Positive Adult Connections Play Protective Role for At-Risk Youth

Jan 26 2016

Positive Adult Connections Play Protective Role for At-Risk Youth

OKPositive Adult ConnectionAn adolescent’s life is full of ups and downs, and research has shown that it can be helpful for them to have adults who they can turn to in times of trouble. Unfortunately, youth living in low resource urban neighborhoods may face adversity on a daily basis, which means that these positive adult connections can be especially valuable to them.

In fact, a new study conducted by researchers at The Children’s Hospital of Philadelphia shows that when adolescents in low resource urban environments have adults in their lives who they look up to and can help them handle tough situations, these mentors can have profound protective effects on their development. For many youth, family members can serve in this role, and for others, teachers, community leaders, or clergy can provide this support.

“Our goal was to better understand the role of positive connections with adults in the lives of youth navigating these incredibly challenging circumstances,” said Alison Culyba, MD, MPH, an adolescent medicine physician in the Craig-Dalsimer Division of Adolescent Medicine. “This research suggests that developing positive relationships with adults may be critical.”

Using a structured in-person questionnaire, the study team interviewed 283 adolescent males ages 10 to 24 in Philadelphia, 98 percent of whom were African-American. The researchers inquired about their relationships with adults and asked a series of questions about school experiences, substance use, and violence exposure. The results were encouraging: Positive adult connection was common and was associated with favorable outcomes related to school, substance use, and violence exposure.

Specifically, 86 percent of youth identified a positive adult connection, and they were significantly more likely to report getting good grades and feeling safe at school. They were less likely to report ever using alcohol. They also were less likely to report being jumped, being in a gang, having access to a gun, and being a witness to high levels of violence. This high percentage reflects what Dr. Culyba sees in her clinical practice.

“Some people may think that support networks are not necessarily strong in neighborhoods where people are grappling with a lot of other concerns, but in reality, many youth do have strong sources of support in their lives,” Dr. Culyba said.

On the flip side, she pointed out, it is important for clinicians to identify those youth who do not have a current support and recognize that they may be at particularly high risk for struggling during times of crisis. Dr. Culyba plans to pursue future research to develop and validate a screening tool based on brief, pertinent questions that youth-serving professionals could incorporate into routine or emergency healthcare visits to figure out key people who can support an adolescent and then help youth foster those relationships. In order to help youth think through who are the best support people in their lives, Dr. Culyba also is researching ways to pinpoint which components of positive adolescent-adult connections are the most pivotal.

“Helping youth to identify a supportive adult in their existing network, and identifying opportunities to broaden these networks when youth don’t have a current support, may help youth thrive despite adversity,” Dr. Culyba said.

In previous research using the same cohort of study participants, Dr. Culyba showed that 33 percent reported high levels of violence involvement. These findings are in line with statistics on the national level that show that violence exposure is pervasive among all U.S. adolescents. A 2015 study found that 36.9 percent of 14 to 17 year olds reported witnessing violence and 32.3 percent reported being assaulted in the past year.

Dr. Culyba pointed out that during President Obama’s town hall meeting in January on gun violence, an 18-year-old African-American male from Chicago whose brother had been killed by gun violence asked: “What is your advice to those youth growing up surrounded by poverty and gun violence?”

“Keep listening to your mom,” the President said, as part of his response.

This current study, which appeared in the Journal of Adolescent Health, builds the evidence for that good advice. “There are so many strengths within families, communities, and larger networks of support that exist already,” Dr. Culyba said. “Figuring out how to harness those is an important piece for improving the lives and opportunities for youth in low-resource neighborhoods.”

Dr. Culyba is also an adolescent medicine consultant to CHOP’s Violence Intervention Program, and is a PhD candidate at the Perelman School of Medicine at the University of Pennsylvania. Kenneth Ginsburg, MD, of the Craig-Dalsimer Division of Adolescent Medicine; Joel Fein, MD, MPH, of CHOP’s department of Emergency Medicine and Co-director of the CHOP Violence Prevention Initiative; Charles Branas, PhD, and Douglas Wiebe, PhD, of the department of Biostatistics and Epidemiology at UPenn; and Therese Richmond, PhD, of the School of Nursing at UPenn, also contributed to the article.