Grossoehme, D. H. 2001. "Self-Reported Value of Spiritual Issues among Adolescent Psychiatric Inpatients." Journal of Pastoral Care vol. 55, pp. 139-145.
Abstract: Reports on a survey of a prospective, uncontrolled sample of adolescent psychiatric inpatients on the importance of spiritual issues to them. Results indicated that the vast majority of adolescents in this sample indicated that spiritual beliefs are considered important. Notes that a majority reported that mental health professionals rarely asked them about their beliefs in the spiritual areas. Observes that nearly all the patients reported having a chaplain-led spiritual group that they perceived as a helpful part of the therapeutic milieu. [Source: ML]

Taha, W., D. Chin, A. I. Silverberg, L. Lashiker, N. Khateeb, and H. Anhalt. 2001. "Reduced Spinal Bone Mineral Density in Adolescents of an Ultra-Orthodox Jewish Community in Brooklyn." Pediatrics vol. 107, p. E79.
Abstract: OBJECTIVES: Bone mass increases throughout childhood, with maximal bone mass accrual rate occurring in early to mid-puberty and slowing in late puberty. Prevention of osteoporosis and its morbidities depends primarily on the establishment of adequate peak bone mass. Physical activity, calcium intake, and vitamin D stores (from sunlight conversion of precursors of vitamin D and to a lesser degree from dietary intake) are vital determinants of bone mineral density (BMD). BMD is further controlled by genetic and environmental factors that are poorly understood. Observance of ultra-Orthodox Jewish customs may have a negative effect on the factors that promote bone health, and there have been anecdotal reports of higher fracture rates in this population. The ultra-Orthodox Jewish lifestyle encourages scholarly activity in preference to physical activity. Additionally, modest dress codes and inner-city dwelling reduce sunlight exposure. Orthodox Jews do not consume milk products for 6 hours after meat ingestion, leading to potentially fewer opportunities to consume calcium. Foods from the milk group are some of the best sources of dietary calcium. Our aims are to examine BMD in a group of healthy ultra-Orthodox Jewish adolescents in an urban community and to attempt to correlate it to physical activity and dietary factors. DESIGN AND METHODS: We recruited 50 healthy, ultra-Orthodox Jews, ages 15 to 19 years (30 males and 20 females). None were taking corticosteroids or had evidence of malabsorption. All girls were postmenarchal and nulliparous. Pubic hair Tanner stage for boys and breast Tanner stage for girls were determined. Weight and height standard deviation scores were calculated. Calcium, phosphorus, protein, vitamin D, and calorie intake were assessed using a comprehensive food questionnaire referring to what has been eaten over the last year. Hours per week of weight-bearing exercise and walking were determined. Serum levels of calcium, intact parathyroid hormone (PTH), 25 hydroxyvitamin D (25[OH]D) and 1,25 dihydroxyvitamin D (1,25[OH](2)D) were measured. Lumbar spine (L) BMD was assessed by dual energy radiograph absorptiometry. The pediatric software supplied by Lunar Radiation Corporation, which contains gender- and age-specific norms, provided a z score for the lumbar BMD for each participant. L2 to L4 bone mineral apparent density (BMAD) was calculated from L2 to L4 BMD. RESULTS: BMD of L2 to L4 was significantly decreased compared with age/sex-matched normative data: mean z score was -1.25 +/- 1.25 (n = 50). The mean L2 to L4 BMD z score +/- standard deviation was -1.71 +/- 1.18 for boys and -0.58 +/- 1.04 for girls. Eight boys (27%) had L2 to L4 BMD z scores <-2.5, which defines osteoporosis in adulthood. Twenty-seven adolescents (54%), 16 boys and 11 girls, had Tanner stage V. Two participants (4%) had delayed development of Tanner stage V. Mean consumption of calcium by participants under 19 years old was 908 +/- 506 mg/day (n = 46), which is lower than the adequate intake of 1300 mg/day for this age. The consumption of phosphorus was 1329 +/- 606 mg/day, and the consumption of vitamin D was 286 +/- 173 IU/day (n = 50). The mean serum 25(OH)D level was 18.4 +/- 7.6 ng/mL, and the mean serum 1,25(OH)(2)D level was 71.1 +/- 15.7 pg/mL (n = 50). Boys had significantly higher serum levels of 1,25(OH)(2)D than did girls (74.9 +/- 16.46 pg/mL vs 65.25 +/- 12.8 pg/mL, respectively). The serum levels of PTH, calcium, and protein were (mean +/- standard deviation): 33 +/- 16 pg/mL, 9.5 +/- 0.69 mg/dL, and 7.8 +/- 0.6 g/dL, respectively (n = 50). L2 to L4 BMD z score had positive correlation with walking hours (r = 0.4). L2 to L4 BMD z score had negative correlation with serum level of 1,25(OH)(2)D )r = -0.33; n = 50). We could not find significant correlation between L2 to L4 BMD z scores for the entire cohort and any of calcium, vitamin D, phosphorus, or protein intake. However, the L2 to L4 BMD z scores of boys had positive correlation with calcium, phosphorus, and protein intake (r = 42, r = 44, and r = 43 [Source: ML]

Adams, T. B., J. R. Bezner, M. E. Drabbs, R. J. Zambarano, and M. A. Steinhardt. 2000. "Conceptualization and Measurement of the Spiritual and Psychological Dimensions of Wellness in a College Population." Journal of American College Health vol. 48, pp. 165-173.
Abstract: Wellness is commonly conceptualized as having many dimensions, but little effort has been made to evaluate how spiritual and psychological dimensions are related to overall wellness. To explore the relationship between measures of spiritual and psychological wellness and perceived wellness in a college student population, the authors administered a series of survey instruments to 112 undergraduate students under quiet classroom conditions. They used the Life Attitude Profile to measure spiritual wellness, the Life Orientation Test and the Sense of Coherence Scale to measure psychological wellness, and the Perceived Wellness Survey to measure overall wellness. Path analysis performed with a proposed theoretical model revealed that the effect of life purpose on perceived wellness was mediated by optimism and sense of coherence, which had independent effects on perceived wellness beyond that of life purpose. The findings suggested that an optimistic outlook and sense of coherence must be present for life purpose to enhance a sense of overall well-being. [Source: CI]

Anonymous. 2000. "Innovative HIV Prevention Campaigns Focus on High-Risk Youth, Minorities: Black Ministers Step into HIV Testing Limelight, Sending Message Home." AIDS Alert vol. 15, pp. 85-88.

Ellis, A. 2000. "Consent and the Teenage Jehovah's Witness." Paediatric Nursing vol. 12, pp. 29-31.

Margolis, R., A. Kilpatrick, and B. Mooney. 2000. "A Retrospective Look at Long-Term Adolescent Recovery: Clinicians Talk to Researchers." Journal of Psychoactive Drugs vol. 32, pp. 117-125.
Abstract: The purpose of the present article is to identify factors associated with long-term recovery for adolescents. A group of 14 young adults were given semistructured in-depth (one to two hour) interviews. The subjects had been in recovery for two to 16 years. Length of stay in treatment, involvement with self-help groups, psychotropic medication, family support, peer support, spirituality, and other factors were identified as helpful for long-term recovery. A major limitation of this inquiry is that it does not meet minimum standards for research. It is hoped, however, that this inquiry can inform directions for further research. [Source: ML]

McCaleb, A. and V. V. Cull. 2000. "Sociocultural Influences and Self-Care Practices of Middle Adolescents." Journal of Pediatric Nursing: Nursing Care of Children & Families vol. 15, pp. 30-35.
Abstract: The purpose of this study was to describe general self-care practices of middle adolescents. In addition, the relation between general self-care practices and specific sociocultural characteristics including socioeconomics and church attendance were explored. Orem's self-care theory and developmental theory provided the framework for the investigation. Findings from the sample of 15- and 16-year-old adolescents (n = 425) showed that they are engaging in self-care practices. The influence of sociocultural characteristics on self-care practices was supported. Implications from the study include the need to continue research endeavors that describe, explain, and predict health behavior in child and adolescent populations. Practicing nurses in diverse health care settings should consider the results of this study when working with adolescents and their families from diverse sociocultural backgrounds. Results from this investigation should be incorporated into the planning of health education programs for the adolescent population. [Source: CI]

