Future orientation: a construct with implications for adolescent health and wellbeing

"We Are Powerful People": Health-Promoting Strengths of LGBTQ Communities of Color

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities of color experience intersecting systems of oppression that limit access to health care, safety, and other basic resources. Important research has documented these disparities, their antecedents, and consequences. However, little research has examined the strengths of multiply marginalized LGBTQ communities. Drawing from a health equity framework, this study is based on interviews with 38 LGBTQ-identified people of color in New York City. We used framework analysis to examine participants' perspectives on the role of community in enhancing health and well-being. Community strengths identified by participants included (a) safety, acceptance, and support; (b) interconnectedness and resource sharing; and (c) advocacy, collective action, and community potential. Recommendations for policy, practice, and future research are suggested, including efforts toward community power building.

Psychosocial correlates of safe sex self-efficacy among in-school adolescent girls in Lagos, Nigeria

BACKGROUND

Adolescent girls in Nigeria are at heightened risk for HIV and other sexually transmitted infections. However, there are limited studies on psychosocial factors that are associated with safe sex intentions among this population. Self-efficacy has been established as an important correlate of behavioral intentions and the actual behavior. The objective of this research was to examine how key psychosocial factors such as social support, parental monitoring, and future orientation influence perceived safe sex self-efficacy among in-school adolescent girls in Nigeria. Furthermore, we assessed the associations between these psychosocial factors and HIV-related knowledge and safe sex self-efficacy.

METHODS

A self-administered questionnaire was distributed to 426 adolescent girls attending public and private school systems in Lagos, Nigeria. Multiple linear regression was used to evaluate the influence of psychosocial and demographic factors on safe sex self-efficacy. Further, stratified analysis was conducted to compare the estimates between participants attending public schools (n = 272) and those attending private schools (n = 154).

FINDINGS

Results from the study show that future orientation (β = 0.17; p < 0.05), participants age (β = 0.14; p < 0.05), and HIV knowledge accuracy (β = 0.17; p < 0.05) were associated with safe sex self-efficacy. Future orientation remained statistically significant in the sub-group analysis among participants attending public (β = 0.13; p < 0.05) and private schools (β = 0.24; p < 0.05). Among participants attending public schools, HIV accuracy (β = 0.2; p < 0.05) remained a significant correlate of safe sex self-efficacy while this association dissipated among private school attendees.

CONCLUSIONS

These findings point to the importance of including future orientation strategies in interventions developed for in-school adolescent girls in Nigeria. School-based interventions that increase positive future orientation outcomes may be beneficial to improve safe sex intentions among adolescent girls in Nigeria.

Different Shades of Beauty: Adolescents' Perspectives on Drawing From Observation

Background

Drawing from observation (DFO) is an art therapy method that entails drawing an object, along with guided reflections on process and outcome. In this qualitative study, we explored adolescents’ perspectives on their DFO experience, and how they perceive it as having influenced their emotional well-being.

Methods

We interviewed 10 adolescents who participated in a DFO group, regarding their perspectives on DFO. Participants were asked to refer to their experience, as well as to provide examples of their drawings. Through a thematic analysis we integrated data from interviews and drawings.

Results

Adolescents experienced three lines of tension in DFO: Between self-acceptance and self-judgment, between merging and separation, and between similarities and differences. Processing these tensions has the potential to increase their emotional well-being.

Conclusion

DFO could make a meaningful contribution to adolescents’ emotional well-being. The unique intersection between object, observation, and drawing in art-therapy addresses adolescents’ emotional-developmental challenges.

Resilience in adolescence: Prospective Self moderates the association of early life adversity with externalizing problems

INTRODUCTION

Early life adversity (ELA) can result in negative behavioral outcomes, including internalizing and externalizing problems. Evidence suggests that adolescence is a critical developmental period for processing ELA. Identity formation, which is crucial to this developmental period, may moderate the effect between ELA and these problems. One potential moderating variable associated with identity formation is the latent construct Prospective Self, comprised of future-oriented attitudes and behaviors.

