Frances M. Costa

Protective factors in adolescent health behavior.

The role of psychosocial protective factors in adolescent health-enhancing behaviors--healthy diet, regular exercise, adequate sleep, good dental hygiene, and seatbelt use--was investigated among 1,493 Hispanic, White, and Black high school students in a large, urban school district. Both proximal (health-related) and distal (conventionality-related) protective factors have significant positive relations with health-enhancing behavior and with the development of health-enhancing behavior. In addition, in cross-sectional analyses, protection was shown to moderate risk. Key proximal protective factors are value on health, perceived effects of health-compromising behavior, and parents who model health behavior. Key distal protective factors are positive orientation to school, friends who model conventional behavior, involvement in prosocial activities, and church attendance. The findings suggest the importance of individual differences on a dimension of conventionality-unconventionality. Strengthening both proximal and distal protective factors may help to promote healthful behaviors in adolescence.

Adolescent Problem Behavior in China and the United States: A Cross-National Study of Psychosocial Protective Factors

An explanatory model of adolescent problem behavior (problem drinking, cigarette smoking, and general delinquency) based on protective and risk factors in the individual and in 4 social contexts (family, peer group, school, and neighborhood) is employed in school-based samples from the People’s Republic of China (N 51,739) and the United States (N 51,596). Despite lower prevalence of the problem behaviors in the Chinese sample, especially for girls, a substantial account of problem behavior is provided by the same protective and risk factors in both countries and for both genders. Protection is generally higher in the Chinese sample than in the U.S. sample, but in both samples protection also moderates the impact of risk. Despite mean differences in psychosocial protective and risk factors, as well as in problem behavior, in the 2 samples—differences that may reflect societal variation— the explanatory model has, to a large extent, cross-national generality.

Adolescent health behavior and conventionality-unconventionality: an extension of problem-behavior theory.

Examined the relation of psychosocial and behavioral conventionality-unconventionality to health-related behavior in cross-sectional data from 1,588 male and female 7th to 12th graders. Conventionality-unconventionality was represented by personality, perceived social environment, and behavior variables selected from the social-psychological framework of problem-behavior theory (R. Jessor & S. L. Jessor, 1977). Greater psychosocial conventionality correlates with more regular involvement in health-related behavior (regular physical activity, adequate sleep, safety belt use, attention to healthy diet). Greater behavioral conventionality (less involvement in problem behaviors such as marijuana use, problem drinking, delinquent-type behavior, and greater involvement in conventional behaviors such as church attendance) was also associated with greater involvement in health-maintaining behavior. The overall findings provide support for the extension of problem-behavior theory to the domain of adolescent health behavior and for the relevance of the dimension of conventionality-unconventionality.

Structure of health-enhancing behavior in adolescence: A latent-variable approach.

The structure of the interrelations among a variety of health-enhancing behaviors was examined using structural equation modeling analyses of questionnaire data from 1,280 middle school students and 2,219 high school students. The health-enhancing behaviors included seat belt use, adequate hours of sleep, attention to healthy diet, adequate exercise, low sedentary behavior, and regular toothbrushing. In the middle school sample, all of the health-enhancing behaviors correlated significantly but modestly with each other, except for sleep with toothbrushing. In the high school sample, all but three of the 15 correlations among the behaviors were significant. The results further show that a single underlying factor can account for the modest correlations among these health-enhancing behaviors in both samples. The generality of the single-factor model was also established for male, female, White, Hispanic, and Black students at each school level. These findings provide some support for the existence of health-related lifestyles in adolescence.

The Role of Social Contexts in Adolescence: Context Protection and Context Risk in the United States and China

A theoretical framework about protective factors (models protection, controls protection, support protection) and risk factors (models risk, opportunity risk, vulnerability risk) was employed to articulate the content of 4 key contexts of adolescent life—family, peers, school, and neighborhood—in a cross-national study of problem behavior among 7th-, 8th-, and 9th-grade adolescents in the United States (n = 1,596) and the Peoples Republic of China (n = 1,739). Results were very similar in both samples and across genders. Measures of protection and risk in each of the 4 contexts uniquely contributed to the account of problem behavior involvement even when individual-level measures of protection and risk were controlled. Context protection was also shown to moderate individual-level risk and protection in 1 context moderated risk within that context and in other contexts. Controls protection—protection provided by rules, regulations, and expected sanctions for transgression from adults and peers—was the most important measure of context protection in all but 1 context. The family and peer contexts were the most influential in the U.S. sample, and the peer and school contexts were the most influential in the Chinese sample; the neighborhood context was least influential in both samples.

