The impact of youth, family, peer and neighborhood risk factors on developmental trajectories of risk involvement from early through middle adolescence

Effect of multi-level social risk factors on developmental trajectories of sexual risk behaviors among Bahamian middle-to-late adolescents

Background

Few studies have examined how multi-level social factors interact and affect developmental patterns of sexual risk among middle-to-late adolescents who are at risk of experiencing sexual risk behaviors. We examined developmental trajectories of sexual risk behaviors of boys and girls in middle-to-late adolescence and the effects of exposure to three social risk factors (poor parental monitoring, peer risk, and neighborhood risk).

Methods

We followed 2,332 Bahamian adolescents every six months from Grades 10-12. We used group-based trajectory modeling to identify distinct trajectories of sexual risk behaviors for boys and girls.

Results

We identified three trajectories each for boys and girls. Peer risk and neighborhood risk predicted a high sexual-risk trajectory for boys, and peer risk (alone or combined with other risk factors) had the greatest impact on the membership of moderate-to-high-risk trajectory for girls. Parental monitoring had a relatively small effect on adolescents' sexual risk behavior.

Conclusion

Our results underscore the importance of early identification of adolescents with sexual risk behavior and development of targeted prevention interventions to improve adolescent health outcomes.

Exploring effects of multi-level factors on transitions of risk-taking behaviors among middle-to-late adolescents

Adolescents experiment with risk behaviors, including delinquency, substance use, and sexual activity. Multi-level social factors, such as having high-risk peers, neighborhood risks, and parental monitoring, influence adolescents' behaviors. We modeled transition patterns in Bahamian adolescents' risk behaviors across three high school years and examined the effects of multi-level factors. We collected data from 2,564 Bahamian adolescents in Grade 10 and follow-ups through Grade 12. We used latent transition model to identify adolescents' risk statuses. Further analyses used multinomial logistic regression to explore the effects of multi-level factors on assignment to those latent statuses and transitions. We identified four distinct statuses: "low risk" (47.9% of the sample at baseline), "alcohol use" (36.8%), "alcohol use and sexual activity" (5.5%), and "high risk" (9.8%). Males were more likely to be in higher-risk statuses at baseline and to transition from a lower-risk status in Grade 10 to a higher-risk status in Grade 11. Social risk factors were significantly associated with higher-risk statuses at baseline. Neighborhood risk and peer risk involvement continued to affect transitions from lower to higher risk; parental monitoring did not have a significant effect in later years. Our findings have important implications for developing targeted and developmentally appropriate interventions to prevent and reduce risk behaviors among middle-to-late adolescents.

Effects of Social Attachment on Experimental Drug Use From Childhood to Adolescence: An 11-Year Prospective Cohort Study

Background

Drug use among adolescents are still crucial issues that endanger their lifetime health. Evidence concerning the interpersonal-related factors influencing youngsters' experimental drug use behavior, especially from longitudinal and school-based prospective cohort studies, is insufficient. We aimed to describe the annual incidence rate and mean annual incidence rate of experimental drug use from childhood to adolescence by education stage, clarify the risk in childhood and examine the longitudinal relationship between social attachment factors and experimental drug use.

Materials and Methods

The data were derived from the 1st to 11th wave of the longitudinal study. In total, 1,106 respondents aged 19–20-year-old were followed up for 11 years (from 9 to 10-year-old) in Taiwan. A survival analysis was used to analyze the time-invarying/time-dependent effects of social attachment factors on experimental drug use.

Results

The mean annual incidence rate of experimental drug use from childhood to adolescence was 6.8‰. The incidence increased over time and was the highest in the first year of university (19.3‰). Boys were more likely to use drugs than girls. A low degree of self-perceived likeability in childhood was a risk factor influencing experimental drug use. On average, a low degree of parental supervision and a high degree of family conflict were both influential risk factors. According to the time-dependent models, a high degree of parental supervision, a high degree of family support and a low degree of family conflict in the current year can protect children and adolescents from drug use, whereas a sustained low degree of parental supervision and a high degree of family conflict may promote students' experimental drug use.

Conclusion

Parents should be informed and educated to avoid family conflict during childhood, maintain consistent supervision of their children's behavior, provide adequate family support, and pay attention to their children's interpersonal relationships in school. Teachers should focus on the social attachment status of their students while considering their attachments to their families and peers.