METHODS

Participants are from the first wave of an ongoing longitudinal study designed to characterize behavioral and cognitive correlates of risk behavior trajectories. A community sample of 10th and 12th grade adolescents (N = 2017, 55% female) were recruited from nine public school districts across eight Southeastern Michigan counties in the United States. Data were collected in schools during school hours or after school via self-report, computer-administered surveys. Structural equation modeling was utilized to assess Prospective Self as a latent construct and to evaluate the relationship between ELA, internalizing and externalizing problems, and Prospective Self.

RESULTS

Preliminary findings indicated a satisfactory fit for the construct Prospective Self. The predicted negative associations between Prospective Self and internalizing and externalizing problems were found and evidence of moderation was observed for externalizing problems, such that the effects of ELA (i.e., childhood maltreatment) on externalizing problems were lower for individuals with higher levels of Prospective Self.

CONCLUSIONS

These results indicate that Prospective Self may play a role in supporting resilience against externalizing problems associated with ELA among adolescents.

Early information needs of adolescents and young adults about late effects of cancer treatment

BACKGROUND

Adolescent and young adult (AYA) cancer survivors have high risks of late effects. Little is known about the late-effect information needs of AYAs early in treatment or their role in treatment decision making. This study evaluated the importance, quality, and implications of information about late effects in AYAs recently diagnosed with cancer.

METHODS

This study surveyed 201 AYAs with cancer who were 15 to 29 years old and were treated at the Dana-Farber Cancer Institute (Boston, Massachusetts). Patients were approached within 6 weeks of their diagnosis and were asked about their late-effect and infertility information needs, treatment decision making, and communication outcomes.

RESULTS

Forty-five percent of the participants were female; 88% were white. Most AYAs (87% [173 of 200]) considered information about the risks of late effects to be extremely or very important; 80% (159 of 200) valued information about infertility. Many were distressed by information about late effects (53% [105 of 200]) and infertility (45% [89 of 200]); those who considered late-effect information distressing were more likely to value this information (P < .0001). Consideration of late effects (41% [82 of 201]) and infertility (36% [72 of 201]) greatly influenced many patients' treatment decision making. Although 92% of the patients (184 of 199) reported receiving high-quality information about the diagnosis, 57% (113 of 199; P < .0001) and 65% (130 of 199; P < .0001) felt that they had received high-quality information about late effects and infertility, respectively.

CONCLUSIONS

Most AYAs with cancer value early information about the risks of late effects and infertility, yet many patients felt that they had not received high-quality information about these topics. The development of age-appropriate late-effect communication strategies that recognize high AYA distress may help to address the gap between desired information and perceived information quality.

Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol

BACKGROUND

Self-regulation (SR), or the capacity to control one's thoughts, emotions, and behaviors in order to achieve a desired goal, shapes health outcomes through many pathways, including supporting adherence to medical treatment regimens. Type 1 Diabetes (T1D) is one specific condition that requires SR to ensure adherence to daily treatment regimens that can be arduous and effortful (e.g., monitoring blood glucose). Adolescents, in particular, have poor adherence to T1D treatment regimens, yet it is essential that they assume increased responsibility for managing their T1D as they approach young adulthood. Adolescence is also a time of rapid changes in SR capacity and thus a compelling period for intervention. Promoting SR among adolescents with T1D may thus be a novel method to improve treatment regimen adherence. The current study tests a behavioral intervention to enhance SR among adolescents with T1D. SR and T1D medical regimen adherence will be examined as primary and secondary outcomes, respectively.

