For Parents and Teens

Many of the articles published in the Journal of Adolescent Health offer important health-related information that parents and teens can use right now. Each month, the authors and editors prepare short, plain-language summaries of these articles so that you’ll get the information that you need quickly and easily. If you’d like to read the full articles, JAH is pleased to offer free access to the articles referenced below for 30 days after they’re posted. Let us know what you think at [email protected].

How Can Adolescents with Obesity Achieve a Healthier Weight in Young Adulthood?

Image: Eat Healthy by Wendy (CC BY-SA 2.0)

Researchers from the University of Minnesota recently tried to answer this question using data from a long-term nutrition study called Project EAT. They found that positive changes in an adolescent’s behavior and environment could lead to healthier weight in young adulthood. The Project EAT study included 175 adolescents with obesity. Although the majority of those continued to have obesity as young adults, one third were able to achieve a healthier weight in young adulthood.

The researchers found that the teenagers who lost weight shared some things in common. Those who

  1. Increased fruit and vegetable intake
  2. Decreased fast food intake
  3. Increased physical activity level
  4. and Decreased screen time

were less likely to still be obese when they reached young adulthood. By contrast, adolescents who tried dieting were more likely to remain obese than those who didn’t diet, making this the latest study to demonstrate that dieting doesn’t seem to be helpful over the long term.

Other factors also tended to contribute to healthy weight change. As they moved from adolescence into young adulthood, teenagers whose home environments changed to include

  1. More fruits and vegetables available
  2. More vegetables at the dinner meal
  3. and More meals together with their family

were more likely to achieve a healthy weight as young adults.

Teenagers and their parents should consider avoiding diets and instead focus on eating healthy meals, stocking more fruits and vegetables in the home, and trading sedentary activities for active ones.

How Parent Involvement Reduces Substance Abuse Over the Long Term

Parents often wonder whether their involvement in school activities has an influence on their children’s behavior later in life. This question led researchers at the University of Minnesota to examine the long-term impact of parent involvement on their children’s substance abuse during early adulthood.

They found that children who participated in a high-quality preschool program with an emphasis on parent engagement had parents who became more involved in school and had higher expectations for their children during middle childhood. Having engaged parents helped kids develop the tools they needed to better tolerate frustrating situations, and show fewer problem behaviors, when they reached early adolescence. Ultimately, these well-equipped adolescents were less likely to abuse substances in early adulthood. What can parents do?

Parents who participated in many school events when their children were in preschool and early elementary school — including volunteering in the classroom, assisting the teacher, and participating in various events and workshops offered at the school — had young adults who were less likely to abuse substances.

What’s Keeping Your Teen Awake?

Image: IMG_5799 by kathryn (CC BY 2.0)

Teenagers are notoriously sleep deprived. Researchers in Melbourne, Australia, wanted to learn what kinds of bedtime activities might be contributing to poor sleep among teens. They created a list of 24 activities that adolescents typically do in the hour before bed: things like sending e-mails or text messages, exercise, snacking, playing video games, reading, listening to music, browsing social media, and so on. They then looked at how each these activities relate to sleep, taking into account chronotype; that is, whether teens tend to be more alert later in the evening ("night owls") or more alert in the morning ("morning larks").

Surprisingly, they found that most of these activities had little effect on the teens’ sleep duration or quality. The most important factor affecting sleep was the teenagers’ chronotype. Night owls tend to stay up later regardless of their bedtime activities, and morning larks go to sleep earlier even when they engage in these activities right before bed. So it may be that these bedtime activities are simply filling the time during which kids are feeling alert. Night owls might engage in late-night activities because they’re not sleepy, and they need something to pass the time until they feel like going to sleep.

There were some exceptions. Teenagers who frequently played video games right before bed tended to have significantly later bedtimes, regardless of chronotype. This might have something to do with the more compulsive nature of video game playing. There is also good news: kids who spent time with their families before bed tended to have earlier bedtimes and longer sleep duration.

The results from this study seem to show that teenagers’ natural body clock and their day-to-day schedules have much stronger effects on sleep than most bedtime activities. While avoiding certain problematic activities (such as gaming) is important, things like creating a sleep schedule that accommodates your teens’ particular chronotype (e.g., avoid early morning commitments for night owls), encouraging bright light upon awakening, and working for a better understanding of why your teenager does not sleep well may be particularly beneficial.

