Longitudinal Follow-up of Poor Inner-city Youth Between Ages 8 and 18: Intentions Versus Reality

Abstract

OBJECTIVES: (1) To document, at ages 8 to 10, children’s perceptions of their future and, at ages 16 to 18, youth outcomes; and (2) to assess early childhood factors associated with trajectory-altering events (TAEs), defined as youth risk behaviors that may modify developmental trajectories. METHODS: A prospective longitudinal study of 97 poor, inner-city, African American youth followed since birth who completed (1) early childhood environment, cognitive, and social-emotional evaluations, as well as an inventory at ages 8 to 10 of perceptions of their futures; and (2) evaluation for presence or absence of 4 TAEs documented at ages 16 to 18: drug use, adjudication, school failure, and teen parenthood. RESULTS: At age 9.4 ± 0.5, 94% of participants felt it unlikely they would try marijuana; 93% felt they were unlikely to get arrested; 92% felt they were likely to attend college or trade school; 81% did not know one could become pregnant with first-time sex. Age 18.1 ± 0.8 outcomes showed that 33% had used drugs, 33% had been adjudicated, 19% had school failure, and 20% had become parents. Fifty-six percent had ≥1 TAE. No relationship was found between childhood perceptions and intentions and documented outcomes. Odds of having a TAE increased with greater exposure to violence and poorer home environment. CONCLUSIONS: Young inner-city children are idealistic regarding their future. By ages 16 to 18 however, more than half of this cohort had a TAE. Factors most strongly associated with a TAE were greater exposure to violence and poorer home environment.

Barriers to Adherence in Juvenile Idiopathic Arthritis: A Multicenter Collaborative Experience and Preliminary Results

“…10 Adherence is defined as the extent to which a person’s behavior corresponds with provider health recommendations. 11 While adherence rates vary among general pediatric populations, average adherence is 50%. 12 Studies of adherence in JIA have been limited, with most focusing on self- and parent-reported adherence, which tend to be inflated relative to more objective measures (e.g., electronic monitoring).…”

Adolescent and young adult medicine is a special and specific area of medical practice

“…While for many AYA, the life‐style balance sheet remains positive; this may not be the case for vulnerable groups including the homeless, the incarcerated, refugees and immigrants, rural and remote youth, AYA mothers and those with limited social competencies. The life trajectories for all these groups may be severely impaired with much of day to day living spent in survival mode . AYAM would have a great deal to offer these under‐served populations, who do not easily access traditional models of care.…”

“…The life trajectories for all these groups may be severely impaired with much of day to day living spent in survival mode. 37 AYAM would have a great deal to offer these under-served populations, who do not easily access traditional models of care.…”

Patient-provider communication in nephrology care for adolescents and young adults

“…There is a remarkable dearth of research on healthcare communication during the transition from pediatric to adult care. For adolescent and young adult patients (AYAs), understanding the relative participation of conversation by all participants has the potential to promote successful transitions for AYAs with chronic health conditions [8].…”