Naomi N. Duke

Adolescent violence perpetration: associations with multiple types of adverse childhood experiences.

OBJECTIVE: Adverse childhood experiences are associated with significant functional impairment and life lost in adolescence and adulthood. This study identified relationships between multiple types of adverse events and distinct categories of adolescent violence perpetration. METHODS: Data are from 136 549 students in the 6th, 9th, and 12th grades who responded to the 2007 Minnesota Student Survey, an anonymous, self-report survey examining youth health behaviors and perceptions, characteristics of primary socializing domains, and youth engagement. Linear and logistic regression models were used to determine if 6 types of adverse experiences including physical abuse, sexual abuse by family and/or other persons, witnessing abuse, and household dysfunction caused by family alcohol and/or drug use were significantly associated with risk of adolescent violence perpetration after adjustment for demographic covariates. An adverse-events score was entered into regression models to test for a dose-response relationship between the event score and violence outcomes. All analyses were stratified according to gender. RESULTS: More than 1 in 4 youth (28.9%) reported at least 1 adverse childhood experience. The most commonly reported adverse experience was alcohol abuse by a household family member that caused problems. Each type of adverse childhood experience was significantly associated with adolescent interpersonal violence perpetration (delinquency, bullying, physical fighting, dating violence, weapon-carrying on school property) and self-directed violence (self-mutilatory behavior, suicidal ideation, and suicide attempt). For each additional type of adverse event reported by youth, the risk of violence perpetration increased 35% to 144%. CONCLUSIONS: Multiple types of adverse childhood experiences should be considered as risk factors for a spectrum of violence-related outcomes during adolescence. Providers and advocates should be aware of the interrelatedness and cumulative impact of adverse-event types. Study findings support broadening the current discourse on types of adverse events when considering pathways from child maltreatment to adolescent perpetration of delinquent and violent outcomes.

From adolescent connections to social capital: predictors of civic engagement in young adulthood

PURPOSE This study examined the ability of adolescent connection in family and community contexts to promote an aspect of healthy youth development and transition into adulthood, civic engagement. METHODS Data are from Wave 1 (1995) and Wave 3 (2001-2002) of the in-home interviews from the National Longitudinal Study of Adolescent Health. The sample for this study included 9130 young adults aged 18-26 years. Linear and logistic regression models were used to measure the influence of connection in family and community contexts (Wave 1) on outcomes of civic engagement in young adulthood (Wave 3). RESULTS Stronger connection in all family and community contexts during adolescence predicted greater likelihood of voting, community volunteer service, involvement in social action/solidarity groups, education groups, and/or conservation groups, and endorsement of civic trust in young adulthood. Select connections in family and community contexts were also significant predictors of political voice/involvement and blood product donation. In a final multivariate model, frequency of shared activities with parent(s) and school connection during adolescence emerged as unique predictors of young adult civic engagement. CONCLUSIONS Connections in family and community contexts during adolescence promote healthy youth development through facilitation of multiple aspects of civic engagement in young adulthood. The importance of these connections in fostering youth capacity to bond to a broader community construct is discussed.

Examining Youth Hopelessness as an Independent Risk Correlate for Adolescent Delinquency and Violence

Prior research has identified a relationship between youth hopelessness and violence perpetration within specific groups of young people. The purpose of this study was to evaluate the relationship between youth hopelessness and violence perpetration in a population-based sample of adolescents. This study is a cross-sectional analysis of data from 136,549 students in the 6th, 9th, and 12th grades responding to the 2007 Minnesota Student Survey. Logistic regression models were used to evaluate the relationship between hopelessness and youth violence perpetration, including comparison analyses for gender and race/ethnic subgroups as well as adjustment for a measure of poor-low affect. One in four youth (25.1%) reported levels of hopelessness at least enough to bother them in the previous month. Moderate-high levels of hopelessness exhibited a statistically significant independent relationship with a range of violence-related outcomes for youth subgroups: delinquent behavior, weapon carrying on school property, and all forms of self-directed violence. Relationships between hopelessness and interpersonal and intimate partner violence suggest a greater contribution by poor affective functioning for some groups. Interventions designed to reduce youth violence perpetration may benefit from increased strategies to address youth hopelessness as well as youth mental health in general.

