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I. Introduction:
Adolescence is a period
of intense change, characterized by a number of biological, emotional,
psychological, and social transitions. In addition, for many adolescents,
family and social environments do not always provide the support and guidance
adolescents need to make responsible decisions about engaging in risky
health behavior. Adolescence thus poses some unique concerns for those
working to improve the health of teens. This module presents a number
of important concepts regarding adolescent health, including: risk factors
for development; problems with access to health care; the effects of age,
race, and sex on adolescent health; and recommendations for improving
adolescents' access to quality health care. The module includes (1) information
on trends in adolescent health with links to resources; (2) a reference
list of recommended readings; and (3) links to websites that provide useful
information regarding adolescent health.
II. Goals
and Objectives of Module:
- To provide an overview
of adolescents' current access to health care
- To present several
key risk factors to adolescent development and well-being
- To consider the
impact of race, gender, age, socioeconomic status, and sexual orientation
on adolescent health
- To provide recommendations
for improving adolescents' access to health care
- To make available
resources (both in print and on the Internet) that will provide understanding
of key issues in the arena of adolescent health.
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III. Lecture Notes:
Issues
in Adolescent Health (in
PowerPoint)
Risky
Sexual Behavior among Adolescents (in
PowerPoint)
Health Status Overview
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| 1.
Adolescence Defined |
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a.
According to the US Census Bureau, there are approximately
41.7 million adolescents living in the U.S. (2003).
Census Bureau Population Estimates .
b. Adolescence
(age 10-19) is the transitional stage between childhood and
adult life.
c.
Adolescence, one of the most dynamic stages of human development,
is a time of very profound physical, cognitive, emotional
and social changes. -- Bright
Futures.org
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| 2.
Poverty Statistics |
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a. Poverty
is the most influential factor affecting adolescent health
(Klein, Slap, Elster, and Schonberg, 1992).
According
to the
Children's Defense Fund:
b. 16.6%
of children under 18 are poor.
c. The 2000
poverty rates vary significantly according to race and ethnicity.
- 11.2%
of white children are poor.
- 33.1%
of black children are poor.
- 27.8%
of Hispanic children are poor.
- 14.3%
of Asian children are poor.
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| 3.
Health Insurance |
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a. According
to the 2003 Medical
Expenditure Panel Survey conducted by the Agency for Health
Care Research and Quality:
- 60.6%
of children had private health insurance.
- 27.5%
had public coverage.
- 11.9%
of children had no insurance.
b. This
same survey found insurance coverage varied according to race
and ethnicity:
- 20.8%
of Hispanic children were uninsured.
- 10.0%
of black children were uninsured.
- 9.6%
of white children were uninsured.
c. The
survey also reported that 90% of uninsured children lived
in households with a working adult.
d. An
estimated 11% of adolescents (12-17) have no health insurance.
--
CDC National Health Interview Survey, 2002
e. Adolescents
from low-income families (<$35,000) are nearly seven times
as likely to be in fair or poor health than those from higher-income
families (Singer & Hussey, 1995).
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| 4.
Healthy People 2010 |
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a. Healthy
People 2010 is a federal initiative to improve the health
of Americans through prevention. Healthy People 2010 was developed
through the Office of Disease Prevention and Health Promotion
and the U.S. Department of Health and Human Services and through
the efforts of more than 400 national membership organizations.
b. The
overall goals are to
- Increase
the span of healthy life.
- Reduce
health disparities.
c. The
plan groups a range of specific health promotion and disease
prevention objectives under ten leading health indicators.
-- Healthy
People Factsheet
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Sexual Behaviors
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| 1.
Trends |
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a. The
CDC
Youth Risk Behavior Surveillance System (YRBSS) measures
adolescent risk behaviors through national, state and local
surveys. The 2003 YRBSS surveyed more than 15,000 respondents.
46.7% of high school students reported having had sexual intercourse.
- 32.8%
of ninth grade students.
- 61.6%
of twelve grade students.
- Overall, the prevalence of having had sexual intercourse is higher among black students (67.3%) than Hispanic (51.4%) than white students (41.8%).
b. The
2003
YRBSS indicated that 37% of sexually active high school
students had not used a condom during their last incident
of sexual intercourse.
c. According to the same survey, among the 34.3% of current sexually active adolesecents nationwide, 25.4% had drunk alcohol or used drugs before last sexual intercourse.
d. Reports in the popular press indicate that oral sex among adolescents is becoming more prevalent. Teens view oral sex as a behavior to avoid pregnancy risk, but many are unaware of the risk of STDS associated with oral sex. It is important for teenagers to have an understanding of the full meaning of sexuality and of the importance of defining sex as a whole range of behaviors (Remez, 2000).
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2. Pregnancy
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a. More
than 870,000 U.S. adolescent females become pregnant every
year making the U.S. have the highest rate among developed
countries. -- Maternal
and Child Health Bureau: "Child Health USA 2002 "
b. According
to a
2004 Children's Defense Fund report , 1 in 9 babies is born
to a teen-age mother.
c. The
federal government's 2003 annual report, "America's
Children: Key National Indicators of Well-being," states
that the adolescent birth rate declined one-third, from 39
to 25 births per 1,000, between 1991 and 2001. The 2001 adolescent
birth rate is a record low for the U.S.
d.According to the
Child Health USA 2002 report, birth rates varied considerably by race and ethnicity. Birth rates for adolescents 15-19 were:
- 41.7 per 1,000 for whites
- 73.1 per 1,000 for blacks
- 92.4 per 1,000 for Hispanics
- 65.7 per 1,000 for American Indians
- 20.5 per 1,000 for Asian or Pacific Islanders
e. The largest decline in the teen birth rate has been among black teens, while the least amount of decline is among Hispanic teens, who currently have the highest teen birth rate of all five racial and ethnic groups.
