Youth Violence, Novice Drivers, Obesity and Sexual Behavior

This week’s In the News tackles some risky business, from youth violence, to novice drivers, and the relationship between obesity in adolescence and sexual behavior. Read on to find out how researchers are exploring new approaches to these complex issues.

Treating Youth Violence as a Health Crisis

A feature story by Philadelphia magazine highlighted the physician researchers involved with The Children’s Hospital of Philadelphia’s Violence Prevention Initiative who are taking a novel approach to addressing youth violence as a public health crisis. Joel Fein, MD, MPH, and Stephen Leff, PhD, co-directors of the initiative, along with Ruth Abaya, MD, MPH, an attending physician in the department of Emergency Medicine at CHOP, described how they have developed an intensive, individualized Violence Intervention Program (VIP) to help at-risk juveniles who come into the emergency room to be treated for violent injuries.

After a comprehensive assessment, VIP specialists meet with these youth at the hospital and their homes once a week for six months to a year and teach them conflict resolution strategies to help them navigate dangerous situations. So far, 75 patients and their families have participated in the program, and the next step is the measure outcomes for these children.

“A lot of these kids don’t see themselves as having a future much past adolescence because they’re living in an environment where they see things happening all the time, and it’s traumatizing them to a point where they’re not necessarily seeing their future,” Dr. Fein said in the interview. “But we know they do have a future, and we want to make sure that future is a kind of healthy, happy one just like anyone else would want.”

Learn more about CHOP’s Violence Prevention Initiative.

Estimating Compliance With Graduated Driver Licensing Programs

New teen drivers need to gain valuable driving experience behind the wheel in low-risk situations, which is why Graduated Driver Licensing (GDL) programs that include limitations on passengers and nighttime driving are in place. But do novice drivers comply with these restrictions?

In a new study published in Traffic Injury Prevention, Allison Curry, PhD, MPH, a senior scientist and director of Epidemiology and Biostatistics for the Center for Injury Research and Prevention (CIRP) at CHOP, demonstrated that a traffic safety research method called the quasi-induced exposure technique could help to find the answer. She estimated that 8.4 percent of 17- to 20-year-old intermediate drivers’ trips were not in compliance with New Jersey’s GDL passenger restriction.

Dr. Curry suggested that this method could help to determine the extent of non-compliance among young novice drivers and how it differs by gender, age, licensing age, sociodemographic groups, and driving environments. Performing such in-depth analysis eventually could lead to better ways to target interventions designed to increase compliance, she explained in a new CIRP blog post.

“Although it can be challenging for researchers to access identifiable traffic safety data given legislative and administrative barriers and then to utilize it due to the data’s complex administrative nature, it is well worth the effort,” Dr. Curry wrote. “We need more rigorous epidemiologic methods to advance teen driver safety, and I look forward to streamlining this novel approach.”

Obesity and Sexual Behavior

The Huffington Post reported on a congressional exhibition where Aletha Akers, MD, MPH, medical director of Adolescent Gynecology Consultative Services in the division of Adolescent Medicine at CHOP, presented her research on why obese adolescents are more likely to engage in risky sexual behavior even though they are less likely than other adolescents to date. The end goal of her research is to develop intervention strategies that would have public health benefits, such as for example, decreasing the number of pregnancies before the age of 13.

Previous work by Dr. Akers, published in Pediatrics in 2009, showed girls who perceive themselves to be overweight may be less likely to negotiate condom use and more likely to initiate sex early. Moreover, the relationship between obesity and sexual behaviors varied significantly by race.

Dr. Akers, who also is a faculty member at PolicyLab, was one of several researchers from across the country who came to defend their research that had come under fire from some members of Congress who questioned its premise as wasteful. Read more about the importance of her research here.

ICYMI

In case you missed it, this week on Cornerstone we brought you a Q&A with Christopher Forrest, MD, PhD, newly appointed chair of the research committee for the national patient-centered clinical research network called PCORnet.

“PCORnet’s goal is to transform the clinical research infrastructure to make research faster, cheaper, and better,” Dr. Forrest said.

Also, new research by Claire O’Leary, PhD, a postdoctoral fellow at CHOP, describes for the first time how a molecular braking system works to keep T cells from instigating hyperactivity of the immune system.

“We think of these proteins as being negative regulators of inappropriate activation,” Dr. O’Leary said. “In the absence of these proteins, the cells are accelerating immune reactions without a lot of guidance.”

Last week’s “In the News” summary discussed a step toward a drug therapy to treat a condition that turns the body’s soft tissues into bone, genetic superheroes who may not even know about their resilience, and reminder tools embedded in electronic health records that pediatricians can use to help their patients’ parents quit smoking.

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