METHODS

We will use a randomized control trial design to test the impact of a behavioral intervention on three SR targets: Executive Functioning (EF), Emotion Regulation (ER), and Future Orientation (FO); and T1D medical regimen adherence. Adolescents with T1D (n = 94) will be recruited from pediatric endocrinology clinics and randomly assigned to treatment or control group. The behavioral intervention consists of working memory training (to enhance EF), biofeedback and relaxation training (to enhance ER), and episodic future thinking training (to enhance FO) across an 8-week period. SR and treatment regimen adherence will be assessed at pre- and post-test using multiple methods (behavioral tasks, diabetes device downloads, self- and parent-report). We will use an intent-to-treat framework using generalized linear mixed models to test our hypotheses that: 1) the treatment group will demonstrate greater improvements in SR than the control group, and 2) the treatment group will demonstrate better treatment regimen adherence outcomes than the control group.

DISCUSSION

If successful, SR-focused behavioral interventions could improve health outcomes among adolescents with T1D and have transdiagnostic implications across multiple chronic conditions requiring treatment regimen adherence.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT03688919; registered September 28, 2018.

Future orientation of youth with a history of war trauma: a qualitative study in the African context

Adolescence is an important developmental period for social relationships, identity formation and future planning. Traumatic experiences, such as war and persecution, may interfere with optimal development, including the future orientation of adolescents. The present study examines how young adult war survivors construct, make sense of, and narrate their future goals, plans, and expectations. The participants were 13 Liberian 25-35-year old male and female refugees living in Ghana. This qualitative study is based on semi-structured interviews with prompting questions. By applying a phenomenological approach the interview transcripts were categorized into themes and subthemes about future orientations. Results revealed three main themes, two of them desired a positive future orientation, indicating optimism and determination to improve one's own life and to contribute to a flourishing nation and to peacebuilding. The third theme illustrated a failure to reconstruct war-shattered lives and involved pessimistic views of the future. The results are discussed in relation to peacebuilding and the developmental challenges of young adults as war survivors.

Associations Between Internalized HIV Stigma and Tobacco Smoking Among Adolescents and Young Adults Living with HIV: The Moderating Role of Future Orientations

HIV stigma and future orientations impact the health of adolescents and young adults living with HIV (AYALWH); however, little is known about how these factors may impact tobacco use, and thereby long-term health status. This study examined associations between internalized HIV stigma, future orientations, and smoking behavior using a cross sectional survey of AYALWH ages 18 to 29 (N = 109). Greater levels of stigma were associated with increased odds of smoking, and greater future orientations were associated with a reduced odds of smoking. The interaction was significant, illustrating that stigma was significantly associated with an increased odds of smoking among AYALWH who reported low levels of future orientations, but not for those with high levels of future orientations. Findings underscore the importance of understanding how HIV stigma may undermine future aspirations of AYALWH. Interventions that target HIV stigma and future orientations may be critical for tobacco prevention and cessation.

A longitudinal investigation of protective factors for bereaved maltreated youth

BACKGROUND

Maltreated youth are at an elevated risk for the development of problem behaviors. Coping with the death of a family member or close friend during adolescence, referred to as bereavement, is a stressful event that could potentiate risk linked to maltreatment. However, developmental research suggests that youth adjustment is a product of multiple risk and protective factors. Although maltreated youth who experience loss may be particularly vulnerable to behavior problems, personal and contextual factors may attenuate or exacerbate youths' risk for internalizing and externalizing psychopathology.

OBJECTIVE

The overarching goal of this study is to examine individual, family, and community-level protective factors for maltreated youth who experience bereavement. Specifically, we aim to examine the effect of age 12 bereavement on age 16 internalizing and externalizing psychopathology, and to investigate the moderating role of multi-level protective factors at ages 14 and 16.

METHODS

The study consisted of a sample of 800 youth (52.4% female, 45.1% African-American) drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), collected from 1998 to 2011.

RESULTS

Maltreated youth who experienced significant loss were at increased risk for externalizing symptoms, compared to non-bereaved maltreated youth (β = 0.085, p < .05). Individual future orientation (β = 0.103, p < .05) family future orientation (β = -0.120, p < .05), parental monitoring (β = -0.123, p< .01), and neighborhood collective efficacy (β = -0.126, p < .01) each significantly moderated the association between bereavement and externalizing symptoms.

