Summary Worldwide, societal shifts and behavioural patterns exacerbated by unique developmental vulnerabilities create a confluence of factors that place today's adolescents at heightened risks for ...poor health outcomes. Country-level data show that continued investment in effective prevention and treatment strategies is essential to protect adolescents' sexual and reproductive health. Whereas strategies must be tailored to the developmental needs of this age group and their social contexts, effective approaches are multifaceted. All adolescents need access to quality youth-friendly services provided by clinicians trained to work with this population. Sex education programmes should offer accurate, comprehensive information while building skills for negotiating sexual behaviours. Girls and boys also need equal access to youth development programmes that connect them with supportive adults and with educational and economic opportunities. Although progress has been made since the 1994 International Conference on Population and Development, adolescents continue to be disproportionately burdened by threats to their sexual and reproductive health.
Worldwide, societal shifts and behavioural patterns exacerbated by unique developmental vulnerabilities create a confluence of factors that place today's adolescents at heightened risks for poor ...health outcomes. Country-level data show that continued investment in effective prevention and treatment strategies is essential to protect adolescents' sexual and reproductive health. Whereas strategies must be tailored to the developmental needs of this age group and their social contexts, effective approaches are multifaceted. All adolescents need access to quality youth-friendly services provided by clinicians trained to work with this population. Sex education programmes should offer accurate, comprehensive information while building skills for negotiating sexual behaviours. Girls and boys also need equal access to youth development programmes that connect them with supportive adults and with educational and economic opportunities. Although progress has been made since the 1994 International Conference on Population and Development, adolescents continue to be disproportionately burdened by threats to their sexual and reproductive health. PUBLICATION ABSTRACT
Because little is known about long-term effects of adolescent protective factors across multiple health domains, we examined associations between adolescent connectedness and multiple health-related ...outcomes in adulthood.
We used weighted data from Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (
= 14 800). Linear and logistic models were used to examine associations between family and school connectedness in adolescence and self-reported health risk behaviors and experiences in adulthood, including emotional distress, suicidal thoughts and attempts, physical violence victimization and perpetration, intimate partner physical and sexual violence victimization, multiple sex partners, condom use, sexually transmitted infection (STI) diagnosis, prescription drug misuse, and other illicit drug use.
In multivariable analyses, school connectedness in adolescence had independent protective associations in adulthood, reducing emotional distress and odds of suicidal ideation, physical violence victimization and perpetration, multiple sex partners, STI diagnosis, prescription drug misuse, and other illicit drug use. Similarly, family connectedness had protective effects for emotional distress, all violence indicators, including intimate partner violence, multiple sex partners, STI diagnosis, and both substance use indicators. Compared to individuals with low scores for each type of connectedness, having high levels of both school and family connectedness was associated with 48% to 66% lower odds of health risk behaviors and experiences in adulthood, depending on the outcome.
Family and school connectedness may have long-lasting protective effects across multiple health outcomes related to mental health, violence, sexual behavior, and substance use. Increasing both family and school connectedness during adolescence has the potential to promote overall health in adulthood.
Over the past 30 years, prevention science in the adolescent health field has moved from interventions focused on preventing single problem behaviors to efforts employing a dual approach, addressing ...risk factors that predict problems while simultaneously nurturing protective factors and promoting positive development. Through an examination of previous research and empirical case examples with vulnerable youth, this article considers the hypothesis that adolescents' sense of connectedness to caring adults acts as a protective factor against a range of risk behaviors. Multivariate analyses with existing data examined indicators of youth-adult connectedness among two groups at high risk for poor health outcomes: (1) mentor-youth relationship quality in an urban, ethnically diverse sample of students in a school-based mentoring program (2014 survey, N=239); and (2) parent-youth connectedness in a statewide sample of high school students who reported homelessness in the past year (2013 survey, N=3,627). For youth in the mentoring program, a high-quality youth-mentor relationship was significantly associated with positive social, academic, and health-related behaviors. Among students who experienced homelessness, all measures of parent connectedness were significantly associated with lower sexual risk levels. Collectively, findings from these analyses and previously published studies by this research group provide evidence that strong, positive relationships with parents and other caring adults protect adolescents from a range of poor health-related outcomes and promote positive development. Youth-adult connectedness appears to be foundational for adolescent health and well-being. Program, practice, and policy decisions should consider what strengthens or hinders caring, connected youth-adult relationships.
