Health-risk behaviors in teens investigated by u.s. child welfare agencies

Amy Heneghan, Ruth E.K. Stein, Michael S. Hurlburt, Jinjin Zhang, Jennifer Rolls-Reutz, Bonnie D. Kerker, John Landsverk, Sarah Mc Cue Horwitz

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Purpose The aim of this study was to examine prevalence and correlates of health-risk behaviors in 12- to 17.5-year-olds investigated by child welfare and compare risk-taking over time and with a national school-based sample. Methods Data from the National Survey of Child and Adolescent Well-Being (NSCAW II) were analyzed to examine substance use, sexual activity, conduct behaviors, and suicidality. In a weighted sample of 815 adolescents aged 12-17.5 years, prevalence and correlates for each health-risk behavior were calculated using bivariate analyses. Comparisons to data from NSCAW I and the Youth Risk Behavior Survey were made for each health-risk behavior. Results Overall, 65.6% of teens reported at least one health-risk behavior with significantly more teens in the 15- to 17.5-year age group reporting such behaviors (81.2% vs. 54.4%; p ≤.001). Almost 75% of teens with a prior out-of-home placement and 77% of teens with child behavior checklist scores ≥64 reported at least one health-risk behavior. The prevalence of smoking was lower than in NSCAW I (10.5% vs. 23.2%; p ≤.05) as was that of sexual activity (18.0% vs. 28.8%; p ≤.05). Prevalence of health-risk behaviors was lower among older teens in the NSCAW II sample (n = 358) compared with those of the 2011 Youth Risk Behavior Surveillance System high school-based sample with the exception of suicidality, which was approximately 1.5 times higher (11.3% [95% confidence interval, 6.5-19.0] vs. 7.8% [95% confidence interval, 7.1-8.5]). Conclusions Health-risk behaviors in this population of vulnerable teens are highly prevalent. Early efforts for screening and interventions should be part of routine child welfare services monitoring.

Original languageEnglish (US)
Pages (from-to)508-514
Number of pages7
JournalJournal of Adolescent Health
Issue number5
StatePublished - May 1 2015


  • Adolescent
  • Adolescent
  • Child and
  • Child welfare
  • Child welfare investigation
  • Foster care
  • Health-risk behavior
  • National
  • Social risk
  • Survey of
  • Teens
  • Well-Being

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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