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PubMed2005

Adolescents' behavior in the presence of interparental hostility: developmental and emotion regulatory influences.

Within-family covariation between interparental hostility and adolescent behavior across three interactions over a 2-year period was explored in a sample that included 37 typical adolescents and 35 adolescents recently hospitalized for psychiatric difficulties. More interparental hostility across the three interactions was associated with more adolescent hostility and more positive engagement (at a trend level) regardless of psychiatric background. Parent-to-child hostility in each interaction mediated the link for adolescent hostility but not for positive adolescent engagement. Emotion regulation capacities and age were linked to variability in adolescents' behavior in the presence of interparental conflict. In interactions with more interparental hostility, adolescents with greater capacity to tolerate negative affect were more likely to show increased positive engagement, and adolescents who were better able to modulate their emotional expression were less likely to show increased hostility. Covariation between interparental and adolescent hostility across the three family interactions decreased as the adolescent aged. These findings are consistent with the theory that exposure to interparental hostility is emotionally disequilibrating, and that adolescent responses may reflect differences in emotion regulation and other developmentally based capacities. Gender and variations across families in overall levels of hostile parenting were also linked with adolescent behavior in the presence of interparental hostility.

Adolescent↗
PubMedDate not supplied

Violent behavior in Chinese adolescents with an economic disadvantage. Psychological, family and interpersonal correlates.

Two studies investigating the psychological, family and interpersonal correlates of adolescent violent behavior are reported in this paper. In Study 1, secondary school students (N = 1,519) responded to established scales assessing their psychological attributes, family functioning, parenting qualities and psychosocial support and conflict. Results of Study 1 showed that: a) adolescents who showed higher levels of perceived stress and psychological symptoms displayed more signs of adolescent violence; b) adolescents who had a higher sense of mastery and existential mental health displayed less signs of violence; c) adolescents' attitudes towards poverty and traditional Chinese beliefs about adversity were significantly related to adolescent violence; d) higher levels of family functioning, positive parenting styles as well as interpersonal support and lower levels of interpersonal conflicts were associated with a lower level of adolescent violence. Results further showed that some of the above factors were more strongly related to adolescent violence in adolescents experiencing economic disadvantage than in adolescents who did not experience economic disadvantage. Some of the findings of Study 1 were replicated in Study 2, where adolescents from 229 families (either families on welfare or low income families) were recruited. These studies suggested that several psychological, family and interpersonal factors are related to adolescent violent behavior, particularly in adolescents with economic disadvantage.

Adolescent↗
PubMed2005

Oral versus vaginal sex among adolescents: perceptions, attitudes, and behavior.

OBJECTIVE: Despite studies indicating that a significant proportion of adolescents are having oral sex, the focus of most empirical studies and intervention efforts concerning adolescent sexuality have focused on vaginal intercourse. This narrow focus has created a void in our understanding of adolescents' perceptions of oral sex. This study is the first to investigate adolescents' perceptions of the health, social, and emotional consequences associated with having oral sex as compared with vaginal sex, as well as whether adolescents view oral sex as more acceptable and more prevalent than vaginal sex. METHODS: Participants were 580 ethnically diverse ninth-grade adolescents (mean age: 14.54; 58% female) who participated in a longitudinal study on the relationship between risk and benefit perceptions and sexual activity. Participants completed a self-administered questionnaire that inquired about their sexual experiences and percent chance of experiencing outcomes from, attitudes toward, and perceived prevalence of oral versus vaginal sex among adolescents. RESULTS: More study participants reported having had oral sex (19.6%) than vaginal sex (13.5%), and more participants intended to have oral sex in the next 6 months (31.5%) than vaginal sex (26.3%). Adolescents evaluated oral sex as significantly less risky than vaginal sex on health, social, and emotional consequences. Adolescents also believed that oral sex is more acceptable than vaginal sex for adolescents their own age in both dating and nondating situations, oral sex is less of a threat to their values and beliefs, and more of their peers will have oral sex than vaginal sex in the near future. CONCLUSIONS: Given that adolescents perceive oral sex as less risky, more prevalent, and more acceptable than vaginal sex, it stands to reason that adolescents are more likely to engage in oral sex. It is important that health care providers and others who work with youths recognize adolescents' views about oral sex and broaden their clinical preventive services to include screening, counseling, and education about oral sex.

