Agency Outside the Margins: Identity Development of Youth Attending Alternative High Schools

Thesis (Ph.D.)--University of Washington, 2016-05

Development and evaluation of a youth mental health community awareness campaign - The Compass Strategy

Background: Early detection and treatment of mental disorders in adolescents and young adults can lead to better health outcomes. Mental health literacy is a key to early recognition and help seeking. Whilst a number of population health initiatives have attempted to improve mental health literacy, none to date have specifically targeted young people nor have they applied the rigorous standards of population health models now accepted as best practice in other health areas. This paper describes the outcomes from the application of a health promotion model to the development, implementation and evaluation of a community awareness campaign designed to improve mental health literacy and early help seeking amongst young people. Method: The Compass Strategy was implemented in the western metropolitan Melbourne and Barwon regions of Victoria, Australia. The Precede-Proceed Model guided the population assessment, campaign strategy development and evaluation. The campaign included the use of multimedia, a website, and an information telephone service. Multiple levels of evaluation were conducted. This included a cross-sectional telephone survey of mental health literacy undertaken before and after 14 months of the campaign using a quasi-experimental design. Randomly selected independent samples of 600 young people aged 12 - 25 years from the experimental region and another 600 from a comparison region were interviewed at each time point. A series of binary logistic regression analyses were used to measure the association between a range of campaign outcome variables and the predictor variables of region and time. Results: The program was judged to have an impact on the following variables, as indicated by significant region-by-time interaction effects ( p < 0.05): awareness of mental health campaigns, self-identified depression, help for depression sought in the previous year, correct estimate of prevalence of mental health problems, increased awareness of suicide risk, and a reduction in perceived barriers to help seeking. These effects may be underestimated because media distribution error resulted in a small amount of print material leaking into the comparison region. Conclusion: We believe this is the first study to apply the rigorous standards of a health promotion model including the use of a control region to a mental health population intervention. The program achieved many of its aims despite the relatively short duration and moderate intensity of the campaign.

Long-term outcomes of an Australian universal prevention trial of anxiety and depression symptoms in children and youth: An evaluation of the friends program

This study evaluated the long-term effectiveness of the FRIENDS Program in reducing anxiety and depression in a sample of children from Grade 6 and Grade 9 in comparison to a control condition. Longitudinal data for Lock and Barrett's (2003) universal prevention trial is presented, along with data from 12-month follow-up to 24- and 36-month follow-up. Results of this study indicate that intervention reductions in anxiety reported in Lock and Barrett were maintained for students in Grade 6, with the intervention group reporting significantly lower ratings of anxiety at long-term follow-up. A significant Time times Intervention Group times Gender Effect on Anxiety was found, with girls in the intervention group reporting significantly lower anxiety at 12-month and 24-month follow-up but not at 36-month follow-up in comparison to the control condition. Results demonstrated a prevention effect with significantly fewer high-risk students at 36-month follow-up in the intervention condition than in the control condition. Results are discussed within the context of prevention research.

Lifetime suicide risk in major depression: sex and age determinants

Background: Recent work has demonstrated that the lifetime suicide risk for patients with DSM IV Major Depression cannot mathematically approximate the accepted figure of 15%. Gender and age significantly affect both the prevalence of major depression and suicide risk, Methods: Gender and age stratified calculations were made on the entire population of the USA in 1994 using a mathematical algorithm. Sex specific corrections for under-reporting were incorporated into the design. Results: The lifetime suicide risks for men and women were 7% and 1%, respectively. The combined risk was 3.4%. The male:female ratio for suicide risk in major depression was 10:1 for youths under 25, and 5.6:1 for adults. Conclusions: Suicide in major depression is predominantly a male problem, although complacency towards female sufferers is to be avoided. Diagnosis of major depression is of limited help in predicting suicide risk compared to case specific factors. The male experience of depression that leads to suicide is often not identified as a legitimate medical complaint by either sufferers or professionals. Increasing help-accessing by males is a priority. Clinical implications: Patients with a history of hospitalisation; comorbidity, especially for substance abuse; and who are male, require greater vigilance for suicide risk. It may be that for males che threshold for diagnosing and treating major depression needs to be lowered. Limitations: This research is based on a mathematical algorithm to approximate a life-long longitudinal study that identifies community cases of depression. Our findings therefore rely on the validity of the statistics used. Extrapolation is limited to populations with an actual suicide rate of 17/100,000 or less and a lifetime prevalence of major depression of 17% or more. (C) 1999 Elsevier Science B.V. All rights reserved.

