Violence, substance abuse, unprotected sex, and related risky behaviors take a tragic toll on the lives of individuals and their communities. To prevent these risks, we must first understand the factors and circumstances that contribute to risk-taking. EDC’s Center for Research on High Risk Behaviors (RHRB) conducts a variety of research projects that develop, evaluate, and disseminate effective interventions for reducing health risks. This article reports on one of the center’s long-term projects, the Reach for Health Study, which follows New York City African American and Latino youth from middle school into young adulthood.
The interconnections of high-risk behaviors among youth, the focus of EDC’s decade-long study of adolescents living in high-poverty urban settings, has produced new findings on violence, suicide, sexual initiation, and parent involvement.
The most recent studies, published over the past year, reveal that girls who are aggressive in middle school are more likely to think about or attempt suicide in high school, that parenting practices have a powerful influence on sexual initiation decisions among middle-schoolers, and that parent education can reduce risky behaviors among middle-schoolers. Reach for Health researchers have previously explored the impact of health education and community service, and have studied patterns of partner and sexual violence.
“This research is pivotal for addressing ongoing disparities in the physical and mental health of youth growing up in economically disadvantaged communities,” says Lydia O’Donnell, Ed.D., who directs the center and leads the Reach for Health team.
Exploring the Links: Suicide and Aggression
While a great deal of research has been devoted to studying interpersonal violence among urban youth, there is little information about suicidality—thinking about or attempting suicide—in this population. O’Donnell’s team examined whether youth who reported aggressive behaviors during middle school were more likely to report suicidal thoughts and suicide attempts during high school. The research, which surveyed 769 African American and Latino males and females in the 8th grade and again in the 11th grade, found that girls who engaged in aggressive behaviors, such as fighting and weapon-carrying, during 8th grade were more likely to report suicidality in 11th grade.
However, this connection between outer-directed and inner-directed violence was not observed among males. “Early warning signs of suicidality may differ by gender and require different interventions,” says O’Donnell. “In particular, our findings point to the need to pay greater attention to aggression among girls and its connection to mental health.”
Early Sexual Initiation
Early sexual initiation is related to multiple health and social consequences and contributes to epidemic levels of sexually transmitted infections and the spread of HIV among minority young people. To study the early sexual risk behavior among urban youth, researchers surveyed 294 urban sixth graders. Researchers identified a number of risk factors: being male, parental approval of having a girlfriend or boyfriend, lower parental oversight of activities, having older or mixedaged peers, and expressing peer norms supporting sexual behaviors. The study highlights the importance of parenting practices, including monitoring and rule-setting, on early heterosexual risk behaviors. Even as peer relationships become important, young adolescents look to parents for continued guidance and support, says O’Donnell.
“We hope these findings will contribute to parents’ understanding of the influence they have on what adolescents are likely to do,” O’Donnell adds.
O’Donnell’s team also assessed the impact of Saving Sex for Later, an audio CD program that educates parents about helping their sons and daughters navigate normal pubertal changes and the challenges of becoming a teenager and supporting them in staying abstinent during the critical early adolescent years. Developed with extensive input from parents and youth, Saving Sex for Later uses engaging and dramatic stories to model how parents can communicate effectively with their children.
The research, a randomized experimental trial, involved about 850 families with fifth and sixth grade students in New York City schools. The results show that listening to the Saving Sex for Later CDs helped parents talk to their children about puberty, romantic relationships, and delaying sexual activity. Youth whose parents received the CDs reported more family rules, greater family support, and less risky behavior.
“Saving Sex for Later is a simple, promising intervention for promoting youth abstinence that is designed to reach busy parents at their convenience,” says O’Donnell. The Reach for Health studies have been funded primarily by the U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Child Health and Human Development.
“Aggressive Behaviors in Early Adolescence and Subsequent Suicidality Among Urban Youths” appears in the December 2005 issue of the Journal of Adolescent Health.
“Heterosexual Risk Behavior Among Urban Young Adolescents” was published in the Journal of Early Adolescence in 2006.
“Saving Sex for Later: An Evaluation of a Parent Education Intervention” was published in Perspectives on Sexual and Reproductive Health, December 2005.
Examples of Current RHRB Projects
- The VOICES/VOCES HIV prevention program, for heterosexual African American and Latino men and women, is being distributed as one of the proven HIV interventions through the Centers for Disease Control and Prevention’s (CDC) Diffusion of Effective Behavioral Interventions program. In large part because of its low-intensity approach to intervention, it has been one of the most widely used CDC programs; as of February 2006, more than 400 agencies have participated in trainings, and thousands of individuals have participated in VOICES/VOCES sessions.
- Under a contract from CDC, a VOICES/VOCES replication study is underway at sexually transmitted infection clinics in New York City and Puerto Rico. This research is testing whether the intervention is effective in reducing new sexually transmitted infections when delivered by health agency staff.
- The New York City Collaborative to Address HIV Risk Among Latino Men Who Have Sex with Men is exploring the prevalence, incidence, and determinants of HIV infection among that population.
- Reducing Alcohol and Risks Among Young Adolescent Females is a study of the effectiveness of a parent education program to reduce early sexual initiation and alcohol use.
Originally published on May 31, 2006