Adolescent↗
PubMed2002

Acute effects of ethanol on social behavior of adolescent and adult rats: role of familiarity of the test situation.

BACKGROUND: Adolescence is a time when the risk for extensive alcohol use is elevated. At least two important qualities of alcohol may contribute to extensive alcohol use in adolescence: its ability to facilitate certain forms of social behavior, including interactions with peers, and its properties to alleviate anxiety. These issues may be addressed using sensitive animal tests of social behavior. METHOD: A modified social interaction test was used to investigate acute effects of ethanol on different forms of social behavior (social investigation, contact behavior, and play fighting) and social motivation of adolescent and adult rats tested in a familiar (nonanxiogenic) or unfamiliar (anxiogenic) test situation. Testing in the familiar environment assessed age-related differences in sensitivity of social behavior to activating and/or suppressing effects of ethanol (ethanol-induced social facilitation or social inhibition), whereas testing in the unfamiliar environment provided information about age-related differences in ethanol anxiolytic effects (ethanol-induced reduction in the social inhibition provoked by the unfamiliar environment). RESULTS: Ethanol-induced social facilitation was observed only in adolescent animals: 0.5 g/kg of ethanol significantly increased social investigation and play fighting in adolescents tested in the familiar environment. Ethanol-induced reduction of social inhibition in the unfamiliar test situation was observed in both adolescents and adults, however, higher doses of ethanol were required to attenuate social inhibition in adolescents than in adults. Adolescent animals were also less sensitive than adults to the inhibition of social behavior evident at higher doses. Adolescents decreased contact behavior and play fighting (but not social investigation) following ethanol only in the familiar test situation and only at the highest dose, whereas adults showed inhibition of all forms of social activity in both contexts after the highest dose of ethanol, and in the familiar environment after the two highest doses. No age-related differences were found in blood alcohol concentrations assessed 30 min after ethanol administration. CONCLUSIONS: Adolescent animals were more sensitive than adults to ethanol-induced social facilitation, but were less sensitive than adults to ethanol anxiolytic effects, as indexed by an ethanol-related reinstatement of social interactions in an unfamiliar, anxiogenic environment that typically decreases social activity. Adolescents were also less sensitive than adults to the suppression of social interactions seen at higher ethanol doses in both test situations. These adolescent-associated alterations in ethanol sensitivity are unlikely to be attributable to ontogenetic differences in ethanol pharmacokinetics, given that observed age-related changes included both suppressant and facilitatory effects, and that blood alcohol levels were similar in adolescent and adult animals. These findings demonstrate age-related differences in sensitivity to the effects of ethanol in a social milieu that vary dramatically with the context and particular ethanol consequences. The results suggest the importance of considering social and environmental factors as contributors to patterns of extensive alcohol use, particularly in adolescence.

Age Factors↗
PubMed2004

Trends in private and public health insurance for adolescents.

CONTEXT: Previous studies (1984-1995) of adolescent health insurance have shown little change in the proportion with coverage. Federally mandated expansions in Medicaid were offset by declines in private coverage. Further expansions of Medicaid and implementation of the State Children's Health Insurance Program (SCHIP) have opened new avenues for increasing coverage rates. OBJECTIVES: To assess the current health insurance status of adolescents, the demographic and socioeconomic correlates of insurance coverage, and document recent changes in public and private coverage rates. DESIGN, SETTING, AND PARTICIPANTS: We analyzed data on 12 995 adolescents aged 10 to 18 years, who had been included in the 2002 National Health Interview Survey. We conducted multivariate analyses to assess the independent association of age, sex, race, poverty status, family structure, family size, and region on the likelihood of having insurance coverage. Results are compared with previously published findings on adolescent health insurance coverage spanning 1984 to 1995. MAIN OUTCOME MEASURE: Insurance coverage for adolescents. RESULTS: An estimated 12.2% of adolescents were uninsured in 2002, which is a decrease from 14.1% in 1995 (P<.003). The decrease occurred entirely because of an expansion of public coverage and is concentrated among children in poor (<100% of the federal poverty level) and near-poor (100%-199% of the federal poverty level) families. A substantial decrease in the differences between poor and higher-income groups occurred between 1995 and 2002 due to gains in coverage for adolescents in poor and near-poor families and losses in coverage among those in middle- and upper-income families (> or =200% of the federal poverty level). Specifically, the proportion of adolescents in poor families without coverage declined from 27.4% in 1995 to 19.7% in 2002 (P<.001). The proportion of adolescents in near-poor families without coverage declined from 24.8% in 1995 to 19.2% in 2002 (P<.002). In contrast, the proportion of adolescents in middle- and higher-income families without insurance increased from 4.1% in 1995 to 6.3% in 2002 because availability of insurance through the private market declined (P<.001). CONCLUSIONS: A modest but significant reduction in the percentage of adolescents without insurance has occurred since 1995, largely as a result of expansions in public coverage. An even larger reduction in the proportion of adolescents without coverage would have occurred, if not for a reduction in private coverage for adolescents in middle- and higher-income families.