CONCLUSIONS

These results have implications for future interventions aimed towards reducing problem behaviors in adolescents with a history of child maltreatment and who experience bereavement.

Understanding factors related to nonsmoking intention among college students

Objective: While cigarette smoking in the United States has declined, the age range of smoking initiation has risen to include young adults. This study investigated the relationship of Theory of Planned Behavior constructs (TPB; attitudes, subjective norms, and perceived behavioral control [PBC]) to nonsmoking intention among college students. Participants: Participants were 619 students at a Southeastern US university (69.8% female, 70.8% ≤ age 21, and 73.5% white). Methods: Students were recruited by email in March 2013 to participate in an online TPB-based questionnaire. Results: Future-oriented attitudes and PBC predicted higher nonsmoking intention; subjective norms did not. Moderator analyses indicated injunctive norms were more influential for occasional smokers and PBC was less influential. Conclusions: Findings suggest TPB is useful in predicting nonsmoking intention, but differentially for nonsmokers and occasional smokers. Future work should consider the health-related utility of future-oriented attitudes toward nonhealth domains and the differing beliefs of occasional smokers.

The pathways from parental and neighbourhood socioeconomic status to adolescent educational attainment: An examination of the role of cognitive ability, teacher assessment, and educational expectations

Adolescents with high educational attainment generally have better outcomes across the lifespan than adolescents with lower educational attainment. This study investigated how three measures of socioeconomic status (SES)–maternal education, paternal education, and neighbourhood SES–combined to predict adolescent educational attainment (track level at age 17). We proposed three mechanisms for this pathway: cognitive ability (at age 11), primary school teacher assessment (stating the secondary education level suitable for a child at age 11), and educational expectations (at age 14). Using the data of 2,814 Dutch adolescents from the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study, logistic regressions tested associations between SES and educational attainment. Structural equation modelling (SEM) tested mediational pathways between SES and educational attainment. In models with three SES measures, having a medium-educated mother was associated with higher educational attainment relative to having a low-educated mother (OR; 95% CI: 1.83; 1.41–2.38), and having a high-educated mother was associated with higher educational attainment relative to having a low-educated mother (OR; 95% CI: 3.44; 2.59–4.55). The odds ratios for paternal education showed a similar pattern. We found no association between neighbourhood SES and adolescent educational attainment, so neighbourhood SES was removed from further analyses. Mediational analyses revealed that cognitive ability (30.0%), teacher assessment (28.5%), and educational expectations (1.2%) explained 59.8% of the total association between parental SES and educational attainment. The results showed that mother education and father education were both important for understanding the strong association between parental SES and adolescent educational attainment. In the Netherlands, the association between parental SES and educational attainment can be largely explained by cognitive ability and teacher assessments.

Profiles of Future Orientation among Assault-injured Adolescents: Correlates and Concurrent Outcomes

Future orientation has been established as having positive associations with health and educational outcomes for adolescents exposed to violence. However, conceptualizations of future orientation have been inconsistent. This study uses latent profile analysis to understand the interrelationships between measures of future orientation (e.g., commitment to learning, goal orientation, hope, expectancies, fatalism). Participants were 188 primarily African American male early adolescents ranging from 10 to 15 years old (60.6% male; M_age = 12.87, SD_age = 1.52). Adolescents in the high- and low-future orientation profiles differed on academic behaviors and aggressive behavior. A discordant profile emerged with adolescents moderate on all measures of future orientation except expectancies. Relational aspects of parenting were associated with higher likelihood of adolescents being assigned to the high- and low-future orientation profiles. These findings suggest the importance of parental warmth in promoting future orientation for adolescents in risky environments, as improving future orientation might mitigate risk for future negative academic comes or engagement in violent behavior.

