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154. Correlates of Stress Among Youth in Correctional Facilities
Poster Abstracts / 48 (2011) S18 –S120
Sources of Support: Telstra Foundation Community Grant and the Shepherd Foundation grant. 153. RESOURCES TO SUPPORT PSYCHOSOCIAL ASSESSMENTS WITH YOUNG PEOPLE Fiona Robards, BSc, MA, MAATh, MHA, MPH2, Carmen Jarrett, BA (hons), MPsychol, MPH, PhD2, David Bennett, MD, FRACP, FSAHM1. 1 Department of Adolescent Medicine 2NSW Center for the Advancement of Adolescent Health Purpose: General Practitioners (GPs) are the Australian medical healthcare providers from whom young people are most likely to seek help. Approximately a fifth of Australian young people aged 12 to 24 years experience serious health issues, some of which can be life threatening. Many of the causes of harm or death for young people, such as drug and alcohol misuse, road accidents and suicide, are psychosocial in nature and potentially preventable. However, GPs do not routinely screen young people for psychosocial risk, and young people are reluctant to access primary health care. Research into young people’s access to health care in New South Wales has identified key barriers to young people accessing health care, and key issues, including professional development and evidence-based practice, in developing quality health services. NSW CAAH has developed both a clinical resource kit, Adolescent Health GP Resource Kit and, building on this a training toolkit Youth Friendly General Practice: Essential skills in youth health care to increase GP skills and confidence in working with young people and to encourage practice staff to make youth friendly organizational changes. Both resources aim to increase the “youth friendliness” of GPs and promote their assessment of psychosocial risk and protective factors of young people. Methods: To assist in the development of the training toolkit, four focus groups were conducted with GPs. Heterogeneity sampling was used to ensure the representation of diverse experiences and views and groups were purposefully selected to include both urban and rural, those who actively support and promote youth health programs, and those who did not. Informed by a conceptual framework for the implementation of programs and practices, the themes explored with GPs in relation to their work with young people included: factors that help and hinder effective service provision; training received to date; and additional training required to bolster their knowledge and skill-base. Results: Analysis of the focus group interviews yielded three themes: the context in which GPs work with young people; how GPs see young people and their work with them; and GPs’ expressed training preferences. GPs described working with young people as difficult, suggesting that the self-efficacy of GPs may need to be addressed in training. GPs also described systemic barriers to working with young people that can be addressed through training, advocacy and policy development. While addressing the developmental and contextual factors that influence youth health, the clinical resource kit includes practical information about the skills needed to support young people and their families. It contains information
S97
pertaining to youth-friendly consultation; appropriate ways to address sexual health, mental health and substance use; confidentiality and privacy; collaborative care; and other important skills for youth friendly care. The training toolkit supports the teaching of doctors the skills embodied in the clinical resource kit. It includes conducting a youth friendly consultation, acquiring cultural competence, understanding medicolegal issues, and management of key youth health problems. Conclusions: This paper presents a practical approach to enhancing doctors’ capacity to engage, assess, and support young people through the creation of evidence-based resources. Sources of Support: None. 154. CORRELATES OF STRESS AMONG YOUTH IN CORRECTIONAL FACILITIES Chinwe Umez, MD, Iris Borowsky, MD, PhD, Marla Eisenberg, ScD, MS. University of Minnesota Purpose: To describe characteristics associated with stress level among youth in correctional facilities. Methods: This study utilized data from the 2007 Minnesota Student Survey. Detained youth in Minnesota (n ⫽ 587), aged 13-18 years, reported their perceived level of stress in the last 30 days. Multivariate analyses examined the association between stress level and various characteristics, guided by the social-ecological framework. Analyses were stratified by gender. Results: Response rate was 93% (n ⫽ 545). Overall, 61% of detained youth perceived high stress and 39% low stress. More females than males reported high stress (73% vs. 58%, p ⬍ .005). For females (n ⫽ 100), factors significantly associated with low stress included higher emotional well-being, no history of drug abuse treatment, and no history of a physical exam within the last two years. Compared to males who endorsed high stress, males who reported low stress levels were significantly more likely to be younger (OR 0.8, CI 0.6-0.9), have higher emotional well-being (OR 1.6, CI 1.4-1.7), be of minority race/ethnicity (OR 2.4, CI 1.1-5.3), have no absent father (OR 0.5, CI 0.2-0.8), have a chronic physical condition (OR 2.5, CI 1.1-6), and no history of mental health treatment (OR 0.4, CI 0.2-0.8). Conclusions: Most detained youth reported high levels of stress, especially females, however, a significant minority perceived low stress. Differences in characteristics of detained youth who endorse high and low stress underscore the importance of physical/emotional health screening in juvenile correctional facilities. Sources of Support: This work was supported by a grant from the Health Resources and Services Administration (HRSA), Bureau of Health Professions. 155. SCREENING AND REFERRAL FOR MENTAL HEALTH CONCERNS IN EMPLOYMENT TRAINING PROGRAMS FOR LOW-INCOME ADOLESCENTS AND YOUNG ADULTS Darius Tandon, PhD. Johns Hopkins University