Millennials Figuring Out Health Insurance &

What is a health insurance plan deductible or co-insurance? And how do I choose a health insurance plan for myself?

These are the sorts of questions that young adults are asking themselves as they shop for health insurance on is an online marketplace established under the Affordable Care Act that allows people to compare health insurance options and shop for a plan.

Researchers at the University of Pennsylvania and The Children's Hospital of Philadelphia recently asked young adults about their experiences using Those who responded said that it was challenging. Many young adults simply don’t understand how health insurance works. Less than half of participants in this study were able to define things like the deductible (the amount you pay before your health plan starts to pay for services), the out-of-pocket maximum (the most that you would pay out of your own pocket during a year before your insurance starts to pay 100% of health benefits) and coinsurance (the amount you pay when your health plan pays less than 100% for covered services).

Here’s an example of a deductible and coinsurance:

John falls off his roof and is taken to the hospital by an ambulance. He has an annual deductible of $500. The ambulance ride costs $600. Because the ambulance service is subject to his deductible, and because John has not yet paid anything toward his health care costs this year, he is responsible for the first $500 of the $600 cost. Also, because his plan has a 30 percent coinsurance, John is also responsible for paying $30 of the remaining bill of $100.

Because choosing a health insurance plan is complex, many young adults are turning to their parents, friends, or professional health insurance guides called navigators for help. There are also online tools to help young adults learn more about the Affordable Care Act, get definitions of insurance terms, and find out how to choose a health insurance plan. The next open enrollment period on and other state-run health insurance marketplaces begins on November 1, 2015. If you need to sign up for health insurance, make sure to allow yourself enough time to understand this complex task. Seek guidance if you need help. (Image: Health Insurance Deductibles by Sharon Sinclair / CC BY 2.0.)

Students and E-cigarette Use

More and more teenagers are experimenting with e- cigarettes. In fact, more teens now use e-cigarettes than traditional tobacco cigarettes. Public health and tobacco control advocates are concerned about this for several reasons. First, teens who have never tried tobacco before are now starting out with e-cigarettes. Next, studies have shown that using e-cigarette often goes hand in hand with use of traditional tobacco or other drugs. And finally, we still don’t really know how e-cigarettes affect the lungs, especially young developing lungs.
Young woman somoking

Recently, researchers at East Carolina University and University of Kentucky set out to study e cigarette use among teens. The researchers gave a questionnaire to all the public high school students in a Southern, tobacco-growing county. Most students had already heard of e-cigarettes, and those who were using them, in many cases, started in their freshman year. A full quarter of e- cigarette users had never used any tobacco before and were likely attracted by the marketing campaigns or use by their friends. About three-quarter of e- cigarette users also used other tobacco products, such as tobacco cigarettes and smokeless tobacco.

Other studies have reported the potentially harmful contents and adverse health effects of e- cigarettes, but the students in this study thought of them as trendy, safe, healthy, and a good way to quit tobacco products. Numerous students didn’t even realize that e-cigarettes contained nicotine. These misunderstanding were probably related to the fact that students reported almost no discussion about e-cigarettes with their school, parents, or healthcare providers. In fact, kids whose parents or friends used tobacco or e-cigarette were more likely to use e-cigarettes themselves.

E-cigarettes are very new, and they seem cool and high-tech. Teens are seeing their parents or friends or celebrities in ads using e-cigarettes, and they want to try them out before they really know what’s in them. The rapid growth of e-cigarette use seems to have caught parents, schools, and healthcare providers by surprise, so nobody is talking to teens about them. We need more research about the health effects of e-cigarettes, and more education about what they are and how they work. (Image: Electronic Cigarette Smoking by Michael Dorausch / CC BY-SA 2.0.)

“Liking” Alcohol on Facebook: An Opportunity to Intervene

Teenager with bottles of alcohol

College is a common time for young people to have their first experiences with alcohol. Even though a certain amount of experimentation can be expected, inexperience with alcohol can lead to problematic behavior. Binge drinking can lead to injury, unwanted sexual experiences, lower grades and other undesirable consequences.

One place where college students often end up describing their experiences with alcohol is on Facebook. References to alcohol on Facebook can show up photos, status updates, or “likes.” Since parents and good friends are often paying close attention to a student’s Facebook posts, they may be the first to notice posts about alcohol. When a parent or friend notices a reference to alcohol in a Facebook profile, how can they know if they should worry or not?

