitudinal Study of Adolescent Health (n = 11,153; 50.6% female; mean age = 21.8 years), this study extends prior research on adolescents to young adults. We examine whether lesbian, gay, and bisexual (LGB) young adults report lower levels of parental support than their heterosexual peers and whether differences in parental support help explain why LGB young adults tend to have worse health-related outcomes. We find that lesbian and bisexual women report lower levels of parental support than heterosexual women and that gay men report lower levels of parental support than bisexual and heterosexual men. Compared to heterosexual women, lesbian and bisexual women have higher odds of suicidal thoughts and recent drug use; bisexual women also have higher odds of elevated depressive symptomatology and heavy drinking. Gay men have higher odds of suicidal thoughts than heterosexual men. With the exception of heavy drinking, parental support either partially or fully mediates each of the observed associations. Even though the transition from adolescence to young adulthood is characterized by increased independence from parents, parental support remains an important correlate of health-related outcomes during this stage of life. Sexual minorities report lower levels of parental support during young adulthood, which helps explain why they have worse health-related outcomes. Interventions designed to strengthen relationships between LGB young adults and their parents could lead to a reduction in health disparities related to sexual orientation.

Comparison of neurological health outcomes between two adolescent cohorts exposed to pesticides in Egypt.

PubMed

Ismail, Ahmed A; Bonner, Matthew R; Hendy, Olfat; Abdel Rasoul, Gaafar; Wang, Kai; Olson, James R; Rohlman, Diane S

2017-01-01

Pesticide-exposed adolescents may have a higher risk of neurotoxic effects because of their developing brains and bodies. However, only a limited number of studies have addressed this risk among adolescents. The aim of this study was to compare neurological outcomes from two cohorts of Egyptian adolescents working as pesticide applicators. In 2005 and 2009, two cohorts of male adolescents working as pesticide applicators for the cotton crop were recruited from Menoufia Governorate, Egypt. The same application schedule and pesticides were used at both times, including both organophosphorus, and pyrethroid compounds. Participants in both cohorts completed three neurobehavioral tests, health and exposure questionnaires, and medical and neurological screening examinations. In addition, blood samples were collected to measure butyryl cholinesterase (BChE) activity. Pesticide applicators in both cohorts reported more neurological symptoms and signs than non-applicators, particularly among participants in the 2005 cohort (OR ranged from 1.18 to 15.3). Except for one test (Trail Making B), there were no significant differences between either applicators or non-applicators of both cohorts on the neurobehavioral outcome measures (p > 0.05). The 2005 cohort showed greater inhibition of serum BChE activity than the 2009 cohort (p < 0.05). In addition, participants with depressed BChE activity showed more symptoms and signs than others without BChE depression (p < 0.05). Our study is the first to examine the consistency of health outcomes associated with pesticide exposure across two cohorts tested at different times from the same geographical region in rural Egypt. This similar pattern of findings across the two cohorts provides strong evidence of the health impact of exposure of adolescents to pesticides.

Economic volatility in childhood and subsequent adolescent mental health problems: a longitudinal population-based study of adolescents

PubMed Central

Bøe, Tormod; Skogen, Jens Christoffer; Sivertsen, Børge; Hysing, Mari; Petrie, Keith J; Dearing, Eric; Zachrisson, Henrik Daae

2017-01-01

Objective The aim of the current paper was to investigate the association between the patterns of duration, timing and sequencing of exposure to low family income during childhood, and symptoms of mental health problems in adolescence. Setting Survey administered to a large population-based sample of Norwegian adolescents. Participants Survey data from 9154 participants of 16–19 years age (53% participation rate; 52.7% girls) were linked to registry-based information about childhood family income from tax return data. Outcome measures Mental health outcomes were symptoms of emotional, conduct, hyperactivity, peer problems and general mental health problems measured with the Strengths and Difficulties Questionnaire, symptoms of depression measured with Short Mood and Feelings Questionnaire and symptoms of attention-deficit/hyperactivity disorder (ADHD) measured with the Adult ADHD Self-Report Scale. Results Latent class analysis and the BCH approach in Mplus were used to examine associations between patterns of poverty exposure and mental health outcomes. Four latent classes of poverty exposure emerged from the analysis. Participants moving into poverty (2.3%), out of poverty (3.5%) or those chronically poor (3.1%) had more symptoms of mental health problems (Cohen’s d=16-.50) than those with no poverty exposure (91.1%). This pattern was, however, not found for symptoms of ADHD. The pattern of results was confirmed in robustness checks using observed data. Conclusions Exposure to poverty in childhood was found to be associated with most mental health problems in adolescence. There was no strong suggestion of any timing or sequencing effects in the patterns of associations. PMID:28928191

Using Epidemiologic Methods to Test Hypotheses regarding Causal Influences on Child and Adolescent Mental Disorders

ERIC Educational Resources Information Center

Lahey, Benjamin B.; D'Onofrio, Brian M.; Waldman, Irwin D.

2009-01-01

Epidemiology uses strong sampling methods and study designs to test refutable hypotheses regarding the causes of important health, mental health, and social outcomes. Epidemiologic methods are increasingly being used to move developmental psychopathology from studies that catalogue correlates of child and adolescent mental health to designs that…

A Media Literacy Education Approach to Teaching Adolescents Comprehensive Sexual Health Education

ERIC Educational Resources Information Center

Scull, Tracy Marie; Malik, Christina V.; Kupersmidt, Janis Beth

2014-01-01

As states are moving toward comprehensive sexual health education, educators require engaging and effective curricula. This pre-post study (N = 64) examined the feasibility of a comprehensive, media literacy education program for influencing adolescents' sexual health and media literacy outcomes. After the program, participants were more likely to…

Preparing the Next Generation for Electoral Engagement: Social Studies and the School Context

ERIC Educational Resources Information Center

Callahan, Rebecca M.; Muller, Chandra; Schiller, Kathryn S.

2010-01-01

In an era of accountability focused primarily on academic outcomes, it may be useful to reconsider the other original aim of U.S. schools: citizenship development. Using longitudinal, nationally representative data (Adolescent Health and Academic Achievement Study [AHAA] and the National Longitudinal Study of Adolescent Health [Add Health]), we…

Predictors of Birth Weight and Gestational Age Among Adolescents

PubMed Central

Harville, Emily W.; Madkour, Aubrey Spriggs; Xie, Yiqiong

2012-01-01

Although pregnant adolescents are at high risk of poor birth outcomes, the majority of adolescents go on to have full-term, healthy babies. Data from the National Longitudinal Study of Adolescent Health, a longitudinal study of a nationally representative sample of adolescents in grades 7–12 in the United States who were surveyed from 1994–1995 through 2008, were used to examine the epidemiology of preterm birth and low birth weight within this population. Outcomes of pregnancies were reported by participants in the fourth wave of data collection (when participants were 24–32 years of age); data were compared between female participants who reported a first singleton livebirth at less than 20 years of age (n = 1,101) and those who were 20 years of age or older (n = 2,846). Multivariable modeling was used to model outcomes; predictors included demographic characteristics and maternal health and behavior. Among black adolescents, low parental educational levels and older age at pregnancy were associated with higher birth weight, whereas low parental educational levels and being on birth control when one got pregnant were associated with higher gestational age. In nonblack adolescents, lower body mass index was associated with lower birth weight, whereas being unmarried was associated with lower gestational age. Predictors of birth outcomes may differ by age group and social context. PMID:23035139

Family leadership styles and adolescent dietary and physical activity behaviors: a cross-sectional study

PubMed Central

2012-01-01

Background Transformational leadership is conceptualized as a set of behaviors designed to inspire, energize and motivate others to achieve higher levels of functioning, and is associated with salient health-related outcomes in organizational settings. Given (a) the similarities that exist between leadership within organizational settings and parenting within families, and (b) the importance of the family environment in the promotion of adolescent health-enhancing behaviors, the purpose of this exploratory study was to examine the cross-sectional relationships between parents’ transformational leadership behaviors and adolescent dietary and physical activity behaviors. Methods 857 adolescents (aged 13–15, mean age = 14.70 yrs) completed measures of transformational parenting behaviors, healthful dietary intake and leisure-time physical activity. Regression analyses were conducted to examine relationships between family transformational leadership and adolescent health outcomes. A further ‘extreme group analysis’ was conducted by clustering families based on quartile splits. A MANCOVA (controlling for child gender) was conducted to examine differences between families displaying (a) HIGH levels of transformational parenting (consistent HIGH TP), (b) LOW levels of transformational parenting (consistent LOW TP), and (c) inconsistent levels of transformational parenting (inconsistent HIGH-LOW TP). Results Results revealed that adolescents’ perceptions of family transformational parenting were associated with both healthy dietary intake and physical activity. Adolescents who perceived their families to display the highest levels of transformational parenting (HIGH TP group) displayed greater healthy eating and physical activity behaviors than adolescents who perceived their families to display the lowest levels of transformational parenting behaviors (LOW TP group). Adolescents who perceived their families to display inconsistent levels of transformational parenting behaviors (HIGH-LOW TP group) displayed the same levels of healthy eating behaviors as those adolescents from the LOW TP group. For physical activity behaviors, adolescents who perceived their families to display inconsistent levels of transformational parenting behaviors (HIGH-LOW TP group) did not differ in terms of physical activity than those in either the HIGH TP or LOW TP group. Conclusions Family transformational parenting behaviors were positively associated with both healthful dietary intake and leisure-time physical activity levels amongst adolescents. The findings suggest that transformational leadership theory is a useful framework for understanding the relationship between family leadership behaviors and adolescent health outcomes. PMID:22546151

Individual and collective exposure to political violence: Palestinian adolescents coping with conflict.

PubMed

Giacaman, Rita; Shannon, Harry S; Saab, Hana; Arya, Neil; Boyce, Will

2007-08-01

We conducted a survey of Palestinian adolescents in school. We hypothesized that collective and individual exposures to violence would both negatively affect adolescents' mental health. We also anticipated that the negative effect of collective exposures on mental health would be less than that of individual exposures. Our analysis was designed to test these hypotheses. A representative sample of 3415 students of 10th and 11th grades from the Ramallah District of the West Bank participated in the survey. The primary independent variables were scales of individual and collective exposures to trauma/violence (ETV) by the Israeli military and settlers. Factor analysis revealed several sub-scales. Outcome measures were constructed and included: a binary measure of depressive-like states, and emotional, depressive-like state, and somatic scales. Several variables were identified as possible covariates: gender, age, school-type, residence, employment status of father, and identity documents held. Logistic and multiple regression analyses revealed a strong relationship between ETV and adolescents' mental health, with both individual and collective exposures having independent effects. There was a higher prevalence of depressive-like symptoms among girls compared with boys, and in adolescents living in Palestinian refugee camps compared with those living in cities, towns and villages. The findings confirmed our hypothesis that both individual and collective ETV independently affect the mental health of adolescents. Contrary to expectations, individual exposures did not consistently have a greater negative effect on health outcomes than collective exposures, although the sub-scale of direct personal exposures to violence consistently showed the strongest effect among sub-scales. The results emphasize the importance of going beyond individual experiences and including the health outcomes of collective violation when analyzing violent and traumatic contexts.

What predictors matter: Risk factors for late adolescent outcomes.

PubMed

Wall-Wieler, Elizabeth; Roos, Leslie L; Chateau, Dan G; Rosella, Laura C

2016-06-27

A life course approach and linked Manitoba data from birth to age 18 were used to facilitate comparisons of two important outcomes: high school graduation and Attention-Deficit/Hyperactivity Disorder (ADHD). With a common set of variables, we sought to answer the following questions: Do the measures predicting high school graduation differ from those that predict ADHD? Which factors are most important? How well do the models fit each outcome? Administrative data from the Population Health Research Data Repository at the Manitoba Centre for Health Policy were used to conduct one of the strongest observational designs: multilevel modelling of large population (n = 62,739) and sibling (n = 29,444) samples. Variables included are neighbourhood characteristics, measures of family stability, and mental and physical health conditions in childhood and adolescence. The adverse childhood experiences important for each outcome differ. While family instability and economic adversity more strongly affect failing to graduate from high school, adverse health events in childhood and early adolescence have a greater effect on late adolescent ADHD. The variables included in the model provided excellent accuracy and discrimination. These results offer insights on the role of several family and social variables and can serve as the basis for reliable, valid prediction tools that can identify high-risk individuals. Applying such a tool at the population level would provide insight into the future burden of these outcomes in an entire region or nation and further quantify the burden of risk in the population.

Factors associated with unhealthy behaviours and health outcomes: a cross-sectional study among Tuscan adolescents (Italy).

PubMed

Lazzeri, Giacomo; Azzolini, Elena; Pammolli, Andrea; Simi, Rita; Meoni, Veronica; Giacchi, Mariano Vincenzo

2014-09-25

We aimed to determine the extent to which three core variables (school environment, peer group and family affluence) were associated with unhealthy behaviours and health outcomes among Tuscan adolescents. The unhealthy behaviours considered were smoking, alcohol consumption, sedentary lifestyle and irregular breakfast consumption; health outcomes were classified as self-reported health, multiple health complaints and life satisfaction. School environment was measured in terms of liking school, school pressure, academic achievement and classmate support; peer groups were evaluated in terms of the number of peers and frequency of peer contact. Family affluence was measured on a socioeconomic scale. Data were taken from the Tuscan 2009/10 survey of "Health Behaviour in School-aged Children", a WHO cross-national survey. A binary logistic multiple regression (95% confidence intervals) was implemented. The total sample comprised 3291 school students: 1135 11-year-olds, 1255 13-year-olds and 901 15-year-olds. Peer group and school environment were associated with unhealthy behaviours such as smoking, alcohol consumption and sedentary lifestyle. Family affluence proved to have less impact on unhealthy behaviours, except in the case of adolescents living in low-income families. Poor health outcomes were directly related to a negative school environment. Regarding the influence of family affluence, the results showed higher odds of life dissatisfaction and poor self-reported health status in medium-income families, while low-income families had higher odds only with regard to life dissatisfaction. A consistent pattern of gender differences was found in terms of both unhealthy behaviours and health outcomes. Unhealthy behaviours are strongly related to the school environment and peer group. A negative school environment proved to have the strongest relation with poor health outcomes.

Linking online sexual activities to health outcomes among teens.

PubMed

O'Sullivan, Lucia F

2014-01-01

New digital technologies are highly responsive to many of the developmental needs of adolescents, including their need for intimate connection and social identity. This chapter explores adolescents' use of web-based sexual information, texting and "sexting," online dating sites, role-playing games, and sexually explicit media, and presents new data comparing the interpersonal and intrapersonal health outcomes among youth who engage in online sexual activities to those who do not. Despite the media-stoked concerns surrounding adolescents' participation in online sexual activities, the ubiquity of online activities and close overlap between online and offline activities indicate that this type of behavior should not be pathologized or used as a metric of problem behavior. The chapter concludes with implications for parents, educators, researchers, counselors, and health care providers, a call to challenge our deep discomfort around adolescent sexuality and to harness these technologies in ways that help promote growth and positive development. © 2014 Wiley Periodicals, Inc.

Prevalence and Mental Health Outcomes of Homicide Survivors in a Representative U.S. Sample of Adolescents: Data from the 2005 National Survey of Adolescents

PubMed Central

Rheingold, Alyssa A.; Zinzow, Heidi; Hawkins, Alesia; Saunders, Benjamin E.; Kilpatrick, Dean G.

2011-01-01

Background Each homicide leaves behind several friends and family members, or homicide survivors. However, limited information is available on the impact of homicide on adolescent survivors. The purpose of the current study was to identify the prevalence of homicide survivorship and to determine mental health outcomes within a sample of U.S. adolescent survivors. Methods A nationally representative sample of American adolescents (N=3,614) between the ages of 12–17 completed structured telephone interviews assessing homicide survivorship and mental health consequences including posttraumatic stress disorder (PTSD), depression, drug use, and alcohol abuse. Results Reported prevalence within this sample of losing a loved one to criminal homicide was 9%, losing a loved one to vehicular homicide was 7%, and losing a loved one to both types of homicide was 2%. Logistic regression analyses found that adolescents who reported being homicide survivors were significantly more likely to report depression, drug use, and alcohol abuse after controlling for demographic factors and other violence exposure. Conclusions If the results from this study are generalizable to the US population, roughly 1 in 5 American adolescents may be impacted by homicide. Further, adolescents exposed to such a loss are at increased risk for mental health sequalae. Results suggest that greater attention needs to be paid to address the needs of these often underserved victims. PMID:22211367

Internet Use, Depression, and Anxiety in a Healthy Adolescent Population: Prospective Cohort Study.

PubMed

Thom, Robyn Pauline; Bickham, David S; Rich, Michael

2018-05-22

Psychiatric disorders, including conduct disturbances, substance abuse, and affective disorders, emerge in approximately 20% of adolescents. In parallel with the rise in internet use, the prevalence of depression among adolescents has increased. It remains unclear whether and how internet use impacts mental health in adolescents. We assess the association between patterns of internet use and two mental health outcomes (depression and anxiety) in a healthy adolescent population. A total of 126 adolescents between the ages of 12 and 15 years were recruited. Participants reported their typical computer and internet usage patterns. At baseline and one-year follow-up, they completed the Beck Depression Index for primary care (BDI-PC) and the Beck Anxiety Inventory for Primary Care (BAI-PC). Individual linear regressions were completed to determine the association between markers of internet use at baseline and mental health outcomes at one-year follow-up. All models controlled for age, gender, and ethnicity. There was an inverse correlation between minutes spent on a favorite website per visit and BAI-PC score. No association was found between internet use and BDI-PC score. There is no relationship between internet use patterns and depression in adolescents, whereas internet use may mitigate anxiety in adolescents with higher levels of baseline anxiety. ©Robyn Pauline Thom, David S Bickham, Michael Rich. Originally published in JMIR Mental Health (http://mental.jmir.org), 22.05.2018.

Widening the aim of health promotion to include the most disadvantaged: vulnerable adolescents and the social determinants of health.

PubMed

Mohajer, Nicole; Earnest, Jaya

2010-06-01

Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health promotion. Drawing on a review of literature on health promotion for marginalized and out-of-school adolescents, this paper highlights some urgent areas of focus for researchers and policy makers addressing adolescent health. Social determinants of health affecting marginalized adolescents identified by the review were education, gender, identity, homelessness, poverty, family structure, culture, religion and perceived racism, yet there is little solid evidence as to how to best address these factors. More systematic research, evaluation and global debate about long-term solutions to chronic poverty, lack of education and social marginalization are needed to break the cycle of ill health among vulnerable adolescents.

Subjective Health and Mental Well-Being of Adolescents and the Health Promoting School: A Cross-Sectional Multilevel Analysis

ERIC Educational Resources Information Center

Levin, Kate; Inchley, Jo; Currie, Dorothy; Currie, Candace

2012-01-01

Purpose: The aim of this paper is to examine the impact of the health promoting school (HPS) on adolescent well-being. Design/methodology/approach: Data from the 2006 Health Behaviour in School-aged Children: WHO-collaborative Study in Scotland were analysed using multilevel linear regression analyses for outcome measures: happiness, confidence,…

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras.

PubMed

Hendrick, C Emily; Marteleto, Leticia

2017-06-01

Maternal decision-making autonomy has been linked to positive outcomes for children's health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children's outcomes into adolescence and whether it impacts other domains of children's lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents' environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12-16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011-12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents' school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers' high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents' school enrollment above and beyond other maternal, household, and regional influences.

Lack of evidence on mental health and well-being impacts of individual-level interventions for vulnerable adolescents: systematic mapping review.

PubMed

Vojt, G; Skivington, K; Sweeting, H; Campbell, M; Fenton, C; Thomson, H

2018-05-30

To review empirical evaluations of individual-level interventions intended to improve mental health or well-being for vulnerable adolescents. This is a systematic mapping review. Thirteen databases covering academic and gray literature were searched for published reviews and randomised controlled trials, and gray literature (2005-2016) and the results quality-assessed to prioritise best available evidence. We aimed to identify well-conducted systematic reviews and trials that evaluated individual-level interventions, for mental health/well-being outcomes, where the population was adolescents aged 10-24 years in any of 12 vulnerable groups at high risk of poor health outcomes (e.g. homeless, offenders, 'looked after', carers). Thirty systematic reviews and 16 additional trials were identified. There was insufficient evidence to identify promising individual-level interventions that improve the mental health/well-being of any of the vulnerable groups. Despite Western policy to promote health and well-being among vulnerable young people, the dearth of evidence suggests a lack of interest in evaluating interventions targeting these groups in respect of their mental health/well-being outcomes. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Economic Evaluation of Text-Messaging and Smartphone-Based Interventions to Improve Medication Adherence in Adolescents with Chronic Health Conditions: A Systematic Review.

PubMed

Badawy, Sherif M; Kuhns, Lisa M

2016-10-25

The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking. The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs. Searches included PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, and Inspec. Eligibility criteria included age (12-24 years old), original articles, outcomes for medication adherence, and economic outcomes. Our search identified 1118 unique articles that were independently screened. A total of 156 articles met inclusion criteria and were then examined independently with full-text review. A total of 15 articles met most criteria but lacked economic outcomes such as cost effectiveness or cost-utility data. No articles met all predefined criteria to be included for final review. Only 4 articles (text messaging [n=3], electronic directly observed therapy [n=1]) described interventions with possible future cost-saving but no formal economic evaluation. The evidence to support the cost effectiveness of text-messaging and smartphone-based interventions in improving medication adherence in adolescents with CHCs is insufficient. This lack of research highlights the need for comprehensive economic evaluation of such interventions to better understand their role in cost-savings while improving medication adherence and health outcomes. Economic evaluation of technology-based interventions can contribute to more evidence-based assessment of the scalability, sustainability, and benefits of broader investment of such technology tools in adolescents with CHCs.

Emotion regulation, mental health, and social wellbeing in a young adolescent sample: A concurrent and longitudinal investigation.

PubMed

Chervonsky, Elizabeth; Hunt, Caroline

2018-04-26

Previous research has established that the ability to manage emotions effectively is critical to healthy psychological and social development in adolescents. However, less research has considered the relationships between specific emotion regulation (ER) strategies, such as reappraisal and suppression, and social wellbeing in this age group. The current study investigated the concurrent and longitudinal relationships between 2 ER strategies (reappraisal and suppression) and social outcomes (peer victimization, friendship satisfaction, and family satisfaction) in young adolescents. Analyses also controlled for mental health (anxiety and depression). Given likely gender differences in these variables, key analyses were conducted in parallel for males and females. There were 232 Australian adolescents who completed measures in Grade 7 (Age Mean = 11.97, SD = .35; 64% female) and a year later in Grade 8. Zero-order correlations indicated an inverse relationship between suppression use and social wellbeing variables, although a number of these associations were no longer significant when controlling for mental health. There was limited evidence that reappraisal was uniquely related to social outcomes. However, interaction effects suggested that greater use of reappraisal might have provided some protection against the negative social effects of poorer mental health. Poorer mental and social wellbeing also appeared to be related to ER strategy use, particularly greater suppression use. The findings suggest that ER strategy use, mental health, and social outcomes all play important and interrelated roles in adolescent wellbeing. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A Family-Based Randomized Controlled Trial of Pain Intervention for Adolescents with Sickle Cell Disease

PubMed Central

Barakat, Lamia P.; Schwartz, Lisa A.; Salamon, Katherine S.; Radcliffe, Jerilynn

2010-01-01

The study had two aims--to determine the efficacy of a family-based cognitive-behavioral pain management intervention for adolescents with sickle cell disease (SCD) in (1) reducing pain and improving health-related variables and (2) improving psychosocial outcomes. Each adolescent and a family support person were randomly assigned to receive a brief pain intervention (PAIN) (n = 27) or a disease education attention control intervention (DISEASE ED) (n = 26) delivered at home. Assessment of primary pain and health-related variables (health service use, pain coping, pain-related hindrance of goals) and secondary psychosocial outcomes (disease knowledge, disease self-efficacy, and family communication) occurred at baseline (prior to randomization), post-intervention, and one-year follow-up. Change on outcomes did not differ significantly by group at either time point. When groups were combined in exploratory analyses, there was evidence of small to medium effects of intervention on health-related and psychosocial variables. Efforts to address barriers to participation and improve feasibility of psychosocial interventions for pediatric SCD are critical to advancing development of effective treatments for pain. Sample size was insufficient to adequately test efficacy, and analyses did not support this focused cognitive-behavioral pain management intervention in this sample of adolescents with SCD. Exploratory analyses suggest that comprehensive interventions, that address a broad range of skills related to disease management and adolescent health concerns, may be more effective in supporting teens during healthcare transition. PMID:20686425

Association Between Early Life Adversity and Risk for Poor Emotional and Physical Health in Adolescence: A Putative Mechanistic Neurodevelopmental Pathway.

PubMed

Luby, Joan L; Barch, Deanna; Whalen, Diana; Tillman, Rebecca; Belden, Andy

2017-12-01

Adverse childhood experiences (ACEs) have been associated with poor mental and physical health outcomes. However, the mechanism of this effect, critical to enhancing public health, remains poorly understood. To investigate the neurodevelopmental trajectory of the association between early ACEs and adolescent general and emotional health outcomes. A prospective longitudinal study that began when patients were aged 3 to 6 years who underwent neuroimaging later at ages 7 to 12 years and whose mental and physical health outcomes were observed at ages 9 to 15 years. Sequential mediation models were used to investigate associations between early ACEs and brain structure, emotion development, and health outcomes longitudinally. Children were recruited from an academic medical center research unit. Early life adversity. Early ACEs in children aged 3 to 7 years; volume of a subregion of the prefrontal cortex, the inferior frontal gyrus, in children aged 6 to 12 years; and emotional awareness, depression severity, and general health outcomes in children and adolescents aged 9 to 15 years. The mean (SD) age of 119 patients was 9.65 (1.31) years at the time of scan. The mean (SD) ACE score was 5.44 (3.46). The mean (SD) depression severity scores were 2.61 (1.78) at preschool, 1.77 (1.58) at time 2, and 2.16 (1.64) at time 3. The mean (SD) global physical health scores at time 2 and time 3 were 0.30 (0.38) and 0.33 (0.42), respectively. Sequential mediation in the association between high early ACEs and emotional and physical health outcomes were found. Smaller inferior frontal gyrus volumes and poor emotional awareness sequentially mediated the association between early ACEs and poor general health (model parameter estimate = 0.002; 95% CI, 0.0002-0.056) and higher depression severity (model parameter estimate = 0.007; 95% CI, 0.001-0.021) in adolescence. An increase from 0 to 3 early ACEs was associated with 15% and 25% increases in depression severity and physical health problems, respectively. Study findings highlight 1 putative neurodevelopmental mechanism by which the association between early ACEs and later poor mental and physical health outcomes may operate. This identified risk trajectory may be useful to target preventive interventions.

The Impact of Gender and Family Processes on Mental Health and Substance Use Issues in a Sample of Court-Involved Female and Male Adolescents

ERIC Educational Resources Information Center

Gavazzi, Stephen M.; Lim, Ji-Young; Yarcheck, Courtney M.; Bostic, Jennifer M.; Scheer, Scott D.

2008-01-01

Greater empirical attention directed toward gender-sensitive assessment strategies that concentrate on family-specific factors is thought to be both timely and necessary, especially with regard to outcome variables associated with mental health and substance abuse in at-risk adolescent populations. A sample of 2,646 court-involved adolescents was…

Does adolescent self-esteem predict later life outcomes? A test of the causal role of self-esteem.

PubMed

Boden, Joseph M; Fergusson, David M; Horwood, L John

2008-01-01

This paper examines the relationship between self-esteem in adolescence and later mental health, substance use, and life and relationship outcomes in adulthood. The investigation analyzed data from a birth cohort of approximately 1,000 New Zealand young adults studied to the age of 25. Lower levels of self-esteem at age 15 were associated with greater risks of mental health problems, substance dependence, and lower levels of life and relationship satisfaction at ages 18, 21, and 25. Adjustment for potentially confounding factors reduced the strength of these associations to either moderate or statistically nonsignificant levels. It was concluded that the effects of self-esteem during adolescence on later developmental outcomes were weak, and largely explained by the psychosocial context within which self-esteem develops.

A comparative study of adoloscents' perceived stress and health outcomes among adolescent mothers and their infants in Lesotho.

PubMed

Yako, E M

2007-03-01

The purpose of this study was to compare perceived stress in general, stress due to pregnancy, and post partum complications between a group of unmarried adolescent first-time mothers and a group of married adolescent first-time mothers. Never-pregnant adolescents served as a comparison group on perceived stress. Health outcomes of infants of the two groups of adolescent mothers were also compared on birth weight, nutritional status (weight gain) and immunization status. The study design was non-experimental, comparative and descriptive. A convenience sample of dyads of 64 unmarried adolescent mothers and their infants, 64 married adolescents and their infants, and 64 high school students participated in this study. Data were collected in 3 hospitals, 2 health centres (clinics) and a high school in Lesotho. The differences between the three groups of adolescents in perceived stress, were determined using ANOVA. The t-test was used to determine the differences between the group of unmarried adolescent mothers and the group of married mothers on stress due to pregnancy. The difference in postpartum complications between these two groups of adolescent mothers was determined using Chi-square. The t-test was also used to determine differences in birth weight, nutritional status and immunization status between the group of infants of unmarried mothers and infants of married mothers. Findings of this study revealed significant differences in perceived stress between both groups of adolescent mothers and the group of never pregnant adolescents (p < .0001). The Chaffe' test revealed that never pregnant adolescents had lowest levels of perceived stress than both groups of adolescent mothers (p < .0001). Both groups of adolescent mothers had high levels of stress due to pregnancy and the difference between the two groups was non-significant. No differences were observed between infant health outcomes of unmarried mothers and infants of married mothers. The infants of both groups were generally healthy and the majority of them had appropriate type and doses of immunizations six weeks post birth. Adolescent mothers in the low lands of Lesotho perceive pregnancy to be a stressful event despite marriage. Therefore adolescents should be discourage from early childbirth. Policy makers need to come up with gender sensitive policies that will make it easier for girls who get pregnant to continue with their education, so that they may be productive and self-reliant.

Multiple Types of Harassment: Associations with Emotional Well-being and Unhealthy Behaviors in Adolescents

PubMed Central

Bucchianeri, Michaela M.; Eisenberg, Marla E.; Wall, Melanie M.; Piran, Niva; Neumark-Sztainer, Dianne

2014-01-01

Purpose To explore relationships between harassment (i.e., race-, weight-, SES-based, sexual) and health-related outcomes, including self-esteem, depressive symptoms, body satisfaction, substance use, and self-harm behavior, among diverse adolescents. Method Cross-sectional analysis using data from a population-based study with socioeconomically and racially/ethnically diverse sample (81% racial/ethnic minority; 54% low or low-middle income) of adolescents participating in Eating and Activity in Teens 2010 (EAT 2010) (n = 2,793; mean age = 14.4 years). Results Harassment experiences were significantly associated with negative health behaviors and well-being. After mutually adjusting for other types of harassment, weight-based harassment was consistently associated with lower self-esteem and lower body satisfaction in both genders (standardized βs ranged in magnitude from 0.39 to 0.48); sexual harassment was significantly associated with self-harm and substance use in both genders (ORs: 1.64 to 2.92); and both weight-based and sexual harassment were significantly associated with depressive symptoms among girls (standardized βs = 0.34 and 0.37). Increases in the number of harassment types reported by adolescents were associated with elevated risk for all outcomes regarding substance use/self-harm (ORs: 1.22 to 1.42) and emotional well-being (standardized βs: 0.13 to 0.26). Conclusions Harassment—particularly weight-based and sexual harassment— is associated with a variety of negative health and well-being outcomes among adolescents, and risk for these outcomes increases with the number of harassment types an adolescent experiences. Early detection and intervention to decrease harassment experiences may be particularly important in mitigating psychological and behavioral harm among adolescents. PMID:24411820

Associations between motor vehicle crashes and mental health problems: data from the National Survey of Adolescents-Replication.

PubMed

Williams, Joah L; Rheingold, Alyssa A; Knowlton, Alice W; Saunders, Benjamin E; Kilpatrick, Dean G

2015-02-01

Motor vehicle crashes (MVCs) are a leading cause of physical injuries and mortality among children and adolescents in the United States. The purpose of this study was to examine associations between having an MVC and mental health outcomes, including posttraumatic stress disorder (PTSD), depression, and drug and alcohol misuse in a nationally representative sample of adolescents. A sample of 3,604 adolescents, aged 12-17 years, was assessed as part of the 2005 National Survey of Adolescents-Replication (NSA-R) study. Data were weighted according to the 2005 U.S. Census estimates. Within this sample, 10.2% of adolescents reported having at least 1 serious MVC. The prevalence of current PTSD and depression among adolescents having an MVC was 7.4% and 11.2%, respectively. Analyses revealed that an MVC among adolescents aged 15 years and younger was independently associated with depression (OR = 2.17) and alcohol abuse (OR = 2.36) after adjusting for other risk factors, including a history of interpersonal violence. Among adolescents aged 16 years and older, an MVC was associated only with alcohol abuse (OR = 2.08). This study was the first attempt to explore adverse mental health outcomes associated with MVCs beyond traumatic stress symptoms among adolescents in a nationally representative sample. Copyright © 2015 International Society for Traumatic Stress Studies.

School-Based Health Centers and Adolescent Substance Use: Moderating Effects of Race/Ethnicity and Socioeconomic Status

ERIC Educational Resources Information Center

Bersamin, Melina; Paschall, Mallie J.; Fisher, Deborah A.

2017-01-01

Background: School-based health centers (SBHCs) have been associated with many positive health and academic outcomes. The current study extends previous research and examines possible differences in the association between SBHC exposure and adolescent alcohol, tobacco, and other drug use by race/ethnicity, sex, and socioeconomic status (SES).…

Health Outcomes in Adolescence: Associations with Family, Friends and School Engagement

ERIC Educational Resources Information Center

Carter, Melissa; McGee, Rob; Taylor, Barry; Williams, Sheila

2007-01-01

Aim: To examine the associations between connectedness to family and friends, and school engagement, and selected health compromising and health promoting behaviours in a sample of New Zealand adolescents. Methods: A web-based survey was designed and administered to a random sample of 652 Year 11 students aged 16 years from all Dunedin (NZ) high…

Sexual Orientation, Parental Support, and Health during the Transition to Young Adulthood

ERIC Educational Resources Information Center

Needham, Belinda L.; Austin, Erika L.

2010-01-01

Some recent studies suggest that sexual minorities may have worse health-related outcomes during adolescence because they report lower levels of family connectedness, a key protective resource. Using data from wave 3 of the National Longitudinal Study of Adolescent Health (n = 11,153; 50.6% female; mean age = 21.8 years), this study extends prior…

Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review.

PubMed

Zhou, Huaqiong; Roberts, Pamela; Dhaliwal, Satvinder; Della, Phillip

2016-11-01

This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. A search was carried out using the EBSCOhost, Embase, MEDLINE, PsycINFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be established by stakeholders as a formal channel to monitor patients' outcomes post- transition. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Child Maltreatment and Adolescent Mental Health Problems in a Large Birth Cohort

ERIC Educational Resources Information Center

Mills, Ryan; Scott, James; Alati, Rosa; O'Callaghan, Michael; Najman, Jake M.; Strathearn, Lane

2013-01-01

Objective: To examine whether notified child maltreatment is associated with adverse psychological outcomes in adolescence, and whether differing patterns of psychological outcome are seen depending on the type of maltreatment. Methods: The participants were 7,223 mother and child pairs enrolled in a population-based birth cohort study in…

Game on… girls: associations between co-playing video games and adolescent behavioral and family outcomes.

PubMed

Coyne, Sarah M; Padilla-Walker, Laura M; Stockdale, Laura; Day, Randal D

2011-08-01

Video game use has been associated with several behavioral and health outcomes for adolescents. The aim of the current study was to assess the relationship between parental co-play of video games and behavioral and family outcomes. Participants consisted of 287 adolescents and their parents who completed a number of video game-, behavioral-, and family-related questionnaires as part of a wider study. Most constructs included child, mother, and father reports. At the bivariate level, time spent playing video games was associated with several negative outcomes, including heightened internalizing and aggressive behavior and lowered prosocial behavior. However, co-playing video games with parents was associated with decreased levels of internalizing and aggressive behaviors, and heightened prosocial behavior for girls only. Co-playing video games was also marginally related to parent-child connectedness for girls, even after controlling for age-inappropriate games played with parents. This is the first study to show positive associations for co-playing video games between girls and their parents. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Mental health of transgender youth in care at an adolescent urban community health center: a matched retrospective cohort study.

PubMed

Reisner, Sari L; Vetters, Ralph; Leclerc, M; Zaslow, Shayne; Wolfrum, Sarah; Shumer, Daniel; Mimiaga, Matthew J

2015-03-01

Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exist to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the present study aimed to fill this gap. A retrospective cohort study of electronic health record data from 180 transgender patients aged 12-29 years seen between 2002 and 2011 at a Boston-based community health center was performed. The 106 female-to-male (FTM) and 74 male-to-female (MTF) patients were matched on gender identity, age, visit date, and race/ethnicity to cisgender controls. Mental health outcomes were extracted and analyzed using conditional logistic regression models. Logistic regression models compared FTM with MTF youth on mental health outcomes. The sample (N = 360) had a mean age of 19.6 years (standard deviation, 3.0); 43% white, 33% racial/ethnic minority, and 24% race/ethnicity unknown. Compared with cisgender matched controls, transgender youth had a twofold to threefold increased risk of depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment (all p < .05). No statistically significant differences in mental health outcomes were observed comparing FTM and MTF patients, adjusting for age, race/ethnicity, and hormone use. Transgender youth were found to have a disparity in negative mental health outcomes compared with cisgender youth, with equally high burden in FTM and MTF patients. Identifying gender identity differences in clinical settings and providing appropriate services and supports are important steps in addressing this disparity. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Exploring mediating factors in the association between parental psychological distress and psychosocial maladjustment in adolescence.

PubMed

Roustit, Christelle; Campoy, Eric; Chaix, Basile; Chauvin, Pierre

2010-07-01

Parental psychopathology is associated with increased psychosocial maladjustment in adolescents. We examined, from a psychosocial perspective, the association between parental psychological distress and psychosocial maladjustment in adolescents and assessed the mediating role of psychosocial covariates. This is a cross-sectional survey and the setting include representative sample of Quebec adolescents in 1999. The participants of the study include 13- and 16-year-old children (N = 2,346) in the Social and Health Survey of Quebec Children and Adolescents. The main outcome measures are internalizing disorders, externalizing disorders, substance use, and alcohol consumption. For statistical analysis, we used structural equation modeling to test for mediation. Internalizing and externalizing disorders were significantly associated with parental psychological distress, but not substance use or alcohol consumption. The higher the parental distress, the higher the risk of adolescent mental health disorders. The association between parental psychological distress and internalizing disorders was mediated by adolescent self-esteem, parental emotional support and extrafamilial social support. As for externalizing disorders, these variables only had an independent effect. In conclusion, A family's well being is a necessary condition for psychosocial adjustment in adolescence. Beyond the psychiatric approach, psychosocial considerations need to be taken into consideration to prevent negative mental health outcomes in children living in homes with distressed parents.

Exploring mediating factors in the association between parental psychological distress and psychosocial maladjustment in adolescence

PubMed Central

Campoy, Eric; Chaix, Basile; Chauvin, Pierre

2010-01-01

Abstract Parental psychopathology is associated with increased psychosocial maladjustment in adolescents. We examined, from a psychosocial perspective, the association between parental psychological distress and psychosocial maladjustment in adolescents and assessed the mediating role of psychosocial covariates. This is a cross-sectional survey and the setting include representative sample of Quebec adolescents in 1999. The participants of the study include 13- and 16-year-old children (N = 2,346) in the Social and Health Survey of Quebec Children and Adolescents. The main outcome measures are internalizing disorders, externalizing disorders, substance use, and alcohol consumption. For statistical analysis, we used structural equation modeling to test for mediation. Internalizing and externalizing disorders were significantly associated with parental psychological distress, but not substance use or alcohol consumption. The higher the parental distress, the higher the risk of adolescent mental health disorders. The association between parental psychological distress and internalizing disorders was mediated by adolescent self-esteem, parental emotional support and extrafamilial social support. As for externalizing disorders, these variables only had an independent effect. In conclusion, A family’s well being is a necessary condition for psychosocial adjustment in adolescence. Beyond the psychiatric approach, psychosocial considerations need to be taken into consideration to prevent negative mental health outcomes in children living in homes with distressed parents. PMID:20127380

Longitudinal Effects of Gendered Harassment Perpetration and Victimization on Mental Health Outcomes in Adolescence.

PubMed

Rinehart, Sarah J; Espelage, Dorothy L; Bub, Kristen L

2017-08-01

Gendered harassment, including sexual harassment and homophobic name-calling, is prevalent in adolescents and is linked to negative outcomes including depression, anxiety, suicidality, substance abuse, and personal distress. However, much of the extant literature is cross-sectional and rarely are perpetrators of these behaviors included in studies of outcomes. Therefore, the current study examined the effects of longitudinal changes in gendered harassment perpetration and victimization on changes in mental health outcomes among a large sample of early adolescents. Given that these behaviors commonly occur in the context of a patriarchal society (males hold power), we also investigated the impact of gender on gendered harassment. Participants included 3,549 students from four Midwestern middle schools (50.4% female, 49% African American, 34% White) at two time points (13 and 17 years old). Results indicated that increases from age 13 to 17 years in sexual harassment perpetration and victimization and homophobic name-calling perpetration and victimization predicted increases in depression symptoms and substance use. Gender did not moderate these pathways. These findings highlight that negative outcomes are associated with changes in gendered harassment among adolescents and emphasize the importance of prevention efforts. Implications for school interventions are discussed.

Neighborhoods, Social Support, and African American Adolescents' Mental Health Outcomes: A Multilevel Path Analysis

ERIC Educational Resources Information Center

Hurd, Noelle M.; Stoddard, Sarah A.; Zimmerman, Marc A.

2013-01-01

This study explored how neighborhood characteristics may relate to African American adolescents' internalizing symptoms via adolescents' social support and perceptions of neighborhood cohesion. Participants included 571 urban, African American adolescents (52% female; "M" age = 17.8). A multilevel path analysis testing both direct and…

Contextual and Intrapersonal Predictors of Adolescent Risky Sexual Behavior and Outcomes

ERIC Educational Resources Information Center

Shneyderman, Yuliya; Schwartz, Seth J.

2013-01-01

The present study was designed to test a model of contextual and intrapersonal predictors of adolescent risky sexual behaviors and of sexually transmitted infection diagnoses. Using Waves I and II from the National Longitudinal Study of Adolescent Health, the authors estimated a structural model in which intrapersonal factors such as adolescents'…

Understanding quality of life and patient expectations among adolescents with neonatal brachial plexus palsy: a qualitative and quantitative pilot study.

PubMed

Squitieri, Lee; Larson, Bradley P; Chang, Kate W C; Yang, Lynda J S; Chung, Kevin C

2013-12-01

To explore the quality of life (QOL) and patient expectations among adolescents with neonatal brachial plexus palsy (NBPP)and their parents using qualitative and quantitative approaches. A total of 18 adolescents (10-17 y) with residual NBPP impairment and their parents under went separate 1-hour tape-recorded semistructured interviews. We also collected quantitative physical examination measures and patient-rated outcome scores, specifically the Pediatric Outcomes Data Collection Instrument and the Child Health Questionnaire, to quantify the severity of each adolescent’s functional deficit and increase our understanding of QOL and patient expectations. Through qualitative analysis, we identified several patient- and system-dependent factors contributing to QOL, such as social impact and peer acceptance, emotional adjustment,aesthetic concerns and body image, functional limitations, physical and occupational therapy, finances, pain, and family dynamics. Despite residual impairment, most adolescents and their parents reported a good overall QOL according to quantitative outcome measures. Our study results showed that functional and aesthetic factors were responsible for most observed differences in QOL among NBPP adolescents. We also found that the Pediatric Outcomes Data Collection Instrument might be more sensitive than the Child Health Questionnaire in assessing patient expectations and QOL among this patient population. Understanding patient expectations and QOL in NBPP adolescents is essential for medical decision making and advancing care. Physical examination measurements alone may not be sufficient for measuring outcome, and knowledge regarding environmental factors and family dynamics is important for clinicians to consider when counseling families of children with NBPP and improving overall outcome. Prognostic IV.

The Effects of School-Based Discrimination on Adolescents of Color Sexual Health Outcomes: A Social Determinants Approach.

PubMed

Respress, Brandon N; Amutah-Onukagha, Ndidiamaka N; Opara, Ijeoma

2018-01-01

Social inequalities are at the heart of disparities in sexual health outcomes among African American and Latino/a adolescents living in the United States. Schools are typically the largest and primary context in youth development. School characteristics such as peer and teacher discrimination and school performance were examined to determine whether such characteristics predict sexual behavior in adolescents of color. This study utilized a representative sample of high school age students to assess sexual risk behavior. Findings indicate that there was a clear disparity in sexually transmitted infection diagnoses. School characteristics such as teacher discrimination and Grade Point Average were significant predictors to sexual risky behaviors among adolescents of color. The study adds to the literature in examining contextual factors that are associated with adolescent sexual risk behavior, and findings provide implications for future prevention work.

Improving Adolescent Health Risk Assessment: A Multi-method Pilot Study.

PubMed

Thompson, Lindsay A; Wegman, Martin; Muller, Keith; Eddleton, Katie Z; Muszynski, Michael; Rathore, Mobeen; De Leon, Jessica; Shenkman, Elizabeth A

2016-12-01

Objectives Given poor compliance by providers with adolescent health risk assessment (HRA) in primary care, we describe the development and feasibility of using a health information technology (HIT)-enhanced HRA to improve the frequency of HRAs in diverse clinical settings, asking adolescents' recall of quality of care as a primary outcome. Methods We conducted focus groups and surveys with key stakeholders (Phase I) , including adolescents, clinic staff and providers to design and implement an intervention in a practice-based research network delivering private, comprehensive HRAs via tablet (Phase II). Providers and adolescents received geo-coded community resources according to individualized risks. Following the point-of-care implementation , we collected patient-reported outcomes using post-visit quality surveys (Phase III). Patient-reported outcomes from intervention and comparison clinics were analyzed using a mixed-model, fitted separately for each survey domain. Results Stakeholders agreed upon an HIT-enhanced HRA (Phase I). Twenty-two academic and community practices in north-central Florida then recruited 609 diverse adolescents (14-18 years) during primary care visits over 6 months; (mean patients enrolled = 28; median = 20; range 1-116; Phase II). Adolescents receiving the intervention later reported higher receipt of confidential/private care and counseling related to emotions and relationships (adjusted scores 0.42 vs 0.08 out of 1.0, p < .01; 0.85 vs 0.57, p < .001, respectively, Phase III) than those receiving usual care. Both are important quality indicators for adolescent well-child visits. Conclusions Stakeholder input was critical to the acceptability of the HIT-enhanced HRA. Patient recruitment data indicate that the intervention was feasible in a variety of clinical settings and the pilot evaluation data indicate that the intervention may improve adolescents' perceptions of high quality care.

Widening the Aim of Health Promotion to Include the Most Disadvantaged: Vulnerable Adolescents and the Social Determinants of Health

ERIC Educational Resources Information Center

Mohajer, Nicole; Earnest, Jaya

2010-01-01

Growing numbers of adolescents are marginalized by social factors beyond their control, leading to poor health outcomes for their families and future generations. Although the role of the social determinants of health has been recognized for many years, there is a gap in our knowledge about the strategies needed to address these factors in health…

Adolescent health in Asia: insights from Singapore.

PubMed

Oh, Jean-Yin; Rajasegaran, Kumudhini

2016-08-01

The introduction of adolescent medicine as a medical subspecialty in Singapore was a welcome in an evolving health care system that is unique in terms of both efficiency, in financing and the results achieved in community health outcomes. The Ministry of Health (MOH) already recognized the need to accommodate the health care concerns related to adolescent psychosocial health risk behaviors and an increased prevalence of young people living with chronic illness. The challenge for the pioneer team of physicians trained in adolescent medicine was to develop and sustain a model of care that integrated (i) core clinical services that include quality measures of care to adolescents; (ii) professional development and capacity building needing an expansive teaching agenda at every level of health education; (iii) strong inter-sectorial collaborations within hospital and community partners; and (iv) robust research and evaluation strategies that keep clinical practice relevant and evidence based.

Addressing sexual and reproductive health in adolescents and young adults with intellectual and developmental disabilities.