Adolescent↗
PubMed2006

Adolescent quality of life and satisfaction with care.

PURPOSE: 1) To describe adolescents' responses to a client satisfaction and family-centered care survey; 2) to examine the relationship between satisfaction with health care and health-related quality of life (HRQL) among these adolescents; and 3) to determine if adolescents and their parents differ in their satisfaction with services. METHODS: We recruited 104 adolescents who attended the Alberta Children's Hospital pediatric neurology clinic. Each family completed the Client Satisfaction Questionnaire (CSQ), the Family Centered Care Survey (FCCS), the Measure of Processes of Care (MPOC) survey, the Give Youth a Voice (GYV) survey, and the Pediatric Quality of Life Inventory (PedsQL). RESULTS: Of 116 eligible families, 104 (90%) completed the study. The majority (83%) of adolescents were satisfied with services provided. Adolescents who were very satisfied on the CSQ and the FCCS had higher PedsQL psychosocial scores (p = .009 and .013, respectively). Multivariate analysis revealed that adolescents' psychosocial HRQL was the most significant predictor of their satisfaction with care (odds ratio [OR] 1.03, 95% confidence interval [CI] 1.01 to 1.06). There was a difference between parents' and adolescents' responses to the FCCS (p = .02), with adolescents being less satisfied overall. CONCLUSIONS: Given that adolescents and parents differ in their satisfaction with health care, it is helpful to have direct input from adolescents on health services surveys. The positive relationship between adolescents' psychosocial HRQL and satisfaction with care highlights the potential impact of emotional health on subjective rating of services. Further studies should determine if improvement in adolescents' mental health is associated with greater satisfaction with health care and/or increased adherence with medical treatments.

Adolescent↗
PubMed2001

Adoption as a risk factor for attempted suicide during adolescence.