–Child Health USA 2002
f. Conditions
associated with teen childbearing:
- having
economically disadvantaged families and communities,
- performing
poorly in school and holding low aspirations for their own
educational achievement,
- having
dysfunctional families, and
- having
substance abuse and behavioral problems. -- 2004 KIDS COUNT data book
g. "A
child born to an unmarried, teenage, high school dropout is
10 times as likely to be living in poverty as a child born to
a mother with none of these characteristics." -- 2004
KIDS COUNT data book
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| 3. STDs
and HIV |
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a. According
to the 2003 YRBSS, about 3 million adolescents contract a sexually transmitted
disease each year.
b. Each
year young people (ages 5-24) account for 25% of the new cases
of HIV and 25% of the new cases of STDs. CDC
Adolescent and School Health Data
c. Among
youth (ages 5-24) HIV infection accounted for 2% of all deaths
in 1998. 1999
YRBSS
d. HIV
infection was the sixth leading cause of death in young adults
(ages 15-24) in 1997. Health
and Human Services Press Release
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Substance use / abuse
| 1.
Cigarette Use |
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a. The
National Institute on Drug Abuse demonstrated in the 2003
Monitoring the Future Survey that 24.4% of 12th
and 10.2% of 8th graders reported smoking during
the preceding month.
b. In
2000, daily smoking rates varied according to ethnicity.
c. The
1999 National
Household Survey on Drug Abuse (NHSDA) found that, among
youths aged 12 to 17 years, 41.1 percent of past month smokers
reported past month use of an illicit drug as compared to
5.6 percent of the adolescent non-smokers.
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| 2.
Alcohol Use |
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a. In
the 2003
Monitoring the Future Survey, 70.1% of high school seniors
reported the use of alcohol within the past year.
b.The
study also found that 6.7% of eighth graders and 18.2% of
10th graders and 30.9% of 12th graders reported having been drunk within the last month.
c.The
federal government's 2001 "America's
Children" Report indicates that heavy drinking (5
or more drinks in a row during the preceding 2 weeks) varied
according to ethnicity and gender. For example, among 12th
graders:
- 35%
of whites
- 31%
of Hispanics
- 12%
of blacks
- 37%
of 12th grade males
- 24%
of 12th grade females
d. The
2003 National Survey on Drug Use and Health
found that youth who started to drink before the age of 15
were 4 times more likely to develop alcohol dependence and
twice as likely to abuse alcohol as people who began drinking
at 21 years of age. -- National Survey on Drug Use and Health
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| 3.
Drug Use |
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a. In
the 2003 National Survey on Drug Use and Health,
11.2% of youth (ages 12 - 17) reported illicit drug use within
the past month.
b. In
this same study, 7.7% of youths (ages 12 - 17) reported marijuana
use within the past month.
c. The
2003
Monitoring the Future Survey found that 4.8% of high school
seniors reported having used cocaine at least once.
d. 1.1%
of 8th and 1.5% of 12th graders reported
having used heroin in the past year. Monitoring the Future
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| 4.
Perceived Behavior Risk |
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a. 34.9%
of the youth (age 12-17) surveyed in the 2003 National Survey on Drug Use and Health consider the use of marijuana once a month to be
a great risk.
b. 50%
of these surveyed youth consider the use of cocaine once a
month to be a great risk. This is a decrease from 72% in 1990.
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| 5.
Access to Controlled Substances in Schools |
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a. In
the U.S. Department of Justice's 1993 National Household Education
Survey, 29% of the students reported easy access to beer,
wine or marijuana at school.
b. 26%
of the students reported easy access to liquor.
c. 22%
of the students reported easy access to other drugs.
d. The
students who reported easy access to controlled substances
at school were more likely than others to know of violence
at schools. --
National Council of Juvenile and Family Court Judges Report
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Violence
| 1.
Homicides |
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a. According
to the CDC National Vital Statistics System, in 2000 the firearm
homicide rate for adolescents (ages 15-19) was 7.7 per 100,000
deaths, making homicide the second leading cause of death.
The 7.7 rate does represent a decrease from the 1995 rate
of 15.4 per 100,000 deaths.
b. The
2000 adolescent firearm homicide rate varied according to
race and gender.
- White
males - 2.5 per 100,000 deaths
- Black
males - 51.7 per 100,000 deaths
- Hispanic males- 21.9 per 100,000 deaths
- White
females - 0.9 per 100,000 deaths
- Black
females - 4.9 per 100,000 deaths
- Hispanic females - 2.0 per 100,000 deaths
"America's Children 2003"
c. Among
young people (ages 5-24) homicides cause 20% of all deaths.
-- CDC
Adolescent and School Health Data
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| 2.
Suicides |
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a. The
2003 YRBSS data shows that from 1991 to 2003, the percentage
of adolescents who had seriously considered attempting suicide
declined from 29% to 16.9%. CDC
Youth Risk Behavior Trends Fact Sheet
b. The 2003 YRBSS also found that the percentage of adolescents who
had seriously considered suicide during the previous year
varied according to race and gender.
- Male
12.8%
- Female
21.3%
- White
16.5%
- Black
12.5%
- Hispanic
18.1%
c. The
percentage of adolescents who had attempted suicide during
the previous year also varied according to race and gender.
d. 1,450
youth (less than 20 years old) died in firearm suicides in
1995. -- Children's
Defense Fund 1998 U.S. Profile
e. Everyday in America, 5 children or teens will commit suicide. -- Children's Defense Fund
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| 3.
Juvenile Violent Crime Rate |
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a. The
rate of juveniles arrested for violent crimes decreased from
506 arrests per 100,000 juveniles in 1993 to 276 per 100,000
in 2002. -- Office of Juvenile Justice and Delinquency Prevention
b. According
to the 2003
YRBSS, 26.9% of male and 6.7% of female students (grades
9-12) reported carrying a weapon (razor, knife, club or firearm)
at least once during the previous month.
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Unintentional Injury
| 1.
Trends |
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a. Unintentional
injuries is the leading cause of adolescent mortality and
accounts for more deaths than all other causes combined. --
America's Children 2003
b. Among
young people (ages 10-24) motor vehicle crashes cause 32.3%
of all deaths. -- 2003
YRBSS
c. Among
young people (ages 10-24) other injuries (falls, fires, drownings,
etc.) cause 11% of all deaths. -- 2003
YRBSS
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| 2.