PubMed

Walters, Frinny Polanco; Gray, Susan Hayden

2018-05-24

This review provides support for promoting the sexual health of adolescents and young adults with developmental disabilities, and particularly those with intellectual disabilities. It offers guidance for pediatricians on incorporating counseling on sexuality and reproductive healthcare, socially appropriate behavior, and sexual abuse prevention for adolescents and young adults with developmental disabilities into healthcare visits. Additionally, it provides resources for developmentally appropriate sexuality education in the home and community to allow access to the comprehensive sexual and reproductive healthcare patients deserve. Adolescents and young adults with developmental disabilities often do not receive developmentally appropriate sexual health education, and this is associated with poor sexual health outcomes and increased rates of sexual abuse in this population. Pediatricians should discuss sexual health with all patients, including adolescents and young adults with developmental disabilities. They are well suited to provide sexual health education and inform families about appropriate sexual health resources.

Family structure and risk behaviors: the role of the family meal in assessing likelihood of adolescent risk behaviors.

PubMed

Goldfarb, Samantha; Tarver, Will L; Sen, Bisakha

2014-01-01

Previous literature has asserted that family meals are a key protective factor for certain adolescent risk behaviors. It is suggested that the frequency of eating with the family is associated with better psychological well-being and a lower risk of substance use and delinquency. However, it is unclear whether there is evidence of causal links between family meals and adolescent health-risk behaviors. The purpose of this article is to review the empirical literature on family meals and adolescent health behaviors and outcomes in the US. A SEARCH WAS CONDUCTED IN FOUR ACADEMIC DATABASES: Social Sciences Full Text, Sociological Abstracts, PsycINFO®, and PubMed/MEDLINE. We included studies that quantitatively estimated the relationship between family meals and health-risk behaviors. Data were extracted on study sample, study design, family meal measurement, outcomes, empirical methods, findings, and major issues. Fourteen studies met the inclusion criteria for the review that measured the relationship between frequent family meals and various risk-behavior outcomes. The outcomes considered by most studies were alcohol use (n=10), tobacco use (n=9), and marijuana use (n=6). Other outcomes included sexual activity (n=2); depression, suicidal ideation, and suicide attempts (n=4); violence and delinquency (n=4); school-related issues (n=2); and well-being (n=5). The associations between family meals and the outcomes of interest were most likely to be statistically significant in unadjusted models or models controlling for basic family characteristics. Associations were less likely to be statistically significant when other measures of family connectedness were included. Relatively few analyses used sophisticated empirical techniques available to control for confounders in secondary data. More research is required to establish whether or not the relationship between family dinners and risky adolescent behaviors is an artifact of underlying confounders. We recommend that researchers make more frequent use of sophisticated methods to reduce the problem of confounders in secondary data, and that the scope of adolescent problem behaviors also be further widened.

Preparing Adolescents With Chronic Disease for Transition to Adult Care: A Technology Program

PubMed Central

Terrones, Laura; Tompane, Trevor; Dillon, Lindsay; Pian, Mark; Gottschalk, Michael; Norman, Gregory J.; Bartholomew, L. Kay

2014-01-01

BACKGROUND: Adolescents with chronic disease (ACD) must develop independent disease self-management and learn to communicate effectively with their health care team to transition from pediatric to adult-oriented health care systems. Disease-specific interventions have been implemented to aid specific ACD groups through transition. A generic approach might be effective and cost-saving. METHODS: Eighty-one ACD, aged 12 to 20 years, were recruited for a randomized clinical trial evaluating an 8-month transition intervention (MD2Me). MD2Me recipients received a 2-month intensive Web-based and text-delivered disease management and skill-based intervention followed by a 6-month review period. MD2Me recipients also had access to a texting algorithm for disease assessment and health care team contact. The intervention was applicable to adolescents with diverse chronic illnesses. Controls received mailed materials on general health topics. Disease management, health-related self-efficacy, and health assessments were performed at baseline and at 2 and 8 months. Frequency of patient-initiated communications was recorded over the study period. Outcomes were analyzed according to assigned treatment group over time. RESULTS: MD2Me recipients demonstrated significant improvements in performance of disease management tasks, health-related self-efficacy, and patient-initiated communications compared with controls. CONCLUSIONS: Outcomes in ACD improved significantly among recipients of a generic, technology-based intervention. Technology can deliver transition interventions to adolescents with diverse chronic illnesses, and a generic approach offers a cost-effective means of positively influencing transition outcomes. Further research is needed to determine whether improved short-term outcomes translate into an improved transition for ACD. PMID:24843066

Preparing adolescents with chronic disease for transition to adult care: a technology program.

PubMed

Huang, Jeannie S; Terrones, Laura; Tompane, Trevor; Dillon, Lindsay; Pian, Mark; Gottschalk, Michael; Norman, Gregory J; Bartholomew, L Kay

2014-06-01

Adolescents with chronic disease (ACD) must develop independent disease self-management and learn to communicate effectively with their health care team to transition from pediatric to adult-oriented health care systems. Disease-specific interventions have been implemented to aid specific ACD groups through transition. A generic approach might be effective and cost-saving. Eighty-one ACD, aged 12 to 20 years, were recruited for a randomized clinical trial evaluating an 8-month transition intervention (MD2Me). MD2Me recipients received a 2-month intensive Web-based and text-delivered disease management and skill-based intervention followed by a 6-month review period. MD2Me recipients also had access to a texting algorithm for disease assessment and health care team contact. The intervention was applicable to adolescents with diverse chronic illnesses. Controls received mailed materials on general health topics. Disease management, health-related self-efficacy, and health assessments were performed at baseline and at 2 and 8 months. Frequency of patient-initiated communications was recorded over the study period. Outcomes were analyzed according to assigned treatment group over time. MD2Me recipients demonstrated significant improvements in performance of disease management tasks, health-related self-efficacy, and patient-initiated communications compared with controls. Outcomes in ACD improved significantly among recipients of a generic, technology-based intervention. Technology can deliver transition interventions to adolescents with diverse chronic illnesses, and a generic approach offers a cost-effective means of positively influencing transition outcomes. Further research is needed to determine whether improved short-term outcomes translate into an improved transition for ACD. Copyright © 2014 by the American Academy of Pediatrics.

Increased Risk for School Violence-Related Behaviors among Adolescents with Insufficient Sleep

ERIC Educational Resources Information Center

Hildenbrand, Aimee K.; Daly, Brian P.; Nicholls, Elizabeth; Brooks-Holliday, Stephanie; Kloss, Jacqueline D.

2013-01-01

Background: School violence is associated with significant acute and long-term negative health outcomes. Previous investigations have largely neglected the role of pertinent health behaviors in school violence, including sleep. Insufficient sleep is associated with adverse physical, behavioral, and psychosocial consequences among adolescents, many…

Teacher Involvement as a Protective Factor from the Association between Race-Based Bullying and Smoking Initiation

ERIC Educational Resources Information Center

Earnshaw, Valerie A.; Rosenthal, Lisa; Carroll-Scott, Amy; Peters, Susan M.; McCaslin, Catherine; Ickovics, Jeannette R.

2014-01-01

Experiencing bullying as a victim is associated with negative health and health behavior outcomes, including substance use, among adolescents. However, understandings of protective factors--factors that enhance adolescents' resilience to the negative consequences of bullying--remain limited. The current study investigates whether teacher…

Psychometric properties of the Revised Chen Internet Addiction Scale (CIAS-R) in Chinese adolescents.

PubMed

Mak, Kwok-Kei; Lai, Ching-Man; Ko, Chih-Hung; Chou, Chien; Kim, Dong-Il; Watanabe, Hiroko; Ho, Roger C M

2014-10-01

The Revised Chen Internet Addiction Scale (CIAS-R) was developed to assess Internet addiction in Chinese populations, but its psychometric properties in adolescents have not been examined. This study aimed to evaluate the factor structure and psychometric properties of CIAS-R in Hong Kong Chinese adolescents. 860 Grade 7 to 13 students (38 % boys) completed the CIAS-R, the Young's Internet Addiction Test (IAT), and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) in a survey. The prevalence of Internet addiction as assessed by CIAS-R was 18 %. High internal consistency and inter-item correlations were reported for the CIAS-R. Results from the confirmatory factor analysis suggested a four-factor structure of Compulsive Use and Withdrawal, Tolerance, Interpersonal and Health-related Problems, and Time Management Problems. Moreover, results of hierarchical multiple regression supported the incremental validity of the CIAS-R to predict mental health outcomes beyond the effects of demographic differences and self-reported time spent online. The CIAS is a reliable and valid measure of internet addiction problems in Hong Kong adolescents. Future study is warranted to validate the cutoffs of the CIAS-R for identification of adolescents with Internet use problems who may have mental health needs.

The young adult Strengths and Difficulties Questionnaire (SDQ) in routine clinical practice.

PubMed

Brann, Peter; Lethbridge, Melissa J; Mildred, Helen

2018-06-01

Expansion of the youth mental health sector has exposed a need for an outcome measure for young adults accessing services. The Strengths and Difficulties Questionnaire (SDQ) is a widely used consumer and carer outcome measure for children and adolescents. The aim of this study was to evaluate the psychometric properties of a young adult SDQ. The young adult SDQ was introduced for routine clinical practice at Eastern Health Child and Youth Mental Health Service (EH-CYMHS), complementing the well-established adolescent and child versions. Data for adolescents (aged 12-17) and young adults (aged 18-25) where both self-report and parent SDQs had been completed at entry point to the service were extracted from a two-year period. Overall, paired cases involved 532 adolescents and 125 young adults. Across both self-report and parent SDQs, a similar pattern of results was found between adolescents and young adults on mean scores, inter-scale correlations, internal consistency, and inter-rater agreement. The findings of the current study support the use of the young adult SDQ in public mental health as an instrument whose psychometric properties, to date, appear consistent with those of the adolescent version. Further investigation is warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

Race, Age, and Neighborhood Socioeconomic Status in Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry.

PubMed

Coley, Sheryl L; Nichols, Tracy R

2016-01-01

Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers. Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial status, age, and neighborhood socioeconomic status (as defined by census-tract median household income) and low birth weight outcomes across census tracts. Significant racial differences were identified in which African-American adolescents had greater odds of low birth weight outcomes than Caucasian adolescents (OR=1.88, 95% CI 1.64, 2.15). Although racial disparities in low birth weight outcomes remained significant in context of maternal age and neighborhood socioeconomic status, the greatest disparities were found between African-American and Caucasian adolescents that lived in areas of higher socioeconomic status (p<.001). Maternal age was not significantly associated with racial differences in low birth weight outcomes. These findings indicate that racial disparities in low birth weight outcomes among adolescent mothers can vary by neighborhood socioeconomic status. Further investigations using intersectional frameworks are needed for examining the relationships between neighborhood socioeconomic status and birth outcome disparities among infants born to adolescent mothers.

Change in Receptive Vocabulary from Childhood to Adulthood: Associated Mental Health, Education and Employment Outcomes

ERIC Educational Resources Information Center

Armstrong, Rebecca; Arnott, Wendy; Copland, David A.; McMahon, Katie; Khan, Asaduzzaman; Najman, Jake M.; Scott, James G.

2017-01-01

Background: Population-based studies have found that early language delays are associated with poorer long-term outcomes in adolescence and adulthood. Few studies have explored the influence of change in language ability over time on adult outcomes. Aim: To examine the educational, vocational and mental health outcomes for adults accounting for…

The global epidemiology of adolescents living with HIV: time for more granular data to improve adolescent health outcomes.

PubMed

Slogrove, Amy L; Sohn, Annette H

2018-05-01

The aim of this study was to summarize recent evidence on the global epidemiology of adolescents (age 10-19 years) living with HIV (ALHIV), the burden of HIV on the health of adolescents and HIV-associated mortality. In 2016, there were an estimated 2.1 million (uncertainty bound 1.4-2.7 million) ALHIV; 770 000 younger (age 10-14 years) and 1.03 million older (age 15-19 years) ALHIV, 84% living in sub-Saharan Africa. The population of ALHIV is increasing, as more peri/postnatally infected ALHIV survive into older ages; an estimated 35% of older female ALHIV were peri/postnatally infected, compared with 57% of older male ALHIV. Although the numbers of younger ALHIV deaths are declining, deaths among older ALHIV have remained static since peaking in 2012. In 2015, HIV-associated mortality was the eighth leading cause of adolescent death globally and the fourth leading cause in African low and middle-income countries. Needed investments into characterizing and improving adolescent HIV-related health outcomes include strengthening systems for nationally and globally disaggregated data by age, sex and mode of infection; collecting more granular data within routine programmes to identify structural, social and mental health challenges to accessing testing and care; and prioritizing viral load monitoring and adolescent-focused differentiated models of care.

Educational Outcomes Associated With School Behavioral Health Interventions: A Review of the Literature.

PubMed

Kase, Courtney; Hoover, Sharon; Boyd, Gina; West, Kristina D; Dubenitz, Joel; Trivedi, Pamala A; Peterson, Hilary J; Stein, Bradley D

2017-07-01

There is an unmet need for behavioral health support and services among children and adolescents, which school behavioral health has the potential to address. Existing reviews and meta-analyses document the behavioral health benefits of school behavioral health programs and frameworks, but few summaries of the academic benefits of such programs exist. We provide exemplars of the academic benefits of school behavioral health programs and frameworks. A literature review identified school behavioral health-related articles and reports. Articles for inclusion were restricted to those that were school-based programs and frameworks in the United States that included an empirical evaluation of intervention academic-related outcomes. Findings from 36 primary research, review, and meta-analysis articles from the past 17 years show the benefits of school behavioral health clinical interventions and targeted interventions on a range of academic outcomes for adolescents. Our findings are consistent with reports documenting health benefits of school behavioral health frameworks and programs and can facilitate further efforts to support school behavioral health for a range of stakeholders interested in the benefits of school behavioral health programs and frameworks on academic outcomes. © 2017, American School Health Association.

Severe physical punishment and mental health problems in an economically disadvantaged population of children and adolescents.

PubMed

Bordin, Isabel Altenfelder Santos; Paula, Cristiane Silvestre; do Nascimento, Rosimeire; Duarte, Cristiane Seixas

2006-12-01

To estimate the prevalence of severe physical punishment of children/adolescents in a low-income community, and to examine child mental health problems as a potential correlate. This study is a Brazilian cross-sectional pilot study of the World Studies of Abuse in Family Environments. A probabilistic sample of clusters including all eligible households (women aged 15-49 years, son/daughter < 18 years) was evaluated. One mother-child pair was randomly selected per household (n = 89; attrition = 11%). Outcome (severe physical punishment of children/adolescents by mother/father) was defined as shaking (if age

Cognitive Ability and Health-Related Behaviors during Adolescence: A Prospective Study across Five Years

ERIC Educational Resources Information Center

Ciarrochi, Joseph; Heaven, Patrick C. L.; Skinner, Timothy

2012-01-01

Longitudinal research on the links between intelligence and health behaviors among adolescents is rare. We report longitudinal data in which we assessed the relationships between intelligence as assessed in Grade 7 and consequential health outcomes in Grade 11. The mean age of respondents (N = 420; 188 males, 232 females) was 12.30 years (SD =…

Sexual Attraction and Trajectories of Mental Health and Substance Use during the Transition from Adolescence to Adulthood

ERIC Educational Resources Information Center

Needham, Belinda L.

2012-01-01

Previous research suggests that sexual minority youth have poorer health-related outcomes than their heterosexual peers. The purpose of this study is to determine whether sexual orientation disparities in mental health and substance use increase, decrease, or remain the same during the transition from adolescence to adulthood. Data are from Waves…

Factors Associated with Pregnancy among Married Adolescents in Nepal: Secondary Analysis of the National Demographic and Health Surveys from 2001 to 2011

PubMed Central

Pradhan, Rina; Wynter, Karen; Fisher, Jane

2018-01-01

Pregnancy-related morbidity and mortality are much more prevalent among adolescents than adults, particularly in low-income settings. Little is known about risk factors for pregnancy among adolescents in Nepal, but setting-specific evidence is needed to inform interventions. This study aimed to describe the prevalence, and identify factors associated with pregnancy among adolescents in Nepal between 2001 and 2011. Secondary analyses of Nepal Demographic Health Surveys (NDHS) data from 2001, 2006, and 2011 were completed. The outcome was any pregnancy or birth among married adolescents; prevalence was calculated for each survey year. Although the rate of marriage among adolescent women in Nepal decreased significantly from 2001 to 2011, prevalence of pregnancy and birth among married adolescent women in Nepal remains high (average 56%) in Nepal, and increased significantly between 2001 and 2011. Regression analyses of this outcome indicate higher risk was associated with living in the least resourced region, early sexual debut, and older husband. Despite national efforts to reduce pregnancies among married adolescent women in Nepal, prevalence remains high. Integrated, cross-sectoral prevention efforts are required. Poverty reduction and infrastructure improvements may lead to lower rates of adolescent pregnancy. PMID:29385771

Family and Cultural Processes Linking Family Instability to Mexican American Adolescents' Adjustment

PubMed Central

Vargas, Danyel A.; Roosa, Mark W.; Knight, George P.; O'Donnell, Megan

2013-01-01

Despite the rapidly growing Mexican American population, no studies to date have attempted to explain the underlying relations between family instability and Mexican American children's development. Using a diverse sample of 740 Mexican American adolescents (49% female; 5th grade M age = 10.4; 7th grade M age = 12.8) and their mothers, we prospectively examined the relations between family instability and adolescent academic outcomes and mental health in the 7th grade. The model fit the data well and results indicated that family instability between 5th and 7th grade was related to increased 7th grade mother-adolescent conflict and in turn, mother-adolescent conflict was related to decreased school attachment and to increased externalizing and internalizing symptoms in the 7th grade. Results also indicated that 7th grade mother-adolescent conflict mediated the relations between family instability and 7th grade academic outcomes and mental health. Further, we explored adolescent familism values as a moderator and found that adolescent familism values served as a protective factor in the relation between mother-adolescent conflict and grades. Implications for future research and intervention strategies are discussed. PMID:23750521

Adolescent Obesity and Young Adult Psychosocial Outcomes: Gender and Racial Differences

ERIC Educational Resources Information Center

Merten, Michael J.; Wickrama, K. A. S.; Williams, Amanda L.

2008-01-01

Using a sample of 7,881 African American (915 males and 1,073 females) and White (2,864 males and 3,029 females) adolescents from Waves 1 and 3 of the National Longitudinal Study of Adolescent Health, this study examined the psychosocial consequences that obese adolescents encounter as they reach young adulthood. Results indicate that obesity…

Adolescents Engaging in Risky Sexual Behavior: Sexual Activity and Associated Behavioral Risk Factors in Bolivian Adolescents

ERIC Educational Resources Information Center

Novilla, M. Lelinneth B.; Dearden, Kirk A.; Crookston, Benjamin T.; De La Cruz, Natalie; Hill, Susan; Torres, Scott B.

2006-01-01

This study describes the prevalence of risky sexual activities among Bolivian adolescents within the context of other behavioral factors that contribute to compromised health outcomes, unintended pregnancies, and sexually transmitted infections including HIV/AIDS. Data was collected from 576 adolescents, 13-18 years of age, from six schools in La…

Adolescent Perceptions of Maternal Approval of Birth Control and Sexual Risk Behavior.

ERIC Educational Resources Information Center

Jaccard, James; Dittus, Patricia J.

2000-01-01

Used data from the Longitudinal Study of Adolescent health to examine the relationship between adolescent perception of maternal approval of the use of birth control and sexual outcomes over 12 months. Overall, adolescents' perceptions of maternal approval related to an increased likelihood of sexual intercourse in the next year and an increase in…

A psychosocial resilience curriculum provides the "missing piece" to boost adolescent physical health: A randomized controlled trial of Girls First in India.

PubMed

Leventhal, Katherine Sachs; DeMaria, Lisa M; Gillham, Jane E; Andrew, Gracy; Peabody, John; Leventhal, Steve M

2016-07-01

Despite a recent proliferation of interventions to improve health, education, and livelihoods for girls in low and middle income countries, psychosocial wellbeing has been neglected. This oversight is particularly problematic as attending to psychosocial development may be important not only for psychosocial but also physical wellbeing. This study examines the physical health effects of Girls First, a combined psychosocial (Girls First Resilience Curriculum [RC]) and adolescent physical health (Girls First Health Curriculum [HC]) intervention (RC + HC) versus its individual components (i.e., RC, HC) and a control group. We expected Girls First to improve physical health versus HC and controls. Over 3000 girls in 76 government middle schools in rural Bihar, India participated. Interventions were delivered through in-school peer-support groups, facilitated by pairs of local women. Girls were assessed before and after program participation on two primary outcomes (health knowledge and gender equality attitudes) and nine secondary outcomes (clean water behaviors, hand washing, menstrual hygiene, health communication, ability to get to a doctor when needed, substance use, nutrition, safety, vitality and functioning). Analyses included Difference-in-Difference Ordinary Least-Squares Regressions and F-tests for equality among conditions. Girls First significantly improved both primary and eight secondary outcomes (all except nutrition) versus controls. Additionally, Girls First demonstrated significantly greater effects, improving both primary and six secondary outcomes (clean water behaviors, hand washing, health communication, ability to get to a doctor, nutrition, safety) versus HC. This study is among the first to assess the impact of a combined psychosocial and adolescent health program on physical health. We found that combining these curricula amplified effects achieved by either curriculum alone. These findings suggest that psychosocial wellbeing should receive much broader attention, not only from those interested in improving psychosocial outcomes but also from those interested in improving physical health outcomes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Family dinners, communication, and mental health in Canadian adolescents.

PubMed

Elgar, Frank J; Craig, Wendy; Trites, Stephen J

2013-04-01

To examine the association between the frequency of family dinners and positive and negative dimensions of mental health in adolescents and to determine whether this association is explained by the quality of communication between adolescents and parents. A community sample of 26,069 adolescents (aged 11 to 15 years) participated in the 2010 Canadian Health Behaviour of School-aged Children study. Adolescents gave self-report data on the weekly frequency of family dinners, ease of parent-adolescent communication, and five dimensions of mental health (internalizing and externalizing problems, emotional well-being, prosocial behavior, and life satisfaction). Regression analyses tested relations between family dinners, parent-adolescent communication, and mental health. The frequency of family dinners negatively related to internalizing and externalizing symptoms and positively related to emotional well-being, prosocial behavior, and life satisfaction. These associations did not interact with differences in gender, grade level, or family affluence. However, hierarchical regression analyses found that these associations were partially mediated by differences in parent-adolescent communication, which explained 13% to 30% of the effect of family dinners on mental health, depending on the outcome. These findings, though correlational, revealed a dose-response association between the frequency of family dinners and positive and negative dimensions of adolescent mental health. The ease of communication between parents and adolescents accounted for some of this association. Copyright © 2013 Society for Adolescent Health and Medicine. All rights reserved.

Discrimination and Depressive Symptoms Among Latina/o Adolescents of Immigrant Parents.

PubMed

Lopez, William D; LeBrón, Alana M W; Graham, Louis F; Grogan-Kaylor, Andrew

2016-01-01

Discrimination is associated with negative mental health outcomes for Latina/o adolescents. While Latino/a adolescents experience discrimination from a number of sources and across contexts, little research considers how the source of discrimination and the context in which it occurs affect mental health outcomes among Latina/o children of immigrants. We examined the association between source-specific discrimination, racial or ethnic background of the source, and school ethnic context with depressive symptoms for Latina/o adolescents of immigrant parents. Using multilevel linear regression with time-varying covariates, we regressed depressive symptoms on source-specific discrimination, racial or ethnic background of the source of discrimination, and school percent Latina/o. Discrimination from teachers (β = 0.06, p < .05), students (β = 0.05, p < .05), Cubans (β = 0.19, p < .001), and Latinas/os (β = 0.19, p < .001) were positively associated with depressive symptoms. These associations were not moderated by school percent Latina/o. The findings indicate a need to reduce discrimination to improve Latina/o adolescents' mental health. © The Author(s) 2016.

Media Use and Health Outcomes in Adolescents: Findings from a Nationally Representative Survey

PubMed Central

Casiano, Hygiea; Kinley, D. Jolene; Katz, Laurence Y.; Chartier, Mariette J.; Sareen, Jitender

2012-01-01

Objective: Examine the association between quantity of media use and health outcomes in adolescents. Method: Multiple logistic regression analyses were conducted with the Canadian Community Health Survey 1.1 (youth aged 12–19 (n=9137)) to determine the association between hours of use of television/videos, video games, and computers/Internet, and health outcomes including depression, alcohol dependence, binge drinking, suicidal ideation, help-seeking behaviour, risky sexual activity, and obesity. Results: Obesity was associated with frequent television/video use (Adjusted Odds Ratio (AOR) 1.10). Depression and risky sexual behaviour were less likely in frequent video game users (AOR 0.87 and 0.73). Binge drinking was less likely in frequent users of video games (AOR 0.92) and computers/Internet (AOR 0.90). Alcohol dependence was less likely in frequent computer/Internet users (AOR 0.89). Conclusions: Most health outcomes, except for obesity, were not associated with using media in youth. Further research into the appropriate role of media will help harness its full potential. PMID:23133464

Could music potentially serve as a functional alternative to alcohol consumption? The importance of music motives among drinking and non-drinking adolescents.

PubMed

Jonker, Anna; Kuntsche, Emmanuel

2014-12-01

This study investigated whether adolescents who drink and those who are teetotal differ in the link between music motives and health-related outcomes (life satisfaction, self-rated health, school pressure, somatic complaints, depressed and aggressive mood, physical powerlessness, frequency of being bullied and bullying others and evenings spent out with friends). It also looked at whether associations between music motives and health-related outcomes remained significant when drinking motives were included among drinkers. Confirmatory factor analysis and structural equation models were estimated based on data from 4,481 adolescents from Switzerland (mean age 14.5, SD = 0.9). It was confirmed that the four music motives and the four drinking motives obtained by crossing the valence (positive–negative) and the source (internal–external) of expected change in affect form distinct dimensions (i.e. the 8-factor model best fitted the data). Drinkers and non-drinkers differed in the various links between music motives and health-related outcomes. For example, almost all the links between conformity music motives and the health-related outcomes were significant for non-drinkers but not for drinkers. Enhancement music motives, by contrast, were often significant for drinkers but not for non-drinkers. Coping music motives were significant among both drinkers and non-drinkers. These links were basically unchanged when drinking motives were taken into account. This study indicates that music serves important functions in the lives of adolescents, even among those who use alcohol for different motives. This makes listening to music a promising potential alternative to alcohol use.

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: a Review of the Literature

PubMed Central

Chapman, Daniel P.; Croft, Janet B.

2015-01-01

BACKGROUND Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students’ academic performance, reduce engagement in risk behaviors, and improve health. METHODS This paper reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students. RESULTS Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes. CONCLUSIONS Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies. PMID:27040474

The use of routine outcome measures in two child and adolescent mental health services: a completed audit cycle

PubMed Central

2013-01-01

Background Routine outcome measurement (ROM) is important for assessing the clinical effectiveness of health services and for monitoring patient outcomes. Within Child and Adolescent Mental Health Services (CAMHS) in the UK the adoption of ROM in CAMHS has been supported by both national and local initiatives (such as government strategies, local commissioning policy, and research). Methods With the aim of assessing how these policies and initiatives may have influenced the uptake of ROM within two different CAMHS we report the findings of two case-note audits: a baseline audit conducted in January 2011 and a re-audit conducted two years later in December 2012-February 2013. Results The findings show an increase in both the single and repeated use of outcome measures from the time of the original audit, with repeated use (baseline and follow-up) of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) scale increasing from 10% to 50% of cases. Re-audited case-notes contained more combined use of different outcome measures, with greater consensus on which measures to use. Outcome measures that were applicable across a wide range of clinical conditions were more likely to be used than symptom-specific measures, and measures that were completed by the clinician were found more often than measures completed by the service user. Conclusions The findings show a substantial improvement in the use of outcome measures within CAMHS. These increases in use were found across different service organisations which were subject to different types of local service priorities and drivers. PMID:24139139

Functional outcomes of child and adolescent mental disorders. Current disorder most important but psychiatric history matters as well.

PubMed

Ormel, J; Oerlemans, A M; Raven, D; Laceulle, O M; Hartman, C A; Veenstra, R; Verhulst, F C; Vollebergh, W; Rosmalen, J G M; Reijneveld, S A; Oldehinkel, A J

2017-05-01

Various sources indicate that mental disorders are the leading contributor to the burden of disease among youth. An important determinant of functioning is current mental health status. This study investigated whether psychiatric history has additional predictive power when predicting individual differences in functional outcomes. We used data from the Dutch TRAILS study in which 1778 youths were followed from pre-adolescence into young adulthood (retention 80%). Of those, 1584 youths were successfully interviewed, at age 19, using the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) to assess current and past CIDI-DSM-IV mental disorders. Four outcome domains were assessed at the same time: economic (e.g. academic achievement, social benefits, financial difficulties), social (early motherhood, interpersonal conflicts, antisocial behavior), psychological (e.g. suicidality, subjective well-being, loneliness), and health behavior (e.g. smoking, problematic alcohol, cannabis use). Out of the 19 outcomes, 14 were predicted by both current and past disorders, three only by past disorders (receiving social benefits, psychiatric hospitalization, adolescent motherhood), and two only by current disorder (absenteeism, obesity). Which type of disorders was most important depended on the outcome. Adjusted for current disorder, past internalizing disorders predicted in particular psychological outcomes while externalizing disorders predicted in particular health behavior outcomes. Economic and social outcomes were predicted by a history of co-morbidity of internalizing and externalizing disorder. The risk of problematic cannabis use and alcohol consumption dropped with a history of internalizing disorder. To understand current functioning, it is necessary to examine both current and past psychiatric status.

Multiple types of harassment: associations with emotional well-being and unhealthy behaviors in adolescents.

PubMed

Bucchianeri, Michaela M; Eisenberg, Marla E; Wall, Melanie M; Piran, Niva; Neumark-Sztainer, Dianne

2014-06-01

To explore relationships between harassment (i.e., race-, weight-, socioeconomic-status (SES)-based, and sexual) and health-related outcomes, including self-esteem, depressive symptoms, body satisfaction, substance use, and self-harm behavior, among diverse adolescents. Cross-sectional analysis using data from a population-based study of adolescents participating in Eating and Activity in Teens 2010 (EAT 2010) (n = 2,793; mean age = 14.4 years). Sample was socioeconomically and racially/ethnically diverse (81% racial/ethnic minority; 54% low or low-middle income). Having experienced any type of harassment was significantly associated with poor self-esteem, depressive symptoms, low body satisfaction, substance use, and self-harm behaviors. After mutually adjusting for other types of harassment, weight-based harassment was consistently associated with lower self-esteem and lower body satisfaction in both genders (standardized βs ranged in magnitude from .39 to .48); sexual harassment was significantly associated with self-harm and substance use in both genders (ORs: 1.64 to 2.92); and both weight-based and sexual harassment were significantly associated with depressive symptoms among girls (standardized βs = .34 and .37). Increases in the number of different harassment types reported by adolescents were associated with elevated risk for alcohol, cigarette, and marijuana use, and self-harm (ORs: 1.22 to 1.42) as well as emotional well-being (standardized βs: .13 to .26). Having had any harassment experience was significantly associated with a variety of negative health and well-being outcomes among adolescents, and risk for these outcomes increases with the number of harassment types an adolescent experiences. Early detection and intervention to decrease harassment experiences may be particularly important in mitigating psychological and behavioral harm among adolescents. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Predicting Postsurgical Satisfaction in Adolescents With Idiopathic Scoliosis: The Role of Presurgical Functioning and Expectations.

PubMed

Sieberg, Christine B; Manganella, Juliana; Manalo, Gem; Simons, Laura E; Hresko, M Timothy

2017-12-01

There is a need to better assess patient satisfaction and surgical outcomes. The purpose of the current study is to identify how preoperative expectations can impact postsurgical satisfaction among youth with adolescent idiopathic scoliosis undergoing spinal fusion surgery. The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospective, multicentered registry examining postsurgical outcomes. The Scoliosis Research Society Questionnaire-Version 30, which assesses pain, self-image, mental health, and satisfaction with management, along with the Spinal Appearance Questionnaire, which measures surgical expectations was administered to 190 patients before surgery and 1 and 2 years postoperatively. Regression analyses with bootstrapping (with n=5000 bootstrap samples) were conducted with 99% bias-corrected confidence intervals to examine the extent to which preoperative expectations for spinal appearance mediated the relationship between presurgical mental health and pain and 2-year postsurgical satisfaction. Results indicate that preoperative mental health, pain, and expectations are predictive of postsurgical satisfaction. With the shifting health care system, physicians may want to consider patient mental health, pain, and expectations before surgery to optimize satisfaction and ultimately improve clinical care and patient outcomes. Level I-prognostic study.

The Use of Student Self-Report Screening Data for Mental Health Risk Surveillance

ERIC Educational Resources Information Center

Dever, B. V.; Raines, T. C.

2013-01-01

Child and adolescent mental health disorders are known to increase the risk for numerous poor school and life outcomes for children and adolescents including suicidal ideation and attempts, academic underachievement and school dropout, substance use and disorders, and physical fighting or victimization by a weapon (Bradley, Doolittle, &…

Parent Resources during Adolescence: Effects on Education and Careers in Young Adulthood

ERIC Educational Resources Information Center

Faas, Caitlin; Benson, Mark J.; Kaestle, Christine E.

2013-01-01

Building on the Wisconsin Model of Status Attainment, this study examined the contextual process of obtaining educational attainment and the subsequent work outcomes and career satisfaction. This study used the National Longitudinal Study of Adolescent Health (Add Health) with structural equation modeling techniques to assess US participants from…

Brief report: identity processes in Filipino late adolescents and young adults: parental influences and mental health outcomes.

PubMed

Pesigan, Ivan Jacob Agaloos; Luyckx, Koen; Alampay, Liane Peña

2014-07-01

This study focused on a process-oriented approach to identity formation using a sample of Filipino late adolescents and young adults (17-30 years; N = 779). Indirect relations between parenting and mental health via identity formation processes were examined. Two parenting dimensions (psychological control and support), two types of mental health outcomes (depression and psychological well-being), and five identity dimensions (commitment making (CM), identification with commitment (IC), exploration in breadth (EB), exploration in depth (ED), and ruminative exploration (RE)) were assessed. Recursive path analysis showed indirect relations between parenting and mental health via EB, ED, RE, and IC. Model differences between late adolescents (17-21 year olds) and young adults (22-30 year olds) were examined using multigroup path analysis. Results showed that the direct effect of psychological control on RE, and its indirect effect on depression through RE differed between the age groups. Implications and suggestions for future research are provided. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Associations of Timing of Sexual Orientation Developmental Milestones and Other Sexual Minority Stressors with Internalizing Mental Health Symptoms Among Sexual Minority Young Adults.

PubMed

Katz-Wise, Sabra L; Rosario, Margaret; Calzo, Jerel P; Scherer, Emily A; Sarda, Vishnudas; Austin, S Bryn

2017-07-01

Sexual minorities (mostly heterosexual, bisexual, lesbian/gay) are more likely than heterosexuals to have adverse mental health, which may be related to minority stress. We used longitudinal data from 1461 sexual minority women and men, aged 22-30 years, from Wave 2010 of the Growing Up Today Study, to examine associations between sexual minority stressors and mental health. We hypothesized that sexual minority stressors (earlier timing of sexual orientation developmental milestones categorized into early adolescence, middle adolescence, late adolescence/young adulthood; greater sexual orientation mobility; more bullying victimization) would be positively associated with mental health outcomes (depressive and anxious symptoms). Linear regression models stratified by gender and sexual orientation were fit via generalized estimating equations and controlled for age and race/ethnicity. Models were fit for each stressor predicting each mental health outcome. Reaching sexual minority milestones in early versus middle adolescence was associated with greater depressive and anxious symptoms among lesbians and gay men. Reaching sexual minority milestones in late adolescence/young adulthood versus middle adolescence was associated with greater depressive symptoms among lesbians, but fewer depressive and anxious symptoms among gay men. Greater sexual orientation mobility was associated with greater depressive symptoms among mostly heterosexual women. More bullying victimization was associated with greater depressive symptoms among bisexual women and with greater anxious symptoms among mostly heterosexual women. Sexual minority stressors are associated with adverse mental health among some sexual minority young adults. More research is needed to understand what may be protecting some subgroups from the mental health effects of sexual minority stressors.

Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review.

PubMed

Gotovac, Sandra; Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

2018-04-01

The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families.

A critical social theory approach to nursing care of adolescents with diabetes.

PubMed

Dickinson, J K

1999-01-01

This paper explores the viewpoint that, as a group, adolescents with diabetes are oppressed by health care professionals who use approaches to diabetes care delivery that are paternalistic in nature. These approaches can lead to negative health/diabetes outcomes in this age group. As inherent in oppressed group characteristics, adolescents with diabetes may not realize that they are being treated unfairly or that they have rights as patients. Nurses are in a unique position to advocate for these adolescents and to help them become advocates for themselves.

Along for the Ride: Best Friends' Resources and Adolescents' College Completion

ERIC Educational Resources Information Center

Cherng, Hua-Yu Sebastian; Calarco, Jessica McCrory; Kao, Grace

2013-01-01

Research on social capital in education rarely considers how the resources students can access through their friendships affect educational outcomes later in life. Using the National Longitudinal Study of Adolescent Health, we explore how having resource-rich best friends impacts adolescents' college completion. We compare the influence of…

School-Based Cognitive-Behavioral Therapy for Adolescent Depression: A Benchmarking Study

ERIC Educational Resources Information Center

Shirk, Stephen R.; Kaplinski, Heather; Gudmundsen, Gretchen

2009-01-01

The current study evaluated cognitive-behavioral therapy (CBT) for adolescent depression delivered in health clinics and counseling centers in four high schools. Outcomes were benchmarked to results from prior efficacy trials. Fifty adolescents diagnosed with depressive disorders were treated by eight doctoral-level psychologists who followed a…

Positive and Negative Associations between Adolescents' Religiousness and Health Behaviors via Self-Regulation.

PubMed

Holmes, Christopher J; Kim-Spoon, Jungmeen

It has been proposed that self-regulation may be the explanatory mechanism for the relation between religiousness and positive health behaviors. However, different religious motivations have differential effects on a variety of health related outcomes, which may explain the adverse effects of religiousness found in some studies. The current study hypothesized that higher identification as religious motivation would be linked to higher health-promoting behavior and lower health-risk behavior through higher self-regulation, whereas higher introjection would be linked to lower health-promoting behavior and higher health-risk behavior through lower self-regulation. The sample included 220 adolescents (mean age = 15 years, 55% male) and their primary caregivers. Structural equation modeling results supported the hypotheses and indicated that adolescent self-regulation mediated the relations between their religious motivation and health behavior. The findings suggest that different types of religious motivation may be promotive or hindering for adolescents' health.

Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures.

PubMed

Deighton, Jessica; Croudace, Tim; Fonagy, Peter; Brown, Jeb; Patalay, Praveetha; Wolpert, Miranda

2014-01-01

There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures' psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against standards of feasibility and psychometric credibility in relation to use for practice and policy.

Measuring mental health and wellbeing outcomes for children and adolescents to inform practice and policy: a review of child self-report measures

PubMed Central

2014-01-01

There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures’ psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against standards of feasibility and psychometric credibility in relation to use for practice and policy. PMID:24834111

Low self-esteem during adolescence predicts poor health, criminal behavior, and limited economic prospects during adulthood.

PubMed

Trzesniewski, Kali H; Donnellan, M Brent; Moffitt, Terrie E; Robins, Richard W; Poulton, Richie; Caspi, Avshalom

2006-03-01

Using prospective data from the Dunedin Multidisciplinary Health and Development Study birth cohort, the authors found that adolescents with low self-esteem had poorer mental and physical health, worse economic prospects, and higher levels of criminal behavior during adulthood, compared with adolescents with high self-esteem. The long-term consequences of self-esteem could not be explained by adolescent depression, gender, or socioeconomic status. Moreover, the findings held when the outcome variables were assessed using objective measures and informant reports; therefore, the findings cannot be explained by shared method variance in self-report data. The findings suggest that low self-esteem during adolescence predicts negative real-world consequences during adulthood. Copyright (c) 2006 APA, all rights reserved.

Availability of reproductive healthcare services at schools and subsequent birth outcomes among adolescent mothers

PubMed Central

Madkour, Aubrey Spriggs; Xie, Yiqiong; Harville, Emily Wheeler

2016-01-01

BACKGROUND Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group. METHODS Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants after Wave I and before age 20, were still in secondary school while pregnant, and had complete data (N=402) were included. Mothers reported infants’ birthweight and gestational age. School administrators reported whether family planning counseling, diagnostic screening (including sexually transmitted diseases [STDs]), STD treatment, and prenatal/postpartum healthcare were provided on-site at school at Wave I. Multilevel models adjusted for individual and school characteristics were conducted. RESULTS Few schools offered reproductive healthcare services on-site. In multilevel analyses, availability of family planning counseling (Est. β=0.21, 95% confidence interval [CI] 0.04, 0.38) and prenatal/postpartum healthcare (Est. β=0.21, 95% CI 0.02, 0.40) were significantly associated with increased infant birthweight. No services examined were significantly associated with increased gestational age. CONCLUSIONS Some school-based reproductive health services may improve subsequent birth outcomes among adolescent mothers. Future analyses should examine the mechanisms by which services impact birth outcomes. PMID:27246673

Posttraumatic stress disorder and physical comorbidity among female children and adolescents: results from service-use data.

PubMed

Seng, Julia S; Graham-Bermann, Sandra A; Clark, M Kathleen; McCarthy, Ann Marie; Ronis, David L

2005-12-01

In adults, posttraumatic stress disorder (PTSD) is associated with adverse health outcomes and high medical utilization and cost. PTSD is twice as common in women and is associated with increased risk for a range of diseases, chronic conditions, and reproductive-health problems. Little is known about the health effects of PTSD in children. The purpose of this study was to explore patterns of physical comorbidity in female children and adolescents with PTSD by using population data. This study was a cross-sectional, descriptive epidemiologic case-control analysis of a Midwestern state's Medicaid eligibility and paid-claims data for girls (0-8 years old) and teens (9-17 years old). Data were from 1994-1997. All those with the PTSD diagnostic code were compared with randomly selected controls in relation to 3 sets of outcomes: (1) International Classification of Diseases, Ninth Revision (ICD-9) categories of disease; (2) chronic conditions previously associated with sexual trauma and PTSD in women; and (3) reproductive-health problems. Analyses included bivariate odds ratios (OR) and logistic-regression models that control for the extent of insurance coverage and the independent associations of victimization and psychiatric comorbidity with the 3 sets of outcomes. The mental health covariate was categorical to allow consideration of a range of severity. There were 4 categories for the young girls: neither PTSD nor depression, PTSD without depression, depression without PTSD, and PTSD + depression. For the adolescent analysis, a fifth category reflecting a "complex PTSD" was added, defined as having PTSD complicated by a dissociative disorder or borderline personality disorder diagnosis. There were 647 girls and 1025 adolescents with the PTSD diagnosis. Overall, PTSD was associated with adverse health outcomes in both age strata. Victimization was sometimes independently associated with adverse health outcomes, but PTSD often was a mediator, especially in the adolescent age stratum. The importance of PTSD diagnosis as a predictor of the ICD-9 categories of disease or chronic conditions seemed to increase with age. In the younger age stratum, the increased bivariate ORs of significant associations with PTSD ranged from 1.4 for digestive disorders to 3.4 for circulatory disorders. Among younger girls, PTSD diagnosis was associated with significantly greater bivariate odds for 9 of the 12 ICD-9 categories of disease but not for neoplasms, blood disorders, or respiratory disorders and with threefold increased odds for chronic fatigue. They also had 1.8 times greater odds for sexually transmitted infections, some of which could be from congenital transmission in this age group, which includes infants. In the multivariate models for the young girls, the mental health variable seemed to mediate the relationship between victimization and increased odds of infectious and parasitic diseases, endocrine/metabolic/immune disorders, circulatory diseases, skin and cutaneous tissue disorders, and having any 1 of the 5 chronic conditions. The mental health categories that were significantly associated with health outcomes varied across the conditions. There were no health outcomes in which the depression-without-PTSD category was the only one significantly associated with the outcome condition. Circulatory and musculoskeletal disorders were significantly associated with all 3 of the mental health categories. Having any 1 of the 5 chronic conditions was significantly associated only with simple PTSD (PTSD without depression). Genitourinary disorders and signs/symptoms/ill-defined conditions were significantly associated with both simple and comorbid PTSD. PTSD with comorbid depression, the most severe of the mental health categories in this younger age group, was the only category associated with the endocrine/metabolic/immune disorders and skin disorders outcomes. In the adolescent age stratum, the bivariate ORs significantly associated with PTSD ranged from 2.1 for blood disorders to 5.2 for irritable bowel syndrome. Adolescents with PTSD were nearly twice as likely to have a sexually transmitted infection and 60% more likely to have cervical dysplasia. However, their rate of pregnancy was lower (23% vs 31%), a one-fourth decreased odds. In the adolescent group, only 4 outcomes (nervous system/sense organ, digestive, and genitourinary disorders and signs/symptoms/ill-defined conditions) remained statistically significantly associated with victimization after the mental health variable was added, suggesting an additive model of risk for these outcomes but a mediating role for PTSD in relation to the majority of the health outcomes. Among the adolescent girls, the range of ORs for the ICD-9 and chronic-condition diagnoses generally increased across the categories of the mental health variable in a dose-response pattern. Compared with adolescents with neither PTSD nor depression, those with PTSD without depression had statistically significant ORs from 1.5 to 3.6. Those with depression without PTSD had statistically significant ORs from 1.9 to 4.4. The significant ORs for those with PTSD comorbid with depression were from 2.3 to 6.6, and those in the complex-PTSD category had significant ORs of between 2.5 and 14.9. Only blood disorders seemed to be more strongly associated with depression alone than with the comorbid and complex forms of PTSD. The simple-PTSD category was not significantly associated with blood disorders, chronic pelvic pain, fibromyalgia, or dysmenorrhea. Depression without PTSD was not significantly associated with chronic pelvic pain or fibromyalgia. Fibromyalgia was only significantly associated with complex PTSD. In young girls who receive Medicaid benefits, PTSD was associated with increased odds of a range of adverse health conditions. The pattern and odds of physical comorbidity among adolescent recipients with PTSD was nearly as extensive as that seen in adult women. Overall, the pattern observed suggests that objective disease states (eg, circulatory problems, infections) may be associated with PTSD to an extent nearly as great as that of PTSD with more subjective somatic experience of loss of wellness. Using the concepts of allostatic load and allostatic support, professionals who work with children and adolescents may be able to decrease the toll that traumatic stress takes on health even if available interventions can only be thought of as supportive and fall short of completely preventing trauma exposure or completely healing posttraumatic stress. Clinical research to extend these exploratory findings is warranted.

Detained Adolescent Females' Multiple Mental Health and Adjustment Problem Outcomes in Young Adulthood

ERIC Educational Resources Information Center

van der Molen, E.; Vermeiren, R. R. J. M.; Krabbendam, A. A.; Beekman, A. T. F.; Doreleijers, T. A. H.; Jansen, L. M. C.

2013-01-01

Background: Although prior studies have shown that detained females are marked by significant adverse circumstances, little is known about their adult outcomes. Method: Prospective follow-up study of 184 (80.4% of original sample of 229) detained adolescent females who were reassessed 4.5 SD = 0.6) years later in young adulthood (mean age = 20.0,…

The Timing of Parental Income and Child Outcomes: The Role of Permanent and Transitory Shocks. CEE DP 120

ERIC Educational Resources Information Center

Tominey, Emma

2010-01-01

How do shocks to parental income drive adolescent human capital, such as university attendance, IQ and health? Unexpected changes to family income may have a predictable effect on child adolescent outcomes, by shifting the money parents spend on human capital investments in their children. The extent to which consumers insure themselves against…

Prevalence of, and factors associated with, adolescent physical fighting while under the influence of alcohol or drugs.

PubMed

Kodjo, Cheryl M; Auinger, Peggy; Ryan, Sheryl A

2004-10-01

To determine: (a) the prevalence of physical fighting while under the influence of alcohol or drugs, and (b) the associations among demographic factors, other risk behaviors, and physical fighting while under the influence of substances. Cross-sectional analysis of The National Longitudinal Study of Adolescent Health (Add Health) 1994-1995, a school-based, nationally representative survey of 6504 7th to 12th graders. The dependent outcome variables of interest were: "The most recent time you got into a fight, had you been drinking?" and "Have you ever gotten into a fight when you had been using drugs?" Independent variables included: demographics, adolescent characteristics and risk behaviors, home environment, and peer substance use. Univariate and bivariate analyses, and logistic regressions, using SUDAAN, were performed for the two outcome behaviors for the overall sample (p

Parenting programs during adolescence: Outcomes from universal and targeted interventions offered in real-world settings.