Strategic and operational risk in an international collaboration agency: a knowledge management solution

The International Cooperation Agency (identified in this article as IDEA) working in Colombia is one of the most important in Colombian society with programs that support gender rights, human rights, justice and peace, scholarships, aboriginal population, youth, afro descendants population, economic development in communities, and environmental development. The identified problem is based on the diversified offer of services, collaboration and social intervention which requires diverse groups of people with multiple agendas, ways to support their mandates, disciplines, and professional competences. Knowledge creation and the growth and sustainability of the organization can be in danger because of a silo culture and the resulting reduced leverage of the separate group capabilities. Organizational memory is generally formed by the tacit knowledge of the organization members, given the value of accumulated experience that this kind of social work implies. Its loss is therefore a strategic and operational risk when most problem interventions rely on direct work in the socio-economic field and living real experiences with communities. The knowledge management solution presented in this article starts first, with the identification of the people and groups concerned and the creation of a knowledge map as a means to strengthen the ties between organizational members; second, by introducing a content management system designed to support the documentation process and knowledge sharing process; and third, introducing a methodology for the adaptation of a Balanced Scorecard based on the knowledge management processes. These three main steps lead to a knowledge management “solution” that has been implemented in the organization, comprising three components: a knowledge management system, training support and promotion of cultural change.

A magyar fiatalok jellemzése pénzügyi attitűdjeik és magatartásuk mentén – Vizsgálat a felsőoktatásban tanulók pénzügyi attitűdjeiről és magatartásáról = Characterization of the Hungarian youth with their financial attitudes and behaviours – A survey about the financial behaviour and attitudes of students

A pénzügyi piacok és termékek egyre komplexebbé válnak, ami együtt jár a pénzügyeket illető információs szakadék mélyülésével is – a lakosság egyre kevésbé képes pénzügyeiről körültekintő döntéseket hozni. Jelen tanulmány a magyar felsőoktatásban tanuló fiatalokat pénzügyi attitűdjeik mentén szegmentálja és jellemzi, annak érdekében, hogy hozzájáruljon a pénzügyi kultúra szintjét növelő programok sikerességéhez, legyen az állami indíttatású (pénzügyi edukáció) vagy a versenyszféra által vezérelt. A vizsgált fiatalok alapvetően három csoportba sorolhatók: (1) Konzervatívak, (2) Lázadók és (3) Tapasztaltak. A Konzervatívakra a stabil morális értékrend, alacsony kockázatvállalási hajlandóság jellemző, céljaik között egyaránt találunk rövid és hosszú távúakat is – informáltságuk, és ebből eredően pénzügyi ismeretszintjük alacsony, a hitelekkel szembeni attitűdjük negatív. A Lázadók csoportjára az „Élj a mának!” magatartás a jellemző, vagyis rövid távú céljaik vannak, kevésbé tudatosak, pénzügyi ismeretszintjük alacsony, ugyanakkor nyitottak az újdonságokra és a kockázatvállalási szintjük magasabb a másik két csoporténál. A Tapasztaltak csoportjára a tudatosság és a pénzügyi megfontoltság a jellemző – pénzügyi ismeretszintjük magasabb a másik két csoporténál. Náluk a hosszú távú célok dominálnak, de alacsony kockázatvállalási hajlandóság mellett. _____ Financial markets and financial instruments have become more and more complex in the last decades. Unfortunately, financial literacy of population cannot keep up with the innovation activity of financial sector. By segmenting and describing Hungarian young adults along their financial attitudes, the aim of this study is to provide recommendations to the programs aiming to enhance the development of financial literacy. According to the authors’ results, 18-25 year-old young adults can be categorized as (1) conservatives, (2) rebels and (3) experienced. Conservatives can be characterized by stable moral and values, low risktaking willingness and inappropriate financial knowledge. Both short and long term goals can be explored among their preferences. Conservatives have negative attitude to bank loans. The rebels can be described by the ancient Latin saying: “Carpe Diem”. They have short-term goals and the future financial stability is not an issue for them – their financial literacy is low. However, rebels are open-minded and their risk-taking willingness is greater than the other two group members. Despite of the low level of risk-taking willingness, the highest level of financial literacy is showed by the experienced group. They have long-term goals and are able to receive information about complex financial instruments.