Future orientation buffers depression in daily and specific stress

Future orientation has been regarded as a protective factor that helps prevent problem behaviors, such as drug and alcohol use, smoking, and unprotected sex. Recently, many studies have focused on the relationship between a person's orientation towards the future and his or her depression symptoms; however, relatively few studies have explored the effect of future orientation on depressive responses to ordinary stress. The present study aimed to test whether future orientation could be a protective factor against depression in ordinary stress contexts. We conducted two studies to test this hypothesis and recruited 369 participants. Study 1 was a cross-sectional study that involved 217 employees from a food-processing company and examined the effect of future orientation in a daily stress context. Study 2 tested a hierarchical linear model in which 152 college students from an examination training institution in Beijing completed a five-wave assessment with 3-week intervals before taking the national entrance examination for postgraduate studies. The results showed that future orientation moderated the stress-depression relationship in the two samples. The present study provides evidence supporting the hypothesis that future orientation helps individuals cope with stress and protects people from depression, suggesting that future orientation plays a protective role in the stress-depression relationship.

Adolescent Risk Behavior: Differentiating Reasoned And Reactive Risk-taking

Although explanatory models of adolescent risk behavior have predominantly focused on adolescents' limited ability to self-regulate impulsive and/or reward-driven behavior (reactive risk behavior), recent arguments suggest that a significant proportion of adolescent risk behavior may actually be strategic and planned in advance (reasoned risk behavior). The present study evaluates hypothesized predictors of reasoned versus reactive risk behavior using self-reported and neurocognitive task data from a large, diverse adolescent sample (N = 1266 participants; N = 3894 risk behaviors). Participants' mean age was 16.5 years (SD = 1.1); 56.9% were female, 61.9% White, 17.1% Black, 7.0% Hispanic, and 14.1% other race/ethnicity; 40% were in 10th grade, 60% in 12th grade. As hypothesized, reasoned risk behavior (compared to reactive risk behavior) was associated with higher levels of sensation seeking, better working memory, greater future orientation, and perceiving risk behavior to be more beneficial than risky. These results support the distinction between reasoned and reactive risk behavior as meaningful subtypes of adolescent risk behavior and challenge prevailing frameworks that attribute adolescent risk behavior primarily to poor response inhibition.

Racial/ethnic measurement invariance of the School Success Profile (SSP)'s future orientation scale

Future orientation (FO) has received increasing attention for its positive effects on adolescent well-being and successful transition to adulthood. Although numerous measures of FO exist, most are not developmentally appropriate for diverse populations of adolescents, do not assess all theoretical components of FO, and/or were not developed for administration in schools. Additionally, the invariance of existing measures across racial/ethnic groups has not been examined using appropriately rigorous procedures. Using data from 2575 students in grades 6-9, this study examined the psychometric quality and measurement invariance of the FO scale on the School Success Profile (SSP) across African American (34.8%), Latino (27.0%), and European American (38.1%) subsamples. A one-factor model fit the data well in all three groups. Analyses identified only a small number of noninvariant parameters, supporting the conclusion that the scale has partial measurement invariance across the three groups. On average, African Americans had significantly higher levels of FO than the other two groups; mean scores for Latinos and European Americans were lower and statistically equivalent to each other. Construct validity of the SSP FO scale was also supported by findings of medium-sized relationships of FO scores to scores on five other constructs: low grades, school engagement, parent educational support, psychological distress, and school behavior. Multiple group tests of the magnitude and direction of the validity relationships indicated statistical equivalence across the three groups. Results support the use of the SSP FO scale by school psychologists to assess FO and to evaluate the effects of interventions targeting FO as a promoter of well-being and school success.

Creating the Safety and Respect Necessary for "Shared" Decision-making

Beyond the rhetoric of bioethics, patients and families need help facing tragic diagnoses and prognoses and coping with traumatic treatment options. In this article, I will draw from developmental psychology, psychodynamic psychotherapy, and bioethics to show what we are still missing about shared decision-making and how we can do better. Before we bring in new models of shared decision-making we need to ensure that doctors know how to create the foundational conditions for safe emotional communication. For pediatricians, this requires knowing enough about how adolescents process cognitive, affective and sensory information to avoid traumatizing their patients, knowing enough about the doctor's own fears not to project them onto the patient, and providing the supportive others that help the teenager tolerate and process information that is otherwise intolerable. To fail to do so can lead to tragic outcomes.