To try to answer this question, researchers at Seattle Children’s Research Institute evaluated college students’ references to alcohol on Facebook, and compared those references to the students’ recent use (or non-use) of alcohol. The researchers found that about half of the college students made a reference to alcohol on Facebook during their first two years of college. Of those students who made a reference to alcohol on Facebook, almost 85% had at least one recent binge drinking experience. Students’ who posted alcohol references as a profile picture or a cover photo were more likely to report multiple episodes of binge drinking. But posting an alcohol reference as a “like” was less likely to be related to recent alcohol use.

If you notice that your child or friend has an alcohol-themed Facebook profile picture or cover photo, you might want to consider having an open and caring discussion about safe alcohol use, including the dangers of binge drinking. Rather than using Facebook posts as “evidence” to chastise your friend or child, the information can be used as an opportunity to check in, provide positive support, and encourage healthy behavior. (Image: Nice pair! by Peter Burgess / CC BY-SA 2.0

Teen Marijuana Use Can Limit Chances Later In Life

As a high school senior, can using marijuana have negative effects for the rest of your life?

Researchers at the University of Michigan and Pennsylvania State University conducted a study to see whether marijuana users were as likely to graduate from college as non-users. They chose to look at college graduation because research shows a strong connection between having a college degree and having a higher income, more family stability, and better health throughout adulthood.

The researchers surveyed almost 5000 high school seniors across the US with questions about marijuana use, other behaviors, and life circumstances. They measured their level of marijuana use a couple of years later and asked them more questions in their mid-20s.

The discovery: Frequent marijuana users were less likely to earn college degrees than non-users.

You might wonder what was meant by “frequent” — in this study, it didn’t mean daily or even near-daily, but 6 or more times in 30 days, including, for example, just on weekends or 1 to 2 times a week. You might also wonder if the results were due to just the marijuana use or if other things were involved. The researchers accounted for many other factors related to using marijuana and to not graduating from college. Frequent marijuana users continued to stand out as less likely to earn college degrees than non-users.

Teens and parents may be unsure about the harmful effects of marijuana use amid the many media stories about marijuana in recent years. In research, the negative effects of marijuana use on long-term health and well-being continue to be demonstrated. This study adds to other studies showing that frequent use of marijuana can limit opportunities later in life. (Image: Photo by Will Folsom / CC BY-SA 2.0.)

Parents’ Work Schedules That Support Teen Children’s Sleep

sleeping teen

Adolescence is a time of dramatic change in physical development, thinking styles and abilities, and social interests and activities. But one thing that doesn’t change is the importance of getting a good night’s sleep. Teens in the U.S., however, are generally more sleep deprived than either younger children or adults. Teenagers should get about nine hours of sleep per night; on average, they get about seven. And teens who sleep fewer hours, nap during the day, and go to bed and get up at different times each night are more likely to feel sad and moody, be overweight, do poorly in school, and engage in risky behaviors like getting into fights and using alcohol and drugs.

Researchers from the Work, Family and Health Network showed that it’s not just the teens themselves who are responsible for their sleep patterns. The researchers studied the effects of program held at parents’ workplaces that was designed to increase supervisor support for employees’ work and personal lives and employees’ control over their work schedules. The results of this study revealed that when parents participated in the program, which reduced conflicts between their work and family responsibilities, their teenage children showed improved sleep patterns.

This study shows that teens’ sleep is sensitive to what’s going on in their families. What parents bring home from work can affect their children — including in positive ways. Even though teens are growing more mature and independent, parents still have a considerable impact on their health.>(Image: Sleeping by Rowan Saunders / CC BY-ND 2.0 [].)

Is Cyberbullying Different than Traditional Bullying?

More and more lately, we see stories in the media about the growing problem of cyberbullying. With increased

access to electronic devices and less online supervision, young people do seem to be experiencing more bullying online these days. But we still don’t seem to know whether cyberbullying is different from regular, in-person bullying. Are the same kids getting bullied online and in person? Are the same bullies doing the bullying? Does cyberbullying hurt more or less than regular bullying?
To try to answer these questions, researchers at Johns Hopkins Bloomberg School of Public Health surveyed 28,104 high school students about whether they’d been cyberbullied or bullied in person. Less than 5% of the kids who said they had been bullied reported that they were only cyberbullied. Most victims of cyberbullying had also been bullied in person. In other words, if you know somebody who is being bullied online, there’s a good chance that they’re also being bullied in-person.
The researchers also discovered that victims of cyberbullying often thought that their online bully was a “friend” or someone they “thought was a friend,” which could make it especially hard to cope with the experience. Although most cyberbullying happened on a social networking site like. Facebook, almost 30% of cyberbullying victims did not know their online bully, which would make it harder to address than traditional, face-to-face bullying. And about 70% of kids who were cyberbullied never told an adult about it.
Face-to-face bullying is usually obvious to friends, parents, and teachers. But it looks like a lot of cyberbullying happens in the shadows of the online world, which might increase victims’ feelings of isolation and powerlessness. If you’re being cyberbullied, or you know someone who is, tell someone about it.

