Journal of Adolescent Health RSS feed: Current Issue. The Journal of Adolescent Health is a multidisciplinary scientific Journal, which seeks to publish new research findings in the field of Adolescent Medicine and Health ranging from the basic biological and behavioral sciences to public health and policy. We seek original manuscripts, review articles, letters to the editor, commentaries, and case reports from our colleagues in Anthropology, Dentistry and Oral Health, Education, Health Services Research, International Health, Law, Medicine, Mental Health, Nursing, Nutrition, Psychology, Public Health and Policy, Social Work, Sociology, Youth Development, and other disciplines that work with or are committed to improving the lives of adolescents and young adults. The Journal is the official publication of the Society for Adolescent Medicine (SAM) , a multidisciplinary organization committed to improving the health and well-being of adolescents. One of the Society's primary goals is the development, synthesis, and dissemination of scientific and scholarly knowledge unique to the health needs of adolescents. To meet this goal, the Society established the Journal of Adolescent Health in 1980. The Journal of Adolescent Health is ranked 8th of 86 in the Pediatrics category and 20th of 105 journals in the Public, Environmental & Occupational Health category in the 2009 Journal Citation Reports®, published by Thomson Reuters, and has an Impact Factor of 2.910.http://www.jahonline.org/?rss=yesElsevier Inc.en © 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved. Journal of Adolescent Health1054-139X462February 2010 © 2010 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.jahonline.org/article/PIIS1054139X0900634X/abstract?rss=yes See Related Articles pgs. 124 and 133Adolescents and Emerging Adults' Sleep Patterns: New DevelopmentsAmy R. Wolfson10.1016/j.jadohealth.2009.11.210Journal of Adolescent Health 46, 2 (2010)2010-02-01Journal of Adolescent Health2010-02-01462S1054-139X(09)X0014-5Editorial9799http://www.jahonline.org/article/PIIS1054139X09003978/abstract?rss=yesTo address the critical shortage of physician scientists in the field of adolescent medicine, a conference of academic leaders and representatives from foundations, National Institutes of Health, Maternal and Child Health Bureau, and the American Board of Pediatrics was convened to discuss training in transdisciplinary research, facilitators and barriers of successful career trajectories, models of training, and mentorship. The following eight recommendations were made to improve training and career development: incorporate more teaching and mentoring on adolescent health research in medical schools; explore opportunities and electives to enhance clinical and research training of residents in adolescent health; broaden educational goals for Adolescent Medicine fellowship research training and develop an intensive transdisciplinary research track; redesign the career pathway for the development of faculty physician scientists transitioning from fellowship to faculty positions; expand formal collaborations between Leadership Education in Adolescent Health/other Adolescent Medicine Fellowship Programs and federal, foundation, and institutional programs; develop research forums at national meetings and opportunities for critical feedback and mentoring across programs; educate Institutional Review Boards about special requirements for high quality adolescent health research; and address the trainee and faculty career development issues specific to women and minorities to enhance opportunities for academic success.Improving Adolescent and Young Adult Health — Training the Next Generation of Physician Scientists in Transdisciplinary ResearchS. Jean Emans, S. Bryn Austin, Elizabeth Goodman, Donald P. Orr, Robert Freeman, David Stoff, Iris F. Litt, Mark A. Schuster, Robert Haggerty, Robert Granger, Charles E. Irwin, participants of the W.T. Grant Foundation conference on Training Physician Scientists10.1016/j.jadohealth.2009.10.004Journal of Adolescent Health 46, 2 (2010)2010-02-01Journal of Adolescent Health2010-02-01462S1054-139X(09)X0014-5Commentaries100109http://www.jahonline.org/article/PIIS1054139X09006351/abstract?rss=yesEditor's Note: On May 4, 2009, Mark Schuster, MD, PhD, received the Academic Pediatric Association 2009 Research Award for career achievement. The chair of the APA's Research Committee, Benard