Safety Measures |
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a. The
2003
YRBSS reported that 18.2% of the high school students
surveyed rarely or never wore a seatbelt.
b. In
this same survey, 30.2% of students reported having had ridden
with a driver who had been drinking alcohol during the preceding
month.
c. Half
of the motor vehicle deaths among youth (ages 5-24) are alcohol
associated. CDC
Adolescent and School Health Data
d. In
the 2003 YRBSS, 85.9% of students (9-12 grades) who rode bicycles
during the preceding 12 months reported rarely or never wearing
a bicycle helmet.
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| Access to Health Care
A position paper
by the Society for Adolescent Medicine identified 7 criteria for
evaluating adolescents' access to health care:
1. Availability
a. Recommendations
- Health care
providers and age appropriate services should be available in
all communities.
- Clinic location
and hours of operation should allow for adolescent attendance.
- Health care
services should be available in a variety of settings: community
health centers, school-based and school-linked health centers,
physicians' offices, family planning clinics, HMOs and hospitals
(Klein, Slap, Elster, and Schonberg, 1992).
b. Current Status
- The lack
of available health care services and transportation are serious
problems for rural youth (Klein et al., 1992).
- Low physician
participation in Medicaid can limit health care availability for
adolescents enrolled in Medicaid (Klein et al., 1992).
c. Model Programs
and Other Resources
2. Visibility
a. Recommendations
- Health services
should be convenient and recognizable -- access should not require
extensive planning by the adolescent.
- Health services
should include outreach to educate adolescents both on the use
of the health services and about the importance of preventive
health care (Klein et al., 1992).
b. Current Status
c. Model Programs
and Other Resources
3. Quality
a. Recommendations
- Service providers
should have a basic level of competence regarding adolescent health.
- Adolescents
should be satisfied with the quality of care received.
b. Current Status
- There is
a lack of providers trained on adolescent health care (Klein et
al., 1992).
- Only 11 states
mandate that insurance programs include preventive care for children
(Klein et al., 1992).
- 97.5% of
families of children with a usual source of health care reported
being "somewhat" or "very" satisfied with their care. -- Agency
for Health Care Research and Quality Research Findings
c. Model
Programs and Other Resources
4. Confidentiality
a. Recommendations
- Generally,
adolescents should be encouraged to involve their families in
their health concerns; however, confidentiality should be assured
(Klein et al., 1992).
b. Current Status
- Confidentiality
issues can prevent insured adolescents from using their parent's
policy (Klein et al., 1992).
c. Model
Programs and Other Resources
5. Affordability
a. Recommendations
- Insurance
programs should include preventive services and should allow for
additional time and intensity to meet adolescent-specific health
care needs.
- Employer
insurance programs should include adolescents as employees or
as dependents (Klein et al., 1992).
b. Current Status
- 60% of the
families who lacked health care cited affordability as the barrier
to receiving the necessary care.
- 27% of uninsured
children did not have a usual source of health care.
- Uninsured
children were over nine times more likely to have no usual source
of health care than were insured children. -- "America's
Children 2001"
- The health
insurance of many under-insured adolescents does not cover counseling,
substance abuse treatment or preventive care (Klein et al., 1992).
- Adolescents
with health insurance may not be able to afford out-of-pocket
co-payments (Klein et al., 1992).
c. Model Programs
and Other Resources
- Two federal
programs provide insurance coverage for adolescents from lower-income
families:
i. Medicaid
ii. Children's
Health Insurance Program
6. Flexibility
a. Recommendations
- Cultural,
ethnic and social diversity factors should be considered.
- Providers
should assist in the transition between receiving pediatric and
adult health care services (Klein et al., 1992).
b. Current Status
- The Institute
of Medicine found that some adolescents enrolled in Medicaid cannot
access health care because of culture, geography, or race barriers
(Klein et al., 1992)
7. Coordination
a. Recommendations
- Service providers
should ensure comprehensive services (e.g., medical, mental health,
social services) to adolescents.
- Service providers
should coordinate services when adolescents have to access multiple
service sites (Klein et al., 1992).
b. Current Status
- Adolescent
health care is often fragmented and office visits are often problem-oriented.
- 49% of adolescent
visits with physicians are 10 minutes or less in duration.
- 30% of adolescent
visits with physicians are 11-15 minutes in duration.
- The current
patchwork system of services may delay or prevent adolescents
from accessing care (Klein et al., 1992).
c. Model Programs
and Other Resources
- By 1989,
50% of the state Maternal and Child Health offices had adolescent
health coordinators (Klein et al., 1992).
- The Bridge
over Troubled Water program is a good example of coordinated
adolescent services.
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IV.
Suggested Readings:
I. Health Status Overview
Blum, C. W., &
Sells, R. W. (1996). Current trends in adolescent health. In R. J. Diclemente,
R. J. Hansen, & L. E. Ponton (Eds.), Handbook of adolescent health
risk behavior (pp. 5-33). New York: Plenum Press.
Carnegie Council
on Adolescent Development. (1995, October). Great transitions: Preparing
adolescents for a new century. New York: Author.
Resnick, M. D.,
Bearman, P. S., Blum, R.W., Bauman, K. E., Harris, K. M., Jones, J.,
Tabor, J., Beuhring, T., Sieving, R. E., Shew, M., Ireland, M., Bearinger,
L. H., & Udry, J. R. (1997). Protecting adolescents from harm: Findings
from a national longitudinal study on adolescent health. The Journal
of the American Medical Association, 278(10), 823-32.
Sells, C. W., &
Blum, R. W. (1996). Morbidity and mortality among US adolescents: An
overview of data and trends. American Journal of Public Health,
86(4), 513-519.
Singer, M. I. &
Hussey, D. L. (1995). Adolescents: Direct practice. In R. L. Edwards
& J. G. Hopps (Eds.), Encyclopedia of social work (19th ed.,
pp.40-48). Washington, DC: NASW Press.
Recommended Websites
II. Access to Health
Care
Ackard, D. M., Neumark-Sztainer,
D. (2001). Health care information sources for adolescents: Age and
gender differences on use, concerns, and needs. Journal of Adolescent
Health, 29(3), 170-176.