PubMed

Alfredsson, Elin K; Thorvaldsson, Valgeir; Axberg, Ulf; Broberg, Anders G

2018-04-26

The aim of this naturalistic study was to explore short and long-term outcomes of five different group-based parenting programs offered to parents of 10 to 17-year-olds. Three hundred and fifteen parents (277 mothers and 38 fathers) who had enrolled in a parenting program (universal: Active Parenting, COPE; Connect; targeted: COMET; Leadership training for parents of teenagers [LFT]) answered questionnaires at three measurement waves (baseline, post-measurement, and one-year follow-up). The questions concerned parenting style, parental mental health, family climate and adolescent mental health. Results revealed small to moderate changes in almost all outcome variables and in all parenting programs. Overall, parents in COMET reported the largest short and long-term changes. No substantial differences in change were seen between the other programs. The results support the general effectiveness of parenting programs for parents of adolescents. © 2018 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Health-related quality of life in children and adolescents in Germany: results of the BELLA study.

PubMed

Ravens-Sieberer, Ulrike; Erhart, Michael; Wille, Nora; Bullinger, Monika

2008-12-01

The self-perceived health or health-related quality of life of children and adolescents is increasingly recognised as a relevant outcome in medical practice and public health research. Identifying children and adolescents with particularly low health-related quality of life allows for an early detection of hidden morbidity and health care needs. The present study investigates health-related quality of life in children and adolescents in Germany. In the Mental Health Module (BELLA study) of the German National Health Interview and Examination Survey for Children and Adolescents (KiGGS), the parents of 2,863 children and adolescents aged 7-17 years, and 1,700 children and adolescents aged 11-17 years completed the KINDL-R quality of life questionnaire. The reliability (Cronbach's alpha=0.86) and validity of the measurements using the parent-reported KINDL-R were confirmed. Means and percentiles were calculated for the total sample as well as for strata defined by age, sex, geographical region (east/west), migration status and socioeconomic status. Expected differences in health-related quality of life of children and adolescents from different social backgrounds and with different health statuses were demonstrated by differences in the KINDL-R scores (effect size d up to 1.29). This study provides representative, normative data (self-report and parent-report) on the test scores of health-related quality of life (KINDL-R) for the population of children and adolescents in Germany in general, as well as in sociodemographic and socioeconomic subpopulations.

Young adolescents who combine alcohol and energy drinks have a higher risk of reporting negative behavioural outcomes.

PubMed

Holubcikova, Jana; Kolarcik, Peter; Madarasova Geckova, Andrea; Joppova, Eva; van Dijk, Jitse P; Reijneveld, Sijmen A

2017-04-01

To explore whether young adolescents consuming alcohol and energy drinks combined were more likely to report negative behavioural outcomes than their peers who drink only one type of these beverages or are abstinent. We analysed data on a representative sample of Slovak adolescents 8502 adolescents (mean age 13.21, 49.4 % boys) from the 2014 Health Behaviour in School-aged Children cross-sectional study. We assessed the associations of alcohol and energy drinks consumption with negative outcomes and their potential synergy, as measured by the synergy index (SI). Adolescents consuming both alcohol and energy drinks were at higher risk of negative behavioural outcomes than their peers who drank only alcohol or energy drinks or were non-consumers. Consumers of alcohol and energy drinks were highly prone to be involved in fighting-the joint association of alcohol and energy drinks consumption was greater than sum of its associations separately in relation to fighting (SI 1.49; 95 % confidence interval 1.03-2.16). Preventive strategies should aim at increasing awareness of negative behavioural outcomes-especially aggressive behaviour associated with alcohol and energy drinks consumption among young adolescents.

Development of a music group psychotherapy intervention for the primary prevention of adjustment difficulties in Korean adolescent girls.

PubMed

Kim, Sunah; Kverno, Karan; Lee, Eun Mi; Park, Jeong Hwa; Lee, Hyun Hwa; Kim, Hyun Lye

2006-08-01

Traditionally, adolescent mental health in Korea has not been a prime focus for educators, health workers, and politicians, yet a majority of sampled adolescents report interpersonal sensitivity (Kim, 2003). Thirty-five adolescent girls took part in a six-session school-based music group psychotherapy pilot intervention designed to promote relationships and improve self-control skills. Participants identified several outcome benefits that may serve as protective factors in their continued social and emotional development. Music is a medium that promotes interpersonal relatedness among Korean adolescent girls. More research is necessary to identify long-term benefits of preventive music group psychotherapy interventions among the adolescent population.

Long-Term Effect of Exposure to a Friend's Adolescent Childbirth on Fertility, Education, and Earnings.

PubMed

Kapinos, Kandice A; Yakusheva, Olga

2016-09-01

To examine the long-term effect of a female adolescent's exposure to a peer's childbirth on fertility, schooling, and earnings. Estimating causal peer effects in fertility is challenging because the exposure variable (peer pregnancy and childbirth) is nonrandomly assigned. Miscarriages in early pregnancy occur spontaneously in a significant proportion of pregnancies and, therefore, create a natural experiment within which the causal effect of childbirth can be examined. This exploratory study compared adjusted fertility, educational, and labor market outcomes of female adolescents whose adolescent pregnant friend gave birth to female adolescents whose pregnant friend miscarried. Longitudinal data from the National Longitudinal Study of Adolescent Health were analyzed using logistic, ordinal logistic, linear, and log-linear regressions. Females whose adolescent pregnant friends gave birth (instead of miscarried) had decreased adolescent sexual activity, pregnancy, and teen childbearing and increased educational attainment, but there were no significant long-term effects on total fertility or differences in labor market outcomes, relative to females whose pregnant adolescent friend miscarried. Adolescent females appear to learn vicariously from teen childbearing experiences of their friends, resulting in delayed childbearing and higher educational attainment. Interventions that expose adolescents to the reality of teen motherhood may be an effective way of reducing the rates of teen childbearing and improving schooling. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Sexual risk behavior and STI health literacy among ethnic minority adolescent women.

PubMed

Dimmitt Champion, Jane; Harlin, Badia; Collins, Jennifer L

2013-11-01

Although information is available for prevention of sexually transmitted infection (STI/HIV), adolescents continue to engage in high risk sexual behavior particularly ethnic minority adolescent women with histories of STI or abuse. A description therefore of STI/HIV knowledge and sexual risk behavior among these women is indicated for modification of prevention efforts for sexual health promotion. African-American (n=94) and Mexican-American (n=465) adolescent women 14-18 years of age were included in the study. Assessments of sexual risk behavior and STI/HIV knowledge among these adolescent women described Mexican-American women as at higher risk of STI, pregnancy, substance use and abuse with lower levels of STI/HIV knowledge, previous HIV testing and perceptions of risk than African-American women. A focus on Mexican-American adolescent women with histories of STI and abuse is indicated for translation of community-based health promotion interventions for amelioration of potential adverse sexual health outcomes among ethnic minority adolescent women. © 2013.

Measurement of alienation among adolescents: construct validity of three scales on powerlessness, meaninglessness and social isolation.

PubMed

Rayce, Signe Boe; Kreiner, Svend; Damsgaard, Mogens Trab; Nielsen, Tine; Holstein, Bjørn Evald

2017-01-01

Psychological alienation is an important concept in the study of adolescents' health and behavior but no gold standard for measuring alienation among adolescents exists. There is a need for new scales with high validity for use in adolescent health and social research. The purpose of the present study was to develop and validate alienation scales in accordance with Seeman's conceptualization of alienation focusing on three independent variants specifically relevant in adolescent health research: powerlessness, meaninglessness and social isolation. Cross-sectional data from 3083 adolescents aged 13 to 15 years from the Danish contribution to the cross-national study Health Behaviour in School-aged Children (HBSC) were used. We identified and developed items, addressed content and face validity through interviews, and examined the criterion-related construct validity of the scales using graphical loglinear Rasch models (GLLRM). The three scales each comprised three to five face valid items. The powerlessness scale reflected the adolescent's expectancy as to whether his/her behavior can determine the outcome or reinforcement he/she seeks. The meaninglessness scale reflected the expectancy as to whether satisfactory predictions regarding the effects of one's behavior are possible. Finally, the social isolation scale reflected whether the adolescent had a low expectancy for inclusion and social acceptance. All scales contained some uniform local dependency and differential item functioning. However, only to a limited degree, which could be accounted for using GLLRM. Thus the scales fitted GLLRMs and can therefore be considered to be essentially construct valid and essentially objective. The three alienation scales appear to be content and face valid and fulfill the psychometric properties of a good construct valid reflective scale. This suggests that the scales may be appropriate in future large-scale surveys to examine the relation between alienation and a range of adolescent health outcomes such as health, behavior and wellbeing.

Mental health outcomes of developmental coordination disorder in late adolescence.

PubMed

Harrowell, Ian; Hollén, Linda; Lingam, Raghu; Emond, Alan

2017-09-01

To assess the relationship between developmental coordination disorder (DCD) and mental health outcomes in late adolescence. Data were analyzed from the Avon Longitudinal Study of Parents and Children. Moderate-to-severe DCD was defined at 7 to 8 years according to the DSM-IV-TR criteria. Mental health was assessed at 16 to 18 years using self-reported questionnaires: Strengths and Difficulties Questionnaire, Short Moods and Feelings Questionnaire, and the Warwick-Edinburgh Mental Well-being Scale. Logistic and linear regressions assessed the associations between DCD and mental health, using multiple imputation to account for missing data. Adjustments were made for socio-economic status, IQ, and social communication difficulties. Adolescents with DCD (n=168) had an increased risk of mental health difficulties (total Strengths and Difficulties Questionnaire score) than their peers (n=3750) (odds ratio 1.78, 95% confidence interval 1.12-2.83, adjusted for socio-economic status and IQ). This was, in part, mediated through poor social communication skills. Adolescent females with DCD (n=59) were more prone to mental health difficulties than males. Greater mental well-being was associated with better self-esteem (β 0.82, p<0.001). Individuals with DCD, particularly females, had increased risk of mental health difficulties in late adolescence. Interventions that aim to promote resilience in DCD should involve improving social communication skills and self-esteem. © 2017 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Stressful life experiences in adolescence and cardiometabolic risk factors in young adulthood.

PubMed

Wickrama, Kandauda A S; Lee, Tae-Kyoung; O'Neal, Catherine Walker

2015-04-01

An increasing number of studies have provided evidence for the persistent influence of childhood/adolescent socioeconomic adversities on subsequent health outcomes. However, less is known about the distinct and additive influences of these early socioeconomic adversities and adolescents' own stressful life experiences on health outcomes in young adulthood. We used data from 11,030 adolescents who participated in the National Longitudinal Study of Adolescent Health at Waves 1, 3, and 4 and provided biomarker data at Wave 4. Three early socioeconomic adversities (community socioeconomic adversity, family economic hardship, and low parental education) were evaluated. Adolescents' stressful transition to young adulthood was captured by six specific precocious life events as follows: early sex, early marriage or cohabitation, early leaving home, early pregnancy, early employment, and truncated education. A summary measure of cardiovascular and metabolic disease risk was assessed using nine biomarkers. Univariate, bivariate, and multivariate regression analyses were employed. Early socioeconomic adversities and stressful life transition events were uniquely associated with elevated levels of cardiometabolic (CM) biomarkers and cumulative CM disease risk. For all of the biomarkers, young adults in high-adversity/stress groups were more likely to be in the high CM disease risk groups (>75th percentile) than in the low-adversity/stress groups. These findings provide support for the influence of multiple early socioeconomic adversities and adolescents' stressful life transitions on their CM disease risk as young adults. Increased efforts to prevent and mitigate these experiences may improve disease risks across a number of biomarkers. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Testing Components of a Self-Management Theory in Adolescents With Type 1 Diabetes Mellitus.

PubMed

Verchota, Gwen; Sawin, Kathleen J

The role of self-management in adolescents with type 1 diabetes mellitus is not well understood. The purpose of the research was to examine the relationship of key individual and family self-management theory, context, and process variables on proximal (self-management behaviors) and distal (hemoglobin A1c and diabetes-specific health-related quality of life) outcomes in adolescents with type 1 diabetes. A correlational, cross-sectional study was conducted to identify factors contributing to outcomes in adolescents with Type 1 diabetes and examine potential relationships between context, process, and outcome variables delineated in individual and family self-management theory. Participants were 103 adolescent-parent dyads (adolescents ages 12-17) with Type 1 diabetes from a Midwest, outpatient, diabetes clinic. The dyads completed a self-report survey including instruments intended to measure context, process, and outcome variables from individual and family self-management theory. Using hierarchical multiple regression, context (depressive symptoms) and process (communication) variables explained 37% of the variance in self-management behaviors. Regimen complexity-the only significant predictor-explained 11% of the variance in hemoglobin A1c. Neither process variables nor self-management behaviors were significant. For the diabetes-specific health-related quality of life outcome, context (regimen complexity and depressive symptoms) explained 26% of the variance at step 1; an additional 9% of the variance was explained when process (self-efficacy and communication) variables were added at step 2; and 52% of the variance was explained when self-management behaviors were added at Step 3. In the final model, three variables were significant predictors: depressive symptoms, self-efficacy, and self-management behaviors. The individual and family self-management theory can serve as a cogent theory for understanding key concepts, processes, and outcomes essential to self-management in adolescents and families dealing with Type 1 diabetes mellitus.

Youth Risk Factors and Educational Outcomes of Mentored and Non-Mentored Youth

ERIC Educational Resources Information Center

Castellanos-Brown, Karen

2010-01-01

As mentoring is receiving increasing attention as a method to improve youth educational outcomes, it is important to continue to examine the effects of mentoring on these youth outcomes. This study uses secondary data from Waves I and III of the National Longitudinal Study of Adolescent Health (Add Health) and transcript data from the Adolescent…

Systematic review of effectiveness of universal self-regulation-based interventions and their effects on distal health and social outcomes in children and adolescents: review protocol.

PubMed

Pandey, Anuja; Hale, Daniel; Goddings, Anne-Lise; Blakemore, Sarah-Jayne; Viner, Russell

2017-08-29

Growing evidence suggests that childhood and adolescence self-regulation contributes to multiple health, educational and social outcomes. Considering the potential impact of self-regulation skills on improved life chances in conjunction with evidence suggesting that self-regulation can be modified by interventions, there is a need to identify interventions which are most effective in improving childhood and adolescence self-regulation. The present systematic review was designed to determine the effectiveness of universal interventions focused on enhancing the self-regulation of children and adolescents. As secondary outcomes, we will also examine the effectiveness of such interventions on distal health and social outcomes. Eligible studies include randomised controlled trials (including cluster randomised trials) reporting on universal interventions designed to improve self-regulation in childhood and adolescence (age 0-19 years). The following databases will be searched for peer-reviewed publications using an iterative search strategy: Medline, PsycINFO, EMBASE, ERIC, CINAHL Plus, British Education Index, Child Development & Adolescent Studies and CENTRAL without applying language or date filters. Additionally, reference lists and citations of included studies will be searched for eligible studies. A 10% proportion of the total titles and abstracts will be randomly selected and screened independently by two reviewers (AP and DH). Results will be compared to ensure less than 5% discrepancy, followed by screening of all results by one reviewer (AP). Full-text review and data collection will be independently performed by two reviewers. Any discrepancies will be solved by mutual discussion, and if unresolved, a third reviewer (RV) will be consulted. Meta-analysis will be conducted to quantify trial effects, if the data is sufficiently homogenous to allow quantitative synthesis. Otherwise, results will be described narratively. The evidence derived from the systematic review will strengthen the evidence base to inform planning of effective interventions targeting self-regulation skills in childhood and adolescence. This will benefit policy makers, academicians, researchers, health professionals, and also, young people who will benefit from policy and interventions informed by this review. CRD42016047661 .

Victimization among Peruvian Adolescents: Insights into Mental/Emotional Health from the Young Lives Study

ERIC Educational Resources Information Center

Lister, Cameron E.; Merrill, Ray M.; Vance, David L.; West, Joshua H.; Hall, Parley C.; Crookston, Benjamin T.

2015-01-01

Background: Bullying is a global problem among children and adolescents. The purpose of this study was to explore bully victimization in Peru and to identify potential adverse mental health and social outcomes resulting from bully victimization. Methods: This study analyzed data from an ongoing prospective cohort of children taking part in the…

Prevalence and Mental Health Correlates of Witnessed Parental and Community Violence in a National Sample of Adolescents

ERIC Educational Resources Information Center

Zinzow, Heidi M.; Ruggiero, Kenneth J.; Resnick, Heidi; Hanson, Rochelle; Smith, Daniel; Saunders, Benjamin; Kilpatrick, Dean

2009-01-01

Background: Although research suggests that witnessed violence is linked to adverse mental health outcomes among adolescents, little is known about its prevalence or its significance in predicting psychiatric symptoms beyond the contribution of co-occurring risk factors. The purpose of this study was to identify the national prevalence of…

Women Aboard Navy Ships: A Comprehensive Health and Readiness Research Project

DTIC Science & Technology

1996-03-01

Pediatric Adolescent Endocrinology 1980; 10: 123-132. 19. Inui TS, Yourtee EL, Williamson JW. Improved outcomes in hypertension after physician...These shipboard, duty, and military life stressors and psychosocial stress outcomes need to be examined in relationship to a number of health and health...Pregnancy outcomes were investigated in large-scale surveys conducted by the Navy in 1988, 1990, and 1992 [9]. The findings indicated that military

Patient-reported outcomes in child and adolescent mental health services (CAMHS): use of idiographic and standardized measures.

PubMed

Wolpert, Miranda; Ford, Tamsin; Trustam, Emma; Law, Duncan; Deighton, Jessica; Flannery, Halina; Fugard, Andrew J B; Fugard, Rew J B

2012-04-01

There is increasing emphasis on use of patient-reported outcome measures (PROMs) in mental health but little research on the best approach, especially where there are multiple perspectives. To present emerging findings from both standardized and idiographic child-, parent- and clinician-rated outcomes in child and adolescent mental health services (CAMHS) and consider their correlations. Outcomes were collected in CAMHS across the UK. These comprised idiographic measures (goal-based outcomes) and standardized measures (practitioner-rated Children's Global Assessment Scale; child- and parent-rated Strengths and Difficulties Questionnaire). There was reliable positive change from the beginning of treatment to later follow-up according to all informants. Standardized clinician function report was correlated with standardized child difficulty report (r  =  - 0.26), standardized parent report (r  =  - 0.28) and idiographic joint client-determined goals (r  =  0.38) in the expected directions. These results suggest that routine outcome monitoring is feasible, and suggest the possibility of using jointly agreed idiographic measures alongside particular perspectives on outcome as part of a PROMs approach.

Transition into First Sex among Adolescents in Slum and Non-Slum Communities in Nairobi, Kenya

ERIC Educational Resources Information Center

Kabiru, Caroline W.; Beguy, Donatien; Undie, Chi-Chi; Zulu, Eliya Msiyaphazi; Ezeh, Alex C.

2010-01-01

While early sexual experiences are a key marker of the transition from childhood to adulthood, it is widely acknowledged that precocious initiation of sexual activity predisposes adolescents to negative health and psychological outcomes. Extant studies investigating adolescent sexuality in sub-Saharan Africa often rely on cross-sectional data…

Heterogeneity in Two-Parent Families and Adolescent Well-Being

ERIC Educational Resources Information Center

Halpern-Meekin, Sarah; Tach, Laura

2008-01-01

This study highlights the heterogeneity in two-parent families and examines how adolescents fare when they reside in simple two-parent, blended, and stepfamilies. Using the National Longitudinal Study of Adolescent Health (N= 1,769), we find that shared biological children in blended families have worse outcomes than children in simple two-parent…

Frontostriatal Maturation Predicts Cognitive Control Failure to Appetitive Cues in Adolescents

ERIC Educational Resources Information Center

Somerville, Leah H.; Hare, Todd; Casey, B. J.

2011-01-01

Adolescent risk-taking is a public health issue that increases the odds of poor lifetime outcomes. One factor thought to influence adolescents' propensity for risk-taking is an enhanced sensitivity to appetitive cues, relative to an immature capacity to exert sufficient cognitive control. We tested this hypothesis by characterizing interactions…

Practice-Based Evidence for Children and Adolescents: Advancing the Research Agenda in Schools

ERIC Educational Resources Information Center

Kratochwill, Thomas R.; Hoagwood, Kimberly Eaton; Kazak, Anne E.; Weisz, John R.; Hood, Korey; Vargas, Luis A.; Banez, Gerard A.

2012-01-01

The American Psychological Association Task Force on Evidence- Based Practice for Children and Adolescents (2008) recommended a systems approach to enhancing care in order to improve outcomes for children and adolescents with mental health needs and redress persistent systemic problems with the structure of services. Recommendations for enhancing…

Sleep Patterns and Academic Performance during Preparation for College Entrance Exam in Chinese Adolescents

ERIC Educational Resources Information Center

Wang, Guanghai; Ren, Fen; Liu, Zhijun; Xu, Guangxing; Jiang, Fan; Skora, Elizabeth; Lewin, Daniel S.

2016-01-01

Background: Deficient sleep is linked to detrimental outcomes in health and school performance for adolescents. This study characterized sleep patterns in Chinese adolescents preparing for the College Entrance Exam (CEE) and evaluated the association between sleep patterns, self-rated academic performance, and the CEE scores. Methods: A sample of…

Predictors of Asian American Adolescents' Suicide Attempts: A Latent Class Regression Analysis

ERIC Educational Resources Information Center

Wong, Y. Joel; Maffini, Cara S.

2011-01-01

Although suicide-related outcomes among Asian American adolescents are a serious public health problem in the United States, research in this area has been relatively sparse. To address this gap in the empirical literature, this study examined subgroups of Asian American adolescents for whom family, school, and peer relationships exerted…

Generalized Anxiety Symptoms and Identity Processes in Cross-Cultural Samples of Adolescents from the General Population

ERIC Educational Resources Information Center

Crocetti, Elisabetta; Hale, William W., III.; Dimitrova, Radosveta; Abubakar, Amina; Gao, Cheng-Hai; Agaloos Pesigan, Ivan Jacob

2015-01-01

Background: Approximately 20% of adolescents around the world experience mental health problems, most commonly depression or anxiety. High levels of anxiety disorder symptoms can hinder adolescent development, persist into adulthood, and predict negative mental outcomes, such as suicidal ideation and attempts. Objectives: We analyzed generalized…

A Review of Hip Hop-Based Interventions for Health Literacy, Health Behaviors, and Mental Health.

PubMed

Robinson, Cendrine; Seaman, Elizabeth L; Montgomery, LaTrice; Winfrey, Adia

2018-06-01

African-American children and adolescents experience an undue burden of disease for many health outcomes compared to their White peers. More research needs to be completed for this priority population to improve their health outcomes and ameliorate health disparities. Integrating hip hop music or hip hop dance into interventions may help engage African-American youth in health interventions and improve their health outcomes. We conducted a review of the literature to characterize hip hop interventions and determine their potential to improve health. We searched Web of Science, Scopus, PsycINFO, and EMBASE to identify studies that assessed hip hop interventions. To be included, studies had to (1) be focused on a psychosocial or physical health intervention that included hip hop and (2) present quantitative data assessing intervention outcomes. Twenty-three articles were identified as meeting all inclusion criteria and were coded by two reviewers. Articles were assessed with regards to sample characteristics, study design, analysis, intervention components, and results. Hip hop interventions have been developed to improve health literacy, health behavior, and mental health. The interventions were primarily targeted to African-American and Latino children and adolescents. Many of the health literacy and mental health studies used non-experimental study designs. Among the 12 (of 14) health behavior studies that used experimental designs, the association between hip hop interventions and positive health outcomes was inconsistent. The number of experimental hip hop intervention studies is limited. Future research is required to determine if hip hop interventions can promote health.

Youth marijuana use: state of the science for the practicing clinician.

PubMed

Hadland, Scott E; Harris, Sion K

2014-08-01

Despite widespread marijuana use among adolescents, accurate information on known health effects is poorly disseminated to clinicians and their patients. Amidst rapidly evolving drug policy in the United States and elsewhere, it is imperative that providers understand the short-term and long-term consequences of marijuana use. Research on regular marijuana use highlights a unique susceptibility of the developing adolescent brain to adverse neurocognitive and psychiatric outcomes. Although studies have not firmly established causality, onset of regular marijuana use in adolescence is associated with later decline in cognitive function, as well as with adult onset of psychosis and anxiety. Educational and employment outcomes may be poorer among regular marijuana-using adolescents. A number of other adverse respiratory, cardiovascular, endocrine and gastrointestinal associations with regular marijuana use have also been established. Good screening tools and promising brief intervention and behavioral treatment programs are available to clinicians, who are in a position to identify problematic marijuana use among adolescents. A common misperception among youth is that marijuana use is without harm. However, adolescent marijuana use may have measurable, durable, and potentially irreversible effects on later cognitive function and mental health.

Does the quality of parent-child connectedness matter for adolescents' sexual behaviors in Nairobi informal settlements?

PubMed

Sidze, Estelle M; Elungata'a, Patricia; Maina, Beatrice W; Mutua, Michael M

2015-04-01

This study investigated the associations between parent-child connectedness and sexual behaviors among adolescents living in informal settlements in Nairobi, Kenya, a vulnerable group with respect to reproductive health outcomes. The study was based on data from the Transition to Adulthood project, a study designed to follow adolescents aged 12-22 for 3 years in the informal settlements of Korogocho and Viwandani. Direct face-to-face questions were asked to adolescents about parenting variables and sexual behaviors. This study used a subsample of 689 sexually experienced 12-22-years-olds at Wave 2. Bivariate analysis compared gender differences for three outcomes-sexual activity in the 12 months prior to the survey and, among those who had had sex in this period, multiple sexual partners and condom use at last sex. Multivariate logistic regressions were used to identify associations between these outcomes and the quality of parent-child connectedness. About 60% of adolescent females and males were sexually active in the 12 months prior to the survey. The multivariate results showed a strong association between the quality of parent-child connectedness and condom use among adolescent males. Living with related or unrelated guardians (versus living with biological parents) was also associated with higher odds of multiple sexual partners and lower odds of condom use at last sex among adolescent females and with higher odds of sexual activity among adolescent males. Sexual and reproductive health programs targeting adolescents living in Nairobi informal settlements would benefit from attention to assisting parents to improve their ability to play the connectedness role.

Adolescent sexual behavior and reproductive outcomes in Central America: trends over the past two decades.

PubMed

Samandari, Ghazaleh; Speizer, Ilene S

2010-03-01

Compared with the Latin American average, adolescent fertility is high in El Salvador, Guatemala, Honduras and Nicaragua, countries that also have high poverty levels and poor access to reproductive health care. For each country, data were drawn from four national health surveys conducted between 1987 and 2007, and analysis focused on trends in sexual and reproductive behavior among adolescent females aged 15-19. Event history analysis examined transitions to first sexual intercourse, first union and first live birth across survey years; Cox hazard and logistic regression analyses assessed associations between selected demographic characteristics and these outcomes, as well as ever-use of a modern contraceptive method. The likelihood that adolescent females have initiated sexual intercourse has increased over time in El Salvador, Honduras and Nicaragua, and has remained stable in Guatemala. Meanwhile, the odds of having entered their first union have declined in Nicaragua and risen in El Salvador, but have not changed in Honduras or Guatemala. Notably, the likelihood that adolescents have ever used a modern contraceptive method has increased in all four countries over the survey years. Nicaraguan adolescents became significantly less likely to have had their first live birth over the study period. Finally, urban residence, education level and socioeconomic status were important predictors of adolescents' sexual and reproductive outcomes. Programmatic and policy initiatives should focus on improving adolescents' education and socio- economic prospects, and efforts are especially needed to help adolescents delay the age at which they become sexually active and enter their first union.

Could music potentially serve as a functional alternative to alcohol consumption? The importance of music motives among drinking and non-drinking adolescents

PubMed Central

JONKER, ANNA; KUNTSCHE, EMMANUEL

2014-01-01

Background and aims: This study investigated whether adolescents who drink and those who are teetotal differ in the link between music motives and health-related outcomes (life satisfaction, self-rated health, school pressure, somatic complaints, depressed and aggressive mood, physical powerlessness, frequency of being bullied and bullying others and evenings spent out with friends). It also looked at whether associations between music motives and health-related outcomes remained significant when drinking motives were included among drinkers. Methods: Confirmatory factor analysis and structural equation models were estimated based on data from 4,481 adolescents from Switzerland (mean age 14.5, SD = 0.9). Results: It was confirmed that the four music motives and the four drinking motives obtained by crossing the valence (positive–negative) and the source (internal–external) of expected change in affect form distinct dimensions (i.e. the 8-factor model best fitted the data). Drinkers and non-drinkers differed in the various links between music motives and health-related outcomes. For example, almost all the links between conformity music motives and the health-related outcomes were significant for non-drinkers but not for drinkers. Enhancement music motives, by contrast, were often significant for drinkers but not for non-drinkers. Coping music motives were significant among both drinkers and non-drinkers. These links were basically unchanged when drinking motives were taken into account. Discussion and conclusions: This study indicates that music serves important functions in the lives of adolescents, even among those who use alcohol for different motives. This makes listening to music a promising potential alternative to alcohol use. PMID:25592307

Relationships between familial HIV/AIDS and symptoms of anxiety and depression: the mediating effect of bullying victimization in a prospective sample of South African children and adolescents.

PubMed

Boyes, Mark E; Cluver, Lucie D

2015-04-01

South African children and adolescents living in HIV/AIDS-affected families are at elevated risk of both symptoms of anxiety and depressive symptoms. Poverty and HIV/AIDS-related stigma are additional risk factors for these negative mental health outcomes. Community level factors, such as poverty and stigma, are difficult to change in the short term and identifying additional potentially malleable mechanisms linking familial HIV/AIDS with mental health is important from an intervention perspective. HIV/AIDS-affected children are also at increased risk of bullying victimization. This longitudinal study aimed to determine whether prospective relationships between familial HIV/AIDS and both anxiety symptoms and depressive symptoms operate indirectly via bullying victimization. Adolescents (M = 13.45 years, 56.67 % female, n = 3,515) from high HIV-prevalent (>30 %) communities in South Africa were interviewed and followed-up one year later (n = 3,401, 96.70 % retention). Census enumeration areas were randomly selected from urban and rural sites in two provinces, and door-to-door sampling included all households with a resident child/adolescent. Familial HIV/AIDS at baseline assessment was not directly associated with mental health outcomes 1 year later. However, significant indirect effects operating via bullying victimization were obtained for both anxiety and depression scores. Importantly, these effects were independent of poverty, HIV/AIDS-related stigma, and baseline mental health, which highlight bullying victimization as a potential target for future intervention efforts. The implementation and rigorous evaluation of bullying prevention programs in South African communities may improve mental health outcomes for HIV/AIDS-affected children and adolescents and this should be a focus of future research and intervention.

Maternal work hours and adolescents' school outcomes among low-income families in four urban counties.

PubMed

Gennetian, Lisaa A; Lopoo, Leonard M; London, Andrew S

2008-02-01

We examine how changes in maternal work hours affect adolescent children's school participation and performance outcomes using data from interviews in 1998 and 2001 with approximately 1700 women who, in May 1995, were welfare-reliant, single mothers of adolescents living in neighborhoods of concentrated poverty in Cuyahoga (Cleveland), Los Angeles, Miami-Dade, and Philadelphia counties. Analyses control for a broad array of mothers' characteristics, including their psychological and physical health, experiences with domestic violence and substance abuse, as well as unobserved time-invariant characteristics. In fixed-effects models, we find unfavorable effects of increased maternal work hours on three of six outcomes: skipping school, performing above average, and parental contact about behavior problems. Adolescent-aged sons seem to be particularly sensitive to changes in mothers' hours of work.

Adolescent outcomes and opportunities in a Canadian province: looking at siblings and neighbors.

PubMed

Roos, Leslie L; Walld, Randy; Witt, Julia

2014-05-26

Well-organized administrative data with large numbers of cases (building on linked files from several government departments) and a population registry facilitate new studies of population health and child development. Analyses of family relationships and a number of outcomes--educational achievement, health, teen pregnancy, and receipt of income assistance--are relatively easy to conduct using several birth cohorts. Looking both at means/proportions and at sibling correlations enriches our study of opportunity and well-being in late adolescence. With observational research possibly exaggerating the causal effects of risk factors, sibling comparisons involving individuals sharing both many family characteristics and many genes help deal with such criticisms. This paper uses a rich dataset from one Canadian province (Manitoba) covering a wide range of geographical areas (cities to rural regions). Influences on opportunity and well-being are analyzed looking at both means/proportions and sibling correlations. We measure a variety of outcomes that may reflect different causal influences. A creative application of linear programming advances the use of data on residential location. Predicting educational achievement using available variables was much easier than predicting adolescent health status (R-square of .200 versus R-square of .043). Low levels of educational achievement, high levels of teenage pregnancy, and high sibling correlations outside Winnipeg and within Winnipeg's lower income areas highlight inequalities across socioeconomic and geographic backgrounds. Stratifying our analyses by different variables, such as income quintiles, reveals differences in means and correlations within outcomes and across groups. Particular events--changes in mother's marital status and in place of residence--were associated with less favorable outcomes in late adolescence. Our findings suggest a paradox: Canadian developmental outcomes through late adolescence appear quite similar to those in the United States, even though intergenerational mobility in Canada is closer to mobility in the Nordic countries than to that in the United States.

Adolescent outcomes and opportunities in a Canadian province: looking at siblings and neighbors

PubMed Central

2014-01-01

Background Well-organized administrative data with large numbers of cases (building on linked files from several government departments) and a population registry facilitate new studies of population health and child development. Analyses of family relationships and a number of outcomes--educational achievement, health, teen pregnancy, and receipt of income assistance--are relatively easy to conduct using several birth cohorts. Looking both at means/proportions and at sibling correlations enriches our study of opportunity and well-being in late adolescence. With observational research possibly exaggerating the causal effects of risk factors, sibling comparisons involving individuals sharing both many family characteristics and many genes help deal with such criticisms. Methods This paper uses a rich dataset from one Canadian province (Manitoba) covering a wide range of geographical areas (cities to rural regions). Influences on opportunity and well-being are analyzed looking at both means/proportions and sibling correlations. We measure a variety of outcomes that may reflect different causal influences. A creative application of linear programming advances the use of data on residential location. Results Predicting educational achievement using available variables was much easier than predicting adolescent health status (R-square of .200 versus R-square of .043). Low levels of educational achievement, high levels of teenage pregnancy, and high sibling correlations outside Winnipeg and within Winnipeg’s lower income areas highlight inequalities across socioeconomic and geographic backgrounds. Stratifying our analyses by different variables, such as income quintiles, reveals differences in means and correlations within outcomes and across groups. Particular events--changes in mother’s marital status and in place of residence--were associated with less favorable outcomes in late adolescence. Conclusion Our findings suggest a paradox: Canadian developmental outcomes through late adolescence appear quite similar to those in the United States, even though intergenerational mobility in Canada is closer to mobility in the Nordic countries than to that in the United States. PMID:24884832

Delivering an action agenda for nutrition interventions addressing adolescent girls and young women: priorities for implementation and research.

PubMed

Bhutta, Zulfiqar A; Lassi, Zohra S; Bergeron, Gilles; Koletzko, Berthold; Salam, Rehana; Diaz, Angela; McLean, Mireille; Black, Robert E; De-Regil, Luz Maria; Christian, Parul; Prentice, Andrew M; Klein, Jonathan D; Keenan, William; Hanson, Mark

2017-04-01

Adolescent nutritional behaviors are assuming considerable importance in nutrition interventions given their important relationships with medium- and long-term outcomes. This is the period when young people undergo major anatomical and physiological maturational changes in preparation for adulthood. Nutritional requirements during puberty are higher during adolescence than during the prepubertal stage and during adulthood. A significant proportion of adolescents also become parents, and hence the importance of their health and nutritional status before as well as during pregnancy has its impact on their own health, fetal well-being, and newborn health. In this paper, we describe the evidence-based nutrition recommendations and the current global guidance for nutrition actions for adolescents. Despite the limitations of available information, we believe that a range of interventions are feasible to address outcomes in this age group, although some would need to start earlier in childhood. We propose packages of preventive care and management comprising nutrition-specific and nutrition-sensitive interventions to address adolescent undernutrition, overnutrition, and micronutrient deficiencies. We discuss potential delivery platforms and strategies relevant to low- and middle-income countries. Beyond the evidence synthesis, there is a clear need to translate evidence into policy and for implementation of key recommendations and addressing knowledge gaps through prioritized research. © 2017 New York Academy of Sciences.

The role of pharmacotherapy in the treatment of adolescent substance use disorders

PubMed Central

Hammond, Christopher J.

2016-01-01

Summary Adolescent substance use disorders (SUDs) are associated with elevated morbidity and mortality, and represent a significant public health cost. While psychosocial interventions for adolescent SUDs have demonstrated short-term efficacy, many youth relapse after treatment. A potential approach to improve treatment response is to use adjunctive pharmacotherapy. An increasing number of medications have been shown to improve SUD treatment outcomes for alcohol, tobacco, and opioid use disorders in adults. Although relatively few randomized controlled medication trials have been conducted in adolescents, results suggest that pharmacotherapies when added to psychosocial interventions may hold similar promise for improving outcomes for adolescents with SUDs. This article provides a review of current research on the safety and efficacy of pharmacotherapies used in the treatment of adolescent SUDs. PMID:27613346

Screening for Adolescent Idiopathic Scoliosis: Evidence Report and Systematic Review for the US Preventive Services Task Force.

PubMed

Dunn, John; Henrikson, Nora B; Morrison, Caitlin C; Blasi, Paula R; Nguyen, Matt; Lin, Jennifer S

2018-01-09

Adolescent idiopathic scoliosis (AIS), a spinal curvature of 10° or more, is the most common form of scoliosis, with a prevalence of 1% to 3%. Curves progress in approximately two-thirds of patients with AIS before skeletal maturity, and large curves (>50°) may be associated with adverse health outcomes. To systematically review evidence on benefits and harms of AIS screening for the US Preventive Services Task Force (USPSTF). Cochrane Central Register of Controlled Trials, MEDLINE, ERIC, PubMed, CINAHL, and relevant systematic reviews were searched for studies published from January 1966 to October 20, 2016; studies included in a previous USPSTF report were also reviewed. Surveillance was conducted through July 24, 2017. Fair- and good-quality studies that evaluated the accuracy of screening children and adolescents aged 10 to 18 years for AIS, the benefits of AIS treatment, the harms of AIS screening or treatment, or long-term health outcomes. Two investigators independently reviewed abstracts and full-text articles and extracted data into evidence tables. Results were qualitatively summarized. Health outcomes and spinal curvature in adolescence and adulthood, accuracy of screening for AIS, any harm of AIS screening or treatment. Fourteen studies (N = 448 276) in 26 articles were included. Accuracy of AIS screening was highest (93.8% sensitivity; 99.2% specificity) in a cohort study of a clinic-based program using forward bend test, scoliometer, and Moiré topography screening (n = 306 082); accuracy was lower in cohort studies of 6 programs using fewer modalities (n = 141 161). Four controlled studies (n = 587) found evidence for benefit of bracing on curve progression compared with controls. A randomized clinical trial and a nonrandomized trial of exercise treatment (N = 184) found favorable reductions in Cobb angle of 0.67° to 4.9° in the intervention group compared with increases of 1.38° to 2.8° in the control group. Two cohort studies (n = 339) on long-term outcomes found that braced participants reported more negative treatment experience and body appearance compared with surgically treated or untreated participants. A study that combined a randomized clinical trial and cohort design (n = 242) reported harms of bracing, which included skin problems on the trunk and nonback body pains. There was no evidence on the effect of AIS screening on adult health outcomes. Screening can detect AIS. Bracing and possibly exercise treatment can interrupt or slow progression of curvature in adolescence. However, there is little or no evidence on long-term outcomes for AIS treated in adolescence, the association between curvature at skeletal maturity and adult health outcomes, the harms of AIS screening or treatment, or the effect of AIS screening on adult health outcomes.

Running Away from Home: A Longitudinal Study of Adolescent Risk Factors and Young Adult Outcomes

ERIC Educational Resources Information Center

Tucker, Joan S.; Edelen, Maria Orlando; Ellickson, Phyllis L.; Klein, David J.

2011-01-01

Little is known about the adolescent risk factors and young adult health-related outcomes associated with running away from home. We examined these correlates of running away using longitudinal data from 4,329 youth (48% female, 85% white) who were followed from Grade 9 to age 21. Nearly 14% of the sample reported running away in the past year at…

Family structure and risk behaviors: the role of the family meal in assessing likelihood of adolescent risk behaviors

PubMed Central

Goldfarb, Samantha; Tarver, Will L; Sen, Bisakha

2014-01-01

Background Previous literature has asserted that family meals are a key protective factor for certain adolescent risk behaviors. It is suggested that the frequency of eating with the family is associated with better psychological well-being and a lower risk of substance use and delinquency. However, it is unclear whether there is evidence of causal links between family meals and adolescent health-risk behaviors. Purpose The purpose of this article is to review the empirical literature on family meals and adolescent health behaviors and outcomes in the US. Data sources A search was conducted in four academic databases: Social Sciences Full Text, Sociological Abstracts, PsycINFO®, and PubMed/MEDLINE. Study selection We included studies that quantitatively estimated the relationship between family meals and health-risk behaviors. Data extraction Data were extracted on study sample, study design, family meal measurement, outcomes, empirical methods, findings, and major issues. Data synthesis Fourteen studies met the inclusion criteria for the review that measured the relationship between frequent family meals and various risk-behavior outcomes. The outcomes considered by most studies were alcohol use (n=10), tobacco use (n=9), and marijuana use (n=6). Other outcomes included sexual activity (n=2); depression, suicidal ideation, and suicide attempts (n=4); violence and delinquency (n=4); school-related issues (n=2); and well-being (n=5). The associations between family meals and the outcomes of interest were most likely to be statistically significant in unadjusted models or models controlling for basic family characteristics. Associations were less likely to be statistically significant when other measures of family connectedness were included. Relatively few analyses used sophisticated empirical techniques available to control for confounders in secondary data. Conclusion More research is required to establish whether or not the relationship between family dinners and risky adolescent behaviors is an artifact of underlying confounders. We recommend that researchers make more frequent use of sophisticated methods to reduce the problem of confounders in secondary data, and that the scope of adolescent problem behaviors also be further widened. PMID:24627645

Spiritual well-being and mental health outcomes in adolescents with or without inflammatory bowel disease.

PubMed

Cotton, Sian; Kudel, Ian; Roberts, Yvonne Humenay; Pallerla, Harini; Tsevat, Joel; Succop, Paul; Yi, Michael S

2009-05-01

The purpose of this study was threefold: 1) to describe spiritual well-being (existential and religious well-being) in adolescents with inflammatory bowel disease (IBD) versus healthy peers; 2) to examine associations of spiritual well-being with mental health outcomes (emotional functioning and depressive symptoms); and 3) to assess the differential impact of existential versus religious well-being on mental health. A total of 155 adolescents aged 11-19 years from a children's hospital and a university hospital filled out questionnaires including the Spiritual Well-Being Scale, the Children's Depression Inventory-Short Form, and the Pediatric Quality of Life Inventory. Covariates in multivariable models included demographics, disease status, and interactions. Participants' mean (SD) age was 15.1 (2.0) years; 80 (52%) were male; and 121 (78%) were of white ethnicity. Levels of existential and religious well-being were similar between adolescents with IBD and healthy peers. In multivariable analyses, existential well-being was associated with mental health (partial R(2) change = .08-.11, p < .01) above and beyond other characteristics (total R(2) = .23, p < .01). Presence of disease moderated both the relationship between existential well-being and emotional functioning and that between religious well-being and depressive symptoms: that is, the relationships were stronger in adolescents with IBD as compared with healthy peers. Religious well-being was only marginally significantly associated with mental health after controlling for other factors. Although both healthy adolescents and those with IBD had high levels of spiritual well-being, having IBD moderated the relationship between spiritual well-being and mental health. Meaning/purpose was related to mental health more than was connectedness to the sacred.

Asthma and Respiratory Foundation NZ child and adolescent asthma guidelines: a quick reference guide.

PubMed

Asher, Innes; McNamara, David; Davies, Cheryl; Demetriou, Teresa; Fleming, Theresa; Harwood, Matire; Hetaraka-Stevens, Lorraine; Ingham, Tristram; Kristiansen, John; Reid, Jim; Rickard, Debbie; Ryan, Debbie

2017-12-01

The purpose of the New Zealand Child and adolescent asthma guidelines: a quick reference guide is to provide simple, practical, evidence-based recommendations for the diagnosis, assessment and management of asthma in children and adolescents in New Zealand, with the aim of improving outcomes and reducing inequities. The intended users are health professionals responsible for delivering asthma care in the community and hospital emergency department settings, and those responsible for the training of such health professionals.

Use of a resiliency framework to examine pregnancy and birth outcomes among adolescents: A qualitative study

PubMed Central

Solivan, Amber E.; Wallace, Maeve E.; Kaplan, Kathryn C.; Harville, Emily W.

2015-01-01

Introduction Adolescent childbearing has been viewed as a social, political, and public health priority since the 1970s. Research has primarily focused on the negative consequences of teen pregnancy; less research has explored factors associated with healthy pregnancy and birth experiences in this population. Methods Using open-ended and qualitative techniques, researchers performed individual interviews with fifteen adolescent mothers (15–19 years of age) recruited from a Women’s and Children’s Clinic in Southern Louisiana, who had experienced a healthy pregnancy and bore a full-term, normal birth weight infant. We used a resiliency framework to identify factors that may have supported positive health outcomes despite risks associated with low-income and/or marginalized minority status. Results A total of 15 mothers of multiple racial/ethnic identities were included in the analysis. Mothers discussed potential protective factors that we classified as either assets (internal factors) or resources (external factors). Mothers demonstrated strong assets including self-efficacy and self-acceptance and important resources including familial support and partner support during pregnancy which may have contributed to their resiliency. Discussion Ensuring access to social and structural supports as well as supporting adolescent-friendly health and social policies may be key to promoting healthy maternal and infant outcomes among young women who become pregnant. PMID:26237055

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature.

PubMed

Wheaton, Anne G; Chapman, Daniel P; Croft, Janet B

2016-05-01

Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades. However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insufficient sleep in this population and potentially to improve students' academic performance, reduce engagement in risk behaviors, and improve health. This article reviews 38 reports examining the association between school start times, sleep, and other outcomes among adolescent students. Most studies reviewed provide evidence that delaying school start time increases weeknight sleep duration among adolescents, primarily by delaying rise times. Most of the studies saw a significant increase in sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes. Although additional research is necessary, research results that are already available should be disseminated to stakeholders to enable the development of evidence-based school policies. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Adolescent Risk Screening Instruments for Primary Care: An Integrative Review Utilizing the Donabedian Framework.

PubMed

Hiott, Deanna B; Phillips, Shannon; Amella, Elaine

2017-07-31

Adolescent risk-taking behavior choices can affect future health outcomes. The purpose of this integrative literature review is to evaluate adolescent risk screening instruments available to primary care providers in the United States using the Donabedian Framework of structure, process, and outcome. To examine the literature concerning multidimensional adolescent risk screening instruments available in the United States for use in the primary care setting, library searches, ancestry searches, and Internet searches were conducted. Library searches included a systematic search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier, Health Source Nursing Academic Ed, Medline, PsycINFO, the Psychology and Behavioral Sciences Collection, and PubMed databases with CINAHL headings using the following Boolean search terms: "primary care" and screening and pediatric. Criteria for inclusion consisted of studies conducted in the United States that involved broad multidimensional adolescent risk screening instruments for use in the pediatric primary care setting. Instruments that focused solely on one unhealthy behavior were excluded, as were developmental screens and screens not validated or designed for all ages of adolescents. In all 25 manuscripts reviewed, 16 screens met the inclusion criteria and were included in the study. These 16 screens were examined for factors associated with the Donabedian structure-process-outcome model. This review revealed that many screens contain structural issues related to cost and length that inhibit provider implementation in the primary care setting. Process limitations regarding the report method and administration format were also identified. The Pediatric Symptom Checklist was identified as a free, short tool that is valid and reliable.

The associations between self-reported sleep duration and adolescent health outcomes: what is the role of time spent on Internet use?

PubMed

Do, Young Kyung; Shin, Eunhae; Bautista, Mary Ann; Foo, Kelvin

2013-02-01

This study aimed to examine the associations of self-reported sleep duration with adolescent health outcomes, taking into account time spent on Internet use. We used data from the 2008-2009 Korea Youth Behavioral Risk Factor Survey, a cross-sectional online survey of middle and high school students aged 13-18years in South Korea (N=136,589) to examine the associations of self-reported sleep duration with four mental and physical health measures, e.g. self-report of depressive symptoms, suicidal ideation, weight status, and self-rated health. The binary logit and generalized ordered logit models controlled for time spent on Internet use for non-study purposes and other factors. Shorter self-reported sleep duration was associated with a higher likelihood of reporting depressive symptoms, suicidal ideation, and overweight or obese status, and a lower likelihood of reporting better self-rated health, even after accounting for time spent on Internet use. Excessive Internet use was found to be an independent risk factor for these outcomes. Among in-school adolescents in South Korea, shorter sleep duration and excessive Internet use are independently and additively associated with multiple indicators of adverse health status. Excessive Internet use may have not only direct adverse health consequences, but also have indirect negative effects through sleep deprivation. Copyright © 2012 Elsevier B.V. All rights reserved.

