RESUMO
Formal youth mentoring is an effective intervention strategy for healthy development during adolescence. Modest and varied effects across programs, however, demonstrate a need to identify factors that can reliably improve outcomes for mentored youth. The purpose of this randomized controlled trial was to test the relative impact of embedding mentee-mentor matches in small groups on youth outcomes and to examine whether this effect was mediated by the quality of the program setting and mentoring relationship quality. Participants included 676 adolescents (Mage = 14.21, range = 11-18; 41.6% female) enrolled in Campus Connections, a site-based youth mentoring program. Most measured outcomes in both conditions (i.e., mentoring groups and a control condition in which pairs were not embedded in a group) were significantly better at post-intervention as compared to pre-intervention. The hypothesis that mentoring groups would have stronger impact, however, was not supported. The results imply that organizing mentor-mentee matches in small groups offer no advantage or disadvantage and that youth may be able to garner benefit from both structures.
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Tutoria , Adolescente , Feminino , Humanos , Masculino , Mentores , Avaliação de Programas e Projetos de SaúdeRESUMO
An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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Youth mentoring can have a profound impact on the lives of high-risk youth. This study presents the Campus Corps program, a time-limited (12-week), structured mentoring program for high-risk youth (ages 11-18), and results from a quasi-experimental pilot evaluation. Baseline and post-intervention problem behavior data from 315 offending youth were used in multiple regression analyses. After accounting for baseline group differences, pre-intervention scores, and demographic covariates, Campus Corps participants (n=187, 63.1% male) reported less engagement in problem behavior, lower acceptance of problem behavior, and greater sense of autonomy from marijuana use post-intervention than participants in the comparison condition (n=128, 66.4% male). Conversely, post-intervention group differences were not observed for peer refusal skills or autonomy from alcohol use. A description of the Campus Corps program design and supplemental preliminary findings contribute to the growing knowledge base of youth mentoring program designs and outcomes.
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PURPOSE: To examine the use patterns and charges for adolescents with special health care needs (ASHCN) and adolescents engaging in risky behaviors (ARB) and both (BOTH), compared with adolescents with no identified special health care or risky behavior diagnosis (ANIC) in a pool of adolescent enrollees eligible for Title XXI services. METHODS: Claims and encounter data were used to classify 11,459 who had been enrolled in Florida's Healthy Kids Program for 2 consecutive years into 4 groups: ASHCN (n = 1363); ARB (n = 1801); BOTH (n = 773); and ANIC (n = 7522). Monthly per capita inpatient, outpatient, emergency room, and total use and charges were calculated and compared across groups using the Wilcoxon rank sum test, descriptive statistics, and odds ratios. RESULTS: The data indicated that ASHCN, ARB, and BOTH consume significantly more health care services than ANIC and that their higher use and charges are attributable not only to condition-related costs but also to their higher use of non-condition-related services as well. The data also revealed that adolescents with a special health care diagnosis (ASHCN and BOTH) had a higher percentage of costs owing to inpatient stays, whereas adolescents with a risky behavior diagnosis (ARB and BOTH) had a higher percentage of costs owing to emergency room usage. Finally, relevant to the total resources necessary to provide health care for adolescents, the data showed that 65% of the total annual costs of this program emanate from the 35% of adolescents who have special health care needs, engage in risky behaviors, or both. CONCLUSIONS: This study underscores two important points that can be used to ensure that adequate financing, provider network, and service delivery systems are developed to best meet the needs of the adolescent population: (a) the importance of considering the unique needs of adolescents in reimbursement rate setting strategies and (b) the importance of considering category of service utilization in weighting premiums for various groups.
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Comportamento do Adolescente , Atenção à Saúde/estatística & dados numéricos , Seguro Saúde , Assunção de Riscos , Adolescente , Atenção à Saúde/economia , Feminino , Custos de Cuidados de Saúde , Implementação de Plano de Saúde , Humanos , MasculinoRESUMO
OBJECTIVE: Emerging evidence about optimal youth development highlights the importance of both reducing negative behavior and promoting positive behavior. In our study we tested a contextual model derived from positive youth-development theory by examining the association of family, school, and community risk and promotive factors, with several outcome indices of both positive and negative adolescent development. METHODS: A sample of 42305 adolescents aged 11 to 17 (51% girls) was drawn from the 2003 National Survey of Children's Health. Survey item composites were formed representing promotive and risk factors in the family (eg, closeness, aggression) and school and community (eg, community connectedness, school violence). Outcome composites reflected positive (social competence, health-promoting behavior, self-esteem) and negative (externalizing, internalizing, academic problems) developmental outcomes. Ordinary least squares regression was used to test the overall model. RESULTS: Between 0.10 and 0.50 of the variance in each outcome was explained by the contextual model. Multiple positive family characteristics were related to adolescent social competence and self-esteem, as well as lowered levels of internalizing and externalizing behavior and academic problems. Family communication, rules about television, and parents' own healthy behavior were related to adolescent health-promoting behavior. School and community safety were associated with increased social competence and decreased externalizing behavior. School violence was related to adolescent internalizing and externalizing behavior, as well as academic problems and lower self-esteem. CONCLUSIONS: Our results support the proposition that healthy adolescent development has roots in multiple contexts. Youth who were involved in contexts that provided positive resources from important others (ie, parents, schools, and communities) not only were less likely to exhibit negative outcomes, but also were more likely to show evidence of positive development. These findings provide important implications for intervention and prevention efforts and, more generally, for the promotion of positive, competent, and healthy youth development.