Pfund, R. 2000. "Nurturing a Child's Spirituality."Journal of Child Health Care vol. 4, pp. 143-148.
Abstract: Nurturing a child's spirituality should be an integral part of holistic care., The concept of spirituality is linked to the child's cognitive, social, psycho-sexual and moral development., Knowledge of childhood spirituality can help to support children coping with traumatic life-events., The expression of beliefs and feelings that encompass spirituality can be facilitated through literature and music and through other strategies. Educators need to empower professionals to have the awareness, emotional resources and skills to ensure that they can be spiritually supportive. [Source: CI]

Trockel, M. T., M. D. Barnes, and D. L. Egget. 2000. "Health-Related Variables and Academic Performance among First- Year College Students: Implications for Sleep and Other Behaviors." Journal of American College Health vol. 49, pp. 125-131.
Abstract: The authors analyzed the effect of several health behaviors and health-related variables on grade point averages of a random sample of 200 students living in on-campus residence halls at a large private university. The set of variables included exercise, eating, and sleep habits; mood states; perceived stress; time management; social support; spiritual or religious habits; number of hours worked per week; gender; and age. Of all the variables considered, sleep habits, particularly wake- up times, accounted for the largest amount of variance in grade point averages. Later wakeup times were associated with lower average grades. Variables associated with the Ist-year students' higher grade point averages were strength training and study of spiritually oriented material. The number of paid or volunteer hours worked per week was associated with lower average grades. [Source: SC]

Barbarin, Oscar A. 1999. "Do Parental Coping, Involvement, Religiosity, and Racial Identity Mediate Children's Psychological Adjustment to Sickle Cell Disease?" Journal of Black Psychology vol. 25, pp. 391-426.
Abstract: Many African Americans with sickle cell disease (SCD) also experience significant economic hardship. Yet, few studies of the psychosocial effects of SCD employ designs robust enough to control socioeconomic factors. This study compares the functioning of families with SCD to that of healthy controls matched for race and SES. Child Ss (aged 5-18 yrs) included 77 children with SCD, 28 siblings of children with SCD, and 74 children who had neither an illness nor siblings with an illness. A total of 71 parents of SCD children and 50 control parents also participated in the study. Results show that in general, functioning within SCD and control families did not differ. However parents granted less autonomy to, and were less involved in the schooling of children with SCD. Overall, SCD had a greater impact on children's social and academic competence than on their emotional functioning. However adolescents with SCD and their siblings were at greater risk for mental health difficulties than were controls. The more SCD interfered with living normally, the greater the risk of psychological dysfunction. Importantly, emotional well-being in parents moderated the adverse effects of SCD on children. Similarly, racial consciousness, religiosity, and emotional support enhanced parental coping. [Source: PI]

Lindsey, B. J. and C. M. Saunders. 1999. "College Students' Health Interests: A Comparison by Ethnicity, Gender, and Other Demographic Variables." Journal of Health Education vol. 30, pp. 36-41.
Abstract: Using the social marketing principle of audience segmentation, a random sample of university undergraduate students, stratified by ethnicity, gender, year in school, and undergraduate college, was selected to respond to the College Health Interest Inventory via a telephone survey. This survey assessed level of interest (strong, some, or none) in 35 health topics. Three hundred forty-two students responded to the survey, achieving a response rate of 81.4%. A factor analysis resulted in a seven-factor solution of the 35 health topics: Sexual Health, Physical Health, Relationships, Mental Health, Environmental Health, Alternatives, and Alcohol-Related Issues. Analysis of variance found significant explanatory variables for various factors, including gender, ethnicity, year in school, political ideology, and/or religion. The findings of this study can aid college and university health educators to plan, market, and implement more responsive health education programs and services. Providing health programs that are of high interest to different groups of students may result in better utilization of resources, increased participation rates in health education programs, and a healthier campus. [Source: CI]

Neumark-Sztainer, D., M. Story, C. Perry, and M. A. Casey. 1999. "Factors Influencing Food Choices of Adolescents: Findings from Focus-Group Discussions with Adolescents." Journal of the American Dietetic Association vol. 99, pp. 929-937.
Abstract: OBJECTIVE: To assess adolescents' perceptions about factors influencing their food choices and eating behaviors. DESIGN: Data were collected in focus-group discussions. SUBJECTS/SETTING: The study population included 141 adolescents in 7th and 10th grade from 2 urban schools in St Paul, Minn, who participated in 21 focus groups. ANALYSIS: Data were analyzed using qualitative research methodology, specifically, the constant comparative method. RESULTS: Factors perceived as influencing food choices included hunger and food cravings, appeal of food, time considerations of adolescents and parents, convenience of food, food availability, parental influence on eating behaviors (including the culture or religion of the family), benefits of foods (including health), situation-specific factors, mood, body image, habit, cost, media, and vegetarian beliefs. Major barriers to eating more fruits, vegetables, and dairy products and eating fewer high-fat foods included a lack of sense of urgency about personal health in relation to other concerns, and taste preferences for other foods. Suggestions for helping adolescents eat a more healthful diet include making healthful food taste and look better, limiting the availability of unhealthful options, making healthful food more available and convenient, teaching children good eating habits at an early age, and changing social norms to make it "cool" to eat healthfully. APPLICATIONS/CONCLUSIONS: The findings suggest that if programs to improve adolescent nutrition are to be effective, they need to address a broad range of factors, in particular environmental factors (e.g., the increased availability and promotion of appealing, convenient foods within homes schools, and restaurants). [Source: ML]

Shillinglaw, Regina Dillingham. 1999. "Protective Factors among Adolescents from Violent Families: Why Are Some Youth Exposed to Child Abuse and/or Interparental Violence Less Violent Than Others?" Ph.D. Thesis, University of South Carolina, Columbia.
Abstract: The transactional model of development suggests that the development of violent behavior is the result of reciprocal processes between individual, family, and environmental variables, some of which increase the probability of violent behavior and some of which decrease the probability of violent behavior. The purpose of this study was to identify factors which are associated with less violent behavior among at-risk adolescents. The risk status of the participants was defined as being a victim of familial violence, a witness to familial violence, or both. In addition, the participants were juvenile delinquents which also placed them at risk for violent behavior. The following protective factors were examined: flexible temperament, positive mood, positive relationship with a non-parental adult, empathy, religious beliefs, cognitive ability, positive attitude toward school, approach-oriented temperament, high self-esteem, internal locus of control, and prosocial success. Data was obtained from 226 male adolescents committed to the Department of Juvenile Justice via self-report measures and file review. An analysis of covariance revealed that the protective factors which are significantly associated with lower levels of violence were: a withdrawal-oriented temperament, empathy, religious beliefs, and high self-esteem. Possible explanation of the findings and implications for future research are discussed. [Source: PI]

Gustafson, Cynthia Zotalis. 1998. "The Effects of a Health Promotion Program on Parental Attitudes and Behaviors and Adolescent Sexual Well-Being." Thesis, University of Michigan.
Abstract: Fifty-two parents and their 35 teens participated in an eight-week church-based health promotion program designed to strengthen parental attitudes and behaviors that enhance adolescent sexual well-being. Measures of interpersonal influences of parents and adolescent sexual well-being of this group were compared with 37 parents and their 28 teens who did not participate in the program. Teens in the program increased satisfaction with their own personal sexuality and clarity of personal sexual values. Families also displayed a trend toward increased quality of parent-teen communication about sex when compared to families not participating in the program. These are positive initial effects given the limited time frame for intervention and measurement of outcomes. Implementation of the program by the investigator was successfully completed in the religious communities and is an example of a community-based nursing intervention that can be tested further as a means to address the health promotion needs of the parent-teen population. [Source: PI]