Study protocol: evaluation of 'JenMe', a commercially-delivered weight management program for adolescents: a randomised controlled trial.

PubMed

Dordevic, Aimee L; Bonham, Maxine P; Ware, Robert S; Brennan, Leah; Truby, Helen

2015-06-19

Early lifestyle intervention with overweight and obese adolescents could help to avoid serious health events in early adulthood, ultimately alleviating some of the strain on the public health system due to obesity-related morbidity. Commercial weight loss programs have wide reach into the community setting, and have demonstrated success in long term weight management in adults, beyond that of current public health care. Commercial weight-management programs have not been evaluated as a method of delivery for overweight and obese adolescents. This study aims to evaluate the efficacy of a new adolescent weight management program in a commercial environment. One hundred and forty adolescents, 13 to 17 years old, will be randomised to either a weight management program intervention or a wait-listed group for 12 weeks. The commercial program will consist of a combined dietary and lifestyle approach targeting improved health behaviours for weight-loss or weight-stability. Participants will be overweight or obese (above the 85(th) percentile for BMI) and without existing co-morbidities. Outcome measures will be assessed at baseline and after 12 weeks. Primary outcome measures will be changes in BMI Z-score and waist-height ratio. Secondary outcome measures will include changes in behaviour, physical activity and psychosocial wellbeing. Intervention participants will be followed up at 6 months following completion of the initial program. Ethics approval has been granted from the Monash University Human Research Ethics Committee (CF11/3687-2011001940). This independent evaluation of a weight management program for adolescents, delivered in a commercial setting, will provide initial evidence for the effectiveness of such programs; which may offer adolescents an avenue of weight-management with ongoing support prior to the development of obesity related co-morbidities. The protocol for this study is registered with the International Clinical Trials Registry ISRCTN13602313.

Identifying sexual orientation health disparities in adolescents: analysis of pooled data from the Youth Risk Behavior Survey, 2005 and 2007.

PubMed

Mustanski, Brian; Van Wagenen, Aimee; Birkett, Michelle; Eyster, Sandra; Corliss, Heather L

2014-02-01

We studied sexual orientation disparities in health outcomes among US adolescents by pooling multiple Youth Risk Behavior Survey (YRBS) data sets from 2005 and 2007 for 14 jurisdictions. Here we describe the methodology for pooling and analyzing these data sets. Sexual orientation-related items assessed sexual orientation identity, gender of sexual contacts, sexual attractions, and harassment regarding sexual orientation. Wording of items varied across jurisdictions, so we created parallel variables and composite sexual minority variables. We used a variety of statistical approaches to address issues with the analysis of pooled data and to meet the aims of individual articles, which focused on a range of health outcomes and behaviors related to cancer, substance use, sexual health, mental health, violence, and injury.

Identifying Sexual Orientation Health Disparities in Adolescents: Analysis of Pooled Data From the Youth Risk Behavior Survey, 2005 and 2007

PubMed Central

Van Wagenen, Aimee; Birkett, Michelle; Eyster, Sandra; Corliss, Heather L.

2014-01-01

We studied sexual orientation disparities in health outcomes among US adolescents by pooling multiple Youth Risk Behavior Survey (YRBS) data sets from 2005 and 2007 for 14 jurisdictions. Here we describe the methodology for pooling and analyzing these data sets. Sexual orientation–related items assessed sexual orientation identity, gender of sexual contacts, sexual attractions, and harassment regarding sexual orientation. Wording of items varied across jurisdictions, so we created parallel variables and composite sexual minority variables. We used a variety of statistical approaches to address issues with the analysis of pooled data and to meet the aims of individual articles, which focused on a range of health outcomes and behaviors related to cancer, substance use, sexual health, mental health, violence, and injury. PMID:24328640

Evaluating Training Programs for Primary Care Providers in Child/Adolescent Mental Health in Canada: A Systematic Review

PubMed Central

Espinet, Stacey; Naqvi, Reza; Lingard, Lorelei; Steele, Margaret

2018-01-01

Introduction The need for child/adolescent mental health care in Canada is growing. Primary care can play a key role in filling this gap, yet most providers feel they do not have adequate training. This paper reviews the Canadian literature on capacity building programs in child and adolescent psychiatry for primary care providers, to examine how these programs are being implemented and evaluated to contribute to evidence-based initiatives. Methods A systematic literature review of peer-reviewed published articles of capacity building initiatives in child/adolescent mental health care for primary care practitioners that have been implemented in Canada. Results Sixteen articles were identified that met inclusion criteria. Analysis revealed that capacity building initiatives in Canada are varied but rigorous evaluation methodology is lacking. Primary care providers welcome efforts to increase mental health care capacity and were satisfied with the implementation of most programs. Discussion Objective conclusions regarding the effectiveness of these programs to increase mental health care capacity is challenging given the evaluation methodology of these studies. Conclusion Rigorous evaluation methods are needed to make evidence-based decisions on ways forward to be able to build child/adolescent mental health care capacity in primary care. Outcome measures need to move beyond self-report to more objective measures, and should expand the measurement of patient outcomes to ensure that these initiative are indeed leading to improved care for families. PMID:29662521

Current, future and potential use of mobile and wearable technologies and social media data in the ABCD study to increase understanding of contributors to child health.

PubMed

Bagot, K S; Matthews, S A; Mason, M; Squeglia, Lindsay M; Fowler, J; Gray, K; Herting, M; May, A; Colrain, I; Godino, J; Tapert, S; Brown, S; Patrick, K

2018-08-01

Mobile and wearable technologies and novel methods of data collection are innovating health-related research. These technologies and methods allow for multi-system level capture of data across environmental, physiological, behavioral, and psychological domains. In the Adolescent Brain Cognitive Development (ABCD) Study, there is great potential for harnessing the acceptability, accessibility, and functionality of mobile and social technologies for in-vivo data capture to precisely measure factors, and interactions between factors, that contribute to childhood and adolescent neurodevelopment and psychosocial and health outcomes. Here we discuss advances in mobile and wearable technologies and methods of analysis of geospatial, ecologic, social network and behavioral data. Incorporating these technologies into the ABCD study will allow for interdisciplinary research on the effects of place, social interactions, environment, and substance use on health and developmental outcomes in children and adolescents. Copyright © 2018. Published by Elsevier Ltd.

Depression, psychological distress and Internet use among community-based Australian adolescents: a cross-sectional study.

PubMed

Hoare, Erin; Milton, Karen; Foster, Charlie; Allender, Steven

2017-04-27

There has been rapid increase in time spent using Internet as a platform for entertainment, socialising and information sourcing. This study aimed to evaluate the relationship between duration of time spent using Internet for leisure, depressive symptoms, and psychological distress among Australian adolescents. Depressive symptoms were indicated by the youth self-report module from the Diagnostic and Statistical Manual of Mental Disorders Version IV criteria, and psychological distress was measured by Kessler Psychological Distress scale. Internet use was self-reported based on use on an average weekday, and an average weekend day. Multivariate logistic regression models were used to examine the relationship between Internet use and mental health outcomes. Models were adjusted for potential confounders: age; relative level of socio-economic disadvantage, and body mass index. Adolescents were aged 11-17 years (M = 14.5 years, SD = 2.04 years). Greatest time spent using internet (≥7 h a day) was significantly associated with experiencing depressive symptoms among females (OR = 2.09, 95% CI = 1.16, 3.76, p < 0.05), and high/very high levels of psychological distress for male (OR = 2.23, 95% CI = 1.36, 3.65, p < 0.01) and female (OR = 2.38, 95% CI = 1.55, 3.67, p < 0.01) adolescents. With current initiatives to improve health behaviours among adolescents to improve physical health outcomes such as overweight or obesity, it is imperative that the reciprocal relationship with mental health is known and included in such public health developments. Internet use may interact with mental health and therefore could be a modifiable risk factor to reach and improve mental health outcomes for this age group. Caution is advised in interpretation of findings, with some inconsistencies emerging from this evidence.

Parental separation in childhood as a risk factor for depression in adulthood: a community-based study of adolescents screened for depression and followed up after 15 years.

PubMed

Bohman, Hannes; Låftman, Sara Brolin; Päären, Aivar; Jonsson, Ulf

2017-03-29

Earlier research has investigated the association between parental separation and long-term health outcomes among offspring, but few studies have assessed the potentially moderating role of mental health status in adolescence. The aim of this study was to analyze whether parental separation in childhood predicts depression in adulthood and whether the pattern differs between individuals with and without earlier depression. A community-based sample of individuals with adolescent depression in 1991-93 and matched non-depressed peers were followed up using a structured diagnostic interview after 15 years. The participation rate was 65% (depressed n = 227; non-depressed controls n = 155). Information on parental separation and conditions in childhood and adolescence was collected at baseline. The outcome was depression between the ages 19-31 years; information on depression was collected at the follow-up diagnostic interview. The statistical method used was binary logistic regression. Our analyses showed that depressed adolescents with separated parents had an excess risk of recurrence of depression in adulthood, compared with depressed adolescents with non-separated parents. In addition, among adolescents with depression, parental separation was associated with an increased risk of a switch to bipolar disorder in adulthood. Among the matched non-depressed peers, no associations between parental separation and adult depression or bipolar disorder were found. Parental separation may have long-lasting health consequences for vulnerable individuals who suffer from mental illness already in adolescence.

Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa

PubMed Central

Cluver, Lucie D; Meinck, Franziska; Steinert, Janina I; Shenderovich, Yulia; Doubt, Jenny; Herrero Romero, Rocio; Lombard, Carl J; Redfern, Alice; Ward, Catherine L; Tsoanyane, Sibongile; Nzima, Divane; Sibanda, Nkosiyapha; Wittesaele, Camille; De Stone, Sachin; Boyes, Mark E; Catanho, Ricardo; Lachman, Jamie McLaren; Salah, Nasteha; Nocuza, Mzuvukile; Gardner, Frances

2018-01-01

Objective To assess the impact of ‘Parenting for Lifelong Health: Sinovuyo Teen’, a parenting programme for adolescents in low-income and middle-income countries, on abuse and parenting practices. Design Pragmatic cluster randomised controlled trial. Setting 40 villages/urban sites (clusters) in the Eastern Cape province, South Africa. Participants 552 families reporting conflict with their adolescents (aged 10–18). Intervention Intervention clusters (n=20) received a 14-session parent and adolescent programme delivered by trained community members. Control clusters (n=20) received a hygiene and hand-washing promotion programme. Main outcome measures Primary outcomes: abuse and parenting practices at 1 and 5–9 months postintervention. Secondary outcomes: caregiver and adolescent mental health and substance use, adolescent behavioural problems, social support, exposure to community violence and family financial well-being at 5–9 months postintervention. Blinding was not possible. Results At 5–9 months postintervention, the intervention was associated with lower abuse (caregiver report incidence rate ratio (IRR) 0.55 (95% CI 0.40 to 0.75, P<0.001); corporal punishment (caregiver report IRR=0.55 (95% CI 0.37 to 0.83, P=0.004)); improved positive parenting (caregiver report d=0.25 (95% CI 0.03 to 0.47, P=0.024)), involved parenting (caregiver report d=0.86 (95% CI 0.64 to 1.08, P<0.001); adolescent report d=0.28 (95% CI 0.08 to 0.48, P=0.006)) and less poor supervision (caregiver report d=−0.50 (95% CI −0.70 to −0.29, P<0.001); adolescent report d=−0.34 (95% CI −0.55 to −0.12, P=0.002)), but not decreased neglect (caregiver report IRR 0.31 (95% CI 0.09 to 1.08, P=0.066); adolescent report IRR 1.46 (95% CI 0.75 to 2.85, P=0.264)), inconsistent discipline (caregiver report d=−0.14 (95% CI −0.36 to 0.09, P=0.229); adolescent report d=0.03 (95% CI −0.20 to 0.26, P=0.804)), or adolescent report of abuse IRR=0.90 (95% CI 0.66 to 1.24, P=0.508) and corporal punishment IRR=1.05 (95% CI 0.70 to 1.57, P=0.819). Secondary outcomes showed reductions in caregiver corporal punishment endorsement, mental health problems, parenting stress, substance use and increased social support (all caregiver report). Intervention adolescents reported no differences in mental health, behaviour or community violence, but had lower substance use (all adolescent report). Intervention families had improved economic welfare, financial management and more violence avoidance planning (in caregiver and adolescent report). No adverse effects were detected. Conclusions This parenting programme shows promise for reducing violence, improving parenting and family functioning in low-resource settings. Trial registration number Pan-African Clinical Trials Registry PACTR201507001119966. PMID:29564157

Do school-based health centers improve adolescents' access to health care, health status, and risk-taking behavior?

PubMed

Kisker, E E; Brown, R S

1996-05-01

The purpose of this investigation was to assess the School-Based Adolescent Health Care Program, which provided comprehensive health-related services in 24 school-based health centers. The outcomes evaluation compared a cohort of students attending 19 participating schools and a national sample of urban youths, using logit models to control for observed differences between the two groups of youths. Outcome measures included self-reports concerning health center utilization, use of other health care providers, knowledge of key health facts, substance use, sexual activity, contraceptive use, pregnancies and births, and health status. The health centers increased students' access to health care and improved their health knowledge. However, the estimated impacts on health status and risky behaviors were inconsistent, and most were small and not statistically significant. School-based health centers can increase students' health knowledge and access to health-related services, but more intensive or different services are needed if they are to significantly reduce risk-taking behaviors.

Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study.

PubMed

Olbers, Torsten; Beamish, Andrew J; Gronowitz, Eva; Flodmark, Carl-Erik; Dahlgren, Jovanna; Bruze, Gustaf; Ekbom, Kerstin; Friberg, Peter; Göthberg, Gunnar; Järvholm, Kajsa; Karlsson, Jan; Mårild, Staffan; Neovius, Martin; Peltonen, Markku; Marcus, Claude

2017-03-01

Severe obesity in adolescence is associated with reduced life expectancy and impaired quality of life. Long-term benefits of conservative treatments in adolescents are known to be modest, whereas short-term outcomes of adolescent bariatric surgery are promising. We aimed to compare 5-year outcomes of adolescent surgical patients after Roux-en-Y gastric bypass with those of conservatively treated adolescents and of adults undergoing Roux-en-Y gastric bypass, in the Adolescent Morbid Obesity Surgery (AMOS) study. We did a nationwide, prospective, non-randomised controlled study of adolescents (aged 13-18 years) with severe obesity undergoing Roux-en-Y gastric bypass at three specialised paediatric obesity treatment centres in Sweden. We compared clinical outcomes in adolescent surgical patients with those of matched adolescent controls undergoing conservative treatment and of adult controls undergoing Roux-en-Y gastric bypass. The primary outcome measure was change in BMI over 5 years. We used multilevel mixed-effect regression models to assess longitudinal changes. This trial is registered with ClinicalTrials.gov, number NCT00289705. Between April, 2006, and May, 2009, 100 adolescents were recruited to the study, of whom 81 underwent Roux-en-Y gastric bypass (mean age 16·5 years [SD 1·2], bodyweight 132·8 kg [22·1], and BMI 45·5 kg/m 2 [SD 6·1]). 80 matched adolescent controls and 81 matched adult controls were enrolled for comparison of outcomes. The change in bodyweight in adolescent surgical patients over 5 years was -36·8 kg (95% CI -40·9 to -32·8), resulting in a reduction in BMI of -13·1 kg/m 2 (95% CI -14·5 to -11·8), although weight loss less than 10% occurred in nine (11%). Mean BMI rose in adolescent controls (3·3 kg/m 2 , 95% CI 1·1-4·8) over the 5-year study period, whereas the BMI change in adult controls was similar to that in adolescent surgical patients (mean change -12·3 kg/m 2 , 95% CI -13·7 to -10·9). Comorbidities and cardiovascular risk factors in adolescent surgical patients showed improvement over 5 years and compared favourably with those in adolescent controls. 20 (25%) of 81 adolescent surgical patients underwent additional abdominal surgery for complications of surgery or rapid weight loss and 58 (72%) showed some type of nutritional deficiency; health-care consumption (hospital attendances and admissions) was higher in adolescent surgical patients compared with adolescent controls. 20 (25%) of 81 adolescent controls underwent bariatric surgery during the 5-year follow-up. Adolescents with severe obesity undergoing Roux-en-Y gastric bypass had substantial weight loss over 5 years, alongside improvements in comorbidities and risk factors. However, gastric bypass was associated with additional surgical interventions and nutritional deficiencies. Conventional non-surgical treatment was associated with weight gain and a quarter of patients had bariatric surgery within 5 years. Swedish Research Council; Swedish Governmental Agency for Innovation Systems; National Board of Health and Welfare; Swedish Heart and Lung Foundation; Swedish Childhood Diabetes Foundation; Swedish Order of Freemasons Children's Foundation; Stockholm County Council; Västra Götaland Region; Mrs Mary von Sydow Foundation; Stiftelsen Göteborgs Barnhus; Stiftelsen Allmänna Barnhuset; and the US National Institute of Diabetes, Digestive, and Kidney Diseases (National Institutes of Health). Copyright © 2017 Elsevier Ltd. All rights reserved.

Adolescent Cancer Education (ACE) to increase adolescent and parent cancer awareness and communication: study protocol for a cluster randomised controlled trial.

PubMed

Kyle, Richard G; Macmillan, Iona; Rauchhaus, Petra; O'Carroll, Ronan; Neal, Richard D; Forbat, Liz; Haw, Sally; Hubbard, Gill

2013-09-08

Raising cancer awareness among adolescents has potential to increase their knowledge and confidence in identifying cancer symptoms and seeking timely medical help in adolescence and adulthood. Detecting cancer at an early stage is important because it reduces the risk of dying of some cancers and thereby contributes to improved cancer survival. Adolescents may also play an important role in increasing cancer communication within families. However, there are no randomised controlled trials (RCT) of the effectiveness of school-based educational interventions to increase adolescents' cancer awareness, and little is known about the role of adolescents in the upward diffusion of cancer knowledge to parents/carers. The aim of this study is to determine the effectiveness of a school-based educational intervention to raise adolescent and parent cancer awareness and adolescent-parent cancer communication. The Adolescent Cancer Education (ACE) study is a school-based, cluster RCT. Twenty secondary schools in the area covered by Glasgow City Council will be recruited. Special schools for adolescents whose additional needs cannot be met in mainstream education are excluded. Schools are randomised to receive a presentation delivered by a Teenage Cancer Trust educator in Autumn 2013 (intervention group) or Spring 2014 following completion of six-month follow-up measures (control group). Participants will be students recruited at the end of their first year of secondary education (S1) (age 12 to 13 years) and one parent/carer for each student, of the student's choice. The primary outcome is recognition of cancer symptoms two weeks post-intervention. Secondary outcomes are parents' cancer awareness and adolescent-parent cancer communication. Outcomes will be assessed at baseline (when adolescents are in the final term of S1), two-week, and six-month follow-up (when adolescents are in S2, age 13 to 14 years). Differences in outcomes between trial arms will be tested using multiple regression methods, adjusted for clustering by school. An audit of cancer-related and health-promotion activity within the school curriculum and environment during the RCT will be conducted at six-month follow-up to contextualise the intervention effect. Results from the ACE study will provide evidence about the public health effectiveness of a school-based intervention designed to increase adolescent and parent cancer awareness and adolescent-parent cancer communication. ISRCTN75542411.

Assessing the reach and effectiveness of mHealth: evidence from a reproductive health program for adolescent girls in Ghana.

PubMed

Rokicki, Slawa; Fink, Günther

2017-12-20

While mobile health (mHealth) programs are increasingly used to provide health information and deliver interventions, little is known regarding the relative reach and effectiveness of these programs across sociodemographic characteristics. We use data from a recent trial of a text-messaging intervention on adolescent sexual and reproductive health (SRH) to assess the degree to which mHealth programs reach target adolescent subpopulations who may be at higher risk of poor SRH outcomes. The study was conducted among girls aged 14-24 in 22 secondary schools in Accra, Ghana. The mHealth intervention was an interactive mobile phone quiz in which participants could win phone credit for texting correct answers to SRH questions. We use detailed data on individuals' level of engagement with the program, SRH knowledge scores, and self-reported pregnancy collected as part of the original trial to assess the extent to which engagement and program impact vary across parental education, sexual experience, SRH knowledge deficit, and parental support. Eighty-one percent of participants engaged with the mHealth program, with no evidence that the program disproportionally reached better-off groups. The program was effective at increasing knowledge of SRH across all strata. Higher levels of engagement were associated with higher knowledge scores up to year later. There was no significant impact of the program on self-reported pregnancy within subgroups. mHealth programs for adolescents have the potential to engage and increase SRH knowledge of adolescent girls across sociodemographic strata, including those who may be at higher risk of poor SRH outcomes. ClinicalTrials.gov NCT02031575 . Registered 07 Jan 2014.

Concordance Between Self-Reported Childhood Maltreatment Versus Case Record Reviews for Child Welfare–Affiliated Adolescents: Prevalence Rates and Associations With Outcomes

PubMed Central

Negriff, Sonya; Schneiderman, Janet U.; Trickett, Penelope K.

2017-01-01

The present study used data from an ongoing longitudinal study of the effects of maltreatment on adolescent development to (1) describe rates of maltreatment experiences obtained from retrospective self-report versus case record review for adolescents with child welfare–documented maltreatment histories, (2) examine self-reported versus child welfare–identified maltreatment in relation to mental health and risk behavior outcomes by maltreatment type, and (3) examine the association between the number of different types of maltreatment and mental health and risk behavior outcomes. Maltreatment was coded from case records using the Maltreatment Case Record Abstraction Instrument (MCRAI) and participants were asked at mean age = 18.49 about childhood maltreatment experiences using the Comprehensive Trauma Interview (CTI). Results showed that an average of 48% of maltreatment found by the MCRAI for each type of maltreatment were unique cases not captured by the CTI, whereas an average of 40% self-reported maltreatment (CTI) was not indicated by the MCRAI. Analyses with outcomes showed generally, self-reported maltreatment, regardless of concordance with MCRAI, was related to the poorest outcomes. The difference in associations with the outcomes indicates both self-report and case record review data may have utility depending on the outcomes being assessed. PMID:27777329

Perceptions of Vietnamese Fathers' Acculturation Levels, Parenting Styles, and Mental Health Outcomes in Vietnamese American Adolescent Immigrants

ERIC Educational Resources Information Center

Nguyen, Peter V.

2008-01-01

Vietnamese adult and adolescent immigrants in the United States acculturate to the Western culture at different rates. Most Vietnamese parents tend to use the authoritarian parenting method in which dictatorial approaches are enforced, possibly leading to family conflicts and mental health issues. By means of the Suinn-Lew Asian Self-Identity…

Teachers as Builders of Respectful School Climates: Implications for Adolescent Drug Use Norms and Depressive Symptoms in High School

ERIC Educational Resources Information Center

LaRusso, Maria D.; Romer, Daniel; Selman, Robert L.

2008-01-01

Positive school climates have been found to have favorable effects on adolescent health risk behaviors and mental health outcomes. However, the mechanisms by which teacher behavior may promote such effects in high schools have not been extensively studied. Based on social control theory and a social developmental-contextual model, it was predicted…

Adolescent Risk Behaviors: Studying Typical and Atypical Individuals via Multidimensional Scaling Profile Analysis

ERIC Educational Resources Information Center

Dong, Yang; Ding, Cody

2012-01-01

Within the framework of problem behavior theory, the purpose of this study was to examine risk behavior profiles of typical and atypical adolescents and the differential outcomes of well-beings for these individuals in the United States. Based on the data from the survey of Health Behavior of School-Aged Children by World Health Organization,…

Quality of care in American Indian child and adolescent behavioral health: A pilot study of patient and family perspectives

PubMed Central

Podlogar, Matthew C.; Novins, Douglas K.

2015-01-01

Research regarding the quality of behavioral health care for American Indian (AI) children and adolescents is extremely limited, and no study has considered the qualitative perspectives of the AI children receiving such services or that of their families. This pilot study investigated AI patient and family perspectives of what quality of care means to them. Data were drawn from interviews of parents (n = 15), and the youth (if they were age 11 or older; n = 11) of 16 children and adolescents who received treatment at three behavioral health programs serving AI communities. Interview transcripts were coded and analyzed for key themes that related to treatment structure, process, and outcomes. According to these participants, the principal indicator of treatment quality was “being able to trust the clinician.” The most valued treatment outcomes for improvement were the youth’s “self-efficacy and self-worth,” “functioning in school,” and “relationship with the family.” Future research is needed on how to best integrate these domains into specific and objective indicators for standardized quality of care assessments of AI child and adolescent behavioral health services. PMID:25961647

Effects of stigma on the mental health of adolescents orphaned by AIDS.

PubMed

Cluver, Lucie D; Gardner, Frances; Operario, Don

2008-04-01

By 2010, an estimated 18.4 million children in Sub-Saharan Africa will be orphaned by AIDS. Research in South Africa shows that AIDS orphanhood is independently associated with heightened levels of psychological problems. This study is the first to explore the mediating effects of stigma and other factors operating on a community level, on associations between AIDS orphanhood and mental health. We assessed the associations of four risk factors that can potentially be addressed at a community level (bullying, stigma, community violence, and lack of positive activities) with psychological problems and orphanhood status. One thousand twenty-five participants aged 10-19 were recruited from deprived urban settlements in South Africa. The sample included adolescents orphaned by AIDS (n = 425), adolescents orphaned by non-AIDS causes (n = 241), and nonorphaned adolescents (n = 278). Participants were interviewed using standardized psychological measures of depression, anxiety, posttraumatic stress, peer problems, delinquency, and conduct problems. Information on risk factors and demographic characteristics were also assessed. AIDS-orphaned adolescents reported higher levels of stigma and fewer positive activities than other groups. There were no reported differences on bullying or community violence. All community-level risk factors were associated with poorer psychological outcomes. Multivariate analyses controlling for age and gender showed that experience of stigma significantly mediated associations between AIDS orphanhood and poor psychological outcomes. Reduction of AIDS-related stigma could potentially reduce adverse psychological outcomes among AIDS-orphaned adolescents.

Latent profiles of non-residential father engagement six years after divorce predict long term offspring outcomes

PubMed Central

Modecki, Kathryn Lynn; Hagan, Melissa; Sandler, Irwin; Wolchik, Sharlene

2014-01-01

This study examined profiles of non-residential father engagement (i.e., support to the adolescent, contact frequency, remarriage, relocation, and interparental conflict) with their adolescent children (N = 156) six to eight years following divorce and the prospective relation between these profiles and the psychosocial functioning of their offspring, nine years later. Parental divorce occurred during late childhood to early adolescence; indicators of non-residential father engagement were assessed during adolescence, and mental health problems and academic achievement of offspring were assessed nine years later in young adulthood. Three profiles of father engagement were identified in our sample of mainly White, non-Hispanic divorced fathers: Moderate Involvement/Low Conflict, Low Involvement/Moderate Conflict, and High Involvement/High Conflict. Profiles differentially predicted offspring outcomes nine years later when they were young adults, controlling for quality of the mother-adolescent relationship, mother’s remarriage, mother’s income, and gender, age and offspring mental health problems in adolescence. Offspring of fathers characterized as Moderate Involvement/Low Conflict had the highest academic achievement and the lowest number of externalizing problems nine years later compared to offspring whose fathers had profiles indicating either the highest or lowest levels of involvement but higher levels of conflict. Results indicate that greater paternal psychosocial support and more frequent father-adolescent contact do not outweigh the negative impact of interparental conflict on youth outcomes in the long-term. Implications of findings for policy and intervention are discussed. PMID:24484456

The effects of bedtime and sleep duration on academic and emotional outcomes in a nationally representative sample of adolescents.

PubMed

Asarnow, Lauren D; McGlinchey, Eleanor; Harvey, Allison G

2014-03-01

The overall aim of this study was to clarify and better characterize the sleep/circadian patterns of adolescents in a nationally representative sample. We used three waves of data from the National Longitudinal Study of Adolescent Health to assess sleep/circadian patterns of 2,700 adolescents in grades seven through 12. Late school year bedtime was associated with shorter total sleep time cross-sectionally, whereas late summertime bedtime was not. Moreover, late school year bedtime was not associated with late summertime bedtime cross-sectionally. Late school year bedtime in Wave I (1994-1995) was associated with worse educational outcomes and emotional distress 6-8 years later. In addition, late summertime bedtime in Wave II (1996) was associated with more emotional distress at Wave III (2001-2002). Short total sleep time was not associated longitudinally with changes in emotional and academic functioning. Across Waves I and II, more than three quarters of adolescents who went to sleep at 11:15 a.m. or later during the school year or 1:30 a.m. or later during the summer reported sleeping fewer than the recommended 9 hours. These findings underscore the significance of evaluating and monitoring bedtime in adolescents and the importance of intervention strategies that target bedtimes in an effort to reduce associated functional impairments, and improve academic and emotional outcomes. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Latent profiles of nonresidential father engagement six years after divorce predict long-term offspring outcomes.

PubMed

Modecki, Kathryn Lynn; Hagan, Melissa J; Sandler, Irwin; Wolchik, Sharlene A

2015-01-01

This study examined profiles of nonresidential father engagement (i.e., support to the adolescent, contact frequency, remarriage, relocation, and interparental conflict) with their adolescent children (N = 156) 6 to 8 years following divorce and the prospective relation between these profiles and the psychosocial functioning of their offspring, 9 years later. Parental divorce occurred during late childhood to early adolescence; indicators of nonresidential father engagement were assessed during adolescence, and mental health problems and academic achievement of offspring were assessed 9 years later in young adulthood. Three profiles of father engagement were identified in our sample of mainly White, non-Hispanic divorced fathers: Moderate Involvement/Low Conflict, Low Involvement/Moderate Conflict, and High Involvement/High Conflict. Profiles differentially predicted offspring outcomes 9 years later when they were young adults, controlling for quality of the mother-adolescent relationship, mother's remarriage, mother's income, and gender, age, and offspring mental health problems in adolescence. Offspring of fathers characterized as Moderate Involvement/Low Conflict had the highest academic achievement and the lowest number of externalizing problems 9 years later compared to offspring whose fathers had profiles indicating either the highest or lowest levels of involvement but higher levels of conflict. Results indicate that greater paternal psychosocial support and more frequent father-adolescent contact do not outweigh the negative impact of interparental conflict on youth outcomes in the long term. Implications of findings for policy and intervention are discussed.

Family Homework and School-Based Sex Education: Delaying Early Adolescents' Sexual Behavior

ERIC Educational Resources Information Center

Grossman, Jennifer M.; Frye, Alice; Charmaraman, Linda; Erkut, Sumru

2013-01-01

Background: Early sexual activity can undermine adolescents' future school success and health outcomes. The purpose of this study was to assess the role of a family homework component of a comprehensive sex education intervention in delaying sexual initiation for early adolescents and to explore what social and contextual factors prevent…

The Impact of Negative Life Events on Young Adolescents: Comparing the Relative Vulnerability of Middle Level, High School, and College-Age Students

ERIC Educational Resources Information Center

Mann, Michael J.; Kristjansson, Alfgeir L.; Sigfusdottir, Inga Dora; Smith, Megan L.

2014-01-01

Early adolescence represents a particularly vulnerable period of development during which young people are susceptible to establishing lifelong behavior patterns associated with poor life, health, and educational outcomes. Previous research demonstrates older adolescents and young adults often experience negative life events (NLEs) prior to…

The health perspectives of Australian adolescents from same-sex parent families: a mixed methods study.

PubMed

Crouch, S R; Waters, E; McNair, R; Power, J

2015-05-01

Research involving adolescents from same-sex parent families provides an important contribution to the evidence base on their health, well-being and the impact of stigma. To date reports on the perspectives of adolescents with same-sex attracted parents have been limited. This study aimed to describe the multidimensional experiences of physical, mental and social well-being of adolescents living in this context. A mixed methods study of adolescents with same-sex attracted parents comprising of an adolescent-report survey of 10- to 17-year-olds and family interviews with adolescents and their parents. Data were collected in 2012 and 2013 as part of the Australian Study of Child Health in Same-Sex Families. The findings from qualitative interviews with seven adolescents and responses to an open-ended survey question (n = 16) suggest four themes: perceptions of normality, positive concepts of health, spheres of life (including family, friends and community) and avoiding negativity. The quantitative sample of adolescents with same-sex attracted parents (n = 35) reported higher scores than population normative data on the dimensions general health and family activities within the Child Health Questionnaire (CHQ) as well as higher on the peer problems scale on the Strengths and Difficulties Questionnaire (SDQ). Perceived stigma correlates with lower health and well-being overall. Positive health outcomes are informed by the ways adolescents conceptualize health and how they construct their spheres of life. Peer relationships, and community perspectives of same-sex families, inform perceived stigma and its correlation with poorer health and well-being. Although adolescents see their families as essentially normal they are negatively affected by external societal stigma. © 2014 John Wiley & Sons Ltd.

Self-investigation in adolescent chronic fatigue syndrome: narrative changes and health improvement.

PubMed

van Geelen, Stefan M; Fuchs, Coralie E; Sinnema, Gerben; van de Putte, Elise M; van Geel, Rolf; Hermans, Hubert J M; Kuis, Wietse

2011-05-01

A small-scale intervention study into narrative self-investigation in adolescent chronic fatigue syndrome (CFS). The self-confrontation method (SCM) is an instrument to assess and change personal life stories. Forty-two adolescents diagnosed with CFS were included and randomly assigned to either 6 or 12 sessions with the SCM. Twenty-five healthy adolescents were assigned to 6 sessions. Outcome was measured directly after the self-investigation procedure at 4 months. Follow-up measurements were made 10 months later. The Checklist Individual Strength and the Child Health Questionnaire were used to measure changes in fatigue, physical and psychosocial functioning. Self-investigation resulted in significant changes in participants' narratives. Moreover, after self-investigation there was a significant improvement in fatigue, physical and psychosocial functioning for the adolescents with CFS. The patients who completed 12 sessions improved most. At follow-up, the positive effects were maintained. Self-investigation enables a move beyond the symptoms of CFS in an individualized, patient centered way. Narrative transformation seems to contribute to improved physical and psychosocial outcome in adolescent CFS. The SCM allows adolescents to discover (for themselves) factors that might cause or perpetuate their fatigue. The results suggest that self-investigation is a useful instrument in the management of adolescent CFS. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Homeless but connected: the role of heterogeneous social network ties and social networking technology in the mental health outcomes of street-living adolescents.

PubMed

Rice, Eric; Kurzban, Seth; Ray, Diana

2012-12-01

Although social integration tends to have positive effects on the mental health of housed adolescents, the role of homeless adolescents' social networks is more ambiguous. Social network data were collected from 136 homeless adolescents in Hollywood, California to examine how network ties are associated with symptoms of anxiety and depression. Face-to-face relationships with street-based peers were a risk factor for both anxiety and depression, while contacting home-based friends through social networking technology was found to be protective for depression. Community-based and public agencies serving homeless adolescents should consider facilitating the maintenance of these protective relationships by providing internet access.

The relationship between parent mental health and intimate partner violence on adolescent behavior, stigma and school attendance in families in rural Democratic Republic of Congo.

PubMed

Glass, Nancy; Kohli, Anjalee; Surkan, Pamela J; Remy, Mitma Mpanano; Perrin, Nancy

2018-01-01

Prolonged conflict and economic instability challenge the existing support networks in families and society places significant stress on both adults and adolescents. Exploring individual, family and social factors that increase the likelihood of or protect adolescents from negative outcomes are important to the development of evidence-based prevention and response programing in global settings. Examine the relationship between parent mental health and experience/perpetration of intimate partner violence (IPV) and adolescent behaviors, stigma, and school attendance. The relationship is further examined for differences by gender. Secondary analysis of data from an ongoing comparative effectiveness trial of a productive asset transfer program in eastern Democratic Republic of Congo (DRC). Three hundred and eighty-eight adolescent and parent dyads were included in the analysis. The analysis demonstrated that parent mental health and IPV can have a negative impact their children's well-being and the impact is different for boys and girls, likely linked to gender roles and responsibilities in the home and community. Social relationships of adolescents, as reported through experienced stigma, were negatively impacted for both boys and girls. Parent report of symptoms of PTSD and depression had a stronger negative effect on girls' outcomes, including experienced stigma, externalizing behaviors, and missed days of school than boys. For adolescent boys, their parent's report of IPV victimization/perpetration was associated with more negative behaviors at the 8-month follow-up assessment. The findings reinforce the critical importance of interventions that engage parents and their children in activities that advance health and improve relationships within the family.

A positive perspective of knowledge, attitude, and practices for health-promoting behaviors of adolescents with congenital heart disease.

PubMed

Huang, Hui-Ru; Chen, Chi-Wen; Chen, Chin-Mi; Yang, Hsiao-Ling; Su, Wen-Jen; Wang, Jou-Kou; Tsai, Pei-Kwei

2018-03-01

Health-promoting behaviors could serve as a major strategy to optimize long-term outcomes for adolescents with congenital heart disease. The associations assessed from a positive perspective of knowledge, attitudes, and practice model would potentially cultivate health-promoting behaviors during adolescence. The purpose of this study was to examine the relationships between disease knowledge, resilience, family functioning, and health-promoting behaviors in adolescents with congenital heart disease. A total of 320 adolescents with congenital heart disease who were aged 12-18 years were recruited from pediatric cardiology outpatient departments, and participated in a cross-sectional survey. The participants completed the Leuven Knowledge Questionnaire for Congenital Heart Disease; Haase Adolescent Resilience in Illness Scale; Family Adaptability, Partnership, Growth, Affection, and Resolve; and Adolescent Health Promotion scales. The collected data were analyzed using descriptive statistics and three multiple regression models. Greater knowledge of prevention of complications and higher resilience had a more powerful effect in enhancing health-promoting behaviors. Having symptoms and moderate or severe family dysfunction were significantly more negatively predictive of health-promoting behaviors than not having symptoms and positive family function. The third model explained 40% of the variance in engaging in health-promoting behaviors among adolescents with congenital heart disease. The findings of this study provide new insights into the role of disease knowledge, resilience, and family functioning in the health-promoting behavior of adolescents with congenital heart disease. Continued efforts are required to plan family care programs that promote the acquisition of sufficient disease knowledge and the development of resilience for adolescents with congenital heart disease.

Mental Health Mobile Apps for Preadolescents and Adolescents: A Systematic Review.

PubMed

Grist, Rebecca; Porter, Joanna; Stallard, Paul

2017-05-25

There are an increasing number of mobile apps available for adolescents with mental health problems and an increasing interest in assimilating mobile health (mHealth) into mental health services. Despite the growing number of apps available, the evidence base for their efficacy is unclear. This review aimed to systematically appraise the available research evidence on the efficacy and acceptability of mobile apps for mental health in children and adolescents younger than 18 years. The following were systematically searched for relevant publications between January 2008 and July 2016: APA PsychNet, ACM Digital Library, Cochrane Library, Community Care Inform-Children, EMBASE, Google Scholar, PubMed, Scopus, Social Policy and Practice, Web of Science, Journal of Medical Internet Research, Cyberpsychology, Behavior and Social Networking, and OpenGrey. Abstracts were included if they described mental health apps (targeting depression, bipolar disorder, anxiety disorders, self-harm, suicide prevention, conduct disorder, eating disorders and body image issues, schizophrenia, psychosis, and insomnia) for mobile devices and for use by adolescents younger than 18 years. A total of 24 publications met the inclusion criteria. These described 15 apps, two of which were available to download. Two small randomized trials and one case study failed to demonstrate a significant effect of three apps on intended mental health outcomes. Articles that analyzed the content of six apps for children and adolescents that were available to download established that none had undergone any research evaluation. Feasibility outcomes suggest acceptability of apps was good and app usage was moderate. Overall, there is currently insufficient research evidence to support the effectiveness of apps for children, preadolescents, and adolescents with mental health problems. Given the number and pace at which mHealth apps are being released on app stores, methodologically robust research studies evaluating their safety, efficacy, and effectiveness is promptly needed. ©Rebecca Grist, Joanna Porter, Paul Stallard. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 25.05.2017.

Mental Health Mobile Apps for Preadolescents and Adolescents: A Systematic Review

PubMed Central

Porter, Joanna; Stallard, Paul

2017-01-01

Background There are an increasing number of mobile apps available for adolescents with mental health problems and an increasing interest in assimilating mobile health (mHealth) into mental health services. Despite the growing number of apps available, the evidence base for their efficacy is unclear. Objective This review aimed to systematically appraise the available research evidence on the efficacy and acceptability of mobile apps for mental health in children and adolescents younger than 18 years. Methods The following were systematically searched for relevant publications between January 2008 and July 2016: APA PsychNet, ACM Digital Library, Cochrane Library, Community Care Inform-Children, EMBASE, Google Scholar, PubMed, Scopus, Social Policy and Practice, Web of Science, Journal of Medical Internet Research, Cyberpsychology, Behavior and Social Networking, and OpenGrey. Abstracts were included if they described mental health apps (targeting depression, bipolar disorder, anxiety disorders, self-harm, suicide prevention, conduct disorder, eating disorders and body image issues, schizophrenia, psychosis, and insomnia) for mobile devices and for use by adolescents younger than 18 years. Results A total of 24 publications met the inclusion criteria. These described 15 apps, two of which were available to download. Two small randomized trials and one case study failed to demonstrate a significant effect of three apps on intended mental health outcomes. Articles that analyzed the content of six apps for children and adolescents that were available to download established that none had undergone any research evaluation. Feasibility outcomes suggest acceptability of apps was good and app usage was moderate. Conclusions Overall, there is currently insufficient research evidence to support the effectiveness of apps for children, preadolescents, and adolescents with mental health problems. Given the number and pace at which mHealth apps are being released on app stores, methodologically robust research studies evaluating their safety, efficacy, and effectiveness is promptly needed. PMID:28546138

Urban adolescent sexual and reproductive health in low-income and middle-income countries.

PubMed

Mmari, Kristin; Astone, Nan

2014-08-01

One of the most important aspects of adolescent health is sexual and reproductive health (SRH). Currently, sexually transmitted infections (STIs) threaten the health of adolescents more than any other age group, and as many as 2.2 million adolescents are living with HIV. Understanding adolescents' SRH needs and how to invest in improving their health can be best addressed by knowing more about the contexts that increase their vulnerability to poor sexual health outcomes. Recent evidence has highlighted an increasingly marginalised segment of the adolescent population--and that is the urban poor adolescent population in low and middle income countries (LMIC). Using an urban health framework, this paper examines the contextual factors within an urban community that influence the SRH of adolescents in LMIC. Findings show that while there is substantial research that has explored factors within the social environment, there is limited research that has explored factors within the physical environment, as well as research that has specifically explored urban adolescents' use of SRH services and how such services can be best provided to this vulnerable population. This paper highlights the need for further research to understand the relationships between the urban poor environment and the SRH risks that adolescents face while living in such environments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Factors affecting effective communication about sexual and reproductive health issues between parents and adolescents in zandspruit informal settlement, Johannesburg, South Africa.

PubMed

Motsomi, Kegaugetswe; Makanjee, Chandra; Basera, Tariro; Nyasulu, Peter

2016-01-01

Communication between parents and adolescents regarding sexuality is an important reproductive health topic. Due to complexities associated with adolescent's physiological development, sexuality should be dealt with holistically. This study aimed to investigate factors affecting effective communication between parents and adolescents concerning sexual and reproductive health issues. An exploratory qualitative study using the focus group discussions method was done to explore amongst other things; social, cultural and religious barriers to communication. Thematic content analysis was done. Factors identified included: embarrassment when discussing sexual topics; adolescent misperceptions that guardians want to engage in sexual activities with them; strong belief amongst guardians that reproductive health discussions with adolescents encourages sexual experimentation; belief that adolescents were too young to understand; non-conducive environment for open discussions of sexual and reproductive health matters; cultural and religious beliefs. In view of these findings, there are still barriers in terms of parent-adolescent engagement on issues related to risks associated with sexual behaviours and erroneous reproductive health choices among adolescents. Therefore, there is a need to encourage engagement by creating neutral platforms facilitated by community healthcare providers and/ or social workers. This will help create awareness and bridge the communication and interaction gap by emphasising the importance of effective engagement among adolescents and their parents on matters related to risks associated with sexual behaviours and erroneous reproductive health choices. Post implantation intervention studies are needed to inform on the outcomes of the intervention.

Social networking site (SNS) use by adolescent mothers: Can social support and social capital be enhanced by online social networks? - A structured review of the literature.

PubMed

Nolan, Samantha; Hendricks, Joyce; Ferguson, Sally; Towell, Amanda

2017-05-01

to critically appraise the available literature and summarise the evidence relating to adolescent mothers' use of social networking sites in terms of any social support and social capital they may provide and to identify areas for future exploration. social networking sites have been demonstrated to provide social support to marginalised individuals and provide psycho-social benefits to members of such groups. Adolescent mothers are at risk of; social marginalisation; anxiety disorders and depressive symptoms; and poorer health and educational outcomes for their children. Social support has been shown to benefit adolescent mothers thus online mechanisms require consideration. a review of original research articles METHOD: key terms and Boolean operators identified research reports across a 20-year timeframe pertaining to the area of enquiry in: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science, Health Collection (Informit) and Google Scholar databases. Eight original research articles met the inclusion criteria for this review. studies demonstrate that adolescent mothers actively search for health information using the Internet and social networking sites, and that social support and social capital can be attributed to their use of specifically created online groups from within targeted health interventions. Use of a message board forum for pregnant and parenting adolescents also demonstrates elements of social support. There are no studies to date pertaining to adolescent mothers' use of globally accessible social networking sites in terms of social support provision and related outcomes. further investigation is warranted to explore the potential benefits of adolescent mothers' use of globally accessible social networking sites in terms of any social support provision and social capital they may provide. Copyright © 2017 Elsevier Ltd. All rights reserved.

The relationship between hunger and mental health outcomes among school-going Ecuadorian adolescents.

PubMed

Romo, Matthew L; Abril-Ulloa, Victoria; Kelvin, Elizabeth A

2016-06-01

Mental health and food insecurity are major public health issues among adolescents in Ecuador. Our objective was to determine the relationship between hunger, symptoms of depression, and suicidal ideation among school-going Ecuadorian adolescents. We conducted crude and multivariable logistic regression models using data from the 2007 Global School-based Student Health Survey from Quito, Guayaquil, and Zamora, Ecuador (N = 5524). Hunger was defined as having gone hungry in the past 30 days due to lack of food in the home. Outcomes of interest were symptoms of depression and suicidal ideation with or without planning in the past year. Overall, 41.2 % (2200/5467) of students reported experiencing hunger. In multivariable logistic regression models, hunger had an increasing exposure-response relationship with symptoms of depression [sometimes hungry odds ratio (OR) 1.80, P = 0.0001; most of the time or always hungry OR 2.01, P < 0.0001] and suicidal ideation with planning (sometimes hungry OR 1.55, P = 0.04; most of the time or always hungry OR 2.63, P = 0.001). Hunger was associated with increased odds of symptoms of depression and suicidal ideation with planning. Strategies to improve mental health among adolescents in Ecuador should consider the potential contribution of hunger and food insecurity.

Associations of overweight and of weight dissatisfaction among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004).

PubMed

Al Sabbah, H; Vereecken, C; Abdeen, Z; Coats, E; Maes, L

2009-02-01

Overweight and obesity as well as weight dissatisfaction have been increasing in prevalence worldwide. Body weight dissatisfaction and fear of fatness are potential contributors to disordered eating. The present study aimed to investigate the prevalence of self-reported overweight and weight dissatisfaction along with associations with socio-demographic characteristics, body image, health complaints, risk behaviours, physical activity and television viewing in adolescents in Palestine. The 2003/04 Palestinian Health Behaviour in School-aged Children (HBSC) is a cross-sectional survey of 17,817 adolescents from 405 randomly selected schools. Students from a representative sample of grades 6, 8, 10 and 12 (aged 12-18 years) self-completed a modified version of the international World Health Organization collaborative Health Behaviour in School-aged Children (HBSC-2002) questionnaire. Although 16.5% of the adolescents were overweight, almost twice that number (32.1%) were dissatisfied with their weight (i.e. dieting or perceiving a need to diet). Of those adolescents, two-thirds were not actually overweight (56.4% boys; 73.5% girls). One-fifth of the total number of adolescents (16.0% boys; 24.0% girls) were not overweight but were dissatisfied with their weight. Boys reporting overweight or weight dissatisfaction were more likely to have mothers with higher education or to be from more affluent families. Among both genders, but especially among girls, weight dissatisfaction was positively associated with most of the outcome variables (body image, health complaints, risk behaviours, and television viewing) regardless of weight status, whereas weight status was associated with only a few of the outcome variables. Weight dissatisfaction, independent of weight status, is associated with body image, health complaints, risk behaviours and television viewing, and represents a potential health risk factor for adolescents. Preventive interventions should focus not only on weight status, but also on body weight dissatisfaction.