Bethell C., Klein,
J., Peck, C. (2001). Assessing health system provision of adolescent
preventative services: The Young Adult Health Care Survey. Medical
Care, 39(5), 478-490.
Britto, M. T., Klostermann,
B. K., Bonny, A. E., Altum, S. A., Hornung, R. W. (2000). Impact of
a multi-dimensional school-based intervention on access to health care
for underserved adolescents. Pediatric Research, 47(4),
11.
Gold. R. B., Sonfield,
A. (2001). Reproductive health services for adolescents under the State
Children's Health Insurance Program. Family Planning Perspectives,
33(2), 81-87.
Kaplan, D. W., Feinstein,
R. A., Fisher, M. M., Klein, J. D., Olmedo, L. F., Rome, E. S., Yancy,
W. S. (2001). Health care for children and adolescents in the juvenile
correctional care system. Pediatrics, 107(4), 799-803.
Klein, J. D., Allan,
M. J., Elster, A. B., Stevens, D., Cox, C., Hedberg, V. A., Goodman,
R. A. (2001). Improving adolescent preventive care in community health
centers. Pediatrics, 107(2), 318-327.
Klein, J. D., McNulty,
M., Flatau, C. N. (1998). Adolescents' access to health care: Teenagers'
self-reported use of services and perceived access to confidential care.
Archives of Pediatrics and Adolescent Medicine, 152(7),
676-682.
Klein, J. D., Slap,
G. B., Elster, A. B., & Schonberg, S. K. (1992). Access to health
care for adolescents: A position paper of the Society for Adolescent
Medicine. Journal of Adolescent Health, 13(2), 162-170.
Hedberg, V. A.,
Klein, J. D., Andresen, E. (1998). Health counseling in adolescent preventive
visits: Effectiveness, current practices, and quality measurement. Journal
of Adolescent Health, 23(6), 344-353.
Milne, A. C., Chesson,
R. (2000). Health services can be cool: Partnership with adolescents
in primary care. Family Practice, 17(4), 305-308.
Newacheck, P. W.
& Halfon, N. (1988). Preventive care use by school-aged children:
Differences by socioeconomic status. Pediatrics, 82(3
Pt. 2), 462-468.
Newacheck, P. W.,
McManus, M. A., & Brindis, C. (1990). Financing health care for
adolescents, problems, prospects, and proposals. Journal of Adolescent
Health Care, 11(5), 398-403.
Newacheck, P. W.,
Brindis, C. D., Cart, C. U., Marchi, K., Irwin, C. E. (1999). Adolescent
health insurance coverage: Recent changes and access to care. Pediatrics,
104(2), 195-202.
Roberts, J., Boker,
J. R., Oh, M. K., DiClemente, R. J. (2000). Health care service use
and sexual communication: Past experience and future intention of high-risk
male adolescents. Journal of Adolescent Health, 27(5),
298-301.
Santelli, J., Vernon,
M., Lowry, R., Osorio, J., DuShaw, M., Lancaster, M. S., Pham, N., Song,
E., Ginn, E., Kolbe, L. J. (1998). Managed care, school health programs,
and adolescent health services: Opportunities for health promotion.
Journal of School Health, 68(10), 434-440.
Stoddard, J. J.,
St Peter, R. F., & Newacheck, P. W. (1994). Health insurance status
and ambulatory care for children. New England Journal of Medicine,
330(20), 1421-1425.
Wilson, K. M., Klein,
J. D. (2000). Adolescents who use the emergency department as their
usual source of care. Archives of Pediatric and Adolescent Medicine,
154(4), 361-365.
Woods, A. H., Allan,
M. J., Klein, J. D. (2000). Adolescents' use of the Internet as a resource
for health information. Journal of Adolescent Health, 26(2),
124.
Recommended Websites
III. Cultural Diversity
Brooks-Gunn, J.,
Duncan, G. J., Klebanov, P. K., & Sealand, N. (1993). Do neighborhoods
influence child and adolescent development? American Journal of Sociology,
99(2), 353-395.
Davis, B. J. &
Voegtle, K. H. (1994). Culturally competent health care for adolescents:
A guide for primary care providers. Chicago: American Medical Association.
Garofalo, R., Katz,
E. (2001). Health care issues of gay and lesbian youth. Current Opinion
in Pediatrics, 13(4), 298-302.
Martinez, J. (1998).
Declining health care provision to adolescents and the need for considering
culturally competent interventions. Journal of Adolescent Health,
23(4), 189-190.
Price, J. H., Lyle,
P., & Smith, B. J. (Eds.). (1998). Eliminating health disparities
for vulnerable populations. Journal of Health Education, 29(Suppl.
5).
Recommended Websites
IV. Risky Health
Behavior Overview
Beyth-Marom, R.,
& Fischhoff, B. (1997). Adolescents' decisions about risks: A cognitive
perspective. In J. Schulenberg, J. Maggs, & H. Hurrelmann (Eds.),
Health risks and developmental transitions during adolescence
(pp. 110-135). Cambridge UK: Cambridge University Press.
DiClemente, R. J.,
Wingood, G. M., Crosby, R., Sionean, C., Cobb, B. K., Harrington, K.,
Davies, S., Hook, E. W., Oh, M. K. (2001). Parental monitoring: Association
with adolescents' risk behaviors. Pediatrics, 107(6),
1363-1368.
Greene, K., Kremar,
M., Walters, L. H., Rubin, D. L., Hale, J., Hale, L. (2000). Targeting
adolescent risk-taking behaviors: The contributions of egocentrism and
sensation-seeking. Journal of Adolescence, 23(4), 439-461.
Grunbaum, J. A.,
Lowry, R., Kann, L., Pateman, B. (2000). Prevalence of health risk behaviors
among Asian American/Pacific Islander high school students. Journal
of Adolescent Health, 27(5), 322-330.
Hamburg, D. A. (1997).
Toward a strategy for healthy adolescent development. American Journal
of Psychiatry, 154(6), 7-12.
Igra, V., &
Millstein, S. G. (1993). Current status of approaches to improving preventive
services for adolescents. The Journal of the American Medical Association,
269(11), 1408-1412.
Jessor, R. (1992).