Jessor, Richard, Mark S. Turbin, and Frances M. Costa. 1998. "Protective Factors in Adolescent Health Behavior." Journal of Personality and Social Psychology vol. 75, pp. 788-800.
Abstract: The role of psychosocial protective factors in adolescent health-enhancing behaviors--healthy diet, regular exercise, adequate sleep, good dental hygiene, and seatbelt use--was investigated among 1,493 Hispanic, White, and Black high school students in a large, urban school district. Both proximal (health-related) and distal (conventionality-related) protective factors have significant positive relations with health-enhancing behavior and with the development of health-enhancing behavior. In addition, in cross-sectional analyses, protection was shown to moderate risk. Key proximal protective factors are value on health, perceived effects of health-compromising behavior, and parents who model health behavior. Key distal protective factors are positive orientation to school, friends who model conventional behavior, involvement in prosocial activities, and church attendance. The findings suggest the importance of individual differences on a dimension of conventionality--unconventionality. Strengthening both proximal and distal protective factors may help to promote healthful behaviors in adolescence. [Source: PI]

Patton, John Douglas. 1998. "Exploring the Relative Outcomes of Interpersonal and Intrapersonal Factors of Order and Entropy in Adolescence: A Longitudinal Study." Ph.D. Thesis, The University of Chicago, Chicago.
Abstract: This dissertation is based on a data from a national sample of 297 adolescents who were among those participating in the five-year Alfred P. Sloan Foundation Study of Youth and Social Development. This study investigates change over time in various entropic and stabilizing factors - both interpersonal and intrapersonal - and explores their relative contribution to emotional and physical well being with reference to demographics. Data from interpersonal measures (family, school, and religious support; and school and family adversity), intrapersonal measures (the amount of time spent in four quadrants - flow, relaxation, anxiety and apathy), and outcome measures (self-esteem, affect, motivation, anger, physical pain, quality of time use, and the Hope Scale) were collected at three time points between 1992 and 1997. This study found that low social status, compared to higher social status, was associated with greater levels of psychic entropy (apathy and anxiety) and adversity, and lower levels of social support, relaxation, and self- esteem (but higher affect). This suggests that low social status has serious implications for the development of adolescents. The study also indicated that the support of certain social institutions impacts boys and girls differently. Family support was predictive of positive outcomes for both genders, but school and religious support seemed to help only boys. Flow proved beneficial for both genders. The data indicated that low challenge may have a devastating developmental impact on boys, whereas excessive challenge has the worst long-term implications for girls. [Source: DA]

Sawyer, Robin G., Paul J. Pinciaro, and Anne Anderson Sawyer. 1998. "Pregnancy Testing and Counseling-a University Health Center's 5-Year Experience." Journal of American College Health vol. 46, pp. 221-225.

Villarruel, A. M., L. S. Jemmott, M. Howard, L. Taylor, and E. ddBush. 1998. "Practice What We Preach? HIV Knowledge, Beliefs, and Behaviors of Adolescents and Adolescent Peer Educators." Journal of the Association of Nurses in AIDS Care vol. 9, pp. 61-72.
Abstract: The purpose of this article is to (a) describe the knowledge, beliefs, and sexual behaviors of urban adolescents and adolescent peer educators, and (b) identify elements needed to design effective HIV/AIDS prevention programs for out-of-school youth. Thirty-three predominantly African American adolescents (female = 14; male = 19) between the ages of 14 and 24 in a large urban city including adolescents (n = 18) and adolescent peer educators (n = 15) participated. Paper-and-pencil questionnaire and focus-group interviewing methods were used. Adolescents and adolescent peer educators had a moderately high level of HIV knowledge, confidence in their ability to use condoms, and beliefs that condom use would not decrease sexual pleasure or imply infidelity. Both groups reported low perceptions of susceptibility to HIV infection. Engagement in sexual risk behavior was low, but was significantly higher among males. Although adolescent male peer educators engaged in a higher frequency of risk behaviors over time, they had a lower frequency of sexual risk behaviors in the past 2 months compared with male adolescents. Study findings showed that HIV prevention interventions need to include information about specific risk behaviors, such as using condoms for oral sex, and cleaning drug paraphernalia. Community-based and church programs, visible HIV prevention messages, specifically those aimed at increasing perceptions of HIV risk, and the development of condom-use skills were identified by adolescents and adolescent peer educators as relevant approaches to reduce HIV infection among this population. [Source: CI]

Wallace, John M., Jr. and Tyrone A. Forman. 1998. "Religion's Role in Promoting Health and Reducing Risk among American Youth." Health Education and Behaviorvol. 25, pp. 721-741.
Abstract: Although past research has documented religion's salutary impact on adult health-related behaviors and outcomes, relatively little research has examined the relationship between religion and adolescent health. This study uses large, nationally representative samples of high school seniors to examine the relationship between religious importance, attendance, and affiliation and behaviors that compromise or enhance adolescents' health (unintentional and intentional injury, substance use, lifestyle behaviors). Relative to their peers, religious youth are less likely to engage in behaviors that compromise their health (e.g., carrying weapons, getting into fights, drinking and driving) and are more likely to behave in ways that enhance their health (e.g., proper nutrition, exercise, and rest). Multivariate analyses suggest that these relationships persist even after controlling for demographic factors, and trend analyses reveal that they have existed over time. Particularly important is the finding that religious seniors have been relatively unaffected by past and recent increases in marijuana use. [Source: PI]

Ark, Pamela Dale. 1997. "Health Risk Behaviors and Coping Strategies of African- American Sixth Graders."Ph.D. Thesis, The University of Tennessee Center For the Health Sciences, Memphis.
Abstract: Children, eleven to fourteen years, experience times of lifestyle change. Children can develop health behaviors that could result in illness and premature death. The reduction of risk behaviors among children, addressed in the Healthy People 2000 (U.S. Department of Health and Human Services, 1990) goals, recommended education regarding injury prevention, physical activity. and healthy nutritional choices. Study purposes included: examine height, weight, and blood pressure measurements; investigate health risk behaviors and coping strategies; and determine relationships among physiological variables, health behaviors, and coping strategies. Health behaviors were measured by a version of 1995 CDC Youth Risk Behavior Survey (YRBS), a 70 item survey on unintentional injuries; tobacco, alcohol, and drug use; dietary behavior; and physical activity. Coping strategies were measured by Ryan-Wenger's Schoolagers Coping Strategies Inventory (SCSI), a 26 item survey on frequency and effectiveness of coping strategies. The conceptual framework guiding the study was Neuman's Systems Model (1995). Client variables included: physiological: height, weight, and blood pressure measurements; psychological: coping strategies; sociocultural: living in proximity to inner city school; developmental: age and gender; and spiritual: prayer as a coping strategy. The sample was 173 African American sixth graders, ages 11 to 14, females (n = 98) and males (n = 75), from five inner city schools with written parental consent. There was no statistical difference by gender in body mass index. Statistical differences were found by gender with more males than females reporting physical fighting. Older males than females, ages 12 and 13, reported tobacco and marijuana use. There was zero reported use of cocaine and no statistical differences by gender on alcohol, dietary behaviors, or physical activity. Coping strategies (sample mean was 19.4) reported more often were prayer (75 percent) and watch television or listen to music (75 percent). Multiple regression showed interaction effects of unintentional injuries with gender and SCSI effectiveness scale. There were statistical differences in means between females and males, ages 12 and 13, suggesting need for further investigation of coping strategies. Further investigation of coping strategies among sixth graders and their family in relationship with the environment is recommended to determine coping strategies of the family unit. [Source: DA]

Neumark Sztainer, Dianne, Mary Story, Simone A. French, and Michael D. Resnick. 1997. "Psychosocial Correlates of Health Compromising Behaviors among Adolescents." Health Education Research vol. 12, pp. 37-52.
Abstract: Investigated psychosocial correlates of diverse health-compromising behaviors among adolescents of different ages. Ss included 123,132 11-21 yr old males and females in 6th, 9th, and 12th grade. Psychosocial correlates of substance abuse, delinquency, suicide risk, sexual activity, and unhealthy weight loss behaviors were examined. Psychosocial variables included emotional well-being, self-esteem, risk-taking disposition, number of concerns, extracurricular involvement, religiosity, school connectedness and achievement, physical and sexual abuse, and family connectedness and structure. Results show that risk-taking disposition was associated with nearly every behavior across age and gender groups. Other consistent correlates included sexual abuse and family connectedness. Correlates of health-compromising behaviors tended to be consistent across age groups. However, stronger associations were noted between sexual abuse and substance use for younger adolescents, and risk-taking disposition and school achievement were stronger correlates for older youth. Findings suggest the presence of both common and unique etiological factors for different health-compromising behaviors among youth. [Source: PI]

