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Health-risk behaviors in teens investigated by U.S. Child Welfare Agencies.

ABSTRACT: The aim of this study was to examine prevalence and correlates of health-risk behaviors in 12- to 17.5-year-olds investigated by child welfare and compare risk-taking over time and with a national school-based sample.Data from the National Survey of Child and Adolescent Well-Being (NSCAW II) were analyzed to examine substance use, sexual activity, conduct behaviors, and suicidality. In a weighted sample of 815 adolescents aged 12-17.5 years, prevalence and correlates for each health-risk behavior were calculated using bivariate analyses. Comparisons to data from NSCAW I and the Youth Risk Behavior Survey were made for each health-risk behavior.Overall, 65.6% of teens reported at least one health-risk behavior with significantly more teens in the 15- to 17.5-year age group reporting such behaviors (81.2% vs. 54.4%; p ≤ .001). Almost 75% of teens with a prior out-of-home placement and 77% of teens with child behavior checklist scores ≥64 reported at least one health-risk behavior. The prevalence of smoking was lower than in NSCAW I (10.5% vs. 23.2%; p ≤ .05) as was that of sexual activity (18.0% vs. 28.8%; p ≤ .05). Prevalence of health-risk behaviors was lower among older teens in the NSCAW II sample (n = 358) compared with those of the 2011 Youth Risk Behavior Surveillance System high school-based sample with the exception of suicidality, which was approximately 1.5 times higher (11.3% [95% confidence interval, 6.5-19.0] vs. 7.8% [95% confidence interval, 7.1-8.5]).Health-risk behaviors in this population of vulnerable teens are highly prevalent. Early efforts for screening and interventions should be part of routine child welfare services monitoring.

SUBMITTER: Heneghan A

PROVIDER: S-EPMC5564320 | biostudies-other | 2015 May

REPOSITORIES: biostudies-other

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Project description:Between 2012 and 2017, N = 2814 youth between the ages of 4 and 20 were in child protective services (CPS) custody in Hamilton County, Ohio, and placed in out-of-home care. Child welfare administrative records were extracted and linked to electronic health records for all encounters at Cincinnati Children's Hospital Medical Center, with n = 2787 (99.1%) of records successfully linked prior to de-identifying the data for research purposes. Child welfare administrative data fields in the dataset include demographics, dates of entry into and exit from protective custody and out-of-home care, reasons for entry into custody, dates of placement changes, reasons for placement changes, and types of placement (e.g., foster home, kinship home, group home, residential treatment, independent living). Electronic health records (EHR) data fields include demographics, all inpatient and outpatient encounters with medications, diagnoses, screening results, laboratory test results, flowsheet data, and problem list entries. Data have been coded to capture broader categories of health needs and encounter details, medications, and other health concerns. Due to the high representation of children in CPS custody and out-of-home care who are also represented in the EHR data, this dataset provides a comprehensive view of the medical needs and health concerns for school-aged children in CPS custody in an entire county. As a result, these data can be useful for understanding the emergence of global and specific health concerns, frequency of healthcare use, and placement stability for all youth in CPS custody in this community, accounting for variation due to other health and child welfare factors. These data are likely generalizable to other mid-sized urban communities where academic medical centers provide healthcare for children in CPS custody. De-identified data may be made available to other researchers with approved data transfer agreements between academic institutions in place.

Project description:OBJECTIVES:To prospectively examine the health and health-related behaviors of Army Special Forces personnel in comparison with two distinct, but functionally similar Army groups. METHODS:Special Forces, Ranger Qualified, and General Purposes Forces enrolled in the Millennium Cohort Study were identified using data from the Defense Manpower Data Center. Using prospective survey data (2001-2014), we estimated the association of Army specialization with mental health, social support, physical health, and health-related behaviors with multivariable regression models. RESULTS:Among the 5,392 eligible participants (84.4% General Purposes Forces, 10.0% Special Forces, 5.6% Ranger Qualified), Special Forces personnel reported the lowest prevalence of mental disorders, physical health problems, and unhealthy behaviors. In the multivariable models, Special Forces personnel were less likely to report mental health problems, multiple somatic symptoms, and unhealthy behaviors compared with General Purpose Forces infantrymen (odds ratios [OR]: 0.20-0.54, p-values < .01). Overall, Special Forces personnel were similar in terms of mental and physical health compared with Ranger Qualified infantrymen, but were less likely to sleep < 5 hours/night (OR: 0.60, 95% confidence intervals: 0.40, 0.92) and have 5 or more multiple somatic symptoms (OR: 0.69, 95% CI: 0.49, 0.98). Both Special Forces personnel and Ranger Qualified infantrymen engaged in more healthy behaviors compared with General Purpose Forces infantrymen (OR: 2.57-6.22, p-values<0.05). Engagement in more healthy behaviors reduced the odds of subsequent adverse health outcomes, regardless of specialization. CONCLUSIONS:Army Special Forces personnel were found to be mentally and physically healthier than General Purpose Forces infantrymen, which may in part be due to their tendency to engage in healthy behaviors. Findings indicate that engagement in a greater number of healthy behaviors may reduce odds for subsequent adverse outcomes.

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Health-risk behaviors in teens investigated by U.S. Child Welfare Agencies.

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