Be Wary of Alcohol Advertising

Adults and teens alike may be unaware of the influence that advertising can have on their drinking behavior. We all want to believe that we are rationale, thoughtful individuals who are in total control of our own decisions. But a growing body of evidence shows that exposure to alcohol advertising can influence teen drinking.

Recently, researchers asked teens who had already started drinking why they chose to drink a specific brand of alcohol. Some responded that they drank a particular brand because it was cheap or easy to get. However, many said that they choose a drink because they identified with the brand, they liked the brand’s advertising, or they saw others — such as adults, peers, or people in the media — drinking the brand. These teens also reported high levels of risky drinking and lots of negative consequences from drinking, such as fights or injuries.
Parents to talk to their kids about the manipulative nature of advertising, particularly when it’s a dangerous substance such as alcohol. Despite what’s portrayed in alcohol advertisements, alcohol is not the key to popularity, sensuality, nor masculinity. You do not need alcohol to have a good time. Alcohol is the drug most frequently used and abused by young people, and it remains one of the leading contributors to death and disability among young people throughout the world.

Graphic: It's your game. Keep it real.

Sex Ed on a Laptop

Teen pregnancy and sexually transmitted infections (STIs) are serious problems. Effective sex education can help lower teen pregnancy and STIs by teaching adolescents to delay sex until they’re older and to avoid risks when they do start having sex. However, most sex ed programs have yet to include technology, which has vast youth appeal.

So researchers at the University of Texas Health Science Center at Houston developed an interactive, computer-based multimedia sex education program, called It’s Your Game-Tech (IYG-Tech) and tested it with middle-school students. Students went through the program at their own pace using school-issued laptop computers. The lessons take place in an interactive, mall-like environment where the students engage in different activities in various locations. The overall point of the lessons is to Select personal rules or limits (sexual and non-sexual), Detect signs/situations that challenge those rules, and Protect their rules using refusal strategies.
The researchers tested the software on 8th graders. After a year, students who tried IYG-Tech knew more about STIs and condoms and had more positive attitudes about abstinence. This is an early program, and the results were limited. But the researchers will take what they learned and try to improve the effect of IYG-Tech. It’s likely that we’ll be seeing a lot more computer-based sex education in the near future.

  • Efficacy of It's Your Game-Tech: A Computer-Based Sexual Health Education Program for Middle School Youth

    Melissa F. Peskin, Ross Shegog, Christine M. Markham, Melanie Thiel, Elizabeth R. Baumler, Robert C. Addy, Efrat K. Gabay, Susan Tortolero Emery
    Journal of Adolescent Health, Vol. 56, Issue 5, p515–521

Day-to-Day Inconsistency in Parental Knowledge

Youth whose parents know more about their children’s activities are less likely to engage in risky behavior. And, consistency in parents’ discipline also has been linked to youth adjustment. Bringing these lines of research together, a group of researchers at The University of North Carolina at Chapel Hill, The Pennsylvania State University, and Purdue University investigated how day-to-day consistency in parental knowledge was linked to youth health and whether parents’ stress was associated with less consistency in their knowledge. Adolescents
and their parents were telephoned on eight consecutive evenings and asked about their experiences during the past 24 hours. The results revealed substantial inconsistency in parental knowledge from day- to-day and inconsistent knowledge was associated with youths’ health and adjustment: Beyond the effects of parents’ average level of knowledge, when parents were more inconsistent in their knowledge from day-to-day, youth reported with more physical health symptoms, such as colds and flus, and girls reported more risky behavior. These findings imply that communications about youths’ experiences should be an important part of parents’ daily routines. One contradictory finding was that knowledge inconsistency was linked to better psychological well-being in older adolescents—those approximately aged 15 and above--suggesting that, as youth grow older, there are benefits to their increasing autonomy and privacy. Findings also showed that parents who experienced greater stress were more inconsistent in their knowledge. Stress-management techniques may help parents to become more consistent in their knowledge about their children’s daily experiences.