OBJECTIVE: Depression, impulsivity, and aggression during adolescence have been associated with both adoption and suicidal behavior. Studies of adopted adults suggest that impulsivity, even more than depression, may be an inherited factor that mediates suicidal behavior. However, the association between adoption and adolescent suicide attempts and the mechanisms that might explain it remain unknown. The objective of this study was to determine the following: 1) whether suicide attempts are more common among adolescents who live with adoptive parents rather than biological parents; 2) whether the association is mediated by impulsivity, and 3) whether family connectedness decreases the risk of suicide attempt regardless of adoptive or biological status. METHODS: A secondary analysis of Wave I data from the National Longitudinal Study of Adolescent Health was conducted, which used a school-based, clustered sampling design to identify a nationally representative sample of 7th- to 12th-grade students, with oversampling of underrepresented groups. Of the 90 118 adolescents who completed the National Longitudinal Study of Adolescent Health in-school survey, 17 125 completed the in-home interview and had parents of identified gender who completed separate in-home questionnaire. The subset of adolescents for this study was drawn from the in-home sampling according to the following criteria: 1) adolescent living with adoptive or biological mother at the time of the interview, 2) adolescent had never been separated from mother for more than 6 months, 3) mother was in first marriage at the time of the interview, and 4) the adoptive mother had never been married to the adolescent's biological father. Of the 6577 adolescents in the final study sample, 214 (3.3%) were living with adoptive mothers and 6363 (96.7%) were living with biological mothers. Variables. The primary outcome measured was adolescent report of suicide attempt(s) in the past year. Other variables included in the analyses were sociodemographics characteristics (gender, age, race/ethnicity, family income, parental education), general health (self-rated health, routine examination in the past year, need for medical care in the past year that was not obtained), mental health (depressive symptoms, self-image, trouble relaxing in the past year, bad temper, psychological or emotional counseling in the past year), risk behaviors (cigarettes, alcohol, marijuana, sexual intercourse ever, delinquency, physical fighting in the past year, impulsive decision making), school-related characteristics (grade point average, school connectedness), and family interaction (family connectedness, parental presence, maternal satisfaction with parent-adolescent relationship). Data Analysis. Univariate analyses were used to compare adoptees versus nonadoptees, suicide attempters versus nonsuicide attempters, and adopted suicide attempters versus nonadopted suicide attempters on all variables. Variables that were associated with attempted suicide were entered into a forward stepwise logistic regression procedure, and variables that were associated with the log odds of attempt were retained in the model. The area under the model's receiver operating characteristic curve was calculated as a measure of its overall performance. After the association of adoption with attempted suicide was demonstrated, the potential mediating effect of impulsivity was explored by adding it to the model. The same procedure was followed for any variable that was associated with adoption in the full sample or the subsample of suicide attempters. To determine whether any variable in the model moderated the association between adoption and suicide attempt, the interaction term for that variable x adoption was forced into the model. RESULTS: Adoptees differed significantly from nonadoptees on 4 of 26 variables. They were more likely to have attempted suicide (7.6% vs 3.1%) and to have received psychological or emotional counseling in the past year (16.9% vs 8.2%), and their mothers reported higher parental education and family income. Attempters differed significantly from nonattempters on all variables except for age, race/ethnicity, parental education, family income, and routine examination in the past year. On logistic regression, 9 variables were independently associated with attempted suicide: depression (adjusted odds ratio [AOR]: 3.41), counseling (AOR: 2.83), female gender (AOR: 2.31), cigarette use (AOR: 2.31), delinquency (AOR: 2.17), adoption (AOR: 1.98), low self-image (AOR: 1.78), aggression (AOR: 1.48), and high family connectedness (AOR: 0.60). The receiver operating characteristic curve for the model had an area of 0.834, indicating performance significantly better than chance. The AOR for adoption did not change when parental education, family income, and impulsivity were forced into the model. (ABSTRACT TRUNCATED)

Achievement↗
PubMed2004

Shiftworking families: parents' working schedule and sleep patterns of adolescents attending school in two shifts.

OBJECTIVE: To explore whether parents' engagement in shift work affects the sleep habits of their adolescent children who attend school in two shifts. METHODS: The data were drawn from an extensive survey of sleep and daytime functioning of adolescents attending school one week in the morning and the other in the afternoon. The participants were 1,386 elementary and high school students (11-18 years old) whose parents were both employed. The data were analyzed using MANOVA, with parents' work schedule, adolescents' gender and type of school as between-subject factors. RESULTS: Parents' working schedule significantly affected the sleep patterns of high school adolescents. When attending school in the morning, adolescents whose parents were both day workers woke up somewhat later than adolescents with one shiftworking parent. In addition, they slept longer than adolescents whose parents were both shift workers. On weekends, adolescents whose parents both worked during the day went to bed earlier than adolescents whose parents were both shiftworkers. They also had smaller bedtime delay on weekends with respect to both morning and afternoon shifts than adolescents for whom one or both parents worked shifts. A significant interaction between parents' working schedule, adolescents' gender and type of school was found for sleep extension on weekends after afternoon shift school. CONCLUSIONS: Parental involvement in shift work has negative effects on the sleep of high school adolescents. It contributes to earlier wake-up time and shorter sleep in a week when adolescents attend school in the morning, as well as to greater bedtime irregularity.

Adolescent↗
PubMed2004

Risk factors for childbearing during adolescence in a population-based birth cohort in southern Brazil.