Who Adolescents Trust May Impact Their Health: Findings from Baltimore.

PubMed

Mmari, Kristin; Marshall, Beth; Lantos, Hannah; Blum, Robert Wm

2016-06-01

This study is one of the first to explore the relevance of trust to the health of adolescents living in a disadvantaged urban setting. The primary objectives were to determine the differences in the sociodemographic characteristics between adolescents who do and do not trust and to examine the associations between trust and health. Data were drawn from the Well-Being of Adolescents in Vulnerable Environments (WAVE) study, which is a cross-sectional global study of adolescents in very low-income urban settings conducted in 2011-2013. This paper focused on 446 adolescents in Baltimore as it was the primary site where trust was explicitly measured. For the main analyses, six health outcomes were examined: (1) self-rated health; (2) violence victimization; (3) binge drinking; (4) marijuana use; (5) post-traumatic stress disorder (PTSD); and (6) condom use at last sex. Independent variables included sociodemographic variables (age, gender, current school enrolment, perceived relative wealth, and family structure) and two dimensions of trust: community trust (trust in individuals/groups within neighborhood) and institutional trust (trust in authorities). The results show that more than half the sample had no trust in police, and a high proportion had no trust in other types of authority. Among girls, those with higher levels of community trust were less likely to be victimized and involved in binge drinking. Meanwhile, girls with higher levels of institutional trust were more likely to use a condom and less likely to have used marijuana. Among boys, those with higher levels of community trust were more likely to use a condom, while those with higher levels of institutional trust were less likely to use marijuana, but more likely binge drink. Overall, this study highlights the importance of trust for adolescent health. Most surprising were the differences in the associations between boys and girls with regard to the type of trust and specific health outcome that was significant.

Correlates and predictors of sexual health among adolescent Latinas in the United States: A systematic review of the literature, 2004-2015.

PubMed

Morales-Alemán, Mercedes M; Scarinci, Isabel C

2016-06-01

Adolescent Latinas in the United States (US) are disproportionately affected by early pregnancy, sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) in comparison to their non-Hispanic white counterparts. However, only a few studies have sought to understand the multi-level factors associated with sexual health in adolescent Latinas. Adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, we conducted a systematic literature review to better understand the correlates and predictors of sexual health among adolescent Latinas in the US, identify gaps in the research, and suggest future directions for empirical studies and intervention efforts. Eleven studies were identified: five examined onset of sexual intercourse, nine examined determinants of sexual health/risk behaviors (e.g., number of sexual partners and condom use), and three examined determinants of a biological sexual health outcome (i.e., STIs or pregnancy). Two types of variables/factors emerged as important influences on sexual health outcomes: proximal context-level variables (i.e., variables pertaining to the individual's family, sexual/romantic partner or peer group) and individual-level variables (i.e., characteristics of the individual). A majority of the studies reviewed (n=9) examined some aspect of acculturation or Latino/a cultural values in relation to sexual health. Results varied widely between studies suggesting that the relationship between individual and proximal contextual variables (including acculturation) and sexual health may be more complex than previously conceived. This review integrates the findings on correlates and predictors of sexual health among adolescent Latinas, and supports the need for strengths-based theoretically guided research on the mechanisms driving these associations. Copyright © 2016 Elsevier Inc. All rights reserved.

Occupational Therapy and Sexual and Reproductive Health Promotion in Adolescence: A Case Study.

PubMed

Gontijo, Daniela Tavares; de Sena e Vasconcelos, Anna Carolina; Monteiro, Rosana Juliet Silva; Facundes, Vera Lúcia Dutra; Trajano, Maria de Fátima Cordeiro; de Lima, Luciane Soares

2016-03-01

Occupational therapy can contribute to sexual and reproductive health through health education. The purpose of this study was to describe an occupational therapy intervention aimed at sexual and reproductive health promotion in adolescents. Fifty-eight adolescents were involved in the study, before, during and after the interventions. Educative activities such as puzzles, storytelling, mime and board games were used, which occupational therapy faculty and students had constructed. The games were employed as mediators for gaining knowledge in sexual and reproductive health. Outcome was measured using a questionnaire, audio recordings and field diaries. The data were analysed by descriptive statistics and thematic content analysis. The results showed the adolescents' increased knowledge of sexual and reproductive health information immediately after the intervention. The thematic analysis was grouped into three categories: the adolescents' initial expectations regarding the project, reflections on the process experienced during the interventions and use of educational games by occupational therapists. The importance of rapport and dialogue was highlighted in the construction of interventions based on participatory methods. The absence of a longitudinal follow-up is a limitation in this study. Further research is important to systematically assess sexual health promotion strategies in adolescence. Copyright © 2015 John Wiley & Sons, Ltd.

Paternal involvement in the management of pediatric chronic diseases: associations with adherence, quality of life, and health status.

PubMed

Wysocki, Tim; Gavin, Leslie

2006-06-01

This article reports associations among paternal involvement in pediatric chronic disease management and child outcomes. The Dads' Active Disease Support scale (DADS) and measures of treatment adherence, quality of life, health status, and health care utilization were obtained for youths with six chronic diseases, with complete data sets obtained from 190 couples. Paternal involvement was not associated with these outcomes among younger children. Among adolescents, mother-reported and father-reported DADS scores indicating more paternal involvement were associated with maintenance, rather than deterioration, of treatment adherence and more favorable quality of life. Youths' health status and health care utilization were not related significantly to paternal involvement. More paternal involvement was associated with more favorable adherence and quality of life among adolescents but not associated with health status or health care utilization. Longitudinal studies could verify whether paternal involvement merits clinical intervention.

Outcome Domains in Child Mental Health Research Since 1996: Have They Changed and Why Does It Matter?

ERIC Educational Resources Information Center

Hoagwood, Kimberly Eaton; Jensen, Peter S.; Acri, Mary C.; Olin, S. Serene; Lewandowski, R. Eric; Herman, Rachel J.

2012-01-01

Objective: Child mental health treatment and services research yields more immediate public health benefit when they focus on outcomes of relevance to a broader group of stakeholders. We reviewed all experimental studies of child and adolescent treatment and service effectiveness published in the last 15 years (1996-2011) and compared the…

Health status, emotional/behavioral problems, health care use, and expenditures in overweight/obese US children/adolescents.

PubMed

Turer, Christy Boling; Lin, Hua; Flores, Glenn

2013-01-01

To examine the association of overweight/obesity with health, health care utilization, and expenditures in a national sample of 10- to 17-year-old children and adolescents. Secondary analysis of 2005 to 2009 Medical Expenditure Panel Survey data (n = 17,224). Outcome measures included suboptimal health, emotional/behavioral problems, health care utilization, and expenditures. Overweight and obese children and adolescents had greater risk of suboptimal health (adjusted risk ratio [ARR], 1.4 and 1.7; P < .01), use of prescriptions (ARR, both 1.1; P = .01), and emergency department visits (ARR, 1.2 and 1.1; P = .01); overweight children/adolescents had lower mean out-of-pocket expenditures (∼$100, P < .01); and obese children/adolescents had greater risk of emotional/behavioral problems (ARR, 1.2; P < .01) and specialist visits (ARR, 1.1; P = .01). The most common specialty referral among obese children/adolescents was psychiatry. Overweight and obesity were not associated with office visits or total expenditures. A greater proportions of children and adolescents with suboptimal health and emotional/behavioral problems had health care expenditures, and those with suboptimal health were more likely to have out-of-pocket expenditures. Pediatric overweight and obesity affect child and adolescent health status, emotional/behavioral problems, and specific domains of health care utilization, but do not appear to be associated with total health care expenditures. Out-of-pocket expenditures are lower among overweight children and adolescents. These findings highlight the need for early intervention in overweight children/adolescents, when health care expenditures may not be greater, and suggest that it may prove useful to pay special attention to the health status and emotional/behavioral problems of overweight and obese children/adolescents in weight-management interventions. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Effect of the Teaching Kids to Cope (TKC) program on outcomes of depression and coping among rural adolescents.

PubMed

Puskar, Kathryn; Sereika, Susan; Tusaie-Mumford, Kathleen

2003-01-01

Incidence of depressive symptoms and lack of sufficient adaptive coping skills in adolescents. A randomized controlled study to test the effectiveness of a group-administered, cognitive-behavioral interventions method, TKC, on rural adolescents (N = 89). Outcomes were measured by changes in the scores on an Adolescent Depression Scale and the Coping Response Inventory pre/post intervention, at 6 and at 12 months. Results indicated improvement in depressive symptomatology and certain coping skills. Students in the intervention reported a higher use of cognitive problem-solving coping strategies. The role of a psychiatric nurse in the school system providing short-term psychoeducation interventions is a practical and effective mental health practice.

International and Interdisciplinary Identification of Health Care Transition Outcomes.

PubMed

Fair, Cynthia; Cuttance, Jessica; Sharma, Niraj; Maslow, Gary; Wiener, Lori; Betz, Cecily; Porter, Jerlym; McLaughlin, Suzanne; Gilleland-Marchak, Jordan; Renwick, Amy; Naranjo, Diana; Jan, Sophia; Javalkar, Karina; Ferris, Maria

2016-03-01

There is a lack of agreement on what constitutes successful outcomes for the process of health care transition (HCT) among adolescent and young adults with special health care needs. To present HCT outcomes identified by a Delphi process with an interdisciplinary group of participants. A Delphi method involving 3 stages was deployed to refine a list of HCT outcomes. This 18-month study (from January 5, 2013, of stage 1 to July 3, 2014, of stage 3) included an initial literature search, expert interviews, and then 2 waves of a web-based survey. On this survey, 93 participants from outpatient, community-based, and primary care clinics rated the importance of the top HCT outcomes identified by the Delphi process. Analyses were performed from July 5, 2014, to December 5, 2014. Health care transition outcomes of adolescents and young adults with special health care needs. Importance ratings of identified HCT outcomes rated on a Likert scale from 1 (not important) to 9 (very important). The 2 waves of surveys included 117 and 93 participants as the list of outcomes was refined. Transition outcomes were refined by the 3 waves of the Delphi process, with quality of life being the highest-rated outcome with broad agreement. The 10 final outcomes identified included individual outcomes (quality of life, understanding the characteristics of conditions and complications, knowledge of medication, self-management, adherence to medication, and understanding health insurance), health services outcomes (attending medical appointments, having a medical home, and avoidance of unnecessary hospitalization), and a social outcome (having a social network). Participants indicated that different outcomes were likely needed for individuals with cognitive disabilities. Quality of life is an important construct relevant to HCT. Future research should identify valid measures associated with each outcome and further explore the role that quality of life plays in the HCT process. Achieving consensus is a critical step toward the development of reliable and objective comparisons of HCT outcomes across clinical conditions and care delivery locations.

Adolescent exposure to violence and adult physical and mental health problems.

PubMed

Franzese, Robert J; Covey, Herbert C; Tucker, Abigail S; McCoy, Leah; Menard, Scott

2014-12-01

Evidence on the relationship of adolescent exposure to violence (AEV) with adult physical and mental health problems is limited, with studies often focusing on earlier childhood rather than adolescence, and also on short term rather than long term outcomes. Information specifically on the relationship of AEV to seeking help for mental health problems in adulthood from either formal sources such as mental health professionals or informal sources such as friends and clergy is even more difficult to find. The present study investigates how adolescent exposure to violence (AEV), in the form of parental physical abuse, witnessing parental violence, and exposure to violence in the neighborhood, are related to self-reported adult physical problems and seeking formal or informal assistance with mental health, controlling for more general adolescent violent victimization and for self-reports and parent reports of mental health problems in adolescence. This study adds to the literature on AEV and adult physical problems, and provides a rare look at the relationship of AEV to adult help-seeking for mental health problems. The results suggest that AEV is associated with mental health problems in adolescence for both females and males, that for females AEV is related to physical problems and to seeking help for mental health problems in adulthood, but for males the only significant relationship involves inconsistent reports of witnessing parental violence and adult physical problems. Copyright © 2014 Elsevier Ltd. All rights reserved.

"Going beyond the call of doula": a grounded theory analysis of the diverse roles community-based doulas play in the lives of pregnant and parenting adolescent mothers.

PubMed

Gentry, Quinn M; Nolte, Kim M; Gonzalez, Ainka; Pearson, Magan; Ivey, Symeon

2010-01-01

This article presents some of the most salient qualitative results from a larger program evaluation of pregnant and parenting adolescents who participated in a community-based doula program. Using grounded theory analysis, seven problem-solving strategies emerged that doulas apply in helping pregnant and parenting adolescents navigate multiple social and health settings that often serve as barriers to positive maternal- and child-health outcomes. The ethnographic findings of this study suggest that the doulas provide valuable assistance to pregnant and parenting adolescents by addressing social-psychological issues and socio-economic disparities. "Diverse role-taking" results in doulas helping pregnant adolescents navigate more successfully through fragmented social and health service systems that are less supportive of low-income adolescents, who are often perceived to be draining scarce resources. The findings have implications for the roles of community-based doulas assigned to low-income adolescents of color seeking to overcome obstacles and attain better educational and economic opportunities.

Outcomes research in pediatric settings: recent trends and future directions.

PubMed

Forrest, Christopher B; Shipman, Scott A; Dougherty, Denise; Miller, Marlene R

2003-01-01

Pediatric outcomes research examines the effects of health care delivered in everyday medical settings on the health of children and adolescents. It is an area of inquiry in its nascent stages of development. We conducted a systematic literature review that covered articles published during the 6-year interval 1994-1999 and in 39 peer-reviewed journals chosen for their likelihood of containing child health services research. This article summarizes the article abstraction, reviews the literature, describes recent trends, and makes recommendations for future work. In the sample of journals that we examined, the number of pediatric outcomes research articles doubled between 1994 and 1999. Hospitals and primary care practices were the most common service sectors, accounting for more than half of the articles. Common clinical categories included neonatal conditions, asthma, psychosocial problems, and injuries. Approximately 1 in 5 studies included multistate or national samples; 1 in 10 used a randomized controlled trial study design. Remarkably few studies examined the health effects of preventive, diagnostic, long-term management, or curative services delivered to children and adolescents. Outcomes research in pediatric settings is a rapidly growing area of inquiry that is acquiring breadth but has achieved little depth in any single content area. Much work needs to be done to inform decision making regarding the optimal ways to finance, organize, and deliver child health care services. To improve the evidence base of pediatric health care, more effectiveness research is needed to evaluate the overall and relative effects of services delivered to children and adolescents in everyday settings.

Phthalates and metabolic syndrome in U.S. Adolescents (NHANES 2003-2010)

EPA Science Inventory

Children’s health outcomes may result from interactions among chemical and non-chemical stressors. We use NHANES data to investigate: Association between phthalate metabolite concentrations and MetS in adolescents If associations vary by family income (a non-chemical stressor)

Social discrimination, stress, and risk of unintended pregnancy among young women.

PubMed

Hall, Kelli Stidham; Kusunoki, Yasamin; Gatny, Heather; Barber, Jennifer

2015-03-01

Prior research linking young women's mental health to family planning outcomes has often failed to consider their social circumstances and the intersecting biosocial mechanisms that shape stress and depression as well as reproductive outcomes during adolescence and young adulthood. We extend our previous work to investigate relationships between social discrimination, stress and depression symptoms, and unintended pregnancy among adolescent and young adult women. Data were drawn from 794 women aged 18-20 years in a longitudinal cohort study. Baseline and weekly surveys assessed psychosocial information including discrimination (Everyday Discrimination Scale), stress (Perceived Stress Scale), depression (Center for Epidemiologic Studies-Depression Scale), and reproductive outcomes. Multilevel, mixed-effects logistic regression and discrete-time hazard models estimated associations between discrimination, mental health, and pregnancy. Baron and Kenny's method was used to test mediation effects of stress and depression on discrimination and pregnancy. The mean discrimination score was 19/45 points; 20% reported moderate/high discrimination. Discrimination scores were higher among women with stress and depression symptoms versus those without symptoms (21 vs. 18 points for both, p < .001). Pregnancy rates (14% overall) were higher among women with moderate/high (23%) versus low (11%) discrimination (p < .001). Discrimination was associated with stress (adjusted relative risk ratio, [aRR], 2.2; 95% confidence interval [CI], 1.4-3.4), depression (aRR, 2.4; CI, 1.5-3.7), and subsequent pregnancy (aRR, 1.8; CI, 1.1-3.0). Stress and depression symptoms did not mediate discrimination's effect on pregnancy. Discrimination was associated with an increased risk of mental health symptoms and unintended pregnancy among these young women. The interactive social and biological influences on reproductive outcomes during adolescence and young adulthood warrant further study. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Perception of Weight Status in U.S. Children and Adolescents Aged 8-15 Years, 2005-2012. NCHS Data Brief. Number 158

ERIC Educational Resources Information Center

Sarafrazi, Neda; Hughes, Jeffery P.; Borrud, Lori; Burt, Vicki; Paulose-Ram, Ryne

2014-01-01

Childhood obesity is a major public health problem associated with many adverse health outcomes in adulthood. During 2011-2012, nearly 17% of children and adolescents were obese. Weight status misperception occurs when the child's perception of their weight status differs from their actual weight status based on measured height and weight.…

Associations between Health Literacy and Health Behaviors among Urban High School Students

ERIC Educational Resources Information Center

Park, Aesoon; Eckert, Tanya L.; Zaso, Michelle J.; Scott-Sheldon, Lori A. J.; Vanable, Peter A.; Carey, Kate B.; Ewart, Craig K.; Carey, Michael P.

2017-01-01

Background: Health literacy is crucial to develop health-related knowledge, adopt healthy lifestyles, and benefit from health care services. However, research on the association between health literacy and adolescent health outcomes, particularly on their prospective associations, is rare. We assessed health literacy using 3 validated measures,…

Concordance Between Self-Reported Childhood Maltreatment Versus Case Record Reviews for Child Welfare-Affiliated Adolescents.

PubMed

Negriff, Sonya; Schneiderman, Janet U; Trickett, Penelope K

2017-02-01

The present study used data from an ongoing longitudinal study of the effects of maltreatment on adolescent development to (1) describe rates of maltreatment experiences obtained from retrospective self-report versus case record review for adolescents with child welfare-documented maltreatment histories, (2) examine self-reported versus child welfare-identified maltreatment in relation to mental health and risk behavior outcomes by maltreatment type, and (3) examine the association between the number of different types of maltreatment and mental health and risk behavior outcomes. Maltreatment was coded from case records using the Maltreatment Case Record Abstraction Instrument (MCRAI) and participants were asked at mean age = 18.49 about childhood maltreatment experiences using the Comprehensive Trauma Interview (CTI). Results showed that an average of 48% of maltreatment found by the MCRAI for each type of maltreatment were unique cases not captured by the CTI, whereas an average of 40% self-reported maltreatment (CTI) was not indicated by the MCRAI. Analyses with outcomes showed generally, self-reported maltreatment, regardless of concordance with MCRAI, was related to the poorest outcomes. The difference in associations with the outcomes indicates both self-report and case record review data may have utility depending on the outcomes being assessed.

Annual Research Review: The persistent and pervasive impact of being bullied in childhood and adolescence: implications for policy and practice.

PubMed

Arseneault, Louise

2018-04-01

We have known for some time that being bullied was associated with children's and adolescents' adjustment difficulties and well-being. In recent years, we have come to recognise that the impact of childhood bullying victimisation on the development of mental health problems is more complex. This paper aims to review the evidence for an independent contribution of childhood bullying victimisation to the development of poor outcomes throughout the life span, including mental, physical and socioeconomic outcomes, and discuss the implications for policy and practice. Existing research indicates that (a) being bullied in childhood is associated with distress and symptoms of mental health problems. This large body of evidence supports actions aimed at reducing the occurrence of bullying behaviours; (b) the consequences of childhood bullying victimisation can persist up to midlife and, in addition to mental health, can impact physical and socioeconomic outcomes. These new findings indicate that interventions should also focus on supporting victims of bullying and helping them build resilience; (c) research has identified some factors that predispose children to be targeted by bullying behaviours. These studies suggest that public health interventions could aim at preventing children from becoming the target of bullying behaviours from an early age. It is a truism to emphasise that further work is needed to understand why and how young people's aspirations are often cut short by this all too common adverse social experience. In parallel, we must develop effective strategies to tackle this form of abuse and its consequences for the victims. Addressing bullying in childhood could not only reduce children's and adolescents' mental health symptoms but also prevent psychiatric and socioeconomic difficulties up to adulthood and reduce considerable costs for society. © 2017 Association for Child and Adolescent Mental Health.

Relations between Resiliency, Diabetes-Related Quality of Life, and Disease Markers to School-Related Outcomes in Adolescents with Diabetes

ERIC Educational Resources Information Center

Perfect, Michelle M.; Jaramillo, Evelyn

2012-01-01

The current study examined the role that resiliency and diabetes quality of life play in school functioning and glucose control among adolescents with diabetes. Participants included 45 adolescents with diabetes who participated in a larger study evaluating the feasibility of a model of mental health screening, assessment, and referral/service…

Preventing Sexually Transmitted Infections among Adolescents: An Assessment of Ecological Approaches and Study Methods

ERIC Educational Resources Information Center

Shoveller, Jean A.; Johnson, Joy L.; Savoy, Daphne M.; Pietersma, W. A. Wia

2006-01-01

Most primary prevention research has attempted to explain sexual health outcomes, such as sexually transmitted infections, by focusing on individual characteristics (e.g. age), qualities (e.g. knowledge levels), and risk behaviour (e.g. unprotected intercourse). Emerging evidence indicates that population-level health outcomes are unlikely to be…

The Pediatric Quality of Life Inventory (PedsQL) 4.0 as an assessment measure for depressive symptoms: a correlational study with young adolescents.

PubMed

Reinfjell, Trude; Hjemdal, Odin; Aune, Tore; Vikan, Arne; Diseth, Trond H

2008-01-01

Health-related quality of life (HRQOL) is today considered an important assessment measurement, but still only a few measures assess HRQOL outcomes for children and adolescents. One of them is the Pediatric Quality of Life Inventory (PedsQL). This correlation study explored the associations between depressive symptoms in young adolescents and the PedsQL scores when controlling for known risk factors. An adolescent sample (n=425) completed a battery of measures including the PedsQL Norwegian version, the Short Mood and Feeling Questionnaire (SMFQ), the Social Phobia and Anxiety Inventory for children (SPAI-C), and the occurrence of Stressful Life Events (SLE). The results showed a mild to moderate correlation between the measures PedsQL, SMFQ, SPAI-C and SLE. The presence of depressive symptoms significantly predicted the PedsQL scores for the adolescence, and explained 17% of the variance in outcome for the PedsQL Total Scale. The findings suggest that the PedsQL is an adequate assessment instrument regarding depressive symptoms in young adolescents, and can be useful in both clinical practice and further research as an assessment measure regarding children's mental health.

Youth Marijuana Use: State of the Science for the Practicing Clinician

PubMed Central

Hadland, Scott E.; Harris, Sion K.

2014-01-01

Purpose of review Despite widespread marijuana use among adolescents, accurate information on known health effects is poorly disseminated to clinicians and their patients. Amidst rapidly evolving drug policy in the United States and elsewhere, it is imperative that providers understand the short- and long-term consequences of marijuana use. Recent findings Research on regular marijuana use highlights a unique susceptibility of the developing adolescent brain to adverse neurocognitive and psychiatric outcomes. Although studies have not firmly established causality, onset of regular marijuana use in adolescence is associated with later decline in cognitive function, as well as with adult onset of psychosis and anxiety. Educational and employment outcomes may be poorer among regular marijuana-using adolescents. A number of other adverse respiratory, cardiovascular, endocrine and gastrointestinal associations with regular marijuana use have also been established. Good screening tools and promising brief intervention and behavioral treatment programs are available to clinicians, who are in a position to identify problematic marijuana use among adolescents and refer for services. Summary A common misperception among youth is that marijuana use is without harm. However, adolescent marijuana use may have measurable, durable and potentially irreversible effects on later cognitive function and mental health. PMID:24914878

Coping styles as moderating the relationships between terrorist attacks and well-being outcomes.

PubMed

Braun-Lewensohn, Orna; Celestin-Westreich, Smadar; Celestin, Leon-Patrice; Verleye, Gino; Verté, Dominique; Ponjaert-Kristoffersen, Ingrid

2009-06-01

This study aims to explore use of coping strategies among adolescents and their relationships with well being in the context of ongoing terrorism. Furthermore, we aim to explore to what extent coping styles in addition to exposure variables explain well being of adolescents facing ongoing terror. During September 2003, after three years of ongoing terror attacks, 913 Israeli adolescents aged 12-18 years, completed the following questionnaires during regular class sessions: Demographics, Achenbach's Youth Self Report; Exposure to Terror and Post Traumatic Stress (PTS) questionnaire; Adolescent Coping Scale (ACS) and Brief Symptoms Inventory. Adolescents employed mainly problem solving strategies which mean they have the capacity to cope well in spite of stressful events. Emotional focused coping was associated with PTS and mental health problems. Regression analysis of different exposure and coping variables revealed that exposure, appraisal (subjective exposure) and coping styles explained 26-37% of the variance of different psychological problems. The findings highlight the importance of appraisal (subjective exposure) and coping strategies, for understanding adolescents' mental health outcomes. Moreover, these findings are relevant to the development of prevention/intervention programs that facilitate youth's cognitive and emotional adjustments to ongoing trauma risks and terror threats.

Ethnic/racial differences in the self-reported physical and mental health correlates of adolescent obesity.

PubMed

Whaley, Athur L; Smith, Michelle; Hancock, Anyaliese

2011-10-01

Adolescent obesity has increased significantly during the past 20 years disproportionately affecting African-Americans. We tested the cultural hypothesis which suggests that the acceptance of a larger body size among African-Americans serves as a protective factor against negative physical and mental health consequences. Secondary analyses of data from a subsample of 5158 Black and White participants in the 2009 Youth Risk Behavior Survey were conducted to assess the relationship between weight status and global self-reports of physical and psychological health. Planned comparisons revealed support of our hypotheses for some outcomes but not others. Implications for interventions targeting adolescent obesity are discussed.

Three-year chemical dependency and mental health treatment outcomes among adolescents: the role of continuing care.

PubMed

Sterling, Stacy; Chi, Felicia; Campbell, Cynthia; Weisner, Constance

2009-08-01

Few studies have examined the effects of treatment factors, including the types of services [chemical dependency (CD), psychiatric, or both], on long-term outcomes among adolescents following CD treatment, and whether receiving continuing care may contribute to better outcomes. This study examines the effect of the index CD and ongoing CD and psychiatric treatment episodes, 12-step participation, and individual characteristics such as CD and mental health (MH) severity and gender, age, and ethnicity, on 3-year CD and MH outcomes. Participants were 296 adolescents aged 13 to 18 seeking treatment at 4 CD programs of a nonprofit, managed care, integrated health system. We surveyed participants at intake, 1 year, and 3 years, and examined survey and administrative data, and CD and psychiatric utilization. At 3 years, 29.7% of the sample reported total abstinence from both alcohol and drugs (excluding tobacco). Compared with girls, boys had only half the odds of being abstinent (OR = 0.46, p = 0.0204). Gender also predicted Externalizing severity at 3 years (coefficients 18.42 vs. 14.77, p < 0.01). CD treatment readmission in the second and third follow-up years was related to abstinence at 3 years (OR = 0.24, p = 0.0066 and OR = 3.33, p = 0.0207, respectively). Abstinence at 1 year predicted abstinence at 3 years (OR = 4.11, p < 0.0001). Those who were abstinent at 1 year also had better MH outcomes (both lower Internalizing and Externalizing scores) than those who were not (11.75 vs. 15.55, p = 0.0012 and 15.13 vs. 18.06, p = 0.0179, respectively). A CD treatment episode resulting in good 1-year CD outcomes may contribute significantly to both CD and MH outcomes 3 years later. The findings also point to the value of providing a continuing care model of treatment for adolescents.

Adolescent views on comprehensive health risk assessment and counseling: assessing gender differences.

PubMed

Kadivar, Hajar; Thompson, Lindsay; Wegman, Martin; Chisholm, TaJuana; Khan, Maryum; Eddleton, Katie; Muszynski, Michael; Shenkman, Elizabeth

2014-07-01

Adolescence is an important time for the detection of health risk behaviors and factors with subsequent counseling and intervention. Limited research has examined adolescent perceptions of comprehensive health risk assessments (HRAs) and counseling with an assessment of gender differences. Participants were identified using Florida's Medicaid and State Children's Health Insurance Program databases. A total of 35 low-income, racially/ethnically diverse adolescents (ages 14-18 years) participated in eight focus groups stratified by gender. Adolescents completed an internet-based, tablet-administered, comprehensive HRA and then participated in a semi-structured interview. Discussions were recorded, transcribed, and analyzed using a multi-step, team-based approach applying grounded theory to determine major themes. Male adolescents desired less parental involvement, had less understanding of the protections of clinical confidentiality and the need for comprehensive HRA, and placed greater emphasis on the importance of professional appearance. In contrast, more females valued face-to-face interactions and stressed the importance of concern from the health risk assessor. Overall, adolescents placed importance on their relationship with the health risk assessor, and on valuing trust, confidentiality, and nonjudgmental care. Adolescents preferred to complete HRAs in clinical, private, and professional settings, and reported that tablet technology supported their confidentially in completing the HRA. Furthermore, they stressed the importance of autonomy and learning about the health risk outcomes for risk reduction. Gender differences exist in adolescent perceptions of comprehensive HRAs. Adolescent perceptions of HRAs support their use in confidential primary care settings using modalities that emphasize nonjudgmental, private care, and the use of communication techniques that respect adolescents' autonomy to change health risks. Copyright © 2014. Published by Elsevier Inc.

Examining the efficacy of an mHealth media literacy education program for sexual health promotion in older adolescents attending community college.

PubMed

Scull, Tracy Marie; Kupersmidt, Janis Beth; Malik, Christina Valerie; Keefe, Elyse Mallory

2018-04-01

To determine the feasibility of a mobile health (mHealth), media literacy education program, Media Aware, for improving sexual health outcomes in older adolescent community college students. 184 community college students (ages 18-19) participated in the study from April-December 2015. Eight community college campuses were randomly assigned to either the intervention or a wait-list control group. Student participants from each campus completed web-based pretest and posttest questionnaires. Intervention group students received Media Aware in between questionnaires. Several intervention effects of the Media Aware program were significant, including reducing older adolescents' self-reported risky sexual behaviors; positively affecting knowledge, attitudes, normative beliefs, and intentions related to sexual health; and increasing media skepticism. Some gender differences in the findings were revealed. The results from this study suggest that Media Aware is a promising means of delivering comprehensive sexual health education to older adolescents attending community college.

Rural and Urban Differences in Sexual Behaviors Among Adolescents in Florida.

PubMed

Thompson, Erika L; Mahony, Helen; Noble, Charlotte; Wang, Wei; Ziemba, Robert; Malmi, Markku; Maness, Sarah B; Walsh-Buhi, Eric R; Daley, Ellen M

2018-04-01

The national teen birth rate is higher in rural compared to urban areas. While national data suggest rural areas may present higher risk for adverse sexual health outcomes among adolescents, it is unknown whether there are differences within the state of Florida. Overall, Florida has poorer sexual health indicators for adolescents compared to national rates. The purpose of this study was to assess differences in sexual behaviors among Florida adolescents by rural-urban community location. This study includes baseline data from a randomized controlled trial conducted in Florida high schools. Of the 6316 participants, 74% were urban and 26% were rural. Participants responded to questions on sexual behaviors, sexual behavior intentions, and demographics. We estimated the effect of rural-urban status on risk outcomes after controlling for demographic variables using generalized linear mixed models. More teens from rural areas reported ever having sex (24.0%) compared to urban teens (19.7%). No significant differences were observed for most of sexual behaviors assessed. Nonetheless, urban participants were less likely to intend to have sex without a condom in the next year compared to rural participants (aOR = 0.76, 95% CI 0.63-0.92). Overall, there were no major differences in sexual behaviors between rural and urban adolescents in Florida. However, sexual intentions differed between rural and urban adolescents; specifically, rural adolescents were more likely to intend to have sex without a condom in the next year compared to urban adolescents. Understanding the specific disparities can inform contraception and sexual health interventions among rural youth.

Study protocol and overview of the literature on long-term health and quality of life outcomes in patients treated in adolescence for scoliosis with therapeutic exercises.

PubMed

Plaszewski, Maciej; Kotwicki, Tomasz; Chwala, Wieslaw; Terech, Jacek; Cieśliński, Igor

2015-01-01

Scoliosis, the most prevalent orthopaedic condition affecting children and adolescents, may have lasting physical, psychological and social consequences. With limited evidence-base, scoliosis-specific exercise therapies are an option. An overview of the subject and description of a long-term follow-up study including adults who in adolescence were treated with a scoliosis-specific exercise programme investigating the association of the exercise regime with present physical activity, physical functioning and subjective wellbeing. To the authors' best knowledge, this is the first long-term outcome study on scoliosis-specific exercises, in opposition to a number of studies in adults who were braced or treated surgically in adolescence. Observational, registry-based case-control study. Adult subjects who in adolescence were treated with an exercise programme or were under observation are invited. Spine and trunk deformity, respiratory function, physical capacity and trunk muscles' function are measured. Health-related quality of life with generic and condition-specific instruments, general mental health, depression and anxiety symptoms, disability due to low back problems and physical activity are assessed. The report is believed to provide the readers with an overview of this controversial aspect of rehabilitation, and that the proposed protocol will assist researchers designing their studies.

Socioeconomic differences in adolescent substance abuse treatment participation and long-term outcomes.

PubMed

Lui, Camillia K; Sterling, Stacy A; Chi, Felicia W; Lu, Yun; Campbell, Cynthia I

2017-05-01

Socioeconomic status (SES) has been consistently linked to poorer access, utilization and outcomes of health care services, but this relationship has been understudied in adolescent substance abuse treatment research. This study examined SES differences in adolescent's treatment participation and long-term outcomes of abstinence and 12-step attendance over five years after treatment. Data are from 358 adolescents (ages 13-18) who were recruited at intake to substance abuse treatment between 2000 and 2002 at four Kaiser Permanente Northern California outpatient treatment programs. Follow-up interviews of adolescents and their parents were conducted at 1, 3, and 5years, with over 80% response rates across time points. Using parent SES as a proxy for adolescent SES, no socioeconomic differences were found in treatment initiation, treatment retention, or long-term abstinence from alcohol or drugs. Parent education, but not parent income, was significantly associated with 12-step attendance post-treatment such that adolescents with higher parent education were more likely to attend than those with lower parent education. Findings suggest a lack of socioeconomic disparities in substance abuse treatment participation in adolescence, but potential disparities in post-treatment 12-step attendance during the transition from adolescence to young adulthood. Copyright © 2017 Elsevier Ltd. All rights reserved.

Transition into first sex among adolescents in slum and non-slum communities in Nairobi, Kenya

PubMed Central

Kabiru, Caroline W.; Beguy, Donatien; Undie, Chi-Chi; Zulu, Eliya Msiyaphazi; Ezeh, Alex C.

2014-01-01

While early sexual experiences are a key marker of the transition from childhood to adulthood, it is widely acknowledged that precocious initiation of sexual activity predisposes adolescents to negative health and psychological outcomes. Extant studies investigating adolescent sexuality in sub-Saharan Africa often rely on cross-sectional data lacking information on the social-psychological underpinnings of adolescent behavior. Through the theoretical lens of the protection-risk conceptual framework, this paper draws on two waves of longitudinal data collected from 2,134 adolescents to examine sociodemographic, psychosocial and behavioral predictors of transition to first sex among adolescents living in slum and non-slum settlements in urban Kenya. We employ logistic regression models to examine the effect of antecedent sociodemographic and risk and protective factors measured during the first wave of data collection on transition to first sex by the second wave. We observe that transition to first sex is influenced by age, slum residence, perceived parental monitoring, and peer behavior. We also find evidence for coupling of risk behaviors. Study findings underscore the need to focus on very young adolescents and those growing up in resource poor settings as these young people may be highly vulnerable to negative health outcomes stemming from precocious sexual activity. PMID:24955020

Substance Use, Education, Employment, and Criminal Activity Outcomes of Adolescents in Outpatient Chemical Dependency Programs

PubMed Central

Balsa, Ana I.; Homer, Jenny F.; French, Michael T.; Weisner, Constance M.

2010-01-01

Although the primary outcome of interest in clinical evaluations of addiction treatment programs is usually abstinence, participation in these programs can have a wide range of consequences. This study evaluated the effects of treatment initiation on substance use, school attendance, employment, and involvement in criminal activity at 12 months post-admission for 419 adolescents (aged 12 to 18) enrolled in chemical dependency recovery programs in a large managed care health plan. Instrumental variables estimation methods were used to account for unobserved selection into treatment by jointly modeling the likelihood of participation in treatment and the odds of attaining a certain outcome or level of an outcome. Treatment initiation significantly increased the likelihood of attending school, promoted abstinence, and decreased the probability of adolescent employment, but it did not significantly affect participation in criminal activity at the 12-month follow-up. These findings highlight the need to address selection in a non-experimental study and demonstrate the importance of considering multiple outcomes when assessing the effectiveness of adolescent treatment. PMID:18064572

Suubi4Her: a study protocol to examine the impact and cost associated with a combination intervention to prevent HIV risk behavior and improve mental health functioning among adolescent girls in Uganda.

PubMed

Ssewamala, Fred M; Bermudez, Laura Gauer; Neilands, Torsten B; Mellins, Claude A; McKay, Mary M; Garfinkel, Irv; Sensoy Bahar, Ozge; Nakigozi, Gertrude; Mukasa, Miriam; Stark, Lindsay; Damulira, Christopher; Nattabi, Jennifer; Kivumbi, Apollo

2018-06-05

Asset-based economic empowerment interventions, which take an integrated approach to building human, social, and economic capital, have shown promise in their ability to reduce HIV risk for young people, including adolescent girls, in sub-Saharan Africa. Similarly, community and family strengthening interventions have proven beneficial in addressing mental health and behavioral challenges of adolescents transitioning to adulthood. Yet, few programs aimed at addressing sexual risk have applied combination interventions to address economic stability and mental health within the traditional framework of health education and HIV counseling/testing. This paper describes a study protocol for a 5-year, NIMH-funded, cluster randomized-controlled trial to evaluate a combination intervention aimed at reducing HIV risk among adolescent girls in Uganda. The intervention, titled Suubi4Her, combines savings-led economic empowerment through youth development accounts (YDA) with an innovative family strengthening component delivered via Multiple Family Groups (MFG). Suubi4Her will be evaluated via a three-arm cluster randomized-controlled trial design (YDA only, YDA + MFG, Usual Care) in 42 secondary schools in the Central region of Uganda, targeting a total of 1260 girls (ages 15-17 at enrollment). Assessments will occur at baseline, 12, 24, and 36 months. This study addresses two primary outcomes: 1) change in HIV risk behavior and 2) change in mental health functioning. Secondary exploratory outcomes include HIV and STI incidence, pregnancy, educational attainment, financial savings behavior, gender attitudes, and self-esteem. For potential scale-up, cost effectiveness analysis will be employed to compare the relative costs and outcomes associated with each study arm. Suubi4Her will be one of the first prospective studies to examine the impact and cost of a combination intervention integrating economic and social components to reduce known HIV risk factors and improve mental health functioning among adolescent girls, while concurrently exploring mental health as a mediator in HIV risk reduction. The findings will illuminate the pathways that connect economic needs, mental health, family support, and HIV risk. If successful, the results will promote holistic HIV prevention strategies to reduce risk among adolescent girls in Uganda and potentially the broader sub-Saharan Africa region. Clinical Trials NCT03307226 (Registered: 10/11/17).

Phthalates and metabolic syndrome in US Adolescents ...

EPA Pesticide Factsheets

Children’s health outcomes may result from interactions among chemical and non-chemical stressors. We use NHANES data to investigate: Association between phthalate metabolite concentrations and MetS in adolescents If associations vary by family income (a non-chemical stressor) Poster for 2017 CEHN Conference

Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial.

PubMed

Mori, Amani Thomas; Kampata, Linda; Musonda, Patrick; Johansson, Kjell Arne; Robberstad, Bjarne; Sandøy, Ingvild

2017-12-19

Early marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with different standards of living. The study will be conducted alongside a cluster-randomized controlled trial, which is testing the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The CBA will estimate net benefits by comparing total costs with monetary benefits of health-related and non-health outcomes for each intervention package. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain stratified by the standards of living. Cost data include program implementation costs, healthcare costs (i.e. costs associated with adolescent pregnancy and birth complications such as low birth weight, pre-term birth, eclampsia, medical abortion procedures and post-abortion complications) and costs of education and participation in community and youth club meetings. Monetary benefits are returns to education and averted healthcare costs. For the ECEA, health gains include reduced rate of adolescent childbirths and non-health gains include averted out-of-pocket expenditure and financial risk protection. The economic evaluations will be conducted from program and societal perspectives. While the planned intervention is both comprehensive and expensive, it has the potential to produce substantial short-term and long-term health and non-health benefits. These benefits should be considered seriously when evaluating whether such a program can justify the required investments in a setting with scarce resources. The economic evaluations outlined in this paper will generate valuable information that can be used to guide large-scale implementation of programs to address the problem of the high prevalence of adolescent childbirth and school drop-outs in similar settings. ClinicalTrials.gov, NCT02709967. Registered on 2 March 2016. ISRCTN, ISRCTN12727868. Registered on 4 March 2016.

Online racial discrimination and the protective function of ethnic identity and self-esteem for African American adolescents.

PubMed

Tynes, Brendesha M; Umaña-Taylor, Adriana J; Rose, Chad A; Lin, Johnny; Anderson, Carolyn J

2012-03-01

A growing body of literature has shown that being victimized online is associated with poor mental health. Little is known about the factors that protect youth from the negative outcomes that may result from these victimization experiences, particularly those related to race. Using a risk and resilience framework, this study examined the protective function of ethnic identity and self-esteem among African Americans who experience online racial discrimination. For the sample of 125 adolescents, hierarchical regression results revealed that higher levels of ethnic identity and self-esteem significantly moderated the negative impact of online racial discrimination on anxiety levels. These findings show that ethnic identity and self-esteem can buffer the negative mental health outcomes associated with online racial discrimination, at least with respect to adolescents' anxiety. Findings from the current study have significant implications for adolescent adjustment given the increased time youth spend doing online activities. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Parenting for Lifelong Health: a pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa.

PubMed

Cluver, Lucie D; Meinck, Franziska; Steinert, Janina I; Shenderovich, Yulia; Doubt, Jenny; Herrero Romero, Rocio; Lombard, Carl J; Redfern, Alice; Ward, Catherine L; Tsoanyane, Sibongile; Nzima, Divane; Sibanda, Nkosiyapha; Wittesaele, Camille; De Stone, Sachin; Boyes, Mark E; Catanho, Ricardo; Lachman, Jamie McLaren; Salah, Nasteha; Nocuza, Mzuvukile; Gardner, Frances

2018-01-01

To assess the impact of 'Parenting for Lifelong Health: Sinovuyo Teen', a parenting programme for adolescents in low-income and middle-income countries, on abuse and parenting practices. Pragmatic cluster randomised controlled trial. 40 villages/urban sites (clusters) in the Eastern Cape province, South Africa. 552 families reporting conflict with their adolescents (aged 10-18). Intervention clusters (n=20) received a 14-session parent and adolescent programme delivered by trained community members. Control clusters (n=20) received a hygiene and hand-washing promotion programme. Primary outcomes: abuse and parenting practices at 1 and 5-9 months postintervention. Secondary outcomes: caregiver and adolescent mental health and substance use, adolescent behavioural problems, social support, exposure to community violence and family financial well-being at 5-9 months postintervention. Blinding was not possible. At 5-9 months postintervention, the intervention was associated with lower abuse (caregiver report incidence rate ratio (IRR) 0.55 (95% CI 0.40 to 0.75, P<0.001); corporal punishment (caregiver report IRR=0.55 (95% CI 0.37 to 0.83, P=0.004)); improved positive parenting (caregiver report d=0.25 (95% CI 0.03 to 0.47, P=0.024)), involved parenting (caregiver report d=0.86 (95% CI 0.64 to 1.08, P<0.001); adolescent report d=0.28 (95% CI 0.08 to 0.48, P=0.006)) and less poor supervision (caregiver report d=-0.50 (95% CI -0.70 to -0.29, P<0.001); adolescent report d=-0.34 (95% CI -0.55 to -0.12, P=0.002)), but not decreased neglect (caregiver report IRR 0.31 (95% CI 0.09 to 1.08, P=0.066); adolescent report IRR 1.46 (95% CI 0.75 to 2.85, P=0.264)), inconsistent discipline (caregiver report d=-0.14 (95% CI -0.36 to 0.09, P=0.229); adolescent report d=0.03 (95% CI -0.20 to 0.26, P=0.804)), or adolescent report of abuse IRR=0.90 (95% CI 0.66 to 1.24, P=0.508) and corporal punishment IRR=1.05 (95% CI 0.70 to 1.57, P=0.819). Secondary outcomes showed reductions in caregiver corporal punishment endorsement, mental health problems, parenting stress, substance use and increased social support (all caregiver report). Intervention adolescents reported no differences in mental health, behaviour or community violence, but had lower substance use (all adolescent report). Intervention families had improved economic welfare, financial management and more violence avoidance planning (in caregiver and adolescent report). No adverse effects were detected. This parenting programme shows promise for reducing violence, improving parenting and family functioning in low-resource settings. Pan-African Clinical Trials Registry PACTR201507001119966.

Promoting Healthy Lifestyles in High School Adolescents

PubMed Central

Melnyk, Bernadette M.; Jacobson, Diana; Kelly, Stephanie; Belyea, Michael; Shaibi, Gabriel; Small, Leigh; O’Haver, Judith; Marsiglia, Flavio F.

2014-01-01

Background Although obesity and mental health disorders are two major public health problems in adolescents that affect academic performance, few rigorously designed experimental studies have been conducted in high schools. Purpose The goal of the study was to test the efficacy of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) Program, versus an attention control program (Healthy Teens) on: healthy lifestyle behaviors, BMI, mental health, social skills, and academic performance of high school adolescents immediately after and at 6 months post-intervention. Design A cluster RCT was conducted. Data were collected from January 2010 to May of 2012 and analyzed in 2012–2013. Setting/participants A total of 779 culturally diverse adolescents in the U.S. Southwest participated in the trial. Intervention COPE was a cognitive–behavioral skills-building intervention with 20 minutes of physical activity integrated into a health course, taught by teachers once a week for 15 weeks. The attention control program was a 15-session, 15-week program that covered common health topics. Main outcome measures Primary outcomes assessed immediately after and 6 months post-intervention were healthy lifestyle behaviors and BMI. Secondary outcomes included mental health, alcohol and drug use, social skills, and academic performance. Results Post-intervention, COPE teens had a greater number of steps per day (p=0.03) and a lower BMI (p=0.01) than did those in Healthy Teens, and higher average scores on all Social Skills Rating System subscales (p-values <0.05). Alcohol use was 11.17% in the COPE group and 21.46% in the Healthy Teens group (p=0.04). COPE teens had higher health course grades than did control teens. At 6 months post-intervention, COPE teens had a lower mean BMI than teens in Healthy Teens (COPE=24.72, Healthy Teens=25.05, adjusted M= −0.34, 95% CI= −0.56, −0.11). The proportion of those overweight was significantly different from pre-intervention to 6-month follow-up (Chi square=4.69, p=0.03), with COPE decreasing the proportion of overweight teens, versus an increase in overweight in control adolescents. There were no differences in alcohol use at 6 months (p=0.06). Conclusions COPE can improve short- and more long-term outcomes in high school teens. Trial registration This study is registered at www.clinicaltrials.gov NCT01704768. PMID:24050416

Adverse adult consequences of different alcohol use patterns in adolescence: An integrative analysis of data to age 30 years from four Australasian cohorts.

