Friday, September 27, 2002

This presentation is part of : Heeding Adolescent Voice to Promote Health in Vulnerable Populations

Rural Adolescent Voice about Health Concerns, Risks and Assets

Susan Newfield, RN, PhD, associate professor and Dorothy Johnson, RN, EdD. School of Nursing, West Virginia University, Morgantown, WV, USA

Objective: The aim of this study was to assess the health concerns, risk behaviors, and assets of adolescents in a rural high school in a mid-Atlantic state.

Design: The Guidelines for Adolescent Preventive Services Periodic Adolescent Preventive Services Visit Form (GAPS) was used to survey students. The survey included 41 dichotomous (yes/no) items regarding 9 health categories: eating/weight, school, friends/family, weapons/violence, tobacco, alcohol, drugs, maturational development, and emotions. There were three open-ended questions, where students wrote about what they liked about themselves, what they wanted to change, and what they do best.

Sample & Setting: Four hundred and sixty students in grades nine through 12 volunteered for the survey. Each grade level was represented by a percentage commensurate with representation in the general student body. The questionnaires were completed anonymously by the students in their homerooms.

Variables Studied: Risk, health concerns, assets

Methods: The dichotomous rating on each question was coded to distinguish low risk on the behavior from high risk. Frequencies were calculated for each behavior relative to low and high risk. Responses to the open ended questions about self were examined with content analysis and themes were identified. A research-based model of adolescent assets was linked with the themes. The model emerged from surveying a national sample of over 100,000 students. The model includes the 8 asset categories of support, empowerment, boundaries and expectations, constructive use of time, commitment to learning, positive values, social competences, and positive identity. The categories were used to evaluate results from the content analysis and evaluate students’ self-descriptions relative to the established asset model.

Quantitative Findings: Students most frequently identified risk behaviors for the categories of tobacco (35%), alcohol (24%), drug use (21.6%), and health concerns about maturational development (33.5%). They least frequently identified risk behavior associated with weapons/violence (15%) and eating/weight (9%), school (4%), friends/family (11%), and emotions (15%).

Qualitative Findings: The students’ response to the two questions about what they liked about themselves and what they do best, both related to identification of positive aspects, revealed content related to the 5 of the 8 asset categories. The asset categories and sample responses are provided. 1. Positive identity: good at sports, like who I am. 2. Social competencies: be a good friend, have confidence. 3. Positive values: idea of own destiny, caring. 4. Constructive use of time: play sports, dance. 5. Support: my family, caring family The students’ responses to the third question about what they wanted to change about their life or to themselves related to 6 of the 8 asset categories. 1. Commitment to learning: get better, fix school problems. 2. Support: live in a house where everyone is respected, have two parents. 3. Social competencies: better communication, control my temper. 4. Positive identity: my body, less stress. 5. Positive values: be honest, be more positive. 6. Constructive use of time: play sports, get more involved.

Conclusions: Substance abuse and concerns about maturational development were the risk behaviors most often reported. Descriptions of self indicated that adolescents could identify their assets. Students reported positive behaviors related to all of the asset categories except empowerment and boundaries/expectations. Students also identified areas linked to six of the reported assets that they wanted to change about themselves.

Implications: Interventions aimed at immediate change are ones that support and enhance those assets identified by the adolescent as present for them. It is expected that enhancing the asset of social competence would offer promise to support the students’ abilities to resist peer pressure and decrease the use of drugs. Increasing the assets of boundaries/expectations and empowerment might also have an impact on those areas having the greatest number of high-risk behaviors. This intervention would be aimed at increasing the students’ sense of personal power and their experience of positive expectations within appropriate limits.

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