Interplay of Race and Criminal Justice Involvement on Sexual Behaviors of Young Men Who Have Sex With Men

PURPOSE

Criminal justice involvement is a significant problem in the United States, and poses substantial negative immediate and long-term effects, particularly among adolescents and young adults. Research has been mixed on the association between a history of arrest or incarceration and an increased risk of human immunodeficiency virus, but there are clear trends in the association between criminal justice involvement and sexual risk behaviors.

METHODS

Drawing from a racially or ethnically diverse sample of young men who have sex with men, we conducted an investigation into whether there was a temporal relationship between history of criminal justice involvement and engagement in high-risk sexual behaviors. We also examined whether sexual behaviors among black men who have sex with men (MSM) were more substantially impacted by arrest or incarceration than those of non-black MSM. Data were collected within a longitudinal study of young MSM in Chicago.

RESULTS

More than one-third of participants (37.8%) reported having ever been in trouble with the police in their lifetime, and 10% had been incarcerated. In multivariable analysis, black race, history of incarceration, and the interaction were all significantly positively associated with an increase in reported number of male anal sex partners.

CONCLUSIONS

We found that the intersection between race and criminal justice involvement plays a major role in sexual behaviors. More research is needed to understand why a history of arrest or incarceration has a much more profound effect on black MSM than on non-black MSM.

"I Have Strong Hopes for the Future": Time Orientations and Resilience Among Canadian Indigenous Youth

In this article, we demonstrate how concepts of time and the future inform processes of resilience among Indigenous adolescents within an urban Canadian context. This study employed a modified grounded theory methodology by conducting 38 qualitative interviews with 28 Indigenous youth (ages 15-25) over the course of 1 year. The analysis revealed complex processes of and navigations between moments of distress and strategies for resilience. The distressing contexts in which Indigenous youth often find themselves can impact the development of their concepts of time and limit their abilities to conceptualize a future. A future time orientation (FTO) emerged as central to processes of resilience and was supported by (a) nurturing a sense of belonging, (b) developing self-mastery, and

What Do You Want to Be When You Grow up? Career Aspirations as a Marker for Adolescent Well-being

OBJECTIVE

"What do you want to be when you grow up?" is a simple, commonly asked question that might provide insight into adolescent well-being. Career aspirations might reflect an adolescent's sense of identity, hope for the future, and self-efficacy, all of which are critical to identifying at-risk youth and intervening on risky behaviors. However, there are no studies on whether career aspirations are associated with adolescent emotional and health behavior outcomes.

METHODS

We analyzed cross-sectional surveys of 929 ninth to 12th grade low-income minority adolescents in Los Angeles assessing career aspirations and its association with hopelessness, self-efficacy, substance use, violence, and risky sexual activity. We used Department of Labor statistics to categorize career aspirations according to amount of education required, income, and prestige. Generalized estimating equations accounted for sociodemographic characteristics, school type, academic performance, and clustering at the school level.

RESULTS

Grades, standardized test scores, and health behaviors varied according to career type. Adolescents with higher career aspirations, measured according to career-related education, income, and prestige reported less hopelessness and more self-efficacy. After adjusting for confounders, aspirations requiring high levels of education were associated with decreased odds of alcohol use, at-school substance use, and risky sexual activity, and higher prestige scores were associated with decreased odds of other drug use.

CONCLUSIONS

Career aspirations might be a marker for adolescent health and well-being. Adults might consider asking a teen what they want to be when they grow up to gain insight into their levels of hopelessness and self-efficacy and provide context for counseling on healthy behavior change.