A follow-up outcome evaluation of independent living services for foster care youth

This study aimed to evaluate the effectiveness of the Independent Living (IL) program targeting foster youths to prepare them for effective adulthood. The study employed a pre-post, two-group comparative research design. The IL group was composed of 49 young adults who participated in the IL or SIL (subsidized IL) program prior to their emancipation from foster care (mean age, 20.6 years). The comparison was made up of 18 young adults who experienced foster care but never participated in the IL or SIL programs (mean age, 20.2 years). Data were collected via a mailed survey that included the Daniel Memorial Independent Living Assessment (DMILA) and an additional questionnaire developed by the researcher. The study also examined: (1) why youth in foster care do not participate in IL programs, (2) how participating youth evaluate IL services and what recommendations they make to improve services, and (3) the internal consistency of the DMILA. Results suggest that the DMILA assessment has mediocre reliability. IL program participation is associated with better educational, employment, income, housing, early parenting-prevention, transportation, anger control, criminal-prevention, and self-evaluation outcomes. However, IL participation is not associated with better social support, perceived parenting competence, substance abuse-prevention, sexual risk-prevention outcomes, increased knowledge in money management skills, job seeking and job maintenance skills, interpersonal skills, or lower depression. Results also suggest that the outreach activities of the IL program may be flawed. IL participants reported the IL program was doing best in educational preparation, criminal involvement prevention, and money management preparation and least well in parenting preparation, housing preparation, employment preparation, and substance abuse prevention. To improve services, youths recommended primarily that IL counselors develop closer relationships with youths, that IL training better address organizational skills, and that monthly subsidy be raised and SIL eligibility requirements softened. The study's political context and limitations are also discussed and implications are derived regarding prevention, intervention, outreach, mentorship, empowerment, cross-systems collaboration, and future research. ^

Anxiety sensitivity's facets in relation to anxious and depressive symptoms in youth

Anxiety sensitivity is a multifaceted cognitive risk factor currently being examined in relation to anxiety and depression. The paucity of research on the relative contribution of the facets of anxiety sensitivity to anxiety and depression, coupled with variations in existing findings, indicate that the relations remain inadequately understood. In the present study, the relations between the facets of anxiety sensitivity, anxiety, and depression were examined in 730 Hispanic-Latino and European-American youth referred to an anxiety specialty clinic. Youth completed the Childhood Anxiety Sensitivity Index, the Revised Children’s Manifest Anxiety Scale, and the Children’s Depression Inventory. The factor structure of the Childhood Anxiety Sensitivity Index was examined using ordered-categorical confirmatory factor analytic techniques. Goodness-of-fit criteria indicated that a two-factor model fit the data best. The identified facets of anxiety sensitivity included Physical/Mental Concerns and Social Concerns. Support was also found for cross-ethnic equivalence of the two-factor model across Hispanic-Latino and European-American youth. Structural equation modeling was used to examine models involving anxiety sensitivity, anxiety, and depression. Results indicated that an overall measure of anxiety sensitivity was positively associated with both anxiety and depression, while the facets of anxiety sensitivity showed differential relations to anxiety and depression symptoms. Both facets of anxiety sensitivity were related to overall anxiety and its symptom dimensions, with the exception being that Social Concerns was not related to physiological anxiety symptoms. Physical/Mental Concerns were strongly associated with overall depression and with all depression symptom dimensions. Social Concerns was not significantly associated with depression or its symptom dimensions. These findings highlight that anxiety sensitivity’s relations to youth psychiatric symptoms are complex. Results suggest that focusing on anxiety sensitivity’s facets is important to fully understand its role in psychopathology. Clinicians may want to target all facets of anxiety sensitivity when treating anxious youth. However, in the context of depression, it might be sufficient for clinicians to target Physical/Mental Incapacitation Concerns.

