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PubMedDate not supplied

Reconceptualizing adolescent sexual behavior: beyond did they or didn't they?

CONTEXT: Adolescent sexual behavior is typically studied as a dichotomy: Adolescents have had sex or they have not. Broadening this view would lead to a greater understanding of teenagers' sexual behavior. METHODS: Interview data from 907 high school students in Alabama, New York and Puerto Rico were used to examine the relationships between sexual experience and a variety of social, psychological and behavioral variables. Four groups of teenagers are compared: those who did not anticipate initiating sex in the next year (delayers), those who anticipated initiating sex in the next year (anticipators), those who had had one sexual partner (singles) and those who had had two or more partners (multiples). RESULTS: Compared with delayers, anticipators reported more alcohol use and marijuana use; poorer psychological health; riskier peer behaviors; and looser ties to family school and church. Similarly, multiples reported more alcohol and marijuana use, riskier peer behaviors and looser ties to family and school than singles. Risk behaviors, peer behaviors, family variables, and school and church involvement showed a linear trend across the four categories of sexual behavior. CONCLUSIONS: The traditional sex-no sex dichotomy obscures differences among sexually inexperienced teenagers and among adolescents who have had sex. Prevention efforts must be tailored to the specific needs of teenagers with differing sexual experiences and expectations, and must address the social and psychological context in which sexual experiences occur.

Adolescent↗
PubMed2000

Sport participation, risk taking, and health risk behaviors.

Adolescents participate in sports for a variety of reasons. Some seem to enjoy participating in what some might consider very-high-risk or "extreme" sports activities. For some adolescents risk taking becomes pervasive and can be detrimental to normal health and development. The majority of adolescents will do well in the context of athletics, and the many positive benefits of regular physical activity and sports participation should be appropriately emphasized. However, a subset of adolescents may be at greater risk for adverse consequences. This article reviews the reasons for participation and attrition from sports, the phenomenon of thrill seeking in sports, certain risk-taking behaviors of athletes, and studies comparing health risk behaviors in athletes and non-athletes.

Adolescent↗
PubMed2004

Relationship between methamphetamine use and risky sexual behavior in adolescents.

Substance abuse and risky sexual behavior have been identified as behaviors that can endanger adolescent psychosocial development. This study examined the relationship between methamphetamine (MAMP) use and risky sexual behavior in adolescents. Risky sexual behavior was compared not only between MAMP users and non-users, but also between high-frequency and low-frequency MAMP users. We compared the sexual intercourse histories of 85 adolescents formally charged as MAMP users with those of 170 gender-matched adolescents with no record of MAMP use. MAMP usage characteristics were compared between users who had and those who had not experienced sexual intercourse. Previous sexual experience was more likely in MAMP users than in non-users. MAMP users were also more likely to have had a greater total number of sexual partners and were more likely to have had unplanned sex under the influence of alcohol. High-frequency MAMP use was associated with increased tendencies to engage in unprotected sex and to use MAMP before sexual intercourse. In general, the chance of sexual intercourse increased in proportion to frequency of MAMP use. Given the clear link between MAMP use and risky sexual behavior, risk-reduction programs directed at teen MAMP users are urgently needed.

Adolescent↗
PubMed2005

Gender and ethnic differences in the co-occurrence of adolescent risk behaviors.

OBJECTIVES: We consider gender and ethnic differences in the co-occurrence of adolescent behaviors related to health and well-being. DESIGN: Using a nationally representative sample of adolescents in the National Longitudinal Survey of Youth (1997-2000), we examine behavior among students as well as school drop-outs. We use latent class models (LCMs) to identify subpopulations of adolescents with similar patterns of co-occurring behaviors. The generalizability of the findings for African American adolescents in the 1970s is considered using a sample of inner-city youth from the Pathways to Adulthood Survey. RESULTS: For all ethnic groups, we find a subpopulation with 'problem behavior' characteristics (in which early sexual initiation, alcohol use, smoking, marijuana use, and truancy are all highly prevalent). This cluster is most common among European American adolescents and among young men. A subpopulation characterized by behaviors often leading to poor social outcomes (e.g. truancy, early sexual initiation and fighting) is most common for African American adolescents, especially young African American men. CONCLUSION: Our findings suggest that multi-factorial interventions which address the interrelationships between all of the behaviors are relevant regardless of gender or ethnicity. However, the ethnic and gender differences in the likelihood of specific patterns of interrelationships highlight the importance of considering the ethnic and gender composition of a population when developing future research and interventions.

Adolescent↗
PubMed2000

Sexual behavior change among human immunodeficiency virus-infected adolescents with hemophilia. Adolescent Hemophilia Behavioral Intervention Evaluation Project Study Group.

