Maternal and Child Health Library

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May 19, 2006

1. REPORT SUGGESTS STRATEGIES FOR INTEGRATING YOUTH DEVELOPMENT INTO STATE-FUNDED PROGRAMS THAT ADDRESS ADOLESCENT ISSUES

Incorporating Youth Development Principles into Adolescent Health Programs: A Guide for State-Level Practitioners and Policy Makers focuses on how youth development concepts may be applied within the context of specific public health functions and program responsibilities to achieve improved health and well-being among adolescents. The paper, produced by the Forum for Youth Investment, presents an overview of the youth-development approach, which calls for a focus on adolescents’ capacities, strengths, and developmental needs and not solely on their problems, risks, or health-compromising behaviors. The overview is followed by a summary of specific strategies for integrating youth development principles within each of five different public health functional areas: (1) commitment to adolescents and youth development, (2) partnerships and collaboration for health and youth development, (3) programs and services, (4) education and technical assistance, and (5) data collection and surveillance. Examples of how states have implemented the strategies, as well as additional resources, are also provided for each of the five areas. The report is intended for use by adolescent health coordinators and other health professionals and policymakers in incorporating youth development into state-funded programs that address adolescent issues. The report is available at http://www.forumfyi.org/Files/AdolescentHealth.pdf.

• The prevalence of parent-reported diagnosis of autism was 5.7 per 1,000 children in NHIS and 5.5 per 1,000 children in NSCH.
• Prevalence estimates in the two studies were similar across age, sex, and racial and ethnic populations.
• Parental reports of autism were associated with reported social, emotional, and behavioral symptoms and specialized needs.

• The majority (68.2%) of the students were classified as non-overweight, with 31.8% classified as overweight.
• Student report of dieting was common (55.2% of girls and 25.9% of boys).
• Students classified as overweight were roughly 1.5 to 3 times as likely as students classified as non-overweight to report dieting, EWCBs, and body dissatisfaction.
• Girls who reported dieting had elevated odds ratios for EWCBs, low self-esteem, body dissatisfaction, and depressive symptoms, and tobacco use and alcohol use; boys who reported dieting had elevated odds for EWCBs, low self-esteem, body dissatisfaction, and depressive symptoms.
• Increased risks associated with dieting were similar for overweight and non-overweight students, with the exception of body dissatisfaction in non-overweight girls (5.26) vs. overweight girls (3.19).

• After adjusting for maternal race and ethnicity, birthplace, parity, marital status, health insurance status, and the child's gender, mothers ages 35 and older were more than 2 times as likely as mothers ages 20-34 to deliver low-birthweight infants; mothers ages 20 and younger were neither significantly more nor significantly less likely than mothers ages 20-34 to deliver low-birthweight infants.
• When controlling only for the mothers' demographic characteristics (other than age) and the child's gender, fathers ages 19 and younger were less likely than fathers ages 20-34 to have low-birthweight infants, although the association was not statistically significantly.
• When adjusting for the mother's age in addition to the other covariates, fathers ages 19 and younger were 70% as likely as fathers ages 20-23 to have low-birthweight infants.
• Fathers ages 35 and older were 1.9 times as likely as fathers ages 20-34 to have low-birthweight infants, after adjustment for maternal demographic characteristics (other than age) and the child's gender; this was only slightly reduced when adjusting for maternal age.
• For each racial and ethnic subgroup, the association between paternal age (34 and older) and low birthweight was virtually identical to that for the full sample.

• Service need was found to vary by service type and other child characteristics. Poorer ratings of overall health status, less stability of health care needs, and greater severity of the child's health condition(s) were all related to greater need in each service category.
• Although the majority of respondents did not report any unmet need, experiencing unmet needs was increased for children and families who had more needs from multiple service areas, less predictable needs, and less consistent and comprehensive insurance coverage.
• For each of the four access problems studied (problems getting referrals, problems finding a health professional with needed skills, problems getting enough visits with the health professional, and problems with cost), reports of difficulty were greatest for mental health and home health services.
• Parents identified two of the four access problems as most prevalent: finding a health professional with needed skills and experience and getting enough visits with the health professional. Different insurance characteristics are significant predictors of each of these access problems.
• Controlling for all other child health measures, parents of older children reported greater difficulty finding experienced health professionals and an increased likelihood of having an unmet need.
• Parents of children with the highest service needs reported significantly greater unmet needs and a greater likelihood of experiencing each type of access problem than parents of children with fewer service needs.