# Presentation: 682629

## The Youth Asset Study

- 11th Annual Maternal and Child Health Epidemiology Annual Meeting,
- Miami, Florida,
- December 2005

## 	Acknowledgment: This project was supported under a cooperative agreement from the Centers for Disease Control and Prevention (CDC) through the Association of Schools of Public Health (ASPH) Grant Number U36/CCU300430 and under Cooperative Agreement Number U88/CCU612534 from the Centers for Disease Control and Prevention awarded to the Oklahoma Institute for Child Advocacy. 

## Investigators

- Roy F. Oman, PhD
- College of Public Health, University of Oklahoma Health Sciences Center
- Sara K. Vesely, PhD
- College of Public Health, University of Oklahoma Health Sciences Center
- Cheryl Aspy, PhD
- College of Family and Preventive Medicine, University of Oklahoma Health Sciences Center
- Eleni Tolma, PhD
- College of Public Health, University of Oklahoma Health Sciences Center
- Sharon Rodine, MEd
- Oklahoma Institute for Child Advocacy
- Lorrie Gavin, PhD
- CDC, Division of Reproductive Health
- Trisha Mueller, MPH
- CDC, Division of Reproductive Health

## Background

- Youth development programs based on the belief that youth “assets” can help prevent youth from engaging in risk behaviors
- There is little empirical evidence to show that youth assets are causally related to a reduction in risk behaviors

## Background (continued)

- The Youth Asset Study (YAS) is currently underway to test the youth asset/risk behavior relationship by following a cohort of parent-adolescent dyads over a six-year period

## Background (continued)

- Study Goals
- Improve measurement of assets.
- Investigate relationships between youth assets and youth sexual risk behaviors by youth age, gender, and ethnicity.
- Test the assumption that assets are causally related to a reduction in teen sexual and related risk behaviors.

## Purpose

- Describe the YAS,
- present selected baseline results, and
- suggest practical implications

## Methods

- Nine assets
- Developed/conceptualized using data from:
- Needs assessment
- Focus groups
- Assets formed the basis for interventions designed and piloted through the implementation phase of the *HEART of OKC* Study

## Methods (continued)

- Five-year longitudinal study
- 6 assessment points at one-year intervals
- Strong emphasis on retention

## Methods (continued) 

- Questionnaire Development
- Youth Survey
- 16 youth asset constructs (119 items)
- sexual behaviors asked of both sexes or specific to females or males (12 items)
- contraceptive use (6 items)
- intentions or feelings re: pregnancy asked of both sexes or specific to females or males (15 items)
- stages of change for sexual behaviors or behavioral intention scenarios (3 sets of items)
- attitudes, education, peer influences, and family communication related to sexuality (5 items)

## Methods (continued)

- Assets
- Aspirations for the Future
- Constructive Use of Time
- Religion
- Groups/Sports
- Responsible Choices
- Community Involvement
- Good Health Practices (Exercise/Nutrition)
- Family Communication
- Peer Role Models
- Non-Parental Adult Role Models

## Questionnaire Development (continued)

- New Youth Asset Constructs
- Relationship with Mother
- Relationship with Father
- Perceived Parental Monitoring
- General Confidence
- Religiosity
- School Connectedness
- Dispositional Optimism

## Questionnaire Development (continued)

- Parent Survey
- Socioeconomic status measures (approximately 50 items)
- Community-level measures (approximately 30 items)
- informal social control
- public services
- sense of community
- neighborhood involvement
- Broken Windows Survey (5 items)
- Trained observers conduct windshield tours of participants’ neighborhoods and rate each neighborhoods on several criteria

## Examples of new items included on Wave 2 survey
Parent 
Social status (ladder questions) 
Youth 
Life Events (set of items)
Abstinence Pledge (set of items)

- Parent
- Social status (ladder questions)
- Youth
- Life Events (set of items)
- Abstinence Pledge (set of items)

- Questionnaire Development (continued)

## Methods (continued)

- Sampling Strategy
- Census tracts were stratified and randomly selected to achieve a sample of:
- 200 African American Higher SES (6 Tracts) 4
- 200 African American Lower SES (28 Tracts) 5
- 200 Non-Hispanic White Higher SES (43 Tracts) 3
- 200 Non-Hispanic White Lower SES (55 Tracts) 5
- 200 Hispanic All levels SES (26 Tracts) 3

**Notes:**
Number inside parenthesis is the number of tracts that fit the stratification category.  
Number outside the parenthesis is the actual number of tracts that we sampled within the stratification category.  

