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Browsing by Subject "Adolescent behavior"
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Item Dietary Intervention for Glucose Tolerance In Teens (DIG IT): Protocol of a randomized controlled trial using health coaching to prevent youth-onset type 2 diabetes(Elsevier, 2017-02) Wagner, Kelly A.; Braun, Ethan; Armah, Seth M.; Horan, Diarmuid; Smith, Lisa G.; Pike, Julie; Tu, Wanzhu; Hamilton, Marc T.; Delp, Edward J.; Campbell, Wayne W.; Boushey, Carol J.; Hannon, Tamara S.; Gletsu-Miller, Nana; Pediatrics, School of MedicineBACKGROUND: Youth-onset type 2 diabetes (T2D) is a disease that is newly emerging and behavioral strategies for its prevention are limited. Interventions that target the lifestyle behaviors of adolescents, to improve poor dietary quality and reduce excessive sedentariness, promise to reduce the risk of developing T2D. Health coaching is effective for promoting healthy behaviors in patients who have chronic disease, but few experimental studies are in adolescents. This randomized controlled trial, in adolescents with prediabetes, will determine the effectiveness of a health coaching intervention to facilitate adoption of healthy diet and activity behaviors that delay or prevent development of T2D. METHODS/DESIGN: The Dietary Intervention for Glucose Tolerance In Teens (DIG IT) trial will involve an evaluation of a health coaching intervention in adolescents with prediabetes. Eligible participants will be randomized to receive 6months of health coaching or a single dietary consultation that is standard-of-care. The primary outcome will be 2-hour oral glucose tolerance test concentration. Secondary outcomes will include measures of glycemia and insulin action as well as dietary, physical activity and sedentary behaviors measured using an electronic food record, and by inclinometer. Data will be collected before and after the intervention (at 6months) and at 12months (to assess sustainability). DISCUSSION: This trial will determine whether a health coaching intervention, a personalized and low-cost approach to modify dietary and activity behaviors, is effective and sustainable for prevention of youth-onset T2D, relative to standard-of-care. Health coaching has the potential to be widely implemented in clinical or community settings.Item National Instant Criminal Background Check and Youth Gun Carrying(American Academy of Pediatrics, 2020-01) Timsina, Lava R.; Qiao, Nan; Mongalo, Alejandro C.; Vetor, Ashley N.; Carroll, Aaron E.; Bell, Teresa M.; Economics, School of Liberal ArtsBackground: Despite being unable to purchase firearms directly, many adolescents have access to guns, leading to increased risk of injury and death. We sought to determine if the National Instant Criminal Background Check System (NICS) changed adolescents' gun-carrying behavior. Methods: We performed a repeated cross-sectional study using National Youth Risk Behavior Survey data from years 1993 to 2017. We used a survey-weighted multivariable logistic regression model to determine if the NICS had an effect on adolescent gun carrying, controlling for state respondent characteristics, state laws, state characteristics, the interaction between the NICS and state gun laws, and time. Results: On average, 5.8% of the cohort reported carrying a gun. Approximately 17% of respondents who carried guns were from states with a universal background check (U/BC) provision at the point of sale, whereas 83% were from states that did not have such laws (P < .001). The model indicated that the NICS together with U/BCs significantly reduced gun carrying by 25% (adjusted relative risk = 0.75 [95% confidence interval: 0.566-0.995]; P = .046), whereas the NICS independently did not (P = .516). Conclusions: Adolescents in states that require U/BCs on all prospective gun buyers are less likely to carry guns compared with those in states that only require background checks on sales through federally licensed firearms dealers. The NICS was only effective in reducing adolescent gun carrying in the presence of state laws requiring U/BCs on all prospective gun buyers. However, state U/BC laws had no effect on adolescent gun carrying until after the NICS was implemented.Item Psychosocial Outcomes in Long-Term Cochlear Implant Users(Wolters Kluwer, 2018-05) Castellanos, Irina; Kronenberger, William G.; Pisoni, David B.; Psychiatry, School of MedicineOBJECTIVES: The objectives of this study were to investigate psychosocial outcomes in a sample of prelingually deaf, early-implanted children, adolescents, and young adults who are long-term cochlear implant (CI) users and to examine the extent to which language and executive functioning predict psychosocial outcomes. DESIGN: Psychosocial outcomes were measured using two well-validated, parent-completed checklists: the Behavior Assessment System for Children and the Conduct Hyperactive Attention Problem Oppositional Symptom. Neurocognitive skills were measured using gold standard, performance-based assessments of language and executive functioning. RESULTS: CI users were at greater risk for clinically significant deficits in areas related to attention, oppositional behavior, hyperactivity-impulsivity, and social-adaptive skills compared with their normal-hearing peers, although the majority of CI users scored within average ranges relative to Behavior Assessment System for Children norms. Regression analyses revealed that language, visual-spatial working memory, and inhibition-concentration skills predicted psychosocial outcomes. CONCLUSIONS: Findings suggest that underlying delays and deficits in language and executive functioning may place some CI users at a risk for difficulties in psychosocial adjustment.Item Substance Use Trajectories From Early Adolescence Through the Transition to College(Rutgers, 2016) Derefinko, Karen J.; Charnigo, Richard J.; Peters, Jessica R.; Adams, Zachary W.; Milich, Richard; Lynam, Donald R.; Psychiatry, School of MedicineObjective: The transition to college is an important developmental period for the development of alcohol, marijuana, and hard drug (cocaine, opiates, inhalants, stimulants, hallucinogens, Ecstasy, club drugs) use. The current study explored specific changes in substance use patterns during and after the transition to college through the use of trajectory analyses. Method: Participants were 526 students who reported retrospectively and prospectively on their substance use from age 13 through the junior year of college. Group-based trajectory modeling was used to estimate developmental trajectory groups for alcohol, marijuana, and hard drug use during this period. Results: Results supported a five-group model of alcohol use, a four-group model of marijuana use, and a four-group model of hard drug use. Although three of the five alcohol trajectories indicated high escalation throughout adolescence, one of these groups decreased in alcohol use dramatically during the freshman and sophomore years, a trend also found for hard drug use. Trajectories demonstrated significant differences in terms of gender, race, and impulsive personality characteristics. Conclusions: These results indicate that the start of college is an important developmental transition in terms of polysubstance use, and that despite the homogeneity of this undergraduate sample, there is considerable divergence in trajectories during college.