OBJECTIVE: To use a case-control study to analyze risk factors associated with teenage childbearing among adolescents who were in a birth cohort study that began in 1982 in the city of Pelotas, Rio Grande do Sul, Brazil. METHODS: Adolescent mothers in Pelotas who gave birth between January 1995 and March 2001 and who had been born in 1982 were identified through the local birth information system. These subjects from the 1982 birth cohort were compared to adolescents from the same cohort who had not given birth before March 2001. Standardized interviews were used in 2001 to obtain information about socioeconomic, maternal reproductive, demographic, and lifestyle characteristics. This information was combined with data obtained in earlier phases of this 1982 birth cohort study. Unconditional logistic regression was used to analyze the risk factors associated with childbearing during adolescence. RESULTS: A total of 420 parous adolescents from the 1982 birth cohort were identified and then compared with 408 cohort adolescents who had not given birth by March 2001. Higher family income in 1982 and more parental schooling in 1982 were inversely related to childbearing among the birth cohort adolescents. Cohort girls whose mothers were under age 20 when they gave birth in 1982 had a higher risk of becoming pregnant while still an adolescent. Cohort girls who, during childhood, lived with siblings from different fathers were twice as likely to become an adolescent mother. Compared to cohort adolescents who had not failed during the first four years of school, those girls who had done so had twice the risk of giving birth during adolescence. Among the cohort girls a positive association was found between younger age at first intercourse and childbearing in adolescence. CONCLUSIONS: The results indicate that the educational level of the adolescent mothers must be considered in planning policies that attempt to disrupt successive cycles of socioeconomic deprivation. Early interventions to improve sex education and to increase the motivation of young girls to achieve higher levels of education are needed. The interventions should aim for a reduction in the risk of long-term poverty and poorer educational achievements of teenage mothers and their children.

Adolescent↗
PubMedDate not supplied

Characteristics of adolescents' sexual partners and their association with use of condoms and other contraceptive methods.

CONTEXT: While a number of studies have examined the association between individuals' characteristics and their contraceptive use, few studies have examined the influence of partners' characteristics on individuals' contraceptive use. METHODS: Using nationally representative data from the National Longitudinal Study of Adolescent Health, multiple logistic analyses were conducted to identify associations between the demographic characteristics of adolescents' heterosexual partners and adolescents' use of condoms or other contraceptive methods. RESULTS: The partners of white and black adolescents were likely to be similar to them, while the partners of Latino adolescents and of adolescents of "other" race or ethnicity were more likely to be of a different racial or ethnic group. Differences in age between adolescents and their partners were notable in all racial and ethnic groups. As adolescents age, the characteristics of their partners become more heterogeneous. The less similar adolescents and their partners are to one another--whether because of a difference in age, grade or school--the less likely adolescents are to use condoms and other contraceptive methods. CONCLUSIONS: Many adolescents have relationships with partners whose characteristics differ from theirs and with whom they are less likely to use condoms or other contraceptive methods. This behavior is more common as adolescents grow older. To provide appropriate counseling, sexuality educators and family planning providers need to consider the ways in which adolescents' relationships change as they age and discuss with them the dynamics of relationships involving partners who differ in age or other characteristics.

Adolescent↗
PubMed2000

Adolescent pregnancies in Addis Ababa.

OBJECTIVE: To determine the pattern, obstetric outcome, knowledge and practice of modern family planning methods and factors that predispose to pregnancy among adolescent mothers. DESIGN: A descriptive study comparing findings in adolescent and mature mothers. SETTING: Two teaching Hospitals in Addis Ababa. SUBJECTS: Adolescent mothers under 20 years of age and mature mothers aged between 20 and 34 years. MAIN OUTCOME MEASURES: Age at pregnancy, demographic variables, gestational age, parity, antenatal care attendance, modes of deliveries, birthweight, Apgar scores, condition of babies at birth and knowledge and utilisation of modern contraceptive methods. RESULTS: Five hundred and sixty nine (74%) of the adolescents were single compared with 226 (29%) of mature mothers (p<0.001, OR 6.83, 95%; CI=5.47-8.45). There were 391 (51%) unemployed adolescents compared with 99 (13%) of mature mothers (p<0.001, OR 7.0, 95% CI 3.06-5.05). Five hundred and twelve (67%) of the adolescent pregnant mothers failed to attend antenatal clinic compared with 344 (45%) of the mature mothers (p<0.001, OR 0.41, 95% CI=0.33, 0.5). Two hundred (26%) of adolescent mothers underwent Caesarean section compared with 82 (11%) of mature mothers (p<0.001, OR 2.44, 95% CI=1.90, 4.56). Two hundred and fifty six (33%) of the adolescent mothers delivered low birthweight babies compared with 106 (14%) of mature mothers (p<0.001, OR 3.12, 95% CI=2.4, 3.99). The one and five minute Apgar scores were less than seven in 301 (39%) babies born to adolescent mothers compared with 20 (27%) babies born to mature mothers (p<0.001, OR 1.73, 95% CI=1.39, 2.14. Five hundred and twelve (67%) of adolescent mothers had no knowledge about modern contraceptive methods compared with 147 (19%) mature mothers (p<0.001, OR 0.12, 95% CI=0.45-0.49). CONCLUSION: Adolescent pregnancy is common in the city of Addis Ababa. Adolescent pregnancy study revealed low birthweight, high Caesarean section rate and foeto-pelvic disproportion as a consequence of incomplete development of the bony pelvis. Improved education and contraceptive services are needed to reduce the incidence of adolescent pregnancy.

