Authors

  1. Rew, Lynn EdD, RN, AHN-BC, FAAN, Issue Editor

Article Content

The articles in this special issue are the product of a research conference followed by a 2-day intensive collaboratory experience. The multidisciplinary conference and collaboratory were sponsored by the Center for Health Promotion and Disease Prevention in Underserved Populations (P30NR005051) at The University of Texas at Austin. The research conference began with a keynote address by Dr Michael Resnick, Professor of Pediatrics and Public Health and Director of the Healthy Youth Development Prevention Research Center at the University of Minnesota. Following several research presentations and a poster session, participants in the collaboratory retired to a resort center where we spent about 48 hours relaxing, getting to know one another, and responding to each other's first drafts of this collection of papers. Our theme for the collaboratory and for this special issue of Family & Community Health was to address the gap that exists between research evidence and public policy regarding the healthcare issues facing adolescents.

 

We begin this issue with an expanded version of Resnick's keynote address in which he describes a challenge to providing healthcare to adolescents: the difficulty in translating evidence into policy and practice. His article is rich with examples of the political climate that often hinders the acceptance of scientific evidence about preventable public health problems of adolescence such as that of unplanned pregnancy. Resnick appeals to healthcare providers as agenda builders who can help adolescents by advocating for responses in policy and practice that reflect the scientific evidence of what our youth need to be healthy and thrive rather than by caving into emotional and political pressures.

 

The next 2 articles are about sexual abuse in adolescence. In the first of these, Bowman identifies a number of challenges that researchers face in studying the experience of sexual abuse in adolescent mothers. She concludes by offering strategies to help researchers address these challenges in creative and responsive ways. She notes that policies and practices related to this sensitive topic require that researchers provide solid evidence; thus, the challenges must be met head-on. In the second article, Johnson asserts that sexual abuse in childhood and adolescence is a public health problem with enormous implications for health policy. She appeals to us to affirm our commitment to act on solid scientific evidence about prevention of sexual abuse and about interventions that buffer its negative effects.

 

Fredland's article focuses on the various ways in which children and adolescents are victimized in the public school system. She addresses the mixed reviews that policies to reduce school violence have received. In this article, Fredland clearly defines school violence, identifies the magnitude of the problem, and discusses how this type of behavior relates to the health of adolescents. In addition to addressing the relative effectiveness of policies such as Zero Tolerance, she provides a number of examples of best practices, using an ecological framework. These best practices serve as suggestions for families as well as schools.

 

Two articles focus on the special population of homeless adolescents. In the first article, I claim that social and health policies for homeless youth are best when guided by a philosophy, ethic, and the theory of caring and connectedness. After discussing caring theories and characteristics of the adolescent homelessness population, I identify policies, and limitations thereof, that address healthcare, education, and justice. In the second article, Taylor reports findings from her pilot study that highlights the lack of attachment among homeless youth. She notes that the vast majority of youth in her sample had experienced traumatic experiences such as emotional and sexual abuse. Such experiences resulted in their being unable to trust adults. On the streets, these youth dealt with additional stressors through violence and substance use.

 

The last 3 articles deal with a variety of other adolescent health issues. Steiker responds to the controversy surrounding intervention fidelity or adaptation in translating evidence into specific policies and programs. On the basis of her background in social work and experience with drug prevention programs, she discusses the policy implications of adapting curricula to respond to unique cultures of adolescents. Jones speaks to the myriad healthcare needs of adolescents who survived childhood cancer. As a social worker, she identifies the relationship between these needs and the guidelines and policies that exist and that are yet to be developed to meet these needs more comprehensively.

 

Crosnoe and McNeely highlight the importance of studying peer relations and their impact on adolescents' health and on public health research and practice. They conclude by suggesting additional pathways for public health research to promote the health and well-being of American adolescents by focusing on the salient influence of peers.

 

From politics to peers, this special issue reflects the collective thinking of multidisciplinary authors, reviewers, and core directors of the Center for Health Promotion and Disease Prevention in Underserved Populations (CHPR). As a multidisciplinary team, we grappled with a multitude of health-risk behaviors responsible for the major morbidities and mortalities facing American youth today. We also noted the many positive behaviors and resilience that promote adolescent health. Finally, we acknowledged that it truly takes a village to raise youth and that our public health policies must reflect the best that our social, behavioral, and health scientists offer in the way of evidence.

 

I want to add a special note of appreciation to John Santelli, MD, MPH, Director of the Columbia University Mailman School of Public Health, who also attended the collaboratory and served as a cofacilitator of our discussions. And, a note of thanks to Willa Doswell, PhD, RN, from the University of Pittsburgh School of Nursing and to Michael Erard, PhD (Editor of the Cain Center), Eun-Ok Im, PhD, RN, FAAN (CHPR Core Director), and Alexa Stuifbergen, PhD, RN, FAAN (CHPR Director), from The University of Texas at Austin School of Nursing who also participated in the collaboratory discussions. I am also grateful to the many reviewers from both the United States and Canada who provided invaluable feedback to the authors of these articles. Their names are listed elsewhere in this issue. And finally, I want to thank Marian Morris for her endless attention to the many details involved in our collaboratory and in making this special issue a reality.

 

Lynn Rew, EdD, RN, AHN-BC, FAAN

 

Issue Editor School of Nursing The University of Texas at Austin Austin, Texas