Risk behavior in adolescence: A pyschosocial framework for understanding
and action. In D. Rogers & E. Ginzberg (Eds.), Adolescents at
risk: Medical and social perspectives, (pp.19-34).
Lowry, R., Kann,
L., Collins, J., & Kolbe, L. (1996). The effect of socioeconomic
status on chronic disease risk behaviors among US adolescents. The
Journal of the American Medical Association, 276(10), 792-797.
Sarigiani, P. A.,
Ryan, L., Petersen, A. C. (1999). Prevention of high-risk behaviors
in adolescent women. Journal of Adolescent Health, 25(2),
109-119.
Shapiro, R., Siegel,
A. W., Scovill, L. C., Hays, J. (1998). Risk-taking patterns of female
adolescents: What they do and why. Journal of Adolescence, 21(2),
143-159.
Trad, P. V. (1994).
A developmental model for risk avoidance in adolescents confronting
AIDS. AIDS Education and Prevention, 6(4), 322-338.
Recommended
Websites
V. Sexual Behaviors
American Academy
of Pediatrics Committee on Adolescence. (1994). Sexually-transmitted
diseases. Pediatrics, 94(4 Pt. 1), 568-572.
The Annie. E. Casey
Foundation. (1998). When teens have sex: Issues and trends. KIDS COUNT
special report. Baltimore, MD: Author.
Baumer, E. P., South,
S. J. (2001). Community effects on youth sexual activity. Journal
of Marriage and the Family, 63(2), 540-554.
Carter, D. M., Felice,
M. E., Rosoff, J., Zabin, L. S., Beilenson, P. L., & Dannenberg,
A. L. (1994). When children have children: The teen pregnancy predicament.
American Journal of Preventive Medicine, 10(2), 108-113.
Franklin, C., Corcoran,
J. (2000). Preventing adolescent pregnancy: A review of programs and
practices. Social Work, 45(1), 40-52.
Holder, D. W., Durant,
R. H., Harris, T. L., Daniel, J. H., Obeidallah, D., Goodman, E. (2000).
The association between adolescent spirituality and voluntary sexual
activity. Journal of Adolescent Health, 26(4), 295-302.
Keller, S. E, Bartlett,
J. A., Schleifer, S. J., Johnson, R. L., Pinner E., & Dalaney, B.
(1991). HIV-relevant sexual behavior among a healthy inner-city heterosexual
adolescent population in an endemic area of HIV. Journal of Adolescent
Health, 12(1), 44-48.
Kotchick, B. A.,
Shaffer, A., Forehand, R. (2001). Adolescent sexual risk behavior: A
multi-system perspective. Clinical Psychology Review, 21(4),
493-519.
Mertz, K. J., Ransom,
R. L., St. Louis, M. E., Groseclose, S. L., Hadgu, A., Levine, W. C.
(2001). Prevalence of Genital Chlamydial Infection in Young Women Entering
a National Job Training Program, 1990-1997. American Journal of Public
Health, 91(8), 1287-1290.
Moss, N. (1994).
Behavioral risks for HIV in adolescents. Acta Paediatrica, 400
(Suppl.), 81-87.
Nahom, D., Wells,
E., Gilmore, M. R., Hoppe, M., Morrison, D. M., Archibald, M., Murowchick,
E., Wilsdon, A., Graham, L (2001). Differences by gender and sexual
experience in adolescent sexual behavior: Implications for education
and HIV prevention. Journal of School Health, 71(4), 153-158.
National Institute
of Allergy and Infectious Diseases. Workshop
Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted
Disease (STD) Prevention.
Overby, K. J. &
Kegeles, S. M. (1994). The impact of AIDS on an urban population of
high-risk female minority adolescents: Implications for intervention.
Journal of Adolescent Health, 15(3), 216-227.
Rounds, K. (1997).
Preventing sexually-transmitted diseases among adolescents. In M. W.
Fraser (Ed.), Risk and resilience in childhood (pp.171-191).
Washington, DC: NASW press.
Russel, S. T., Joyner,
K. (2001). Adolescent sexual orientation and risk: Evidence from a national
study. American Journal of Public Health, 91(8), 1276-1281.
Santelli, J. S.,
Lowry, R., Brener, N. D., Robin, L. (2000). The association of sexual
behaviors with socioeconomic status, family structure, and race/ethnicity
among US adolescents. American Journal of Public Health, 90(10),
1582-1588.
Shrier, L. A., Harris,
S. K., Sternberg, M., Beardslee, W. R. (2001). Associations of depression,
self-esteem, and substance abuse with sexual risk among adolescents.
Preventive Medicine, 33(3), 179-189.
Smith, C. A. (1997).
Factors associated with early sexual activity among urban adolescents.
Social Work, 42(4), 334-46.
Valois, R. F., Oeltmann,
J. E., Waller, J., Hussey, J. R. (1999). Relationship between number
of sexual intercourse partners and selected health risk behaviors among
public high school adolescents. Journal of Adolescent Health,
25(5), 328-335.
Recommended Websites
VI. Substance Use/Abuse
Cohen, D. A., Richardson,
J., & LaBree, L. (1994). Parenting behaviors and the onset of smoking
and alcohol use: A longitudinal study. Pediatrics, 94(3),
368-75.
De La Rosa, M.,
Vega, R., Radisch, M. A. (2000). The role of acculturation in the substance
abuse behavior of African-American and Latino adolescents: Advances,
issues and recommendations. Journal of Psychoactive Drugs, 32(1),
33-42.
Freshman, A., Leinwand,
C. (2001). The implications of female risk factors for substance abuse
prevention in adolescent girls. Journal of Prevention and Intervention
in the Community, 21(1), 29-51.
Griffin, K. W.,
Botvin, G. J., Scheier, L. M., Diaz, T., Miller, N. L. (2000). Parenting
practices as predictors of substance abuse, delinquency, and aggression
among minority youth: Moderating effects of family structure and gender.
Psychology of Addictive Behaviors, 14(2), 174-184.
Hawke, J. M., Jainchill,
N., De Leon, G. (2000). The prevalence of sexual abuse and its impact
on the onset of drug abuse among adolescents in therapeutic community
drug treatment. Journal of Child and Adolescent Substance Abuse,
9(3), 35-49.
