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Center for Adolescent Health

Center Projects

Implementation of Integrated Health Interventions for Students in Baltimore

Given multiple health risk behaviors displayed by some Baltimore youth, there is a need for broad-based interventions that target multiple risk and protective factors. LifeSkills Training (LST) is a skills-based cognitive behavioral prevention intervention for students in grades 6-8.  After reviewing the multiple problem behaviors of Baltimore’s adolescents and the research on LST, Baltimore City Public Schools, the local Health Department, and the behavioral health organizations decided to expand the delivery of LST in City Schools, but to also add modules specifically focusing on sexual risks. Specifically, eight additional sexual health modules have been developed to supplement the 7th and 8th grade delivery of LST (hereafter referred to as LST+). The goal of this study is to assess the feasibility of implementing integrated health interventions (i.e. LST and LST+) for middle school students in Baltimore, MD. There are two specific aims:

  1. Conduct a pilot test of the newly developed sexual health modules that will supplement the original LST
  2. Implement and assess the implementation quality of LST and LST+
    1. Determine the extent to which LST and LST+ are implemented with fidelity
    2. Identify the factors that promote or inhibit implementation
    3. Examine the acceptability of LST and LST+ among school personnel

Research Assistant Needed to:

Center Contact:
Terri Powell: terri.powell@jhu.edu

Process Evaluation of Grads2Careers (Baltimore's Promise)

Baltimore’s Promise Career Pathways Demonstration Model (Grads2Careers) is a new program that aims to connect recent high school graduates to careers by providing career readiness training, occupational training, and wraparound supports. Through this demonstration model, the project is expecting to not only reduce the proportion of youth who are disconnected, but also to improve the high unemployment rate among Baltimore youth and increase wages for those who have graduated in Baltimore City. At a systemic level, Grads2Careers seeks to establish a pathway for high school graduates to well-paying jobs in high-growth employment sectors in Baltimore City and the nearby region. To understand how Grads2Careers is implemented across different occupational sites, researchers from the Center for Adolescent are conducting a three-year, mixed methods process evaluation to measure feasibility, acceptability, fidelity, systems change and institutional alignment, as well as overall sustainability and scalability.

Center researchers: Kristin Mmari: kmmari1@jhu.edu, Beth Marshall: bmarsha2@jhu.edu

Research assistant needed for future work:

Teen Pregnancy Prevention Initiative (TPPI) Evaluation

The Center is working with the Baltimore City Health Department to evaluate the City’s Teen Pregnancy Prevention Initiative (TPPI). TPPI is a component of B’More for Healthy Babies and works to reduce teen births by improving young people’s access to age-appropriate and evidence-based health education, medically appropriate clinical services, and opportunities to engage their communities and grow as civic leaders. TPPI activities include the Know What You Want campaign, the Youth Advisory Council (YAC), and a multi-agency effort to increase access to Long Acting Reversible Contraceptives (LARCs). The Center has long served as a member of the TPPI coalition and is now evaluating TPPI’s activities as well as the coalition functioning.

Research Assistant Needed to:

Center Contact:
Beth Marshall: bmarsha2@jhu.edu

UChoose Teen Pregnancy Prevention Program

Baltimore City’s UChoose Coalition, led by the Baltimore City Health Department (BCHD), intends to decrease the overall teen birth rate of 43.3 per 1,000 teen girls by 30 percent by the end of the five-year project through reductions in disparities among African American and Hispanic teens, and to ensure sustainable delivery of evidence-based teen pregnancy prevention (TPP) programs in Baltimore City. Through this project, BCHD in partnership with the Baltimore City Schools and a network of seven Title X clinics, plans to reach 15,890 adolescents aged 12-19 each year with evidence-based TPP programs implemented in middle schools, high schools, and Title X clinics in Baltimore City. UChoose will implement It’s Your Game in middle schools, Making Proud Choices in high schools and Seventeen Days in the clinics. The Center is conducting the implementation evaluation of all project activities.

Research Assistant Needed to:

Center Contact: Beth Marshall: bmarsha2@jhu.edu

Rales Center for the Integration of Health and Education

The Ruth and Norman Rales Center for the Integration of Health and Education is redesigning school-based health programs to improve the health and thus the academic achievements and lifelong prospects for youth from low-income communities. The first fully integrated school-based health model in the United States, called “READY” (Rales Educational and Health Advancement of Youth) breaks down historical silos between educational and health-related activities. Weaving comprehensive health services and wellness programming into the school environment helps children thrive and achieve academic success.  READY offers a fundamentally new way of viewing primary care, wherein health (including mental health and oral health) services, wellness programming and prevention, and health education are delivered in the school setting, in partnership with teachers, administrators and parents.

