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The Life Course Perspective (LCP), or Model, is now a guiding framework in Maternal and Child Health (MCH) activities, including training, supported by the Health Resources and Services Administration's Maternal and Child Health Bureau. As generally applied, the LCP tends to focus on pre- through post-natal stages, infancy and early childhood, with less attention paid to adolescents as either the "maternal" or "child" elements of MCH discourse. Adolescence is a distinct developmental period with unique opportunities for the development of health, competence and capacity and not merely a transitional phase between childhood and adulthood. Adequately addressing adolescents' emergent and ongoing health needs requires well-trained and specialized professionals who recognize the unique role of this developmental period in the LCP.

A growing literature suggests that communication strategies can promote or inhibit intimate partner violence (IPV). Research on communication is still needed on a group ripe for early IPV intervention: high school-aged adolescents. This article revisits our previous analyses of young female reproductive clinic patients (Messinger, Davidson, & Rickert, 2011) by examining how the adolescent and young adult respondents differ. To explore replicability of the adolescent results across populations, they are compared to 487 adolescent female students sampled from four urban high schools. Across samples, all communication strategies were used more frequently within violent relationships. Multivariate analysis identified escalating strategies used and received as being positively associated with physical violence used and received in all three samples. Regarding verbal reasoning and temporary conflict avoidance, substantial differences appeared between the young adult and adolescent clinic samples, and results from the adolescent clinic sample were largely replicated with the adolescent school sample, suggesting that young adult samples in this literature are not adequate proxies for adolescents. (Contains 4 tables.)

Population-specific data on factors that affect intimate partner violence (IPV) are needed on female adolescents and young adults, a cohort at greatest risk of IPV in the United States (Rennison, 2001). Studies have frequently overlooked the role of relationship communication as a gatekeeper to IPV (Ridley & Feldman, 2003). To address this gap, negative binomial regression was conducted with data from a 2004 survey of 618 women aged 15 to 24 seeking care at an urban reproductive health facility. Findings suggest that, within the previous year, verbal aggression by either partner was associated with physical violence by either or both partners, and verbal reasoning was negatively correlated with physical violence. Bidirectional and unidirectional IPV relationships may employ communication strategies differently. (Contains 4 tables.)

Acculturation has been shown to positively and negatively affect Latino health. Little research investigates the overlap between acculturation and the different types of relationship violence among Latino youth and most research in this area predominantly involves Mexican-American samples. The current study examined associations between indices of acculturation (language use at home, chosen survey language, and nativity) and relationship physical violence and sexual coercion, both received and delivered, among predominantly Dominican and Puerto Rican adolescents from New York City. From 2006 to 2007, 1,454 adolescents aged 13-21 years in New York City completed an anonymous survey that included the Conflict in Adolescent Relationships Inventory which estimates experiences of physical violence and sexual coercion, both received and delivered, in the previous year. This analysis includes bivariate and multivariate methods to test the associations between language use at home, chosen survey language, and nativity with the different types of relationship violence. Among females, there is a significant association between language use at home and overall level of acculturation with delivering and receiving relationship physical violence; however, we did not find this association in delivering and receiving relationship sexual coercion. We found no association between acculturation and any type of relationship violence among males. Among Latina females, language spoken at home is an indicator of other protective factors of physical relationship violence. Future research in this area should explore the potential protective factors surrounding relationship violence among Latina females of various subgroups using comprehensive measures of acculturation, household composition and family engagement., Author(s): Melissa DuPont-Reyes[sup.1] , Deborah Fry[sup.2] , Vaughn Rickert[sup.3] , Leslie L. Davidson[sup.1] [sup.4] [sup.5] Author Affiliations: (1) Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West [...]

Researchers examined willingness to use a school-based health center's (SBHC) primary care services. Rural 7th through 12th graders completed a survey. Results indicated that, although most were initially unwilling to change their primary care site to an SBHC, many were willing to use a variety of the offered services. (SM)

Objectives. We evaluated changes in tetanus toxoid, reduced diptheria toxoid, acellular pertussis (Tdap), and tetravalen meningococcal (MCV4) vaccine coverage following enactment of a New York State mandate requiring Tdap before entering sixth grade. Methods. Using data from a hospital-based immunization registry, we measured Tdap and MCV4 coverage among youths aged 11 to 14 years in New York City at 3 time points: premandate, mandate year 1, and mandate year 2. Results. Among overlapping cohorts of 4316 (premandate), 4131 (mandate year 1), and 3639 (mandate year 2) youths, Tdap coverage increased steadily overtime (29%, 58%, and 83%, respectively). Increases were observed among all ages. Across the same time points, MCV4 coverage also increased (10%, 30%, and 60%, respectively). Most adolescents did not receive MCV4 during the same visit they received Tdap. Conclusions. A Tdap school-entry mandate was associated with substantial increases in immunization coverage, even in age groups not directly affected by the mandate. At the postmandate time points, MCV4 coverage remained lower than Tdap coverage. Provider education should emphasize the importance of reviewing vaccine records and administering all recommended vaccines at every clinical encounter. (Am J Public Health. 2010;100:1635-1640. doi: 10.2105/AJPH.2009.179341

