PROMOTING POSITIVE
ADOLESCENT HEALTH
BEHAVIORS AND OUTCOMES
Thriving in the 21st Century
Committee on Applying Lessons of Optimal Adolescent Health to
Improve Behavioral Outcomes for Youth
Robert Graham and Nicole F. Kahn, Editors
Board on Children, Youth, and Families
Division of Behavioral and Social Sciences and Education
Health and Medicine Division
A Consensus Study Report of
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by a contract between the National Academy of Sciences and the Office of the Assistant Secretary for Health of the United States Department of Health and Human Services (#10004318). Support for the work of the Board on Children, Youth and Families is provided primarily by grants from the Heising-Simons Foundation (award number is 2016-210), Jacobs Foundation (award number 2015-1168), and the Marguerite Casey Foundation (award number 2018-245). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-49677-3
International Standard Book Number-10: 0-309-49677-2
Digital Object Identifier: https://doi.org/10.17226/25552
Library of Congress Control Number: 2020932720
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. (2020). Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. Washington, DC: The National Academies Press. https://doi.org/10.17226/25552.
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COMMITTEE ON APPLYING LESSONS OF OPTIMAL ADOLESCENT HEALTH TO IMPROVE BEHAVIORAL OUTCOMES FOR YOUTH
ROBERT GRAHAM (Chair), Kansas City, MO
ANGELA BRYAN, University of Colorado Boulder
TAMMY CHANG, University of Michigan Medical School
ROSALIE CORONA, Virginia Commonwealth University
TAMERA COYNE-BEASLEY, University of Alabama at Birmingham
BONNIE HALPERN-FELSHER, Stanford University
JEFFREY W. HUTCHINSON, The Wade Alliance, LLC
VELMA MCBRIDE MURRY, Vanderbilt University
SANDRA JO WILSON, Abt Associates
NICOLE F. KAHN, Study Director
RICHARD ADRIEN, Associate Program Officer (through August 2019)
REBEKAH HUTTON, Program Officer (beginning August 2019)
PAMELLA ATAYI, Program Coordinator
BOARD ON CHILDREN, YOUTH, AND FAMILIES
ANGELA DIAZ (Cochair), Department of Pediatrics and Deparment of Environmental Medicine and Public Health, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai
DAVID V. B. BRITT (Cochair), Sesame Workshop (retired CEO)
HAROLYN BELCHER, Kennedy Krieger Institute and Johns Hopkins University School of Medicine
RICHARD F. CATALANO, School of Social Work, University of Washington
DIMITRI CHRISTAKIS, Seattle Children’s Research Institute, University of Washington
JEFFREY W. HUTCHINSON, The Wade Alliance, LLC
STEPHANIE J. MONROE, The Wrenwood Group, LLC
JAMES M. PERRIN, Harvard Medical School and MassGeneral Hospital for Children
NISHA SACHDEV, Bainum Family Foundation
DONALD F. SCHWARZ, Robert Wood Johnson Foundation
MARTÍN J. SEPÚLVEDA, IBM Corporation (retired)
MARTIN H. TEICHER, Developmental Biopsychiatry Research Program at McLean Hospital and Harvard Medical School
JONATHAN TODRES, Georgia State University College of Law
NATACHA BLAIN, Director
Acknowledgments
We are grateful to many people for their support and contributions to this report. First and foremost, we would like to thank the study sponsor, the Office of the Assistant Secretary for Health (OASH) of the U.S. Department of Health and Human Services.
