Aubrey Spriggs Madkour

Early Adolescent Sexual Initiation as a Problem Behavior: A Comparative Study of Five Nations

PURPOSE Using a Problem Behavior Theory framework, this article examines the extent to which psychosocial correlates of early sexual initiation (before age 16) vary across developed nations. METHODS Fifteen-year-old participants (n = 5,624) in the 1997-1998 World Health Organization collaborative Health Behavior in School-Aged Children survey (Finland, Scotland, France, and Poland) and the 1996 U.S. Add Health survey self-reported substance use (alcohol and tobacco), school attachment, positive parental communication, and early sexual intercourse experience. Stratifying by gender, we performed univariate, bivariate, and multivariable analyses controlling for family socioeconomic status, family structure, and nation fixed effects. RESULTS Self-reported early sexual experience, substance use, school attachment, and positive communication with parents varied significantly across nations for both boys and girls. In both crude and adjusted analyses, substance use was positively associated with early sexual experience among boys and girls across nations, although associations were stronger in Europe than in the United States (adjusted odds ratio [AOR]; range, 1.56-3.74). School attachment was similarly inversely related to early sexual experience among boys and girls across nations (AOR range, .63-.94). However, positive parent communication was significantly inversely related to early sexual experience only among U.S. females (AOR .50). CONCLUSIONS Findings overall supported the fit of early adolescent sexual initiation as a risk behavior within a Problem Behavior Theory framework cross-nationally, suggesting that similar factors could be targeted to prevent early sexual initiation across some developed nations. However, further research is warranted examining the temporality of these relationships.

Predictors of Birth Weight and Gestational Age Among Adolescents

Although pregnant adolescents are at high risk of poor birth outcomes, the majority of adolescents go on to have full-term, healthy babies. Data from the National Longitudinal Study of Adolescent Health, a longitudinal study of a nationally representative sample of adolescents in grades 7-12 in the United States who were surveyed from 1994-1995 through 2008, were used to examine the epidemiology of preterm birth and low birth weight within this population. Outcomes of pregnancies were reported by participants in the fourth wave of data collection (when participants were 24-32 years of age); data were compared between female participants who reported a first singleton livebirth at less than 20 years of age (n = 1,101) and those who were 20 years of age or older (n = 2,846). Multivariable modeling was used to model outcomes; predictors included demographic characteristics and maternal health and behavior. Among black adolescents, low parental educational levels and older age at pregnancy were associated with higher birth weight, whereas low parental educational levels and being on birth control when one got pregnant were associated with higher gestational age. In nonblack adolescents, lower body mass index was associated with lower birth weight, whereas being unmarried was associated with lower gestational age. Predictors of birth outcomes may differ by age group and social context.

Area disadvantage and intimate partner homicide: an ecological analysis of North Carolina counties, 2004-2006.

Using data from the North Carolina Violent Death Reporting System and other sources, we examined ecologic relationships between county (n = 100) disadvantage and intimate partner homicide (IPH), variability by victim gender and county urbanicity, and potential mediators. County disadvantage was related to female-victim homicide only in metropolitan counties (incidence rate ratio [IRR] 1.25); however, disadvantage was associated with male-victim IPH regardless of county urbanicity (IRR 1.17). None of the potential intervening variables examined (shelter availability, intimate partner violence services’ funding) was supported as a mediator. Results suggest disparities across North Carolina counties in IPH according to county disadvantage. Future research should explore other potential mediators (i.e., service accessibility and law enforcement responses), as well as test the robustness of findings using additional years of data.

Academic performance, educational aspiration and birth outcomes among adolescent mothers: a national longitudinal study

BackgroundMaternal educational attainment has been associated with birth outcomes among adult mothers. However, limited research explores whether academic performance and educational aspiration influence birth outcomes among adolescent mothers.MethodsData from Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health) were used. Adolescent girls whose first pregnancy occurred after Wave I, during their adolescence, and ended with a singleton live birth were included. Adolescents’ grade point average (GPA), experience of ever skipping a grade and ever repeating a grade, and their aspiration to attend college were examined as predictors of birth outcomes (birthweight and gestational age; n = 763). Univariate statistics, bivariate analyses and multivariable models were run stratified on race using survey procedures.ResultsAmong Black adolescents, those who ever skipped a grade had higher offspring’s birthweight. Among non-Black adolescents, ever skipping a grade and higher educational aspiration were associated with higher offspring’s birthweight; ever skipping a grade was also associated with higher gestational age. GPA was not statistically significantly associated with either birth outcome. The addition of smoking during pregnancy and prenatal care visit into the multivariable models did not change these associations.ConclusionsSome indicators of higher academic performance and aspiration are associated with better birth outcomes among adolescents. Investing in improving educational opportunities may improve birth outcomes among teenage mothers.