Dreyer, MD, introduced Dr. Schuster. Following are Dr. Schuster's remarks. A slide appeared behind him with the names of his mentors and mentees. This commentary is being published simultaneously in Academic Pediatrics, Vol 10, No 1 (the January–February issue).Excellence in Research: Threats From All DirectionsMark A. Schuster10.1016/j.jadohealth.2009.11.211Journal of Adolescent Health 46, 2 (2010)2010-02-01Journal of Adolescent Health2010-02-01462S1054-139X(09)X0014-5Commentaries110112http://www.jahonline.org/article/PIIS1054139X09006089/abstract?rss=yesAbstract: The quadrivalent human papillomavirus virus vaccine was recently licensed for use in males in the United States. This study reviews available published literature on acceptability among parents, health care providers, and young males. Among 23 published articles, half were conducted in the United States. The majority (87%) used quantitative survey methodology, and 13% used more explorative qualitative techniques. Convenience samples were used in most cases (74%) and 26% relied on nationally representative samples. Acceptability of a human papillomavirus virus (HPV) vaccine that protects against cervical cancer and genital warts was high in studies conducted among male college students (74%–78%) but lower in a community sample of males (33%). Among mothers of sons, support of HPV vaccination varied widely from 12% to 100%, depending on the mother's ethnicity and type of vaccine, but was generally high for a vaccine that would protect against both genital warts and cervical cancer. Health providers' intention to recommend HPV vaccine to male patients varied by patient age but was high (82%–92%) for older adolescent patients. A preference to vaccinate females over males was reported in a majority of studies among parents and health care providers. Messages about cervical cancer prevention for female partners did not resonate among adult males or parents. Future acceptability studies might incorporate more recent data on HPV-related disease, HPV vaccines, and cost-effectiveness data to provide more current information on vaccine acceptability.Acceptability of Human Papillomavirus Vaccine for Males: A Review of the LiteratureNicole Liddon, Julia Hood, Bridget A. Wynn, Lauri E. Markowitz10.1016/j.jadohealth.2009.11.199Journal of Adolescent Health 46, 2 (2010)2010-02-01Journal of Adolescent Health2010-02-01462S1054-139X(09)X0014-5Review Article113123http://www.jahonline.org/article/PIIS1054139X09002389/abstract?rss=yesAbstract: Purpose: To characterize sleep patterns and predictors of poor sleep quality in a large population of college students. This study extends the 2006 National Sleep Foundation examination of sleep in early adolescence by examining sleep in older adolescents.Method: One thousand one hundred twenty-five students aged 17 to 24 years from an urban Midwestern university completed a cross-sectional online survey about sleep habits that included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Horne-Ostberg Morningness–Eveningness Scale, the Profile of Mood States, the Subjective Units of Distress Scale, and questions about academic performance, physical health, and psychoactive drug use.Results: Students reported disturbed sleep; over 60% were categorized as poor-quality sleepers by the PSQI, bedtimes and risetimes were delayed during weekends, and students reported frequently taking prescription, over the counter, and recreational psychoactive drugs to alter sleep/wakefulness. Students classified as poor-quality sleepers reported significantly more problems with physical and psychological health than did good-quality sleepers. Students overwhelmingly stated that emotional and academic stress negatively impacted sleep. Multiple regression analyses revealed that tension and stress accounted for 24% of the variance in the PSQI score, whereas exercise, alcohol and caffeine consumption, and consistency of sleep schedule were not significant predictors of sleep quality.Conclusions: These results demonstrate that insufficient sleep and irregular sleep–wake patterns, which have been extensively documented in younger adolescents, are also present at alarming levels in the college student population. Given the close relationships between sleep quality and physical and mental health, intervention programs for sleep disturbance in this population should be considered.Sleep Patterns and Predictors of Disturbed Sleep