Investigating positive identity development in a school-based youth development project

Adolescence is a pivotal period offering both opportunities and constraints on individual development. It is during this important time that one decides upon and commits to the values, goals, and beliefs which will form one's identity and guide one throughout the lifespan. Positive youth development programs, such as the Miami Youth Development Project's Changing Lives Program, target the formation of a positive sense of identity as a critical intervention point. Through developing a coherent and positive sense of self, adolescents take control of and responsibility for their lives and their decisions. Furthermore, a positive identity has been found to be a developmental asset and is linked to lower risk behaviors and positive outcomes including increased self-esteem, sense of purpose, and a positive view of the future. Positive youth development programs, which promote positive identity development, have been found to be more strongly tied to positive outcomes including skills, values, and competencies than have contextual opportunities. As such, it is critical to determine what leads to positive identity development. ^ The current study used structural equation modeling to evaluate three potential mediators of identity development. Findings indicated good model fit where change in identity commitment and change in identity exploration were mediated by informational identity style, personal expressiveness, and identity distress. There were also significant differences found between the control and intervention groups indicative of intervention effects. The findings of the current study suggest potential areas of intervention as well as the need for further research including longitudinal study and the use of qualitative methodology. ^

A youth vision of the city: The socio-spatial lives and exclusion of street girls in Bogota, Colombia

This dissertation documents the everyday lives and spaces of a population of youth typically constructed as out of place, and the broader urban context in which they are rendered as such. Thirty-three female and transgender street youth participated in the development of this youth-based participatory action research (YPAR) project utilizing geo-ethnographic methods, auto-photography, and archival research throughout a six-phase, eighteen-month research process in Bogotá, Colombia. ^ This dissertation details the participatory writing process that enabled the YPAR research team to destabilize dominant representations of both street girls and urban space and the participatory mapping process that enabled the development of a youth vision of the city through cartographic images. The maps display individual and aggregate spatial data indicating trends within and making comparisons between three subgroups of the research population according to nine spatial variables. These spatial data, coupled with photographic and ethnographic data, substantiate that street girls’ mobilities and activity spaces intersect with and are altered by state-sponsored urban renewal projects and paramilitary-led social cleansing killings, both efforts to clean up Bogotá by purging the city center of deviant populations and places. ^ Advancing an ethical approach to conducting research with excluded populations, this dissertation argues for the enactment of critical field praxis and care ethics within a YPAR framework to incorporate young people as principal research actors rather than merely voices represented in adultist academic discourse. Interjection of considerations of space, gender, and participation into the study of street youth produce new ways of envisioning the city and the role of young people in research. Instead of seeing the city from a panoptic view, Bogotá is revealed through the eyes of street youth who participated in the construction and feminist visualization of a new cartography and counter-map of the city grounded in embodied, situated praxis. This dissertation presents a socially responsible approach to conducting action-research with high-risk youth by documenting how street girls reclaim their right to the city on paper and in practice; through maps of their everyday exclusion in Bogotá followed by activism to fight against it.^