Disaster and Youth Violence: The Experience of School-Attending Youth in New Orleans

PURPOSE Although disaster exposure has been linked with increased child aggression by previous reports, population-level trends are unknown. Pre- to post-Katrina changes in violence-related behaviors among New Orleans high school youth (ages: 12-18 years) were assessed. METHODS Data from the 2003 (pre-Katrina), 2005 (pre-Katrina), and 2007 (post-Katrina) New Orleans Youth Risk Behavior Survey (n = 5,267) were used. Crude comparisons across years of population characteristics and violence behavior prevalence were made with χ(2) analyses. Changes in violence-related behaviors over time were assessed with logistic regression models including indicators for survey years and controls for compositional changes. RESULTS Age, gender, and race/ethnicity of school-attending youth were stable across years. In models controlling for demographics, most behaviors were stable over time. Some changes were observed for all groups; dating violence and forced sex increased before the storm, whereas weapon-carrying and missing school as a result of feeling unsafe decreased after the storm. Among African American adolescents only, being threatened at school increased before Katrina. CONCLUSIONS Results do not support significant population-level increases in violent behavior post-Katrina among school-attending youth in New Orleans. Factors that buffered New Orleans students from post-Katrina violence increases, such as population composition changes or increased supportive services, may explain these findings.

Personality and adolescent pregnancy outcomes.

AIMS To examine the relationship between personality, pregnancy and birth outcomes in adolescents. BACKGROUND Personality has been shown to be a strong predictor of many health outcomes. Adolescents who become pregnant have worse birth outcomes than adults. DESIGN Cross-sectional study using data from the National Longitudinal Study of Adolescent Health (baseline, 1994-1995; follow-up, 2007-2008). METHODS The study sample was 6529 girls, 820 of whom reported on pregnancy outcomes for a teenage birth. Personality data were taken from the Mini International Personality Item Pool personality tool, which measures the five-factor personality traits of neuroticism, conscientiousness, intellect/imagination, extraversion and agreeableness. Logistic regression was used to predict teen pregnancy and linear regression was used to predict birth weight and gestational age with adjustment for confounders and stratification by race. RESULTS Agreeableness and intellect/imagination were associated with a reduced likelihood of becoming pregnant as an adolescent, while neuroticism, conscientiousness and extraversion were all associated with an increased likelihood of becoming pregnant. Higher neuroticism was associated with lower birth weight and gestational age among Black girls, but not non-Black. Conscientiousness was associated with lower gestational age among non-Black girls. No relationships were found with extraversion or agreeableness and birth outcomes. Receiving late or no prenatal care was associated with higher intellect/imagination. CONCLUSIONS Personality is understudied with respect to pregnancy and birth outcomes compared with other health outcomes. Such research could help professionals and clinicians design and target programmes that best fit the characteristics of the population most likely to need them, such as those with high neuroticism.

Pre-Pregnancy Dating Violence and Birth Outcomes Among Adolescent Mothers in a National Sample

Although infants born to adolescent mothers are at increased risk of adverse birth outcomes, little is known about contributors to birth outcomes in this group. Given past research linking partner abuse to adverse birth outcomes among adult mothers, we explored associations between pre-pregnancy verbal and physical dating violence and the birth weight and gestational age of infants born to adolescent mothers. Data from the National Longitudinal Study of Adolescent Health Waves I (1995/1996), II (1996), and IV (2007/2008) were analyzed. Girls whose first singleton live births occurred after Wave II interview and before age 20 (N = 558) self-reported infants’ birth weight and gestational age at Wave IV. Dating violence victimization (verbal and physical) in the 18 months prior to Wave II interview was self-reported. Controls included Wave I age, parent education, age at pregnancy, time between reporting abuse and birth, and childhood physical and sexual abuse. Weighted multivariable regression models were performed separately by race (Black/non-Black).On average, births occurred 2 years after Wave II interview. Almost one in four mothers reported verbal dating violence victimization (23.6%), and 10.1% reported physical victimization. Birth weight and prevalence of verbal dating violence victimization were significantly lower in Black compared with non-Black teen mothers. In multivariable analyses, negative associations between physical dating abuse and birth outcomes became stronger as time increased for Black mothers. For example, pre-pregnancy physical dating abuse was associated with 0.79 kilograms lower birth weight (p< .001) and 4.72 fewer weeks gestational age (p< .01) for Black mothers who gave birth 2 years post-reporting abuse. Physical dating abuse was unassociated with birth outcomes among non-Black mothers, and verbal abuse was unassociated with birth outcomes for all mothers. Reducing physical dating violence in adolescent relationships prior to pregnancy may improve Black adolescent mothers’ birth outcomes. Intervening on long-term violence may be particularly important.

