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Protecting adolescents from harm: findings from the National Longitudinal Study on Adolescent Health

Protecting adolescents from harm: findings from the National Longitudinal Study on Adolescent Health

  1. Calliope
    JAMA, The Journal of the American Medical Association, Sept 10, 1997, Vol.278(10), p.823(10)

    Resnick, Michael D. ; Bearman, Peter S. ; Blum, Robert Wm. ; Bauman, Karl E. ; Harris, Kathleen M. ; Jones, Jo ; Tabor, Joyce ; Beuhring, Trish ; Sieving, Renee E. ; Shew, Marcia ; Ireland, Marjorie ; Bearinger, Linda H. ; Udry, J. Richard

    Abstract
    Context. -- The main threats to adolescents' health are the risk behaviors they choose. How their social context shapes their behaviors is poorly understood. Objective. -- To identify risk and protective factors at the family, school, and individual levels as they relate to 4 domains of adolescent health and morbidity: emotional health, violence, substance use, and sexuality. Design. -- Cross-sectional analysis of interview data from the National Longitudinal Study of Adolescent Health. Participants. -- A total of 12 118 adolescents in grades 7 through 12 drawn from an initial national school survey of 90 118 adolescents from 80 high schools plus their feeder middle schools. Setting. -- The interview was completed in the subject's home. Main Outcome Measures. -- Eight areas were assessed: emotional distress; suicidal thoughts and behaviors; violence; use of 3 substances (cigarettes, alcohol, marijuana); and 2 types of sexual behaviors (age of sexual debut and pregnancy history). Independent variables included measures of family context, school context, and individual characteristics. Results. -- Parent-family connectedness and perceived school connectedness were protective against every health risk behavior measure except history of pregnancy. Conversely, ease of access to guns at home was associated with suicidality (grades 9-12: P[is less than].001) and violence (grades 7-8: (P[is less than] .001; grades 9-12: P[is less than].001). Access to substances in the home was associated with use of cigarettes (P[is less than .001), alcohol (P[is less than].001), and marijuana (P[is less than].001) among all students. Working 20 or more hours a week was associated with emotional distress of high school students (P[is less than].01), cigarette use (P[is less than].001), alcohol use (P[is less than].001), and marijuana use (P[is less than].001). Appearing "older than most" in class was associated with emotional distress and suicidal thoughts and behaviors among high school students (P[is less than].001); it was also associated with substance use and an earlier age of sexual debut among both junior and senior high students. Repeating a grade in school was associated with emotional distress among students in junior high (P[is less than].001) and high school (P[is less than].01) and with tobacco use among junior high students (P[is less than].001). On the other hand, parental expectations regarding school achievement were associated with lower levels of health risk behaviors; parental disapproval of early sexual debut was associated with a later age of onset of intercourse (P[is less than].001). Conclusions. -- Family and school contexts as well as individual characteristics are associated with health and risky behaviors in adolescents. The results should assist health and social service providers, educators, and others in taking the first steps to diminish risk factors and enhance protective factors for our young people.