Adolescent↗
PubMedDate not supplied

Community-based adolescent health services in Israel: from theory to practice.

Despite their engagement in health-risk behaviors and their health-related concerns, adolescents have the lowest rate of health service utilization of any age group. Time constraints during routine medical encounters generally leave little opportunity for professional screening for health-risk behaviors or for discussing psychosocial problems. In addition, providers express low levels of perceived competency in areas such as sexuality, eating disorders or drug abuse. To address these needs, a walk-in Adolescent Health Service was established by the Sheba Medical Center to provide diagnosis and short-term treatment for individual adolescents, as well as counseling and support for local care providers. A three-way model of cooperation and partnership was developed and implemented. A professional and financial partnership with local authorities were established to help define the particular needs of the community's youth and to improve the ability to reach youth with special health needs. The partnership along with the main medical provider (Kupat Holim Clalit) helped define local health needs, served as a referral source of patients with unmet health needs, and improved the continuity of care. The regional medical center (Sheba Medical Center) provided supervision and consultation for the medical staff of the service, as well as a referral center for patients. It was emphasized that the service staff was intended as a professional source for the primary physician and should not be considered a rival. The core staff included a specialist in adolescent medicine, gynecologist, mental health specialist and social worker. A structured intake procedure was developed for assessing health concerns and problems of adolescents in the context of a community clinic. Findings from the first years of services showed that the first 547 female adolescents demonstrated that a majority of adolescents presented with primary complaints of a somatic nature, while one third were diagnosed with psychosocial problems and one-fifth with a sexuality-related problem. A considerable percentage of those diagnosed with psychosocial or sexuality-related problems had not stated these issues as their "reason for encounter". This additional increment probably represents the contribution of the Health Concern Checklist (HCC), in which the adolescent was asked to mark each item for which she had concerns or would like to receive further information. The HCC can help primary care physicians as well as adolescent medical specialists approach the teenage patient and initiate productive communication. A practical approach to confidential health care for adolescents: The issue of confidentiality has not been sufficiently clarified by Israeli law or by the medical community. The need for confidentiality was strongly felt in the adolescent health service. A policy which provides all adolescents with the opportunity to meet with a physician and receive health guidance or advice at least once, even without parental knowledge or consent, was formulated and implemented. If parental consent was not feasible, the minor was allowed to give informed consent for medical and psychosocial care for himself/herself, with certain limitations.

Adolescent↗
PubMed2004

Determinant factors in Ecuador related to pregnancy among adolescents aged 15 or less.

OBJECTIVE: Determine social factors related to pregnancy among young adolescents. METHODS: We obtained socio-demographic data from early adolescent nulliparas aged < or = 15 years. RESULTS: During the study period at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil-Ecuador 201 early adolescent nulliparous patients of low socio-economic status were surveyed and compared with 201 low socio-economic nulliparous controls aged 20 to 30. Mean age of adolescents was 14+/-0.6 years, 58.7% of them were aged 14. Age of menarche and sexual initiation was lower among adolescents (11.8+/-0.9 vs 12.8+/-2 years and 12.6+/-1.1 vs 16.2+/-5 years, respectively, p<0.05). A higher rate of adolescents initiated sexually before menarche onset (18.4% vs 5%, p<0.05). The rate of those who wanted to become pregnant, had adequate prenatal care and had knowledge of conception, used contraception or had knowledge of any contraceptive method prior to pregnancy was significantly lower in adolescents (16.9% vs 86.5%; 37.3% vs 94.5%; 18% vs 70.1%; 6.5% vs 89.5%; 42.8% vs 84.5%, respectively, p<0.05). Age of sexual partner was lower in the adolescent group (20.4+/-3.4 vs 30+/-8 years, p<0.05). Compared to controls, higher rates of adolescents were school dropouts, had problems with the law and were involved in domestic violence (87% vs 9.9%, 7.5% vs 0.5%, 44.7% vs 2.5%, respectively, p <0.05). None of the adolescents were living with mother and father in a complete family structure. Parental illiteracy was higher among adolescents (9% vs 3.5%, p < 0.05). CONCLUSION: In this low socio-economic population, early sexual initiation, poor reproductive health knowledge and the disruption of family structure were the main social factors related to pregnancy among adolescents aged 15 or less.