Wallace, John M., Jr. and David R. Williams. 1997. "Religion and Adolescent Health-Compromising Behavior." Pp. 444-468 in Health Risks and Developmental Transitions During Adolescence, edited by John Schulenberg and Jennifer L. Maggs. New York, NY: Cambridge University Press.
Abstract: (from the chapter) begin to bridge the gap between research on religion (i.e., attitudes, beliefs, values, and behaviors concerning things spiritual) and research on adolescent health outcomes describe the "epidemiology" of religion among American youth discuss the relative neglect of religion by researchers interested in adolescent health review, selectively, empirical research on the relationship between religion and the 2 potentially health-compromising behaviors in which American youth are most likely to engage--precocious sexual involvement and the use of licit and illicit drugs discuss problems and limitations in the extant research on religion and adolescent health outcomes concludes with the discussion of a conceptual framework. [Source: PI]

Chandy, Joseph M., Robert W. Blum, and Michael D. Resnick. 1996a. "Female Adolescents with a History of Sexual Abuse: Risk Outcome and Protective Factors."Journal of Interpersonal Violence vol. 11, pp. 503-518.
Abstract: Examined the school performance, suicidal involvement, disordered eating behaviors, pregnancy risk, and chemical use of 1,011 female teenagers with a history of sexual abuse and a comparison group of 1,011 female teenagers without a background of abuse. Results show that abused Ss had higher rates of these adverse outcomes than nonabused Ss. Among abused Ss, protective factors against adverse outcome included a higher degree of religiosity, perceived health, caring from adults, living with both biological parents, and the presence of a clinic or nurse at school. Risk factors that increased the likelihood of adverse outcome included perceived substance use in school, mothers' use of alcohol, family stressor events during the past year, and worry about sexual coercion. [Source: PI]

Chandy, Joseph M., Robert W. Blum, and Michael D. Resnick. 1996b. "History of Sexual Abuse and Parental Alcohol Misuse: Risk, Outcomes and Protective Factors in Adolescents." Child and Adolescent Social Work Journalvol. 13, pp. 411-432.
Abstract: Examined the factors of school performance, suicidal involvement, disordered eating behaviors, pregnancy risk, and chemical use among 1,959 teenagers with a history of sexual abuse or parental alcohol misuse. It was found that Ss had higher rates of adverse outcomes than among a comparison group of teenagers without such background risk factors. Adolescents with dual-risk background reported higher levels of suicide risk, disordered eating, sexual behaviors, and chemical abuse than did Ss with only one background risk factor. Among index group members, protective factors against adverse outcomes included a high degree of religiosity and the ability to discuss problems with family or friends. Risk factors that increased the likelihood of adverse outcomes included depression, perceived substance use in school, and worries about family financial security. [Source: PI]

Hopkins, Gary Lee. 1996. "An AIDS Risk Appraisal of Students Attending Seventh-Day Adventist High Schools in the United States and Canada." Ph.D. Thesis, Loma Linda University, Loma Linda.
Abstract: Since its first recognition in 1981, the Acquired Immunodeficiency Syndrome (AIDS) has become a global disease of increasing prevalence. Because there is no current cure or vaccination available to effectively prevent AIDS, health education has become an important method of reducing the transmission of the human immunodeficiency virus (HIV) which is known to cause AIDS. A substantial amount of research has been conducted in public high schools aimed at identifying determinants of students AIDS-risk behaviors. With the exception of one study conducted by Ludescher (1992), theory based AIDS- behavioral research in Christian student populations have not been reported. In the present study, 1,748 students attending 69 Seventh-day Adventist (SDA) four-year high schools completed a self-administered questionnaire designed to assess (1) the HIV/AIDS-related behaviors of substance use and sexual intercourse before marriage and the determinants of these two risk behaviors based on the theory of planned behavior (TPB) (Ajzen, 1989), and (2) HIV/AIDS related attitudes, normative beliefs, and perceived control in a sample of SDA high school students based on the TPB. A substantial number of research participants reported prior sexual and drug use behaviors. The rates of both of these behaviors were lower in SDA than in non-SDA respondents. Those students who reported that their parent(s) used either tobacco, alcohol, or marijuana demonstrated higher rates of past sexual intercourse and substance use than those students who reported that their parent(s) were not users of any of the three substances. Using multiple regression analysis, the best predictor of the respondents intention to have sexual intercourse before marriage their perceived control over this behavior. Further, the cognitive underpinnings that best predicted the students perceived control regarding sexual intercourse before marriage were spiritual strength and encouragement from their teachers. Useful conclusions drawn from this research were not that a certain proportion of SDA youth engaged in sexual behaviors or substance use, but were rather that SDA youth are not immune or exempt from engaging in behaviors that place them at risk for unintended pregnancy, sexually transmitted diseases including AIDS. Also, some of the cognitive underpinnings of the student's attitudes, subjective norms, and perceived control as they relate to sexual intercourse have now been identified. Educators can now act by creatively designing strategies that when implemented may serve to reduce the consequences of the acts studied. The Office of Education of the North American Division of Seventh-day Adventists might consider a continuous assessment based on behavioral theory that would further clarify determinants of health risk behaviors in their student population in the future. An analysis such as this would allow for quick corrective interventions when indicated. [Source: DA]

Bennet, T., D.A. Deleuca, and R.W. Allen. 1995. "Religion and Children with Disabilities." Journal of Religion and Health vol. 34, pp. 301-312.

Butler, M. R. 1995. "Self-Esteem and Health-Promoting Lifestyle as Predictors of Health-Risk Behavior among Older Adolescents." Ph.d. Thesis, Texas Woman's University.
Abstract: The purpose of this study was to investigate a model of health-risk behavior among older adolescents. Specifically, relationships between self-esteem, health-promoting lifestyle, and health-risk behavior, and the importance of self-esteem and health-promoting lifestyle in predicting health-risk behavior were examined. The conceptual framework was based on the concepts identified in self and symbolic interactionism theories, as well as those in health promotion, adolescent and problem behavior theories. The interaction among the variables identified in the conceptual framework guided the development of the five research hypotheses. A predictive, correlational research method was used to test the hypotheses. The Rosenberg Self-Esteem Scale (Rosenberg, 1965), the Health-Promoting Lifestyle Profile (Walker, Sechrist, & Pender, 1987), and the Youth Risk Behavior Survey (YRBS) were used to collect data. The study sample consisted of 120 college students attending a small, private, four-year liberal arts college. Mean age was 18.8 years. Students participated after being informed verbally and in writing of the purpose and voluntary nature of the study. Proposed relationships were analyzed by Pearson's product moment correlation and chi-square analysis. Discriminant function analysis was used to determine the power of health-promoting lifestyle and self-esteem in predicting health-risk behavior. Risk behavior was defined by specific YRBS items addressing sexual and alcohol-use behavior. One hypothesis was supported, one was not supported, and three hypotheses were partially supported. Relationships were found between self-esteem and health-promoting lifestyle, between health-promoting lifestyle and specific risk behaviors, and among specific personal characteristics such as academic self-assessment, religiosity, and physical health self-assessment and risk behaviors. Self-esteem was positively correlated with risk behavior, which was opposite the hypothesized direction. Self-esteem and health-promoting lifestyle were found to successfully predict membership into dichotomous risk behavior groups for two of the sexual behavior variables. The study concluded that health-promoting lifestyle may have a positive effect on behavior, and may be used in predicting health-risk behavior among older adolescents, but that self-esteem may have a spurious relationship with risk behavior, and should be investigated further. [Source: CI]

