“The music gets through”: Experiences of classical composers and observations of hospitalized adolescents in a music-based intervention

Music is a valuable aid for hospitalized adolescents as they navigate normative and non-normative stressors. Music-based interventions link these adolescents with composers who write music designed to facilitate emotional well-being; yet little is known about how each engage and find meaning in these interventions. This study examines the motivations and musical choices of composers of music for mental health, as well as how hospitalized adolescents engage in and benefit from the creative process. Ten adolescents with extensive hospital experiences, six composers, two hospital staff, and one program coordinator were observed and/or interviewed in a music-based intervention. Interpretative phenomenological analysis (IPA) of interviews with composers, coordinators, and hospital staff was performed to gain deep understanding of psychosocial benefits for all groups. This was supplemented by ethnographic observation of the program. Qualitative themes of Composer Reasoning, Listener Influence, and Adolescent Engagement revealed interplay of challenges and rewards for composers and adolescents. Composers reported positive change in adolescent mood and engagement and reflected on this within the context of meaning-making and social connection. This study demonstrates the potential value of music as a tool to promote positive identity and contributes to the body of research forging a connection between the arts and health care.

Neighborhood-Level Influences and Adolescent Health Risk Behaviors in Rural and Urban Sub-Saharan Africa: A Systematic Review

The impact of neighborhoods on adolescent engagement in health-risk behaviors (HRBs), such as substance use and sexual activity, has been well documented in high-income countries; however, evidence from low and middle-income country settings is limited, particularly in sub-Saharan African (SSA) countries. Neighborhoods and communities in SSA continue to experience urbanization, epidemiologic transition, and the simultaneous presence of large populations living in rurality and urbanicity. This is a dynamic context for exploring adolescent health challenges. This review seeks to identify and summarize existing literature that investigates adolescent engagement in HRBs when compared across rural and urban neighborhoods across SSA. We performed searches using three electronic databases, targeted grey literature searches and scanned reference lists of included studies. Following dual-screening, our search yielded relevant 23 studies that met all inclusion criteria. These were categorized into six broad themes including studies on: (1) sexual risk taking, (2) injury-related, (3) violence, (4) eating and/or exercise-related, (5) substance use, and (6) personal hygiene. We found that neighborhood factors relating to accessibility and availability of health information and care impacted adolescent engagement in HRBs in rural and urban areas. Urbanization of areas of SSA plays a role in differences in engagement in HRBs between rural and urban dwelling adolescents.

Agency and Empowerment for Adolescent Girls: An Intentional Approach to Policy and Programming

As national governments roll out COVID response plans, an opportunity arises to re-cast adolescent girls’ programs to centrally anchor them on girls’ voices, leadership, ambitions, and assets in development policies and programs. Drawing together the evidence on what we know works for adolescent girls, as well as the growing literature on positive strengths-based programming which are gradually and increasingly being applied, this commentary calls for a girl-intentional approach to policy and programming. A girl-intentional approach is described through 3 case studies, which illustrate the additionality of new or improved adolescent knowledge, skills, and competencies; improved opportunities for adolescent engagement, voice, and agency; improved community safety and support; stronger, healthier relationships; and stronger and healthier norms, attitudes, values, and goals. The case studies describe program hooks that facilitate operationalization, point to measurable outcomes, and identify opportunities for scale, including the re-opening of schools. Overall, inter-sectoral solutions that address the myriad of issues affecting an adolescent girl’s life and tackle pervasive gender inequities require greater emphasis by development actors and national governments.

Development and Validation of the Secondary Transition Fidelity Assessment

In this study, we examined the structural validity of the Secondary Transition Fidelity Assessment (STFA), a measure of secondary schools’ use of programs and practices demonstrated by research to lead to meaningful college and career outcomes for all students, including students at-risk for or with disabilities, and students from diverse backgrounds. Drawing from evidence-based practices endorsed by the National Technical Assistance Center for Transition and the Council for Exceptional Children’s Division on Career Development and Transition, the instrument development and refinement process was iterative and involved collecting stakeholder feedback and pilot testing. Responses from a national sample of educators ( N = 1,515) were subject to an exploratory factor analysis resulting in five measurable factors: (a) Adolescent Engagement, (b) Inclusive and Tiered Instruction, (c) School-Family Collaboration, (d) District-Community Collaboration, and (e) Professional Capacity. The 5-factor model was subject to a confirmatory factor analysis which resulted in good model fit. Invariance testing on the basis of geographical region strengthened validity evidence and showed a high level of variability with regard to implementing evidence-based transition services. Findings highlight the need for consistent and regular use of a robust, self-assessment fidelity measure of transition service implementation to support all students’ transition to college and career.

Early Adolescent Predictors of Violent Behavior: Child and Contextual Risk, and Moderation by Rejecting Parenting

The current study explored early adolescent child-level predictors (physical aggression, impulsivity, empathy) and contextual-level predictors (peer deviance, neighborhood dangerousness) of violent and nonviolent antisocial behavior (AB) in late adolescence. Additionally, we tested the moderating role of rejecting parenting on these associations based on the importance of parent-child relationships in early adolescence and documented bidirectional associations between parenting and our predictor variables. Participants ( N = 272) came from the Pitt Mother and Child Project, a longitudinal study of high-risk boys. Higher levels of early adolescent physical aggression significantly predicted late adolescent engagement in both nonviolent and violent crimes. Peer deviance, impulsivity, and neighborhood dangerousness were also associated with later juvenile AB. Rejecting parenting moderated several of these associations. Results support the predictive validity of several early adolescent child- and contextual-level variables—particularly early adolescent aggression—for subsequent engagement in both violent and nonviolent AB.

Adolescent Engagement in a Binge-Eating Behavioral Health Intervention: Influence of Perceptions of Physical Appearance and Locus of Control

Traditional weight management approaches focused solely on weight loss as a measure of success may lead youth to internalize negative beliefs about their appearance, and feel they have little control over their health. We examined how perceptions of appearance and health-related locus of control (HRLOC) influenced engagement and outcomes in a behavioral health intervention for binge eating. Thirty adolescents aged 14–18 years completed measures of self-perception, HRLOC, and eating behaviors. Half (n = 15) completed baseline assessments only, while the other half participated in a 10-week intervention targeting dysregulated eating behaviors. Analyses revealed negative perceptions of physical appearance and internal HRLOC were higher at baseline among youth who completed the intervention compared to those who completed baseline assessments only. Among those completing the intervention, however, greater internal HRLOC and more positive perception of physical appearance at baseline was associated with greater reduction in objective binge episodes and emotional eating post-intervention. Findings of the present study suggest that while having a more negative perception of one’s appearance may initially motivate youth to participate in weight-related interventions, such perceptions can actually lead to poorer health outcomes, and further supports the extant literature on the benefits of interventions that engender positive body image.