PURPOSE: To determine the factors associated with the adoption or maintenance of consistent safer sexual behaviors among human immunodeficiency virus-positive adolescents and young adults with hemophilia. METHODS: One hundred eleven adolescents at 10 hemophilia care sites participated in an intervention program designed to increase safer sexual behaviors (abstinence, condom use, or nonpenetrative behavior). The theory-based intervention spanned 1 year. Adolescents attended individual sessions, small group activities, and an intensive group retreat. RESULTS: Patients who maintained or improved safer sexual behaviors were compared with those who relapsed or did not improve. Logistic regression analyses found that improvement and maintenance of safer sexual behavior were significantly associated with perceived peer support for outercourse (odds ratio [OR]: 5.47; confidence interval [CI]: 1.4-20.8), perceived peer support for abstinence (OR: 5.08; CI: 1.2-20.1), and decreased general emotional distress (OR: 4.65; CI: 1.04-20.6). Perceived health status and previous sexual behavior were unrelated to change in safer sexual behavior. CONCLUSIONS: These longitudinal data indicate that improvement and maintenance of safer sexual behavior among adolescents during an intervention is strongly associated with perceptions of peer support for safer sex and lesser degrees of emotional distress. Programs for human immunodeficiency virus-infected adolescents may require developmentally appropriate social and psychological approaches to impact peer norms and emotional well-being.

Adolescent↗
PubMed2005

The association of early adolescent problem behavior with adult psychopathology.

OBJECTIVE: The authors investigated whether the association between adolescent problem behavior and adult substance use and mental health disorders was general, such that adolescent problem behavior elevates the risk for a variety of adult disorders, or outcome-specific, such that each problem behavior is associated specifically with an increased risk for disorders clinically linked to that behavior (e.g., early alcohol use with adult alcohol abuse). METHOD: A population-based group of 578 male and 674 female twins reported whether they had ever engaged in, and the age of initiation of, five adolescent problem behaviors: smoking, alcohol use, illicit drug use, police trouble, and sexual intercourse. Participants also completed a structured clinical interview at both ages 17 and 20 covering substance use disorders, major depressive disorder, and antisocial personality disorder. Data were analyzed with simple bivariate methods, survival analysis, and structural equation analysis. RESULTS: Each problem behavior was significantly related with each clinical diagnosis. The association was especially marked for those who had engaged in multiple problem behaviors before age 15. Among those with four or more problem behaviors before age 15, the lifetime rates of substance use disorders, antisocial personality disorder, and major depressive disorder exceeded 90%, 90%, and 30% in males and 60%, 35%, and 55% in females, respectively. The association between the clinical diagnoses and adolescent problem behavior was largely accounted for by two highly correlated factors. CONCLUSIONS: Early adolescent problem behavior identifies a subset of youth who are at an especially high and generalized risk for developing adult psychopathology.

Adolescent↗
PubMedDate not supplied

Health-related behavior and adolescent mothers.

OBJECTIVE: To explore health-related behaviors among adolescent mothers living in the rural area of Taoyuan, Taiwan. DESIGN: A cross-sectional descriptive design and nonrandom survey method were used. SAMPLE: The sample consisted of 37 adolescent mothers, identified by public health nurses. MEASUREMENTS: Standardized interview and Adolescent Health Promotion (AHP) questionnaire. RESULTS: Findings revealed a pattern of economic disadvantage. Nearly half of the participants still lived with their biological parents. Two-thirds needed economic support from their parents (generally coming from their biological mother). Thirty-five percent of participants reported never using contraceptives, two-thirds had never had a Pap smear, and 44% did not breast-feed their infants. Nearly 60% of the children were cared for by the biological mothers of the participants. Adolescent mothers with high school education, and who were employed, married, and received parental economic support had better health-related behaviors than adolescent mothers without these characteristics. CONCLUSIONS: Although the study sample has geographic limitations, future international studies with similar populations of adolescent mothers in rural settings will help public health nurses understand adolescent mothers' stressors and needs which in turn affect their health-related behaviors. Intervention strategies are needed to encourage behaviors to keep this population healthy.

Adolescent↗
PubMedDate not supplied

Implications of racial and gender differences in patterns of adolescent risk behavior for HIV and other sexually transmitted diseases.

