title: Health-risk behaviors in young adolescents in the child welfare system.
abstract: 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.
authors.affiliation: 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
authors.forename: Laurel K
authors.initials: LK
authors.lastname: Leslie
authors.forename: Sigrid
authors.initials: S
authors.lastname: James
authors.forename: Amy
authors.initials: A
authors.lastname: Monn
authors.forename: Milena C
authors.initials: MC
authors.lastname: Kauten
authors.forename: Jinjin
authors.initials: J
authors.lastname: Zhang
authors.forename: Gregory
authors.initials: G
authors.lastname: Aarons
mesh_terms: 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*