Cull, V. V. 1995. "Exposure to Violence and Self-Care Practices of Adolescents." D.S.N. Thesis, University of Alabama at Birmingham.
Abstract: Adolescents are capable of carrying out self-care practices, and there are many influences on the care that they carry out. Nursing literature is limited regarding the influence of adolescent risk factors including exposure to violence on their self-care practices. Therefore, the purpose of this descriptive study was primarily to examine the relationship between exposure to violence and the self-care practices of adolescents. Also, the relationship among exposure to violence, self-care practices, and selected conditioning factors was described. This study used a conceptual framework that combined Orem's Self-Care Model and Bronfenbrenner's Model of the Ecology of Human Development. The sample consisted of 161 Black 10-grade students. Three questionnaires were administered to the students: an investigator-adapted Violence Exposure Questionnaire, Denyes' Self-Care Practice Instrument, and an investigator-adapted Conditioning Factor Profile. Multiple regression analyses resulted in three significant variables (gender, presence of health problems, and church attendance) and three variables with substantive significance (family intactness, education of father, and being a victim of violence). The 12 variables in the final regression equation accounted for 21% of the variance in self-care of adolescents. Being a victim of violence was found to have a substantive negative influence on self-care practices of adolescents. Findings from this study supported the usefulness of Orem's and Bronfenbrenner's models for the study of factors influencing self-care practices of adolescents. Additional research regarding the influence of exposure to violence on adolescents was suggested. Also, recommendations for future research include replication of this study using a sample that is more heterogeneous, randomized, and stratified for different ages. [Source: CI]

Redeker, N. S., S. C. Smeltzer, J. Kirkpatrick, and S. Parchment. 1995. "Risk Factors of Adolescent and Young Adult Trauma Victims." American Journal of Critical Care vol. 4, pp. 370-378.
Abstract: BACKGROUND: Repeated injury, or recidivism, because of intentional or unintentional injury is a growing chronic health problem among urban adolescents and young adults in the United States. OBJECTIVE: To describe demographic, social, environmental, psychological, and developmental antecedents and risk-taking behaviors, and to examine their relationships to type of trauma and rate of trauma recidivism in adolescent and young adults in an urban trauma center. METHODS: One hundred adolescent and young adult trauma victims in an urban trauma center were interviewed, using the Adolescent Risk-Taking Instrument, the Brief Anger/Aggression Questionnaire, and the Trauma Risk Factor Interview Schedule. Bivariate correlation, multiple regression, and discriminant function analysis were used to examine the data. RESULTS: Of the sample, 89% experienced trauma related to interpersonal violence, including firearm injuries, stab wounds, and blunt trauma. Male gender, unemployment, past arrest, lower levels of spirituality, and higher levels of anger/aggression and thrill-seeking accounted for 25% of the variance in the number of risk-taking behaviors. Factors such as male gender, past arrest, unemployment, having been a crime victim in the past, lower autonomy, use of weapons, fighting, and no psychological counseling distinguished subjects with firearm-related injuries from subjects with other injury sources. Use of alcohol on weekdays, past arrest, and higher education levels were associated with trauma recidivism, explaining 14% of the variance. CONCLUSIONS: Social/environmental and psychological/developmental variables, as well as risk-taking behaviors, are important correlates of trauma and recidivism. These findings suggest the importance of advocacy for social policies conducive to reducing the risks of violence and trauma and risk-reduction interventions as components of posttrauma care. [Source: CI]

Romer, D. and S. Kim. 1995. "Health Interventions for African American and Latino Youth: The Potential Role of Mass Media." Health Education Quarterly vol. 22, pp. 172-189.
Abstract: Children in Latino and African American families are far more likely to live in urban, high-poverty settings that greatly increase risks to healthy development. During adolescence, these settings are particularly hazardous for their role in the social transmission of risk behavior. Community-wide health promotion using local mass media can counteract these influences by reaching preadolescents and adolescents, their parents, and other adults in urban communities with safe-behavior messages. These messages can be designed to make safer behavior more acceptable and normative in the community, to increase awareness of community resources for adolescents, and to reverse the stereotyping and disregard that characterize media content about impoverished communities. Evidence is reviewed that, despite their poverty status, African American and Latino communities have considerable social resources to which community-wide health promotion can appeal, including strong family bonds, religious attachment, and concern about the community. The influence of these resources is exemplified by relatively low rates of adolescent drug use. Health promotion conducted regularly through local mass media could be an effective strategy to improve the health of adolescents in urban communities. [Source: CI]

Emmons, Lillian. 1994. "Predisposing Factors Differentiating Adolescent Dieters and Nondieters."Journal of the American Dietetic Association vol. 94, p. 725.
Abstract: Examines whether certain biological, socio-cultural and psychological factors differentiate dieters from non-dieting adolescents. Research design; High-school seniors as subjects; Comparison of dieters and nondieters using weights, parental weights, birth order, socioeconomic status, religion affiliation, self-esteem scores and other psychological factors. [Source: AS]

Kuczmarski, R. J., J. J. B. Anderson, and G. G. Koch. 1994. "Correlates of Blood-Pressure in 7th-Day-Adventist (SDA) and Non-SDA Adolescents." Journal of the American College of Nutrition vol. 13, pp. 165-173.
Abstract: Objective: This comparative study was designed to discover early determinants of systolic (S) and diastolic (D) blood pressure (BP) elevations in 138 Seventh-Day Adventist (SDA) and 89 non-SDA male and female adolescents (median age, 17 years) living at three residential secondary schools in North Carolina. Methods: Measurements were made of blood pressure, body weight, and height, and information was collected on lifestyle factors, dietary intake, and other behaviors, including exercise, religiosity, Type A behavior, and anger, by questionnaire. Multiple stepwise regression analyses were performed with BP, either SBP or DBP, as the independent variable. Results: A significant direct association was found only between body weight and BP, but weak associations were shown between BP and other variables, including exercise, diet, religiosity, Type A behavior, and anger. Male and female SDA students showed significantly higher SBPs and DBPs than did non-SDA adolescents though the differences were small (approximately 5 mm for each sex). Conclusions: These findings suggest that the higher BP values of SDA adolescents, who were all practicing lacto-ovo-vegetarians, compared to similarly aged health-conscious non-SDAs, are determined more by eating behaviors that contribute to gains in body weight than by any other lifestyle variable. Furthermore, these data support the notion that the BP-protective effects of the vegetarian diet may not emerge in these SDA youth until early adulthood. [Source: SC]

Rew, L. and P. Shirejian. 1993. "Sexually Abused Adolescent: Conceptualization of Sexual Trauma and Nursing Interventions." Journal of Psychosocial Nursing & Mental Health Services vol. 31, pp. 29-33.
Abstract: Many adolescent victims of sexual abuse display symptoms that reflect alterations in individual coping and thought processes, social isolation and impaired verbal communication, and alterations in spiritual well-being. Nursing interventions based on a multidimensional model of sexual trauma focus on helping the adolescent learn to plan and carry out activities within a safe environment to improve a sense of self, improve interpersonal relationships, and decrease spiritual isolation and hopelessness. Nursing interventions are designed to assist the adolescent to integrate past experiences, including memories and feelings, with current decisions to engage in self-protective and health-promoting behaviors. [Source: CI]

Ruiz Ruiz, M., J. M. Pena Andreu, and G. Jimenez Lerida. 1993. "Family Ecological Factors and Attitudes Towards Physical Illness." European Journal of Psychiatry vol. 7, pp. 197-201.
Abstract: Examines the significance of family ecological factors in determining attitudes toward physical illness among 100 adolescents ages 16-18 with similar economic, cultural, & environmental characteristics, based on scale data. Statistical analysis shows a significant relationship between familial characteristics & the development of attitudes toward physical illness. Specifically: cohesion, level of conflict, & degree of familial autonomy condition the teenager's attitude toward preventive behavior against illness; autonomy, achievement, morality-religiousness, & degree of control in the family group define the quality of mechanisms that an adolescent uses to cope with physical disease. [Source: SA]