in a Large Population of College StudentsHannah G. Lund, Brian D. Reider, Annie B. Whiting, J. Roxanne Prichard10.1016/j.jadohealth.2009.06.016Journal of Adolescent Health 46, 2 (2010)2009-08-03Journal of Adolescent Health2009-08-03462S1054-139X(09)X0014-5Original Articles124132http://www.jahonline.org/article/PIIS1054139X09002559/abstract?rss=yesAbstract: Purpose: To investigate whether chronic vigorous exercising is related to improved sleep and psychological functioning, and whether this association varies with gender. Both lay and scientific opinions hold that physical activity is an efficient remedy and preventative measure for poor sleep. However, empirical evidence on adolescents is very limited.Methods: A total of 434 adolescents (258 athletes, 176 controls; mean age 17.2 years) took part in the study. Weekly hours spent exercising were 17.69hours and 4.69hours, respectively. To assess sleep patterns and psychological functioning, participants completed a sleep log for 7 consecutive days and several self-rating questionnaires.Results: Compared with controls, athletes reported better sleep patterns including higher sleep quality, shortened sleep onset latency, and fewer awakenings after sleep onset, as well as less tiredness and increased concentration during the day. Athletes reported significantly lower anxiety and fewer depressive symptoms. Compared with males, females reported fewer variations in sleep. Male controls had particularly unfavorable scores related to sleep and psychological functioning.Conclusions: Findings suggest that chronic vigorous exercising is positively related to adolescents' sleep and psychological functioning. Results also indicate that males with low exercise levels are at risk for increased sleep complaints and poorer psychological functioning.High Exercise Levels Are Related to Favorable Sleep Patterns and Psychological Functioning in Adolescents: A Comparison of Athletes and ControlsSerge Brand, Markus Gerber, Johannes Beck, Martin Hatzinger, Uwe Pühse, Edith Holsboer-Trachsler10.1016/j.jadohealth.2009.06.018Journal of Adolescent Health 46, 2 (2010)2009-08-18Journal of Adolescent Health2009-08-18462S1054-139X(09)X0014-5Original Articles133141http://www.jahonline.org/article/PIIS1054139X09006296/abstract?rss=yesAbstract: Purpose: Many countries recommend human papillomavirus (HPV) vaccination in female adolescents at an age when other vaccines are routinely administered. This open, randomized, multicenter study (108464/NCT00426361) evaluated coadministration of HPV-16/18 AS04-adjuvanted vaccine with diphtheria-tetanus-acellular pertussis–inactivated poliovirus vaccine (dTpa-IPV).Methods: Healthy females aged 10–18 years were randomized to receive HPV vaccine at months 0, 1, and 6 (n = 248), HPV vaccine coadministered with dTpa-IPV at month 0 and HPV vaccine at months 1 and 6 (n = 255), or dTpa-IPV at month 0 followed by HPV vaccine at months 1, 2, and 7 (n = 248). Immunogenicity was evaluated at months 0, 1, and 7 or 8 (depending on group). Vaccine reactogenicity and safety were also assessed.Results: Coadministered dTpa-IPV and HPV vaccine was noninferior to dTpa-IPV alone in terms of seroprotection against diphtheria (99.2% and 100%), tetanus (100% and 100%) and poliovirus types 1, 2, and 3 (≥99.6%), and geometric mean antibody concentrations (ELISA Units/mL) for pertussis toxoid (84 vs. 75), filamentous hemagglutinin (612 and 615) and pertactin (426 and 360) at month 1. Coadministered dTpa-IPV and HPV vaccine was noninferior to HPV vaccine alone in terms of seroconversion rates for HPV-16 (99.5% and 100%) and HPV-18 (99.5% and 100%) and geometric mean antibody titers (ELISA Units/mL) for HPV-16 (15,608 and 18,965) and HPV-18 (6,597 and 6,902) at month 7. Coadministration was generally well tolerated. The reactogenicity of dTpa-IPV and the first dose of HPV vaccine was similar.Conclusions: Results from this study support coadministration of the HPV-16/18 AS04-adjuvanted vaccine with dTpa-IPV vaccine in females aged 10–18 years.Immunogenicity and Safety of Human Papillomavirus-16/18 AS04-Adjuvanted Cervical Cancer Vaccine Coadministered With Combined Diphtheria-Tetanus-Acellular Pertussis–inactivated Poliovirus Vaccine to Girls and Young WomenJosé Garcia-Sicilia, Tino F. Schwarz, Alfonso Carmona, Klaus Peters, Jean-Elie Malkin, Phu M. Tran, Ulrich Behre, Enrique B. Iturbe, Gregory Catteau, Florence Thomas, Kurt Dobbelaere, Dominique