What to Expect From Treatment for Eating Disorders

Diagram of Eating Disorder Team. An eating disorder requires treatment from a doctor, a therapist and a nutritionist
Eating disorders are serious, life-threatening illnesses that most often arise during the teen years. An important article in this month’s issue of the Journal of Adolescent Health updates medical providers on the most recent advances in caring for young people with eating disorders.

Not everyone with an eating disorder has anorexia nervosa or bulimia nervosa. Even kids whose weight is in the normal range can have an eating disorder. Most teens with eating disorders can be managed as
outpatients using a type of treatment called family-based treatment (FBT), where the parents play a major role in restoring health weight. Occasionally, inpatient treatment is required, and this paper outlines situations it may be necessary to hospitalize a teen with an eating disorder. For those who do need to be hospitalized, recent research demonstrates that a rapid rate of refeeding can be done safely provided there is close medical monitoring. This rapid refeeding allows the teen to return home and to school more quickly. Medical monitoring is important at every level of care - outpatient, inpatient, residential or partial hospitalization programs. If you suspect that you or your child may have an eating disorder, an evaluation by your medical practitioner is strongly recommended. The sooner the intervention, the better the outcome.
  • Update on the Medical Management of Eating Disorders in Adolescents

    Neville H. Golden, Debra K. Katzman, Susan M. Sawyer, Rollyn M. Ornstein, Ellen S. Rome, Andrea K. Garber, Michael Kohn, Richard E. Kreipe
    Journal of Adolescent Health, Vol. 56, Issue 4, p370–375

Juvenile Gang Membership in the US Doesn’t Conform to Popular Stereotypes

Photograph of group of teens
When people hear of “gangs” it often brings to mind very clear images of certain people, places, and behaviors—minority boys and young men, prisons and inner cities, and violence and drug dealing. It is also thought that gang membership is a lifelong commitment and that if someone joins a gang they can never leave it. Many people also feel that gangs are everywhere, running rampant in our neighborhoods and schools. How true are these popular stereotypes?

Researchers recently reported on a study that tracked the patterns of gang membership among youth between ages 5 and 17 in a national sample. They
found that gang membership is very rare in the USA. At any given time, only about 2% of kids are in gangs.

The kids who do get involved in gangs are from all types of backgrounds—rich and poor, one and two parent households, black and white, and male and female. Kids were most likely to get involved in gangs around the middle school and early high school years, between ages 12 and 16. But most kids left gangs very quickly, and in only rare circumstances stayed in gangs for more than a couple of years. Prior research tells us that gang membership has a wide range of negative health and life outcomes, even long after someone leaves a gang. This means that gang prevention should begin early and that intervention should be reserved for very high-risk gang youth.

The findings from this study are important for kids, parents, and healthcare professionals to better understand and respond to gangs in our schools, neighborhoods, and care facilities based on facts and not popular perceptions.

Establish a Healthy Approach to Screen Time Early

Child eating while using a computer
Between tablets, games, smartphones, and TV, kids these days spend a lot of time in front of screens. But too much screen time can have a negative impact on your health and well-being, even for teens and even when they are otherwise physically active. For this reason, the American Academy of Pediatrics and others recommend limiting children and adolescents to no more than two hours of screen time per day.

Belgian researchers recently set out to see how screen-related behaviors in the early teen years influence screen-related behaviors when you become an adult. The researchers asked a group of 10-year-olds how
much time they spent in front of screens. Ten years later, they asked the same group of now 20-year-olds about their screen time habits.

And sure enough, they found that more screen time at 10 years old meant more screen time at 20. Results for boys were especially dramatic: those who exceeded the two-hour recommendation at 10 years old were three to five times more likely to exceed the recommendation at 20. For girls, other factors came into play. Unhealthy eating – such as drinking too much soda or eating too many chips – at 10 years old resulted in more screen time at 20.

