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The role of Connectivity in Protecting Adolescent Health: Implications for Measurement

The role of Connectivity in Protecting Adolescent Health: Implications for Measurement. Claire Brindis, Dr.P.H. Professor of Pediatrics Associate Director, National Adolescent Health Information Center December 6, 2006 Atlanta, Georgia.

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The role of Connectivity in Protecting Adolescent Health: Implications for Measurement

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  1. The role of Connectivity in Protecting Adolescent Health: Implications for Measurement Claire Brindis, Dr.P.H. Professor of Pediatrics Associate Director, National Adolescent Health Information Center December 6, 2006 Atlanta, Georgia

  2. Weaving A Fabric Of Resilience For All Of Our Children And Youth School CaringRelationships RESILENTYouth Home HighExpectations Community MeaningfulParticipation Peers

  3. External Assets InternalAssets Youth Needs R E S I L I E N C E Supports & Opportunities Positive Developmental Outcomes Improved Health, Social & Academic Outcomes A D U L T • Love • Belonging • Respect • Mastery • Safety • Challenge • Power • Meaning Protective Factors • Resilience Traits • Social competence • Problem Solving • Autonomy and sense of self • Sense of purpose and future • Caring Relationships • High Expectations • Opportunities to participate and contribute Youth Development Process: Resiliency in Action

  4. PARENTAL CONNECTEDNESS The feeling of being loved, accepted, cared about by a parent.

  5. PARENTAL CONNECTEDNESS • Youth who do not experience PARENTAL LOVE • Increased hostility and aggression; • Increased dependency; • Decreased self-esteem and self-adequacy; • Increased emotional instability.

  6. THE ABCs OF PARENTING A: Advocating B: Behavioral Control C: Connectedness

  7. PARENTAL ADVOCACY • Monitoring and mentoring with schoolwork; • Participating in school meetings/activities; • Seeking out needed resources for a child; • Supporting a child in the face of another parent’s opposition; • Creating an environment of civic engagement.

  8. BEHAVIORALCONTROL • Monitoring behavior; • Establishing behavioral rules and consequences for infractions; • Knowing child’s friends and friends’ parent; • Conveying clear expectations.

  9. PARENTAL MONITORING …attending to and tracking a child’s whereabouts, activities and adaptations Dishion and McMahon, 1998

  10. PARENTAL MONITORING • Decreased risk of drug/alcohol use; • Decreased sexual activity; • Later age of pregnancy; • Decreased depression; • Decreased school problems; • Decreased victimization and delinquency; • Decreased negative peer influences.

  11. CONCEPTUAL MODEL (Blum, 2006) Wave 2 Early to Middle Adolescence: Ages 13-17 Wave 1 Early Adolescence:Ages 12-14 Wave 3 Emerging Adulthood: Ages 18-21 Initiation of Health-Compromising Behaviors Poor Health and Health-Related Outcome FamilyCloseness Parental Behavioral Control

  12. HOW WERE FAMILY CLOSENESS AND PARENTAL BEHAVIORAL CONTROL OPERATIONALIZED (Blum, 2006) .42*** My Family Cares for Me FamilyCloseness .72*** My FamilyUnderstandsMe .72*** I Have Fun with My Family .78*** My Family Pays Attention toMe .11** Parent decides amount of TV child watches and what time child comes home onweekend .57*** Parental Behavioral Control .46*** Parent decides what TV programs child watches and time child goes to bed on week- night .43*** Parent decides what child eats, who child hangs with and what child wears

  13. SCHOOL DROPOUT: MALE (Blum, 2006) Family Closeness Ages 12-14 -.01 (.05) -.10* School Dropout Ages 18-21 Skipped School in the Past Year Ages 13-17 .16*** .06 Parental Behavioral Control Ages 12-14 .01 (.003)

  14. SCHOOL DROPOUT: FEMALE (Blum,2006) Family Closeness Ages 12-14 -.08 (-.12**) -.19*** School Dropout Ages 18-21 Skipped School in the Past Year Ages 13-17 .21*** .004 Parental Behavioral Control Ages 12-14 .10 (.01)

  15. Adolescents’ Reporting of Adult Monitoring • Adult supervision – after school, evenings • 81% report having an adult present in the after-school hours; 80% report that parents know their whereabouts in the afternoon and at night. • Adolescents who report less adult presence are more likely to engage in risky behaviors, including sexual activity (27% vs.18%), recent alcohol (27% vs. 16%) and marijuana use (10% vs. 5%) (California Health Interview Survey, 2004).