Jenson, J. (1997).
Risk and protective factors for alcohol and other drug use in childhood
and adolescence. In M. Fraser (Ed.), Risk and resilience in childhood
(pp.117-139). Washington, DC: NASW press.
Kaminer, Y. (2001).
Adolescent substance abuse treatment: Where do we go from here? Psychiatric
Services, 52(2), 147-149.
Kandel, D. B. &
Davies, M. (1996). High school students who use crack and other drugs.
Archives of General Psychiatry, 53(1), 71-80.
Kosterman, R., Hawkins,
J. D., Haggerty, K. P., Spoth, R., Redmond, C. (2001). Preparing for
the drug free years: Session-specific effects of a universal parent-training
intervention with rural families. Journal of Drug Education,
31(1), 47-68.
Minehan, J. A.,
Newcomb, M. D., Galaif, E. R. (2000). Predictors of adolescent drug
use: Cognitive abilities, coping strategies, and purpose in life. Journal
of Child and Adolescent Substance Abuse, 10(2), 33-52.
Sanders, M. R. (2000).
Community-based parenting and family support interventions and the prevention
of drug abuse. Addictive Behaviors, 25(6), 929-942.
Smith, C. W., &
Blum, R. W. (1996). Morbidity and mortality among U.S. adolescents:
An overview of data and trends. American Journal of Public Health,
86(4), 513-519.
Steinberg L., Fletcher,
A., & Darling, N. (1994). Parental monitoring and peer influences
on adolescent substance use. Pediatrics, 93(6 Pt. 2),
1060-1064.
Stoduto, G., Adlaf,
E. M. (2001). A typology of adolescent drinking-drivers. Journal
of Child and Adolescent Substance Abuse, 10(3), 43-58.
Tapert, S. F., Aarons,
G. A., Sedlar, G. R., Brown, S. A. (2001). Journal of Adolescent
Health, 28(3), 181-189.
Weinberg, N. Z.
(2001). Risk factors for adolescent substance abuse. Journal of Learning
Disabilities, 34(4), 343-351.
Recommended Websites
VII. Violence
Barber, C. W., Ozonoff,
V. V., Schuster, M., Hume, B., McLaughlin, H., & Jannelli, L. (1996).
When bullets don't kill. Public Health Reports, 111(6),
482-493.
Berton, M. W., &
Stabb, S. D. (1996). Exposure to violence and post-traumatic stress
disorder in urban adolescents. Adolescence, 31(122), 489-498.
Dornbusch, S. M.,
Lin, I. C., Munroe, P. T., Bianchi, A. J. (1999). Adolescent polydrug
use and violence in the United States. International Journal of Adolescent
Medicine and Health, 11(3-4), 429-437.
Ellickson, P., McGuigan,
K. A. (2000). Early predictors of adolescent violence. American Journal
of Public Health, 90(4), 566-572.
Ellickson P., Saner,
H., & McGuigan, K. A. (1997). Profiles of violent youth: Substance
use and other concurrent problems. American Journal of Public Health,
87(6), 985-991.
Farrell, A. D. &
Bruce, S. E. (1997). Impact of exposure to community violence on violent
behavior and emotional distress among urban adolescents. Journal
of Clinical Child Psychology, 26, 2-13.
Guterman, N. B.
& Cameron, M. (1997). Assessing the impact of community violence
on children and youths. Social Work, 42(5), 495-505.
Hausman, A. J.,
Spivak, H., & Prothrow-Stith, D. (1994). Adolescents' knowledge
and attitudes about and experience with violence. Journal of Adolescent
Health, 15(5), 400-406.
Howard, D. E. (1996).
Searching for resilience among African American youth exposed to community
violence: Theoretical issues. Journal of Adolescent Health, 18(4),
254-262.
Hutchinson, J.,
Langlykke, K. (1998). Adolescent Maltreatment: Youth as Victims of Abuse
and Neglect (Maternal and Child Health Technical Information Bulletin).
Arlington, VA: National Center for Education in Maternal and Child Health.
Lowry, R., Cohen,
L. R., Modzeleski, W., Kann, L., Collins, J. L., Kolbe, L. J. (1999).
School violence, substance abuse, and availability fo illegal drugs
on school property among US high school students. Journal of School
Health, 69(9), 347-355.
Omar, H. A. (1999).
Adolescent violence as viewed by high school students. International
Journal of Adolescent Medicine and Health, 11(3-4), 153-158.
Prinstein, M. J.,
Boergers, J., Spirito, A. Adolescents' and their friends' health-risk
behaviors: Factors that alter or add to peer influence. Journal of
Pediatric Psychology, 26(5), 287-298.
Rodriguez, M. A.
& Brindis, C. D. (1995). Violence and Latino youth: Prevention and
methodological issues. Public Health Reports, 110(3),
260-267.
Short, J. F. (2001).
Youth Collectivities and Adolescent Violence. In S. O. White (Ed.).
Handbook of youth and justice. The Plenum series in crime and justice.
New York, NY: Kluwer Academic/Plenum Publishers, 237-264.
Silverman, J. G.,
Raj, A., Mucci, L. A., Hathaway, J. E. (2001). Dating violence against
adolescent girls and associated substance abuse, unhealthy weight control,
sexual risk behavior, pregnancy, and suicidality. JAMA: Journal of
the American Medical Association, 286(5), 572-579.
Singer, M. I., Anglin,
T. M., Song, L. Y., & Lundghofer, L. (1995). Adolescents' exposure
to violence and associated symptoms of psychological trauma. The
Journal of the American Medical Association, 273(6), 477-482.
Spivak, H., Prothrow-Smith,
D. (2001). The need to address bullying: An important component of violence
prevention. Journal of the American Medical Association, 285(16),
2131-2132.
Tolmas, H. C. (1999).
The epidemic of adolescent violence in the U.S.A. International Journal
of Adolescent Medicine and Health, 11(3-4), 135-151.
Valoism, R. F.,
Zullig, K., Huebner, E. S., Drane, J. W. (2001). Relationship between
life satisfaction and violent behaviors among adolescents. American
Journal of Health Behavior, 25(4), 353-366.