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Desenvolvimento do Adolescente , Modelos Teóricos , Assunção de Riscos , Meio Social , Adolescente , Comportamento do Adolescente , Criança , Família , Feminino , Promoção da Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Relações Interpessoais , Estilo de Vida , Masculino , Características de Residência , Instituições Acadêmicas , Fatores Socioeconômicos , Estados UnidosRESUMO
PURPOSE: To examine a nested model that predicts adolescent risky behavior, health care use, and health care expenditures from individual characteristics, such as age and gender, and community characteristics such as social capital and community-level risky behavior rates. METHODS: Claims and encounter data were used to classify adolescents enrolled in Florida's Healthy Kids Program into two groups: those who engaged in risky behavior (ARB) and those who did not (NRB). Hierarchical linear modeling techniques were used to predict the odds of risky behavior, the odds of health care use, and health care expenditures based on individual and community characteristics. RESULTS: ARB consumed significantly more health care services than NRB, and their higher use and charges were attributable not only to individual level factors (i.e., age, gender, presence of special health care need, metropolitan residence status), but also to community level factors (i.e., social capital, risky behavior rates, violence, and ethnic/racial composition) as well. In particular, community investment in social capital predicted lower levels of risky behavior as well as lower health care expenditures. CONCLUSIONS: This information is important in terms of policy efforts at providing health care for this vulnerable group of individuals, as well as in developing prevention and intervention programs that can be delivered through the health care system and via links to community supports.
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Comportamento do Adolescente , Serviços de Saúde do Adolescente/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Assunção de Riscos , Adolescente , Serviços de Saúde do Adolescente/economia , Fatores Etários , Feminino , Previsões , Humanos , Modelos Lineares , Masculino , Fatores SexuaisRESUMO
BACKGROUND: One of the more controversial issues related to maternal employment in the United States concerns the timing of entry into the workforce and its effect on children, particularly during the first year of the child's life. Some studies show deleterious effects on children, such as increases in aggression and noncompliance, while others document few negative and even positive effects of early employment. METHODS: This study examined the long-term effects of maternal employment during the child's first year of life on the social behavior of 171 third- and fourth-grade children in two-parent families. The moderating effects of child gender and social class were investigated. The extent to which stability in alternative care arrangements statistically explained links between early maternal employment and child outcomes was tested. RESULTS: After controlling for child gender, and maternal ethnicity, social class, and current employment status, third- and fourth-grade children whose mothers were employed during their first year of life evinced more acting out and less frustration tolerance and were nominated more often by peers for 'hitting' and 'being mean' than children whose mothers were not employed. There was some evidence that these associations were moderated by child gender and social class: boys, but not girls, whose mothers were employed during the first year were subsequently rated by teachers as acting out more than other children, and were also more likely to be nominated by peers for hitting. Higher nominations for hitting were only found in the working class. Finally, there was partial evidence that the number of alternative child-care arrangements during the first year accounted for the links between early maternal employment and subsequent child outcomes. CONCLUSIONS: These results are congruent with extant research that posits a risk of early employment on socioemotional development, but show that this risk is partially attributable to child-care instability.
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Transtornos do Comportamento Infantil/epidemiologia , Emprego , Docentes , Mães , Grupo Associado , Comportamento Social , Afeto , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Cuidado da Criança , Etnicidade , Seguimentos , Humanos , Masculino , Variações Dependentes do Observador , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de TempoRESUMO
OBJECTIVES: The purpose of this study was to examine agreement between adolescents and their parents about whether or not the adolescent had a special health care need, using the Children with Special Health Care Needs (CSHCN) Screener. METHODS: Telephone surveys that included the CSHCN Screener were conducted with 522 adolescents and their parents who were new enrollees in Florida's State Children's Health Insurance Program (SCHIP). RESULTS: Analyses revealed substantial agreement as to whether or not the adolescent had a chronic condition. However, a full 15% of pairs disagreed. Analyses of pair disagreement revealed that parents reported adolescents' chronic conditions more often than adolescents, most strikingly for mental health conditions. Additional analyses revealed that pairs with older adolescents, female adolescents, and Hispanic origin had higher odds of being congruent than their counterparts. CONCLUSIONS: The results showed higher congruence using the consequence-based CSHCN Screener than is typically reported for diagnosis-based approaches. Despite an impressive rate of agreement, the analyses also highlighted parents' tendency to overreport special health care needs relative to their adolescent, particularly for mental health issues, and illustrated some of the demographic factors that might predict congruence. These findings are relevant to work related to the use of tools such as the CSHCN Screener in profiling enrollees in health care programs that serve children and adolescents.
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Serviços de Saúde do Adolescente/estatística & dados numéricos , Nível de Saúde , Programas de Rastreamento/métodos , Avaliação das Necessidades/estatística & dados numéricos , Pais , Adolescente , Criança , Doença Crônica/epidemiologia , Doença Crônica/terapia , Coleta de Dados , Feminino , Hispânico ou Latino , Humanos , Masculino , Variações Dependentes do Observador , Grupos Raciais , Inquéritos e QuestionáriosRESUMO
This study investigated agency and communion attributes in adults' spontaneous self-representations. The study sample consisted of 158 adults (80 men, 78 women) ranging in age from 20 to 88 years. Consistent with theorising, significant age and sex differences were found in terms of the number of agency and communion attributes. Young and middle-aged adults included significantly more agency attributes in their self-representations than older adults; men listed significantly more agency attributes than women. In contrast, older adults included significantly more communion attributes in their self-representations than young adults, and women listed significantly more communion attributes than men. Significant Age Group x Self-Portrait Display and Sex x Self-Portrait Display interactions were found for communion attributes, indicating that the importance of communion attributes differed across age groups and by sex. Correlational analyses showed significant associations of agency and communion attributes with personality traits and defence mechanisms. Communion attributes also showed significant correlations with four dimensions of psychological well-being.