  16. Prior research has shown a strong association between adolescent connections to meaningful adults and schools and the prevention of every riskbehaviorstudied as part of the National Longitudinal Study on Adolescent Health (Add Health). • Resnick, M.D., Bearman, P.S., Blum, R.W., Bauman, K.E., Harris, K.M., Jones, J., et al. (1997). Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278(10), 823-832.

  17. Students who Feel Connected to School are Less Likely to Use Substances Frequency of Use: Level of Substance Use (SD Units) Levels of Connectedness

  18. Students who Feel Connected to School Experience Less Emotional Distress Level of Emotional Distress (SD Units) Levels of Connectedness

  19. Students who Feel Connected to School Engage In Less Violent or Deviant Behavior Level of Violence or Deviant Behavior (SD Units) Levels of Connectedness

  20. Students who Feel Connected to School are Less Likely to Become Pregnant Percent ever Pregnant Levels of Connectedness

  21. California School Data% of Students Scoring High in Each External Asset

  22. Home % of Students Scoring High in Each External Asset

  23. Community% of Students Scoring High in Each External Asset

  24. Adolescents’ Perceptions of Parental Monitoring • Adolescents’ perceptions of adult awareness has consequences; adolescents who engage in risky behaviors felt that their parents were less aware of their alcohol and sexual activity than teens who did not engage in those behaviors. • Perceptions varied by gender; • Males felt that parents were more likely to know about alcohol (35%) or smoking (59%); parents were perceived to know less about sexual behavior (19%). • Females reported that parents were equally likely to know about sexual experience (37%) or alcohol use (38%); most likely to know about tobacco use (51%). • The younger the teen, the more likely to know about alcohol use (51%) a compared to older teens (32%).

  25. Implications for Your Work? • Given the importance of connectivity and relationship to health outcomes, use existing data collection systems to gather data on positive indicators • State Examples: • Vermont – Modification of Youth Risk Behavior Survey (asset-based questions), administrative data, and supplement from Search Institute’s Profile of Student: Attitudes and Behaviors Survey. • Maine – Use 24 positive indicators from multiple data sources, including a unique household youth telephone survey. • California – California Household Interview Survey (CHIS) – Adolescent Module with positive indicators, including perceived level of parental monitoring • New York – Youth Development Indicators • Iowa – Youth Development Results Framework, extends early childhood initiative • Types of Indicators (State of Vermont): • Percent of Youth who report parent involvement in schools • Percent of Youth who report they help to decide what goes on in their schools • Percent of Youth who report they are given useful roles in their community • Percent of Students volunteering • Percent of Youth who report high levels of love and support from family • Percent of High School seniors with plans for education, vocational training or employment • Percent of youth who feel valued by their community • .

  26. Examples of Indicators • Types of Indicators (State of Vermont): • Percent of Youth who report parent involvement in schools • Percent of Youth who report they help to decide what goes on in their schools • Percent of Youth who report they are given useful roles in their community • Percent of Students volunteering • Percent of Youth who report high levels of love and support from family • Percent of High School seniors with plans for education, vocational training or employment • Percent of youth who feel valued by their community

  27. National Adolescent Health Information Center & Public Policy Analysis & Education Center for Middle Childhood, Adolescent & Young Adult Health WEB SITES http://nahic.ucsf.edu http://policy.ucsf.edu BY EMAIL nahic@ucsf.edu policycenter@ucsf.edu BY PHONE 415.502.4856 Public Policy Analysis & Education Center for Middle Childhood, Adolescent & Young Adult Health

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