The Car Cushion Hypothesis: Bigger Cars Lead to More Risk Taking-Evidence from Behavioural Data

Car traffic and accidents involving cars create an enormous societal cost, particularly in terms of negative consequences for public health. Mitigating these effects is a daily concern for public and private institutions and people around the world. At least a subset of accidents is attributable to the amount of risk drivers allow in their driving and in related behaviour like mobile phone use or substance abuse. Our study looks at the effect of car size on risk taking. While literature highlights several behavioural effects of car size, the direction of causality of these effects is not always clear, and empirical evidence is lacking. Two behavioural and consequential studies support that car size affects risk taking in driving and that this increase in risk taking generalizes to other domains as well. Based on these results and in line with literature showing that social stability and security can affect financial risk taking, we propose the "car cushion hypothesis." This hypothesis suggests that bigger cars make people feel more secure, which affects their behaviour in terms of generalized risk taking. We discuss policy implications aimed at contributing to reducing the societal and public health cost of car traffic.

Bayesian estimation and model selection in group-based trajectory models

We develop a Bayesian group-based trajectory model (GBTM) and extend it to incorporate dual trajectories and Bayesian model averaging for model selection. Our framework lends itself to many of the standard distributions used in GBTMs, including normal, censored normal, binary, and ordered outcomes. On the model selection front, GBTMs require the researcher to specify a functional relationship between time and the outcome within each latent group. These relationships are generally polynomials with varying degrees in each group, but can also include additional covariates or other functions of time. When the number of groups is large, the model space can grow prohibitively complex, requiring a time-consuming brute-force search over potentially thousands of models. The approach developed in this article requires just one model fit and has the additional advantage of accounting for uncertainty in model selection. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Development and Evaluation of a National School-based HIV Prevention Intervention for Primary School Children in Kenya

Primary schools in Kenya provide a promising venue for widespread delivery of HIV prevention interventions. This article describes the development and evaluation of Making Life's Responsible Choices (MLRC), a school-based HIV prevention intervention for primary school children developed through a collaborative global partnership involving multiple community stakeholders. Intervention development was informed by extensive reviews of youth-focused evidence-based HIV prevention interventions, and was rooted in both the Theory of Planned Behavior and Social Cognitive Theory. MLRC includes six modules: 1) self-awareness, 2) human sexuality, 3) healthy relationships, 4) drug/alcohol abuse, 5) HIV/AIDS and other sexually transmitted infections, and 6) behavior change. Class 5 pupils (N=1846; 52.1% girls, 47.9% boys; mean age = 12) attending 46 different Catholic-sponsored public and private primary schools throughout Kenya participated in the evaluation of the intervention program which was delivered in the classroom and occurred over the course of 40 weeks (one academic term). Changes in knowledge and behavioral intentions were assessed using a one-group pre-test post-test experimental design. Pupils completed module-specific assessment measures, and paired samples t-tests were used to compare changes in knowledge and behavioral intentions at the classroom level. Gender-specific analyses were also conducted. All six modules displayed statistically significant positive changes in the mean percentage of knowledge items answered correctly for the full sample, with marginal gender differences revealed. Statistically significant health-promoting changes were seen in 11 of the 18 behavioral intention items (3 per module), with gender differences also revealed. Findings suggest that implementing interventions such as MLRC has the potential to thwart the spread of HIV among youth in Kenya, and equip youth with health-promoting skills. In addition, school-based programs have the potential to become institutionalized in school settings in order to maintain their long-term sustainability.

Parents Speak: A Needs Assessment for Community Programming for Black Male Youth

INTRODUCTION

Although adolescence can be a difficult developmental period for all children, negative environmental forces make this period particularly risky for many inner-city black males. As part of the Center for Healthy African American Men through Partnerships, this project is utilizing community-based participatory concepts to design and implement programs to address risk-taking behaviors among middle school black males.

METHODS

In 2014, parents of black males between the ages of 11 and 14years were recruited from an urban middle school to participate in focus group discussions. Letters were provided to the school to be mailed to parents inviting them to participate in discussion groups. Four focus groups were conducted. Data analyses were conducted fall 2014.

RESULTS

Twenty-one parents participated. The major issue affecting the well-being and future success of young black males reported by parents was the lack of social support. Other areas of concern included negative peer pressure, bullying, violence, and lack of opportunities. Across groups, parents identified the lack of male parental presence in households and the subsequent perceived need by the young males to assume leadership roles, anger among the young males, and the lack of licensed counselors to address mental health issues as barriers to success and well-being. Parents emphasized the needs of the individual, family, and community for social support, positive role models, self-esteem, and respect.

CONCLUSIONS

The present data can inform prevention programs designed to reduce disparities, such as educational underachievement, exposure to violence, and premature mortality experienced by black males.

SUPPLEMENT INFORMATION

This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.

Phenotypes of childhood wheeze in Japanese children: A group-based trajectory analysis

BACKGROUND

Exploring patterns of childhood wheeze may help to clarify the etiology and prognosis of respiratory diseases. The purpose of this study was to classify phenotypes of wheezing in children up to 9 years of age in Japan and to evaluate the individual and environmental risk factors for these phenotypes.