Ludescher, Gerd. 1992. "AIDS-Related Knowledge, Attitudes, and Behaviors in Adolescents Attending Seventh-Day Adventist Schools in California." Dr.P.H. Thesis, Loma Linda University.
Abstract: Since it was first recognized in 1981, the Acquired Immunodeficiency Syndrome (AIDS) has become a pandemic disease. Because public education has being recognized as the most effective means to fight the spread of AIDS, there has been an increasing assessment of AIDS-related knowledge, attitudes, and behaviors in adolescents at the local, state, and national level. These studies, however, have been conducted almost exclusively in public schools. Data from private Christian high schools have been rarely gathered or analyzed separately. Such studies are (except for drug use) largely non-existent for Seventh-day Adventist (SDA) schools. In the present study, 488 adolescents grades 9 through 12, attending SDA-academies throughout California participated and returned a mailed self-administered questionnaire anonymously. The students belonged to a random cluster sample of 225 SDA churches. The questionnaire assessed AIDS-related knowledge, attitudes, and behaviors; some of their family-, church- , and school-related determinants; and social desirability response tendency (SDRT) of the study participants. AIDS-related findings were compared with the 1990/1991 data of the statewide Youth Risk Behavior Survey in public schools. A significant number of participants reported involvement in drug use and/or sexual intercourse. Occurrence, however, was consistently and markedly lower than in students from public schools. AIDS knowledge and attitude scores were substantially higher in students from SDA-schools. Family-related determinants showed a statistically significant protective effect against drug use and sexual intercourse in contrast to church and school-related factors. As opposed to sexual activities, drug use was reported more frequently by students with low SDRT. Findings indicate that youth in SDA-schools are not immune to drug use and premarital sex. The study suggests a broad approach of early, continuous, and mandated AIDS education in school as well as significant family life programs. Regular and comprehensive youth risk behavior surveys to monitor changes, take corrective actions if necessary, and allow comparison with public schools are also recommended. Finally, further research about the impact of "safe sex" and "abstinence only" curricula on student behavior is encouraged. [Source: DA]

Blaise, T. L. 1991. "Making the Difference: Environmental Effects on Outcomes of AIDS Prevention Efforts in the Adolescent Community." Ph.D. Thesis, University of California, San Francisco.
Abstract: The purpose of this study was to consider the efficacy of an ecological model in explaining variance and evaluating outcomes of an established adolescent AIDS education program (the Wedge). The educational outcomes of knowledge about HIV, attitudes toward people with HIV, and behavioral intent to prevent HIV infection were measured. The study sought to examine effects of age, gender, and selected environmental background variables on educational outcomes, and assess subjects' qualitative perceptions of the educational experience from an environmental perspective. Teachers and educators also provided feedback on the program. The quantitative sample consisted of 373 adolescents attending Family Life classes in five San Francisco schools. The mean age of this ethnically and religiously diverse group was 16.1 years old. Females comprised 56% of the sample, and 20% of the sample was sexually active. Almost 25% of the sample had lived in the USA 5 years or less. One class from each school (except one) was assigned to a control group. Pre- and posttest measures of knowledge, attitudes toward people with HIV, and intent to prevent HIV were obtained from both groups. Multiple regression analyses were performed to control for the effects of pretest on posttest and the covariates. Findings indicated the Wedge program was effective in increasing knowledge, improving attitudes toward people with HIV, and increasing intent to practice HIV prevention. More religious subjects were less likely to be comfortable toward people with HIV. Variances in knowledge and attitudes were observed between racial groups and religions, but the Wedge program was equally effective in increasing scores for these groups. Teacher and educator evaluations were generally positive. Findings from eleven student interviews suggest that incorporating peer educators and more interactive, visual techniques may be efficacious in the delivery of AIDS education to adolescents. Study findings suggest the need for consideration of environmental factors as important in evaluation of the effectiveness of an AIDS educational program for this age group. Future study is required to determine the effects of the program and environmental factors on actual change in behaviors. [Source: CI]

Boyer, Cherrie B. and Susan M. Kegeles. 1991. "AIDS Risk and Prevention among Adolescents." Social Science and Medicine vol. 33, pp. 11-23.
Abstract: Although adolescents currently account for only 1% of the reported cases of AIDS (acquired immune deficiency syndrome) in the US, the % of those infected with the human immunodeficiency virus (HIV) is undoubtedly much greater. Adolescents are at increased risk of HIV transmission because of their behavioral lifestyle, including unprotected sexual activity, multiple sexual partners, & intravenous drug use; inner-city minority teenagers, youth in detention facilities, & street youth are at particular risk. It is argued that prevention programs emphasizing cognitive & behavioral skills training are essential to limit further spread of the HIV-AIDS epidemic. The AIDS Risk Reduction Model, an example of such a social-physiological program, identifies three stages necessary to reduce risky sexual activities: (1) recognizing that one's activities make one vulnerable to contracting HIV; (2) deciding to alter these behaviors & implementing that decision; & (3) overcoming barriers to enacting the decision, eg, problems in sexual communication & seeking help when necessary. To reach all adolescents, it is recommended that HIV prevention programs be age-appropriate & sensitive to cultural values, religious beliefs, sex roles, & adolescent group customs. [Source: SA]

McCaleb, K. A. 1991. "Self-Concept and Self-Care Practices of Healthy Adolescents." D.S.N. Thesis, University of Alabama at Birmingham.
Abstract: The nursing literature is limited with regard to the identification of factors that influence self-care practices in the adolescent population. Therefore, the purposes of this descriptive study were to: (a) ascertain if there is a relationship between self-concept and self-care practices of healthy adolescents; and (b) ascertain if there is a relationship between self-care practices and the covariates of self-concept and the conditioning factors of age, gender, developmental status, family and sociocultural characteristics, and healthy state of adolescents. Orem's Self-Care Model and developmental theory provided the framework for this study. An investigator-developed Conditioning Factor Profile, the Pier-Harris Self-Concept Scale, and Denyes Self-Care Practice Instrument were administered to students in 10th grade English class in two school systems in a rural county in Alabama. The convenience sample consisted of 160 males and females, 15 to 16 years of age. The typical subject was Caucasian (89%), lived with both parents (67%), and had two or less siblings (70%). The findings from this investigation revealed that adolescents are engaging in self-care practices to meet general and universal self-care. Self-care practice scores were lowest in the area of nutrition and highest with regard to safety. The adolescents in this sample had average or slightly above average self-concepts. The statistical hypothesis that there is no relationship between self-concept and self-care practices was rejected (r =.41, p < .001). A stepwise, multiple regression analysis revealed four significant predictors of self-care practices (R squared =.26, F = 11.9, p < .001). Significant predictors included: self-concept, church attendance, race, and participation in the paid lunch program. The single best predictor of self-care practices was self-concept (R squared =.17, F = 28.8, p <.0001). The investigator concluded that some of the variance in self-care practice of healthy adolescents could be explained. Findings from this study supported Orem's proposition that self-concept influences self-care practices. Recommendations for research include replication of the study with a more heterogeneous, randomized sample. In addition, a longitudinal study to explore the relationship of the study variables across various age groups and developmental levels was suggested. (Scientific symbols modified where possible in accordance with CINAHL policy.) [Source: CI]

Persinger, M. A. 1991. "Preadolescent Religious Experience Enhances Temporal Lobe Signs in Normal Young Adults." Perceptual and Motor Skills vol. 72, pp. 453-454.
Abstract: Compared responses to a personal philosophy inventory by 174 university students who indicated that their first religious experience had occurred before they were teenagers and 694 students who denied such an experience. Results support the hypothesis that earlier onset of limbic lability is associated with subjective experiences infused with more affect and meaningfulness. [Source: PI]

Spilka, Bernard, William J. Zwartjes, and Georgia M. Zwartjes. 1991. "The Role of Religion in Coping with Childhood Cancer." Pastoral Psychology vol. 39, pp. 295-304.
Abstract: Examined the role of religion in the crisis of childhood cancer through interviews with 259 members of 118 families that had a child with cancer. 66 patients (mean age 15.1 yrs), 112 mothers, and 81 fathers completed interviews. Measures of family and patient religiosity were related to a broad spectrum of parental and patient perceptions and activities. Religion related positively to familial support of the patient and to efforts to keep school performance at pre-illness levels. As religious commitment increased following diagnosis, there were signs of a narrowing of the family's social field. At the same time, relationships with close friends may be strengthening. Religion appeared to act as a protective-defensive system that motivated efforts by family members to cope constructively with the crisis of illness. [Source: PI]

Weisner, T.S., L. Beizer, and L. Stolze. 1991. "Religion and Families of Children with Developmental Delays."American Journal of Mental Retardation vol. 95, pp. 647-662.