Descamps, Gary Dubin, HPV Vaccine Adolescent Study Investigators Network10.1016/j.jadohealth.2009.11.205Journal of Adolescent Health 46, 2 (2010)2010-02-01Journal of Adolescent Health2010-02-01462S1054-139X(09)X0014-5Original Articles142151http://www.jahonline.org/article/PIIS1054139X09002432/abstract?rss=yesAbstract: Background: Seeking screening and treatment for chlamydia (CT) and gonorrhea (GC) by young women is critical to reduction of asymptomatic cervicitis and its complications.Objectives: To evaluate the efficacy of a client-centered motivational behavioral intervention (MBI), to promote seeking of sexually tranmitted infection (STI) checkups by young women.Methods: Three hundred seventy-six of 770 eligible sexually active, nonpregnant, English-speaking women (mean age 18.5 years) were recruited from an urban reproductive health clinic and randomized to two groups: intervention plus standard care (MBI) or standard care alone (SC). MBI (two sessions plus booster) was based on the Transtheoretical Model of Change and employed motivational interviewing. Outcome measures monitored for 12 months included: client-initiated clinic visits for STI checkups in response to seven high-risk sexual behaviors by self-report (primary), consistent condom use, number of CT and GC episodes, and movement along the stages of change obtained at baseline and 6- and 12-month follow-up assessments (secondary). Analyses included chi-square, logistic regression, and generalized estimating equations.Results: At baseline, more than 70% endorsed the action stage of change for seeking STI checkups for three of seven high-risk sexual behaviors. No significant differences were noted between the two groups for the primary or secondary outcomes. Across groups, having multiple partners and being pregnant or thinking one might be pregnant were associated with STI checkups.Conclusions: This is the first known client-centered clinical trial to promote STI screening. Risk-taking and health-seeking behaviors are complex and interrelated with STI and pregnancy concerns. The intervention may have an effect if it is targeted to women in a less medically connected community-based sample.Efficacy of a Motivational Behavioral Intervention to Promote Chlamydia and Gonorrhea Screening in Young Women: A Randomized Controlled TrialMariam R. Chacko, Constance M. Wiemann, Claudia A. Kozinetz, Kirk von Sternberg, Mary M. Velasquez, Peggy B. Smith, Ralph DiClemente10.1016/j.jadohealth.2009.06.012Journal of Adolescent Health 46, 2 (2010)2009-08-03Journal of Adolescent Health2009-08-03462S1054-139X(09)X0014-5Original Articles152161http://www.jahonline.org/article/PIIS1054139X09002390/abstract?rss=yesAbstract: Purpose: Rapid human immunodeficiency virus (HIV) tests may be more acceptable to adolescents and may improve receipt of test results. We conducted a study to determine (a) adolescent preferences for different HIV testing methods (rapid oral fluid vs. rapid fingerstick vs. traditional venipuncture), (b) factors associated with choice of a rapid vs. traditional test, and (c) whether those who chose a rapid method were more likely to receive test results.Methods: Participants (N=99, 13–22 years old, both genders) were recruited from an urban hospital-based adolescent primary care clinic, agreed to HIV testing with their choice of method, and completed a questionnaire assessing demographic characteristics and attitudes about HIV testing. Logistic regression modeling was used to determine factors associated with choice of a rapid versus traditional test.Results: Half (50.5%) of participants chose rapid oral fluid testing, 30.3% traditional venipuncture testing, and 19.2% rapid fingerstick testing (p < .01). Factors independently associated with choice of a rapid versus traditional method included preference for an oral fluid versus blood test and perceived approval of HIV testing by one's healthcare provider. Participants who chose a rapid test were more likely to receive their test results within the follow-up period than participants who chose a traditional test (91.3% vs. 46.7%, p < .001).Conclusions: In this study, 70% of adolescents preferred rapid to traditional HIV testing, and rapid testers were more likely to receive their results within the follow-up period. Offering rapid testing may lead to improved receipt of results among adolescents in urban primary care settings.Adolescent Preferences for Human Immunodeficiency