Adolescent Perception of Premature Risk for Death: Contributions from Individual and Environmental Contextual Factors

OBJECTIVE Adolescent perception of premature risk for death is a cause of great concern. This study identified individual and environmental characteristics of youth expressing perception of premature risk for death. METHODS Data are from Waves 1 (1995) and 3 (2001-2002) of the in-home interviews from the National Longitudinal Study of Adolescent Health. The study sample included 12,103 adolescents and 10,519 parents (Wave 1) and 9130 young adults (Wave 3). Logistic regression models were used to determine contexts for health risk, connection, safety and monitoring, individual/developmental, and caregiver/family characteristics associated with adolescent early death perception. RESULTS One in 7 youth endorsed perceived risk for early demise. After controlling for demographic factors, adolescent early death perception is a powerful marker for high-risk status, including involvement in self-destructive behaviors (odds ratio [OR] 1.32-13.97, P = .01-P <.001) and physical and psychological distress (OR 8.33-39.37, P < .001). Alternately, models for stronger connection in the primary socializing domains, perceptions of safety, academic achievement, outlets for participation, and better caregiver capacity offered significant protective effect (OR 0.10-0.91, P < .001). In a final multivariate model, unique relationships between adolescent early death perception and health risk behavior and exposure, adult and peer connection, mental health, and parent/family economic security emerged. CONCLUSIONS Study findings support further research into constructs for premature death perception as a potential mechanism to facilitate intervention with youth who may be at risk for further negative life trajectories, including depressive reactions and extreme reactions to future adverse life events.

Adult Perceptions of Neighborhood: Links to Youth Engagement.

Context is important in facilitating healthy youth development. The purpose of this study was to examine the relationship between adult perception of neighborhood and youth engagement in organized activities. This study is a secondary data analysis of 64,076 parents and guardians of school-age youth and adolescents (6-17 years), participating in the 2007 National Survey of Children’s Health. Linear and logistic regression models were used to evaluate the relationship between neighborhood characteristics, including constructs for social capital, physical condition, resource availability, and safety, and youth engagement through participation in sports, clubs, other creative events, and volunteer service. Neighborhood characteristics were significantly associated with the odds of multiple forms of youth engagement even with adjustment for individual and family-level demographic characteristics. Findings support assessment of neighborhood context during health education and behavior counseling in addition to capacity building for deliberate mechanisms of community development offering youth the ability to connect and engage.

Adolescent condom use consistency over time: global versus partner-specific measures.

Background: The conundrum of measuring condom use consistency, particularly with adolescents, has left researchers with a cacophony of strategies, thereby limiting comparability and interpretation. Objective: The aim of this analysis was to compare and contrast two measures of condom use consistency, global versus partner specific, and their relationships with key covariates, using trajectory groups differentiated by stability of condom use consistency over three time points. Method: Using self-report data from sexually active girls (aged 13-17 years) in a clinic-based intervention study aimed at lowering risk for early pregnancy, this analysis compared two measures of self-reported condom use consistency: (a) a global measure: overall condom use consistency in the past 6 months and (b) a partner-specific measure: condom use consistency with the most recent sex partner in the last 6 months. Using a subjective rule-based approach, the adolescent girls in the study (n = 151) were classified into trajectory groups representing their condom use consistency at three time points (baseline and 6 and 12 months). Then, using bivariate methods, trajectory groups were compared on four baseline covariates (age, treatment condition, hormonal use in the last 6 months, and number of sex partners in the last 6 months) and three time-varying covariates measured at baseline and at 6 and 12 months (hormonal use stability, stability of primary sex partner, and stability of number of sex partners). Results: For the trajectory groups formed using the global measure of condom use consistency, stability of the primary sex partner differed significantly between trajectory groups. For the partner-specific trajectory groups, two baseline and one time-varying covariate relationships were significant: hormonal use in the 6 months prior to baseline, number of sex partners in the past 6 months (baseline), and stability of the primary sex partner (time varying), with hormonal use stability (time varying) trending toward significance. Discussion: The larger number of significant covariate relationships with the partner-specific trajectory groups suggests greater utility in assessing partner-linked behavior rather than a global measure. Despite limitations of the analytic strategy, this study sheds light on a measurement conundrum that has been an obstacle to comparing and contrasting indicators of condom use consistency during adolescence.