We would also like to thank the members of the study committee, who dedicated their time, energy, and expertise to the report. The committee also received significant contributions from several outside experts. Thank you to Robert Mahaffey (Rural School and Community Trust), Wesley Thomas (District of Columbia Public Schools), Sandra Shephard (Prince George’s County Board of Education), Lisa Rue (cliexa), Ty Ridenour (RTI International), Elizabeth D’Amico (RAND Corporation), Aaron Hogue (Center on Addiction), Heather Hensman Kettrey (Clemson University), Kim Robinson (Forum for Youth Investment), Randall Juras (Abt Associates), Irene Ericksen (Institute for Research and Evaluation), and Jennifer Manlove (Child Trends) for sharing their work and expertise during our public information-gathering session. We also would like to thank the authors of our five commissioned papers: Cady Berkel (Arizona State University) for “The Role of Sexual Agency and Consent in Healthy Adolescent Development,” Bethany Everett (University of Utah) for “Optimal Adolescent Health to Improve Behavioral Outcomes for LGBTQ Youth,” Willi Horner-Johnson and Lindsay Sauvé (Oregon Health & Science University) for “Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth with Disabilities,” Megan Moreno (University of Wisconsin–Madison) for “Adolescent Health and Media,” and the University of Michigan MyVoice team for “Youth Perspectives
on Being Healthy and Thriving.” We are grateful as well to the following Teen Pregnancy Prevention (TPP) program Tier 1B grantees, who shared successes and challenges of program implementation in memorandums to the committee: the Baltimore City Health Department, the Mary Black Foundation, Methodist Le Bonheur Community Outreach, Morehouse School of Medicine, San Diego Youth Services, and the Center for Black Women’s Wellness, Inc.
In addition, we would like to sincerely thank the youth who provided valuable input for this report. Thank you to Richard Nukpeta (Mentor Foundation USA), Shayna Shor (University of Maryland Health Center Peer Educator Program), and Natnael Abate (Promising Futures DC) for taking a healthy risk and sharing their experiences at our public information-gathering session. We also thank the MyVoice project participants, whose responses to our text message poll added important depth to this report.
This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.
We thank the following individuals for their review of this report: Suzanne R. Bakken, School of Nursing, Columbia University; Claire D. Brindis, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco; Julianna Deardorff, Center of Excellence in Maternal, Child, and Adolescent Health, University of California, Berkeley; Phillip W. Graham, Center on Social Determinants, Risk Behaviors, and Prevention Science, RTI International; Norval J. Hickman, Tobacco-Related Disease Research Program, University of California Office of the President; Denese Shervington, Institute of Women and Ethnic Studies, New Orleans, Louisiana; Laurence Steinberg, Department of Psychology, Temple University; Benjamin W. Van Voorhees, Department of Pediatrics, University of Illinois at Chicago; and Janet A. Welsh, Bennett-Pierce Prevention Research Center, Pennsylvania State University.
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by Rosemary Chalk, independent consultant, Bethesda, Maryland, and Bobbie A. Berkowitz, Columbia University School of Nursing (emerita). They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and
that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.
We are grateful to the staff of the National Academies, in particular to Richard Adrien and Rebekah Hutton, who provided critical research, writing, and editing support. To Pamella Atayi, thank you for the behind the scenes administrative and logistical support that was essential to our success. We would also like to thank Katrina Ferrara for her help during the editing process. In addition, we are exceedingly grateful to the Research Center at the National Academies, particularly Jorge Mendoza-Torres, for conducting our systematic literature search and fact checking this report.
Thank you to Natacha Blain, director of the Board on Children, Youth, and Families; Mary Ellen O’Connell, executive director of the Division of Behavioral and Social Sciences and Education (DBASSE); and Monica Feit, deputy executive director of DBASSE, who provided helpful oversight throughout this project. We are also grateful to Anthony Bryant and Faye Hillman for providing assistance in managing finances for this project. From the DBASSE Reports Office, we thank Kirsten Sampson Snyder and Yvonne Wise, who organized and moved this report through the review and production processes. In addition, we would like to thank Douglas Sprunger from the DBASSE Communications Office and Nicole Joy from the Health and Medicine Division Communications Office, who helped identify, plan, create, and execute our ideas for communication and dissemination. Finally, we thank Steve and Sarah Olson for their technical writing support and Rona Briere for her detailed editing.
Robert Graham, Chair
Nicole F. Kahn, Study Director Committee on Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth
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Contents
Brief Overview of the Teen Pregnancy Prevention Program
2 Normative Adolescent Development
Conclusions of The Promise of Adolescence: Realizing Opportunity for All Youth (2019)
Adolescent Development According to the Five Domains of the Optimal Health Framework
3 The Current Landscape of Adolescent Risk Behavior
The Nature of Adolescent Risk Taking
Alcohol Use, Tobacco Use, and Sexual Behavior: Trends and Influences
4 Core Components of Programs Focused on Optimal Health
The Core Components Approach to Evidence-Based Practice
Results of the Committee’s Systematic Review
Results of Core Components Paper Review
5 Recommendations and Promising Approaches
Recommendation for OASH Programs