THE HEALTH OF YOUNG ADULTS WITH DISABILITIES IN THE UNITED STATES: THE COLLECTIVE ROLES OF RISK FACTORS IN SOCIAL ECOLOGIC FRAMEWORK

Background: Over the last few decades, the prevalence of young adults with disabilities (YAD) has steadily risen as a result of advances in medicine, clinical treatment, and biomedical technologythat enhanced their survival into adulthood. Despite investments in services, family supports, and insurance, they experience poor health status and barriers to successful transition into adulthood. Objectives: We investigated the collective roles of multi-faceted factors at intrapersonal, interpersonal and community levels within the social ecological framework on health related outcome including self-rated health (SRH) of YAD. The three specific aims are: 1) to examine sociodemographic differences and health insurance coverage in adolescence; 2) to investigate the role of social skills in relationships with family and peers developed in adolescence; and 3) to collectively explore the association of sociodemographic characteristics, social skills, and community participation in adolescence on SRH. Methods: Using longitudinal data (N=5,020) from the National Longitudinal Transition Study (NLTS2), we conducted multivariate logistic regression analyses to understand the association between insurance status as well as social skills in adolescence and YAD’s health related outcomes. Structural equation modeling (SEM) assessed the confluence of multi-faceted factors from the social ecological model that link to health in early adulthood. Results: Compared with YAD who had private insurance, YAD who had public health insurance in adolescence are at higher odds of experiencing poorer health related outcomes in self-rated health [adjusted odds ratio (aOR=2.89, 95% confidence interval (CI): 1.16, 7.23), problems with health (aOR=2.60, 95%CI: 1.26, 5.35), and missing social activities due to health problems (aOR=2.86, 95%CI: 1.39, 5.85). At the interpersonal level, overall social skills developed through relationship with family and peers in adolescence do not appear to have association with health related outcomes in early adulthood. Finally, at the community level, community participation in adolescence does not have an association with SRH in early adulthood. Conclusions: Having public health insurance coverage does not equate to good health. YAD need additional supports to achieve positive health outcomes. The findings in social skills and community participation suggest other potential factors may be at play for health related outcomes for YAD and the need for further investigation.

RISK FACTORS FOR NONMEDICAL PRESCRIPTION ANALGESIC USE AMONG COLLEGE STUDENTS: RESULTS OF A PROSPECTIVE STUDY

Purpose—Nonmedical Prescription Analgesic (NPA) use is a serious public health concern and studies on risk factors for NPA use are lacking. This investigation used preexisting data from a landmark longitudinal, prospective study of college students, the College Life Study (CLS), to examine the longitudinal relationship between four suspected risk factors—affective dysregulation, conduct problems, depressive symptoms, and general psychological health—and NPA use. Methods—The sample was comprised of 1,253 young adults originally recruited as first-year college students from a large, mid-Atlantic university. Results—10.5% (n=103) of the participants during year 3 of the study reported past year NPA use, of which 55.3% (n=57) were male and 81.6% (n=84) were white. Affective dysregulation and conduct problems were found to be significantly and longitudinally (baseline to year 3) associated with incident NPA use after controlling for gender, parents’ education, and race/ethnicity. Conclusions—Affective dysregulation and conduct disorder are longitudinally associated with NPA use among college students. These findings might aid in prevention efforts to reduce NPA use among college students.

Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.

THE EFFECT OF SCHOOL CLIMATE (STUDENT AND TEACHER ENGAGEMENT) ON STUDENT PERFORMANCE

Title of Dissertation: THE EFFECT OF SCHOOL CLIMATE (STUDENT AND TEACHER ENGAGEMENT) ON STUDENT PERFORMANCE Kenneth L. Marcus, Doctor of Education, 2016 Directed By: Dr. Thomas Davis, Assistant Professor, Education Policy and Leadership, Department of Teaching and Learning, Policy and Leadership This quantitative research study was designed to compute correlations/relationships of student engagement and student achievement of fifth grade students. Secondary information was collected on the relationship of FARMS, type of school, hope, and well-being on student achievement. School leaders are charged with ensuring that students achieve academically and demonstrate their ability by meeting identified targets on state and district mandated assessments. Due to increased pressure to meet targets, principals implement academic interventions to improve student learning and overlook the benefits of a positive school climate. This study has provided information on the impact of school climate on student achievement. To conduct this study, the researcher collected two sets of public fifth grade data (Gallup Survey student engagement scores and DSA reading, mathematics, and science scores) to determine the relationship of student performance and school climate. Secondary data were also collected on teacher engagement and the percentage of students receiving FARMS to determine the effect on students. The findings from this study reinforced the belief that school climate can have a positive effect on student achievement. This study contributed quantitative data about the relationship between school climate and school achievement.