Improving the Health, Safety, and Well-Being of Young Adults Workshop Summary (2013) / Chapter Skim
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Appendix D: Background Paper: Pathways to Young Adulthood and Preventive Interventions Targeting Young Adults--Sabrina Oesterle
Appendix D: Background Paper: Pathways to Young Adulthood and Preventive Interventions Targeting Young Adults--Sabrina Oesterle
Pages 147-176
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, 148 Health, Safety, and Well-Being Vulnerabilities and Risks During Young Adulthood, 149 Diverse Pathways to Adulthood, 151 Evidence-Based Interventions Targeting Young Adults, 158 Summary and Conclusions, 166 References, 169 This paper was commissioned by the Institute of Medicine (IOM) and the National Research Council (NRC)
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Completing school, moving into full-time employment, leaving the parental home to establish one's own residence, forming romantic relationships, getting married, and becoming a parent are key normative developmental tasks in young adulthood that are expected to be completed during this life period (Booth et al., 1999; Cohen et al., 2003; George, 1993; Macmillan and Eliason, 2003; Modell, 1989; Neugarten et al., 1965; Roisman et al., 2004; Shanahan, 2000)
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Although some young adults still follow a pathway into young adulthood that is characterized by sequencing high school completion with work or college attendance in the early 20s, and family formation during the mid- to late 20s, this previously normative sequence is less common for contemporary young adults. Some young adults do not attend college, but move into both work and family roles simultaneously or in more rapid succession during their early 20s.
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. Because there is variability in the timing of transitions into adult roles, some young adults will be more vulnerable to the health, safety, and well-being risks than others and at different times in their life course.
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provide excellent treatments of the issues associated with the transition to adulthood for many of these vulnerable populations. DIVERSE PATHWAYS TO ADULTHOOD To understand pathways to young adulthood and their consequences for health, safety, and well-being, it is important to consider transitions to adult roles simultaneously across different salient domains, such as work, education, and family, because they are interdependent within and across time (Elder, 1998, p.
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. Roughly speaking, about 40-45 percent of young adult men and women attend college and postpone family formation (pathway 1)
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suggests that unmarried young adult mothers may need greater supports to successfully manage the transition to adulthood. More than men at this age, young unmarried mothers may need to take on multiple adult roles simultaneously to support their children, combining school, work, and parenting responsibilities.
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Young African American women seem to have the greatest need for support during young adulthood because they face a particularly vulnerable situation with a high likelihood of raising children outside of marriage combined with lower employment and less participation in postsecondary education (Macmillan and Copher, 2005)
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pathway study found that more frequent substance use in adolescence and having been arrested in adolescence were significantly associated with a lower probability of being on a pathway to adulthood characterized by investment in postsecondary education and postponed family formation when these factors were considered by themselves. However, because youth from more disadvantaged families are more likely to engage in these behaviors, adolescent substance use and arrest did not uniquely predict different pathways to adulthood once family resources and family structural factors were considered at the same time.
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However, research has shown that those who move into adulthood quickly and early, especially with respect to early parenthood, seem to fare worse in adulthood than those who are college bound and delay family formation (Amato and Kane, 2011)
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In the Amato and Kane (2011) study, women who attended college and postponed family formation experienced a significantly greater increase in heavy drinking than women on other pathways, controlling for their drinking behavior in adolescence.
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. EVIDENCE-BASED INTERVENTIONS TARGETING YOUNG ADULTS Most of the health risks faced by young adults (unintentional injuries, violence, drug use, risky sexual behaviors and associated STIs, mental health problems, and overweight and obesity)
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. A few additional inventories of tested and effective programs exist, but were not included in Table D-1 because they draw on several of the reviewed databases in the table and, therefore, do not provide any additional information (e.g., Child Trends' LINKS database [www.childtrends.org/ Links]
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Department of Justice http://www.ojjdp.gov/ mpg Office of Adolescent Office of Adolescent Teen pregnancy, High study rating Health Evidence- Health (OAH)
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young adult population. As studies of pathways to adulthood indicate, half to twothirds of young adults are taking a pathway to adulthood that does not involve college attendance or only to a limited extent.
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OJJDP: Exemplary NREPP: 3.1-3.3 CTC Guide InShape College students Alcohol use College Blueprints: Promising (ages 18-25) Substance use NREPP: 2.5-2.7 Physical health Mental health Motivational Interviewing Ages 18-25 Alcohol use College NREPP: 3.4-3.5 Drinking and driving Health clinics Alcohol-related injuries Community Motivational Enhancement College students Alcohol use College NREPP: 3.3 Therapy Training for Intervention College students Alcohol use College NREPP: 3.2 ProcedureS (TIPS)
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The Adolescent Ages 18-25 Substance use Health clinics Crime Solutions: Effective Community Reinforcement Physical health Community Approach Mental health (A-CRA) Communities Mobilizing Ages 18-25 Alcohol use Community OJJDP: Exemplary for Change on Alcohol NREPP: 2.7-2.9 (CMCA)
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prevention Community FOCUS: Preventing Young adult women STI prevention Military OAH: High study rating Sexually Transmitted (16 years and older) Unintended pregnancies College Infections and Unwanted Health clinics Pregnancies in Young Community Women Respeto/Proteger Young adult Latino Parenting skills Health clinic OAH: Moderate study rating parents HIV prevention Community
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Educational and Vocational Skills InsideTrack College College students College attendance, College Coalition for Evidence-Based Coaching persistence, and Policy: One RCT only graduation Job Corps At-risk young adults Vocational skills Community OJJDP: Exemplary (ages 16-24) Employment Crime Solutions: Promising CTC Guide H&R Block College Low- and moderate- College attendance and Community Coalition for Evidence-Based Financial Aid Application income families with persistence Policy: Top Tier Assistance college-age child 165
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We identified a few evidence-based programs aimed at other outcomes in the areas of suicide prevention, mental health, educational and vocational skills, and crime or antisocial behavior. What is striking, however, is that few young adult programs are focused specifically on building the life skills required to transition into and successfully navigate new adult roles, such as relationship skills, financial management, and parenting skills.
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4-9 Crime Solutions: Effective Healthy Families America 0-5 Crime Solutions: Promising Child FIRST 6-36 months Coalition: Near Top Tier Family Foundations Prenatal NREPP: 3.6-3.7 ParentCorps 3-6 NREPP: 3.2-3.6 Chicago Parent Program 2-5 NREPP: 3.3-3.5 Active Parenting Now 2-12 NREPP: 3.1-3.2 Parents as Teachers 0-5 NREPP: 3.0-3.4 Parenting Fundamentals 0-7 NREPP: 3.0-3.3 Systematic Training for Effective 0-12 NREPP: 2.1-3.2 Parenting (STEP)
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specifically for that population. Furthermore, with the exception of parenting programs, there seems to be a lack of preventive interventions that focus on building the life skills required to make a successful transition to adulthood (e.g., relationship skills, financial skills, workplace-related skills)
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1999. Consequences of adolescent marijuana use: Incompatibility with the assumption of adult roles.
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1998. The life course and human development.
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2007. Pathways to childlessness: A life course perspective.
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2003. Characterizing the life course as role configurations and pathways: A latent structure approach.
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2001. The gendered life course.
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1987. Disorder in the life course: How common and does it matter?
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2000. Pathways to adulthood in changing societies: Variability and mecha nisms in life course perspective.
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2004. Marital status, marital transitions, and health: A gendered life course perspective.
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