Adolescents' perceptions of health from disadvantaged urban communities: Findings from the WAVE study

Mmari, Kristin; Blum, Robert W.; Sonenstein, Freya L.; Marshall, Beth; Brahmbhatt, Heena; Venables, Emily; Delany‐Moretlwe, Sinead; Lou, Chaohua; Gao, Ershang; Acharya, Rajib; Jejeebhoy, Shireen J.; Sangowawa, Adesola O

doi:10.1016/j.socscimed.2013.12.012

Cited by 60 publications

(51 citation statements)

References 33 publications

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“…This cross-sectional study utilized a two-phase mixed methods approach. Phase I utilized a qualitative approach [16]. Information obtained from the qualitative phase was used to develop the study instruments utilized in the quantitative phase (Phase II).…”

Section: Methodsmentioning

confidence: 99%

Predictors of Substance Use Among Vulnerable Adolescents in Five Cities: Findings From the Well-Being of Adolescents in Vulnerable Environments Study

Olumide

Robinson

Levy

et al. 2014

Journal of Adolescent Health

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Introduction Adolescent substance use has numerous consequences. Our goals in this paper are to compare the prevalence and correlates of substance use among ethnically diverse adolescents. Methods Data are from 2332 adolescents aged 15 – 19 years recruited via respondent driven sampling from disadvantaged settings in five cities. Multivariate logistic regression was used to identify correlates of current substance use. Results About half of the respondents were male. Most adolescents (73.4%) were currently enrolled in school; and identified a father (87.6%) and mother (89.6%) -figure and strong peer support (71.9%). About two-thirds reported lifetime use of at least one substance. Overall, the most common substances ever used were alcohol (44.6%), cigarette (26.2%) and marijuana (17.9%). Mean age at first use of alcohol was 14.2±3.1 years. Current alcohol use was highest in Johannesburg (47.4%) and lowest in Delhi (2.1%). The mean age at first use of cigarette was 14.4±2.8 years. Current cigarette smoking was highest in Johannesburg (32.5%) and lowest in Delhi (3.7%). Male gender predicted current alcohol use in all sites, while older age was a predictor in Baltimore. Male gender (Johannesburg and Shanghai), older age (Baltimore and Shanghai) and being out-of-school (Baltimore, Johannesburg and Shanghai) predicted current cigarette smoking. Absence of a caring father figure was predictive of current alcohol use in Baltimore and Shanghai. Strong peer support predicted alcohol (Johannesburg and Shanghai) and cigarette use (Johannesburg). Conclusion Substance use is still a major issue among adolescents around the world underscoring the need for continued research and interventions.

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Section: Methodsmentioning

confidence: 99%

Predictors of Substance Use Among Vulnerable Adolescents in Five Cities: Findings From the Well-Being of Adolescents in Vulnerable Environments Study

Olumide

Robinson

Levy

et al. 2014

Journal of Adolescent Health

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“…The first phase of the study, the formative phase, was launched in June of 2011 to: 1) explore adolescents’ perceived health and their top health challenges and; 2) describe the factors within their urban communities which were perceived to be related to their health and health seeking behaviors. Data were collected using identical research protocols across the five study sites: key informant interviews among representatives from schools, places of worship, and youth-serving organizations; in-depth interviews among adolescents; community mapping and focus groups among adolescents; and a Photovoice exercise among adolescents 26 . Findings from this formative phase, interestingly, showed that adolescents perceived that factors within the physical and social environments to be the most influential to their health.…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, given the dominant findings from the qualitative phase of this study in regards to the perceptions of safety and violence affecting adolescent health 26 , we included several measures that tapped into these constructs. Social cohesion was measured as a continuous variable by summing nine items in a scale, many of which were borrowed from the social cohesion scale first developed by Sampson, Raudenbush, and Earls (1997) 27 .…”

Section: Methodsmentioning

confidence: 99%

A Global Study on the Influence of Neighborhood Contextual Factors on Adolescent Health