Sources of Support: Telstra Foundation Community Grant and the Shepherd Foundation grant. 153. RESOURCES TO SUPPORT PSYCHOSOCIAL ASSESSMENTS WITH YOUNG PEOPLE Fiona Robards, BSc, MA, MAATh, MHA, MPH2, Carmen Jarrett, BA (hons), MPsychol, MPH, PhD2, David Bennett, MD, FRACP, FSAHM1. 1 Department of Adolescent Medicine 2NSW Center for the Advancement of Adolescent Health Purpose: General Practitioners (GPs) are the Australian medical healthcare providers from whom young people are most likely to seek help. Approximately a fifth of Australian young people aged 12 to 24 years experience serious health issues, some of which can be life threatening. Many of the causes of harm or death for young people, such as drug and alcohol misuse, road accidents and suicide, are psychosocial in nature and potentially preventable. However, GPs do not routinely screen young people for psychosocial risk, and young people are reluctant to access primary health care. Research into young people’s access to health care in New South Wales has identified key barriers to young people accessing health care, and key issues, including professional development and evidence-based practice, in developing quality health services. NSW CAAH has developed both a clinical resource kit, Adolescent Health GP Resource Kit and, building on this a training toolkit Youth Friendly General Practice: Essential skills in youth health care to increase GP skills and confidence in working with young people and to encourage practice staff to make youth friendly organizational changes. Both resources aim to increase the “youth friendliness” of GPs and promote their assessment of psychosocial risk and protective factors of young people. Methods: To assist in the development of the training toolkit, four focus groups were conducted with GPs. Heterogeneity sampling was used to ensure the representation of diverse experiences and views and groups were purposefully selected to include both urban and rural, those who actively support and promote youth health programs, and those who did not. Informed by a conceptual framework for the implementation of programs and practices, the themes explored with GPs in relation to their work with young people included: factors that help and hinder effective service provision; training received to date; and additional training required to bolster their knowledge and skill-base. Results: Analysis of the focus group interviews yielded three themes: the context in which GPs work with young people; how GPs see young people and their work with them; and GPs’ expressed training preferences. GPs described working with young people as difficult, suggesting that the self-efficacy of GPs may need to be addressed in training. GPs also described systemic barriers to working with young people that can be addressed through training, advocacy and policy development. While addressing the developmental and contextual factors that influence youth health, the clinical resource kit includes practical information about the skills needed to support young people and their families. It contains information
S97
pertaining to youth-friendly consultation; appropriate ways to address sexual health, mental health and substance use; confidentiality and privacy; collaborative care; and other important skills for youth friendly care. The training toolkit supports the teaching of doctors the skills embodied in the clinical resource kit. It includes conducting a youth friendly consultation, acquiring cultural competence, understanding medicolegal issues, and management of key youth health problems. Conclusions: This paper presents a practical approach to enhancing doctors’ capacity to engage, assess, and support young people through the creation of evidence-based resources. Sources of Support: None. 154. CORRELATES OF STRESS AMONG YOUTH IN CORRECTIONAL FACILITIES Chinwe Umez, MD, Iris Borowsky, MD, PhD, Marla Eisenberg, ScD, MS. University of Minnesota Purpose: To describe characteristics associated with stress level among youth in correctional facilities. Methods: This study utilized data from the 2007 Minnesota Student Survey. Detained youth in Minnesota (n ⫽ 587), aged 13-18 years, reported their perceived level of stress in the last 30 days. Multivariate analyses examined the association between stress level and various characteristics, guided by the social-ecological framework. Analyses were stratified by gender. Results: Response rate was 93% (n ⫽ 545). Overall, 61% of detained youth perceived high stress and 39% low stress. More females than males reported high stress (73% vs. 58%, p ⬍ .005). For females (n ⫽ 100), factors significantly associated with low stress included higher emotional well-being, no history of drug abuse treatment, and no history of a physical exam within the last two years. Compared to males who endorsed high stress, males who reported low stress levels were significantly more likely to be younger (OR 0.8, CI 0.6-0.9), have higher emotional well-being (OR 1.6, CI 1.4-1.7), be of minority race/ethnicity (OR 2.4, CI 1.1-5.3), have no absent father (OR 0.5, CI 0.2-0.8), have a chronic physical condition (OR 2.5, CI 1.1-6), and no history of mental health treatment (OR 0.4, CI 0.2-0.8). Conclusions: Most detained youth reported high levels of stress, especially females, however, a significant minority perceived low stress. Differences in characteristics of detained youth who endorse high and low stress underscore the importance of physical/emotional health screening in juvenile correctional facilities. Sources of Support: This work was supported by a grant from the Health Resources and Services Administration (HRSA), Bureau of Health Professions. 155. SCREENING AND REFERRAL FOR MENTAL HEALTH CONCERNS IN EMPLOYMENT TRAINING PROGRAMS FOR LOW-INCOME ADOLESCENTS AND YOUNG ADULTS Darius Tandon, PhD. Johns Hopkins University