The teen years are a time of great change and development, but some habits, when established early, can be remarkably persistent throughout adolescence. Parents and teens should focus on establishing healthy and reasonable screen habits early by setting limits and emphasizing non-screen-related activities.
  • Tracking and Predictors of Screen Time From Early Adolescence to Early Adulthood: A 10-Year Follow-up Study

    Cedric Busschaert, Greet Cardon, Jelle Van Cauwenberg, Lea Maes, Joris Van Damme, Anne Hublet, Ilse De Bourdeaudhuij, Katrien De Cocker
    Journal of Adolescent Health, Vol. 56, Issue 4, p440–448

Who Gets Addicted to Video Games?

photograph of 3 staring children
Addiction to video games is a growing problem in today’s society. Video game addiction is related to a host of negative outcomes including aggression, depression, anxiety, social problems, and more. Why do some kids get addicted to games, but others can play games without getting addicted? New research from Brigham Young University suggests that it may be a matter of biology.

Usually, when we face a task that is mentally stimulating, our bodies show subtle involuntary reactions – for instance, our breathing quickens and our palms get a little sweaty. In this study, when teens who were not
addicted to video games attempted to solve a Rubik’s Cube in a very short amount of time, they showed these physiological reactions. Teens who were addicted to video games did not show the same physiological reactions. It may be that some kids are not as easily stimulated by every day activities. Consequently, they may turn to video games as a way to get that stimulation. However, even if video games provide some cognitive fulfillment, they can become problematic when they interfere with school, employment, and real world relationships.

The teens in the study were also asked to discuss something that they typically fight about with their parents, such as money, homework, or media use. Teens who were addicted to video games showed a heightened physiological response when talking about conflict, which suggests sensitivity to stress. Teens who are stressed by real-world conflict may be tempted to withdraw to a virtual world where the conflict isn’t real.

So what’s a parent to do? If your teen knows that he or she doesn’t get enrichment from typical activities, work together to find something besides video games that provides it. It could be building robots, painting, or playing chess. And research shows that teens can use strategies such as meditation, mindfulness, and biofeedback to reduce the stress that can come with conflict.

What’s with Those iPads in the Doctor’s Office?

Computer tablets seem to be everywhere these days, including doctor’s offices, where they are increasingly being used to screen teens for common conditions, risk behaviors and mental health problems before they go in to see the doctor. But how does this type of screening affect the doctor visit? Is it more efficient? Does everything get covered? Does it change how teens and doctors interact?

To answer these questions, researchers recorded the conversations between teens and their doctors and compared visits with screening to visits without. Before the screened visit, teens used iPads to complete almost 100 questions about potential physical and mental
Doctor with iPad
problems, as well as risky behaviors. At the beginning of the visit, doctors received the same iPad displaying a summary of the results.

This screening process was especially helpful in identifying possible mental health issues, issues that the teens may not have been fully aware of themselves. Armed with the results of the iPad screening program, doctors had more frequent discussions with their teen patients about these issues, which should go a long way in identifying kids who are really in need of further help. Bringing mental health questions into the doctor’s visit didn’t push out other important teen issues such as nutrition and physical health, either. Doctors reported that pre-visit screening improved the organization and efficiency of the visit, which is a great thing because covering all those important teen issues once a year during an annual visit can be a challenge.
  • Integrating Mental Health Into Adolescent Annual Visits: Impact of Previsit Comprehensive Screening on Within-Visit Processes

    Anne M. Gadomski, Kate E. Fothergill, Susan Larson, Lawrence S. Wissow, Heather Winegrad, Zsolt J. Nagykaldi, Ardis L. Olson, Debra L. Roter
    Journal of Adolescent Health, Vol. 56, Issue 3, p267–273

Social Support and Adolescent Suicide

Photograph of a woman holding a note that says help
Thoughts about wanting to end ones life and even doing things to try to end ones life are common among teens. Teens who think about or attempt suicide often feel like they do not have enough support (like getting help when they need it) from their parents, friends, or school. Recently, researchers at the University of Washington tried to figure out which form of social support was most important to teens that thought about or attempted suicide. The researchers surveyed a group of teens getting help for things like depression and anxiety and asked them how much they felt supported by their friends, parents, and school.
Teens who did not feel supported in their school had more intense thoughts of suicide compared to teens who felt more supported in school. The group of teens who had the most intense suicidal thoughts reported low support from both their school and parents. Support from friends was less important.

The researchers also found that teens who reported low support from parents were more likely to have attempted suicide in the past. Teens were also likely to have a suicide attempt history if they felt low support from both school and friends.