Comprehensive sexuality education (CSE) has been shown to reduce sexual risk-taking behaviors and promote healthy sexual development, and studies have shown high support for this approach. However, ...the past decade has seen many changes in the political landscape and social controversies. The present study reports on an updated survey and analysis of changes in support from 2006 to 2021.
Survey data were collected by telephone in 2006 (N = 1,605) and online and in-person in 2021 (N = 719) from separate samples of Minnesota parents of school-age children. Parents responded to items regarding preferences for CSE, support for teaching numerous specific sexuality education topics, and the grade level at which topics should be introduced. Chi-square tests and logistic regression (with weighted 2021 data) were used to detect differences in support between survey years and across demographic and personal characteristics.
At both time points, approximately 90% of parents thought that CSE should be taught in schools, with significant increases in support within several demographic categories. Support for including all specific topics was high, including for topics typically considered highly controversial (e.g., gender identity, 68.7%; abortion, 77.7% in 2021). Parents endorsed introducing most topics in elementary or middle school years.
Findings suggest that policy makers and educators in Minnesota can be confident of strong parental support for CSE covering a wide range of content to meet students’ needs. Advocacy and action to advance the use of national sexuality education standards are in keeping with the views of the overwhelming majority of parents of school-age children.
Dating violence among U.S. adolescents is a substantial concern. Previous research indicates that Latino youth are at increased risk of dating violence victimization. This secondary data analysis ...examined the prevalence of physical and sexual dating violence victimization among subgroups of Latino adolescents and associations of parent communication, parent caring, and dating violence victimization using data from the 2010 Minnesota Student Survey (N = 4,814). Parallel analyses were conducted for Latino-only and multiple-race Latino adolescents, stratified by gender. Multivariate logistic regression models tested associations between race/ethnicity, parent communication, perceived parent caring, and adolescent dating violence experiences. Overall, 7.2% to 16.2% of Latinos reported physical or sexual dating violence. Both types of dating violence were more prevalent among multiple-race Latinos than among Latino-only adolescents, with prevalence rates highest among multiple-race Latino females (19.8% and 19.7% for physical and sexual dating violence victimization, respectively). In multivariate models, perceived parent caring was the most important protective factor against physical and sexual dating violence among males and females. High levels of mother and father communication were associated with less physical violence victimization among males and females and with less sexual violence victimization among females. Results highlight the importance of parent communication and parent caring as buffers against dating violence victimization for Latino youth. These findings indicate potential for preventive interventions with Latino adolescents targeting family connectedness to address dating violence victimization.
To quantify adolescent- and parent-perceived importance of provider-adolescent discussions about sexual and reproductive health (SRH), describe prevalence of provider confidentiality practices and ...provider-adolescent discussions about SRH topics during preventive visits, and identify missed opportunities for such conversations.
We used data from a national Internet survey of 11- to 17-year-old adolescents and their parents. Data were weighted to represent the noninstitutionalized US adolescent population. Adolescents who had a preventive visit in the past 2 years and their parents reported on perceived importance of provider-adolescent discussions about SRH topics: puberty, safe dating, gender identity, sexual orientation, sexual decision-making, sexually transmitted infections and HIV, methods of birth control, and where to get SRH services. Adolescents and parents reported whether they had ever discussed confidentiality with the adolescent's provider. Adolescents reported experiences at their most recent preventive visit, including whether a provider spoke about specific SRH topics and whether they had time alone with a provider.