Virus Testing Methods and Impact of Rapid Tests on Receipt of ResultsTanya L. Kowalczyk Mullins, Paula K. Braverman, Lorah D. Dorn, Linda M. Kollar, Jessica A. Kahn10.1016/j.jadohealth.2009.06.015Journal of Adolescent Health 46, 2 (2010)2009-07-30Journal of Adolescent Health2009-07-30462S1054-139X(09)X0014-5Original Articles162168http://www.jahonline.org/article/PIIS1054139X0900247X/abstract?rss=yesPurpose: This study tested the effects of a theory-based, middle-school human immunodeficiency virus, STI, and pregnancy prevention program, It's Your Game: Keep it Real (IYG), in delaying sexual behavior. We hypothesized that the IYG intervention would decrease the number of adolescents who initiated sexual activity by the ninth grade compared with those in the comparison schools.Methods: The target population consisted of English-speaking middle school students from a large, urban, predominantly African-American and Hispanic school district in Southeast Texas. Ten middle schools were randomly assigned either to receive the intervention or to the comparison condition. Seventh-grade students were recruited and followed through ninth grade. The IYG intervention comprises 12 seventh-grade and 12 eighth-grade lessons that integrate group-based classroom activities with computer-based instruction and personal journaling. Ninth-grade follow-up surveys were completed by 907 students (92% of the defined cohort). The primary hypothesis tested was that the intervention would decrease the number of adolescents who initiated sexual activity by the ninth grade compared with those in the comparison schools.Results: Almost one-third (29.9%, n=509) of the students in the comparison condition initiated sex by ninth grade compared with almost one-quarter (23.4%, n=308) of those in the intervention condition. After adjusting for covariates, students in the comparison condition were 1.29 times more likely to initiate sex by the ninth grade than those in the intervention condition.Conclusions: A theory-driven, multi-component, curriculum-based intervention can delay sexual initiation up to 24 months; can have impact on specific types of sexual behavior such as initiation of oral and anal sex; and may be especially effective with females. Future research must explore the generalizabilty of these results.It's Your Game: Keep It Real: Delaying Sexual Behavior with an Effective Middle School ProgramSusan R. Tortolero, Christine M. Markham, Melissa Fleschler Peskin, Ross Shegog, Robert C. Addy, S. Liliana Escobar-Chaves, Elizabeth R. Baumler10.1016/j.jadohealth.2009.06.008Journal of Adolescent Health 46, 2 (2010)2009-08-18Journal of Adolescent Health2009-08-18462S1054-139X(09)X0014-5Original Articles169179http://www.jahonline.org/article/PIIS1054139X09002456/abstract?rss=yesAbstract: Purpose: To examine effects of the Runaway Intervention Program (RIP), a strengths-based home visiting, case management, and group support program for sexually assaulted or exploited young runaway girls; staffed by advanced-practice nurses, RIP aims to restore healthy developmental trajectories by reestablishing protective factors, reducing trauma responses, and lowering risk behaviors that are common sequelae of sexual violence.Methods: Quasi-experimental study of RIP girls (N = 68) ages 12 to 15 (mean, 13.75 years), assessed at baseline, 6 and 12 months for changes in family and school connectedness, other adult caring, self-esteem, emotional distress, suicidality, recent substance use, plus risky sexual behaviors. Responses at each time were also compared to nonabused and abused urban ninth-grade girls (mean age, 14.64, N = 12,775) from the 2004 Minnesota Student Survey (MSS). Analyses used paired t-tests, McNemars test, Wilcoxon sign-rank, chi-square, and Pearson's correlations.Results: At entry, RIP girls were most like sexually abused MSS peers, with lower levels of protective factors and higher levels of distress and risk behaviors than nonabused MSS girls (p < .05 to p < .01). However, they saw significant improvements by 6 and 12 months, such that all measures of protective factors, positive development, distress, and risk behaviors more closely resembled nonabused MSS girls by 12 months. Of equal note, RIP girls with the greatest emotional distress, the lowest levels of connectedness, and lowest self-esteem at baseline demonstrated the greatest improvement (all p < .001).Conclusions: This appears to be a