School-based youth health nurses and adolescent decision-making concerning reproductive and sexual health advice : how can the law guide healthcare practitioners in this context?

This paper outlines some of the issues faced by School-Based Youth Health Nurses working in Queensland, in relation to the legal principles surrounding the provision of reproductive and sexual health advice. The paper outlines a number of specific issues faced by nurses working within this setting and considers the legal principles underpinning the issues concerning consent and confidentiality. The discussion in this paper demonstrates how the legal principles – which are often viewed as complex and uncertain by nurses working within this field – may be used as a guide to underpin good practice and compliance with the law. Although this paper is considered in the context of nurses working within Queensland, the principles and factors outlined are relevant to healthcare practitioners working within all Australian jurisdictions.

Present simple and continuous: emergence of self-regulation and contextual sophistication in adolescent decision-making

Sophisticated, intentional decision-making is a hallmark of mature, self-aware behaviour. Although neural, psychological, interpersonal, and socioeconomic elements that contribute to such adaptive, foresighted behaviour mature and/or change throughout the life-span, here we concentrate on relevant maturational processes that take place during adolescence, a period of disproportionate developmental opportunity and risk. A brief, eclectic overview is presented of recent evidence, new challenges, and current thinking on the fundamental mechanisms that mature throughout adolescence to support adaptive, self-controlled decision-making. This is followed by a proposal for the putative contribution of frontostriatal mechanisms to the moment-to-moment assembly of evaluative heuristics that mediate increased decision-making sophistication, promoting the maturation of self-regulated behaviour through adolescence and young adulthood.

The Rational Adolescent: Strategic Information Processing during Decision Making Revealed by Eye Tracking.

Adolescence is often viewed as a time of irrational, risky decision-making - despite adolescents' competence in other cognitive domains. In this study, we examined the strategies used by adolescents (N=30) and young adults (N=47) to resolve complex, multi-outcome economic gambles. Compared to adults, adolescents were more likely to make conservative, loss-minimizing choices consistent with economic models. Eye-tracking data showed that prior to decisions, adolescents acquired more information in a more thorough manner; that is, they engaged in a more analytic processing strategy indicative of trade-offs between decision variables. In contrast, young adults' decisions were more consistent with heuristics that simplified the decision problem, at the expense of analytic precision. Collectively, these results demonstrate a counter-intuitive developmental transition in economic decision making: adolescents' decisions are more consistent with rational-choice models, while young adults more readily engage task-appropriate heuristics.

Adolescent men's attitudes and decision-making in relation to an unplanned pregnancy. Responses to an interactive video drama

This study confronts a gender bias in research on adolescent pregnancy by exploring adolescent men’s decisions relating to a hypothetical unplanned pregnancy. A cross-sectional survey was conducted with adolescent men (N = 360) aged between 14 and 18 years attending schools in the Republic of Ireland. The study, the first of its kind in Europe, extends the small body of evidence on adolescent men and pregnancy decision-making by developing and examining reactions to an interactive video drama used in a comparable study in Australia. In addition, we tested a more comprehensive range of sociological and psychological determinants of adolescent men’s decisions regarding an unplanned pregnancy. Results showed that adolescent men were more likely to choose to keep the baby in preference to abortion or adoption. Adolescent men’s choice to continue the pregnancy (keep or adopt) in preference to abortion was significantly associated with anticipated feelings of regret in relation to abortion, perceived positive attitudes of own mother to keeping the baby and a feeling that a part of them might want a baby. Religiosity was also shown to underlie adolescent men’s views on the perceived consequences of an abortion in their lives.