Wilkinson, D. L.,
Fagan, J. (2001). What we know about gun use among adolescents. Clinical
Child and Family Psychology Review, 4(2), 109-132.
Recommended Websites
VIII. Suicide
Brent, D. A. (2001).
Firearms and suicide. In H. Hendin & J. J. Man (Ed.) The clinical
science of suicide prevention. Annals of the Ney York Academy of Sciences,
Vol. 932. New York, NY: Ney York Academy of Sciences, 225-240.
Cappelli, M., Clulow,
M. K., Goodman, J. T., Davidson, S. I., Feder, S. H., Baron, P., Manion,
I. G., & McGrath, P. J. (1995). Identifying depressed and suicidal
adolescents in a teen health clinic. Journal of Adolescent Health,
16(1), 64-70.
Culp, A. M., Clyman,
M. M., & Culp, R. E. (1995). Adolescent depressed mood, reports
of suicide attempts, and asking for help. Adolescence, 30(120),
827-837.
Gold, M. S., Kramer,
R. A. (2001). Youth suicide prevention. Suicide and Life Threatening
Behavior, 31(Suppl.), 6-31.
Hershberger, S.
L., Pilkington, N. W., & D'Augelli, A. R. (1997). Predictors of
suicide attempts among gay, lesbian, and bisexual youth. Journal
of Adolescent Research, 12(4), 477-497.
King, R. A., Schwab-Stone,
M., Flisher, A. J., Greenwald, S., Kramer, R. A., Goodman, S. H., Lahey,
B. B., Shaffer, D., Gould, M. S. (2001). Journal of the American
Academy of Child and Adolescent Psychiatry, 40(7), 837-846.
Morris, R. E., Harrison,
E. A., Knox, G., W., Tromanhauser, E., Marquis, D. K., & Watts,
L. L. (1995). Health risk behavioral survey from 39 juvenile correctional
facilities in the United States. Journal of Adolescent Health,
17(6), 334-344.
Orphans, P. K.,
Basen-Engquist, K., Grunbaum, J. A., & Parcel, G. S. (1995). The
co-morbidity of violence-related behaviors with health-risk behaviors
in a population of high school students. Journal of Adolescent Health,
16(3), 216-225.
Pharris, M. D.,
Resnick, M. D, & Blum, R. W. (1997). Protecting against hopelessness
and suicidality in sexually abused American Indian adolescents. Journal
of Adolescent Health, 21(6), 400-406.
Sosin, D. M., Koepsell,
T. D., Rivara, F. P., & Mercy, J. A. (1995). Fighting as a marker
for multiple problem behaviors in adolescents. Journal of Adolescent
Health, 16(3), 209-215.
Speaker, K. M.,
Petersen, G. J. (2000). School violence and adolescent suicide: Strategies
for effective intervention. Educational Review, 52(1),
65-73.
Recommended Websites
IX. Unintentional
Injury
Cobb, B. K., Cairns,
B. D., Miles, M. S., & Cairns, R. B. (1995). A longitudinal study
of the role of sociodemographic factors and childhood aggression on
adolescent injury and "close calls." Journal of Adolescent
Health, 17(6), 381-388.
Dunn, K. A., Runyan,
C. W., Cohen, L. R., & Schulman, M. D. (1998). Teens at work: A
statewide study of jobs, hazards, and injuries. Journal of Adolescent
Health, 22(1), 19-25.
Spirito, A., Rasile,
D. A., Vinnick, L. A., Jelalian, E., & Arrigan, M. E. (1997). Relationship
between substance use and self-reported injuries among adolescents. Journal
of Adolescent Health, 21(4), 221-224.
Recommended Websites
X. Model Programs:
School Based and School Linked Health Centers
Anglin, T. M., Naylor,
K. E., & Kaplan, D. W. (1996). Comprehensive school-based health
care: High school students' use of medical, mental health, and substance
abuse services. Pediatrics, 97(3), 318-330.
Fothergill, K. &
Ballard, E. (1998). The school-linked heath center: A promising model
of community-based care for adolescents. Journal of Adolescent Health,
23(1), 29-38.
Jepson, L. Juszczak,
L. & Fisher, M. (1998). Mental health care in a high school based
health service. Adolescence, 33(129), 1-15.
Kisker, E. E. &
Brown, R. S. (1996). Do school-based health centers improve adolescents'
access to health care, health status, and risk-taking behavior? Journal
of Adolescent Health, 18(5), 335-343.
Santelli, J., Morreale,
M., Wigton, A., & Grason, H. (1996). School health centers and primary
care for adolescents: A review of the literature. Journal of Adolescent
Health, 18(5), 357-366.
XI. Model Programs:
Substance Abuse
Cheadle, A., Pearson,
D., Wagner, E., Psaty, B. M., Diehr, P., & Koepsell, T. (1995).
A community-based approach to preventing alcohol use among adolescents
on an American Indian reservation. Public Health Reports, 110(4),
439-347.
Harding, C. G.,
Safer, L. A., Kavanagh, J., Bania, R., Carty, H., Lisnov, L., &
Wysockey, K. (1996). Using live theatre combined with role playing and
discussion to examine what at-risk adolescents think about substance
abuse, its consequences, and prevention. Adolescence, 31(124),
783-796.
Prince, F. (1995).
The relative effectiveness of a peer-led and adult-led smoking intervention
program. Adolescence, 30(117), 187-194.
XII. Model Programs:
Sexual Behaviors
Bearss, N., Santelli,
J. S., & Papa, P. (1995). A pilot program of contraceptive continuation
in six school-based clinics. Journal of Adolescent Health, 17(3),
178-183.
Kirby, D., Short,
L., Collins, J., Rugg, D., Kolbe, L., Howard, M., Miller, B., Sonenstein,
F., & Zabin, L. S. (1994). School-based programs to reduce sexual
behaviors: A review of effectiveness. Public Health Reports,
109(3), 339-360.
Wolk, L. I. &
Rosenbaum, R. (1995). The benefits of school-based condom availability:
Cross-sectional analysis of a comprehensive high school-based program.
Journal of Adolescent Health, 17(3), 184-188.