CONTEXT: Sexual and substance use behaviors covary in adolescence. Prevalence of HIV and other sexually transmitted diseases (STDs) differs according to race and gender, yet few studies have systematically investigated risk behavior patterns by subgroup, particularly with nationally representative data. METHODS: A priori considerations and K-means cluster analysis were used to group 13,998 non-Hispanic black and white participants in the National Longitudinal Study of Adolescent Health, Wave 1, according to self-reported substance use and sexual behavior. Multinomial logit analyses examined racial and gender differences by cluster. RESULTS: Among 16 clusters, the two defined by the lowest risk behaviors (sexual abstinence and little or no substance use) comprised 47% of adolescents; fewer than 1% in these groups reported ever having received an STD diagnosis. The next largest cluster-characterized by sexual activity (on average, with one lifetime partner) and infrequent substance use-contained 15% of participants but nearly one-third of adolescent with STDs. Blacks were more likely than whites to be in this group. Black males also were more likely than white males to be in three small clusters characterized by high-risk sexual behaviors (i.e., having had sex with a male or with at least 14 partners, or for drugs or money). Black females generally were the least likely to be in high-risk behavior clusters but the most likely to report STDs. CONCLUSIONS: Adolescents' risk behavior patterns vary by race and gender, and do not necessarily correlate with their STD prevalence. Further investigation of adolescents' partners and sexual networks is needed.

Adolescent↗
PubMed2000

[Suicidal behavior in adolescents. What questions for the professional?].

Suicidal behaviors are a major public health concern, particularly among adolescents. Yet health care providers are often ill-prepared in dealing with at-risk adolescents, and particularly uncomfortable with the issue of suicide. By means of ten simple questions, the author tries to address some of the common queries of primary health care providers, hoping to increase their understanding of the phenomenon and their skills in detection, guidance and prevention.

Adolescent↗
PubMed1996

Cumulative sexual intercourse patterns among middle adolescents: problem behavior precursors and concurrent health risk behaviors.

PURPOSE: The purpose of this study is to document associations among problem behaviors in childhood and early adolescence and several health risk behaviors in middle adolescence, including a cumulative index of sexual intercourse risk. METHOD: A nontreatment sample of 1167 10th and 11th grade students was recruited from three homogeneous suburban high schools in western New York. Intercourse activity and number of sexual partners were assessed four times at 6-month intervals over a 2-year period via self-report questionnaires administered in classroom settings. RESULTS: Sexual intercourse activity, once initiated, was found to be relatively persistent, rather than sporadic, for most adolescents. Repeated intercourse experience with multiple partners over the assessed time periods was associated with higher levels of externalizing childhood behavior problems, earlier onset of antisocial behaviors and substance use, and higher concurrent substance use. An avoidant, withdrawn behavioral style in childhood was associated with lower rates of sexual involvement in adolescence. CONCLUSIONS: Temporal linkages among childhood precursors and adolescent sexual behaviors were identified as critical to understanding adolescent risk behaviors. These cross-time relationships may identify potential targets for future intervention/prevention efforts among high risk subsamples of children and adolescents.

Adolescent↗
PubMed2003

Adolescent risk behavior screening: the difference between patients who come in frequently and infrequently.

Charts were examined retrospectively to identify evidence of risk behavior screening in adolescents, identified from billing data as visiting at least 9 times during a 1-year period (n=55), frequent attenders (FA). These were matched 2:1 on age, gender, and ethnicity with 121 nonfrequent attenders (NFA), < or = 3 visits in 1 year. FA had more evidence of risk behavior screening than NFA, but less preventive care. Risk screening in males occurred less than in females in both FA and NFA. Chart review demonstrated many missed opportunities. Providers are encouraged to fully utilize well teen exams as well as acute visits for risk behavior screening.

Adolescent↗
PubMed2003

Youth Resilience Framework for reducing health-risk behaviors in adolescents.

Adolescents engage in risky behaviors that compromise their health. Leading causes of morbidity and mortality are associated with a few preventable health-risk behaviors initiated in childhood and early adolescence. Interventions that enhance protective factors in childhood are needed to offset these vulnerabilities and thus promote the health of adolescents. The Youth Resilience Framework is presented that addresses individual and sociocultural risk factors and protective resources that can influence health outcomes throughout adolescence. This framework incorporates a developmental approach to address precursors and health-risk behaviors that may be amenable to early health-promoting interventions.

Adaptation, Psychological↗
PubMed1998

Transtheoretical Model: examining adolescent exercise behavior.