Antosz, Lawrence J. 1990. "Religiosity, Identity Development, and Health Outcomes in a Late Adolescent Sample." Ph.D. Thesis, Michigan State University, East Lansing.
Abstract: The current study (N = 440) attempted to replicate and extend the findings of a previous study by this author on the role of religion in coping with stress in a late adolescent sample. That study suggested that religion, particularly personal religious beliefs and prayer, may help late adolescents cope with the stresses associated with their developmental period by selectively influencing their perceptions of minor daily events. The current research investigated whether this relationship between religion and the perception of minor daily events was in turn related to physical and mental health outcomes. Several hypotheses were made about the indirect and direct relationship of specific religious variables with health measures. Correlational and path analyses failed to support many of the hypotheses. Only some small positive, as well as negative, direct links between religion and health outcomes were found. In general, the results for this sample of late adolescents were consistent with the findings in the literature for adult samples that religion has a positive but small relationship to measures of well-being. Additional analyses uncovered some information about the relationship of religion to general identity development as well as pointing to some of the components of religion that seem to be particularly salient for this age group. Based on this sample, it appears that there are important gender differences in the structure and function of religion. For this sample, religion seemed to be closely associated with the Foreclosure identity status for males, while it related to the Achievement status for females. For both males and females of this age group, the personal meaning that is associated with religious belief and commitment appears to be the crucial element in religion. In particular for females, the social aspects of religious involvement seem to be important. Finally, this study provided further psychometric support for the religiosity measure developed by this author in a previous study. [Source: DA]

Coisman, Frederick G. 1990. "Adolescent Depression and Eating Disorders." Journal of Psychology and Christianity vol. 9, pp. 72-80.
Abstract: Examines definitions of anorexia nervosa and bulimia with their relationship to clinical depression. A partial review includes the literature regarding the diagnostic controversy surrounding anorexia nervosa, bulimia, and depression; belief systems of those with these disorders; and treatment approaches. It is concluded that eating disorders may be highly correlated with depression but that causality may be apparent in few cases. Treatment has been effective when it has targeted the whole person including eating behavior, cognitive distortions, affect, and depression when present. Implications for Christian researchers and therapists are discussed. [Source: PI]

Mahaffey, Barbara. 1990. "The Influence of Family Environment on Diabetic Adjustment and Metabolic Control in Diabetic Adolescents." M.SC. Thesis, University of Alberta (Canada).
Abstract: Juvenile diabetes mellitus is a chronic illness which has considerable impact on adolescents with diabetes and their families. This study examined the relationship between diabetic adjustment, family environment and metabolic control. There was a positive and statistically significant relationship between one aspect of diabetic adjustment and metabolic control. Thus, adolescents who had better attitudes to diabetes had better levels of metabolic control. The relationship between diabetic adjustment and social support was such that the more support the parents received from their spouse and children, the better the adolescent's diabetic adjustment. The most important informal sources of support identified were the family. The relationship between metabolic control and social support was such that increased levels of support to the parents was associated with poorer levels of adolescent metabolic control. Social support was represented by four sources: relatives and friends, groups, religion, media and one kind of support, altruistic support. These results suggest that social support may have been used by the parents as a coping strategy. [Source: DA]

McKaig, Charlene S. 1989. "The Relationships among Adolescent Future Time Perspective, Self-Esteem and Present Health Behavior." Ed.D. Thesis, State University of New York At Buffalo.
Abstract: The purpose of this research was to examine the relationship of adolescent health behavior to future time perspective, self-esteem, and the demographic characteristics of gender, race, age, grade in school, socioeconomic status, and religion. The health promotion model was used as the organizing framework. Four instruments were used to measure the variables: the Teen Wellness Check measured health behavior, the dependent variable; the Coopersmith Self-esteem Inventory; the Future Time Perspective Inventory; and a short questionnaire eliciting information about religion, church attendance, and parents' education and occupation. In addition, parent questionnaires were completed by 18 parents to compare their responses on selected health behavior items with their adolescents' responses. A sample of 303 adolescents were surveyed from three different high schools in one public city school system in the Southeastern United States. The majority (64.4%) of the sample was in middle adolescence, 15 and 16 years old and in the 9th grade (69.6%). More than half were female (59.7%). The adolescents were predominantly Black (95.7%) and came from families where the mothers (92.6%) and fathers (89.9%) had a high school education or less. Two hundred sixty-one subjects (86.7%) identified themselves as Protestants and 194 (64.7%) said they attended a church once a week or more. Multiple regression analyses resulted in three variables being mildly predictive (17.9% of the variance at p $leq$.05) of positive health behavior: high self-esteem, church attendance weekly or more often, and a father with less than a high school education. Self-esteem accounted for over one third (38.1%) of the variance. A longer future time perspective, although weakly correlated (r = $-$0.19), was not predictive of positive health behavior. Future recommendations include expanding the research to include a more heterogeneous sample, adolescents in each developmental category, and adolescents from a variety of identified family constellations. Another recommendation is to continue to evaluate instrumentation to gather data about the multiple factors that influence adolescent health behavior. [Source: DA]

Gordon, Samuel A. 1988. "The Impact of Adolescent and Maternal Religiousness on the Psychological Functioning of Chronically Ill Adolescents." Thesis, University of Maryland, College Park.

James, L. A. 1988. "Validation of an Instrument to Assess Health Promoting Activities Performed by Senior High School Adolescents." Ph.D. Thesis, University of Kansas.
Abstract: The purpose of this study was to validate an instrument to assess the health promoting activities performed by 509 senior high school adolescents. This investigator sought to establish the validity of the main research instrument, the Health-Promoting Lifestyle Profile, with an adolescent population (ages from 15-19 years). This investigator also sought to establish reliability of selected scaled content items in the Health Diary with a sample of thirty 18-year-old adolescents over a seven day period of time. Using the principal factor analysis with oblique (PROMAX) rotation confirmation of the 6 factors (self-actualization, health responsibility, interpersonal support, exercise, nutrition, and stress management) in the Health-Promoting Lifestyle Profile were obtained with an adolescent population. Internal consistency for the instrument was high; the Cronbach's alpha coefficients calculated for the first 4 factors ranged from.815-.899 and for the total instrument was.926. Statistically significant positive correlations were found between the 6 confirmed factors in the Health-Promoting Lifestyle Profile and selected health screening items (e.g., arthritis, broken bone(s), and you (adolescent) hospitalized), selected demographic items (e.g., age, grade, gender, religion, father's occupation, mother's occupation, father's education level, and mother's education level), and data from the General Activities Questionnaire (e.g., 55 correlations). Clinical significance, however, can not be accepted because the correlations accounted for very small amounts of variance (and therefore very small amounts of clinical reality) and because the experiment wide error rate was not controlled in the study. The correlation coefficients for each of the 12 items on day one in the Health Diary with its respective item on each of the other six days resulted in statistically significant positive correlations (ranging from.385-.776) for the following five items: item 2 (performance of normal activities), item 4 (rating of health), item 5 (answered the open-ended question), item 10-2 (performance of basic exercises), and item 10-4 (performance of strenuous exercises). Only items 2 and 4 were scaled content items; the rest were dichotomous items. Preliminary reliability, then, was established for 2 types of items in the Health Diary. [Source: CI]

Watson, Charles G., Teresa Kucala, Victor Manifold, and Mark Juba, et al. 1988. "The Relationship of Post-Traumatic Stress Disorder to Adolescent Illegal Activities, Drinking, and Employment." Journal of Clinical Psychology vol. 44, pp. 592-598.
Abstract: Compared the self-reported incidences of adolescent legal problems, drinking, employment, and church attendance in 116 male psychiatric patients with and without posttraumatic stress disorder (PTSD) and in 28 normal controls. Data raise doubts about the validity of the theory that PTSD is at least partially a result of pretraumatic personality maladjustment. [Source: PI]

