Center for Adolescent Health

Allenstown Elementary School, United States

Center for Adolescent Health

Allenstown Elementary School, United States
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Maulik P.K.,Center for Adolescent Health | Tandon S.D.,Johns Hopkins University
Journal of Behavioral Health Services and Research | Year: 2011

Research related to mental health service use among vulnerable young adults is limited. This study used an expanded version of Andersen's Behavioral Model of Health Services Use to evaluate factors associated with the use of different types of mental health services among a sample of predominantly African-American 16-24 year olds (n=500) in an employment training program in Baltimore City. Results indicated that participants were more likely to have received mental health services in correctional facilities than in community- or school-based contexts. Use of mental health services in correctional facilities was significantly greater among males, those less than 18 years, and those who experienced more stressful events. Findings illustrate the need to develop seamless mental health services for vulnerable young adults in multiple contexts, including the criminal justice system. © 2010 NationalCouncil for Community Behavioral Healthcare.

Dariotis J.K.,Center for Adolescent Health | Pleck J.H.,University of Illinois at Urbana - Champaign | Astone N.M.,Center for Adolescent Health | Sonenstein F.L.,Center for Adolescent Health
Perspectives on Sexual and Reproductive Health | Year: 2011

CONTEXT: Racial and ethnic health disparities are an important issue in the United States. The extent to which racial and ethnic differences in STDs among youth are related to differences in socioeconomic characteristics and risky sexual behaviors requires investigation. METHODS: Data from three waves of the National Survey of Adolescent Males (1988, 1990-1991 and 1995) were used to examine 1,880 young men's history of STDs and their patterns and trajectories of sexual risk behavior during adolescence and early adulthood. Multinomial and logistic regression analyses were conducted to test whether racial and ethnic differences in STDs are due to the lower socioeconomic status and higher levels of risky sexual behavior among minority groups. RESULTS: Young black men reported the highest rates of sexual risk and STDs at each wave and across waves. Compared with white men, black and Latino men had higher odds of maintaining high sexual risk and increasing sexual risk over time (odds ratios, 1.7-1.9). In multivariate analyses controlling for socioeconomic characteristics, black men were more likely than white men to have a history of STDs (3.2-5.0); disparities persisted in analyses controlling for level of risky sexual behavior. CONCLUSIONS: Race and ethnicity continue to differentiate young black and Latino men from their white peers in terms of STDs. Prevention programs that target different racial and ethnic subgroups of adolescent men and address both individual- and contextual-level factors are needed to curb STD incidence. © 2011 by the Guttmacher Institute.

Dariotis J.K.,Center for Adolescent Health | Hafeez Q.,Dow University of Health Sciences
AIDS Patient Care and STDs | Year: 2010

The purpose of the study is to assess frequency and determinants of discussions between HIV-infected women and their HIV providers about childbearing plans, and to identify unmet need for reproductive counseling. We conducted a cross-sectional, audio computer-assisted self-interview (ACASI) among 181 predominately African American HIV-infected women of reproductive age receiving HIV clinical care in two urban health clinics. We used descriptive statistics to identify unmet need for reproductive counseling by determining the proportion of women who want to, but have not, discussed future reproductive plans with their primary HIV care provider. Multivariate analysis determined which factors were associated with general and personalized discussions about pregnancy. Of the 181 women interviewed, 67% reported a general discussion about pregnancy and HIV while 31% reported a personalized discussion about future childbearing plans with their provider. Of the personalized discussions, 64% were patient initiated. Unmet reproductive counseling needs were higher for personalized discussions about future pregnancies (56%) than general discussions about HIV and pregnancy (23%). Younger age was the most powerful determinant of provider communication about pregnancy. A significant proportion of HIV-infected women want to talk about reproductive plans with their HIV provider; however, many have not. HIV care providers and gynecologists can address this unmet communication need by discussing reproductive plans with all women of childbearing age so that preconception counseling can be provided when appropriate. Providers will miss opportunities to help women safely plan pregnancy if they only discuss reproductive plans with younger patients. © 2010, Mary Ann Liebert, Inc.