Trends in the Association of Obesity and Self‐Reported Overall Health in 30 Years of the Integrated Health Interview Series

This research examines trends in the relationship between obesity based on self‐report height and weight and self‐perceived health over a 30‐year period. Importantly, this period included the articulation of comprehensive public health campaigns on excess weight and thus provides opportunities for assessment of the efficacy of the campaign, as well as the broader psycho‐social impact of excess weight. Using novel data from the Integrated Health Interview Series, odds ratios for the association between obesity and self‐perceived health were estimated for repeated cross‐sectional samples that are nationally representative of noninstitutionalized American adults aged 18–85 and older spanning 1976–2006. Our findings show that (i) there are weak associations between obesity and self‐perceived poor health; (ii) these associations are particularly small among men, often to the point of being nonexistent; and (iii) weak relationships for both men and women have remained virtually unchanged over the past 30 years. Several reasons why the public health campaign around excess weight has had limited traction are discussed including the collective problem of excess weight in America and how this undermines current approaches in public health efforts addressing excess weight.

Culturally Sensitive Community Engaged Research With African American Young Women: Lessons Learned

The use of culturally sensitive research approaches is of paramount importance in conducting community-engaged research with African American communities. The purpose of this article is to describe the development and use of culturally and community sensitive research methods in a study to understand social messages about pregnancy and childbearing among low-income urban African American adolescent girls. Key elements of this community accepted focused ethnography study are described, including study design, recruitment, data collection, and analysis techniques.

Early Death Perception in Adolescence: Identifying Factors Associated With Change From Pessimism to Optimism About Life Expectancy

US teens overestimate risk for early death. The purpose of this study was to identify factors associated with an adolescent’s change from early death perception to a belief in living into adulthood. Data are from 9140 adolescents participating in waves 1 (1995) and 2 (1996) of the National Longitudinal Study of Adolescent Health. Logistic regression models were used to determine contexts of healthy and unhealthy change associated with the likelihood of early death perception change. Youth report of increased caring and connection to other adults and increased self-esteem were associated with greater likelihood of moving from pessimism to optimism about life expectancy (P = .003 and P = .038, respectively). Reductions in self-esteem and poorer perception of health were associated with decreased odds of death perception change (P = .017 and P = .011, respectively). Nurturing positive connections with adults and strategies that improve a youth’s self-esteem offer 2 opportunities to facilitate adolescent early death perception change.

Schooling, Skills, and Self-rated Health A Test of Conventional Wisdom on the Relationship between Educational Attainment and Health

Education is a key sociological variable in the explanation of health and health disparities. Conventional wisdom emphasizes a life course–human capital perspective with expectations of causal effects that are quasi-linear, large in magnitude for high levels of educational attainment, and reasonably robust in the face of measured and unmeasured explanatory factors. We challenge this wisdom by offering an alternative theoretical account and an empirical investigation organized around the role of measured and unmeasured cognitive and noncognitive skills as confounders in the association between educational attainment and health. Based on longitudinal data from the National Longitudinal Survey of Youth-1997 spanning mid-adolescence through early adulthood, results indicate that (1) effects of educational attainment are vulnerable to issues of omitted variable bias, (2) measured indicators of cognitive and noncognitive skills account for a significant proportion of the traditionally observed effect of educational attainment, (3) such skills have effects larger than that of even the highest levels of educational attainment when appropriate controls for unmeasured heterogeneity are incorporated, and (4) models that most stringently control for such time-stable abilities show little evidence of a substantive association between educational attainment and health.