The most important thing to take away from this study is that teens need to feel supported by their parents and school in particular. However, friends do play an important role in helping teens feel safe when things get tough. Teens, if you ever feel like you want to hurt yourself, always tell a parent or responsible adult. You can also call this number 1-800-273-8255 or TEXT “START” TO 741-741 for help. Parents, a great resource for learning about effective treatments can be found at

Twitter Chatter about Marijuana


Parents need to step-up their game when it comes to monitoring what their kids are posting on social media. Right now it is pretty easy for teenagers to say anything and everything on social media and our study seems to support this idea. In our research, we looked at what people were saying about marijuana on Twitter. Teenagers and young adults like Twitter because it allows for easy interaction with strangers and friends alike. In this study, we were specifically interested in knowing what popular Tweeters were posting about marijuana, because their Tweets have the potential to be seen by more people than just the average Twitter user. We examined the most common themes of 7,000 Tweets from popular Twitter handles. From this sample, we found that Tweeting about marijuana happens a lot, especially among teenagers. When we looked more closely at what was being said about marijuana, we found that Tweeters tended to post about their own marijuana use and how they needed and wanted to use marijuana. Because Twitter allows users to network with large audiences, it is possible that these pro-marijuana Tweets can make using marijuana seem normal and maybe even increase use in teenagers. Marijuana use can have harmful health effects, and it is important that use, especially in young people, is limited. More research will need to be done to understand the impact of pro-marijuana messages on Twitter and other social media sites.

More Alcohol Outlets Means More Teens Buying Alcohol

Liquor store sign

There is a strong argument that drinking among teens should be discouraged. Drinking alcohol as a teen increases the likelihood of having problems with alcohol in adulthood. It can affect grades and may affect brain development.

Researchers in Australia explored the connection between the number of “alcohol outlets” in a community and the risk that teens in the community will be able to buy alcohol. In other words, the more places there are to buy or otherwise get alcohol, the more likely it is that teens will buy alcohol before they are of legal age - which is 18 in all states in Australia. They had a theory that the ability of young people to buy alcohol outside the law was one way in which problem drinking might happen among teens. The researchers asked over 10,000 students aged 12-17 if they had bought alcohol..

The study found that, as the number of alcohol outlets increased, so did the students’ reports of getting alcohol illegally. Also, the type of alcohol outlet made a difference. Having lots of membership clubs and liquor stores in the area was linked to higher reports of underage teens getting alcohol. The researchers theorized that membership clubs may reflect more liberal social values of a community, making teen drinking more acceptable. Increasing numbers of liquor stores might compete with each other for business by becoming more willing to break the law and sell alcohol to teens.

Communities might want to consider these kinds of things when they are licensing new alcohol outlets. Charging these businesses higher fees might reduce the number of new outlets, and the money could be used to increase the monitoring of existing businesses.

Antisocial Media Exposure and Cyberbullying Behavior – Is There a Link?

teen holding smartphone that says I hate u!!!!

Communication scientists in the Netherlands have been exploring whether teens who watch a lot of media that shows antisocial or risky behaviors are more likely to be cyberbullies than others who don’t. ‘Cyberbullying’ is where someone deliberately sets out to hurt or harass another person using new technologies like Facebook or cellphone texts. There has been quite a lot of research about the effects of cyberbullying – it can damage self-esteem, affect school work, and make victims think about self-harm including suicide. There has been much less research, however, about what makes people get involved in cyberbullying. Better understanding could help to stop the problem before it starts.

The Dutch scientists asked 1,005 adolescents aged 11-17 about their exposure to ‘antisocial media content’, which included fighting, drug use, reckless driving and even gossiping. They also asked questions about cyberbullying behavior, such as whether they had ever sent threatening or insulting messages by email or cell phone. They used statistics to test the links between teens’ answers to the two types of questions.

The team found that high use of antisocial media increased the chance of cyberbullying behavior over time, and the link was stronger for boys than girls. They related this to a ‘downward spiral’ model where seeing violence leads to real-life aggression. They suggested discussing these findings in school media literacy lessons as a prevention strategy.