Turner A.K.,New York Academy of Sciences | Sonenstein F.,Center for Adolescent Health | Tandon S.D.,Johns Hopkins University
Drug and Alcohol Dependence | Year: 2011

Purpose: To examine the association between symptoms of psychiatric disorder (i.e. depression, anxiety, and substance use) and sexual risk behavior in a sample of African-American adolescents and young adults in an employment training program. Methods: Baseline data were used from a pilot study of an intervention to reduce depressive symptoms among youth disconnected from school and the workforce. Participants were recruited from two employment training programs in East and West Baltimore (N=617; age 16-23 years). Data were collected through audio computer-assisted self-interview (ACASI). Mental health indicators were measured using the Center for Epidemiological Studies Depression Scale and Beck Anxiety Inventory. Multivariate logistic regression was used to determine the odds of sexual risk behavior for each mental health condition and combinations of conditions. Results: Lack of condom use at last sex was significantly associated with elevated anxiety symptoms. Number of sexual partners was associated with elevated depression symptoms and substance use. Early sexual debut was associated with substance use in the past 30 days. Also, there were differences in the likelihood of engaging in sexual risk behavior comparing groups with different combinations of mental health problems to those with no symptoms of disorder or substance use. Conclusions: The results demonstrate the need for HIV prevention programs that target out-of-school youth, as they are likely to engage in risky sexual behavior. Our findings highlight the need to develop behavioral interventions that address disorder symptoms, substance use, and risky sexual behavior among youth in employment training programs. © 2010 Elsevier Ireland Ltd.

Steiner R.J.,Family and Reproductive Health | Sarah F.-K.,University of Kansas Medical Center | Sarah F.-K.,University of Missouri - Kansas City | Dariotis J.K.,Center for Adolescent Health | Dariotis J.K.,Hopkins Population Center
American Journal of Public Health | Year: 2013

Provider-initiated conversations with people living with HIV about reproductive plans are lacking. Providers must know whether their patients want to bear children to tailor treatment and refer for HIV preconception counseling to help achieve patients' reproductive goals while minimizing transmission to partners and children. The early focus on men who have sex with men largely excluded consideration of the epidemic's impact on reproductive health. We used a historical review of the US epidemic to describe the problem's scope and understand if this legacy underlies the current neglect of reproductive planning. Drawing on peer-reviewed literature, we discuss key themes relevant to assessing and understanding attention to desires for children among HIV-positive people. We conclude with recommendations for addressing persistent stigma and enhancing patient-provider communication about reproductive intentions. © 2013 American Journal of Public Health.

Dariotis J.K.,Center for Adolescent Health | Dariotis J.K.,University of Cincinnati | Johnson M.W.,Johns Hopkins University
Experimental and Clinical Psychopharmacology | Year: 2015

Youth under 25 show substantial sexual and substance use risk behaviors. One factor associated with risk behaviors is delay discounting, the devaluation of delayed outcomes. This study determined if delay discounting for sexual outcomes is related to sexual risk and substance use among 18-24 year olds. Females (70) and males (56) completed the Sexual Discounting Task, which assessed their likelihood of having unprotected immediate sex versus waiting for sex with a condom, at various delays, with 4 hypothetical sexual partners selected from photographs: the person they most wanted to have sex with, least wanted to have sex with, judged most likely to have a sexually transmitted infection (STI), and judged least likely to have an STI. They also completed instruments assessing HIV knowledge, sexual behaviors, substance use, risk attitudes, inhibition, impulsivity, and sensation-seeking. Condom use likelihood generally decreased with increasing delay. Preference for immediate, unprotected sex was greater for partners whom participants most (vs. least) wanted to have sex with and judged least (vs. most) likely to have an STI. Preference for immediate, unprotected sex in the "most want to have sex with" and "least likely to have an STI" conditions was related to greater lifetime risky sexual partners, lifetime number of unique substances used, disregard of social approval/danger, disinhibition, and sensation/excitement-seeking. Males showed greater likelihood of unprotected sex than females when condom use was undelayed, but delay similarly affected condom use between sexes. Delay discounting should be considered in strategies to minimize youth risk behavior. © 2014 American Psychological Association.

Pearson S.,Menzies Research Institute | Schmidt M.,Menzies Research Institute | Schmidt M.,University of Georgia | Patton G.,Center for Adolescent Health | And 4 more authors.
Diabetes Care | Year: 2010

OBJECTIVE - To examine the association between depressive disorder and insulin resistance in a sample of young adults using the Composite International Diagnostic Interview to ascertain depression status. RESEARCH DESIGN AND METHODS - Cross-sectional data were collected from 1,732 participants aged between 26 and 36 years. Insulin resistance was derived from blood chemistry measures of fasting insulin and glucose using the homeostasis model assessment method. Those identified with mild, moderate, or severe depression were classified as having depressive disorder. RESULTS - The 12-month prevalence of depressive disorder was 5.4% among men and 11.7% among women. In unadjusted models mean insulin resistance was 17.2% (95% CI 0.7-36.0%, P = 0.04) higher in men and 11.4% (1.5-22.0%, P = 0.02) higher in women with depressive disorder. After adjustment for behavioral and dietary factors, the increased level of insulin resistance associated with depressive disorder was 13.2% (-3.1 to 32.3%, P = 0.12) in men and 6.1% (-4.1 to 17.4%, P = 0.25) in women. Waist circumference was identified as a mediator in the relationship between depression and insulin resistance, reducing the β coefficient in the fully adjusted models in men by 38% and in women by 42%. CONCLUSIONS - A positive association was found between depressive disorder and insulin resistance in this population-based sample of young adult men and women. The association seemed to be mediated partially by waist circumference. © 2010 by the American Diabetes Association.