promising intervention for restoring sexually abused runaway girls to a healthy developmental trajectory.Restoring Healthy Developmental Trajectories for Sexually Exploited Young Runaway Girls: Fostering Protective Factors and Reducing Risk BehaviorsElizabeth M. Saewyc, Laurel D. Edinburgh10.1016/j.jadohealth.2009.06.010Journal of Adolescent Health 46, 2 (2010)2009-08-03Journal of Adolescent Health2009-08-03462S1054-139X(09)X0014-5Original Articles180188http://www.jahonline.org/article/PIIS1054139X09002535/abstract?rss=yesAbstract: Purpose: Behavioral problems occur more frequently among adolescents in deprived areas, but most evidence concerns urbanized areas. Our aim was to assess the impact of area deprivation and urbanization on the occurrence and development of behavioral problems among adolescents in a mixed urban and rural area and to examine the contributory factors.Methods: We obtained data from the first two waves (n=2,230; mean ages, 11.5 and 13.5 years respectively; response at follow-up, 96.4%) of the TRacking Adolescents' Individual Lives Survey (TRAILS). TRAILS is a prospective study of adolescent mental health in a mixed urban and rural region of the Netherlands. We assessed adolescent behavioral problems using the parent-reported Child Behavior Checklist (CBCL), the adolescent-reported Youth Self-Report (YSR) and the Antisocial Behavior Scale (ABS). Living areas were categorized into tertiles of deprivation. We further collected data on child temperament, perceived rearing style, parental socioeconomic position (education, income and occupation), family composition, and parental mental health history.Results: At baseline, adolescents living in the most deprived tertile more frequently had elevated behavioral problem scores than those from the least deprived tertile on the CBCL (11.2% against 7.1%), YSR (11.9% against 6.9%), and ASB (11.5% against 7.4%) (all p < .05). Socioeconomic position explained half of the differences due to area deprivation. Other familial and parental characteristics did not significantly contribute to the explanation of observed area differences.Conclusions: As in highly urbanized areas, behavioral problems occur more frequently among adolescents in deprived mixed rural and urban areas. Urbanization has little effect on these area differences.Area Deprivation Affects Behavioral Problems of Young Adolescents in Mixed Urban and Rural Areas: The TRAILS StudySijmen A. Reijneveld, Rene Veenstra, Andrea F. de Winter, Frank C. Verhulst, Johannes Ormel, Gea de Meer10.1016/j.jadohealth.2009.06.004Journal of Adolescent Health 46, 2 (2010)2009-08-12Journal of Adolescent Health2009-08-12462S1054-139X(09)X0014-5Original Articles189196http://www.jahonline.org/article/PIIS1054139X09002468/abstract?rss=yesAbstract: To compare traditional in-store age verification with a newly developed remote age verification system, 100 cigarette purchase attempts were made by 15-year-old “mystery shoppers.” The remote system led to a strong increase in compliance (96% vs. 12%), reflecting more identification requests and more sale refusals when adolescents showed their identification cards.Shop Floor Compliance with Age Restrictions for Tobacco Sales: Remote Versus In-Store Age VerificationJoris J. van Hoof, Jordy F. Gosselt, Menno D.T. de Jong10.1016/j.jadohealth.2009.06.009Journal of Adolescent Health 46, 2 (2010)2009-08-10Journal of Adolescent Health2009-08-10462S1054-139X(09)X0014-5Adolescent Health Briefs197199http://www.jahonline.org/article/PIIS1054139X0900305X/abstract?rss=yesAbstract: Little is known about Internet use among adolescents with chronic conditions (CCs). Our results indicate that CC females, but not males, are more likely to be heavy Internet users than their peers. CC youths are also more likely to visit health-related web sites, but less frequently than other sites.Chronically Connected? Internet Use Among Adolescents With Chronic ConditionsJoan-Carles Suris, Christina Akré, André Berchtold, Richard E. Bélanger, Pierre-André Michaud10.1016/j.jadohealth.2009.07.008Journal of Adolescent Health 46, 2 (2010)2009-11-02Journal of Adolescent Health2009-11-02462S1054-139X(09)X0014-5Adolescent Health Briefs200202http://www.jahonline.org/article/PIIS1054139X09006612/abstract?rss=yesTable of Contents10.1016/S1054-139X(09)00661-2Journal of Adolescent Health 46, 2 (2010)2010-02-01Journal of Adolescent Health2010-02-01462S1054-139X(09)X0014-5FrontmatterA3A4