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An International Comparison of Risk and Protective Factors in the Lives of Young People

An International Comparison of Risk and Protective Factors in the Lives of Young People. Robert Wm. Blum, M.D. M.P.H. Ph.D. Professor & Director Center for Adol,escent Health and Development WHO Collaborating Centre for Adolescent Health University of Minnesota Prepared for:

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An International Comparison of Risk and Protective Factors in the Lives of Young People

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  1. An International Comparison of Risk and Protective Factors in the Lives of Young People Robert Wm. Blum, M.D. M.P.H. Ph.D. Professor & Director Center for Adol,escent Health and Development WHO Collaborating Centre for Adolescent Health University of Minnesota Prepared for: Youth Support Conference London, England 24 October 2002

  2. Why do some who are raised in adverse circumstances appear to live healthy and productive lives?

  3. Resilience The capacity to recoverand maintain adaptive behavior after insult. Garmezy

  4. An Ecological Model of Resilience • Macro-level Environment • Political Realities • Youth Laws/Policies • Macrolevel Economics • Historical Events

  5. An Ecological Model of Resilience Macro-level Environment Community Environment Risk Protection • arrests by age, type • community fertility rates by age • poverty • single parent • female head of household • age of migration • Medicaid (proportion & payment) • exposure to violent media • exposure to youth-oriented advertising • access to tobacco, alcohol, drugs, firearms • educational attainmentby age • school enrollment for 16-19 • health care facilities • health care utilization • employment rates of adults • informal support systems • religious institutions • access to role models • pro-social media

  6. An Ecological Model of Resilience Macro-level Environment Community Environment Family Risk Protection • low parental education • family mental illness • maternal stress • large family size • overcrowding • poverty • access to weapons • engaging in health compromising behaviors • authoritarian parenting style • exposure to family violence • connectedness • parental presence • parental values - towards school - toward risk taking • two parents • fewer siblings • family cohesion • authoritative parenting style

  7. An Ecological Model of Resilience Macro-level Environment Community Environment Family Peers Protection Risk • prejudice from peers • perception of threat • social isolation • participation in deviant culture • being treated fairly by peers • having low-risk friends • peers with pro-social norms

  8. An Ecological Model of Resilience Macro-level Environment Community Environment Family Peers School Protection Risk • connectedness to school • improved academic performance • number of schools attended • school policies • retention • size of school • absenteeism • suspension

  9. Macro-level Environment Community Environment Family School Peers Individual An Ecological Model of Resilience Individual Risk Protection • spirituality/religiosity • social skills • average intelligence • late maturation • positive self-image • positive self-efficacy • perceived importance of parents • biological vulnerability • intellectual impairment • dyssynchronous maturation • aggressive temperament • impulsivity • affective disorder • ADHD • aggressive behavior • stress reactivity

  10. Macro-level Environment Community Environment Family School Peers Individual SexualReproductive Substance Use Diet & Exercise Injury & Violence - inactivity - disordered eating - eating disorders - over-consumption - weapon carrying - interpersonal violence - seat belt use - helmet use - motorcycle use - drinking & driving - sexual assault - tobacco - alcohol - marijuana - other - non contraception - condom avoidance - early sexual debut - multiple sexual partners An Ecological Model of Resilience Macrolevel Environment Health Risk Behaviors

  11. The empirical evidence for resilience in adolescent health.

  12. CaribbeanParticipating Countries

  13. Ever Had Intercourse Countries of Caribbean l= protective, statistically significant m = protective, trend s = risk, statistically significant

  14. Suicide Attempt Countries of Caribbean l= protective, statistically significant m = protective, trend s = risk, statistically significant

  15. Violence Countries of Caribbean l= protective, statistically significant m = protective, trend s = risk, statistically significant

  16. Problems Due to Substance Use Countries of Caribbean l= protective, statistically significant m = protective, trend s = risk, statistically significant

  17. Global Research on Risk and Protective Factors (WHO)

  18. Early Sexual Initiation Risk or Protective factors for Adolescents l= protective, statistically significant  = not measured s = risk, statistically significant NS = not significant

  19. Substance Use(tobacco, alcohol and other psychoactive substances) Risk or Protective factors for Adolescents l= protective, statistically significant  = not measured s = risk, statistically significant NS = not significant

  20. Depression Risk or Protective factors for Adolescents l= protective, statistically significant  = not measured s = risk, statistically significant NS = not significant

  21. What Can We Conclude Across Cultures? Risk or Protective factors for Adolescents l= protective, statistically significant s = risk, statistically significant

  22. What works? What doesn’t work?

  23. Evaluation research has repeatedly shown that problem reductioninterventions alone directed at youth arerarely effective.

  24. Ineffective Strategies for Teen Pregnancy Prevention • Providing information alone; • Scare tactics; • Short-term interventions; • Abstinence only; • Contraception only; • School-based services.

  25. The 5 Assets of Youth • Caring and Compassion; • Character; • Competence in academic, social and vocational arenas; • Confidence; • Connection.

  26. The 5 Assets of YouthLead to a 6th Asset CONTRIBUTION

  27. Program Elements that Promote Youth Assets • Programs that incorporate more elements of positive youth development appear to be more effective in achieving their goals; • Programs that strengthen adult-adolescent relationships appear to have better outcomes; • Long-term programs with a strong youth participation component are most effective.

  28. Positive youth development has as a basic tenet that youth are resources to be developed not problems to be fixed. Pittman

  29. Development is ... both an outcome and an intervention.

  30. As An Outcome Positive youth development is defined as participation in pro-social behaviors and avoidance of health compromising and future jeopardizing behaviors.

  31. PCAP Model People An adult who cares, who is connected; a network of adults who are involved in the life of the adolescent. Contributions Place The opportunitiesto contribute to family, neighborhood, community, youth involvement. A safe place for youthto congregate, to recreate with adult supervision,to develop friendships Activities School and community activities that develop a sense of connection/belonging The Adolescent P C P A A

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