Adolescent Health: A Multidisciplinary Approach to Theory, Research, and Intervention

Books

Lynn Rew

  • Citations
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  • Chapters
  • Front Matter
  • Back Matter
  • Subject Index
  • Dedication

    This book is dedicated to my twin children, Richard and Carina, who safely navigated their adolescence to become competent, caring, and compassionate young adults.

    Copyright

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    List of Figures

    • Figure 1.1 A Model of Positive Health Practices in Adolescents 3
    • Figure 2.1 Diagramming Relationships Among Concepts in a Theory to Determine Logical Adequacy 26
    • Figure 2.2 Linkages Among Levels of Theory Development 29
    • Figure 2.3 Methods Used in Theory Construction 30
    • Figure 2.4 Matrix to Examine Relationships Between Concepts Within a Theory to Determine Logical Adequacy 43
    • Figure 2.5 Conceptual Model of Sexual Health Practices Among Homeless Adolescents 45
    • Figure 3.1 A Holistic Model of Human Development 52
    • Figure 3.2 Sibling Bereavement as a Catalyst for Spiritual Development in Children and Adolescents 71
    • Figure 3.3 The Quest to Understand Life's Meaning and Spiritual Growth After a Sibling Dies 72
    • Figure 3.4 Conceptual Framework for the Paternal Niche: An Application of an Ecological Model of Human Development 79
    • Figure 3.5 Human Development From the Perspective of Developmental Contextualism 82
    • Figure 3.6 Logic Model for Increasing Developmental Assets 88
    • Figure 3.7 Conceptual Framework for Youth Development Theory and Research 93
    • Figure 4.1 A Schematic Interpretation of William James's Conceptualization of the Self 103
    • Figure 4.2 Original Model of the Determinants and Consequences of Self-Worth 106
    • Figure 4.3 A General Model of the Predictors of Depression and Adjustment 107
    • Figure 4.4 Process Model of the Effects of Validation and Authentic-Self Behavior on Self-Worth and Affect or Mood 107
    • Figure 4.5 Relationships in the Identity Control Process 120
    • Figure 4.6 Relationships Among Major Concepts of Orem's Self-Care Theory 131
    • Figure 5.1 Selye's General Adaptation Syndrome 138
    • Figure 5.2 A Revised Model of Stress and Coping 143
    • Figure 5.3 Relationships Among Concepts in Cognitive Appraisal and Coping Theory 144
    • Figure 5.4 Logical Adequacy of the Conservation of Resources Theory 148
    • Figure 5.5 Moos's Model of Context, Coping, and Adaptation in Adolescence 149
    • Figure 5.6 Commonsense Model of Illness Representation 152
    • Figure 6.1 The Conceptual Structure of Problem-Behavior Theory 169
    • Figure 6.2 A Conceptual Framework for Adolescent Risk Behavior: Risk and Protective Factors, Risk Behaviors, and Risk Outcomes 179
    • Figure 6.3 A Model of Vulnerability, Risk, and Protection 182
    • Figure 6.4 A Process Model of Risk Perception: Attention and Appraisal Phases 183
    • Figure 7.1 Risk-Resilience Continuum of Experience 196
    • Figure 7.2 The Resiliency Wheel 210
    • Figure 7.3 Profile of a Resiliency-Building School 211
    • Figure 7.4 Continuum of Resilience in Adolescents 212
    • Figure 8.1 Relationships Among Concepts of Reciprocal Determinism in Social Cognitive Theory 223
    • Figure 8.2 Logical Adequacy of Three Core Variables in Social Cognitive Theory 228
    • Figure 8.3 Affective Self-Regulatory Efficacy and Psychosocial Functioning in Older Adolescents 234
    • Figure 8.4 The Theory of Planned Behavior 239
    • Figure 8.5 Relationships Among Constructs in Theory of Planned Behavior 240
    • Figure 8.6 Logical Adequacy of the Prototype/Willingness Model of Health-Risk Behavior 244
    • Figure 9.1 The Health Belief Model 256
    • Figure 9.2 Logical Adequacy of the Health Belief Model 257
    • Figure 9.3 Health Belief Model for Children and Adolescents 259
    • Figure 9.4 Pender's Health-Promotion Model 261
    • Figure 9.5 Logical Adequacy of Pender's Health-Promotion Model 263
    • Figure 9.6 Path Model to Predict Physical Activity Among Taiwanese Adolescents 264
    • Figure 9.7 The PRECEDE-PROCEED Model for Health Promotion 268
    • Figure 9.8 Implementation Components of the Teen Activists for Community Change and Leadership Education Program 280
    • Figure 10.1 Self-Regulation Model of Decision Making 293
    • Figure 10.2 Logical Adequacy of the Self-Regulation Model of Decision Making 295
    • Figure 10.3 Schematic Representation of Stages of Intentional Behavior Change as Conceptualized in the Transtheoretical Model 298
    • Figure 10.4. Logical Adequacy of the Information-Motivation-Behavioral Skills Model 312
    • Figure 11.1. Making Sense of Smoking: An Example of Grounded Theory 324
    • Figure 11.2. A Grounded Theory of Taking Care of Oneself in a High-Risk Environment 326
    • Figure 11.3. Struggling to Understand: Parents' Discovery of Adolescents' Smoking Behavior 328
    • Figure 11.4 Transactional Partnering Process Between Adults and Youth in British Columbia 335

