Multilevel Modeling Approach to Adolescent Risk Perception in the Neighborhood Setting By: Lynn A. Agre, MPH Ph.D. Candidate, Rutgers University, School of Social Work American Public Health Association November, 2007

Ecological Model An ecosystem is defined as interacting environments–i.e. peers, family, relatives, school system, the community, and the social welfare/criminal system (Ginther, Haveman, and Wolfe, 2000.) The Bronfenbrenner ecological approach comprises the individual, family, and extra-familial level which includes peers, school and neighborhood (Small & Luster, 1994). In Bronfenbrenner’s seminal work The Ecology of Human Development (1979), six definitions explain the main premise of an ecosystem. Definition 1: “The ecology of human development involves the scientific study of the progressive, mutual accommodation between an active, growing human being and the changing properties of the immediate settings in which the developing person lives, as this process is affected by relations between these settings, and by the larger context in which the settings are embedded.”

Ecological Model Definitions Definition 2: “A microsystem is a patten of activities, roles, and interpersonal relations experienced by the developing person in a given setting with particular physical and material characteristics.” Definition 3: “A mesosystem comprises the interrelations among two or more settings in which the developing person actively participates” (such as, for a child, the relations among home, school and neighborhood peer group; for an adult, among family, work and social life). Definition 4: “An exosystem refers to one or more settings that do not involve the developing person as an active participant, but in which events occur that affect, or are affected by, what happens in the setting containing the developing person.” Definition 5: “The macrosystem refers to consistencies, in the form and content of lower-order systems (micro-, meso-, and exo-) that exist, or could exist at the level of the subculture as a whole, along with any belief systems or ideology underlying such consistencies.” Definition 6: “An ecological transition occurs whenever a person's position in the ecological environment is altered as a results of a change in role, setting or both.”

Bioecological Life Course Model in Adolescence The interaction, then, between the person and the environment–depending upon personality–dictates how different individuals respond to the environment or what would constitute a genetic-environmental exchange (Crocket and Crouter, 1995). These enduring forms of interaction are referred to as proximal processes. In examining an ecosystem – the micro, meso, exo and macro components -- Elder (1995) offers that we need to consider: process-person-context-time (PPCT). Bronfenbrenner’s Ecological Model reinforces the basic life course principals of historical context; timing of biological and social transitions in relation to culturally defined age, role expectations and opportunities available; cross-generational linked lives of all family members (Elder, 1995). Adolescence is not simply a transition between childhood and adulthood but is a portion of the a total life span trajectory.

Influence of Mother’s Educational Attainment on Risk Perception Social support can be included under the general rubric of social environmental factors as an essential component in buffering certain patterns of behavior and how these affect adolescent health risk decision making. Social support has been demonstrated to buffer catastrophic events and can be viewed as a necessary intervention tool in influencing behaviors detrimental to health. The process of social support is contingent upon the participation of another person in a reciprocal relationship where some benefit is exchanged between the person experiencing the illness episode or crisis and the other who is not. House (1981) defines four different types of social support: emotional, appraisal, informational and instrumental. Informational and appraisal support involve increased educational attainment, leading to better decision making.

Statistical Methods Univariate tests entailed running frequencies on the final model n of 875 study subjects of gender, race (white, black), age, 5 Census Regions in US. Bivariate relationships of adolescent sociodemographic variables, substance use, sexual behavior, risk perception, depression and psychosocial scales were examined with cross tabulations and correlations. Multivariate analyses applied are linear regression (enter method) and discriminant analysis on the composite dependent variable of age first had sex and number of sexual partners. 7 7

National Longitudinal Survey on Youth Young Adult Survey U.S. Sample

Study Subjects n = 875

Model I: Most Significant Effects on Sexual Behavior Composite: Age 1st Had Sex and No. of Sexual Partners LINEAR REGRESSION: Older Adolescent Age White Race Male Gender Lower Neighborhood Quality Age When 1st Smoked Cigarettes Lower Parenting Quality High Self-Rated Risk Perception Region not significant Adjusted R Square = .133 11

Model I Discriminant Analysis: Age When 1st Had Sex by Region South Atlantic West Pacific States Black Male Safer Neighborhood Female Higher Depression Higher Depression (Female) Lower Mastery Higher Mastery Lower Risk Perception Higher Maternal Educational Attainment

Conclusions Mother’s educational attainment is related to region of risk behaviors. Male adolescents are not necessarily more likely to engage in sexual behavior at an earlier age than females. Neighborhood quality does increase likelihood of a adolescent to engage in risk behaviors. Depressive symptoms (self-rated) and lower mastery scores are associated with tobacco use and risk perception (also self-rated Likert Scale).

Social Support Concepts as Applied to the Ecosystem of Bronfenbrenner Social support can be included under the general rubric of social environmental factors as an essential component in buffering certain patterns of behavior and how these affect adolescent social conduct. House (1981) defines four different types of social support: emotional, appraisal, informational and instrumental. Emotional support refers to emotional concern, love and empathy received from those in the domain. Appraisal support entails deriving information relevant to self-evaluation. Informational support pertains to seeking knowledge about the situation. Instrumental support involves help with daily activities. Different types of support are expected from different persons in different environments respectively—including the micro, meso and macrosystems.

Limitations In the NLSY, proxies for social support measures in the micro, meso and exo systems need to be viewed within the context of family, peer and school relationships. The social support measures within the microsystem or family context could be measured as the adolescent’s perception of relationship quality between the adolescent’s mother and father or mother and step-father. The influence of peers could serve as a social support proxy within the mesosytem. Social support in the school setting could be assessed as the quality of relationships between adolescent and school authorities as related to health risk behaviors. The macrosystem may be seen as the adolescent’s interaction with the social welfare and or criminal justice system through incarceration, measured as convictions of certain misdemeanors. 15

Future Research Applications Social support predictor i.e. mother’s educational attainment could be used in conjunction with other sociodemogrphic control variables to demonstrate its buffering effect on adolescent physical health risk outcomes behaviors, including sexual activity, drug/alcohol use, motor vehicle hazards, and suicide ideation. The relationship between depression and deleterious health behavior needs to be explored further. One explanation: perhaps the exhilaration experienced with risk behavior counteracts depressed mood, thus elevating adrenalin and releasing certain endorphins to create a “high,” elevated further by alcohol/drug use.