Adolescents' future orientation and nonmedical use of prescription drugs

INTRODUCTION

How adolescents think about their future (i.e., future orientation) impacts their risk-taking behavior. The purpose of the present analysis was to explore whether future orientation (future planning, perceived risk to future goals, and positive future expectations) was associated with nonmedical use of stimulants and analgesics in a sample of high school students.

METHODS

Information on future orientation and nonmedical use of prescription drugs (NMUPD) were collected using a paper-and-pencil survey from a sample of 9th-12th grade students in a Midwestern school.

RESULTS

Higher perceived risk to future goals and positive future expectations were associated with a lower likelihood of self-reported nonmedical use of stimulants (n=250; OR=0.46, 95% CI: 0.26, 0.83; OR=0.15, 95% CI: 0.05, 0.47, respectively). Only higher perceived risk to future goals was associated with a lower likelihood of self-reported nonmedical use of analgesics (n=250; OR=0.40, 95% CI: 0.24, 0.68). In a follow-up analysis limited to students who endorsed alcohol or marijuana use, perceived risk to future goals remained associated with a lower likelihood of nonmedical use of stimulants and analgesics.

CONCLUSIONS

Results suggest that risk perception might be a salient protective factor against both nonmedical use of stimulants and analgesics. Overall, the differential impact of conceptualizations of future orientation might depend on the class of prescription drug used, demonstrating a need to consider prescription drugs individually in the development of future studies and interventions.

The Relationship Between Hope and Adolescent Likelihood to Endorse Substance Use Behaviors in a Sample of Marginalized Youth

BACKGROUND

Hopefulness has been associated with increased treatment retention and reduced substance abuse among adults, and may be a promising modifiable factor to leverage in substance abuse treatment settings. Few studies have assessed the relationship between hopefulness and substance use in adolescents, particularly those with high-risk backgrounds.

OBJECTIVE

We explored whether high hope is associated with less likelihood for engaging in a variety of substance use behaviors in a sample of marginalized adolescents.

METHODS

Using logistic regression, we assessed results from a cross-sectional anonymous youth behavior survey (n = 256 youth, ages 14 to 19). We recruited from local youth serving agencies (e.g., homeless shelters, group homes, short-term detention).

RESULTS

The sample was almost 60% male and two thirds African American. Unadjusted models showed youth with higher hope had a 50-58% (p = <.05) decreased odds of endorsing heavy episodic drinking, daily tobacco use, recent or lifetime marijuana use, and sex after using substances. Adjusted models showed a 52% decreased odds of lifetime marijuana use with higher hope, and a trend towards less sex after substance use (AOR 0.481; p = 0.065). No other substance use behaviors remained significantly associated with higher hope scores in adjusted models.

CONCLUSIONS/IMPORTANCE

Hopefulness may contribute to decreased likelihood of substance use in adolescents. Focusing on hope may be one modifiable target in a comprehensive primary or secondary substance use prevention program.

Predictors of Weapon-Related Behaviors among African American, Latino, and White Youth

OBJECTIVE

To identify risk and protective factors for weapon involvement among African American, Latino, and white adolescents.

STUDY DESIGN

The National Longitudinal Study of Adolescent to Adult Health is a nationally representative survey of 7th-12th grade students. Predictors at wave 1 and outcome at wave 2 were analyzed. Data were collected in the mid-1990s, when rates of violent crime had been declining. The outcome was a dichotomous measure of weapon-involvement in the past year, created using 3 items (weapon-carrying, pulled gun/knife, shot/stabbed someone). Bivariate and multilevel logistic regression analyses examined associations of individual, peer, family, and community characteristics with weapon involvement; stratified analyses were conducted with African American, Latino, and white subsamples.

RESULTS

Emotional distress and substance use were risk factors for all groups. Violence exposure and peer delinquency were risk factors for whites and African Americans. Gun availability in the home was associated with weapon involvement for African Americans only. High educational aspirations were protective for African Americans and Latinos, but higher family connectedness was protective for Latinos only.