Adolescent cigarette smoking: health-related behavior or normative transgression?

Relations among measures of adolescent behavior were examined to determine whether cigarette smoking fits into a structure of problem behaviors—behaviors that involve normative transgression—or a structure of health-related behaviors, or both. In an ethnically and socioeconomically diverse sample of 1782 male and female high school adolescents, four first-order problem behavior latent variables—sexual intercourse experience, alcohol abuse, illicit drug use, and delinquency—were established and together were shown to reflect a second-order latent variable of problem behavior. Four first-order latent variables of health-related behaviors—unhealthy dietary habits, sedentary behavior, unsafe behavior, and poor dental hygiene—were also established and together were shown to reflect a second-order latent variable of health-compromising behavior. The structure of relations among those latent variables was modeled. Cigarette smoking had a significant and substantial loading only on the problem-behavior latent variable; its loading on the health-compromising behavior latent variable was essentially zero. Adolescent cigarette smoking relates strongly and directly to problem behaviors and only indirectly, if at all, to health-compromising behaviors. Interventions to prevent or reduce adolescent smoking should attend more to factors that influence problem behaviors.

Psychosocial conventionality, health orientation, and contraceptive use in adolescence

PURPOSE The purpose of this paper is to determine psychosocial and behavioral factors that are associated with variation in contraceptive use among adolescents. Because regular use of contraception may be seen both as a conventional behavior and as a health-protective behavior, analyses assess the association between psychosocial conventionality and health orientation, on the one hand, and variation in contraceptive use, on the other. METHODS Analyses are based on an urban sample of 971 white, African-American, and Hispanic male and female sexually active high school students. Study participants filled out a 38-page questionnaire that included a wide range of measures derived from Problem-Behavior Theory. RESULTS Correlational analysis and hierarchical regression analysis indicate that more regular contraceptive use is associated with greater psychosocial conventionality and also with greater orientation toward health for both male and female adolescents. These relationships hold when the sociodemographic characteristics of race/ethnicity, socioeconomic status, grade in school, family composition, and pregnancy experience are controlled. The linkages of psychosocial conventionality and health orientation to contraceptive behavior are stronger for African-American than for white and Hispanic adolescents. CONCLUSIONS The present findings establish a more comprehensive and more distal set of influences on regularity of contraceptive use. In its negative relationship to problem behavior and its positive linkage with health behavior, contraceptive behavior may be seen as part of a larger, organized system of behavior in this stage of development (i.e., a more conventional adolescent lifestyle).

Protective and risk factors in health-enhancing behavior among adolescents in China and the United States: does social context matter?

An explanatory model of adolescent health-enhancing behavior based on protective and risk factors at the individual level and in 4 social contexts was used in a study of school-based samples from the Peoples Republic of China (n = 1,739) and the United States (n = 1,596). A substantial account of variation in health-enhancing behavior--and of its developmental change over time--was provided by the model for boys and girls, and for the 3 grade cohorts, in both samples. In both samples, social context protective and risk factors accounted for more unique variance than did individual-level protective and risk factors, and context protection moderated both contextual and individual-level risk. Models protection and controls protection were of particular importance in the explanatory account.

Psychosocial correlates and antecedents of abortion: An exploratory study

Longitudinal data are used to examine the relation between young adult womens abortion experience and a variety of antecedent and subsequent personality, perceived environment, and behavior variables. About one-quarter of the women in two separate samples reported that they had had an abortion. Bivariate analyses show that young adult women who have had an abortion are characterized by greater psychosocial unconventionality than women who have not had an abortion. Similar differences along an underlying dimension of conventionality-unconventionality distinguish, antecedent to the abortion experience, women who would later have an abortion from those who would not. The findings are consistent with the expectations of Problem-Behavior Theory (Jessor & Jessor, 1977).

Problem Behavior Theory and the Dynamics of Protection and Risk

The relation of psychosocial protective factors to involvement in problem behavior—alcohol and drug use, delinquency, and sexual precocity—was investigated in a longitudinal study of 7th-, 8th-, and 9th-grade adolescents in a large, urban school district. Protective factors were drawn from the personality, the perceived environment, and the behavior systems of Problem Behavior Theory. The findings show a significant inverse relation between protection and problem behavior involvement. There is a significant interaction between protection and risk in the prediction of problem behavior: Protection is shown to moderate the relation of risk to problem behavior. Protective factors are also significant predictors of change in adolescent problem behavior over time. Direct effects of protection are consistent across all gender and racial/ethnic subgroups; moderator effects are evident for female, White, and Hispanic subgroups only.