    List of Tables

    • Table 1.1 Top Ten Concerns of a Sample of Rural Adolescents 5
    • Table 1.2 Sexually Transmitted Diseases Prevalent Among Adolescents 10
    • Table 2.1 Relationship Between Theory and Research 46
    • Table 2.2 Relationship Between Theory and Practice 47
    • Table 2.3 Steps in Using Theory to Plan a Health Promotion Intervention 49
    • Table 3.1 Stages in Kohlberg's Theory of Moral Reasoning 61
    • Table 3.2 Bloom's Taxonomy of Learning 62
    • Table 3.3 Gagné's Eight Events of Learning Critical Thinking 63
    • Table 3.4 Fowler's Stages of Faith Development 69
    • Table 3.5 Definitions in Bronfenbrenner's Theory of the Ecology of Human Development 77
    • Table 3.6 The Search Institute's List of 40 Developmental Assets 86
    • Table 4.1 Erikson's Stages of Psychosocial Development 109
    • Table 7.1 Protective Factors Within the Family That Promote Resilience 208
    • Table 7.2 Taussig's Working Model of Risk and Protective Factors in Maltreated Youth in Foster Care 215
    • Table 9.1 Developing Health Behavior Programs: Ten Steps 274
    • Table 10.1 Characteristics of Self-Regulated Decision Makers 294
    • Table 10.2 Strong and Weak Principles of Progress in the Transtheoretical Model 304
    • Table 11.1 Sequence and Characteristics of Focus Group Questions 321
    • Table 11.2 Hauser's Content Themes of Resilient Outcomes 332

    Foreword

    How refreshing to find a single volume that not only tells us where we've been, but clearly illuminates the critical pathways we must travel for the foreseeable future of interdisciplinary adolescent health research. A generation of insights has led us to some inescapable truths: No one discipline has a monopoly on the theories, methods, and skills needed to adequately describe and understand the health, behaviors, and social contexts of youth. Breadth of perspective is a necessary ingredient for scholars and practitioners alike who are engaged in the science and skills of adolescent health. And our learners, more diverse than ever before, are in need of accessible yet sophisticated material that grounds them in a field characterized by rapidly expanding boundaries and a dazzling array of theory and methods to guide and propel their research.

    It would have been so much easier to write a book like this one 20 years ago—but even then, it would have been a daunting task. Instead, Dr. Lynn Rew, with the insights of a clinician and the imagination of an adolescent health researcher unfettered by disciplinary parochialism, has provided us with a thoughtful and comprehensive work that will, at once, accomplish two things: It will guide and inspire learners at multiple levels, and it will provide well-organized and richly articulated material for the teachers of that interdisciplinary audience.

    In this last generation, we have nurtured a group of adolescent health investigators who often lack formal schooling in relevant theory and the skills and logic of theory testing. For many, that lack of formal preparation is offset to a large extent by a substantial dose of practical wisdom arising from clinical and programmatic interactions with young people. However, the transition to scholarly sensitivities requires deliberate instruction that is often lacking among those who have not grown up through the mechanisms of classic academic research training. This volume does an extraordinary job of helping such learners understand theory as a guide to and framer of their understanding. Rew also thoroughly grounds the reader in contemporary threats to the health of young people, the principles of adolescent development, and the organized response to those health threats as reflected in national objectives to improve the health of young people.

    Through a well-orchestrated and thoughtful progression, this book provides us with the theories to frame our questions and the language to give those questions real substance and application. This work helps us to reach across the divides of discipline-specific thinking and methods and leaves us enriched, ultimately, and better able to collaborate with each other. Our field, and the needs of young people, deserve no less.