## Tract 1085.22; 188 Interviews

**Tract 1085.22; 188 Interviews**

- Kilpatrick Turnpike

## Methods (continued)

- Every building in the randomly selected census blocks were enumerated (e.g., house vs. business) – If block had more than 70 households – then 70 or less households were randomly chosen to be enumerated

## Methods (continued)

- A final disposition was determined for every enumerated residence:
- 	- Completed interview
- 	- No youth in residence
- 	- Refused to participate (collected youth
-       race/ethnicity, # of parents, rent or own
-       residence, education of female parent)
- 	- House uninhabited
- 	- Business
- 	- Etc.

## Baseline interviews began Aug. 03 and completed Dec. 04

1120 completed interviews 
Final n = 1111 youth/parent pairs
61% response rate 
731 Refusals
Extremely low missing data rate 
165 interviews completed in Spanish

- 1120 completed interviews
- Final n = 1111 youth/parent pairs
- 61% response rate
- 731 Refusals
- Extremely low missing data rate
- 165 interviews completed in Spanish

- Methods (continued)

## Methods (continued)

- Interview Methods
- -  One parent and one teenager from each household
- -  Two interviewers interviewed youth and parent in separate rooms of household using a computer-assisted data entry system
- -  Youth self-administered the risk behavior portion of the questionnaire using headphones and computer entry

**Notes:**
These procedures minimized missing data, insured respondent confidentiality, and reduced non-compliance due to reading ability.

## Methods (continued)

- Outcomes analyzed for this presentation
-    - Sexual intercourse
- Have you ever had sexual intercourse ("done it", "had sex", "made love", "gone all the way")?
-    - Tobacco use
- During the past 30 days, have you used any tobacco (smoked, dipped, or chewed)?

## Methods (continued)

-  	- Alcohol use
- During the past 30 days, did you drink any alcohol, such as beer, wine, or liquor?
-  	- Drug use
- During the past 30 days, did you use or do any drugs such as marijuana, inhalants, methamphetamine, speed, crack or heroin?

## Methods (continued)

- Assets
- - Aspirations for the Future
- - Constructive Use of Time
- Religion
- Groups/Sports
- - Responsible Choices
- - Community Involvement
- - Good Health Practices (Exercise/nutrition)
- - Family Communication
- - Peer Role Models
- - Non-Parental Adult Role Models

## Methods (continued)

- Logistic regression analyses were conducted, controlling for demographic variables
- Youth assets were the independent variables
- Risk factors were the dependent variables

## Results

- Final sample of 1,111 households (parent/youth pairs)
- Youth demographics
- Mean age = 14.3 1.6 years
- 53% female
- Race/Ethnicity
- 39% White
- 28 % Hispanic
- 24% African-American
- 9% Other

## Results (Continued)

- Sex of interviewed parent
- Female – 81%
- Male –     19%
- Family structure
- One parent/guardian –     30.5%
- Two parents/guardians – 69.5%

## Youth Age

## Ever Had Sexual Intercourse by Age

## Results (continued) 

- Baseline analyses indicate that youth assets are significantly associated with a lower likelihood of participation in sexual and related risk behaviors

## Results (continued)

- No Sexual Intercourse
- Seven assets each significantly related (*p*<.05) to never having participated in sexual intercourse (ORs ranged from 1.58 to 2.22)

## Results (continued)

| Relationship Between Youth Assets and Non-Sexual Intercourse: Adjusted Odds Ratios (OR) with 95% Confidence Intervals (CI) from Individual Multiple Logistic Regression Models |  |  |  |
| --- | --- | --- | --- |
| Youth Asset |  | Adjusted |  |
|  | N | OR | 95% CI |
| Non-Parental Adult Role Models | 1073 | 1.58* | (1.03, 2.43) |
| Peer Role Models | 1081 | Interaction |  |
| Family Communication | 1081 | 2.03* | (1.47, 2.80) |
| Use of Time (Religion) | 1081 | 1.72* | (1.24, 2.38) |
| Community Involvement | 1081 | 1.78* | (1.04, 3.01) |
| Aspirations for the Future | 1081 | 2.22* | (1.29, 3.80) |
| Responsible Choices | 1081 | 2.17* | (1.48, 3.18) |
| *p ≤ 0.05 |  |  |  |

## Results (continued)

| Adjusted Odds Ratios (OR) with 95% Confidence Intervals (CI) from Multiple Logistic Regression Model for Interaction Between Peer Role Models Asset and Youth Race |  |  |  |
| --- | --- | --- | --- |
|  |  | Adjusted |  |
|  | N | OR | 95% CI |
| Non-Hispanic African-American | 255 | 1.13 | (0.62, 2.08) |
| Non-Hispanic Caucasian | 418 |   3.79* | (2.12, 6.75) |
| Hispanic | 305 | 1.82 | (0.96, 3.45) |
| Other | 103 |   3.93* | (1.06, 14.54) |
| *p ≤ 0.05 |  |  |  |