CONCLUSIONS

Interventions to prevent weapon-related behaviors among African American, Latino, and white adolescents may benefit from addressing emotional distress and substance use. Risk and protective factors vary by race/ethnicity after adjusting for individual, peer, family, and community characteristics. Addressing violence exposure, minimizing the influence of delinquent peers, promoting educational aspirations, and enhancing family connectedness could guide tailoring of violence prevention interventions.

Do Savings Mediate Changes in Adolescents' Future Orientation and Health-Related Outcomes? Findings From Randomized Experiment in Uganda

PURPOSE

This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset accumulation (in this case, by increasing family savings).

METHODS

Using longitudinal data from the cluster-randomized experiment, we ran generalized estimating equation models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents' future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping-to address the assumption of normal distribution.

RESULTS

Results indicate that participation in a matched Child Savings Account (CSA) program improved adolescents' future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents' confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched CSA program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings.

CONCLUSIONS

Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched CSAs, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how?

Promoting "Healthy Futures" to Reduce Risk Behaviors in Urban Youth: A Randomized Controlled Trial

There is increasing evidence of the interconnection between educational and health outcomes. Unfortunately wide disparities exist by both socioeconomic status and race/ethnicity in educational and vocational success. This study sought to promote urban youths' career readiness as a way to reduce involvement in risk behaviors. Two hundred primarily African-American youth (ages 14-21) were recruited from a pediatric primary care clinic. Youth randomized to the intervention received three motivational interviewing sessions focused around expectations and planning for the future. Baseline and 6-month follow-up assessments included measures of career readiness and risk behavior involvement (i.e., physical fighting, alcohol and marijuana use). At 6-months, youth randomized to the intervention condition showed increased confidence in their ability to perform the behaviors needed to reach their college/career goals. Additionally, youth randomized to the intervention arm showed decreased fighting behavior (adjusted rate ratio: .27) and marijuana use (adjusted rate ratio: .61). Assisting urban youth in thinking and planning about their future holds promise as a way to reduce their involvement in risk behaviors. This study also demonstrated that motivational interviewing could be used to promote positive behaviors (i.e., career readiness).

Understanding the Association Between School Climate and Future Orientation

Promoting students' future orientation is inherently a goal of the educational system. Recently, it has received more explicit attention given the increased focus on career readiness. This study aimed to examine the association between school climate and adolescents' report of future orientation using data from youth (N = 27,698; 49.4 % female) across 58 high schools. Three-level hierarchical linear models indicated that perceptions of available emotional and service supports, rules and consequences, and parent engagement were positively related to adolescents' future orientation. Additionally, the school-level average future orientation was significantly related to individuals' future orientation, indicating a potential influence of contextual effects on this construct. Taken together, these findings suggest that interventions targeting school climate may hold promise for promoting future orientation.

Coping Skills Help Explain How Future-Oriented Adolescents Accrue Greater Well-Being Over Time

Adolescents who endorse greater levels of future orientation report greater well-being over time, but we do not know the mechanism by which this happens. The present longitudinal study examined whether both adaptive as well as maladaptive coping strategies might explain how future orientation leads to ill-being and well-being over time in young New Zealanders. A sample of 1,774 preadolescents and early adolescents (51.9 % female) aged 10-15 years at Time 1 completed a self-report survey three times with 1 year intervals in between. Longitudinal mediation path models were constructed to determine whether and how maladaptive and adaptive coping strategies at Time 2 functioned as mediators between future orientation at Time 1 and ill-being and well-being at Time 3. Results showed that future orientation predicted lower maladaptive coping, which in turn predicted lower substance use and self-harming behavior. All three well-being outcomes (i.e., happiness with weight, vitality, and sleep) were consistently predicted by future orientation, and all three pathways were mediated by both lower maladaptive and higher adaptive coping strategies (with the exception of happiness with weight, which was mediated only by lower maladaptive coping). The results suggest that several pathways by which future orientation leads to greater well-being occurs through an increased use of adaptive coping, a decreased use of maladaptive coping, or both.