More information is available at The Rales Center website.

Research Assistant Needed to:

Center Contact: Beth Marshall: bmarsha2@jhu.edu

Health and Wellbeing of Baltimore's Youth

The Baltimore City Health Department and a coalition of City and State agencies, youth-led networks, academic institutions, and community members are collaborating together to develop and evaluate the implementation and outcomes of Baltimore City’s Youth Health and Wellness (YHW) strategy, baltimoreyouthhealthandwellness.com. This is a five-year plan with the goal of ensuring that all young people in Baltimore ages 6-19 have equal opportunities to connect with the people and services they need to be healthy and successful. The Initiative has three different but related foci: Healthy Minds, Healthy Bodies and Healthy Connections, all important to health and each one affecting the other. Center researchers are in the process of developing a number of reports concerning trends in health and wellbeing, geographic and other variations in Baltimore, and the outcomes or lack of outcomes from current and future initiatives.

Center Contact: Philip Leaf: pleaf@jhu.edu; Beth Marshall: bmarsha2@jhu.edu

Updating the Strategic Plan to Reduce Teen Births in Baltimore City

In 2009 the Baltimore City Health Department, Healthy Teen Network, Johns Hopkins Urban Health Institute and the Center for Adolescent Health partnered to develop a strategic plan to reduce the high teen birth rate within Baltimore City. The efforts can be categorized as part of the Teen Pregnancy Prevention Initiative (TPPI). The plan’s three recommendations were to (1) to increase access to evidence‐based sexuality education and confidential contraceptive services for all young people in Baltimore City through partnerships between the Baltimore City Public Schools and Health Department; (2) increase youth outreach and connection, especially among certain high risk sub‐populations of Baltimore youth who face greater risk for teen births, STI and HIV, and who may not be reached by school‐based approaches or social marketing campaigns; and (3) create a citywide coalition to manage this comprehensive plan, collect data, and advocate at the city and state levels. The goal of the current research is to assess progress on the three recommendations and identify next steps for prevention.

Research Assistant Needed to:

Center Contact: Terri Powell: terri.powell@jhu.edu

East Baltimore Trauma Response

Following the city’s uprising, Johns Hopkins President Ronald Daniels has asked Dr. Leaf to create the East Baltimore Community Trauma Response Program.  The goal of the East Baltimore Trauma Response is to improve the health and well-being of the local East Baltimore community especially youth by systematically addressing the traumas experienced. In partnership with local residents, community leaders, clergy, educators, and health and human service professionals, we will work towards this goal by promoting safer communities, breaking the cycle of violence, identifying and helping those that have pathological stress responses, fostering resilience, and building a trauma-informed culture for those who provide services to affected individuals so that our community and city can begin the process of healing.

To achieve these goals, we are in the process of creating a Trauma Response Team that will support the following activities:

  1. Training first responders (health professionals, police, and community) for incidents of violence involving children, youth, and families
  2. Developing trauma-informed community responses for mental health first aid, community supports, and clinical outreach
  3. Expanding trauma-informed clinical services and procedures at the Johns Hopkins Hospital Emergency Department, Trauma Surgery, and Psychiatry.
  4. Creating more trauma-informed institutions, including training of human resources personnel, supervisory staff, and others working with Baltimore’s children, youth, families, and those working with Baltimore’s children, youth, and families.

Center Contact: Philip Leaf:  pleaf@jhu.edu

Project POWER

This 5-year randomized controlled trial assesses the impact of a trauma-informed coping skills program (RAP Club) as compared with a health education program (Healthy Topics) on the emotional, behavioral, and academic functioning of 8th graders in Baltimore City Public Schools. Quantitative and qualitative data are being gathered from students, teachers, and academic records at multiple points across 8th grade, with follow up data collected in 9th grade. Programs are delivered by trained clinicians and other staff members and are co-facilitated by young adult community members; school personnel are trained to deliver programming so that schools can continue to implement the programs following the study. The programming targets 8th graders in order to promote a positive transition into high school.