McGrath, Eileen Agnes. 1987. "Supportive or Non-Supportive Religious Beliefs of Children with Life-Threatening Diseases." Ph.D. Thesis, New York University.
Abstract: Problem. The purpose of this researcher was to investigate the relationship between religious beliefs, religious backgrounds, and the supportive effect of those on the attitudes toward sickness and death of children with diagnosed life-threatening disease. Procedure. Through the use of a semi-structured interview, this descriptive study involved an individual analysis of the content of religious beliefs held by children with life-threatening diseases. There were thirteen boys and twelve girls in the sample, aged nine to twelve, eleven diagnosed with acute lymphocytic or lymphoblastic leukemia, nine with other neoplasms, four with cystic fibrosis, and one child with Coolies anemia. The children were affiliated with various Protestant and Catholic faiths. The Graebner Child Concept of God Inventory, consisting of twenty-two pictures and accompanying questions, was the instrument used by the investigator to assess the children's religious beliefs. The children's responses were tape-recorded verbatim and written by the researcher. The children answered the standardized questions and stated whether the designated concepts of God were supportive or non-supportive to them. The children's answer sheet and tapes were analyzed by the researcher and were also reviewed by a consultant of that child's religion. The parents completed a fourteen-item questionnaire which included the religious background, church attendance, and the child's and sibling's medical history. Findings. It was determined that all the children in this sample had religious beliefs, and for the majority of the children, these beliefs had a supportive effect upon their attitudes toward sickness and death. Seven children stated that one or two concepts of God were not supportive to them, although their overall responses indicated that they held supportive religious beliefs. It could not be concluded if a relationship existed among the religious affiliation, formal years or type of religious education, the children's age, sex, or indication of intelligence, and their supportive or non-supportive beliefs. Parental attitudes and beliefs toward religion and church attendance appeared to have an influence on the child and siblings. Most participants expressed a deep faith and trust in God who was supporting them throughout their illness. Parental attitudes toward the treatment and disease outcome also influenced the child. [Source: DA]

Tucker, Larry A. 1987. "Television, Teenagers, and Health." Journal of Youth and Adolescence vol. 16, pp. 415-425.
Abstract: The effect of TV viewing on adolescents' health-related attitudes & practices & physical fitness level is investigated using data from questionnaires containing multiple assessment instruments completed by 406 white, Mc, high school Ms. Multiple discriminant analysis reveals that high levels of TV watching are significantly associated with poorer physical & emotional health, increased drug & alcohol use, & decreased church attendance, exercise, self-control, self-confidence, & Coll aspirations. Though the directionality of causality cannot be assumed, it is argued that since TV viewing is a passive pastime, the media has great power to shape attitudes & behaviors. At present, its messages largely promote antisocial norms & unhealthy lifestyles. Suggestions are proposed to help health professionals & other specialists develop & promote more healthy, constructive uses of TV. [Source: SA]

Hanson, Shirley M. 1986. "Healthy Single Parent Families." Family Relations: Journal of Applied Family and Child Studies vol. 35, pp. 125-132.
Abstract: Assessed the characteristics of 42 healthy single-parent families. A total of 84 Ss--the parent (mean age 41.6 yrs) and a target child (mean age 14.1 yrs)--participated. The variables included socioeconomic status (SES), social support, communication, religiousness, problem solving, and the physical and mental health status of single parents and their children. The effects of the sex of custodial parents and the custody arrangements on health outcomes were also analyzed. A multimethod, multivariable approach was used. Data collection procedures included 6 questionnaires (e.g., Family Environment Scale, Family Interaction Schedule) and an interview in the home setting. Single parents and their children reported fairly high levels of both physical and mental health. Communication, social support, SES, religiousness, and problem solving were also correlated with the mental and physical health of parents and children. [Source: PI]

Newell Withrow, Cora. 1986. "Identifying Health-Seeking Behaviors: A Study of Adolescents." Adolescencevol. 21, pp. 641-658.
Abstract: Investigated how 354 female and 393 male adolescents' health-seeking behaviors, which include self-management and information-seeking behaviors, differed according to age, race, socioeconomic status (SES), gender, and religion. The study was based on 2 assumptions: (1) self-management and information-seeking behaviors are fundamental to adolescents' health-seeking behaviors, and (b) Ss answer self-management and information-seeking questions in terms of past behaviors and their behavioral intent. A 142-item questionnaire was administered. Findings included confirmation of (a) gender as a differentiating variable for the performance of information-seeking behavior, and (b) positive health behaviors among Black adolescents. Ss reported an overall positive composite of health-seeking behaviors. [Source: PI]

Silber, Tomas J. and Mary Reilly. 1985. "Spiritual and Religious Concerns of the Hospitalized Adolescent."Adolescence vol. 20, pp. 217-224.
Abstract: 114 hospitalized 11-29 yr olds completed a Likert scale questionnaire on spiritual and religious concerns. ANOVA was performed to correlate responses with sex, race, religion, type of school, and severity of illness. A subgroup of Ss, those with more serious disease, experienced intensified spiritual and religious concerns. Religious concerns were more frequent among Blacks than Whites, Catholics than Protestants, and parochial school students than public school students. In response to the questionnaire, over 15% of the Ss requested further help. Findings suggest that training in adolescent health care and the provision of services to teenagers ought to include teaching in the area of spiritual and religious values of teenagers, with emphasis on the hospitalized adolescent. [Source: PI]

Critchfield, Arthur Barry. 1982. "Religious Achievement of Hearing Impaired Youth in the Church of Jesus Christ of Latter-Day Saints." Ph.D. Thesis, Brigham Young University.
Abstract: The purpose of this study was to assess the religious achievement levels of hearing impaired youth in the Church of Jesus Christ of Latter-day Saints in comparison with that of other youth in the same Church. A test of L.D.S. religious knowledge was developed and comparable groups of 72 deaf and 77 non-deaf subjects were evaluated as to their knowledge of basic Church doctrine. Deaf subjects' responses were evaluated to assess what factors lead to improved scores of religious knowledge. Results of the study indicated that hearing impaired youth scored significantly lower on the test of religious knowledge than similar non-hearing impaired young people. Recommendations for improved programming and service delivery were made. [Source: DA]

Insel, Paul M., Gary E. Fraser, Roland Phillips, and Phyllis Williams. 1981. "Psychosocial Factors and Blood Pressure in Children." Journal of Psychosomatic Researchvol. 25, pp. 505-511.
Abstract: 1,567 10-26 yr old children attending Seventh-Day Adventist or public schools completed the Type A Activity Scale, Family Climate Inventory, Eysenck Personality Questionnaire, Symptom Distress Checklist, and Adjective Check List. Blood pressure data were also obtained. Results suggest important associations between blood pressure and an adolescent life-style that emphasizes control, ambition, competitiveness, order and organization, religious orientation, and strong pressures to achieve. Seventh-Day Adventist compared to public school Ss strongly emphasized religious orientation and family control. [Source: PI]

Remmers, H and B Shimberg. 1949. "Problems of High School Youth. (Purdue Opinion Poll for Young People. Rep. No. 21.)." Purdue University.
Abstract: A 300-item Problem Checklist was administered to 15,000 high school students in all sections of the U. S. Problem areas covered were (1) school, (2) vocational, (3) personal, (4) social, (5) family, (6) sex, (7) health, (8) general. Methodology and overall results are discussed briefly. Tables are included showing what percentage of students in various sub-groups checked each item. These include breakdowns for (1) total group, (2) sex, (3) school grade, (4) region of U. S., (5) size of community, (6) religion, and (7) family income level. The analysis was based on a stratified sample of 2500 signed questionnaires. The authors compared matched samples of signed and unsigned questionnaires and found that while the unsigned questionnaires yielded slightly higher percentages on nearly all items, the results obtained from both samples were essentially the same. [Source: PI]