PubMed

Silins, Edmund; John Horwood, L; Najman, Jake M; Patton, George C; Toumbourou, John W; Olsson, Craig A; Hutchinson, Delyse M; Degenhardt, Louisa; Fergusson, David; Becker, Denise; Boden, Joseph M; Borschmann, Rohan; Plotnikova, Maria; Youssef, George J; Tait, Robert J; Clare, Philip; Hall, Wayne D; Mattick, Richard P

2018-05-10

Studies have linked adolescent alcohol use with adverse consequences in adulthood; yet it is unclear how strong the associations are and to what extent they may be due to confounding. Our aim was to estimate the strength of association between different patterns of adolescent drinking and longer-term psychosocial harms taking into account individual, family, and peer factors. Participant-level data were integrated from four long running longitudinal studies: Australian Temperament Project; Christchurch Health and Development Study; Mater Hospital and University of Queensland Study of Pregnancy; Victorian Adolescent Health Cohort Study. Australia and New Zealand. Participants were assessed on multiple occasions between ages 13 and 30 years (from 1991-2012). Number of participants varied (up to N=9453) by analysis. Three patterns of alcohol use (frequent, heavy episodic, and problem drinking) were assessed prior to age 17. Thirty outcomes were assessed to age 30 spanning substance use and related problems, antisocial behavior, sexual risk-taking, accidents, socioeconomic functioning, mental health, and partner relationships. After covariate adjustment, weekly drinking prior to age 17 was associated with a two to three-fold increase in the odds of binge drinking (OR: 2.14; 95%CI: 1.57-2.90), drink driving (OR: 2.78; 95%CI: 1.84-4.19), alcohol-related problems (OR: 3.04; 95%CI: 1.90-4.84), and alcohol dependence (OR: 3.30; 95%CI: 1.69-6.47) in adulthood. Frequency of drinking accounted for a greater proportion of the rate of most adverse outcomes than the other measures of alcohol use. Associations between frequent, heavy episodic, and problem drinking in adolescence and most non-alcohol outcomes were largely explained by shared risk factors for adolescent alcohol use and poor psychosocial functioning. Frequency of adolescent drinking predicts substance use problems in adulthood as much as, and possibly more than, heavy episodic and problem drinking independent of individual, family and peer predictors of those outcomes. This article is protected by copyright. All rights reserved.

In-home firearm access among US adolescents and the role of religious subculture: Results from a nationally representative study.

PubMed

Stroope, Samuel; Tom, Joshua C

2017-09-01

Religious participation is linked to numerous positive safety outcomes for adolescents. Scant attention, however, has been paid to associations between religious participation and safety risks among adolescents. Using data from Add Health (N = 18,449), a nationally representative school-based sample of US adolescents, this study examines the relationship between adolescents' religious affiliation and easy access to firearms at home. Regression analyses adjust for complex sampling design and compare easy firearm access at home among conservative Protestant adolescents to adolescent firearm access in other religious traditions. Conservative Protestant adolescents have a substantially greater likelihood of easy access to a gun at home compared to adolescents of all other major religious traditions in the United States. Recognizing differences in adolescent firearm access between subcultural groups can help public health interventions more effectively identify and address the needs of vulnerable populations. The paper's conclusion considers suggestions for effective policy and programmatic initiatives. Copyright © 2017 Elsevier Inc. All rights reserved.

Postoperative perceived health status in adolescent following idiopathic scoliosis surgical treatment: results using the adapted French version of Scoliosis Research Society Outcomes questionnaire (SRS-22).

PubMed

Chaib, Y; Bachy, M; Zakine, S; Mary, P; Khouri, N; Vialle, R

2013-06-01

Assessing functional outcome from patient-based outcomes questionnaires are essential to the evaluation of adolescent idiopathic scoliosis surgical treatment At the minimum follow-up of 2 years, 45 operated on adolescent idiopathic scoliosis patients were mailed the French version of the Scoliosis Research Society Outcome Instrument (SRS-22) questionnaires containing items on pain, activities of daily living, and satisfaction. Mean values of the SRS-22 domains were 3,66 for the Pain domain, 3,85 for the Self-perceived image domain, 4,32 for the Function domain, 3,52 for the Mental health domain and 4,12 for the Global satisfaction with management domain. Mean value of the global SRS-22 score was 3,88. We showed no differences in functional SRS-22 health status in patients according to the type of curve (Lenke classification). We showed statistically significant correlations between the gain of Cobb angle and Patients self-image and function domain scores. There was a statistically significant correlation between preoperative Cobb angle and patient satisfaction with management. Even if Function and Self-image scores in our patients are close to control group values, indicating good short to mid-term outcome of surgical treatment, scores for pain and mental health status were significantly lower in patients than controls. Long-term follow-up studies conducted by multiple surgeons over successive generations are mandatory to assess clinical significance of these differences. Level IV. Retrospective study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

A Pilot Randomised Controlled Trial of a School-Based Resilience Intervention to Prevent Depressive Symptoms for Young Adolescents with Autism Spectrum Disorder: A Mixed Methods Analysis.

PubMed

Mackay, Bethany A; Shochet, Ian M; Orr, Jayne A

2017-11-01

Despite increased depression in adolescents with Autism Spectrum Disorder (ASD), effective prevention approaches for this population are limited. A mixed methods pilot randomised controlled trial (N = 29) of the evidence-based Resourceful Adolescent Program-Autism Spectrum Disorder (RAP-A-ASD) designed to prevent depression was conducted in schools with adolescents with ASD in years 6 and 7. Quantitative results showed significant intervention effects on parent reports of adolescent coping self-efficacy (maintained at 6 month follow-up) but no effect on depressive symptoms or mental health. Qualitative outcomes reflected perceived improvements from the intervention for adolescents' coping self-efficacy, self-confidence, social skills, and affect regulation. Converging results remain encouraging given this population's difficulties coping with adversity, managing emotions and interacting socially which strongly influence developmental outcomes.

Family and housing instability: Longitudinal impact on adolescent emotional and behavioral well-being.

PubMed

Fowler, Patrick J; Henry, David B; Marcal, Katherine E

2015-09-01

This study investigated the longitudinal effects of family structure changes and housing instability in adolescence on functioning in the transition to adulthood. A model examined the influence of household composition changes and mobility in context of ethnic differences and sociodemographic risks. Data from the National Longitudinal Study of Adolescent Health measured household and residential changes over a 12-month period among a nationally representative sample of adolescents. Assessments in young adulthood measured rates of depression, criminal activity, and smoking. Findings suggested housing mobility in adolescence predicted poorer functioning across outcomes in young adulthood, and youth living in multigenerational homes exhibited greater likelihood to be arrested than adolescents in single-generation homes. However, neither family structure changes nor its interaction with residential instability or ethnicity related to young adult outcomes. Findings emphasized the unique influence of housing mobility in the context of dynamic household compositions. Copyright © 2015 Elsevier Inc. All rights reserved.

Reducing child abuse amongst adolescents in low- and middle-income countries: A pre-post trial in South Africa.

PubMed

Cluver, Lucie; Meinck, Franziska; Yakubovich, Alexa; Doubt, Jenny; Redfern, Alice; Ward, Catherine; Salah, Nasteha; De Stone, Sachin; Petersen, Tshiamo; Mpimpilashe, Phelisa; Romero, Rocio Herrero; Ncobo, Lulu; Lachman, Jamie; Tsoanyane, Sibongile; Shenderovich, Yulia; Loening, Heidi; Byrne, Jasmina; Sherr, Lorraine; Kaplan, Lauren; Gardner, Frances

2016-07-13

No known studies have tested the effectiveness of child abuse prevention programmes for adolescents in low- or middle-income countries. 'Parenting for Lifelong Health' ( http://tiny.cc/whoPLH ) is a collaborative project to develop and rigorously test abuse-prevention parenting programmes for free use in low-resource contexts. Research aims of this first pre-post trial in South Africa were: i) to identify indicative effects of the programme on child abuse and related outcomes; ii) to investigate programme safety for testing in a future randomised trial, and iii) to identify potential adaptations. Two hundred thirty participants (adolescents and their primary caregivers) were recruited from schools, welfare services and community-sampling in rural, high-poverty South Africa (no exclusion criteria). All participated in a 12-week parenting programme, implemented by local NGO childcare workers to ensure real-world external validity. Standardised pre-post measures with adolescents and caregivers were used, and paired t-tests were conducted for primary outcomes: abuse (physical, emotional abuse and neglect), adolescent behaviour problems and parenting (positive and involved parenting, poor monitoring and inconsistent discipline), and secondary outcomes: mental health, social support and substance use. Participants reported high levels of socio-economic deprivation, e.g. 60 % of adolescents had either an HIV-positive caregiver or were orphaned by AIDS, and 50 % of caregivers experienced intimate partner violence. i) indicative effects: Primary outcomes comparing pre-test and post-test assessments showed reductions reported by adolescents and caregivers in child abuse (adolescent report 63.0 % pre-test to 29.5 % post-test, caregiver report 75.5 % pre-test to 36.5 % post-test, both p < 0.001) poor monitoring/inconsistent discipline (p < .001), adolescent delinquency/aggressive behaviour (both p < .001), and improvements in positive/involved parenting (p < .01 adolescent report, p < .001 caregiver report). Secondary outcomes showed improved social support (p < .001 adolescent and caregiver reports), reduced parental and adolescent depression (both p < .001), parenting stress (p < .001 caregiver report) and caregiver substance use (p < .002 caregiver report). There were no changes in adolescent substance use. No negative effects were detected. ii) Programme acceptability and attendance was high. There was unanticipated programme diffusion within some study villages, with families initiating parenting groups in churches, and diffusion through school assemblies and religious sermons. iii) potential adaptations identified included the need to strengthen components on adolescent substance use and to consider how to support spontaneous programme diffusion with fidelity. The programme showed no signs of harm and initial evidence of reductions in child abuse and improved caregiver and adolescent outcomes. It showed high acceptability and unexpected community-level diffusion. Findings indicate needs for adaptations, and suitability for the next research step of more rigorous testing in randomised trials, using cluster randomization to allow for diffusion effects.

An evaluation of Health of the Nation Outcome Scales data to inform psychiatric morbidity following the Canterbury earthquakes.

PubMed

Beaglehole, Ben; Frampton, Chris M; Boden, Joseph M; Mulder, Roger T; Bell, Caroline J

2017-11-01

Following the onset of the Canterbury, New Zealand earthquakes, there were widespread concerns that mental health services were under severe strain as a result of adverse consequences on mental health. We therefore examined Health of the Nation Outcome Scales data to see whether this could inform our understanding of the impact of the Canterbury earthquakes on patients attending local specialist mental health services. Health of the Nation Outcome Scales admission data were analysed for Canterbury mental health services prior to and following the Canterbury earthquakes. These findings were compared to Health of the Nation Outcome Scales admission data from seven other large District Health Boards to delineate local from national trends. Percentage changes in admission numbers were also calculated before and after the earthquakes for Canterbury and the seven other large district health boards. Admission Health of the Nation Outcome Scales scores in Canterbury increased after the earthquakes for adult inpatient and community services, old age inpatient and community services, and Child and Adolescent inpatient services compared to the seven other large district health boards. Admission Health of the Nation Outcome Scales scores for Child and Adolescent community services did not change significantly, while admission Health of the Nation Outcome Scales scores for Alcohol and Drug services in Canterbury fell compared to other large district health boards. Subscale analysis showed that the majority of Health of the Nation Outcome Scales subscales contributed to the overall increases found. Percentage changes in admission numbers for the Canterbury District Health Board and the seven other large district health boards before and after the earthquakes were largely comparable with the exception of admissions to inpatient services for the group aged 4-17 years which showed a large increase. The Canterbury earthquakes were followed by an increase in Health of the Nation Outcome Scales scores for attendees of local mental health services compared to other large district health boards. This suggests that patients presented with greater degrees of psychiatric distress, social disruption, behavioural change and impairment as a result of the earthquakes.

Parenting an overweight or obese teen: issues and advice from parents.

PubMed

Boutelle, Kerri N; Feldman, Shira; Neumark-Sztainer, Dianne

2012-01-01

This qualitative study addresses: (1) what challenges parents of overweight adolescents face and (2) what advice parents of overweight adolescents have for other parents. One-on-one interviews were conducted with parents of overweight or previously overweight adolescents. Medical clinic at the University of Minnesota. Twenty-seven parents of adolescents (12-19 years) who were either currently or previously overweight recruited from the community. Qualitative interviews related to parenting overweight adolescents. Content analysis was used to identify themes regarding parental experiences. Issues most frequently mentioned were (1) uncertainty regarding effective communication with adolescent about weight-related topics; (2) inability to control adolescents' decisions related to healthful eating and activity behaviors; (3) concern for adolescents' well-being; and (4) parental feeling of responsibility/guilt. Parental advice most often provided included: (1) setting up a healthful home environment; (2) parental role modeling of healthful behaviors; and (3) providing support/encouragement for positive efforts. Topics for potential intervention development include communication and motivation of adolescents regarding weight-related topics, appropriate autonomy, and addressing negative emotions concerning the adolescent's weight status. Targeting these topics could potentially improve acceptability and outcomes for treatments. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Health Outcomes of Information System Use Lifestyles among Adolescents: Videogame Addiction, Sleep Curtailment and Cardio-Metabolic Deficiencies.

PubMed

Turel, Ofir; Romashkin, Anna; Morrison, Katherine M

2016-01-01

Obesity is a rising problem among adolescents in modern societies; it results in long-term cardio-metabolic problems. Possible overlooked drivers of obesity and its consequent cardio-metabolic deficits include videogame addiction and the resulting curtailed sleep; both are growing problems among adolescents. The objective of this study is to examine possible associations among these concepts in adolescents, as a means to point to plausible interventions. Data were collected from 94 adolescents who play videogames and are enrolled in outpatient clinics, using surveys, wearable sleep monitors (FitBit), physical exams, and blood tests at three points in time. These data were subjected to structural equation modeling (SEM) analyses and bootstrapping-based mediation testing procedures. Videogame addiction among adolescents was negatively associated with sleep duration (β = -0.24). Sleep duration was negatively associated with obesity (β = -0.30), which in turn was associated with elevated blood pressure (β = 0.26), low high-density lipoprotein cholesterol (β = -0.18), high triglycerides (β = 0.61), and high insulin resistance (β = 0.39). The model explained 36.2% of the variation in sleep duration, 32.7% of the variation in obesity, and between 12.8% and 28.1% of the variation in cardio-metabolic indicators. Post-hoc analyses indicated that curtailed sleep is a possible full mediator of the association between videogame addiction, abdominal obesity and the associated cardio-metabolic deficits. The findings point to possible information systems use lifestyle-health links, which behooves researchers and practitioners to pay closer attention to possible adverse health outcomes of technology-related addictions. Interventions that target problematic video-gaming and sleep should be devised as a possible means for improving adolescents' long-term cardio-metabolic health.

Longitudinal Effects of Early Childhood Maltreatment on Co-Occurring Substance Misuse and Mental Health Problems in Adulthood: The Role of Adolescent Alcohol Use and Depression

PubMed Central

Skinner, Martie L.; Hong, Seunghye; Herrenkohl, Todd I.; Brown, Eric C.; Lee, Jungeun Olivia; Jung, Hyunzee

2016-01-01

Objective: This study tested a developmental model in which subtypes of childhood maltreatment were hypothesized to have direct and indirect effects on co-occurring depression, anxiety, and substance misuse in adulthood. Indirect effects involved adolescent alcohol use and depression, which were included as mediators in the tested models. Method: This prospective longitudinal study (N = 332; 52.4% male) followed the participants from childhood (18 months to 6 years of age) to adulthood (31–41 years old, M = 36.21). Maltreatment subtypes included parent-reported physical and emotional abuse and child-reported sexual abuse. Adult outcomes included measures of substance misuse and mental health (i.e., depression and anxiety). Latent class analysis and structural equation models were used to identify classes of substance misuse and mental health co-occurrence and to test mediating effects of adolescent alcohol use and depression. Results: Three classes were identified: (a) low risk of substance misuse and low mental health symptoms, (b) moderate substance misuse risk and mild depression and anxiety, and (c) moderate substance misuse risk and moderate to high depression and anxiety. Structural models showed that effects of childhood sexual abuse were fully mediated by adolescent alcohol use and depression. Physical abuse increased adolescent depression but did not have direct or indirect effects on adult outcome classes. Emotional abuse had a direct effect on the adult classes. Conclusions: Children exposed to severe emotional abuse are at higher risk for comorbid substance misuse, depression, and anxiety into their mid-30s, after taking into account evidence of alcohol use and depression during adolescence. Sexual and physical abuse have more proximal effects on adolescent alcohol use and depression, which then influence the risk of adult problems. PMID:27172579

Implementation and preliminary effectiveness of a real-time pain management smartphone app for adolescents with cancer: A multicenter pilot clinical study.

PubMed

Jibb, Lindsay A; Stevens, Bonnie J; Nathan, Paul C; Seto, Emily; Cafazzo, Joseph A; Johnston, Donna L; Hum, Vanessa; Stinson, Jennifer N

2017-10-01

Pain in adolescents with cancer (12-18 years) is common and negatively impacts health-related quality of life (HRQL). The Pain Squad+ smartphone app, which provides adolescents with real-time pain self-management support, was developed to address this issue. This study evaluated the implementation of the app to inform a future randomized controlled trial (RCT) and obtain treatment effect estimates for pain intensity, pain interference, HRQL, and self-efficacy. A one-group baseline/poststudy design with 40 adolescents recruited from two pediatric tertiary care centers was used. Baseline questionnaires were completed and adolescents used the app at least twice daily for 28 days, receiving algorithm-informed self-management advice depending on their reported pain. A nurse received alerts in response to sustained pain and contacted adolescents to assist in pain care. Poststudy questionnaires were completed. Descriptive analyses, with exploratory inferential testing conducted on health outcome data, were used to address study aims. Most (40/52; 77%) eligible adolescents participated. Two participants withdrew participation. Intervention fidelity was impacted by technical difficulties (occurring for 15% of participants) and a prolonged time for nurse contact in the event of sustained pain. Adherence to pain reporting was 68.8 ± 38.1%. Outcome measure completion rates were high and the intervention was acceptable to participants. Trends in improvements in pain intensity, pain interference, and HRQL were significant, with effect sizes of 0.23-0.67. Implementation of Pain Squad+ is feasible and the app appears to improve pain-related outcomes for adolescents with cancer. A multicenter RCT will be undertaken to examine app effectiveness. © 2017 Wiley Periodicals, Inc.

Patterns of adolescent physical activity and dietary behaviours

PubMed Central

Pearson, Natalie; Atkin, Andrew J; Biddle, Stuart JH; Gorely, Trish; Edwardson, Charlotte

2009-01-01

Background The potential synergistic effects of multiple dietary and physical activity behaviours on the risk of chronic conditions and health outcomes is a key issue for public health. This study examined the prevalence and clustering patterns of multiple health behaviours among a sample of adolescents in the UK. Methods Cross-sectional survey of 176 adolescents aged 12–16 years (49% boys). Adolescents wore accelerometers for seven days and completed a questionnaire assessing fruit, vegetable, and breakfast consumption. The prevalence of adolescents meeting the physical activity (≥ 60 minutes moderate-to-vigorous physical activity/day), fruit and vegetable (≥ 5 portions of FV per day) and breakfast recommendations (eating breakfast on ≥ 5 days per week), and clustering patterns of these health behaviours are described. Results Boys were more active than girls (p < 0.001) and younger adolescents were more active than older adolescents (p < 0.01). Boys ate breakfast on more days per week than girls (p < 0.01) and older adolescents ate more fruit and vegetables than younger adolescents (p < 0.01). Almost 54% of adolescents had multiple risk behaviours and only 6% achieved all three of the recommendations. Girls had significantly more risk factors than boys (p < 0.01). For adolescents with two risk behaviours, the most prevalent cluster was formed by not meeting the physical activity and fruit and vegetable recommendations. Conclusion Many adolescents fail to meet multiple diet and physical activity recommendations, highlighting that physical activity and dietary behaviours do not occur in isolation. Future research should investigate how best to achieve multiple health behaviour change in adolescent boys and girls. PMID:19624822

Transition Readiness in Adolescents and Emerging Adults with Diabetes: The Role of Patient-Provider Communication

PubMed Central

Hilliard, Marisa; Sweenie, Rachel; Riekert, Kristin

2013-01-01

Transition from pediatric to adult care represents a high risk period for adolescents and emerging adults with diabetes. Fundamental differences between pediatric and adult care delivery models may contribute to increased risk for poor health outcomes. This review provides a brief overview of models of care in pediatric and adult settings and focuses on patient-provider communication content and quality as potential points of intervention to improve transition-related outcomes. This review also highlights disparities in transition and communication for adolescents and emerging adults from racial/ethnic minority groups and discusses recent changes in health care legislation that have significant implications for the transition process. Intervention opportunities include programs to enhance developmentally-appropriate patient-provider interactions and increased attention to promoting transition readiness skills. Improving patient-provider communication may hasten the development of vital self-advocacy skills needed in adult health care systems and, thus, help establish a lasting pattern of positive diabetes self-care. PMID:24014075

Mind how you cross the gap! Outcomes for young people who failed to make the transition from child to adult services: the TRACK study

PubMed Central

Islam, Zoebia; Ford, Tamsin; Kramer, Tami; Paul, Moli; Parsons, Helen; Harley, Katherine; Weaver, Tim; McLaren, Susan; Singh, Swaran P.

2016-01-01

Aims and method The Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK) study was a multistage, multicentre study of adolescents' transitions between child and adult mental health services undertaken in England. We conducted a secondary analysis of the TRACK study data to investigate healthcare provision for young people (n = 64) with ongoing mental health needs, who were not transferred from child and adolescent mental health services (CAMHS) to adult mental health services mental health services (AMHS). Results The most common outcomes were discharge to a general practitioner (GP; n = 29) and ongoing care with CAMHS (n = 13), with little indication of use of third-sector organisations. Most of these young people had emotional/neurotic disorders (n = 31, 48.4%) and neurodevelopmental disorders (n = 15, 23.4%). Clinical implications GPs and CAMHS are left with the responsibility for the continuing care of young people for whom no adult mental health service could be identified. GPs may not be able to offer the skilled ongoing care that these young people need. Equally, the inability to move them decreases the capacity of CAMHS to respond to new referrals and may leave some young people with only minimal support. PMID:27280035

Mind how you cross the gap! Outcomes for young people who failed to make the transition from child to adult services: the TRACK study.

PubMed

Islam, Zoebia; Ford, Tamsin; Kramer, Tami; Paul, Moli; Parsons, Helen; Harley, Katherine; Weaver, Tim; McLaren, Susan; Singh, Swaran P

2016-06-01

Aims and method The Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK) study was a multistage, multicentre study of adolescents' transitions between child and adult mental health services undertaken in England. We conducted a secondary analysis of the TRACK study data to investigate healthcare provision for young people (n = 64) with ongoing mental health needs, who were not transferred from child and adolescent mental health services (CAMHS) to adult mental health services mental health services (AMHS). Results The most common outcomes were discharge to a general practitioner (GP; n = 29) and ongoing care with CAMHS (n = 13), with little indication of use of third-sector organisations. Most of these young people had emotional/neurotic disorders (n = 31, 48.4%) and neurodevelopmental disorders (n = 15, 23.4%). Clinical implications GPs and CAMHS are left with the responsibility for the continuing care of young people for whom no adult mental health service could be identified. GPs may not be able to offer the skilled ongoing care that these young people need. Equally, the inability to move them decreases the capacity of CAMHS to respond to new referrals and may leave some young people with only minimal support.

Positive attitudes and self-harming behavior of adolescents in a juvenile detention house in Taiwan.

PubMed

Tsai, Mei-Hua; Fang, Kai-Chi; Lu, Chia-Hui; Chen, Chih-Dao; Hsieh, Chi-Pan; Chen, Tsung-Tai

2011-08-01

This study aimed to evaluate the less stigmatizing positivity construct screening measurement and its association with recent self-harming behaviors among adolescents. Participants were 193 detained Taiwanese adolescents. Questionnaires consisted of a deliberate self-harm inventory, a positivity construct measurement, a depression scale, data concerning risky health behaviors and demographics. The prevalence rate of recent self-harming behavior among adolescents in the detention house was 43.5%. The logistic model showed that age, gender and level of positivity demonstrated significant odds ratios for self-harm behavior. Results showed that younger age and female gender increased self-harming behavior. In addition, low score on positivity construct screening measurement increased the probability of self-harming behavior. Furthermore, these adolescents also engaged in risky health behaviors and were more depressed. Parental and school awareness for these risky behaviors should be enhanced and appropriate early interventions implemented to prevent negative health outcomes.

Friendship Attachment Style Moderates the Effect of Adolescent Exposure to Violence on Emerging Adult Depression and Anxiety Trajectories.

PubMed

Heinze, Justin E; Cook, Stephanie H; Wood, Erica P; Dumadag, Anne C; Zimmerman, Marc A

2018-01-01

Exposure to violence during adolescence is associated with increased risk behaviors and mental health problems in adulthood. Friendship attachment during adolescence may, however, mitigate the negative effects of exposure to violence on trajectories of depression and anxiety in young adulthood. In this study, we used growth curve modeling to examine associations between exposure to violence and mental health outcomes, followed by multi-group analyses with friendship attachment as the moderator. The sample was drawn from a longitudinal study (12 waves; 1994-2012) of 676 (54% female) urban high school students. We found strong positive associations between exposure to violence during adolescence and later self-reported depressive and anxiety symptoms. Notably, securely attached adolescents reported faster decreases in mental health symptoms as a function of violence relative to their insecurely attached peers as they transitioned into adulthood.

Economic volatility in childhood and subsequent adolescent mental health problems: a longitudinal population-based study of adolescents.

PubMed

Bøe, Tormod; Skogen, Jens Christoffer; Sivertsen, Børge; Hysing, Mari; Petrie, Keith J; Dearing, Eric; Zachrisson, Henrik Daae

2017-09-18

The aim of the current paper was to investigate the association between the patterns of duration, timing and sequencing of exposure to low family income during childhood, and symptoms of mental health problems in adolescence. Survey administered to a large population-based sample of Norwegian adolescents. Survey data from 9154 participants of 16-19 years age (53% participation rate; 52.7% girls) were linked to registry-based information about childhood family income from tax return data. Mental health outcomes were symptoms of emotional, conduct, hyperactivity, peer problems and general mental health problems measured with the Strengths and Difficulties Questionnaire, symptoms of depression measured with Short Mood and Feelings Questionnaire and symptoms of attention-deficit/hyperactivity disorder (ADHD) measured with the Adult ADHD Self-Report Scale. Latent class analysis and the BCH approach in Mplus were used to examine associations between patterns of poverty exposure and mental health outcomes. Four latent classes of poverty exposure emerged from the analysis. Participants moving into poverty (2.3%), out of poverty (3.5%) or those chronically poor (3.1%) had more symptoms of mental health problems (Cohen's d =16-.50) than those with no poverty exposure (91.1%). This pattern was, however, not found for symptoms of ADHD. The pattern of results was confirmed in robustness checks using observed data. Exposure to poverty in childhood was found to be associated with most mental health problems in adolescence. There was no strong suggestion of any timing or sequencing effects in the patterns of associations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Multisite musculoskeletal pain in adolescence and later mental health disorders: a population-based registry study of Norwegian youth: the NAAHS cohort study

PubMed Central

Eckhoff, Christian; Straume, Bjørn; Kvernmo, Siv

2017-01-01

Objectives To examine the association between multisite musculoskeletal pain in adolescence and mental health disorders in young adulthood. Design and setting Data were obtained from a linkage between the Norwegian Patient Registry (2008–2012) and the Norwegian Arctic Adolescent Health Study, a school-based survey conducted among 10th grade students in North Norway (2003–2005). Participants In total, 3987 (68%) of all 5877 invited participants consented to the registry linkage. Outcome measures Mental healthcare use and disorders from age 18–20 to 23–25 years (5 years). Methods Musculoskeletal pain was measured by the number of musculoskeletal pain sites. Multivariable logistic regression was used to explore the association with later mental healthcare use and disorders. Results Multisite adolescent musculoskeletal pain was significantly associated with an increase in mental healthcare use and mental health disorders in young adulthood. The relationship was stronger for anxiety and mood disorders, in both genders. Overall, the association between musculoskeletal pain and later mental health problems was attenuated after controlling for adolescent psychosocial and mental health problems, not by physical or sedentary activity. This could be due to confounding or mediation. However, when examining different mental health disorders, we found musculoskeletal pain to be significantly associated with anxiety disorders, and showing a strong trend in mood disorders, when adjusted for the adolescent factors. Conclusions Physicians should be aware that multisite adolescent pain is associated with mental health problems in adolescence, and that these adolescents are at increased risk of mental health disorders in young adulthood. As youth troubled by mental health problems commonly present physical symptoms it is important to examine for psychosocial problems in order to offer early interventions. PMID:28188150

Adolescents' expectations for the future predict health behaviors in early adulthood.

PubMed

McDade, Thomas W; Chyu, Laura; Duncan, Greg J; Hoyt, Lindsay T; Doane, Leah D; Adam, Emma K

2011-08-01

Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual's investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.-perceived chances of living to middle age and perceived chances of attending college-are associated with an individual's engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health. Copyright © 2011 Elsevier Ltd. All rights reserved.

Setting Adolescents Up for Success: Promoting a Policy to Delay High School Start Times.

PubMed

Barnes, Margaux; Davis, Krista; Mancini, Mackenzie; Ruffin, Jasmine; Simpson, Tina; Casazza, Krista

2016-07-01

A unique biological shift in sleep cycles occurs during adolescence causing later sleep and wake times. This shift is not matched by a concurrent modification in school start times, resulting in sleep curtailment for a large majority of adolescents. Chronic inadequate sleep is associated with poor academic performance including executive function impairments, mood, and behavioral issues, as well as adverse health outcomes such as an increased risk of obesity, hypertension, and cardiovascular disease. In order to address sleep deficits and the potential negative outcomes associated with chronic sleep deprivation, the American Academy of Pediatrics (AAP) and US Centers for Disease Control and Prevention (CDC) support delaying school start times for middle and high school students. We summarize current evidence, explicate the need for policy change, and urge school districts to put adolescent students' health as top priority and implement school start times consistent with their developmental needs. Whereas substantial evidence illustrating adverse consequences of inadequate sleep on psychological and physical health, and recommendations exist to adapt daytime school schedules to match sleep needs have been released, actual implementation of these recommendations have been limited. This is a call to action for the implementation of AAP/CDC recommendations across the state and nation. © 2016, American School Health Association.

Social connectedness, mental health and the adolescent brain.

PubMed

Lamblin, M; Murawski, C; Whittle, S; Fornito, A

2017-09-01

Social relationships promote health and wellbeing. Brain regions regulating social behavior continue to develop throughout adolescence, as teens learn to navigate their social environment with increasing sophistication. Adolescence is also a time of increased risk for the development of psychiatric disorders, many of which are characteristically associated with social dysfunction. In this review, we consider the links between adolescent brain development and the broader social environment. We examine evidence that individual differences in social ability, partly determined by genetic influences on brain structure and function, impact the quality and quantity of social ties during adolescence and that, conversely, the structure of one's social network exerts complex yet profound influences on individual behavior and mental health. In this way, the brain and social environment sculpt each other throughout the teenage years to influence one's social standing amongst peers. Reciprocal interactions between brain maturation and the social environment at this critical developmental stage may augment risk or promote resilience for mental illness and other health outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential.

PubMed

Bearinger, Linda H; Sieving, Renee E; Ferguson, Jane; Sharma, Vinit

2007-04-07

Worldwide, societal shifts and behavioural patterns exacerbated by unique developmental vulnerabilities create a confluence of factors that place today's adolescents at heightened risks for poor health outcomes. Country-level data show that continued investment in effective prevention and treatment strategies is essential to protect adolescents' sexual and reproductive health. Whereas strategies must be tailored to the developmental needs of this age group and their social contexts, effective approaches are multifaceted. All adolescents need access to quality youth-friendly services provided by clinicians trained to work with this population. Sex education programmes should offer accurate, comprehensive information while building skills for negotiating sexual behaviours. Girls and boys also need equal access to youth development programmes that connect them with supportive adults and with educational and economic opportunities. Although progress has been made since the 1994 International Conference on Population and Development, adolescents continue to be disproportionately burdened by threats to their sexual and reproductive health.

Perspectives of adolescent girls with cystic fibrosis and parents on disease-specific sexual and reproductive health education.

PubMed

Kazmerski, Traci M; Hill, Kelsey; Prushinskaya, Olga; Nelson, Eliza; Greenberg, Jonathan; Pitts, Sarah Ab; Borrero, Sonya; Miller, Elizabeth; Sawicki, Gregory S

2018-04-26

Adolescent girls with cystic fibrosis (CF) face significant disease-specific sexual and reproductive health (SRH) concerns that are not typically addressed in routine clinical care. Additionally, there is a paucity of developmentally appropriate CF-specific SRH educational resources for this population. The goal of this study was to explore patient and parent attitudes toward SRH educational resources for adolescent girls with CF. Adolescent girls ages 13-18 years with CF and parents of daughters ages 10-18 years with CF completed individual, semi-structured interviews regarding their experiences and preferences around CF-specific SRH education and care. To facilitate discussion, participants provided feedback on the format and design of existing SRH educational resources. Qualitative analysis was conducted using a thematic analysis approach. We interviewed 26 participants (14 parents and 12 patients). The majority reported they had never discussed SRH in the CF care setting. All participants preferred a comprehensive, online patient educational resource complemented by real patient stories and interactive components. Participants noted that such resources should create a sense of normalcy and community around CF and female SRH. Most desired more frequent communication around SRH between adolescent girls with CF and their healthcare providers as a way to promote SRH knowledge, decision making, and health outcomes. Adolescent girls with CF and their parents desire an online patient educational resource that normalizes SRH and enhances patient-provider communication around these topics. Creation of developmentally appropriate resources would facilitate improved health outcomes around this aspect of comprehensive care in CF. © 2018 Wiley Periodicals, Inc.

Bullying and Discrimination Experiences among Korean-American Adolescents

ERIC Educational Resources Information Center

Shin, Jin Y.; D'Antonio, Emily; Son, Haein; Kim, Seong-A.; Park, Yeddi

2011-01-01

The bullying experiences of Korean-American adolescents (N = 295) were explored in relation to discrimination and mental health outcomes. Bullying experiences were assessed by the "Bully Survey" (Swearer, 2005), discrimination by the "Perceived Ethnic and Racial Discrimination Scale" (Way, 1997) and depression by the "Center for Epidemiological…

School context, friendship ties and adolescent mental health: A multilevel analysis of the Korean Youth Panel Survey (KYPS).

PubMed

Kim, Harris Hyun-Soo

2015-11-01

Research on the social determinants of health suggests that interpersonal networks play a critical role in facilitating individual mental and physical well-being. Prior studies also indicate that ecological or contextual factors contribute to positive health outcomes. This study extends prior research by examining the factors associated with adolescent health in an Asian context. Based on the multilevel analysis of the Korean Youth Panel Survey (2006 & 2007), a longitudinal project funded by the Korean government, it investigates some of the key variables related to the mental health of Korean students. Much of previous research focuses on the functions of social capital. This study contributes to the social epidemiology literature by investigating the possible downside of network ties. Specifically, it asks whether having delinquent friends is associated with negative mental health experiences. In addition, little research has been conducted concerning the associations between adolescent health outcomes and school characteristics. This study moves in that direction by examining the relationship between mental well-being of students and a variety of school related variables (e.g., subjective attitude toward school and quality of relationship with peers and teachers). Hierarchical linear modeling shows that, among the social capital control variables, being properly integrated into the family and frequent peer interaction significantly add to mental health. At the individual (student) level only, ties to delinquent friends are negatively associated with mental health, while at both individual and contextual levels, school characteristics are positively related to adolescent subjective well-being. Copyright © 2015 Elsevier Ltd. All rights reserved.

Can social support protect bullied adolescents from adverse outcomes? A prospective study on the effects of bullying on the educational achievement and mental health of adolescents at secondary schools in East London

PubMed Central

Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen

2011-01-01

This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to achieve the appropriate academic achievement benchmark for their age group and bullied boys (but not girls) were more likely to exhibit depressive symptoms compared to those not bullied. High levels of social support from family were important in promoting good mental health. There was evidence that high levels of support from friends and moderate (but not high) family support was able to protect bullied adolescents from poor academic achievement. Support from friends and family was not sufficient to protect adolescents against mental health difficulties that they might face as a result of being bullied. More active intervention from schools is recommended. PMID:20637501

The globalization of training in adolescent health and medicine: one size does not fit all.

PubMed

Leslie, Karen

2016-08-01

Adolescent medicine across the globe is practiced within a variety of healthcare models, with the shared vision of the promotion of optimal health outcomes for adolescents. In the past decade, there has been a call for transformation in how health professionals are trained, with recommendations that there be adoption of a global outlook, a multiprofessional perspective and a systems approach that considers the connections between education and health systems. Many individuals and groups are now examining how best to accomplish this educational reform. There are tensions between the call for globally accepted standards of education models and practice (a one-size fits all approach) and the need to promote the ability for education practices to be interpreted and transformed to best suit local contexts. This paper discusses some of the key considerations for 'importing' training program models for adolescent health and medicine, including the importance of cultural alignment and the utilization of best evidence and practice in health professions education.

What mediates the relationship between family meals and adolescent health issues.

PubMed

Franko, Debra L; Thompson, Douglas; Affenito, Sandra G; Barton, Bruce A; Striegel-Moore, Ruth H

2008-03-01

To determine whether the frequency of family meals in childhood is associated with positive health outcomes in adolescence through the mediating links of increased family cohesion and positive coping skills. Data were obtained from the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS), a 10-year longitudinal study of 2,379 black and white girls assessed annually from ages 9-19. The mediational analysis framework of H. C. Kraemer and colleagues (2001) was used to test the hypothesis that the frequency of family meals in childhood (Study Years 1 and 3) would be related to health outcomes (Study Year 10) through the mediating links of family cohesion and coping skills (Study Years 7/8), after adjusting for baseline (Year 1) demographics as well as previous levels of the outcome variables (Years 5/6). Several measures of adolescent health variables were included as outcome measures. These included the Perceived Stress Scale, three Eating Disorders Inventory subscales (drive for thinness, body dissatisfaction, and bulimia), number of days of alcohol and tobacco consumption, and engaging in extreme weight control behaviors (e.g., self-induced vomiting). More frequent family meals in the first 3 study years predicted greater family cohesion and problem- and emotion-focused coping in Years 7 and 8. Family cohesion mediated family meals and risk of smoking in Year 10. Problem-focused coping mediated family meals and both stress and disordered eating-related attitudes and behaviors in Year 10. Eating together as a family during childhood may have multiple benefits in later years. (c) 2008 APA, all rights reserved

Bullying and mental health and suicidal behaviour among 14- to 15-year-olds in a representative sample of Australian children.

PubMed

Ford, Rebecca; King, Tania; Priest, Naomi; Kavanagh, Anne

2017-09-01

To provide the first Australian population-based estimates of the association between bullying and adverse mental health outcomes and suicidality among Australian adolescents. Analysis of data from 3537 adolescents, aged 14-15 years from Wave 6 of the K-cohort of Longitudinal Study of Australian Children was conducted. We used Poisson and linear regression to estimate associations between bullying type (none, relational-verbal, physical, both types) and role (no role, victim, bully, victim and bully), and mental health (measured by the Strengths and Difficulties Questionnaire, symptoms of anxiety and depression) and suicidality. Adolescents involved in bullying had significantly increased Strengths and Difficulties Questionnaire, depression and anxiety scores in all bullying roles and types. In terms of self-harm and suicidality, bully-victims had the highest risk of self-harm (prevalence rate ratio 4.7, 95% confidence interval [3.26, 6.83]), suicidal ideation (prevalence rate ratio 4.3, 95% confidence interval [2.83, 6.49]), suicidal plan (prevalence rate ratio 4.1, 95% confidence interval [2.54, 6.58]) and attempts (prevalence rate ratio 2.7, 95% confidence interval [1.39, 5.13]), followed by victims then bullies. The experience of both relational-verbal and physical bullying was associated with the highest risk of self-harm (prevalence rate ratio 4.6, 95% confidence interval [3.15, 6.60]), suicidal ideation or plans (prevalence rate ratio 4.6, 95% confidence interval [3.05, 6.95]; and 4.8, 95% confidence interval [3.01, 7.64], respectively) or suicide attempts (prevalence rate ratio 3.5, 95% confidence interval [1.90, 6.30]). This study presents the first national, population-based estimates of the associations between bullying by peers and mental health outcomes in Australian adolescents. The markedly increased risk of poor mental health outcomes, self-harm and suicidal ideation and behaviours among adolescents who experienced bullying highlights the importance of addressing bullying in school settings.

Health effects of perceived racial and religious bullying among urban adolescents in China: a cross-sectional national study.

PubMed

Pan, Stephen W; Spittal, Patricia M

2013-07-01

Research concerning ethnocultural bullying and adolescent health in China remains extremely limited. This study among Chinese urban adolescents examines associations between ethnocultural bullying and eight health-related outcomes: suicidal ideation, suicide planning, depressive symptomology, anxiety symptomatology, fighting, injury intentionally inflicted by another, smoking and moderate/heavy alcohol consumption. Data were obtained from the World Health Organisation's 2003 Chinese Global School-based Health Survey, a cross-sectional national survey of urban adolescents in four Chinese cities. The analytic sample size was n = 8182, which represented a sampling frame of 769,835 adolescents. Statistical analysis was conducted using generalised linear mixed effects models and sampling weights. Prevalence of ethnocultural bullying was significantly higher in Urumqi, Xinjiang province (2.08%) compared with Beijing municipality (0.72%) or Wuhan, Hubei province (0.67%). Compared to participants who were not bullied, religious bullying victimisation was significantly associated with suicidal ideation, injury intentionally inflicted by another and depressive symptomology. Racial bullying victimisation was significantly associated with suicidal ideation, injury intentionally inflicted by another and among females but not males, depressive symptomology. Health effects of ethnocultural bullying appear to be distinct from that of bullying in general. Additional research on ethnocultural adolescent health issues in China is warranted.

Paternal psychosocial work conditions and mental health outcomes: a case-control study.

PubMed

Maggi, Stefania; Ostry, Aleck; Tansey, James; Dunn, James; Hershler, Ruth; Chen, Lisa; Hertzman, Clyde

2008-03-31

The role of social and family environments in the development of mental health problems among children and youth has been widely investigated. However, the degree to which parental working conditions may impact on developmental psychopathology has not been thoroughly studied. We conducted a case-control study of several mental health outcomes of 19,833 children of sawmill workers and their association with parental work stress, parental socio-demographic characteristics, and paternal mental health. Multivariate analysis conducted with four distinct age groups (children, adolescents, young adults, and adults) revealed that anxiety based and depressive disorders were associated with paternal work stress in all age groups and that work stress was more strongly associated with alcohol and drug related disorders in adulthood than it was in adolescence and young adulthood. This study provides support to the tenet that being exposed to paternal work stress during childhood can have long lasting effects on the mental health of individuals.

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras

PubMed Central

Hendrick, C. Emily; Marteleto, Leticia

2017-01-01

Maternal decision-making autonomy has been linked to positive outcomes for children’s health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children’s outcomes into adolescence and whether it impacts other domains of children’s lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents’ environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12–16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011–12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents’ school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers’ high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents’ school enrollment above and beyond other maternal, household, and regional influences. PMID:29075048

Adapting and Testing Telephone Based Depression Care Management Intervention for Adolescent Mothers

PubMed Central

Logsdon, M. Cynthia; Pinto-Foltz, Melissa D.; Stein, Bradley; Usui, Wayne; Josephson, Allan

2011-01-01

Purpose and Methods This Phase 1 clinical trial combined qualitative and quantitative methods to modify a collaborative care, telephone based, depression care management intervention for adolescent mothers, and to determine the acceptability, feasibility, and initial efficacy of the intervention in a sample of adolescent mothers (n=97) who were recruited from a Teen Parent Program. Outcomes included measures of depressive symptoms, functioning, and use of mental health services. Results Acceptability of the intervention was demonstrated, but feasibility issues related to the complex life challenges confronting the adolescent mother. Although only four adolescent mothers received mental health treatment, there was a trend for improved depressive symptoms over time. Conclusion Results of the study provide data for the need of further refinement of the intervention before a large clinical trial is conducted for adolescent mothers with symptoms of depression. PMID:20020164

Daily Laboratory Monitoring is of Poor Health Care Value in Adolescents Acutely Hospitalized for Eating Disorders.

PubMed

Ridout, Kathryn K; Kole, Jonathan; Fitzgerald, Kelly L; Ridout, Samuel J; Donaldson, Abigail A; Alverson, Brian

2016-07-01

This study investigates how the clinical practice guideline-recommended laboratory monitoring for refeeding syndrome impacts management and outcomes of adolescents with eating disorders hospitalized for acute medical stabilization and examines the value of laboratory monitoring (defined as the patient health outcomes achieved per dollar spent). A retrospective chart review of medical admissions in a children's hospital between October 2010 and February 2014 was performed. Encounters were identified using International Classification of Diseases, Ninth Revision codes of eating disorders as primary or secondary diagnoses. Exclusion criteria included systemic diseases associated with significant electrolyte abnormalities. Chart abstraction was performed using a predetermined form. Costs were estimated by converting hospital-fixed Medicaid charges using a statewide cost-to-charge ratio. Of the 196 patient encounters, there were no cases of refeeding syndrome. A total of 3,960 key recommended laboratories were obtained; 1.9% were below normal range and .05% were critical values. Of these, .28% resulted in supplementation; none were associated with a change in inpatient management. Total laboratory costs were $269,250.85; the calculated health care value of this monitoring is 1.04 × 10(-8) differential outcomes per dollar spent. This study provides evidence to suggest that daily laboratory monitoring for refeeding syndrome is a poor health care value in the management of adolescents hospitalized for acute medical stabilization with eating disorders. This initial analysis suggests that starting at a relatively low caloric level and advancing nutrition slowly may negate the need for daily laboratory assessment, which may have important implications for current guidelines. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Early Adolescents Perceptions of Health and Health Literacy

ERIC Educational Resources Information Center

Brown, Stephen L.; Teufel, James A.; Birch, David A.

2007-01-01

Background: Health illiteracy is a societal issue that, if addressed successfully, may help to reduce health disparities. It has been associated with increased rates of hospital admission, health care expenditures, and poor health outcomes. Because of this, much of the research in the United States has focused on adults in the health care system.…

Parent Conversations about Healthful Eating and Weight: Associations with Adolescent Disordered Eating Behaviors

PubMed Central

Berge, Jerica M.; MacLehose, Rich; Loth, Katie A.; Eisenberg, Marla; Bucchianeri, Michaela M.; Neumark-Sztainer, Dianne

2013-01-01

Objective The prevalence of weight-related problems in adolescents is high. Parents of adolescents may wonder whether talking about eating habits and weight is useful or detrimental. This study aimed to examine the associations between parent conversations about healthful eating and weight and adolescent disordered eating behaviors. Design Cross-sectional analysis using data from two linked multi-level population-based studies. Setting Anthropometric assessments and surveys completed at school by adolescents and surveys completed at home by parents in 2009–2010. Participants Socio-economically and racially/ethnically diverse sample (81% ethnic minority; 60% low income) of adolescents from EAT (Eating and Activity in Teens) 2010 (n = 2,793, mean age=14.4) and parents from F-EAT (Families and Eating and Activity in Teens) (n = 3,709, mean age = 42.3). Main Exposure Parent conversations about healthful eating and weight/size. Outcome Measures Adolescent dieting, unhealthy weight control behaviors, and binge eating. Results Mothers and fathers who engaged in weight-related conversations had adolescents who were more likely to diet, use unhealthy weight control behaviors, and engage in binge eating. Overweight/obese adolescents whose mothers engaged in conversations that were focused only on healthful eating behaviors were less likely to diet and use unhealthy weight control behaviors. Additionally, sub-analyses with adolescents with data from two parents showed that when both parents engaged in healthful eating conversations, their overweight/obese adolescent children were less likely to diet and use unhealthy weight control behaviors. Conclusion Parent conversations focused on weight/size are associated with increased risk for adolescent disordered eating behaviors, whereas conversations focused on healthful eating are protective against disordered eating behaviors. PMID:23797808

Which forms of child/adolescent externalizing behaviors account for late adolescent risky sexual behavior and substance use?

PubMed

Timmermans, Maartje; van Lier, Pol A C; Koot, Hans M

2008-04-01

Health risk behaviors like substance use (alcohol, tobacco, soft/hard drugs) and risky sexual behavior become more prevalent in adolescence. Children with behavior problems are thought to be prone to engage in health risk behaviors later in life. It is, however, unclear which problems within the externalizing spectrum account for these outcomes. Three hundred and nine children were followed from age 4/5 years to 18 years (14-year follow-up). Level and course of parent-rated opposition, physical aggression, status violations and property violations were used to predict adolescent-reported substance use and risky sexual behavior at age 18 years. Both level and change in physical aggression were unique predictors of all forms of adolescent health risk behavior. Levels of status violations predicted smoking and soft drug use only, while change in property violations predicted each of the health risk behaviors. The links between opposition and health risk behaviors were accounted for by co-occurring problem behaviors. Of externalizing problems, physical aggression is the best predictor of adolescent substance use and risky sexual behavior from childhood onwards. Possible explanations and implications of these findings, and future research directions are discussed.

