Friday, September 27, 2002

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

Listening to what Young African-American Adolescents Report about Risk Taking

Nancy Busen, RN, PhD, FNP, BC, associate professor1, Marianne Marcus, RN, EdD, FAAN, professor1, Kirk Von Sternberg, MSW, research associate2, and Thomas Walker, pastor3. (1) School of Nursing, University of Texas, Health Science Center at Houston, Houston, TX, USA, (2) Medical School, University of Texas, Health Science Center at Houston, Houston, TX, USA, (3) Windsor Village, United Methodist Church, Houston, TX, USA

Objectives: The aims of this study were to (1) examine the levels and predictors of social adaptation and risk-taking processes in African American middle school youth from a faith-based community and (2) to examine their ideas about risk-taking and risk. Early adolescence (11-14 years) marks the transition from childhood to adulthood with corresponding vulnerability related to physical, cognitive, social, and emotional changes. As the age of pubescence has declined among African American youth, early experimental behaviors have increased, making them vulnerable to serious health risks, such as sexually transmitted infections and substance abuse.

Design: A correlational design was used to determine relationship between risky behaviors and scores for social adaptation and risk-taking. A descriptive design guided open-ended questions about risk-taking and risk for these young adolescents.

Sample & Setting: Data were collected in a large urban church ministry in the Southwest, the setting for a community-based program designed to prevent substance abuse and HIV among African American youth (Project Bridge). Data collection took place in a quiet space with investigators available to answer questions. The sample included African American boys (n=22) and girls (n=23) between the ages of 11 to 13 years.

Variables Studied: Social adaptation and risk-taking processes, as measured by the Adolescent Risk-Taking Instrument (ARTI), were the dependent variable. Predictive variables included gender, reported sexual activity, birth control use, exposure to violence, school problems, and substance abuse recorded from a brief survey, which allowed answers on a 4-point scale ranging from “strongly agree to “strongly disagree”.

Methods: When adolescents were recruited into Project Bridge, a church youth ministry program, they took the ARTI as part of their baseline assessment. Participants and parents or guardians consented. The ARTI contains 44 items, which compose two subscales, social adaptation and risk-taking. Social adaptation represents positive characteristics and processes necessary to avoid negative risk-taking behavior. It includes items such as “I like to make my own decisions”. The risk-taking subscale represents the propensity to take risks. It includes items such as “Knives and guns don’t scare me”. The alpha reliabilities of the subscales in this study were .70 for social adaptation and .87 for risk-taking. The predictive variables other than gender were identified by adolescent focus groups in previous research, as issues of importance for adolescent health. Multiple regression was used to analyze data. Open-ended questions related to ideas about positive and negative qualities and consequences of risk and risk-taking behavior were examined for common themes.

Findings: Risk-taking scores (on a 4-point scale) ranged from 1.30 to 2.30 (M=1.74, SD=0.30) among females and from 1.56 to 3.22 (M=2.06, SD=.49) among males. Male gender (F=6.64, p=0.01) and alcohol use (F=15.09, p=0.00) predicted risk-taking (ARTI). Social adaptation scores (on a 4-point scale) ranged from 1.78 to 2.44 (M=2.13, SD=0.17) for males and from 1.52 to 2.33 (M=2.01, SD=.22) for females, but there were no significant associations. Major themes regarding negative ideas about risk-taking were related to peer pressure, drug use, and aggressive, impulsive and thrill-seeking behaviors. Positive ideas about risk-taking were reflected by statements such as “taking a chance at something, hoping for the best”. Of greatest concern to this sample as a consequence of risk-taking was parental disapproval.

Conclusions: Male gender and alcohol-use were related to risk-taking, a finding consistent with the current literature. Social adaptation scores were relatively low, which may reflect the psychosocial development of these early adolescents. Early adolescents frequently lack self-confidence and social skills. Although girls are known to experience psychosocial maturation sooner than boys, it was not apparent in these data. Major themes related to ideas about risk-taking suggested these early adolescents recognized that risk-taking has both positive and negative qualities and consequences, and that parents are important influences in preventing risky behaviors.

Implications: Interventions such as Project Bridge, which offer support and education before risky behavior becomes habitual should emphasize parental participation. Strategies to enhance social adaptation can be incorporated into programs to bolster personal qualities, which deter risk-taking. It may be useful in these younger adolescents to intensify information and discussion about alcohol use, especially with boys. Because middle-school children rarely seek preventive health services from health care institutions, the community becomes an important avenue for listening to early adolescents and responding to their voice through developmentally and ethnically appropriate community-based programs.

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