Journal of Adolescent Health
Volume 47, Issue 1 , Pages 26-34, July 2010

Health-Risk Behaviors in Young Adolescents in the Child Welfare System

  • Laurel K. Leslie, M.D.

      Affiliations

    • Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
    • The Child and Adolescent Services Research Center, San Diego, California
    • Corresponding Author InformationAddress correspondence to: Laurel K. Leslie, M.D., M.P.H., Center on Child and Family Outcomes, The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Tufts MC #345, Boston, MA 02111.
    • ,
  • Sigrid James, Ph.D.

      Affiliations

    • The Child and Adolescent Services Research Center, San Diego, California
    • Loma Linda University, Loma Linda, California
    • ,
  • Amy Monn, B.A.

      Affiliations

    • The University of Minnesota, Twin Cities, Minneapolis, Minnesota
    • ,
  • Milena C. Kauten, B.A.

      Affiliations

    • Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts
    • ,
  • Jinjin Zhang, M.S.

      Affiliations

    • The Child and Adolescent Services Research Center, San Diego, California
    • ,
  • Gregory Aarons, Ph.D.

      Affiliations

    • The Child and Adolescent Services Research Center, San Diego, California
    • The University of California, San Diego, California

Received 30 October 2009; accepted 30 December 2009. published online 15 March 2010.

Abstract 

Purpose

To examine rates and patterns of health-risk behavior (e.g., sexuality, depression/suicidality, substance use, delinquency) among a national probability sample of youth active to the child welfare/child protective services system. Recent federal legislation, P.L. 110-351, encourages child welfare systems, Medicaid, and pediatric experts to collaborate to ensure youth entering foster care receive comprehensive health examinations.

Methods

Analysis of baseline caregiver, caseworker, and child interviews, and assessment data for a subsample (n = 993) of youth, aged 11–15 years, from the National Survey of Child and Adolescent Well-Being, a national probability sample of children and adolescents undergoing investigation for abuse or neglect.

Results

Almost half of the sample (46.3%) endorsed at least one health-risk behavior. On Poisson multivariate regression modeling, factors related to higher rates of health-risk behaviors included older age, female gender, abuse history, deviant peers, limited caregiver monitoring, and poor school engagement.

Conclusion

Given the heightened vulnerability of this population, early screening for health-risk behaviors must be prioritized. Further research should explore specific subpopulations at risk for health-risk behaviors and possible interventions to change these youths' trajectories.

Keywords: Child welfare, Foster care, Pediatrics, Health-risk behaviors, Sexuality, Depression, Substance use, Delinquency

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 The National Survey of Child and Adolescent Well-Being (NSCAW) was developed under contract to RTI from the ACYF/DHHS. The information and opinions expressed herein reflect solely the position of the author(s). Nothing herein should be construed to indicate the support or endorsement of its content by ACYF/DHHS.

PII: S1054-139X(10)00018-2

doi:10.1016/j.jadohealth.2009.12.032

Journal of Adolescent Health
Volume 47, Issue 1 , Pages 26-34, July 2010

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