Adolescent↗
PubMed1999

Physicians' perceptions of the status of adolescent health care within the military health system.

OBJECTIVE: To describe the nature of the health care delivered to dependent adolescents throughout the military and compare services provided in adolescent medicine clinics with those provided in other medical departments and clinics. METHOD: Questionnaires were sent to physicians in pediatrics, internal medicine, family practice, primary care, emergency care, and adolescent medicine at 101 randomly selected military treatment facilities. A subsample of experts was selected to provide facility-specific, informed, representative information on the care provided to adolescents. RESULTS: Sixty-six percent (N = 345) of physicians returned completed questionnaires, providing information on 100% of the facilities sampled. More than half of responders felt that adolescents avoided care in their department. Two-thirds of all physicians, and three-fourths of the expert subsample, believed that adolescents are best served within adolescent medicine clinics. The expert subsample reported that adolescents served in facilities with adolescent medicine clinics received broader services. Only 28% of the facilities sampled provided any specialized adolescent medicine services. CONCLUSION: The military health care system has made progress in providing care to adolescent dependents, but reaching larger numbers of adolescents requires additional efforts.

Adolescent↗
PubMed2002

Longitudinal study of the number and choice of leisure time physical activities from mid to late adolescence: implications for school curricula and community recreation programs.

BACKGROUND: Physical activity (PA) declines during adolescence. There has been little research describing this decline or examining participation and nonparticipation in specific activities. OBJECTIVE: To describe the pattern of change in the number of physical activities, the time spent on specific activities, and the stability of participation and nonparticipation in specific activities during adolescence. DESIGN AND SETTING: A population-based 4-year longitudinal study of adolescents recruited from a single suburban school district near Pittsburgh, Pa. PARTICIPANTS: A total of 782 adolescents, aged 12 to 15 years at baseline. MAIN OUTCOME MEASURES: Physical activity was measured annually via questionnaire. Outcome measures include hours per week of PA, number of reported activities, and participation (yes or no) in specific activities. RESULTS: Physical activity declined during the 4 years by 26%. The decline in PA was primarily due to a decrease in the number of reported activities. Adolescents who continued to report an activity during the 4 years of the study maintained or increased the time spent on that specific activity. Female adolescents were more likely to report individual activities, while male adolescents were more likely to report team activities. The probability of maintaining participation in a specific activity during the 4 years was low to moderate, 0.02 to 0.47 for female adolescents and 0.04 to 0.71 for male adolescents. The probability of not participating in a specific activity during the 4 years was extremely high and consistent for male and female adolescents, 0.70 to 1.00. CONCLUSIONS: The decline in PA during adolescence is primarily due to a decrease in the number of activities in which the adolescent is participating, and there is only a moderate probability that an adolescent will continue to participate in an activity during the 4-year period from junior to senior high. Future efforts should be directed at identifying factors associated with initiating and maintaining participation in specific activities.

Adolescent↗
PubMed2006

Trends in the association of poverty with overweight among US adolescents, 1971-2004.