## Results (continued)

- Non-use of tobacco
- Eight assets each significantly related (*p*<.05) to non-use of tobacco (ORs ranged from 2.0 to 3.1)

## Results (continued)

| Relationship Between Youth Assets and Tobacco Non-Use: Adjusted Odds Ratios (OR) with 95% Confidence Intervals (CI) from Individual Multiple Logistic Regression Models |  |  |  |
| --- | --- | --- | --- |
| Youth Asset |  | Adjusted |  |
|  | N | OR | 95% CI |
| Peer Role Models | 1069 | 3.10* | (2.14, 4.48) |
| Family Communication | 1069 | 2.42* | (1.69, 3.47) |
| Use of Time (Groups/Sports) | 1062 | 2.05* | (1.33, 3.16) |
| Use of Time (Religion) | 1069 | 2.01* | (1.40, 2.88) |
| *p ≤ 0.05 |  |  |  |

## Results (continued)

| Tobacco Non-Use– Continued |  |  |  |
| --- | --- | --- | --- |
| Youth Asset |  | Adjusted |  |
|  | N | OR | 95% CI |
| Good Health Practices (Exercise/Nutrition) | 1069 | 2.02* | (1.41, 2.90) |
| Community Involvement | 1069 | 2.04* | (1.08, 3.85) |
| Aspirations for the Future | 1069 | 2.03* | (1.15, 3.58) |
| Responsible Choices | 1069 | 2.53* | (1.69, 3.79) |
| *p ≤ 0.05 |  |  |  |

## Results (continued)

- Non-use of alcohol
- Seven assets each significantly related (*p*<.05) to non-use of alcohol (ORs ranged from 1.6 to 2.7)

## Results (continued)

| Relationship Between Youth Assets and Alcohol Non-Use: Adjusted Odds Ratios (OR) with 95% Confidence Intervals (CI) from Individual Multiple Logistic Regression Models |  |  |  |
| --- | --- | --- | --- |
| Youth Asset |  | Adjusted |  |
|  | N | OR | 95% CI |
| Non-Parental Adult Role Models | 1067 | 1.58* | (1.03, 2.43) |
| Peer Role Models | 1074 | 2.37* | (1.72, 3.26) |
| Family Communication | 1074 | 2.68* | (1.95, 3.69) |
| Use of Time (Groups/Sports) | 1067 | 1.71* | (1.19, 2.45) |
| Use of Time (Religion) | 1074 | 1.64* | (1.19, 2.25) |
| Aspirations for the Future | 1074 | 1.75* | (1.02, 3.00) |
| Responsible Choices | 1074 | 1.88* | (1.30, 2.74) |
| *p ≤ 0.05 |  |  |  |

## Results (continued)

- Non-use of drugs
- Eight assets each significantly related (*p*<.05) to non-use of drugs (ORs ranged from 1.7 to 5.8)

## Results (continued)

| Relationship Between Youth Assets and Drug Non-Use: Adjusted Odds Ratios (OR) with 95% Confidence Intervals (CI) from Individual Multiple Logistic Regression Models |  |  |  |
| --- | --- | --- | --- |
| Youth Asset |  | Adjusted |  |
|  | N | OR | 95% CI |
| Peer Role Models | 1071 | 3.07* | (1.99, 4.73) |
| Family Communication | 1071 | 3.19* | (2.09, 4.88) |
| Use of Time (Groups/Sports) | 1065 | 2.42* | (1.43, 4.11) |
| Use of Time (Religion) | 1071 | 2.60* | (1.69, 3.98) |
| *p ≤ 0.05 |  |  |  |

## Results (continued)

| Drug Non-Use– Continued |  |  |  |
| --- | --- | --- | --- |
| Youth Asset |  | Adjusted |  |
|  | N | OR | 95% CI |
| Good Health Practices (Exercise/Nutrition) | 1071 | 1.71* | (1.12, 2.59) |
| Community Involvement | 1071 | 5.80* | (1.80, 18.71) |
| Aspirations for the Future | 1071 | 2.22* | (1.22, 4.05) |
| Responsible Choices | 1071 | 2.07* | (1.31, 3.28) |
| *p ≤ 0.05 |  |  |  |

## Discussion

- Results support research suggesting that specific youth assets are associated with a reduction in risk behaviors
- Minimum of 7 of 9 assets related to any of the risk behaviors
- Confirm original study results
- Longitudinal data needed to examine temporal relationships between assets and risk behaviors

## Implications

- Strengthening or increasing the number of assets youth possess may be an effective intervention strategy
- Some assets seem to protect youth from a range of risk behaviors
- E.g., Family communication, Aspirations for the Future, Responsible Choices
- Challenge is to develop effective programs that promote/strengthen multiple assets