PURPOSE: The entire Transtheoretical Model, consisting of stages of change, processes of change, self-efficacy, and decisional balance, was tested for its applicability to understanding exercise behavior in an adolescent population. METHODS: Students (n = 819) from five community high schools (Grades 9-12) completed self-administered questionnaires, all of which were adapted from previous literature. Stage of exercise behavior change served as the dependent variable. RESULTS: Distribution of the sample across the stages was: precontemplation, n = 17 (2.1%); contemplation, n = 34 (4.2%); preparation, n = 235 (28.7%); action, n = 129 (15.7%); and maintenance, n = 404 (49.3%). Univariate analyses of variance (p < 0.0038) followed up with Tukey's post-hoc analyses revealed that all of the constructs differed significantly across stages. Profile analysis indicated that pros and cons intersected in the action stage using t scores; however, when analyzing raw scores, this intersection was found to be in the precontemplation stage. DISCUSSION: Preliminary evidence was found for the applicability of the Transtheoretical Model to adolescents. The low rate of adolescents in the precontemplation and contemplation stages was not deemed a major limitation, owing to the purpose of the investigation.

Adolescent↗
PubMed2003

Familias Unidas: the efficacy of an intervention to promote parental investment in Hispanic immigrant families.

This paper reports a test of the efficacy of Familias Unidas, a Hispanic-specific, ecologically focused, parent-centered preventive intervention, in promoting protection against and reducing risk for adolescent behavior problems. Specifically, the intervention was designed to foster parental investment, reduce adolescent behavior problems, and promote adolescent school bonding/academic achievement, all protective factors against drug abuse and delinquency. One-hundred sixty seven Hispanic families of 6th and 7th grade students from three South Florida public schools were stratified by grade within school and randomly assigned to intervention and no-intervention control conditions. Results indicated that Familias Unidas was efficacious in increasing parental investment and decreasing adolescent behavior problems, but that it did not significantly impact adolescent school bonding/academic achievement. Summer-vacation rates of adolescent behavior problems were six times higher in the control condition than in the intervention condition. Furthermore, change in parental investment during the intervention was predictive of subsequent levels of adolescent behavior problems. The findings suggest that Familias Unidas is efficacious in promoting protection and reducing risk for adolescent problem behaviors in poor immigrant Hispanic families.

Adolescent↗
PubMed1975

Selected aspects of adolescent postpartum behavior.

Contraceptive, educational, and vocational behavior patterns of postpartum adolescents were examined. Eight months after delivery 269 teenage girls who participated in a comprehensive antepartum psycho-social program were mailed follow-up questionnaires. Eighty-three percent of teenage mothers who responded reported using birth control pills as a form of contraception. We found that single girls were more actively involved in vocational and educational training. This and other observations indicate that marital status of teenage participants is important to their postpartum actions.

Adolescent↗
PubMed2004

Correlates and predictors of violent behavior among adolescent drinkers.

PURPOSE: To examine a wide range of demographic characteristics and psychosocial factors to determine the cross-sectional correlates of violence and longitudinal predictors of violent initiation among adolescent drinkers. METHODS: We conducted secondary analyses of the 1995 (Time 1) and 1996 (Time 2) in-home surveys of the National Longitudinal Study of Adolescent Health (Add Health). This study included a nationally representative school-based sample (N=18,924) of adolescents in grades 7-12. The analyses were restricted to adolescent drinkers (n = 8885). Two logistic regression models were constructed using a backward elimination procedure to identify statistically significant cross-sectional correlates of violence and prospective predictors of violence initiation. RESULTS: Half (49%) of all adolescent drinkers reported violent behavior at Time 1 and 15% of those who were not violent at Time 1 reported initiating violent behavior at Time 2. A total of 14 significant cross-sectional correlates of violence were identified that included measures of alcohol use, drug use and selling, exposure to drugs, delinquency, and poor school functioning. Four variables (high-volume drinking, illicit drug use, low grade point average, and having been suspended and/or expelled from school) were significant longitudinal predictors of the initiation of violent behavior. CONCLUSIONS: The factors significantly associated with violence pertain mostly to alcohol use, drug use and selling, exposure to drugs, delinquency, and poor school functioning. However, most of these problems and behaviors tend to occur in closer temporal proximity to violent behavior (i.e., within a year) and do not seem to developmentally precede initiation in violent behavior.

Adolescent↗
PubMed2000

Adolescent sexual behavior in two ethnic minority groups: a multisystem perspective.

Adolescents are at high risk for a number of negative health consequences associated with early and unsafe sexual activity, such as infection with HIV and other sexually transmitted diseases, as well as unintended pregnancy. In the present study, a multisystem model was applied to one adolescent sexual behavior, penile-vaginal intercourse. Nine hundred seven Black and Hispanic adolescents (aged 14 to 17 years) and their mothers were interviewed. Factors from three systems (self, family, and extrafamilial) that are influential in the lives of adolescents were evaluated using four outcome measures. Factors from most or all systems emerged as predictors of each outcome measure. A cumulative risk index suggested a linear relationship between the number of systems identified as being at risk and indicators of adolescent sexual behavior. The implications for prevention are discussed.

Adolescent↗