Comparison of two mentoring programs for at -risk Black adolescents: A traditional one -to -one mentoring program and a school -to -work transitional program

The purposes of this study were: (a) to compare the impact of One-to-One (OTO) mentoring interventions administered in the high school setting, and the workplace of the students who participated in the School-to-Work (STW) transitional program, and (b) to identify how the participants perceived their experience in the OTO mentoring program and the STW transitional program. A qualitative approach was used to identify how participants perceived their mentoring experiences with the STW and OTO mentoring programs by utilizing focus groups and content analysis. A quantitative approach was used to compare the statistical differences of outcomes between the STW and OTO mentoring programs, by utilizing descriptive statistics, independent samples t-tests, chi-square analyses, and logistic regression. The sample was limited to participants in the STW and OTO mentoring programs resulting in 21 participants for the qualitative approach and 114 participants for the quantitative approach. ^ Results from the qualitative approach indicated that focus group participants in the STW program were satisfied with the program and the relationship with their mentors. They also suggested that the STW program be lengthened to include the entire academic year. Participants from the OTO focus group were dissatisfied with their program due to inadequate mentor involvement. Results from the quantitative approach showed that the increase in school attendance for the STW program's at-risk Black male youth was statistically significant compared to the OTO program participants; the STW program participants displayed a better outlook for attending college that was statistically significant compared to those in the OTO program; and the OTO program participants displayed a better outlook for permanent employment compared to those in the STW program. ^ Therefore, this study finds that mentoring can contribute to reducing school absences and high school completion in order for at-risk Black adolescents to attend college. It is recommended that the OTO program be restructured to eliminate the disparity that exists regarding the administration of the STW program and the OTO program. ^

The possible selves method in evaluating youth development interventions: The use of Integrated Qualitative /Quantitative Data Analytic Strategies (IQ -DAS)

This study investigated the feasibility of using qualitative methods to provide empirical documentation of the long-term qualitative change in the life course trajectories of “at risk” youth in a school based positive youth development program (the Changing Lives Program—CLP). This work draws from life course theory for a developmental framework and from recent advances in the use of qualitative methods in general and a grounded theory approach in particular. Grounded theory provided a methodological framework for conceptualizing the use of qualitative methods for assessing qualitative life change. The study investigated the feasibility of using the Possible Selves Questionnaire-Qualitative Extension (PSQ-QE) for evaluating the impact of the program on qualitative change in participants' life trajectory relative to a non-intervention control group. Integrated Qualitative/Quantitative Data Analytic Strategies (IQ-DAS) that we have been developing a part of our program of research provided the data analytic framework for the study. ^ Change was evaluated in 85 at risk high school students in CLP high school counseling groups over three assessment periods (pre, post, and follow-up), and a non-intervention control group of 23 students over two assessment periods (pre and post). Intervention gains and maintenance and the extent to which these patterns of change were moderated by gender and ethnicity were evaluated using a mixed design Repeated Measures Multivariate Analysis of Variance (RMANOVA) in which Time (pre, post) was the within (repeated) factor and Condition, Gender, and Ethnicity the between group factors. The trends for the direction of qualitative change were positive from pre to post and maintained at the year-end follow-up. More important, the 3-way interaction for Time x Gender x Ethnicity was significant, Roy's Θ =. 205, F(2, 37) = 3.80, p <.032, indicating that the overall pattern of positive change was significantly moderated by gender and ethnicity. Thus, the findings also provided preliminary evidence for a positive impact of the youth development program on long-term change in life course trajectory, and were suggestive with respect to the issue of amenability to treatment, i.e., the identification of subgroups of individuals in a target population who are likely to be the most amenable or responsive to a treatment. ^

Risk and resilience factors associated with delinquent behavior among African -American adolescent males