A majority of adolescents and parents deemed provider-adolescent discussions about puberty, sexually transmitted infections and HIV, and birth control as important. However, fewer than one-third of adolescents reported discussions about SRH topics other than puberty at their most recent preventive visit. These discussions were particularly uncommon among younger adolescents. Within age groups, discussions about several topics varied by sex.
Although most parents and adolescents value provider-adolescent discussions of selected SRH topics, these discussions do not occur routinely during preventive visits. Preventive visits represent a missed opportunity for adolescents to receive screening, education, and guidance related to SRH.
Time alone between health care providers and adolescent patients is a core element of quality adolescent primary care, yet not all adolescents receive this care. Clinicians' apprehension about how ...best to introduce time alone may contribute to lower levels of time alone. This study aims to understand how adolescent patients and their parents or guardians experience the introduction of time alone during adolescent preventive visits.
We conducted semistructured interviews with adolescents, aged 11–17 years (n = 35) and a parent or guardian of the adolescent (n = 35) across metropolitan and nonmetropolitan areas of Minnesota. We used thematic analysis to describe (1) parent and adolescent experiences learning about time alone for the first time and (2) parent and adolescent reactions to this experience.
Key findings from this study suggest that adolescents prefer a universal application of time alone with an option to opt out (e.g., “At this age, I always ask parents to step out for a few minutes, are you okay with that?”), rather than opt in (e.g., “Would you like your parent to step out?”). Parents noted that time alone should not be a surprise but rather should be presented as routine, so they are not left to wonder if time alone was offered to their adolescent for a particular reason.
Findings suggest universal presentation of time alone with the option for adolescents to opt out may improve acceptability of time alone and support delivery of highquality care.
Emans et al express insights about the early COVID-19 impact on adolescent health and medicine programs in the US, reflecting the LEAH program leadership. The US Maternal Child Health Bureau (MCHB) ...funds seven Leadership in Adolescent Health (LEAH) programs across the country. The mission of the network of LEAH programs is to train health professionals from medicine, nursing, nutrition, psychology, and social work to be leaders in clinical care, teaching, research, public health policy, and organization of health services for adolescents and young adults (AYA). In the context of the COVID-19 pandemic, out-of-necessity patient and clinical care needs were prioritized. Programs were developing strategies to balance delivery of patient care with trainees' educational needs. Challenges and emerging approaches to meet the educational needs of multi-disciplinary trainees were discussed.
CONTEXT
Transgender and gender‐diverse youth experience significant health disparities across numerous domains of health, including sexual health. Among general populations, parent connectedness has ...been strongly associated with youth sexual health.
METHODS
The relationships between parent connectedness and sexual health indicators were investigated among 2,168 transgender and gender‐diverse youth who participated in the 2016 Minnesota Student Survey, a statewide population‐based survey of ninth‐ and 11th‐grade students. Multivariate logistic regression models, stratified by sex assigned at birth, tested associations between parent connectedness—youth's perceptions of parent caring and parent–youth communication—and eight sexual health indicators: ever having had sex, having multiple sexual partners in the past year, pregnancy involvement, substance use at last sex, partner communication about STI prevention, partner communication about pregnancy prevention, condom use at last sex and pregnancy prevention methods at last sex.
RESULTS
The level of parent connectedness was inversely associated with ever having had sex, regardless of sex assigned at birth (odds ratios, 0.6–0.8). Although level of connectedness was inversely associated with having multiple sexual partners in the past year and pregnancy involvement among transgender and gender‐diverse youth assigned male at birth (0.6–0.7), these relationships were nonsignificant among transgender and gender‐diverse youth assigned female at birth. Further differences in associations between parent connectedness and four sexual risk–reduction behaviors were found between youth assigned male at birth and those assigned female.
CONCLUSIONS
As with other populations, parent connectedness promotes sexual health among transgender and gender‐diverse youth and may provide a point of intervention.
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