Photograph of stack of papers stamped confidential

Insurance Billing Violates Confidentiality for Young People on their Parents’ Health Plan

Confidentiality is critical for providing effective health care to adolescents and young adults. Unfortunately, the health insurance claim system unintentionally, but routinely, violates confidentiality by sending Explanation of Benefits (EOBs) to policyholders (often parents) for sensitive services. While EOBs have some important information about claims made on a health care insurance plan, they can also have detrimental consequences for teens if EOBs for confidential care are sent to the policy holder. Take the example of Amy, a 17 year old high school student:

Amy felt depressed and thought about seeking counseling. While she wanted to talk to her parents about it, she did not want them to worry or overreact. She felt nervous about making an appointment, because she was afraid her parents might find out. Amy’s friend told her that she recently set up a confidential visit with a therapist. Relieved to hear this, Amy made an appointment with her doctor who referred her to a therapist. She was not sure how her health insurance worked, but was reassured that the visit was confidential. The therapist discussed her feelings of depression and together they came up with some ways for Amy to better manage these feelings. They also discussed Amy’s privacy concerns. The doctor encouraged her to talk with her family when Amy felt ready and gave her some tips to help with this conversation. They also decided it was important for Amy to return for a follow-up visit and scheduled an appointment. Later that month during dinner, her father asked why a visit to the doctor showed up on his insurance claim. She was completely surprised, made up an excuse, never returned to the therapist, and continued to suffer “in silence.”

This scenario highlights the importance of providing confidential care for young people and shows how EOBs can disrupt that care. With more young adults being covered under their parents’ insurance due to provisions of the Affordable Care Act, the problem is becoming more acute. Various local and state initiatives are being explored, but at this time, the problem has not been fully addressed. While it is critical for parents and young people to have open discussions about health issues, parents should also encourage and support their children’s need to have confidential discussions with a trusted doctor, nurse or therapist. While it is understandable that parents would like to be involved in every health issue facing their teenager or young adult, they also need to support their child’s need for greater independence and responsibility in preparation for their transition to adulthood. Parents have to balance the “need to know” with the risk of their son or daughter being too afraid to seek the care that they need.

photograph of woman in a store

Should Teen Girls Need a Prescription for Birth Control Pills?

There is a growing momentum in the United States to allow the birth control pill to be sold over the counter (OTC) without a prescription. Medical organizations such as the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians support this.

But should teenagers also be allowed to obtain birth control pills without a prescription? Researchers recently surveyed adult women about this, and the results were far from conclusive. About a quarter of women surveyed supported OTC access to the pill for teen girls, and a slightly smaller percentage were opposed. By far the largest group said they were unsure. Those who said they were unsure, and the reasons given by those who oppose OTC access for teens, show just how complex this issue is. There are good public health reasons for allowing easier access to birth control pills for women of all ages. But there also may be some compelling reasons for requiring teenagers to get a prescription first.

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Is Your Teen Prepared for Adult Health Care?

Most young people stop seeing their pediatrician and transition to adult care between the ages of 16 and 21. This transition -- from parents making health care decisions for teens in pediatric care to teens making their own decisions in adult care — is a big change, and families often find themselves unprepared for it.

Diagram of Core Elements of Health Care Transition 2.0

Many young people feel ill equipped to manage their own health needs and delay their transition to adult care. Health care experts recognize these challenges and are developing strategies to help young people and their families prepare for this change.

An article in this month’s issue of the Journal of Adolescent Health, “Pediatric to Adult Transition: A Quality Model for Primary Care,” describes a series of steps, called the “Six Core Elements,” that pediatric doctors can take to prepare adolescents and parents for the transition to adult care:

  • Define an office policy on transition,
  • Create an organized method to make certain that young people receive necessary transition services,
  • Conduct an assessment of the patient’s readiness to take on self-care,
  • Create a plan of care with a current medical summary and emergency care plan,
  • Identify the new adult provider and transfer up-to-date medical information,
  • Elicit feedback from young people and their families about their transition experience.

This organized approach to transition is new. Many pediatric, family medicine, and internal medicine practices are just beginning to adopt it. If you’d like more information about what your teen and family can do on your own and with your teen’s doctor, visit, where you’ll find a set of frequently asked questions about transition as well as useful tools and resources.

Does your child’s school have a plan for managing concussions?

Concussive head injuries, or concussions, can have severe consequences, especially for young people. If a student sustains a concussion, it’s critical that the entire school community — including staff, students, and parents — knows how to respond in a way that ensures the student’s best chance of recovery.

Researchers in Oregon have developed a Web-based resource to help schools develop a plan for managing concussions among their students. The program is called Brain 101: The Concussion Playbook, and it can be accessed online at The web site includes scientific evidence on the most effective ways of preventing and responding to concussions, with clear and specific guidance for coaches, teachers, parents, and student athletes. The researchers surveyed school communities before and after they’d used Brain 101, and found that it worked well to improve the schools’ policies and practices around student concussions.