CONTEXT: Prevalence of adolescent overweight in the United States has increased substantially during the past 3 decades. Whether socioeconomic disparities in adolescent overweight increased, decreased, or remained constant during this period is not known. OBJECTIVE: To examine trends in adolescent overweight from 1971 to 2004 by family poverty status, as well as trends in potentially relevant eating and physical activity behaviors. DESIGN, SETTING, AND PARTICIPANTS: Four cross-sectional, nationally representative surveys (US National Health and Nutrition Examination Surveys [NHANES] of 1971-1974, 1976-1980, 1988-1994, and 1999-2004) were examined for trends in the prevalence of overweight among adolescents aged 12 to 17 years by family poverty status. MAIN OUTCOME MEASURES: Prevalence of adolescent overweight, defined as body mass index at or above the 95th percentile for age and sex in the 2000 Centers for Disease Control and Prevention growth charts. Intermediate outcomes were physical inactivity in the past 30 days, proportion of caloric intake from sweetened beverages (24-hour recall), and whether respondent skipped breakfast (24-hour recall). RESULTS: Trends in the association of adolescent overweight with family poverty differed by age stratum (P = .01). In 12- to 14-year-old adolescents, prevalence did not significantly differ by family poverty status in any of the surveys; however, among non-Hispanic black adolescents, overweight prevalence increased faster in nonpoor vs poor families. In contrast, a widening disparity that disfavored adolescents from poor families was present in the 15- to 17-year-old adolescents. This trend was similar among male, female, non-Hispanic white, and non-Hispanic black adolescents, resulting in an overall prevalence of overweight in 1999-2004 more than 50% higher among adolescents in poor vs nonpoor families (23.3% vs 14.4%, respectively; P<.001). Additional analyses suggest that physical inactivity, sweetened beverage consumption, and skipping breakfast may contribute to these disparities. CONCLUSIONS: Trends of increasing overweight showed a greater impact in families living below the poverty line vs not living below the poverty line among older (15-17 years) but not younger (12-14 years) adolescents. Furthermore, physical inactivity, high consumption of sweetened beverages, and breakfast skipping may be candidate targets for prevention programs aimed at reducing this recently emerged disparity.

Adolescent↗
PubMed2004

Differences between adolescents' and parents' reports of health-related quality of life in cystic fibrosis.

Our objective was to determine the magnitude and direction of differences between adolescents with cystic fibrosis (CF) and their parents' reports of the adolescents' health-related quality of life (HRQOL) as measured by the adolescent and parent versions of the Child Health Questionnaire (CHQ). Sixty-two adolescents (mean age, 13.7 years; 46% female; mean forced expired volume in 1 sec, 73%) completed the 87-item adolescent form, and their parents (79% mothers; 77% working full or part time) completed the 50-item parent form of the CHQ during a routine clinic visit. For each scale, ANOVA was used to determine pairwise differences between adolescent and parent scale scores. For scales in which a significant parent-adolescent difference existed, ANCOVA was used to determine disease and demographic factors independently associated with differences in scores. Finally, responses for each pair were compared only on similarly worded items within each scale. For the full CHQ scales, adolescents rated their HRQOL significantly better than did their parents with regard to General Health (mean difference, 12.4 points), Role Function/Physical (mean difference, 9.0 points), Behavior (mean difference, 4.8 points), and Physical Function (mean difference, 4.0 points). No demographic or health factor was associated consistently with differences in parent-adolescent scores. When only similarly worded items were compared, adolescents still tended to rate their HRQOL better, but the difference was significant only for General Health (P = 0.0005), where adolescents rated themselves less susceptible to illness and less worried about their health than their parents. In conclusion, optimal measurement of adolescent HRQOL will likely require determining both parent and adolescent perceptions of HRQOL.

Adolescent↗
PubMed2002

The relationship between adolescent academic capability beliefs, parenting and school grades.

The purpose of this study was to examine the interplay between parenting, adolescent academic capability beliefs and school grades. First, we examined how aspects of parenting and adolescent's cognitive ability predicted adolescent academic capability beliefs and school grades at 6th grade, which, in turn, predicted adolescent school outcomes at 9th grade. Second, we examined how configurations of adolescents (based on cognitive ability, parental involvement, and capability beliefs) at 6th grade, related to their school grades at 9th grade. The sample included 641 German adolescents. The first set of analyses suggest that parents who demonstrated more warmth, engaged in more discussions concerning academic and intellectual matters with their adolescents, had higher school aspirations for their adolescents, and reported more interest/involvement in their adolescent's schooling, had adolescents with higher capability beliefs at 6th grade, and this, in turn, related to better school grades for adolescents at 9th grade. In the second set of analyses, results show that adolescents who were characterized by the configuration of having above average ability, parental school involvement and capability beliefs, received the best school grades. In contrast, adolescents who were characterized by below average ability, parental school involvement and capability beliefs, demonstrated the worst school performance.

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