Leslie E.,Deakin University | Kremer P.,Deakin University | Toumbourou J.W.,Deakin University | Toumbourou J.W.,Center for Adolescent Health | Williams J.W.,Center for Adolescent Health
Journal of Science and Medicine in Sport | Year: 2010

Active travel (walking or cycling for transport) is an important contributor to adolescents overall physical activity (PA). This study examines associations between personal, social and environmental variables and active travel to and from school using data from a large observational study to examine active travel in 2961 year 6 and 8 students (48.7% male), aged 10-14 years (M = 11.4, SD = 0.8. yrs) from 231 schools. Participants completed an on-line survey and all reported living within 2. km of school. Data collected included mode of travel to and from school, self-reported health, and PA variables. Social environmental variables included having playgrounds, parks or gyms close by, feeling safe to walk alone, barriers to walking in the neighbourhood (e.g. traffic, no footpaths), peer and family support for PA, existence of sports teams/scout groups, community disorder and perceived neighbourhood safety. Results showed that while more girls (44.3%) than boys (37.4%) walked to school, lower proportions rode bikes (8.3% vs 22.4%) and hence fewer were active travellers overall. Logistic regression models, adjusted for age, location and socio-economic status were conducted for active travel to/from school, separately for boys and girls. Predictors for boys and girls being 'active travellers' to/from school included recreational facilities close to home, higher perceived safety of the neighbourhood and higher community disorder. For boys, social support from friends, scout groups available and higher enjoyment of physical activity was also important. These findings suggest areas for future research and may be used to guide strategies to increase active travel to and from school. © 2010 Sports Medicine Australia.

Chan G.C.K.,University of Queensland | Kelly A.B.,University of Queensland | Toumbourou J.W.,Deakin University | Toumbourou J.W.,Center for Adolescent Health | Toumbourou J.W.,Murdoch Childrens Research Institute
Journal of Studies on Alcohol and Drugs | Year: 2013

Objective: Heavy alcohol use increases dramatically at age 14, and there is emerging cross-sectional evidence that when girls experience family conflict at younger ages (11-13 years) the risk of alcohol use and misuse is high. This study evaluated the role of family conflict and subsequent depressed mood in predicting heavy alcohol use among adolescent girls. Method: This was a three-wave longitudinal study with annual assessments (modal ages 12, 13, and 14 years). The participants (N = 886, 57% female) were from 12 metropolitan schools in Victoria, Australia, and participants completed questionnaires during school class time. The key measures were based on the Communities That Care Youth Survey and included family conflict (Wave 1), depressed mood (Wave 2), and heavy alcohol use (Wave 3). Control variables included school commitment, number of peers who consumed alcohol, whether parents were living together, and ethnic background. Results: With all controls in the model, depressed mood at Wave 2 was predicted by family conflict at Wave 1. The interaction of family conflict with gender was significant, with girls showing a stronger association of family conflict and depressed mood. Depressed mood at Wave 2 predicted heavy alcohol use at Wave 3. Conclusions: Girls may be especially vulnerable to family conflict, and subsequent depressed mood increases the risk of heavy alcohol use. The results support the need for gender-sensitive family-oriented prevention programs delivered in late childhood and early adolescence. © 2013 Rutgers University.

Robert A.C.,Center for Adolescent Health | Sonenstein F.L.,Center for Adolescent Health
Journal of Adolescent Health | Year: 2010

Purpose: We examine trends in adolescents' reports of discussion with parents about sexually transmitted diseases (STDs) and birth control methods from 1988 to 2002. Methods: Data from the 1988 and 1995 National Survey of Adolescent Males, and the 1988, 1995, and 2002 National Survey of Family Growth were analyzed to evaluate changes in discussions of female adolescents with parents about birth control methods and STDs, and changes in male adolescent discussions with parents about birth control methods. The sample includes never married males and females aged 15-17 years. Results: In 2002, fewer female adolescents reported discussion with a parent about STD or birth control methods than in 1995. The share of female adolescents in 2002 reporting no discussion of either topic with their parents increased by almost half compared to 1995. Patterns across time in male adolescents' discussions of birth control methods with their parents appear stable. Conclusions: The recent decline in female adolescent reports of parent-communication about birth control and STDs, and the increase in female adolescent reports of no discussion of either topic suggest that public health officials, educators, and clinicians should invigorate their efforts to encourage parents to talk with their children about STDs and birth control. © 2010 Society for Adolescent Health and Medicine.

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