XIII. Model Programs:
HIV/AIDS
Bettencourt, T.,
Hodgins, A., Huba, G. J., & Pickett, G. (1998) Bay Area Young Positives:
A model of youth-based approach to HIV/AIDS services. Journal of
Adolescent Health, 23(Suppl. 2), 28-36.
Bourdon, B., Tierney,
S., Huba, G. J., Lothrop, J., Melchior, L. A., Betru, R. & Compoc,
K. (1998). Health Initiative for Youth: A model of youth/adult partnership
approach to HIV/AIDS services. Journal of Adolescent Health,
23(Suppl. 2), 71-82.
Huba, G. & Melchior,
L. (1998). A model for adolescent-targeted HIV/AIDS services: Conclusions
from 10 adolescent-targeted projects funded by the Special Projects
of National Significance Program of the Health Resources and Services
Administration. Journal of Adolescent Health, 23(Suppl.
2), 11-27.
Latkin, C. A. (1998).
Outreach in natural settings: The use of peer leaders for HIV prevention
among injecting drug users' networks. Journal of Adolescent Health,
23(Suppl. 2), 151-159.
Remafedi, G. (1998).
The University of Minnesota Youth and AIDS Projects' Adolescent Early
Intervention Program: A model to link HIV-seropositive youth with care.
Journal of Adolescent Health, 23(Suppl. 2), 115-121.
http://www.hrsa.dhhs.gov/hab/care.html
http://www.themeasurementgroup.com/SPNSoutcomes.htm
Special Projects
of National Significance (SPNS) Adolescent Care Demonstration &
Evaluation Projects, Health Resources and Services Administration (HRSA),
HAB - HIV/AIDS Bureau
Tenner, A. D., Trevithick,
L. A., Wagner, V., & Burch, R. (1998). Seattle YouthCare's prevention,
intervention, and education program: A model of care for HIV-positive,
homeless, and at-risk youth. Journal of Adolescent Health, 23(Suppl.
2), 96-106.
Woods, E. R., Samples,
C. L., Melchiono, M. W., Keenan, P. M., Fox, D. J., Chase, L. H., Tierney,
S., Price, V. A., Paradise, J. E., O'Brien, R. F., Mansfield, C. J.,
Brooke, R. A., Allen, D., & Goodman, E. (1998). Boston HAPPENS Program:
A model of health care for HIV-positive, homeless, and at-risk youth.
Human immunodeficiency virus (HIV) Adolescent Provider and Peer Education
Network for Services. Journal of Adolescent Health, 23(Suppl.
2), 37-48.
Woods, E. R. (1998).
Overview of the Special Projects of National Significance Program's
10 models of adolescent HIV care. Journal of Adolescent Health,
23(Suppl. 2), 5-10.
Wright, E. R., Gonzalez,
C., Werner, J. N., Laughner, S. T., & Wallace, M. (1998). Indiana
Youth Access Project: A model for responding to the HIV risk behaviors
of gay, lesbian, and bisexual youth in the heartland. Journal of
Adolescent Health, 23(Suppl. 2), 83-95.
XIV. Model Programs:
Violence
Hausman, A. J.,
Prothrow-Stith, D., & Spivak, H. (1995). Implementation of violence
prevention education in clinical settings. Patient Education &
Counseling, 25(2), 205-210.
Hausman, A. J.,
Spivak, H., Prothrow-Stith, D., & Roeber, J. (1992). Patterns of
teen exposure to a community-based violence prevention project. Journal
of Adolescent Health, 13(8), 668-675.
http://www.cdc.gov/default.htm
National Center
for Injury Prevention and Control: State Cooperative Agreements
http://www.ncjrs.org
Justice Department
Grant Program to Help Steer Youth away from Crime and Drug Use
CSBG Supports Youth
Non-Violence Conference (Arkansas)
XVI. Model Programs:
Suicide
Anonymous (1998).
Suicide prevention evaluation in a Western Athabaskan American Indian
Tribe--New Mexico, 1988-1997. Morbidity and Mortality Weekly Report,
47(13), 257-61.
Eggert, L. L., Thompson,
E. A., Herting, J. R., & Nicholas, L. J. (1995). Reducing suicide
potential among high-risk youth: Tests of a school-based prevention
program. Suicide and Life-Threatening Behavior, 25(2),
276-296.
http://aepo-xdv-www.epo.cdc.gov/wonder/prevguid/p0000024/p0000024.asp
Illustrative Programs
Lamb, J. M., Puskar,
K. R., Sereika, S. M., & Corcoran, M. (1998). School-based interventions
to promote coping in rural teens. American Journal of Maternal Child
Nursing, 23(4), 187-94.
Metha, A., Weber,
B., & Webb, L. D. (1998). Youth suicide prevention: A survey and
analysis of policies and efforts in the 50 states. Suicide and Life-Threatening
Behavior, 28(2), 150-64.
Orbach, I., &
Bar-Joseph, H. (1993). The impact of a suicide prevention program for
adolescents on suicidal tendencies, hopelessness, ego identity, and
coping. Suicide and Life-Threatening Behavior, 23(2),
120-129.
http://www.ace-network.com/pasprogmat.htm
Preventing Adolescent
Suicide: Developing Effective Prevention/Intervention Programs
http://yspp.org
Washington State
Youth Suicide Prevention Program
Zenere, F. J., &
Lazarus, P. J. (1997). The decline of youth suicidal behavior in an
urban, multicultural public schoool system following the introduction
of a suicide prevention and inervention program. Suicide and Life-Treatening
Behavior, 27(4), 387-402.
XVII. Model Programs:
Homeless Youth
http://www.ncfy.com
The Bridge Over
Troubled Waters: A Youth Service Agency with a Mission
http://www.ncfy.com/pubs/texas1.htm
Promise House, Inc.
V.
Recommended Websites:
Healthy People 2010
Kids
Count 2003
Youth Risk Behavior Survelliance Survey (YRBSS)
Monitoring
the Future Survey (NIDA)
America's
Children 2001: Key National Indicators of Well-Being
Call
to Action to Promote Sexual Health and Responsible Sexual Behavior:
2001
Surgeon General Report
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