Using a theoretical model of access, factors associated with rural adolescents' willingness to use primary care services through a school-based health center (SBHC) were examined Standardized measures of health status and use were administered to 633 adolescents in grades 7-12 who resided in one rural western Maryland county. Although only 6.5% (n = 41) of the sample indicated a willingness to change their regular source of care to an SBHC, greater numbers of adolescents reported a willingness to use SBHC services, with 18%, 38%, 25%, and 16%, indicating interest in routine, acute medical, miscellaneous, and reproductive health care services, respectively. logistic regression analysis found those adolescents who reported eligibility for free-reduced lunch and no regular source of care for illness were 3.3 and 5.4 times more likely, respectively, to use an SBHC as a primary care site than those unwilling to change their source of care. Data suggest that initially many rural adolescents appear unwilling to change their primary' care site to an SBHC, but do express a willingness to use offered services. (J Sch Health. 1997;67(4):144-148), Use of school-based clinics (SBHCs) has been endorsed by health care professionals and policy-makers in an attempt to improve access to health care, especially comprehensive primary care services, to all [...]

Children and adolescents who are left-handed may have a higher risk of unintentional injuries than those who are right-handed. Researchers compared 265 children between six and 18 years old with unintentional injuries to 494 children the same age without injuries (control group). Eighteen percent of the children with unintentional injuries were left-handed, compared with 11% of those in the control group. No other significant differences were found between the two groups of children. Twenty percent of the left-handed children had been admitted to the hospital in the past for unintentional injuries, compared with 12% of the right-handed children. Parents of left-handed children were more likely to view their child as clumsy than parents of right-handed children.

The use of anabolic steroids among high school students appears to be associated with the use of marijuana, smokeless tobacco and cocaine. Anabolic steroids increase muscle size, and about one million Americans illegally take them for cosmetic or athletic purposes every year. Of 1,881 high school students surveyed, 6.5% of the boys and 1.9% of the girls had taken anabolic steroids. Hispanic adolescents were more likely than non-Hispanics to have used steroids. Among those who reported using anabolic steroids, 24.7% had shared needles to inject the drugs. Students who had been taught about AIDS prevention were less likely to have taken steroids or to have shared needles than those who had not been taught. Use of cocaine was the most significant factor associated with steroid use, followed by use of marijuana, shared needles and smokeless tobacco.

Low-birth-weight infants born to teenage mothers who live with the grandmother appear to have improved cognitive development and health. Cognitive development, behavior and health were assessed in 272 three-year-old children who had been low-birth-weight and who were born to mothers between the ages of 15 and 24. Children who were not living with the grandmother and whose mothers were black or Hispanic or had poor verbal skills were more likely to have a low child IQ score. Maternal age by itself was not significantly related to child outcome, but it was related to poverty. Among children of mothers between the ages of 15 and 17 and 20 and 24, living in poverty was strongly associated with low IQ score. Children who were black or Hispanic or who had a very low birth rate had the lowest health scores. Living with the grandmother was significantly associated with improved health among children whose mothers had poor verbal ability. Programs should target mothers with low verbal ability who may have already dropped out of school.

Use of different forms of smokeless tobacco by adolescents may be increasing. Individuals who use smokeless tobacco have a higher risk of developing oral cancer or coronary artery disease than other individuals. Among 2,018 adolescents in sixth through ninth grade at 10 schools in a rural southern state, 12% had used smokeless tobacco at least twice and 25% had smoked on at least three occasions. Use of smokeless tobacco was higher among boys than among girls. It was also higher among white students than among those who were members of other ethnic groups. Students who lived in a rural area were more likely to use smokeless tobacco than those who lived in an urban area. Smoking cigarettes and alcohol use were also common among students who had tried smokeless tobacco. Most of the students who used smokeless tobacco were unaware of the health risks associated with its use., The use of smokeless tobacco products by adolescents has reportedly increased. The purpose of this study was to examine the use of smokeless tobacco by young adolescents across geographic locations and to look at patterns of use and variables associated with continued use beyond experimentation. Participants were 2018 students in sixth through ninth grades. Forty-five percent were male and 76% were white. Use of smokeless tobacco products was reported by 12% of the total population, and 25% reported smoking. Smokeless tobacco use was associated with cigarette smoking, alcohol use, and parental substance abuse. Those reporting alcohol use were more than four times more likely to be users of smokeless tobacco than nondrinkers. We found increased age, being male, being white, smoking, drinking, perceived effects of smokeless tobacco use, and friends' smoking behavior to be significantly associated with continued use beyond experimentation. Smokeless tobacco use was reportedly greater in rural areas. Adolescents who reported initiating use between 6 and 8 years of age were using on a more frequent basis than those who had initiated use when older. This study demonstrated the need for targeting elementary schools for educational interventions aimed at reducing smokeless tobacco use. Pediatrics 1993; 91:75-78; adolescents, smokeless tobacco, high-risk behavior.