Adolescent Self-Organization and Adult Smoking and Drinking over Fifty Years of Follow-Up: The British 1946 Birth Cohort

PubMed Central

2016-01-01

Variations in markers of adolescent self-organization predict a range of economic and health-related outcomes in general population studies. Using a population-based birth cohort study we investigated associations between adolescent self-organization and two common factors over adulthood influencing health, smoking and alcohol consumption. The MRC National Survey of Health and Development (the British 1946 birth cohort) was used to test associations between a dimensional measure of adolescent self-organization derived from teacher ratings, and summary longitudinal measures of smoking and alcohol consumption over the ensuing five decades. Multinomial regression models were adjusted for sex, adolescent emotional and conduct problems, occupational social class of origin, childhood cognition, educational attainment and adult occupational social class. With all covariates adjusted, higher adolescent self-organization was associated with fewer smoking pack years, although not with quitting; there was no association with alcohol consumption across adulthood (none or heavy compared with light to moderate). Adolescent self-organization appears to be protective against smoking, but not against heavy alcohol consumption. Interpretation of this differential effect should be embedded in an understanding of the social and sociodemographic context in which these health behaviours occur over time. PMID:26752724

Adolescent Self-Organization and Adult Smoking and Drinking over Fifty Years of Follow-Up: The British 1946 Birth Cohort.

PubMed

Nishida, Atsushi; Cadar, Dorina; Xu, Man K; Croudace, Timothy; Jones, Peter B; Kuh, Diana; Richards, Marcus

2016-01-01

Variations in markers of adolescent self-organization predict a range of economic and health-related outcomes in general population studies. Using a population-based birth cohort study we investigated associations between adolescent self-organization and two common factors over adulthood influencing health, smoking and alcohol consumption. The MRC National Survey of Health and Development (the British 1946 birth cohort) was used to test associations between a dimensional measure of adolescent self-organization derived from teacher ratings, and summary longitudinal measures of smoking and alcohol consumption over the ensuing five decades. Multinomial regression models were adjusted for sex, adolescent emotional and conduct problems, occupational social class of origin, childhood cognition, educational attainment and adult occupational social class. With all covariates adjusted, higher adolescent self-organization was associated with fewer smoking pack years, although not with quitting; there was no association with alcohol consumption across adulthood (none or heavy compared with light to moderate). Adolescent self-organization appears to be protective against smoking, but not against heavy alcohol consumption. Interpretation of this differential effect should be embedded in an understanding of the social and sociodemographic context in which these health behaviours occur over time.

Can social support protect bullied adolescents from adverse outcomes? A prospective study on the effects of bullying on the educational achievement and mental health of adolescents at secondary schools in East London.

PubMed

Rothon, Catherine; Head, Jenny; Klineberg, Emily; Stansfeld, Stephen

2011-06-01

This paper investigates the extent to which social support can have a buffering effect against the potentially adverse consequences of bullying on school achievement and mental health. It uses a representative multiethnic sample of adolescents attending East London secondary schools in three boroughs. Bullied adolescents were less likely to achieve the appropriate academic achievement benchmark for their age group and bullied boys (but not girls) were more likely to exhibit depressive symptoms compared to those not bullied. High levels of social support from family were important in promoting good mental health. There was evidence that high levels of support from friends and moderate (but not high) family support was able to protect bullied adolescents from poor academic achievement. Support from friends and family was not sufficient to protect adolescents against mental health difficulties that they might face as a result of being bullied. More active intervention from schools is recommended. Copyright © 2010 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Understanding and Promoting Parent-Child Sexual Health Communication

ERIC Educational Resources Information Center

Phelps, Shannon

2017-01-01

Parent-child sexual health communication (PCSHC) can have a positive impact on adolescents' sexual health choices, outcomes, and capabilities for communicating with others about sexual health. Many parents are hesitant and feel unprepared for and uncomfortable with communicating about sexual health with their children. Other parental factors as…

Adolescent Cancer Education (ACE) to increase adolescent and parent cancer awareness and communication: study protocol for a cluster randomised controlled trial

PubMed Central

2013-01-01

Background Raising cancer awareness among adolescents has potential to increase their knowledge and confidence in identifying cancer symptoms and seeking timely medical help in adolescence and adulthood. Detecting cancer at an early stage is important because it reduces the risk of dying of some cancers and thereby contributes to improved cancer survival. Adolescents may also play an important role in increasing cancer communication within families. However, there are no randomised controlled trials (RCT) of the effectiveness of school-based educational interventions to increase adolescents’ cancer awareness, and little is known about the role of adolescents in the upward diffusion of cancer knowledge to parents/carers. The aim of this study is to determine the effectiveness of a school-based educational intervention to raise adolescent and parent cancer awareness and adolescent-parent cancer communication. Methods The Adolescent Cancer Education (ACE) study is a school-based, cluster RCT. Twenty secondary schools in the area covered by Glasgow City Council will be recruited. Special schools for adolescents whose additional needs cannot be met in mainstream education are excluded. Schools are randomised to receive a presentation delivered by a Teenage Cancer Trust educator in Autumn 2013 (intervention group) or Spring 2014 following completion of six-month follow-up measures (control group). Participants will be students recruited at the end of their first year of secondary education (S1) (age 12 to 13 years) and one parent/carer for each student, of the student’s choice. The primary outcome is recognition of cancer symptoms two weeks post-intervention. Secondary outcomes are parents’ cancer awareness and adolescent-parent cancer communication. Outcomes will be assessed at baseline (when adolescents are in the final term of S1), two-week, and six-month follow-up (when adolescents are in S2, age 13 to 14 years). Differences in outcomes between trial arms will be tested using multiple regression methods, adjusted for clustering by school. An audit of cancer-related and health-promotion activity within the school curriculum and environment during the RCT will be conducted at six-month follow-up to contextualise the intervention effect. Discussion Results from the ACE study will provide evidence about the public health effectiveness of a school-based intervention designed to increase adolescent and parent cancer awareness and adolescent-parent cancer communication. Trial registration ISRCTN75542411 PMID:24011093

Depression and suicide ideation in late adolescence and early adulthood are an outcome of child hunger.

PubMed

McIntyre, Lynn; Williams, Jeanne V A; Lavorato, Dina H; Patten, Scott

2013-08-15

Child hunger represents an adverse experience that could contribute to mental health problems in later life. The objectives of this study were to: (1) examine the long-term effects of the reported experience of child hunger on late adolescence and young adult mental health outcomes; and (2) model the independent contribution of the child hunger experience to these long-term mental health outcomes in consideration of other experiences of child disadvantage. Using logistic regression, we analyzed data from the Canadian National Longitudinal Survey of Children and Youth covering 1994 through 2008/2009, with data on hunger and other exposures drawn from NLSCY Cycle 1 (1994) through Cycle 7 (2006/2007) and mental health data drawn from Cycle 8 (2008/2009). Our main mental health outcome was a composite measure of depression and suicidal ideation. The prevalence of child hunger was 5.7% (95% CI 5.0-6.4). Child hunger was a robust predictor of depression and suicidal ideation [crude OR=2.9 (95% CI 1.4-5.8)] even after adjustment for potential confounding variables, OR=2.3 (95% CI 1.2-4.3). A single question was used to assess child hunger, which itself is a rare extreme manifestation of food insecurity; thus, the spectrum of child food insecurity was not examined, and the rarity of hunger constrained statistical power. Child hunger appears to be a modifiable risk factor for depression and related suicide ideation in late adolescence and early adulthood, therefore prevention through the detection of such children and remedy of their circumstances may be an avenue to improve adult mental health. Copyright © 2012 Elsevier B.V. All rights reserved.

Adolescent relationship abuse and reproductive and sexual coercion among teens.

PubMed

Miller, Elizabeth; McCauley, Heather L

2013-10-01

Adolescent relationship abuse (ARA) involves a range of coercive and violent behaviours in romantic or consensual relationships. ARA is prevalent and is associated with multiple poor reproductive and sexual health outcomes, especially for adolescent girls. Recent studies and reviews of ARA research point to the prevalence of ARA, health consequences of ARA and the contribution of social and cultural norms to ARA perpetration, all of which can inform how to address ARA more effectively with adolescents. Emerging research on reproductive and sexual coercion among adolescents and technology-based abuse is directly relevant to the reproductive and sexual healthcare of adolescents. Current findings underscore the extent to which young, reproductive-aged women may particularly benefit from more effective methods to address ARA. In line with recent American Congress of Obstetricians and Gynecologists recommendations, clinicians should assess for and counsel their adolescent female patients about how ARA and reproductive and sexual coercion may influence adolescent girls' reproductive health. Recent evidence also highlights that ARA manifests in ways that may be less recognizable to clinicians, such as cyber dating abuse. Finally, ARA prevention and intervention efforts should continue to promote gender equity and address the social and cultural norms that shape adolescent girls' experiences of abuse.

Adding Perspective: Predicting Adolescent Sunscreen Use with an Extended Health Action Process Approach.

PubMed

Schüz, Natalie; Schüz, Benjamin; Eid, Michael

2016-07-01

Diseases such as skin cancer often have a very long latency period. For adolescents, especially, it may be difficult to grasp that current risk behavior is related to future health outcomes. This study examines the role of health-related time perspective (i.e. the degree to which short-term outcomes are discounted over long-time health benefits) within the Health Action Process Approach (HAPA). More specifically, based on expectancy*value theory, we tested whether time perspective interacts with self-efficacy, the central variable in this approach. A longitudinal study with three measurement points across one year assessed 156 high school students. Data were analyzed using structural equation models. While time perspective had no direct association with sunscreen use intentions, there was an interaction effect with self-efficacy; the shorter the time perspective, the smaller the association of self-efficacy with intention. Intention in turn predicted planning and sunscreen use at Time 3 (one year later). In order to maximise the impact of early onset measures for skin cancer prevention targeting the motivation for sunscreen use in adolescents, time perspective should be addressed in comprehensive sun protection interventions. © 2016 The International Association of Applied Psychology.

The long arm of community: the influence of childhood community contexts across the early life course.

PubMed

Wickrama, K A S; Noh, Samuel

2010-08-01

This study examines the longitudinal effects of childhood community contexts on young adult outcomes. The study uses a sample of 14,000 adolescents (52% female) derived from the 1990 US Census and the National Longitudinal Study of Adolescent Health (Addhealth). The study examines whether community and family environments exert separate and/or joint long-term influences on young adult achievement and depression. We found both direct and indirect long-term influences of childhood community adversity on young adult educational attainment. The indirect influences of childhood community adversity operated through family and individual-level factors. The long-term influence of childhood community adversity on young adult depression was only indirect. Overall, community influences on young adult achievement outcomes were mediated by family context and by the adolescents' adjustments and transitions, including adolescent depression, school adjustment, and disruptive transitional events. The moderating effect of childhood community adversity suggests that the protective effects of family resources on young adult outcomes dissipate significantly in extremely adverse neighborhoods. The findings demonstrate the importance of integrating multiple theoretical perspectives for longitudinal research to capture pathways of community influence on adolescent developmental and young adulthood outcomes.

Programs to Strengthen Parent-Adolescent Communication About Reproductive Health: A Systematic Review.

PubMed

Gavin, Loretta E; Williams, Jessica R; Rivera, Maria I; Lachance, Christina R

2015-08-01

When caring for an adolescent client, providers of contraceptive services must consider whether and how to encourage parent/guardian-child communication about the adolescent's reproductive health. The objective of this systematic review was to summarize the evidence on the effectiveness of programs designed to increase parent-child communication about reproductive health. The review was used to inform national recommendations on quality family planning services. Data analysis occurred from mid-2011 through 2012. Several electronic bibliographic databases were used to identify relevant articles, including PubMed, CINAHL, PsycINFO, and Popline, published from January 1985 through February 2011. Sixteen articles met the inclusion criteria: all studies examined the impact on at least one medium- or short-term outcome, and two studies assessed the impact on teen pregnancy. One study examined the impact of a program conducted in a clinic setting; the remainder examined the impact of programs in community settings. All studies showed a positive impact on at least one short-term outcome, and 12 of 16 studies showed an increase in parent-child communication about reproductive health. Four of seven studies found an impact on sexual risk behavior. Most programs increased parent-child communication, and several resulted in reduced sexual risk behavior of adolescents. This suggests that delivering a clinic-based program that effectively helps parents/guardians talk to their adolescent child(ren) about reproductive health, or referring parents/guardians to an evidence-based program in the community, may be beneficial. However, further rigorous research on delivery of these programs in clinical settings is needed. Published by Elsevier Inc.

Impact of mobile apps to combat obesity in children and adolescents: A systematic literature review.

PubMed

Quelly, Susan B; Norris, Anne E; DiPietro, Jessica L

2016-01-01

This review examines the impact of mobile app technology on obesity-related anthropometric, psychosocial, and behavioral outcomes in children and adolescents. Nine research articles retrieved from a systematic review of the literature met criteria. Evidence is limited and mixed, but argues for an impact of mobile app use on motivation and goal-setting behavior, and supports further study of the impact on childhood obesity-related outcomes such as attitudes, perceptions, physical activity, and dietary habits. Nurses can use this evidence to discuss potential benefits of health promotion mobile apps with parents, children, and adolescents to combat childhood obesity. © 2015, Wiley Periodicals, Inc.

Sexual identity, partner gender, and sexual health among adolescent girls in the United States.

PubMed

Riskind, Rachel G; Tornello, Samantha L; Younger, Brendan C; Patterson, Charlotte J

2014-10-01

We examined associations between adolescent girls' sexual identity and the gender of their sexual partners, on one hand, and their reports of sexual health behaviors and reproductive health outcomes, on the other. We analyzed weighted data from pooled Youth Risk Behavior Surveys (2005 and 2007) representative of 13 US jurisdictions, focusing on sexually experienced girls in 8th through 12th grade (weighted n=6879.56). We used logistic regression with hierarchical linear modeling to examine the strength of associations between reports about sexual orientation and sexual and reproductive health. Sexual minority girls consistently reported riskier behaviors than did other girls. Lesbian girls' reports of risky sexual behaviors (e.g., sex under the influence of drugs or alcohol) and negative reproductive health outcomes (e.g., pregnancy) were similar to those of bisexual girls. Partner gender and sexual identity were similarly strong predictors of all of the sexual behaviors and reproductive health outcomes we examined. Many sexual minority girls, whether categorized according to sexual identity or partner gender, are vulnerable to sexual and reproductive health risks. Attention to these risks is needed to help sexual minority girls receive necessary services.

Sexual Identity, Partner Gender, and Sexual Health Among Adolescent Girls in the United States

PubMed Central

Tornello, Samantha L.; Younger, Brendan C.; Patterson, Charlotte J.

2014-01-01

Objectives. We examined associations between adolescent girls’ sexual identity and the gender of their sexual partners, on one hand, and their reports of sexual health behaviors and reproductive health outcomes, on the other. Methods. We analyzed weighted data from pooled Youth Risk Behavior Surveys (2005 and 2007) representative of 13 US jurisdictions, focusing on sexually experienced girls in 8th through 12th grade (weighted n = 6879.56). We used logistic regression with hierarchical linear modeling to examine the strength of associations between reports about sexual orientation and sexual and reproductive health. Results. Sexual minority girls consistently reported riskier behaviors than did other girls. Lesbian girls’ reports of risky sexual behaviors (e.g., sex under the influence of drugs or alcohol) and negative reproductive health outcomes (e.g., pregnancy) were similar to those of bisexual girls. Partner gender and sexual identity were similarly strong predictors of all of the sexual behaviors and reproductive health outcomes we examined. Conclusions. Many sexual minority girls, whether categorized according to sexual identity or partner gender, are vulnerable to sexual and reproductive health risks. Attention to these risks is needed to help sexual minority girls receive necessary services. PMID:25121821

Adolescents, pregnancy, and mental health.

PubMed

Siegel, Rebecca S; Brandon, Anna R

2014-06-01

Pregnancy during adolescence is a risk factor for adverse medical and psychosocial outcomes, including psychiatric illness. Psychiatric illness is linked with obstetric complications along with impaired maternal functioning in the postpartum period. This article provides a comprehensive review of the research examining the intersection of psychopathology and adolescent pregnancy and the postpartum period. A literature search was conducted using PubMed (Medline), PsycINFO, and CINAHL for articles published between 1990 and 2013 that examined depression, anxiety, bipolar disorder, and psychosis during pregnancy and the postpartum period in adolescents age 21 years or younger. Articles were selected that covered the following topics: Prevalence or incidence, comorbidity, psychosocial correlates, birth outcomes, parenting, child outcomes, and psychosocial treatment. Forty articles were found and reviewed. There is a substantial research base examining self-reported depressive symptoms in adolescents during pregnancy and the postpartum period. Existing research suggests that pregnant and parenting adolescents are at greater risk for experiencing depressive symptoms than pregnant and postpartum adult women. Depression in the perinatal period is also a risk factor for substance and alcohol abuse and a harsher parenting style in adolescents. Areas for future research in this population include investigating the prevalence, psychosocial correlates, and outcomes of clinically diagnosed Major Depressive Disorder, developing and empirically validating psychotherapeutic treatments, and focusing upon other psychiatric diagnoses such as bipolar disorder, anxiety, and psychosis. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Protective Influences on the Negative Consequences of Drinking among Youth

ERIC Educational Resources Information Center

Randolph, Karen A.; Russell, David; Tillman, Kathryn Harker; Fincham, Frank D.

2010-01-01

The prevention of underage drinking and related outcomes focuses on strengthening protective factors. Using data from the National Longitudinal Study of Adolescent Health ( N = 3,862), the authors examine the effects of protective factors from three domains of adolescents' lives (individual, familial, and extrafamilial) on experiencing negative…

Applying Ecological Perspectives to Adolescent Sexual Health in the United States: Rhetoric or Reality?

ERIC Educational Resources Information Center

Salazar, Laura F.; Bradley, Erin L. P.; Younge, Sinead N.; Daluga, Nichole A.; Crosby, Richard A.; Lang, Delia L.; DiClemente, Ralph J.

2010-01-01

This study sought to determine the perspective taken toward understanding adolescent sexual risk behaviors and related biological outcomes (i.e. pregnancy, sexually transmitted diseases) since 1990. We content analyzed 324 abstracts representing observational research published between January 1990 and December 2007 for inclusion of ecological…

Religiosity and Adolescent Narcissism: Implications for Values Counseling.

ERIC Educational Resources Information Center

Aalsma, Matthew C.; Lapsley, Daniel K.

1999-01-01

The fact that religiosity has been consistently associated with positive mental health outcomes is a warrant for counselors to explore the resources of one's religious tradition for therapeutic change. Argues that pastoral counseling is particularly suited for addressing the ego development needs of adolescents, and that the vicissitudes of…

Linking Online Sexual Activities to Health Outcomes among Teens

ERIC Educational Resources Information Center

O'Sullivan, Lucia F.

2014-01-01

New digital technologies are highly responsive to many of the developmental needs of adolescents, including their need for intimate connection and social identity. This chapter explores adolescents' use of web-based sexual information, texting and "sexting," online dating sites, role-playing games, and sexually explicit media, and…

Hypomania spectrum disorder in adolescence: a 15-year follow-up of non-mood morbidity in adulthood

PubMed Central

2014-01-01

Background We investigated whether adolescents with hypomania spectrum episodes have an excess risk of mental and physical morbidity in adulthood, as compared with adolescents exclusively reporting major depressive disorder (MDD) and controls without a history of adolescent mood disorders. Methods A community sample of adolescents (N = 2 300) in the town of Uppsala, Sweden, was screened for depressive symptoms. Both participants with positive screening and matched controls (in total 631) were diagnostically interviewed. Ninety participants reported hypomania spectrum episodes (40 full-syndromal, 18 with brief episode, and 32 subsyndromal), while another 197 fulfilled the criteria for MDD without a history of a hypomania spectrum episode. A follow up after 15 years included a blinded diagnostic interview, a self-assessment of personality disorders, and national register data on prescription drugs and health services use. The participation rate at the follow-up interview was 71% (64/90) for the hypomania spectrum group, and 65.9% (130/197) for the MDD group. Multiple imputation was used to handle missing data. Results The outcomes of the hypomania spectrum group and the MDD group were similar regarding subsequent non-mood Axis I disorders in adulthood (present in 53 vs. 57%). A personality disorder was reported by 29% of the hypomania spectrum group and by 20% of the MDD group, but a statistically significant difference was reached only for obsessive-compulsive personality disorder (24 vs. 14%). In both groups, the risk of Axis I disorders and personality disorders in adulthood correlated with continuation of mood disorder. Prescription drugs and health service use in adulthood was similar in the two groups. Compared with adolescents without mood disorders, both groups had a higher subsequent risk of psychiatric morbidity, used more mental health care, and received more psychotropic drugs. Conclusions Although adolescents with hypomania spectrum episodes and adolescents with MDD do not differ substantially in health outcomes, both groups are at increased risk for subsequent mental health problems. Thus, it is important to identify and treat children and adolescents with mood disorders, and carefully follow the continuing course. PMID:24428938

Mental health promotion and socio-economic disadvantage: lessons from substance abuse, violence and crime prevention and child health.

PubMed

Toumbourou, J W; Hemphill, S A; Tresidder, J; Humphreys, C; Edwards, J; Murray, D

2007-12-01

Mental health promotion aimed at populations with low socio-economic status (SES) may benefit by investigating prevention strategies that effectively address related child and adolescent problems. Evidence from a number of literature reviews and program evaluations was synthesised. First, the impact of SES on development from childhood to adulthood is considered in light of research on substance abuse, violence, crime, and child development problems. Second, evaluations of interventions are reviewed to identify those that have shown outcomes in research studies (efficacy) or in real-world settings (effectiveness) in reducing developmental problems associated with low SES. Low SES is measured in different ways including low levels of education and/or income or definitions that combine several variables into a new indicator of low SES. Factors associated with low SES are also associated to varying extent with the development of violence and crime, substance abuse and child health problems. Interventions that address underlying determinants of low SES show strong efficacy in decreasing adolescent crime and violence and effectiveness in improving child health outcomes. Although there is limited efficacy evidence that substance abuse prevention can be effectively addressed by targeting low SES, programs designed to improve educational pathways show some efficacy in reducing aspects of adolescent substance use. Mental health promotion strategies can draw on the approaches outlined here that are associated with the prevention of child and adolescent problems within low SES communities. Alternatively, such interventions could be supported in mental health promotion policy as they may assist in preventing related problems that undermine mental health.

A randomised controlled trial of the efficacy of the ABCD Parenting Young Adolescents Program: rationale and methodology

PubMed Central

2010-01-01

Background The transition to adolescence is a time of increased vulnerability for risk taking and poor health, social and academic outcomes. Parents have an important role in protecting their children from these potential harms. While the effectiveness of parenting programs in reducing problem behavior has been demonstrated, it is not known if parenting programs that target families prior to the onset of significant behavioral difficulties in early adolescence (9-14 years) improve the wellbeing of adolescents and their parents. This paper describes the rationale and methodology of a randomised controlled trial testing the efficacy of a parenting program for the promotion of factors known to be associated with positive adolescent outcomes, such as positive parenting practices, parent-adolescent relationships and adolescent behavior. Methods/Design One hundred and eighty parents were randomly allocated to an intervention or wait list control group. Parents in the intervention group participated in the ABCD Parenting Young Adolescents Program, a 6-session behavioral family intervention program which also incorporates acceptance-based strategies. Participants in the Wait List control group did not receive the intervention during a six month waiting period. The study was designed to comply with recommendations of the CONSORT statement. The primary outcome measures were reduction in parent-adolescent conflict and improvements in parent-adolescent relationships. Secondary outcomes included improvements in parent psychosocial wellbeing, parenting self-efficacy and perceived effectiveness, parent-adolescent communication and adolescent behavior. Conclusions Despite the effectiveness of parenting programs in reducing child behavioral difficulties, very few parenting programs for preventing problems in adolescents have been described in the peer reviewed literature. This study will provide data which can be used to examine the efficacy of a universal parenting interventions for the promotion of protective factors associated with adolescent wellbeing and will add to the literature regarding the relationships between parent, parenting and adolescent factors. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12609000194268. PMID:20723219

Adolescent and parent motivation for change affects psychotherapy outcomes among youth with poorly controlled diabetes.

PubMed

Ellis, Deborah A; Berio, Heidi; Carcone, April Idalski; Naar-King, Sylvie

2012-01-01

Investigate effect of baseline motivation for change on treatment fidelity, therapeutic alliance, treatment dose, and treatment outcome in a randomized controlled trial of family therapy for youth with poorly controlled diabetes. Seventy-four adolescents and caregivers completed measures of motivation for change. Measures of fidelity, alliance, dose, and youth health status were collected. Structural equation modeling was used to test the direct and indirect effects of motivation on treatment outcomes. Parent motivation was significantly related to alliance and fidelity. Only alliance was significantly related to posttreatment metabolic control. In adolescent models, only motivation was significantly related to alliance. In both models, motivation had a significant indirect effect on metabolic control through alliance. Findings demonstrate the importance of parent and youth initial motivational status and treatment alliance to treatment outcome among youth with poorly controlled diabetes. Additional research on treatment techniques that promote motivation for change is needed.

Adolescent physical activity predicts high education and socio-economic position in adulthood.

PubMed

Koivusilta, Leena K; Nupponen, Heimo; Rimpelä, Arja H

2012-04-01

Based on the knowledge on beneficial effects of physical activity (PA) on health and fitness, we hypothesized that PA in adolescence is related to high education and socio-economic position (SEP) in adulthood. Improved school performance may mediate the hypothesized relationship. The Adolescent Health and Lifestyle Surveys (AHLS), collected biennially in 1981-89 (baseline) and representing 14- and 16-year-old Finns were individually linked with national registries of the highest educational level and SEP. Of the sample, 10 498 (78%) responded the surveys and were followed till the end of 2001 (age group of 28-38 years). Multinomial logistic regression analysis was used to study the associations between the outcomes (highest attained educational level, SEP) and PA (sports clubs, spontaneous, intensity). Participating in sports club or spontaneous PA and practicing with high intensity in adolescence were associated with higher educational levels and SEP in adulthood. Childhood socio-economic background only slightly influenced the associations and largely, PA predicted the outcomes independently of background. Particularly among girls, school performance partly accounted for the associations between PA and the highest educational level and the highest SEP. Participation in PA in adolescence and particularly its high intensity, predicts higher educational levels and SEP in early middle age. School performance to some degree mediates the impact of PA. PA behaviours in adolescence-or possibilities to participate in PA-are a potential mechanism in generating better health of higher socio-economic and educational groups in adult age.

“Going Beyond the Call of Doula”: A Grounded Theory Analysis of the Diverse Roles Community-Based Doulas Play in the Lives of Pregnant and Parenting Adolescent Mothers

PubMed Central

Gentry, Quinn M.; Nolte, Kim M.; Gonzalez, Ainka; Pearson, Magan; Ivey, Symeon

2010-01-01

This article presents some of the most salient qualitative results from a larger program evaluation of pregnant and parenting adolescents who participated in a community-based doula program. Using grounded theory analysis, seven problem-solving strategies emerged that doulas apply in helping pregnant and parenting adolescents navigate multiple social and health settings that often serve as barriers to positive maternal- and child-health outcomes. The ethnographic findings of this study suggest that the doulas provide valuable assistance to pregnant and parenting adolescents by addressing social-psychological issues and socio-economic disparities. “Diverse role-taking” results in doulas helping pregnant adolescents navigate more successfully through fragmented social and health service systems that are less supportive of low-income adolescents, who are often perceived to be draining scarce resources. The findings have implications for the roles of community-based doulas assigned to low-income adolescents of color seeking to overcome obstacles and attain better educational and economic opportunities. PMID:21886419

Tailoring Clinical Services to Address the Unique Needs of Adolescents from the Pregnancy Test to Parenthood

PubMed Central

Daley, Alison Moriarty; Sadler, Lois S.; Reynolds, Heather Dawn

2013-01-01

Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15–19 year old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the health care system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood. PMID:23522339

Health risk behaviours among adolescents in the English-speaking Caribbean: a review

PubMed Central

Maharaj, Rohan G; Nunes, Paula; Renwick, Shamin

2009-01-01

Background The aim of this paper was to review and summarize research on prevalence of health risk behaviours, their outcomes as well as risk and protective factors among adolescents in the English-speaking Caribbean. Methods Searching of online databases and the World Wide Web as well as hand searching of the West Indian Medical Journal were conducted. Papers on research done on adolescents aged 10 – 19 years old and published during the period 1980 – 2005 were included. Results Ninety-five relevant papers were located. Five papers were published in the 1980s, 47 in the 1990s, and from 2000–2005, 43 papers. Health risk behaviours and outcomes were divided into seven themes. Prevalence data obtained for these, included lifetime prevalence of substance use: cigarettes-24% and marijuana-17%; high risk sexual behaviour: initiation of sexual activity ≤ 10 years old-19% and those having more than six partners-19%; teenage pregnancy: teens account for 15–20% of all pregnancies and one-fifth of these teens were in their second pregnancy; Sexually-Transmitted Infections (STIs): population prevalence of gonorrhoea and/or chlamydia in 18–21 year-olds was 26%; mental health: severe depression in the adolescent age group was 9%, and attempted suicide-12%; violence and juvenile delinquency: carrying a weapon to school in the last 30 days-10% and almost always wanting to kill or injure someone-5%; eating disorders and obesity: overweight-11%, and obesity-7%. Many of the risk behaviours in adolescents were shown to be related to the adolescent's family of origin, home environment and parent-child relationships. Also, the protective effects of family and school connectedness as well as increased religiosity noted in studies from the United States were also applicable in the Caribbean. Conclusion There is a substantial body of literature on Caribbean adolescents documenting prevalence and correlates of health risk behaviours. Future research should emphasize the designing and testing of interventions to alleviate this burden. PMID:19292922

Youth-Adult Connectedness:: A Key Protective Factor for Adolescent Health.

PubMed

Sieving, Renee E; McRee, Annie-Laurie; McMorris, Barbara J; Shlafer, Rebecca J; Gower, Amy L; Kapa, Hillary M; Beckman, Kara J; Doty, Jennifer L; Plowman, Shari L; Resnick, Michael D

2017-03-01

Over the past 30 years, prevention science in the adolescent health field has moved from interventions focused on preventing single problem behaviors to efforts employing a dual approach, addressing risk factors that predict problems while simultaneously nurturing protective factors and promoting positive development. Through an examination of previous research and empirical case examples with vulnerable youth, this article considers the hypothesis that adolescents' sense of connectedness to caring adults acts as a protective factor against a range of risk behaviors. Multivariate analyses with existing data examined indicators of youth-adult connectedness among two groups at high risk for poor health outcomes: (1) mentor-youth relationship quality in an urban, ethnically diverse sample of students in a school-based mentoring program (2014 survey, N=239); and (2) parent-youth connectedness in a statewide sample of high school students who reported homelessness in the past year (2013 survey, N=3,627). For youth in the mentoring program, a high-quality youth-mentor relationship was significantly associated with positive social, academic, and health-related behaviors. Among students who experienced homelessness, all measures of parent connectedness were significantly associated with lower sexual risk levels. Collectively, findings from these analyses and previously published studies by this research group provide evidence that strong, positive relationships with parents and other caring adults protect adolescents from a range of poor health-related outcomes and promote positive development. Youth-adult connectedness appears to be foundational for adolescent health and well-being. Program, practice, and policy decisions should consider what strengthens or hinders caring, connected youth-adult relationships. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Clinical and social outcomes of adolescent self harm: population based birth cohort study

PubMed Central

Heron, Jon; Crane, Catherine; Hawton, Keith; Lewis, Glyn; Macleod, John; Tilling, Kate; Gunnell, David

2014-01-01

Objectives To investigate the mental health, substance use, educational, and occupational outcomes of adolescents who self harm in a general population sample, and to examine whether these outcomes differ according to self reported suicidal intent. Design Population based birth cohort study. Setting Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991-92. Participants Data on lifetime history of self harm with and without suicidal intent were available for 4799 respondents who completed a detailed self harm questionnaire at age 16 years. Multiple imputation was used to account for missing data. Main outcome measures Mental health problems (depression and anxiety disorder), assessed using the clinical interview schedule-revised at age 18 years, self reported substance use (alcohol, cannabis, cigarette smoking, and illicit drugs) at age 18 years, educational attainment at age 16 and 19 years, occupational outcomes at age 19 years, and self harm at age 21 years. Results Participants who self harmed with and without suicidal intent at age 16 years were at increased risk of developing mental health problems, future self harm, and problem substance misuse, with stronger associations for suicidal self harm than for non-suicidal self harm. For example, in models adjusted for confounders the odds ratio for depression at age 18 years was 2.21 (95% confidence interval 1.55 to 3.15) in participants who had self harmed without suicidal intent at age 16 years and 3.94 (2.67 to 5.83) in those who had self harmed with suicidal intent. Suicidal self harm, but not self harm without suicidal intent, was also associated with poorer educational and employment outcomes. Conclusions Adolescents who self harm seem to be vulnerable to a range of adverse outcomes in early adulthood. Risks were generally stronger in those who had self harmed with suicidal intent, but outcomes were also poor among those who had self harmed without suicidal intent. These findings emphasise the need for early identification and treatment of adolescents who self harm. PMID:25335825

Pet ownership and adolescent health: cross-sectional population study.

PubMed

Mathers, Megan; Canterford, Louise; Olds, Tim; Waters, Elizabeth; Wake, Melissa

2010-12-01

To determine whether adolescent health and well-being are associated with having a pet in the household (any pet, or specifically dogs, cats or horses/ponies) or average daily time spent caring for/playing with pet(s). Design, setting and participants--Cross-sectional data from the third wave of the Health of Young Victorians Study (HOYVS), a school-based population study in Victoria, Australia. Predictors--Adolescent-reported pet ownership and average daily time spent caring for/playing with pet(s). Outcomes--Self-reported quality of life (KIDSCREEN); average 4-day daily physical activity level from a computerised diary; parent-proxy and self-reported physical and psychosocial health status (PedsQL); measured BMI status (not overweight, overweight, obese) and blood pressure. Statistical Analysis--Regression methods, adjusted for socio-demographic factors, and non-parametric methods. Household pet data were available for 928 adolescents (466 boys; mean age of 15.9 (SD 1.2) years). Most adolescents (88.7%) reported having a pet in their household. Of these, 75.1% reported no activity involving pets over the surveyed days. It appeared that neither owning a pet nor time spent caring for/playing with a pet was related, positively or negatively, to adolescent health or well-being. Despite high rates of pet ownership, adolescents had little interaction with pets. It appears that owning a pet and time spent caring for/playing with a pet was not clearly associated with adolescents' health or well-being. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Reducing HIV-related risk and mental health problems through a client-centred psychosocial intervention for vulnerable adolescents in Addis Ababa, Ethiopia.

PubMed

Jani, Nrupa; Vu, Lung; Kay, Lynnette; Habtamu, Kassahun; Kalibala, Samuel

2016-01-01

Ethiopia is experiencing an increasingly urban HIV epidemic, alongside a rise in urban adolescent migration. Adolescent migrants are often confronted by unique social challenges, including living in a difficult environment, abuse and mental health problems. These issues can increase adolescents' vulnerability to HIV and compromise their capacity to protect themselves and others from HIV. We piloted and assessed the effects of a targeted psychosocial intervention to reduce mental health problems and improve HIV-related outcomes among migrant adolescents in Addis Ababa. A pre- and post-comparison design was used in a cohort of 576 female and 154 male migrant adolescents aged 15 to 18 years in Addis Ababa receiving services from two service delivery organizations, Biruh Tesfa and Retrak. We implemented a three-month client-centred, counsellor-delivered psychosocial intervention, based on findings from formative research among the same target population, to address participants' increased vulnerability to HIV. The intervention package comprised individual, group and creative arts therapy counselling sessions. Key outcome indicators included anxiety, depression, aggressive behaviour, attention problems, social problems, knowledge of HIV, safer sex practices and use of sexual health services. Longitudinal data analysis (McNemar test and random effects regression) was used to assess changes over time in key indicators by gender. For females, aggressive behaviour decreased by 60% (adjusted odds ratio (AOR): 0.4 (0.25 to 0.65)) and any mental health problem decreased by 50% (AOR: 0.5 (0.36 to 0.81)) from baseline to end line. In addition, knowledge of HIV increased by 60% (AOR: 1.6 (1.08 to 2.47)), knowledge of a place to test for HIV increased by 70% (AOR: 1.7 (1.12 to 2.51)) and HIV testing increased by 80% (AOR: 1.8 (1.13 to 2.97)). For males, HIV knowledge increased by 110% (AOR: 2.1 (1.1 to 3.94)), knowledge of a place to test for HIV increased by 290% (AOR: 3.9 (1.02 to 14.9)), HIV testing increased by 630% (AOR: 7.3 (2.6 to 20.7)) and use of sexual health services increased by 220% (AOR: 3.2 (1.62 to 6.27)). We did not find any significant reduction in mental health problems among male adolescents. Our findings suggest that a psychosocial intervention was associated with increased knowledge and uptake of HIV and sexual health services among both male and female migrant adolescents and with reduced mental health problems among female adolescents. Mental health problems varied significantly for male and female adolescents, suggesting that future interventions should be tailored to address their different needs and would benefit from intensive follow-up efforts.

Health implications of new-age technologies: a systematic review.

PubMed

Bilgrami, Zaid; McLAUGHLIN, Laura; Milanaik, Ruth; Adesman, Andrew

2017-08-01

New-age technologies are ubiquitous in the lives of adolescents. Recent trends in media use suggest that adolescents are spending more time than ever engaging with technologies, and are able to do so in virtually all settings at any time. Given that new-age technologies are so heavily integrated within the daily life of adolescents, the health risks and benefits they offer must be closely examined. In this systematic review, we present recent literature related to the implications of new-age technologies on adolescent health. A total of 94 articles published since 2006 were collected using PubMed and Google Scholar on the most popular new-age technologies among adolescents: the internet, television, cell phones, and video games. The current body of research highlights several health risks related to these technologies. Nearly all have the potential for addiction, which can result in other symptoms and impair one's daily life. Excessive use can affect several components of health, such as quality of sleep, body composition, and mental well-being, and certain practices (viewing pornography, sexting) can lead to risky sexual behaviors. However, the technologies discussed in the present review also have tremendous potential to promote adolescent health. Pediatricians must educate parents and patients on how to safely use technology to minimize the potentially harmful outcomes.

Adolescents’ expectations for the future predict health behaviors in early adulthood

PubMed Central

McDade, Thomas W.; Chyu, Laura; Duncan, Greg J.; Hoyt, Lindsay T.; Doane, Leah D.; Adam, Emma K.

2011-01-01

Health-related behaviors in adolescence establish trajectories of risk for obesity and chronic degenerative diseases, and they represent an important pathway through which socio-economic environments shape patterns of morbidity and mortality. Most behaviors that promote health involve making choices that may not pay off until the future, but the factors that predict an individual's investment in future health are not known. In this paper we consider whether expectations for the future in two domains relevant to adolescents in the U.S.—perceived chances of living to middle age and perceived chances of attending college—are associated with an individual's engagement in behaviors that protect health in the long run. We focus on adolescence as an important life stage during which habits formed may shape trajectories of disease risk later in life. We use data from a large, nationally representative sample of American youth (the US National Longitudinal Study of Adolescent Health) to predict levels of physical activity, fast food consumption, and cigarette smoking in young adulthood in relation to perceived life chances in adolescence, controlling for baseline health behaviors and a wide range of potentially confounding factors. We found that adolescents who rated their chances of attending college more highly exercised more frequently and smoked fewer cigarettes in young adulthood. Adolescents with higher expectations of living to age 35 smoked fewer cigarettes as young adults. Parental education was a significant predictor of perceived life chances, as well as health behaviors, but for each outcome the effects of perceived life chances were independent of, and often stronger than, parental education. Perceived life chances in adolescence may therefore play an important role in establishing individual trajectories of health, and in contributing to social gradients in population health. PMID:21764487

Potential for using online and mobile education with parents and adolescents to impact sexual and reproductive health.

PubMed

Guilamo-Ramos, Vincent; Lee, Jane J; Kantor, Leslie M; Levine, Deborah S; Baum, Sarah; Johnsen, Jennifer

2015-01-01

Research supports the central role of parents in the sexual health behaviors and outcomes of their adolescent children. Too often, parents and adolescents with the greatest sexual health disparities are difficult to reach and engage in preventative interventions. Online and mobile technologies (OMTs) represent an innovative opportunity to reach large numbers of youth and their parents. However, there is a dearth of information related to the feasibility and acceptability of OMT-delivered family interventions for reaching vulnerable youths--particularly, ethnic minority youths. The current manuscript addresses this gap in the empirical literature by examining the feasibility and acceptability of OMT-based parent-adolescent sexual health interventions for African American and Latino families. Focus groups were conducted with convenience samples of Latino and African Americans from six US cities. Fourteen focus groups (six parents and eight adolescents) with an average of 10-12 participants each provided data for the study. Researchers used inductive thematic analysis to evaluate data. The findings suggest that parents and adolescents were motivated to obtain sexual health information through OMTs due to their accessibility, widespread use, and ability to deliver large quantities of information. However, personalized and trustworthy information was viewed as less attainable through the Internet or similar digital means, presenting a potential barrier to delivering an adolescent sexual health intervention via OMTs. Sexual health interventions delivered through online and mobile mechanisms present a novel opportunity for reaching potentially at-risk ethnic minority adolescents and their parents. Feelings of discomfort surrounding OMT use with parents, generational differences, and parent-adolescent relationship quality must be considered when developing technology-based sexual health interventions for Latino and African American families.

Sexual health behavior interventions for U.S. Latino adolescents: a systematic review of the literature.

PubMed

Cardoza, Vicky J; Documét, Patricia I; Fryer, Craig S; Gold, Melanie A; Butler, James

2012-04-01

To identify sexual health behavior interventions targeting U.S. Latino adolescents. A systematic literature review. Peer-reviewed articles published between 1993 and 2011, conducted in any type of setting. Male and female Latino adolescents ages 11-21 years. Interventions promoting sexual abstinence, pregnancy prevention, sexually transmitted infection (STI) prevention, and/or HIV/AIDS prevention. Changes in knowledge, attitudes, engagement in risky sexual behaviors, rates of STIs, and/or pregnancy. Sixty-eight articles were identified. Fifteen were included in this review that specifically addressed Latino adolescent sexual health behavior. Among the reviewed interventions, most aimed to prevent or reduce STI and HIV/AIDS incidence by focusing on behavior change at two levels of the social ecological model: individual and interpersonal. Major strengths of the articles included addressing the most critical issues of sexual health; using social ecological approaches; employing different strategies to deliver sexual health messages; and employing different intervention designs in diverse geographical locations with the largest population of Latino communities. Most of the interventions targeted female adolescents, stressing the need for additional interventions that target Latino adolescent males. Latino adolescent sexual health is a new research field with gaps that need to be addressed in reducing negative sexual health outcomes among this population. More research is needed to produce new or validate existing, age-specific, and culturally-sensitive sexual health interventions for Latino male and female adolescents. Further, this research should also be conducted in areas of the U.S. with the newest Latino migration (e.g., North Carolina). Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Oppositional defiant disorder dimensions: genetic influences and risk for later psychopathology.

PubMed

Mikolajewski, Amy J; Taylor, Jeanette; Iacono, William G

2017-06-01

This study was undertaken to determine how well two oppositional defiant disorder (ODD) dimensions (irritable and headstrong/hurtful) assessed in childhood predict late adolescent psychopathology and the degree to which these outcomes can be attributed to genetic influences shared with ODD dimensions. Psychopathology was assessed via diagnostic interviews of 1,225 twin pairs at ages 11 and 17. Consistent with hypotheses, the irritable dimension uniquely predicted overall internalizing problems, whereas the headstrong/hurtful dimension uniquely predicted substance use disorder symptoms. Both dimensions were predictive of antisocial behavior and overall externalizing problems. The expected relationships between the irritable dimension and specific internalizing disorders were not found. Twin modeling showed that the irritable and headstrong/hurtful dimensions were related to late adolescent psychopathology symptoms through common genetic influences. Symptoms of ODD in childhood pose a significant risk for various mental health outcomes in late adolescence. Further, common genetic influences underlie the covariance between irritable symptoms in childhood and overall internalizing problems in late adolescence, whereas headstrong/hurtful symptoms share genetic influences with substance use disorder symptoms. Antisocial behavior and overall externalizing share common genetic influences with both the irritable and headstrong/hurtful dimensions. © 2017 Association for Child and Adolescent Mental Health.

Investigating self-efficacy, disease knowledge and adherence to treatment in adolescents with cystic fibrosis.

PubMed

Faint, Nicholas R; Staton, Janelle M; Stick, Stephen M; Foster, Juliet M; Schultz, André

2017-05-01

Patient adherence is integral to the effectiveness of prescribed treatment, and is associated with beneficial disease outcomes, yet in adolescents with cystic fibrosis, adherence is often sub-optimal. Multiple factors may contribute to treatment adherence, including disease knowledge and self-efficacy. In adolescents with cystic fibrosis: (i) to compare the disease knowledge of adolescents and their parents before transition to adult care; (ii) to determine the relationship between disease knowledge (adolescent, parent) and adherence; and (iii) to evaluate self-efficacy and its association with disease knowledge and adherence. Adolescents with cystic fibrosis and their parents were recruited from a tertiary children's hospital. Disease knowledge and self-efficacy was assessed using the Knowledge of Disease Management-CF and General Self-Efficacy Scales respectively. Using pharmacy records, medication possession ratio was calculated to measure treatment adherence in the preceding year. Thirty-nine adolescent (aged 12-17 (median 14) years) and parent pairs were recruited. Adherence to hypertonic saline, but not other medications, was significantly associated with disease knowledge in adolescents (r 2  = 0.40, P = 0.029). Mean (SD) adolescent self-efficacy was 30.8 (4.0), and not associated with disease knowledge or adherence. Mean (SD) disease knowledge was less in adolescents than parents (55 (16)% and 72 (14)% respectively, P < 0.001). Disease knowledge is sub-optimal in adolescents with cystic fibrosis, even in the 2 years immediately before transition to adult care. Given that adherence with some treatments has been associated with disease knowledge our results suggest the need for educational interventions in adolescents with cystic fibrosis to optimise self-management and health outcomes. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Long-Term Consequences of Early Sexual Initiation on Young Adult Health: A Causal Inference Approach

ERIC Educational Resources Information Center

Kugler, Kari C.; Vasilenko, Sara A.; Butera, Nicole M.; Coffman, Donna L.

2017-01-01

Although early sexual initiation has been linked to negative outcomes, it is unknown whether these effects are causal. In this study, we use propensity score methods to estimate the causal effect of early sexual initiation on young adult sexual risk behaviors and health outcomes using data from the National Longitudinal Study of Adolescent to…

Examining Relations between Negative Life Events, Time Spent in the United States, Language Use, and Mental Health Outcomes in Latino Adolescents

ERIC Educational Resources Information Center

Rubens, Sonia L.; Fite, Paula J.; Gabrielli, Joy; Evans, Spencer C.; Hendrickson, Michelle L.; Pederson, Casey A.

2013-01-01

Background: Despite the growing number of Latino youth in the US, little research has examined factors that influence the development of mental health symptoms among this population, including factors related to immigration. Objectives: This study examined the link between negative life events (NLEs) and two outcomes, symptoms of anxiety and…

Mother-child relationship quality and effective discipline as mediators of the 6-year effects of the New Beginnings Program for children from divorced families.

PubMed

Zhou, Qing; Sandler, Irwin N; Millsap, Roger E; Wolchik, Sharlene A; Dawson-McClure, Spring R

2008-08-01

This study examines whether program effects on mother-child relationship quality and effective discipline mediated the 6-year longitudinal effects of the New Beginnings Program (NBP) to improve mental health and competence outcomes in 218 adolescents from divorced families in a randomized experimental trial. The NBP is a theory-based and parenting-focused preventive intervention to help children adjust to divorce, and it has previously shown significant main and/or Program x Baseline Risk interaction effects to reduce adolescents' mental health and social adaptation problems and to promote competence. Mediation analyses were conducted using single- and two-group (high and low baseline risk) structural equation modeling. A multiple-methods and multiple-informants approach was used to assess the putative mediators and adolescents' outcomes. Results indicated that program-induced improvement in maternal effective discipline at posttest mediated the intervention effect on adolescents' GPA at the 6-year follow-up. Moreover, program-induced improvement in mother-child relationship quality mediated the intervention effect on adolescents' mental health problems for those with high baseline risk for maladjustment. The discussion focuses on the implications of the mediation findings for advancing the developmental theories that informed the design of the NBP and the implications for implementation of the NBP in community settings. Copyright 2008 APA, all rights reserved.

The health status of young adults in the United States.