Perceived Discrimination and Heavy Episodic Drinking Among African-American Youth: Differences by Age and Reason for Discrimination.

PURPOSE The purpose of this study was to examine whether associations between perceived discrimination and heavy episodic drinking (HED) vary by age and by discrimination type (e.g., racial, age, physical appearance) among African-American youth. METHODS National data from the Panel Study of Income Dynamics Transition to Adulthood Study were analyzed. Youth participated in up to four interviews (2005, 2007, 2009, 2011; n = 657) between ages 18 and 25 years. Respondents reported past-year engagement in HED (four or more drinks for females, five or more drinks for males) and frequency of discriminatory acts experienced (e.g., receiving poor service, being treated with less courtesy). Categorical latent growth curve models, including perceived discrimination types (racial, age, and physical appearance) as a time-varying predictors of HED, were run. Controls for gender, birth cohort, living arrangement in adolescence, familial wealth, parental alcohol use, and college attendance were explored. RESULTS The average HED trajectory was curvilinear (increasing followed by flattening), whereas perceived discrimination remained flat with age. In models including controls, odds of HED were significantly higher than average around ages 20-21 years with greater frequency of perceived racial discrimination; associations were not significant at other ages. Discrimination attributed to age or physical appearance was not associated with HED at any age. CONCLUSIONS Perceived racial discrimination may be a particularly salient risk factor for HED around the ages of transition to legal access to alcohol among African-American youth. Interventions to reduce discrimination or its impact could be targeted before this transition to ameliorate the negative outcomes associated with HED.

Parent-child Relationships, Parental Attitudes towards Sex, and Birth Outcomes among Adolescents

STUDY OBJECTIVE To examine how parent-child relationships, parental control, and parental attitudes towards sex were related to pregnancy outcomes among adolescent mothers. DESIGN Prospective cohort study. Parental report of relationship satisfaction, disapproval of adolescent having sex, discussion around sexual health, and sexual communication attitudes, and adolescent report of relationship satisfaction, parental control, and parental disapproval of sex were examined as predictors of self-reported birth outcomes. Weighted multivariable linear regression models were run incorporating interactions by race. SETTING United States. PARTICIPANTS 632 females who participated in Waves I and IV of the National Longitudinal Study of Adolescent Health (Add Health), a nationally-representative sample of students enrolled in grades 7-12 in 1994-95 and followed up in 2007-2008. MAIN OUTCOME MEASURES Birthweight and gestational age. RESULTS For Black adolescents, better parent-child relationship was associated with higher birthweight (0.14 kg, P < .05) and gestational age (0.75 weeks, P < .01), while higher parental disapproval of having sex (adjusted beta 0.15 kg, P < .05) were associated with higher birthweight. For non-Black adolescents, a moderate amount of discussion of birth control was associated with higher birthweight (0.19 kg, P < .01 and lower child-perceived parental disapproval of having sex was associated with higher birthweight (0.08 kg, P < .05) and gestational age (0.37 weeks, P < .05). Higher parental control was associated with a reduced likelihood of smoking during pregnancy and a greater likelihood of early prenatal care. CONCLUSION Parent-child relationships and attitudes about sex affect outcomes of pregnant adolescents.

Preconception Nutrition, Physical Activity, and Birth Outcomes in Adolescent Girls.

STUDY OBJECTIVE Recommendations for preconception care usually include optimal nutrition and physical activity, but these have not been tested extensively for their relationship with birth outcomes such as low birth weight and preterm birth. DESIGN Data from Waves I, II, and IV of the National Longitudinal Study of Adolescent Health (Add Health) contractual dataset were used. METHODS In Wave I in-home interview, participants were asked to recall their frequency of having 5 types of food on the previous day, including milk, fruit, vegetables, grains, and sweets. At Wave II, participants reported the previous days intake of 55 items, and results were categorized into high-calorie sweet, high-calorie nonsweet, and low-calorie food. At Wave I in-home interview, participants were also asked how many times in a week or during the past week they were involved in types of physical activity. At Wave IV, female participants reported pregnancies and birth outcomes. Multivariable linear regression analysis with survey weighting was used to predict birth weight and gestational age. RESULTS There were no associations between reported food intake and birth outcomes. Girls who engaged in more episodes of active behavior had higher birth weights (P < .01), but hours of sedentary behavior was not associated with birth weight. Multivariable analysis also indicated a U-shaped association between BMI and birth weight (P for quadratic term = .01). CONCLUSION Adolescents who are more physically active before pregnancy have more positive birth outcomes as represented by birth weight.