METHODS

Wheeze was evaluated at approximately 1-year intervals based on the mothers' recollection of their child's wheezing or whistling in the chest during the preceding 12 months. The children were aged 1-9 years. In total, 1116 children who had at least five measures of wheezing at all nine time points were used for identifying trajectories. Trajectories were identified with group-based trajectory analysis. A multinomial logit model was built to evaluate the relationships between phenotypes and risk factors.

RESULTS

Five typical trajectories were identified. The probability of group membership was 43.7%, 32.2%, 6.2%, 8.6%, and 9.2% for the never/infrequent wheeze, transient early wheeze, school-age-onset wheeze, early-childhood-onset remitting wheeze, and persistent wheeze trajectories, respectively. Infant tobacco exposure increased the odds of membership in the transient early wheeze trajectory compared to the never/infrequent wheeze trajectory.

CONCLUSIONS

Using the group-based trajectory modeling approach, we identified five trajectories of childhood wheeze development in a Japanese population. The trajectories shown here are based on formal statistical modeling rather than on subjective classification, and an assessment of its precision suggested that the model has high assignment accuracy.

School collective occupation movements and substance use among adolescents: A school-level panel design

BACKGROUND

Recently, social movements across the world have demanded reforms to education systems and other institutions. Although such movements have affected large numbers of people across multiple countries, we know little about the impacts they have had on population health. We focus on one example: the massive strikes and collective occupation of secondary schools across Chile, which occurred contemporaneously with a large increase in marijuana use among students in this age group. We aimed to evaluate the causal effects that the 2011 Chilean school strikes had on adolescent substance use, including the initiation of marijuana use and the use of alcohol and marijuana.

METHODS

School-level, aggregated panel design using data from the National Drug Surveys among Secondary Students from 2005 to 2015 for students in grades 9-12. We used a fixed-effects difference-in-difference model to estimate the effect of school occupations on prevalence of self-reported indicators of drug use.

RESULTS

Reported marijuana use doubled between 2009 and 2013 among Chilean adolescents. After controlling for secular trends in outcomes and for school characteristics, there was no evidence of increased marijuana initiation, alcohol and marijuana use, or of an increase in heavy use among adolescents being directly attributable to school strikes and occupations in 2011.

CONCLUSIONS

The 2011 Occupy school movement in Chile had no detectable causal effect on substance use among Chilean adolescents. The increase in marijuana use from 2009 to 2013 seems to be part of broader social changes occurring among the school-age population.

Predictors of Risky Behavior and Offending for Adolescents With Mild Intellectual Disability

Adolescents with intellectual disability (ID) engage in risky behavior and offending. However, little is known on the impact school-related predictors have on engagement in risky behaviors for adolescents with ID. This study analyzed secondary data from the National Longitudinal Transition Study-2 (NLTS2) to determine levels of engagement in risky behaviors and offending for adolescents with mild and moderate/severe ID. School-related predictors of engagement for adolescents with mild ID were also explored. Results indicated adolescents with mild ID engage in risky behaviors and offending at significantly higher rates as compared to adolescents with moderate/severe ID. Participation in a social skills or life skills class was a significant predictor of less engagement in risky behaviors for individuals with mild ID.

Dynamic Relationships Between Parental Monitoring, Peer Risk Involvement and Sexual Risk Behavior Among Bahamian Mid-Adolescents

CONTEXT

Considerable research has examined reciprocal relationships between parenting, peers and adolescent problem behavior; however, such studies have largely considered the influence of peers and parents separately. It is important to examine simultaneously the relationships between parental monitoring, peer risk involvement and adolescent sexual risk behavior, and whether increases in peer risk involvement and changes in parental monitoring longitudinally predict adolescent sexual risk behavior.

METHODS

Four waves of sexual behavior data were collected between 2008/2009 and 2011 from high school students aged 13-17 in the Bahamas. Structural equation and latent growth curve modeling were used to examine reciprocal relationships between parental monitoring, perceived peer risk involvement and adolescent sexual risk behavior.

RESULTS

For both male and female youth, greater perceived peer risk involvement predicted higher sexual risk behavior index scores, and greater parental monitoring predicted lower scores. Reciprocal relationships were found between parental monitoring and sexual risk behavior for males and between perceived peer risk involvement and sexual risk behavior for females. For males, greater sexual risk behavior predicted lower parental monitoring; for females, greater sexual risk behavior predicted higher perceived peer risk involvement. According to latent growth curve models, a higher initial level of parental monitoring predicted decreases in sexual risk behavior, whereas both a higher initial level and a higher growth rate of peer risk involvement predicted increases in sexual risk behavior.