The Reliability and Validity of a Child and Adolescent Participation in Decision Making Questionnaire

Background
There is a growing impetus across the research, policy and practice communities for children and young people to participate in decisions that affect their lives. Furthermore, there is a dearth of general instruments that measure children and young people’s views on their participation in decision making. This paper presents the reliability and validity of the Child and Adolescent Participation in Decision Making Questionnaire (CAP-DMQ) and specifically looks at a population of looked-after children where a lack of participation in decision making is an acute issue.
Methods
The participants were 151 looked after children and adolescents between 10-23 years of age who completed the 10 item CAP-DMQ. Of the participants 113 were in receipt of an advocacy service that had an aim of increasing participation in decision-making with the remaining participants not having received this service.
Results
The results showed that the CAP-DMQ had good reliability (Cronbach’s alpha = .94) and showed promising uni-dimensional construct validity through an exploratory factor analysis. The items in the CAP-DMQ also demonstrated good content validity by overlapping with prominent models of child and adolescent participation (Lundy 2007) and decision making (Halpern 2014). A regression analysis showed that age and gender were not significant predictors of CAP-DMQ scores but receipt of advocacy was a significant predictor of scores (effect size d=.88), thus showing appropriate discriminant criterion validity.
Conclusion
Overall, the CAP-DMQ showed good reliability and validity. Therefore, the measure has excellent promise for theoretical investigation in the area of child and adolescent participation in decision making and equally shows empirical promise for use as a measure in evaluating services which have increasing the participation of children and adolescents in decision making as an intended outcome.

Real-Time Decision Making and Aggressive Behavior in Youth: A Heuristic Model of Response Evaluation and Decision (RED).

Considerable scientific and intervention attention has been paid to judgment and decision-making systems associated with aggressive behavior in youth. However, most empirical studies have investigated social-cognitive correlates of stable child and adolescent aggressiveness, and less is known about real-time decision making to engage in aggressive behavior. A model of real-time decision making must incorporate both impulsive actions and rational thought. The present paper advances a process model (response evaluation and decision; RED) of real-time behavioral judgments and decision making in aggressive youths with mathematic representations that may be used to quantify response strength. These components are a heuristic to describe decision making, though it is doubtful that individuals always mentally complete these steps. RED represents an organization of social-cognitive operations believed to be active during the response decision step of social information processing. The model posits that RED processes can be circumvented through impulsive responding. This article provides a description and integration of thoughtful, rational decision making and nonrational impulsivity in aggressive behavioral interactions.

Youth Involvement in Organizational Decision Making: The Connection to Youth Initiative and Organizational Functioning

Studying positive adolescent development requires an examination of the mutually beneficial associations between youth and their environment. These youthcontext relations include both the contributions that youth make to others and society and the youth-context interactions that might predict positive youth outcomes. Community and youth-serving organizations, where youth may be involved in decision-making roles such as service delivery, advocacy, or on boards of directors, can provide one important context for youth contributions and for positive adolescent development. Research on the outcomes of youth involvement in organizational decision-making, however, is limited, and largely consists of exploratory qualitative studies. This dissertation is formatted as an integrated article dissertation. It begins with a review of the literature on contexts of structured youth activities and positive youth development. This review is intended to describe theory on development-context relations, in which development is considered an interactive process that occurs between individuals and their contexts, as it pertains the positive development of youth who are involved in various structured activities (e.g., volunteering). This description follows with a review of current research, and conclusions and rationale for the current studies. Following this theoretical and research background, the dissertation includes reports of two studies that were designed to address gaps in the research on youth involvement in organizational decision-making. The first was a qualitative research synthesis to elucidate and summarize the extant qualitative research on the outcomes of youth involvement in organizational decision making on adults and organizations. Results of this study suggested a number of outcomes for service provision, staff, and broader organizational functioning, including both benefits to organizations as well as some costs. The second study was a quantitative analysis of the associations among youth involvement, organizations' learning culture, and youth initiative, and relied on survey data gathered from adults and youth in community-based organizations with youth involvement. As expected, greater youth involvement in organizational decision making was associated with higher learning culture within the organization. Two dimensions of youth involvement, greater program engagement and relationships with adults, were related to greater youth initiative. A third dimension, sense of ownership, was not- .-.- associated with youth's level of initiative. Moreover, the association between relationships with adults and youth initiative was only significant in organizations with relatively low learning culture. Despite some limitations, these studies contribute to the research literature by providing some indication of the potential benefits and costs of youth involvement and by making an important contribution toward the early stages of context-level analyses of youth development. Findings have important implications for practitioners, funders, future research, and lifespan development theory.