PubMed

Park, M Jane; Paul Mulye, Tina; Adams, Sally H; Brindis, Claire D; Irwin, Charles E

2006-09-01

The health issues of young adulthood have received relatively little attention compared with those of adolescence, although the critical issues in young adulthood parallel those of adolescence. Young adults often fare worse than adolescents on health indicators, with many measures of negative outcomes--including rates of injury, homicide, and substance use--peaking during the young adult years. The contextual factors shaping health status and access to care in young adulthood differ significantly from the context of adolescence. This article synthesizes national data to present a health profile of young adults, reviewing social indicators that describe the context of young adulthood and presenting measures of health status. We examine mortality, morbidity, risky behaviors, and health care access and utilization, identifying the most significant gender and racial/ethnic disparities. The article also identifies limitations of existing data and offers suggestions for future research and health monitoring in this area. We conclude with a discussion of current efforts to address the health and well-being of young adults and argue for creating a national health agenda for young adults that includes research, programs and policies to address health issues during this period of the lifespan.

Effectiveness of a pragmatic school-based universal intervention targeting student resilience protective factors in reducing mental health problems in adolescents.

PubMed

Dray, Julia; Bowman, Jenny; Campbell, Elizabeth; Freund, Megan; Hodder, Rebecca; Wolfenden, Luke; Richards, Jody; Leane, Catherine; Green, Sue; Lecathelinais, Christophe; Oldmeadow, Christopher; Attia, John; Gillham, Karen; Wiggers, John

2017-06-01

Worldwide, 10-20% of adolescents experience mental health problems. Strategies aimed at strengthening resilience protective factors provide a potential approach for reducing mental health problems in adolescents. This study evaluated the effectiveness of a universal, school-based intervention targeting resilience protective factors in reducing mental health problems in adolescents. A cluster randomised controlled trial was conducted in 20 intervention and 12 control secondary schools located in socio-economically disadvantaged areas of NSW, Australia. Data were collected from 3115 students at baseline (Grade 7, 2011), of whom 2149 provided data at follow up (Grade 10, 2014; enrolments in Grades 7 to 10 typically aged 12-16 years; 50% male; 69.0% retention). There were no significant differences between groups at follow-up for three mental health outcomes: total SDQ, internalising problems, and prosocial behaviour. A small statistically significant difference in favour of the control group was found for externalising problems. Findings highlight the continued difficulties in developing effective, school-based prevention programs for mental health problems in adolescents. ANZCTR (Ref no: ACTRN12611000606987). Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Factors associated with unintended pregnancy, poor birth outcomes and post-partum contraceptive use among HIV-positive female adolescents in Kenya

PubMed Central

2012-01-01

Background Although the experiences of unintended pregnancies and poor birth outcomes among adolescents aged 15–19 years in the general population are well documented, there is limited understanding of the same among those who are living with HIV. This paper examines the factors associated with experiencing unintended pregnancies, poor birth outcomes, and post-partum contraceptive use among HIV-positive female adolescents in Kenya. Methods Data are from a cross-sectional study that captured information on pregnancy histories of HIV-positive female adolescents in four regions of Kenya: Coast, Nairobi, Nyanza and Rift Valley provinces. Study participants were identified through HIV and AIDS programs in the four regions. Out of a total of 797 female participants, 394 had ever been pregnant with 24% of them experiencing multiple pregnancies. Analysis entails the estimation of random-effects logit models. Results Higher order pregnancies were just as likely to be unintended as lower order ones (odds ratios [OR]: 1.2; 95% confidence interval [CI]: 0.8–2.0) while pregnancies occurring within marital unions were significantly less likely to be unintended compared to those occurring outside such unions (OR: 0.1; 95% CI: 0.1–0.2). Higher order pregnancies were significantly more likely to result in poor outcomes compared to lower order ones (OR: 2.5; 95% CI: 1.6–4.0). In addition, pregnancies occurring within marital unions were significantly less likely to result in poor outcomes compared to those occurring outside such unions (OR: 0.3; 95% CI: 0.1–0.9). However, experiencing unintended pregnancy was not significantly associated with adverse birth outcomes (OR: 1.3; 95% CI: 0.5–3.3). There was also no significant difference in the likelihood of post-partum contraceptive use by whether the pregnancy was unintended (OR: 0.9; 95% CI: 0.5–1.5). Conclusions The experience of repeat unintended pregnancies among HIV-positive female adolescents in the sample is partly due to inconsistent use of contraception to prevent recurrence while poor birth outcomes among higher order pregnancies are partly due to abortion. This underscores the need for HIV and AIDS programs to provide appropriate sexual and reproductive health information and services to HIV-positive adolescent clients in order to reduce the risk of undesired reproductive health outcomes. PMID:23039966

Consequences of Violent Victimization for Native American Youth in Early Adulthood.

PubMed

Turanovic, Jillian J; Pratt, Travis C

2017-06-01

Native American youth are at an elevated risk of violent victimization. And because of their vulnerable position in society, they may also be at risk of experiencing a host of adverse consequences as a result of being victimized. Accordingly, using a subsample of 558 Native American youth and two waves of data from the National Longitudinal Study of Adolescent to Adult Health (49.8 % female; 12-19 years at Wave I; 19-26 years at Wave III), we examined the effects of violent victimization during adolescence on a range of outcomes in early adulthood (poor health, depressive symptoms, suicidality, financial hardship, violent and property offending, alcohol problems, hard drug use, and marijuana use). We also assessed whether youth's attachments to family and to school moderate the effects of victimization on these outcomes. The results showed that adolescent victimization is linked to a small number of outcomes-poor health, depressive symptoms, and violent offending-and that the protective effects of social attachments are not widespread. Specifically, family attachments moderated the effects of victimization on poor health and depressive symptoms, and school attachments moderated the effects of victimization on property offending. These findings suggest that the consequences of victimization and the protective effects of social attachments may differ for Native American youth, and that further quantitative and qualitative research is necessary to understand these patterns.

Multi-system influences on adolescent risky sexual behavior.

PubMed

Chen, Angela Chia-Chen; Thompson, Elaine Adams; Morrison-Beedy, Dianne

2010-12-01

We examined multi-system influences on risky sexual behavior measured by cumulative sexual risk index and number of nonromantic sexual partners among 4,465 single, sexually experienced adolescents. Hierarchical Poisson regression analyses were conducted with Wave I-II data from the National Longitudinal Study of Adolescent Health. Individual and family factors predicted both outcome measures. Neighborhood set predicted cumulative sexual risk index only, and peer factors predicted the number of nonromantic sexual partners only. School set did not predict either outcome. There were significant associations among risky sexual behavior, drug use, and delinquent behaviors. The results highlight the need for multifaceted prevention programs that address relevant factors related to family, peer and neighborhood influence as well as individual factors among sexually active adolescents. Copyright © 2010 Wiley Periodicals, Inc.

Evaluation of Raising Adolescent Families Together Program: A Medical Home for Adolescent Mothers and Their Children

PubMed Central

Buman, Matthew P.; Woods, Elizabeth R.; Famakinwa, Olatokunbo; Harris, Sion Kim

2012-01-01

Objectives. This study described a medical home model for adolescent mothers and their children, and their 1- and 2-year preventive care, repeat pregnancy, and psychosocial outcomes. Methods. In this prospective, single cohort demonstration project, adolescent mothers (14–18 years old) and their children received care in a medical home. Demographic, medical and social processes, and outcomes data were collected at enrollment through 24 months. Change over time and predictors of repeat pregnancy were analyzed. Results. A total of 181 adolescents enrolled, with 79.6% participating for 2 years. At 2 years, 90.2% of children were completely immunized. Children and adolescent mothers met standards for health care visits, and adolescent condom use improved. Rates of cumulative repeat pregnancy were 14.7% and 24.6%, school attendance 77.6% and 68.7%, and employment 21.2% and 32.3% at 1 and 2 years, respectively. Conclusions. A medical home model with comprehensive and integrated medical care and social services can effectively address the complex needs of adolescent parents and their children. PMID:22897537

Coping and parenting: Mediators of 12-month outcomes of a family group cognitive-behavioral preventive intervention with families of depressed parents.

PubMed

Compas, Bruce E; Champion, Jennifer E; Forehand, Rex; Cole, David A; Reeslund, Kristen L; Fear, Jessica; Hardcastle, Emily J; Keller, Gary; Rakow, Aaron; Garai, Emily; Merchant, Mary Jane; Roberts, Lorinda

2010-10-01

In a randomized clinical trial with 111 families of parents with a history of major depressive disorder (86% mothers, 14% fathers; 86% Caucasian, 5% African-American, 3% Hispanic, 1% American Indian or Alaska Native, 4% mixed ethnicity), changes in adolescents' (mean age = 11 years; 42% female, 58% male) coping and parents' parenting skills were examined as mediators of the effects of a family group cognitive-behavioral preventive intervention on adolescents' internalizing and externalizing symptoms. Changes in hypothesized mediators were assessed at 6 months, and changes in adolescents' symptoms were measured at a 12-month follow-up. Significant differences favoring the family intervention compared with a written information comparison condition were found for changes in composite measures of parent-adolescent reports of adolescents' use of secondary control coping skills and direct observations of parents' positive parenting skills. Changes in adolescents' secondary control coping and positive parenting mediated the effects of the intervention on depressive, internalizing, and externalizing symptoms, accounting for approximately half of the effect of the intervention on the outcomes. Further, reciprocal relations between children's internalizing symptoms and parenting were found from baseline to 6-month follow-up. The present study provides the first evidence for specific mediators of a family group cognitive-behavioral preventive intervention for families of parents with a history of major depressive disorder. The identification of both coping and parenting as mediators of children's mental health outcomes suggests that these variables are important active ingredients in the prevention of mental health problems in children of depressed parents. Copyright 2010 APA, all rights reserved.

Evaluation of Outcomes in Adolescent Inflammatory Bowel Disease Patients Following Transfer From Pediatric to Adult Health Care Services: Case for Transition.

PubMed

Cole, Rebecca; Ashok, Dhandapani; Razack, Abdul; Azaz, Amer; Sebastian, Shaji

2015-08-01

We aimed to evaluate the impact of a transition service on clinical and developmental outcomes in adolescent Inflammatory Bowel Disease (IBD) patients on transfer to adult health care services. We reviewed the records of IBD patients diagnosed in pediatric care following their transfer/attendance to the adult IBD service. The data on patients who attended the transition service were compared with those who did not pass through the transition service. Seventy-two patients were included in the study 41M and 31F. Forty-four patients went through the transition system (Group A), and 28 had no formalized transition arrangement before transfer (Group B). A significantly higher number of Group B patients needed surgery within 2 years of transfer when compared with patients in Group A (46% vs. 25%, p = .01). Sixty-one percent of patients in Group B needed at least one admission within 2 years of transfer when compared with 29% of Group A patients (p = .002). Nonattendance at clinics was higher in Group B patients with 78% having at least one nonattendance, whereas 29% of Group A failed to attend at least one appointment (p = .001). In addition, drug compliance rates were higher in the transition group when compared with Group B (89% and 46%, respectively; p = .002). A higher proportion of transitioned patients achieved their estimated maximum growth potential when completing adolescence. There was a trend toward higher dependence on opiates and smoking in Group B patients. In adolescent IBD patients, transition care is associated with better disease specific and developmental outcomes. Prospective studies of different models of transition care in IBD are needed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Healthy Sex and Sexual Health: New Directions for Studying Outcomes of Sexual Health

ERIC Educational Resources Information Center

Lefkowitz, Eva S.; Vasilenko, Sara A.

2014-01-01

Sexual behavior is an important aspect of adolescent development with implications for well-being. These chapters highlight important perspectives on studying sexual health from a normative, developmental perspective, such as viewing a range of sexual behaviors as life events; considering potentially positive physical health, mental health, social…

Educating health care trainees and professionals about suicide prevention in depressed adolescents.

PubMed

Rice, Timothy R; Sher, Leo

2013-01-01

Adolescent depression is a highly prevalent disorder with significant morbidity and suicide mortality. It is simultaneously highly responsive to treatment. Adolescents wish to discuss depression with their providers, and providers routinely receive opportunities to do so. These characteristics of prevalence, morbidity, mortality, responsiveness, and accessibility make adolescent depression an excellent target of care. However, most health care trainees and professionals report low confidence in caring for adolescent depression. As a caregiver community, we fare poorly in routine matters of assessment and management of adolescent depression. All health care professionals are trained within a medical model. In this light, the conceptualization of adolescent depression and suicidality within the medical model may increase provider confidence and performance. Epidemiology and neurobiology are presented with emphasis in this review. Legal concerns also affect health care professionals. For example, providers may deviate from evidence-based medicine owing to anxieties that the identification and treatment of depression may induce suicide and consequent legal culpability. A review of the historical context and relevant outcome trials concerning the increased risk of suicidality in depressed adolescents treated with selective-serotonin reuptake inhibitors may increase provider comfort. Furthermore, increased didactic and experiential training improve provider performance. In this work, proven models were discussed, and the testable hypothesis that education incorporating the views of this article can produce the best care for depressed adolescents.

The Association Between Sexual Health and Physical, Mental, and Social Health in Adolescent Women.

PubMed

Hensel, Devon J; Nance, Jennifer; Fortenberry, J Dennis

2016-10-01

Developmental models link sexual well-being to physical, mental/emotional, and social well-being, yet little empirical literature evaluates these relationships in adolescents. Better understanding of how and when sexuality complements other aspects of health may yield important points to enhance existing health education and prevention efforts. Data were drawn from a 10-year longitudinal cohort study of sexual relationships and sexual behavior among adolescent women (N = 387; 14-17 years at enrollment). Sexual health data were drawn from quarterly partner-specific interviews and were linked to physical, mental/emotional, and social health information in annual questionnaires. Random intercept, mixed effects linear, ordinal logistic, or binary logistic regression were used to estimate the influence of sexual health on health and well-being outcomes (Stata, v.23, StataCorp, College Station, TX). All models controlled for participant age and race/ethnicity. Higher sexual health was significantly associated with less frequent nicotine and substance use, lower self-reported depression, lower thrill seeking, higher self-esteem, having fewer friends who use substances, higher religiosity, better social integration, lower frequency of delinquent behavior and crime, and more frequent community group membership. Sexual health was not associated with the number of friends who used cigarettes. Positive sexually related experiences in romantic relationships during adolescence may complement physical, mental/emotional, and social health. Addressing specific aspects of healthy sexual development during clinical encounters could dually help primary prevention and health education address other common adolescent health issues. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Do savings mediate changes in adolescents’ future orientation and health-related outcomes? Findings from randomized experiment in Uganda

PubMed Central

Karimli, Leyla; Ssewamala, Fred M.

2015-01-01

Purpose This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset-accumulation (in this case, by increasing family savings). Methods Using longitudinal data from the cluster-randomized experiment we ran generalized estimating equation (GEE) models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents’ future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping—to address the assumption of normal distribution. Results Results indicate that participation in a matched Child Savings Account program improved adolescents’ future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents’ confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched Child Savings Account program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings. Conclusions Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched Child Savings Accounts, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how? PMID:26271162

Health Outcomes of Information System Use Lifestyles among Adolescents: Videogame Addiction, Sleep Curtailment and Cardio-Metabolic Deficiencies

PubMed Central

2016-01-01

Background and Objective Obesity is a rising problem among adolescents in modern societies; it results in long-term cardio-metabolic problems. Possible overlooked drivers of obesity and its consequent cardio-metabolic deficits include videogame addiction and the resulting curtailed sleep; both are growing problems among adolescents. The objective of this study is to examine possible associations among these concepts in adolescents, as a means to point to plausible interventions. Methods Data were collected from 94 adolescents who play videogames and are enrolled in outpatient clinics, using surveys, wearable sleep monitors (FitBit), physical exams, and blood tests at three points in time. These data were subjected to structural equation modeling (SEM) analyses and bootstrapping-based mediation testing procedures. Results Videogame addiction among adolescents was negatively associated with sleep duration (β = -0.24). Sleep duration was negatively associated with obesity (β = -0.30), which in turn was associated with elevated blood pressure (β = 0.26), low high-density lipoprotein cholesterol (β = -0.18), high triglycerides (β = 0.61), and high insulin resistance (β = 0.39). The model explained 36.2% of the variation in sleep duration, 32.7% of the variation in obesity, and between 12.8% and 28.1% of the variation in cardio-metabolic indicators. Post-hoc analyses indicated that curtailed sleep is a possible full mediator of the association between videogame addiction, abdominal obesity and the associated cardio-metabolic deficits. Conclusion The findings point to possible information systems use lifestyle-health links, which behooves researchers and practitioners to pay closer attention to possible adverse health outcomes of technology-related addictions. Interventions that target problematic video-gaming and sleep should be devised as a possible means for improving adolescents’ long-term cardio-metabolic health. PMID:27149512

Early life programming as a target for prevention of child and adolescent mental disorders

PubMed Central

2014-01-01

This paper concerns future policy development and programs of research for the prevention of mental disorders based on research emerging from fetal and early life programming. The current review offers an overview of findings on pregnancy exposures such as maternal mental health, lifestyle factors, and potential teratogenic and neurotoxic exposures on child outcomes. Outcomes of interest are common child and adolescent mental disorders including hyperactive, behavioral and emotional disorders. This literature suggests that the preconception and perinatal periods offer important opportunities for the prevention of deleterious fetal exposures. As such, the perinatal period is a critical period where future mental health prevention efforts should be focused and prevention models developed. Interventions grounded in evidence-based recommendations for the perinatal period could take the form of public health, universal and more targeted interventions. If successful, such interventions are likely to have lifelong effects on (mental) health. PMID:24559477

[Assess spirituality with adolescent outpatients: taboo or necessity?].

PubMed

De Germond-Burquier, Véronique; Narring, Françoise; Entremont, Cécile; Basset, Lytta

2016-06-08

Spirituality affects adolescents' as well as adults' daily life. It is usually considered to be a protective factor in physical and psychological health outcomes, but might also be a cause of suffering. In the perspective of an holistic approach, health professional should assess this subject with tact and sensitivity. Until there is a suitable instrument adapted to this age group and European culture, the exploration of spirituality and religious practices can be evaluated while taking the clinical history. Nevertheless, resistance which is common in health professionals, could be overcome by appropriate training.

The health benefits of muscular fitness for children and adolescents: a systematic review and meta-analysis.

PubMed

Smith, Jordan J; Eather, Narelle; Morgan, Philip J; Plotnikoff, Ronald C; Faigenbaum, Avery D; Lubans, David R

2014-09-01

Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status. While research has traditionally focused on the association between cardio-respiratory fitness and health outcomes, the association between muscular fitness (MF) and health status has recently received increased attention. The aim of this systematic review and meta-analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents. A systematic search of six electronic databases (PubMed, SPORTDiscus, Scopus, EMBASE, PsycINFO and OVID MEDLINE) was performed on the 20th May, 2013. Cross-sectional, longitudinal and experimental studies that quantitatively examined the association between MF and potential health benefits among children and adolescents were included. The search yielded 110 eligible studies, encompassing six health outcomes (i.e., adiposity, bone health, cardiovascular disease [CVD] and metabolic risk factors, musculoskeletal pain, psychological health and cognitive ability). The percentage of studies reporting statistically significant associations between MF and the outcome of interest was used to determine the strength of the evidence for an association and additional coding was conducted to account for risk of bias. Meta-analyses were also performed to determine the pooled effect size if there were at least three studies providing standardised coefficients. Strong evidence was found for an inverse association between MF and total and central adiposity, and CVD and metabolic risk factors. The pooled effect size for the relationship between MF and adiposity was r = -0.25 (95% CI -0.41 to -0.08). Strong evidence was also found for a positive association between MF and bone health and self-esteem. The pooled effect size for the relationship between MF and perceived sports competence was r = 0.39 (95% CI 0.34-0.45). The evidence for an association between MF and musculoskeletal pain and cognitive ability was inconsistent/uncertain. Where evidence of an association was found, the associations were generally low to moderate. The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits.

Outdoor Behavioral Healthcare: Definitions, Common Practice, Expected Outcomes, and a Nationwide Survey of Programs. Technical Report.

ERIC Educational Resources Information Center

Russell, Keith C.; Hendee, John C.

Outdoor behavioral healthcare (OBH) is an emerging mental health intervention/treatment to help adolescents overcome emotional, psychological, and addiction problems. Currently, over 100 OBH programs in the United States use elements of wilderness therapy to address adolescents' problem behaviors and foster responsibility and personal growth.…

Project Target: Criterion-Referenced Physical Fitness Standards for Adolescents with Disabilities. Final Report.

ERIC Educational Resources Information Center

Winnick, Joseph P.; Short, Francis X.

This final report discusses the outcomes of a project designed to extend the nation's current emphasis on health-related, criterion-referenced fitness testing and programming to children and adolescents with disabilities. It summarizes project activities leading up to the Brockport Physical Fitness Test and related measures. Activities included:…

Evidence of Parallel Pathways: Gender Similarity in the Impact of Social Support on Adolescent Depression and Delinquency

ERIC Educational Resources Information Center

Meadows, Sarah O.

2007-01-01

Despite an apparent connection, depression and delinquency have rarely been examined simultaneously. Instead, research has examined each topic separately and emphasized gender differences--rather than similarities--in outcomes. Using the National Longitudinal Study of Adolescent Health, this paper examines possible parallel pathways between social…

Structured Extracurricular Activities among Adolescents: Findings and Implications for School Psychologists

ERIC Educational Resources Information Center

Gilman, Rich; Meyers, Joel; Perez, Laura

2004-01-01

One factor that contributes to adolescent positive mental health is active engagement. Engagement is defined as any activity that is initiated to attain an outcome. In general, two forms of activities exist that correspond with engagement: solitary, non-structured, and non-cooperative pursuits, often without adult supervision (e.g., playing video…

The Third Rail of Family Systems: Sibling Relationships, Mental and Behavioral Health, and Preventive Intervention in Childhood and Adolescence

ERIC Educational Resources Information Center

Feinberg, Mark E.; Solmeyer, Anna R.; McHale, Susan M.

2012-01-01

Sibling relationships are an important context for development, but are often ignored in research and preventive interventions with youth and families. In childhood and adolescence, siblings spend considerable time together, and siblings' characteristics and sibling dynamics substantially influence developmental trajectories and outcomes. This…

Emergency Presentations to an Inner-City Psychiatric Service for Children and Adolescents

ERIC Educational Resources Information Center

Dil, L. M.; Vuijk, P. J.

2012-01-01

Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the…

The Roles of Perceived Neighborhood Disorganization, Social Cohesion, and Social Control in Urban Thai Adolescents' Substance Use and Delinquency

ERIC Educational Resources Information Center

Byrnes, Hilary F.; Miller, Brenda A.; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Cupp, Pamela K.; Atwood, Katharine A.; Fongkaew, Warunee; Rosati, Michael J.; Chookhare, Warunee

2013-01-01

Substance use and delinquency in Thai adolescents are growing public health concerns. Research has linked neighborhood characteristics to these outcomes, with explanations focused on neighborhood disorganization, social cohesion, and social control. This study examines the independent associations of these neighborhood constructs with Thai…

Acculturation-Related Stress and Mental Health Outcomes among Three Generations of Hispanic Adolescents

ERIC Educational Resources Information Center

Cervantes, Richard C.; Padilla, Amado M.; Napper, Lucy E.; Goldbach, Jeremy T.

2013-01-01

Stress associated with acculturation and minority status among Hispanic youth is understudied. Using survey data from the Hispanic Stress Inventory-Adolescent Version (HSI-A), we examined psychosocial stress across eight domains including family economic stress and acculturation-gap stress in a national sample of three generations (first, second,…

NEET adolescents grown up: eight-year longitudinal follow-up of education, employment and mental health from adolescence to early adulthood in Mexico City.

PubMed

Gutiérrez-García, Raúl A; Benjet, Corina; Borges, Guilherme; Méndez Ríos, Enrique; Medina-Mora, María Elena

2017-12-01

The purpose is to examine the socio-demographic and mental health outcomes in early adulthood of those who as adolescents were not in education, employment or training, termed NEET, compared to their counterparts who studied, worked, or both. One thousand and seventy-one youth residing in Mexico City participated in a representative, prospective, longitudinal 8-year two-Wave cohort study. At Wave I the participants were aged 12-17 and at Wave II aged 19 and 26. The Composite International Diagnostic Interview assessed psychiatric disorders, substance use and abuse, suicidal behavior, interpersonal relationships, employment and education. The main finding of this study is that being NEET in adolescence was associated with several socio-demographic and mental health outcomes in early adulthood, above and beyond baseline socioeconomic disadvantage and mental health compared to their peers, particularly their peers who studied only or studied and worked. NEET youth were not that different from their peers who worked exclusively highlighting the protective value of keeping youth in school. The strongest differences between NEET youth and all their peer groups were their increased risks of incident suicidal behaviors. Social policies are needed for creating more educational opportunities, greater support for retention of students, and programs to facilitate the transition from school to the labor market considering cultural attitudes towards life trajectory expectations.

Weight- and race-based bullying: health associations among urban adolescents.

PubMed

Rosenthal, Lisa; Earnshaw, Valerie A; Carroll-Scott, Amy; Henderson, Kathryn E; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R

2015-04-01

Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 years, through the mechanism of more negative emotional symptoms. Results support important avenues for future research on mechanisms and longitudinal associations of stigma-based bullying with health. Interventions are needed to reduce stigma-based bullying and buffer adolescents from adverse health effects. © The Author(s) 2013.

Weight- and race-based bullying: Health associations among urban adolescents

PubMed Central

Rosenthal, Lisa; Earnshaw, Valerie A; Carroll-Scott, Amy; Henderson, Kathryn E; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R

2014-01-01

Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 years, through the mechanism of more negative emotional symptoms. Results support important avenues for future research on mechanisms and longitudinal associations of stigma-based bullying with health. Interventions are needed to reduce stigma-based bullying and buffer adolescents from adverse health effects. PMID:24155192

Validation of a Health Literacy Measure for Adolescents and Young Adults Diagnosed with Cancer.

PubMed

McDonald, Fiona E J; Patterson, Pandora; Costa, Daniel S J; Shepherd, Heather L

2016-03-01

Health literacy can influence long-term health outcomes. This study aimed to validate an adapted version of the Functional, Communicative and Critical Health Literacy measure for adolescent and young adult (AYA) cancer patients and survivors (N = 105; age 12-24 years). Exploratory factor analysis was used to validate the measure, and indicated that a slightly modified item structure better fit the results. Furthermore, item response theory analysis highlighted location and discrimination parameter differences among items. Acceptability of the measure was high. This is the first validation of a health literacy measure among AYAs with an illness such as cancer.

Mental health among adolescents living with HIV in Namibia: the role of poverty, orphanhood and social support.

PubMed

Gentz, Shelene G; Calonge-Romano, Isabel; Martínez-Arias, Rosario; Zeng, Chengbo; Ruiz-Casares, Mónica

2018-05-30

The mental health needs of children and adolescents living with HIV (ALHIV) in Namibia are poorly understood, despite the dramatic improvement in their survival. ALHIV in resource poor contexts face particular risk factors, such as poverty, orphanhood, and poor social support. This study examines the mental health of ALHIV in Namibia, and the factors that contribute to mental health problems. A case-control design assessed emotional and behavioural symptoms of distress, risk and protective factors among adolescents aged 12-18 years. Case participants were 99 HIV-positive adolescents. Case controls were 159 adolescents from the same community who were not known to be HIV seropositive at the time of the study. Control group participants were selected from schools using a stratified random sampling. A larger proportion of HIV-positive adolescents were orphaned (62.6% vs. 20.8%, p < .001); the groups showed no differences in poverty factors. HIV-positive adolescents scored lower than the control group on total perceived social support (p < .05) and caregiver support (p < .05), but no differences in perceived friend support and support from a self-selected person were present. HIV-positive adolescents reported significantly more total emotional and behavioural difficulties (p = .027) and conduct problems (p = .025), even after controlling for socio-demographic factors. However, after controlling for the effects of orphanhood, group differences in mental health outcomes were no longer significant. Furthermore, mediation analysis suggested that social support completely mediated the relationship between HIV status and mental health (standardised pathway coefficients = .05, p = .021). Policies and programmes that aim to strengthen social support and take orphanhood status into consideration may improve the mental health of adolescents living with HIV.

Unmet Support Service Needs and Health-Related Quality of Life among Adolescents and Young Adults with Cancer: The AYA HOPE Study.

PubMed

Smith, Ashley Wilder; Parsons, Helen M; Kent, Erin E; Bellizzi, Keith; Zebrack, Brad J; Keel, Gretchen; Lynch, Charles F; Rubenstein, Mara B; Keegan, Theresa H M

2013-01-01

Cancer for adolescents and young adults (AYA) differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under or inadequately served by current support services, which may affect health-related quality of life (HRQOL). We examined unmet service needs and HRQOL in the National Cancer Institute's Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study, a population-based cohort (n = 484), age 15-39, diagnosed with cancer 6-14 months prior, in 2007-2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical, and health insurance variables. Over one-third of respondents reported at least one unmet service need. The most common were financial (16%), mental health (15%), and support group (14%) services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p's < 0.0001). Specific unmet services were related to particular outcomes [e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p's < 0.001)]. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains. Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical therapy and mental health services.

Optimistic Bias, Risk Factors, and Development of High Blood Pressure and Obesity among African American Adolescents in Mississippi (USA)

PubMed Central

White, Monique S.; Addison, Clifton C.; Campbell Jenkins, Brenda W.; Bland, Vanessa; Clark, Adrianne; Antoine LaVigne, Donna

2017-01-01

Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and obesity in a school district. We examined the relationship between individual health risk practices and optimistic bias on health outcomes; 433 African American high school students were administered a survey and had their obesity and blood pressure measured by the school nurse. Canonical correlational analyses were used to examine relationships between health risk practices and descriptive statistics for optimistic bias and health outcomes. Engaging in moderate exercise for at least 30 min in the last 7 days and lower blood pressure was the only statistically significant relationship. Two-thirds of the students did not perceive themselves to be at risk of developing cardiovascular disease with males at greater risk than females, despite the presence of clinical risk factors for hypertension and obesity. Reducing health optimistic bias is an effective way of motivating young people to adopt more positive behaviors using educational institutions to implement intervention programs that promote positive health behavior as a way to reduce health disparities. PMID:28230728

Optimistic Bias, Risk Factors, and Development of High Blood Pressure and Obesity among African American Adolescents in Mississippi (USA).

PubMed

White, Monique S; Addison, Clifton C; Jenkins, Brenda W Campbell; Bland, Vanessa; Clark, Adrianne; LaVigne, Donna Antoine

2017-02-20

Childhood obesity has reached epidemic proportions and is linked to hypertension among African American youth. Optimistic bias influences behavior of youth causing them to underestimate their susceptibility to negative health outcomes. This study explored adolescent behaviors and prevalence of high blood pressure and obesity in a school district. We examined the relationship between individual health risk practices and optimistic bias on health outcomes; 433 African American high school students were administered a survey and had their obesity and blood pressure measured by the school nurse. Canonical correlational analyses were used to examine relationships between health risk practices and descriptive statistics for optimistic bias and health outcomes. Engaging in moderate exercise for at least 30 min in the last 7 days and lower blood pressure was the only statistically significant relationship. Two-thirds of the students did not perceive themselves to be at risk of developing cardiovascular disease with males at greater risk than females, despite the presence of clinical risk factors for hypertension and obesity. Reducing health optimistic bias is an effective way of motivating young people to adopt more positive behaviors using educational institutions to implement intervention programs that promote positive health behavior as a way to reduce health disparities.

Marriage and Health in the Transition to Adulthood: Evidence for African Americans in the Add Health Study

ERIC Educational Resources Information Center

Harris, Kathleen Mullan; Lee, Hedwig; DeLeone, Felicia Yang

2010-01-01

This article explores the relationships among early marriage (before age 26 years), cohabitation, and health for African Americans and Whites during the transition to adulthood using the National Longitudinal Study of Adolescent Health (Add Health). The study examines three categories of health outcomes relevant to young adulthood: physical…

Cost-effectiveness of dialectical behaviour therapy vs. enhanced usual care in the treatment of adolescents with self-harm.

PubMed

Haga, Egil; Aas, Eline; Grøholt, Berit; Tørmoen, Anita J; Mehlum, Lars

2018-01-01

Studies have shown that dialectical behaviour therapy (DBT) is effective in reducing self-harm in adults and adolescents. To evaluate the cost-effectiveness of DBT for adolescents (DBT-A) compared to enhanced usual care (EUC). In a randomised study, 77 adolescents with repeated self-harm were allocated to 19 weeks of outpatient treatment, either DBT-A ( n  = 39) or EUC ( n  = 38). Cost-effective analyses, including estimation of incremental cost-effectiveness ratios, were conducted with self-harm and global functioning (CGAS) as health outcomes. Using self-harm as effect outcome measure, the probability of DBT being cost-effective compared to EUC increased with increasing willingness to pay up to a ceiling of 99.5% (threshold of € 1400), while with CGAS as effect outcome measure, this ceiling was 94.9% (threshold of € 1600). Given the data, DBT-A had a high probability of being a cost-effective treatment.

Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study

PubMed Central

Reisner, Sari L.; Vetters, Ralph; Leclerc, M; Zaslow, Shayne; Wolfrum, Sarah; Shumer, Daniel; Mimiaga, Matthew J.

2014-01-01

Purpose Transgender youth represent a vulnerable population at risk for negative mental health outcomes including depression, anxiety, self-harm, and suicidality. Limited data exists to compare the mental health of transgender adolescents and emerging adults to cisgender youth accessing community-based clinical services; the current study aimed to fill this gap. Methods A retrospective cohort study of electronic health record (EHR) data from 180 transgender patients age 12–29 years seen between 2002–2011 at a Boston-based community health center was performed. The 106 female-to-male (FTM) and 74 male-to-female (MTF) patients were matched on gender identity, age, visit date, and race/ethnicity to cisgender controls. Mental health outcomes were extracted and analyzed using conditional logistic regression models. Logistic regression models compared FTM to MTF youth on mental health outcomes. Results The sample (n=360) had a mean age of 19.6 (SD=3.0); 43% white, 33% racial/ethnic minority, and 24% race/ethnicity unknown. Compared to cisgender matched controls, transgender youth had a two- to three-fold increased risk of depression, anxiety disorder, suicidal ideation, suicide attempt, self-harm without lethal intent, and both inpatient and outpatient mental health treatment (all p<0.05). No statistically significant differences in mental health outcomes were observed comparing FTM and MTF patients, adjusting for age, race/ethnicity, and hormone use. Conclusions Transgender youth were found to have a disparity in negative mental health outcomes compared to cisgender youth, with equally high burden in FTM and MTF patients. Identifying gender identity differences in clinical settings and providing appropriate services and supports are important steps in addressing this disparity. PMID:25577670

Comparison of telephone with World Wide Web-based responses by parents and teens to a follow-up survey after injury.

PubMed

Rivara, Frederick P; Koepsell, Thomas D; Wang, Jin; Durbin, Dennis; Jaffe, Kenneth M; Vavilala, Monica; Dorsch, Andrea; Roper-Caldbeck, Maria; Houseknecht, Eileen; Temkin, Nancy

2011-06-01

To identify sociodemographic factors associated with completing a follow-up survey about health status on the web versus by telephone, and to examine differences in reported health-related quality of life by method of response. Survey about child health status of 896 parents of children aged 0-17 years treated in a hospital emergency department or admitted for a traumatic brain injury or arm injury, and 227 injured adolescents aged 14-17 years. The main outcomes were characteristics of those who completed a follow-up survey on the web versus by telephone and health-related quality of life by method of response. Email addresses were provided by 76.9 percent of parents and 56.5 percent of adolescents at baseline. The survey was completed on the web by 64.9 percent of parents and 40.2 percent of adolescents through email. Parents with email access who were Blacks, Hispanics, had lower incomes, and those who were not working were less likely to choose the web mode for completing the survey. Unlike adolescents, the amount of time for parents to complete the survey online was significantly shorter than completion by telephone. Differences by survey mode were small but statistically significant in some of the six functional outcome measures examined. Survey mode was associated with several sociodemographic characteristics. Sole use of web surveys could provide biased data. © Health Research and Educational Trust.

Gendered role of appraisals of safety in psychological outcome in relation to trauma.

PubMed

Padmanabhanunni, Anita; Campbell, Jerome; Pretorius, Tyrone B

2017-09-01

This study investigated gender differences in the role of appraisals of safety in the relationship between exposure to violence and trauma-related symptoms among South African adolescents living in low socioeconomic settings. Limited research exists in developing contexts on the role of cognitive appraisals in mitigating outcome following exposure to violence. Given the prevalence of violence in South Africa and the vulnerability of youth, this type of research is valuable in identifying adolescents at risk of negative psychological outcome following exposure, and in informing intervention efforts. Adolescents (N = 498) completed an adapted version of the Harvard Trauma Questionnaire (Mollica et al., 1992) and the Safety Index (Ward, Flisher, Zissis, Muller, & Lombard, 2001). The results indicate a significant positive relationship between all violence subscales and trauma-related symptoms, whereas a significant negative relationship was found between sense of safety and trauma-related symptoms. Important gender differences were identified in the role of appraisals of safety, with more effects noted for women than men. For men, the obtained results only demonstrated a health-sustaining role. For women, the results indicated a health-sustaining role, an indirect effect, and a stress-reducing role. These findings stress the necessity of gender-specific interventions. Assessment of psychological trauma, particularly among female adolescents, needs to include measures of cognitive appraisals related to safety. Therapeutic techniques that may be particularly beneficial to adolescent girls are those focusing on promoting sense of safety and targeting dysfunctional threat appraisals. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Role of Religiousness on Substance-Use Disorder Treatment Outcomes: A Comparison of Black and White Adolescents

PubMed Central

Krentzman, Amy R.; Battle, DuWayne; Pagano, Maria E.; Andrade, Fernando H.; Bradley, Jaclyn C.; Delva, Jorge; Johnson, Shannon M.; Robinson, Elizabeth A. R.

2012-01-01

This study compares 41 Black and 124 White adolescents at intake and discharge from a residential treatment program for substance-use disorders. Study data were obtained as part of a larger study (N = 195) that sought to assess the relationship of helping behavior and addiction recovery. This post-hoc analysis aims to identify cultural strengths that may be associated with recovery from substance-use disorders among Black adolescents. Using regression analyses and controlling for the severity of substance use and background variables that distinguish racial groups, religious practices and behaviors at intake were examined. Specifically, Black youth and White youth were compared on treatment outcomes, including alcohol or drug use during treatment, drug craving, 12-Step work, and 12-Step helping. The burden of health and socioeconomic disparities at intake did not disproportionately disfavor Black adolescents. Outcomes related to 12-Step measures were similar between Black and White youth. White adolescents reported higher craving scores at discharge, and Black adolescents were more likely to use drugs during treatment. High levels of religiousness at treatment intake were linked to greater 12-Step work and greater 12-Step helping at discharge. High levels of religiousness at intake were not related to drug use during treatment or to craving scores at discharge. The relationship between intake levels of religiousness and treatment-related outcomes did not differ by race. PMID:22970338

Exploring socioeconomic disparities in self-reported oral health among adolescents in california.

PubMed

Telford, Claire; Coulter, Ian; Murray, Liam

2011-01-01

Socioeconomic factors are associated with disparities in oral health among adolescents; however, the underlying reasons are not clear. The authors conducted a study to determine if known indicators of oral health can explain such disparities. The authors examined data from a 2007 California Health Interview Survey of adolescents. The outcome of interest was self-reported condition of the teeth; covariates were socioeconomic status (SES) (that is, family poverty level and parental education) and a range of other variables representing health-influencing behaviors, dental care and other social factors. The authors conducted analyses by using logistic regression to explain disparities in self-reported condition of the teeth associated with SES. The authors found that socioeconomic disparities decreased substantially after they added all potential explanatory variables to the model, leaving poverty level as the only variable associated with differences in the self-reported condition of the teeth. Adolescents living below the federal poverty guidelines were more likely to report that the condition of their teeth was fair or poor than were adolescents who were least poor (odds ratio = 1.58; 95 percent confidence interval, 1.04-2.41). In multivariate analyses, further oral health disparities existed in relation to behaviors that influence health, social environment and dental care. The results of this study showed that a number of factors decreased, but did not eliminate, the observed relationship between SES and oral health in Californian adolescents. Most of these explanatory factors are modifiable, indicating that socioeconomic differences associated with oral health among adolescents may be amenable to change. Practice Implications. By promoting a healthy lifestyle (including healthy diet, exercise and regular dental attendance) and conveying to patients in languages other than English how to maintain oral health, dentists may be able to ameliorate the effects of socioeconomic disparities in oral health.

High school drug use predicts job-related outcomes at age 29.

PubMed

Ringel, Jeanne S; Ellickson, Phyllis L; Collins, Rebecca L

2007-03-01

The present study examines the relationship between hard drug use in high school and occupational and job quality outcomes measured at approximately age 29. We use two different methods aimed at ruling out the possibility of spurious correlations between high school drug use and occupational outcomes: (1) directly controlling for pre-high school characteristics that may affect both high school drug use and later occupational characteristics (e.g., educational orientation, early drug use and deviant behavior); and (2) matching high school users with a subset of nonusers that have very similar characteristics and then estimating the difference in labor market outcomes for these two groups (i.e., propensity score matching). Overall, the results suggest that adolescent drug use is linked with poorer occupational and job quality outcomes as much as 10 years after high school. Interestingly, which job-related outcomes are affected by early hard drug use varies by gender. Females who use hard drugs as adolescents end up in lower skill, lower status jobs while males who use hard drugs as adolescents are more likely to end up in jobs with fewer benefits (e.g., health, retirement).

Exploring Psychosocial Mechanisms and Interactions: Links Between Adolescent Emotional Distress, School Connectedness, and Educational Achievement

PubMed Central

Pate, Christina M.; Maras, Melissa A.; Whitney, Stephen D.; Bradshaw, Catherine P.

2017-01-01

Internalizing mental health issues are a significant developmental and clinical concern during adolescence, but rarely identified as a problem among school staff. Using data from the National Longitudinal Study of Adolescent Health, this study examined the associations between adolescent emotional distress, school connectedness, and educational achievement by exploring potential mechanistic and interactive roles of perceived school connectedness on the emotion–education association. Emotional distress was negatively associated with adolescents’ perceptions of belonging to school, which, in turn, may negatively influence educational achievement. School connectedness also had both additive and multiplicative interaction effects on the emotion–education relationship. Results support previous evidence of school connectedness as a protective factor for adolescents with internalizing mental health concerns, although much of the work to date has focused on externalizing problems. This study informs our understanding of how, why, and for whom emotional problems influence educational outcomes in light of social support in the school context. PMID:28947921

Longitudinal influences of friends and parents upon unprotected vaginal intercourse in adolescents.

PubMed

Kim, Catherine; Gebremariam, Acham; Iwashyna, Theodore J; Dalton, Vanessa K; Lee, Joyce M

2011-02-01

Both friends and parents may influence occurrence of adolescent sexual intercourse, but these influences have not been studied together and prospectively. We conducted a longitudinal analysis of a nationally representative sample of adolescents aged 15-18 years (n=6649), the National Longitudinal Study of Adolescent Health (Add Health). Baseline in-home and school interviews were conducted during 1995 and follow-up interviews in 1996. The main outcome measure was self-reported unprotected vaginal intercourse. In models which adjusted for age, race, parental attitudes towards contraception and pregnancy, and adolescent sexual intercourse practices at baseline, having a friend who engaged in sexual intercourse at baseline, either unprotected (OR 2.2, 95% CI 1.6-3.2) or protected (OR 1.8, 95% CI 1.4-2.4), increased the odds of unprotected intercourse vs. never intercourse in the adolescent at follow-up (p<.001). A distant relationship with the father (OR 2.4, 95% CI 1.3-4.3) vs. a close relationship at baseline also increased the odds of unprotected intercourse at follow-up compared to never intercourse (p=.028). Parental attitudes were not associated with the outcome after consideration of the adolescent's attitudes and baseline sexual practices. Having a friend who engages in sexual intercourse, unprotected or protected, increases the risk of unprotected intercourse. Parental attitudes are less influential after consideration of adolescent baseline attitudes and sexual practices, suggesting that parental influences are strongest before 15 years of age. Our results suggest that early intervention among both parents and adolescents may decrease the risk of unprotected intercourse. Copyright © 2011 Elsevier Inc. All rights reserved.

An emerging adolescent health risk: caffeinated energy drink consumption patterns among high school students.

PubMed

Azagba, Sunday; Langille, Donald; Asbridge, Mark

2014-05-01

To examine the prevalence, patterns, and correlates of energy drink use among adolescents, and determine whether more frequent use of energy drinks is associated with poorer health and behavioral outcomes. Data were from a 2012 cross-sectional survey of 8210 students in grades 7, 9, 10 and 12 attending public schools in Atlantic Canada. Multinomial logistic regression analysis was used to examine correlates of energy drink use patterns, including substance use, sensation seeking, risk of depression, and socioeconomic status. Nearly two-thirds of survey respondents (62%) reported consuming energy drinks at least once in the previous year, with about 20% reporting use once or more per month. Sensation seeking, depression, and substance use were all higher among energy drink users relative to non-users, and in higher frequency users relative to lower frequency users. The prevalence of energy drink consumption among high school students was high. The association of energy drinks with other potential negative health and behavioral outcomes suggests that use of these products may represent a marker for other activities that may negatively affect adolescent development, health and well-being. Copyright © 2014 Elsevier Inc. All rights reserved.

Benchmarking the cost efficiency of community care in Australian child and adolescent mental health services: implications for future benchmarking.

PubMed

Furber, Gareth; Brann, Peter; Skene, Clive; Allison, Stephen

2011-06-01

The purpose of this study was to benchmark the cost efficiency of community care across six child and adolescent mental health services (CAMHS) drawn from different Australian states. Organizational, contact and outcome data from the National Mental Health Benchmarking Project (NMHBP) data-sets were used to calculate cost per "treatment hour" and cost per episode for the six participating organizations. We also explored the relationship between intake severity as measured by the Health of the Nations Outcome Scales for Children and Adolescents (HoNOSCA) and cost per episode. The average cost per treatment hour was $223, with cost differences across the six services ranging from a mean of $156 to $273 per treatment hour. The average cost per episode was $3349 (median $1577) and there were significant differences in the CAMHS organizational medians ranging from $388 to $7076 per episode. HoNOSCA scores explained at best 6% of the cost variance per episode. These large cost differences indicate that community CAMHS have the potential to make substantial gains in cost efficiency through collaborative benchmarking. Benchmarking forums need considerable financial and business expertise for detailed comparison of business models for service provision.

Socio-ecological correlates of mental health among ethnic minorities in areas of political conflict: a study of Druze adolescents in Israel.

PubMed

Scrimin, Sara; Moscardino, Ughetta; Natour, Miras

2014-04-01

Children and youths living in areas of political conflict are at increased risk of mental health problems, but little is known about psychosocial adjustment among ethnic minorities living in war-afflicted settings. This cross-sectional study used an ecological approach to investigate the unique contributions of child, family/social, and minority related factors as well as traumatic exposure and perceived discrimination to the mental health of 167 Druze adolescents in Northern Israel. Outcome measures included participants' self-reported posttraumatic stress disorder symptoms, psychological distress, and emotional and behavioral problems. Adolescents reported high indirect exposure, moderate discrimination, strong ethnic identity and high religious involvement. Regression analyses showed that female gender, number of traumatic events, and perceived discrimination were associated with more severe mental health outcomes. In addition, low social support and high religious involvement predicted increased PTSD symptom severity, while stronger ethnic identity was associated with less emotional and behavioral problems. Findings are discussed in terms of the cultural characteristics of the Druze community and highlight the need to consider additional stressors, such as discrimination, when working with ethnic minority youth in conflict zones.

Family income and young adolescents' perceived social position: associations with self-esteem and life satisfaction in the UK Millennium Cohort Study.

PubMed

Bannink, Rienke; Pearce, Anna; Hope, Steven

2016-10-01

Self-esteem and life satisfaction are important aspects of positive mental health in young people, and both are socially distributed. However, the majority of evidence is based on socioeconomic characteristics of the family. As children enter adolescence and gain independence, perceptions of their own social position are likely to influence mental health. Using data on 11-year-olds from the UK Millennium Cohort Study, we investigated associations of both family income and young adolescents' perception of their social position with self-esteem and life satisfaction. We hypothesised that there would be differences in the impact of perceived social position on positive mental health when investigating the full scale scoring distribution or the bottom of the distribution. Therefore, we estimated proportional odds for having greater positive mental health (across the distribution of scores) and ORs for poor outcomes (lowest 10% scores). The likelihood of greater self-esteem and life satisfaction increased with income; similarly, the risk of having poor self-esteem and life satisfaction increased as income decreased. Young adolescents who perceived their family as poorer than their friends (instead of about the same) were less likely to have greater self-esteem and life satisfaction and were more likely to have poor outcomes. Young adolescents who perceived their family as richer were more likely to have poor self-esteem, but were not less likely to have greater self-esteem. For life satisfaction, young adolescents who perceived their families as richer were less likely to have greater and more likely to have poor life satisfaction. Policies to redistribute income in families with children are likely to benefit the mental health of young people. However, it is also important to consider the impact of social comparison on young people's mental health as they enter adolescence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/