Juvenile crime is a social problem of increasing concern to many citizens in the United States. In 2000, there were an estimated 2.4 million juvenile arrests for a variety of crimes ranging from misdemeanors to violent felony offenses. African American males are disproportionately represented among juvenile offenders in the United States. In 2000, black youth were approximately 16% of the U.S. population between the ages of 10–17; however, they accounted for 42% of juvenile arrests for violent crime. ^ This study explored putative factors associated with juvenile offending among a sample of African American adolescent males. The independent variables in this study were academic achievement, religiosity, parenting styles and discrimination. The dependent variables were delinquent behavior and arrest. The data used in this study were from a larger NIDA funded longitudinal study that included approximately 425 African American youths. The data collection method involved structured interviews and questionnaires. The participants for the original study were selected via random sampling from all students attending middle school in Miami-Dade County. The study examined the hypotheses that African American males retrospectively reporting (a) high academic achievement, (b) high religiosity, (c) authoritarian parenting and (d) low perceptions of discrimination are less likely to be involved in delinquent behavior and are also less likely to be arrested. ^ Results indicated that among African American adolescent males, delinquent behavior had a significant relationship (p < .05) with academic achievement, perceived discrimination and the interaction between perceived discrimination and experienced discrimination. Arrest was significantly related to academic achievement (p < .001), religious perception (p < .05), and church attendance (p < 05). Neither dependent variable was significantly related to parenting styles. ^ The findings indicated that experimental studies are needed to clarify cause and effect relationship among the variables associated with juvenile offending among African American males, which may differ from those associated with juvenile offending among other groups. ^

Risk and resilience factors associated with delinquent behavior among African American adolescent males

Juvenile crime is a social problem of increasing concern to many citizens in the United States. In 2000, there were an estimated 2.4 million juvenile arrests for a variety of crimes ranging from misdemeanors to violent felony offenses. African American males are disproportionately represented among juvenile offenders in the United States. In 2000, black youth were approximately 16% of the U.S. population between the ages of 10-17; however, they accounted for 42% of juvenile arrests for violent crime. This study explored putative factors associated with juvenile offending among a sample of African American adolescent males. The independent variables in this study were academic achievement, religiosity, parenting styles and discrimination. The dependent variables were delinquent behavior and arrest. The data used in this study were from a larger NIDA funded longitudinal study that included approximately 425 African American youths. The data collection method involved structured interviews and questionnaires. The participants for the original study were selected via random sampling from all students attending middle school in Miami-Dade County. The study examined the hypotheses that African American males retrospectively reporting (a) high academic achievement, (b) high religiosity, (c) authoritarian parenting and (d) low perceptions of discrimination are less likely to be involved in delinquent behavior and are also less likely to be arrested. Results indicated that among African American adolescent males, delinquent behavior had a significant relationship (p The findings indicated that experimental studies are needed to clarify cause and effect relationship among the variables associated with juvenile offending among African American males, which may differ from those associated with juvenile offending among other groups.

Computational Tracking of Mental Health in Youth: Latin American Contributions to a Low-Cost and Effective Solution for Early Psychiatric Diagnosis

The early onset of mental disorders can lead to serious cognitive damage, and timely interventions are needed in order to prevent them. In patients of low socioeconomic status, as is common in Latin America, it can be hard to identify children at risk. Here, we briefly introduce the problem by reviewing the scarce epidemiological data from Latin America regarding the onset of mental disorders, and discussing the difficulties associated with early diagnosis. Then we present computational psychiatry, a new field to which we and other Latin American researchers have contributed methods particularly relevant for the quantitative investigation of psychopathologies manifested during childhood. We focus on new technologies that help to identify mental disease and provide prodromal evaluation, so as to promote early differential diagnosis and intervention. To conclude, we discuss the application of these methods to clinical and educational practice. A comprehensive and quantitative characterization of verbal behavior in children, from hospitals and laboratories to homes and schools, may lead to more effective pedagogical and medical intervention