Health-risk behaviors in young adolescents in the child welfare system.
OBJECTIVE
To examine rates and patterns of health-risk behavior (e.g., sexuality, depression/suicidality, substance use, delinquency) among a national probability sample of youth active to the child welfare/child protective services system. Recent federal legislation, P.L. 110-351, encourages child welfare systems, Medicaid, and pediatric experts to collaborate to ensure youth entering foster care receive comprehensive health examinations.


METHODS
Analysis of baseline caregiver, caseworker, and child interviews, and assessment data for a subsample (n = 993) of youth, aged 11-15 years, from the National Survey of Child and Adolescent Well-Being, a national probability sample of children and adolescents undergoing investigation for abuse or neglect.


RESULTS
Almost half of the sample (46.3%) endorsed at least one health-risk behavior. On Poisson multivariate regression modeling, factors related to higher rates of health-risk behaviors included older age, female gender, abuse history, deviant peers, limited caregiver monitoring, and poor school engagement.


CONCLUSIONS
Given the heightened vulnerability of this population, early screening for health-risk behaviors must be prioritized. Further research should explore specific subpopulations at risk for health-risk behaviors and possible interventions to change these youths' trajectories.
Leslie
Laurel K
LK
Center on Child and Family Outcomes, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA. lleslie@tuftsmedicalcenter.org
James
Sigrid
S
Monn
Amy
A
Kauten
Milena C
MC
Zhang
Jinjin
J
Aarons
Gregory
G
D000124:Achievement; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D002669:Child Welfare / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007604:Juvenile Delinquency / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D015999:Multivariate Analysis; D016487:Parenting / Q000523:psychology; D010379:Peer Group; D011247:Pregnancy; D012044:Regression Analysis; D012309:Risk-Taking; D012737:Sex Factors; D012931:Social Environment; D012932:Social Facilitation; D012951:Socialization; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data*