CONCLUSION

Results highlight the important influence of peer risk involvement on youths' sexual behavior and gender differences in reciprocal relationships between parental monitoring, peer influence and adolescent sexual risk behavior.

Trajectory subtypes after injury and patient-centered outcomes

BACKGROUND

The recent focus on patient-centered outcomes highlights the need to better describe recovery trajectories after injury. The purpose of this study was to characterize recovery trajectory subtypes that exist after non-neurologic injury.

MATERIALS AND METHODS

A prospective, observational cohort of 500 adults with an Injury Severity Score > 10 but without traumatic brain or spinal cord injury from 2009 to 2011 was formed. The Short Form-36 was administered at admission and repeated at 1, 2, 4, and 12 mo after injury. Group-based trajectory modeling was used to determine the number and shape of physical composite score (PCS) and mental composite score (MCS) trajectories.

RESULTS

Three PCS trajectories and five MCS trajectories were identified. For PCS, trajectory 1 (10.4%) has low baseline scores, followed by no improvement over time. Trajectory 2 (65.6%) declines 1 mo after injury then improves over time. Trajectory 3 (24.1%) has a sharp decline followed by rapid recovery. For MCS, trajectory 1 (9.4%) is low at baseline and remains low. Trajectory 2 (14.4%) has a large decrease after injury and does not recover over the next 12 mo. Trajectory 3 (22.7%) has an initial decrease in MCS early, followed by continuous recovery. Trajectory 4 (19.1%) has a steady decline over the study period. Trajectory 5 (34.3%) stays consistently high at all time points.

CONCLUSIONS

Recovery after injury is complex and results in multiple recovery trajectories. This has implications for patient-centered clinical trial design and in development of patient-specific interventions to improve outcomes.

Social Determinants and Health Behaviors: Conceptual Frames and Empirical Advances

Health behaviors shape health and well-being in individuals and populations. Drawing on recent research, we review applications of the widely applied "social determinants" approach to health behaviors. This approach shifts the lens from individual attribution and responsibility to societal organization and the myriad institutions, structures, inequalities, and ideologies undergirding health behaviors. Recent scholarship integrates a social determinants perspective with biosocial approaches to health behavior dynamics. Empirical advances model feedback among social, psychological and biological factors. Health behaviors are increasingly recognized as multidimensional and embedded in health lifestyles, varying over the life course and across place and reflecting dialectic between structure and agency that necessitates situating individuals in context. Advances in measuring and modeling health behaviors promise to enhance representations of this complexity.

Resiliency as a factor protecting youths from risky behaviour: Moderating effects of gender and sport

We hypothesised that resiliency may protect adolescents against risky behaviours, and that both the practicing of sports, and gender are moderating variables in relationships between resiliency and risky behaviours. The study included 18-year-old pupils from a selection of secondary schools (n = 556). A total of 188 individuals practiced competitive sports and the remaining 368 participants were non-athletes. The participants were examined with the Resiliency Assessment Scale for Children and Adolescents (SPP-18) and with a survey containing questions and statements related to high-risk "experiments with adulthood". Adolescent athletes showed higher levels of resiliency than their peers. The power of the "Determination and Persistence in Action" effect on "Alcohol" scale differed significantly between male athletes and male non-athletes. Only in the athletes groups were higher scores on this scale reflected by lower values on the "Drugs" scale. Moreover, it is possible to observe differences in undertaking risky behaviour between male and female athletes. The analysis of risky sexual behaviour suggests that sport is a risk factor for men, and a protective factor for women. These data suggest that consistent prophylactic and psycho-educative activities, with a special attention to differences between genders, should be provided to all the adolescents, irrespective of their sport performance levels.

Cannabis and adolescent brain development

Heavy cannabis use has been frequently associated with increased rates of mental illness and cognitive impairment, particularly amongst adolescent users. However, the neurobiological processes that underlie these associations are still not well understood. In this review, we discuss the findings of studies examining the acute and chronic effects of cannabis use on the brain, with a particular focus on the impact of commencing use during adolescence. Accumulating evidence from both animal and human studies suggests that regular heavy use during this period is associated with more severe and persistent negative outcomes than use during adulthood, suggesting that the adolescent brain may be particularly vulnerable to the effects of cannabis exposure. As the endocannabinoid system plays an important role in brain development, it is plausible that prolonged use during adolescence results in a disruption in the normative neuromaturational processes that occur during this period. We identify synaptic pruning and white matter development as two processes that may be adversely impacted by cannabis exposure during adolescence. Potentially, alterations in these processes may underlie the cognitive and emotional deficits that have been associated with regular use commencing during adolescence.