Mmari

Lantos

Blum

et al. 2014

Journal of Adolescent Health

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Purpose This study uses data collected as part of the Well-Being of Adolescents in Vulnerable Environments (WAVE) study to: 1) compare the perceptions of neighborhood-level factors among adolescents across five different urban sites; 2) examine the associations between factors within the physical and social environments; and 3) examine the influence of neighborhood-level factors on two different health outcomes -- violence victimization in the past 12 months and ever smoked. Methods Across five urban sites (Baltimore, New Delhi, Johannesburg, Ibadan, and Shanghai), 2320 adolescents aged 15-19 years completed a survey using ACASI technology. To recruit adolescents, each site used a respondent-driven sampling method, which consisted of selecting adolescents as ‘seeds’ to serve as the initial contacts for recruiting the entire adolescent sample. All analyses were conducted with Stata 13.1 statistical software, using complex survey design procedures. To examine associations between neighborhood-level factors, as well as among our two outcomes, violence victimization and ever smoked, bivariate and multivariate analyses were conducted. Results Across sites, there was great variability in how adolescents perceived their neighborhoods. Overall, adolescents from Ibadan and Shanghai held the most positive perceptions about their neighborhoods, while adolescents from Baltimore and Johannesburg held the poorest. In New Delhi, despite females having positive perceptions about their safety and sense of social cohesion, they had the highest sense of fear, as well as the poorest perceptions about their physical environment. The study also found that one of the most consistent neighborhood-level factors across sites and outcomes was witnessing community violence, which was significantly associated with smoking among adolescents in New Delhi and Johannesburg, and with violence victimization across nearly every site except Baltimore. No other neighborhood-level factor exerted greater influence. Conclusions This study confirms the important associations between perceptions of a neighborhood and adolescent health. At the same time, it demonstrates that not all neighborhood-level factors are associated with adolescent health outcomes in the same way across different urban contexts. Further longitudinal research is needed to examine the direction of causation between adolescent health neighborhood contexts and health outcomes, and the reasons for why different urban contexts may exert varying levels of influence on the health of adolescents.

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“…Even in neighborhoods characterized as ‘poor’ and ‘dirty’, however, there is some evidence that if residents feel safe and have a shared sense of values, they make use of local facilities which contribute to maintaining their health. On the other hand, having a sense of fear (or lack of safety) creates an environment that undermines mental and physical health, and consequently, research has shown that adult residents don’t seek help or services [20–22]. Whether this is true among adolescents, however, remains to be seen.…”

Section: Introductionmentioning

confidence: 99%

A mixed methods study to examine the influence of the neighborhood social context on adolescent health service utilization

Mmari

Marshall

Hsu

et al. 2016

BMC Health Serv Res

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BackgroundWhile adolescents’ access and utilization of health services is critical for ensuring their health, very few seek care, and if they do, it is primarily from family members, friends, or other non-formal sources of care. Examining the influence of the social context on adolescent health care seeking behaviors may provide us with a better understanding for how interventions can increase adolescents’ utilization of formal health care services.MethodsThe study is based on qualitative and quantitative data collected as part of the Well Being of Adolescents in Vulnerable Environments (WAVE) study, one of the first global studies to focus on very disadvantaged urban adolescents (aged 15–19 years) across five diverse sites, which include: Baltimore (USA), Ibadan (Nigeria), Johannesburg (South Africa), New Delhi (India), and Shanghai (China). Qualitative data was based on numerous methodologies, including key informant interviews, a Photovoice exercise, community mapping, focus groups and in-depth interviews. Quantitative data was gathered from a cross-sectional Audio Computer Assisted Self Interview (ACASI) survey that was administered to approximately 450–500 adolescents per site, yielding a total of 2,393 adolescents. Respondent-driven sampling was used to ensure the sample include out-of-school youth and unstably housed youth who are often underrepresented in school-based or household-based samples.ResultsWhile adolescents in Baltimore, New Delhi, and Johannesburg were more likely to seek health services if they felt illness symptoms, a fairly large proportion of adolescents indicated that even when they needed health care, they didn’t seek it. In Johannesburg, more than 30 % of adolescents did not seek care even when they knew it was needed. Similarly, nearly a quarter of adolescents in Baltimore and in Shanghai indicated not seeking care when needed. Qualitative data indicated that adolescents exhibited a general lack of trust in providers and often felt embarrassed or stigmatized for seeking services. Multivariate analysis revealed that perceived fear and exposure to community violence was associated with a decreased likelihood of seeking care, while adult support from the home increased adolescents’ likelihood to seek care in Baltimore and Johannesburg.ConclusionsAdolescent health care seeking patterns vary substantially by setting and gender. Neighborhood and family environments are important contexts in which health seeking behaviors are shaped. Efforts to connect adolescents to health care will need to target neighborhood safety as well as trust and support among adults outside of provider settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1597-x) contains supplementary material, which is available to authorized users.

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Adolescents' perceptions of health from disadvantaged urban communities: Findings from the WAVE study

Cited by 60 publications

References 33 publications

Predictors of Substance Use Among Vulnerable Adolescents in Five Cities: Findings From the Well-Being of Adolescents in Vulnerable Environments Study

Predictors of Substance Use Among Vulnerable Adolescents in Five Cities: Findings From the Well-Being of Adolescents in Vulnerable Environments Study

A Global Study on the Influence of Neighborhood Contextual Factors on Adolescent Health

A mixed methods study to examine the influence of the neighborhood social context on adolescent health service utilization

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