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Adolescence is a time when youth make decisions, both good and bad, that have consequences for the rest of their lives. Some of these decisions put them at risk of lifelong health problems, injury, or death. The Institute of Medicine held three public workshops between 2008 and 2009 to provide a venue for researchers, health care providers, and community leaders to discuss strategies to improve adolescent health.
"What an extraordinary volume! This book brings together current research integrating adolescent risk and protection across a wide range of topics and disciplines. It is a major contribution to the field." — Robert Wm. Blum, MD, MPH, PhD, Professor and Director, Center for Adolescent Health and Development, University of Minnesota "This book is clearly the best source now available on the topic of adolescent risk taking and its prevention. With chapters written by the very best people in the field, describing the latest thinking and findings, it is an essential guide and resource for prevention researchers and program developers." — Bruce Simons-Morton, EdD, MPH, Chief, Prevention Research Branch Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development "This report shines a bright light on the road our nation has taken to improve adolescent health, the approaching fork, and the path most likely to attain our destination." — Lloyd J. Kolbe, PhD, Director, Division of Adolescent and School Health, U.S. Centers for Disease Control And Prevention "Reducing Adolescent Risk: Toward an Integrated Approach weaves together current research findings with prevailing prevention strategies to shed further light on the developmental pathways leading to a variety of interrelated adolescent risk behaviors. In doing so, the authors skillfully make the case for more integrated policy approaches and for comprehensive programming at the community level that both recognizes the connections between risk behaviors and maximizes young people′s positive potential." — Karen Pittman, Executive Director, The Forum for Youth Investment & President, Impact Strategies, Inc. Many risk behaviors have common developmental pathways. However, most prevention strategies approach adolescent risk behaviors as individual problems requiring separate solutions. This policy of treating one behavior at a time encourages a fractured approach to adolescent health. Reducing Adolescent Risk: Toward an Integrated Approach focuses on common influences that result in a number of interrelated risk behaviors in order to design more unified, comprehensive prevention strategies. Edited by Daniel Romer, this book summarizes presentations and discussions held at the Adolescent Risk Communication Institute of the University of Pennsylvania Annenberg Public Policy Center. Concentrating on common causes for varied risk behaviors, a group of leading researchers and intervention specialists from different health traditions synthesize current knowledge about risks to adolescent health in several areas, including drugs and alcohol, tobacco, unprotected sex, suicide and depression, and gambling. Promoting healthy adolescent development, this innovative volume includes Results of the National Risk Survey Contributions from experts on adolescent decision making and problem solving Research agendas for programs that reduce multiple risks Potential intervention strategies to reduce more than one risk at a time Major findings from the conference that should be pursued in future research Primarily intended for graduate students, scholars, and researchers in psychology, sociology, social work, and public health, Reducing Adolescent Risk is also an extraordinary resource for policy makers in government organizations and foundations.
Current policies treat adolescent risk behaviours as separate problems requiring separate solutions, ignoring the overlap of many risk behaviours. This text seeks to move beyond the fractured approach of preventing one kind of behaviour at a time and suggests more comprehensive prevention strategies.
Recent theoretical developments in our understanding of developmental trends in adolescent memory, judgment, and decision-making suggest ways in which existing risk reduction programs for adolescents can be improved. Using fuzzy-trace theory, these developments were applied to a validated and evidence-based program, Reducing the Risk (RTR) in a randomized controlled trial. Following a baseline assessment, 734 participants aged 14-19 were randomly assigned to one of three 16 hour interventions - RTR, a modified RTR program (RTR+), or a control condition about improving communication skills. Upon completing the intervention, participants completed a post-survey and were then followed up at three, six, and 12 months later. Primary outcome measures included sexual behavior (initiation, number of partners) and prophylactic behavior (e.g., condom use at last sexual encounter and number of unprotected sexual partners). Discrete time survival analysis revealed that participants assigned to RTR+ were significantly less likely to initiate sexual activity one year after the intervention was administered, and random effects models suggested that RTR+ also decreased the sexual partners across all time points. In addition, RTR+ had significant positive effects on measures of knowledge, intentions, attitudes, perceived norms, self efficacy, perceived behavioral control, as well as on several measures of risk perception suggested by the study's theoretical framework. Among 23 domains of outcome variables assessed, positive effects of either curriculum were found in 18 domains. Positive effects of RTR+ were found in 16 domains, and positive effects of RTR were found in 12. RTR+ outperformed RTR in 9 of 18 domains (including sexual behavior), and RTR outperformed RTR+ in two domains. The results demonstrate that simple, theory-driven manipulations can be used to improve upon existing evidence-based programs for reducing adolescent sexual risk taking.
Both research and consultations over the last decades have identified sexuality-related communication as an issue that requires urgent attention. While clients would like their health-care providers to discuss sexual health concerns, health workers lack the necessary training and knowledge to feel comfortable addressing such issues. This guideline provides health policy-makers and decision-makers in health professional training institutions with advice on the rationale for health-care providers' use of counselling skills to address sexual health concerns in a primary health care setting.
This examination of changes in adolescent fertility emphasizes the changing social context within which adolescent childbearing takes place.
Adolescents obviously do not always act in ways that serve their own best interests, even as defined by them. Sometimes their perception of their own risks, even of survival to adulthood, is larger than the reality; in other cases, they underestimate the risks of particular actions or behaviors. It is possible, indeed likely, that some adolescents engage in risky behaviors because of a perception of invulnerabilityâ€"the current conventional wisdom of adults' views of adolescent behavior. Others, however, take risks because they feel vulnerable to a point approaching hopelessness. In either case, these perceptions can prompt adolescents to make poor decisions that can put them at risk and leave them vulnerable to physical or psychological harm that may have a negative impact on their long-term health and viability. A small planning group was formed to develop a workshop on reconceptualizing adolescent risk and vulnerability. With funding from Carnegie Corporation of New York, the Workshop on Adolescent Risk and Vulnerability: Setting Priorities took place on March 13, 2001, in Washington, DC. The workshop's goal was to put into perspective the total burden of vulnerability that adolescents face, taking advantage of the growing societal concern for adolescents, the need to set priorities for meeting adolescents' needs, and the opportunity to apply decision-making perspectives to this critical area. This report summarizes the workshop.