    Michael D.Resnick Ph.D. Professor and Director of Research, Division of General Pediatrics and Adolescent Health, Director, Healthy Youth Development, Prevention Research Center, University of Minnesota

    Acknowledgments

    I am grateful to many professional colleagues, friends, and family members for their support while I was writing this book. Dr. Lorraine Walker, professor in the School of Nursing at The University of Texas at Austin, is not only the author of the theory construction book on which most of Chapter 2 of this book is based, but provided encouragement and review as I began to put my ideas into words. She is a wonderful role model and friend. Dr. Kay Avant also reviewed chapter 2 and provided helpful comments. Dr. Sharon Horner is another colleague who consistently provided “reality checks” for me, and I appreciate her thoughtful critique and support throughout this writing process.

    Not only did I receive critiques and support from my peers, I also received these gifts from my doctoral student, Jane Kass-Wolff, and three of my research assistants, Dann Coakwell, Kate Jackson, and Lou Riesch. They all completed their work in such a way that I was freed up many afternoons to go home and write. I had also learned that Dann Coakwell had great computer skills in drawing figures, so I hired him to work on the weekends, drawing some of the original figures that are in this text. Then there is Margaret Hill, Assistant Dean for Administration at the School of Nursing: I learned that she was also interested in my writing project and was willing to be employed part-time on weekends to proofread the first drafts of chapters. Her eagle eye and gracious support were a great help.

    A book like this does not happen without significant guidance and wisdom from the publisher. I must take this opportunity to thank Dan Ruth at Sage for his assistance in introducing me to Jim Brace-Thompson and Karen Ehrmann. I had worked with Dan for about 6 years as editor of the Journal of Holistic Nursing when I told him about my idea for this book. He immediately put me in contact with Jim, and the ensuing association with these folks has been wonderful.

    None of this would have happened without the mentorship of Michael Resnick from the University of Minnesota and my husband, dick (yes, he prefers the lower case spelling of his name—something left over from late adolescence, being a math major in college, and differential equations). These two men have nurtured me in phenomenal ways, each providing just the right balance between challenge and opportunity. They believed in my vision, my creativity, and my ability to produce.

    Finally, I especially want to acknowledge a family friend, John Langford, who provided a sincere and thoughtful blessing when the book was completed.

    All of these individuals placed their fingerprints on early drafts of this book, but, more important, each made an indelible print on my heart. We rarely take the opportunities we have to thank the important people in our lives. So my last words of thanks must go to my parents, Charles and Clara Cannon. I am thankful that they did not abandon me when I went through my adolescence and that, at 88 years of age, my mom still has the patience to listen to me and to care about my work.

    Introduction

    The 1995–1996 academic year was a defining time period in my professional development. Metaphorically speaking, you could say it was the adolescent phase of my professional development. With funding for a Faculty Research Award from The University of Texas at Austin and a senior fellowship award (1 F33 NR07126–01) from the National Institute of Nursing Research, National Institutes of Health, I participated in a multidisciplinary postdoctoral program at the University of Minnesota School of Medicine. Working with internationally known and caring mentors such as Robert W. Blum, Michael D. Resnick, Lyn H. Bearinger, and Cheryl Perry, I was able to redirect my identity as a researcher and focus my research program on adolescent health-risk behaviors. Not only did I improve and increase my research skills, I also began to connect with an incredible network of researchers, educators, and practitioners in this fascinating field. Through this network I have fielded many questions about the existence of a comprehensive textbook of theories about adolescent health and health-risk behaviors suitable for graduate students in various disciplines. At last, I decided to submit a prospectus to Sage Publications, Inc., for such a book. Their reviewers really liked the idea; thus I've done my best to turn that dream into a reality.

    Writing a book for readers from a variety of disciplines has been a great challenge. The size limitations of the book meant that I had to make critical choices in determining which theories to include and which to leave out. Also, although I am clearly not an expert on all the theoretical perspectives and models that are found in this text, I hope I have given enough details to motivate students and their mentors to think more broadly and deeply about the science of adolescent health.

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    Author Index

    About the Author

    Lynn Rew is the Denton and Louise Cooley and Family Centennial Professor in Nursing at The University of Texas at Austin. Born and raised in rural Iowa, she earned her Bachelor of Science degree in nursing from the University of Hawaii, Honolulu; her master's degree in community health nursing and her Ed.D. in counselor education were earned at Northern Illinois University, DeKalb. In 1996, she completed a postdoctoral fellowship in adolescent health at the University of Minnesota School of Medicine, where Michael D. Resnick, Ph.D., served as her supervising mentor. At The University of Texas at Austin School of Nursing, she serves as Graduate Advisor and is Director of the Southwest Partnership Center for Health Disparities Research. She is currently Principal Investigator on two R01 studies funded by the National Institutes of Health that focus on adolescent health-risk behaviors. She also serves as editor of the Journal of Holistic Nursing.


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