Research Assistant needed to:

Center Contact: Tamar Mendelson: tmendel1@jhu.edu; Kristin Mmari: kmmari1@jhu.edu

Effects of Mindfulness on Stress Physiology in High School Students

This study will evaluate the impact of a 40-session mindfulness program on heart rate variability, an index of stress response, in ninth grade students in Baltimore City Public Schools. Mindfulness interventions hold promise for enhancing the body’s capacity to respond effectively to stress and may be particularly helpful for promoting stress management in chronically-stressed populations, such as youth in low-income urban communities. We currently lack adequate data on how mindfulness impacts key aspects of physiological stress responses in youth. Study findings will provide valuable information about the effects of mindfulness on youth physiology and which youth may benefit most from mindfulness practices. Findings have potential to help improve the way mindfulness interventions are delivered and which youth are targeted so as to produce maximum benefits.

Center Contact: Tamar Mendelson: tmendel1@jhu.edu

Better Together

Better Together is a multiphase research project designed to prevent injury and early substance use among Black youth affected by parental drug abuse. We are partnering with youth affected by parental drug abuse and community organizations to develop and test an intervention to improve health outcomes for youth ages 10-13 who are affected by parental drug abuse. Learn more on their website

Center Contact: Terri Powell: terri.powell@jhu.edu

Mayor’s Call to Action and Mayor’s Office of African American Male Engagement (MOAAME)

Shortly after becoming Mayor in 2017, Mayor Catherine Pugh established the Call to Action.  The Call to Action is an effort to identify and support community-based activities aimed at promoting the development of Baltimore’s children, youth, and families and to reduce violence, especially in those neighborhoods with high levels of violence.  The Mayor meets twice a month with community-based organizations to support efforts of community-based organizations and individuals and to facilitate coordination among these organizations and agencies.  Earlier this year, Mayor Pugh established the Mayor’s Office of African American Male Engagement to reduce violence and support positive opportunities for the group in Baltimore most likely to be the victim or perpetrator of a homicide.  These individuals have not had access or have encountered impediments in accessing services and programs that do exist in Baltimore’s communities.  Likewise, those providing services to these individuals have encountered difficulties in accessing resources and disseminating information about their programs.  The Center has been supporting both efforts and is continuing to work on their expansions.

Center Contact:

Philip Leaf: pleaf@jhu.edu

theCONNECT/BALTIMORE CITY OPPORTUNITY YOUTH COLLABORATIVE

The mission of theCONNECT is to create integrated, sustainable pathways for youth ages 16-25 leading to post-secondary education, employment, and entrepreneurship opportunities with family sustaining-wages. The vision of this initiative is for all youth who are disconnected from school or employment to have access to the resources and supports needed to maximize their potential and be provided opportunities for sustainable employment. TheCONNECT is a broad-based, collective impact collaborative including youth and key leaders from the government, education, business, community, and not-for-profit sectors. Through the development of an integrated network of stakeholders, linked through site-based Pathway and System Navigators, and supported through technological innovations, the network will bridge the silos and mend the gaps in services and supports for these youth. Dr. Leaf and the Center served as the co-backbone during the first three years of theCONNECT’s existence and Center faculty and staff continue to participate in activities related to theCONNECT. 

Center Contact: Philip Leaf:  pleaf@jhu.edu

Promoting Student Resilience (PSR)

In collaboration with the Baltimore City Public Schools, Baltimore City Health Department, and the University of Maryland, Baltimore City has created the Promoting Student Resiliency Initiative aimed at prevention of traumas experienced in schools and providing supports for students, staff, and other working with students who have been impacted by trauma.  Activities for this Initiative has been funded by the U.S. Department of Education, the Center for Adolescent Health, and other sources.  Dr. Leaf serves as the Co-Chair of the School System’s Promoting Student Resilience School System Workgroup and for the City-Wide Steering Committee. 

Activities include:

  1. Creating a system-wide strategy for dealing with the extensive trauma experienced by Baltimore City school students, school staff, and others working with City school children.
  2. Training social workers, school psychologists, counsellors, and other mental health professionals working in City Schools to be more trauma informed and trauma responsive.
  3. Help integrate training efforts of school-based mental health service providers and those providing trauma trainings related to school students.
  4. Provide training for school system leadership and staff concerning the recognition of trauma, understanding the impact of trauma on students and staff, and activities that can reduce trauma and the impact of trauma.
  5. Create a city-wide discussion concerning how trauma of students can be eliminated and how efforts to deal with the impact of the trauma of students improved.

Center Contact:

Philip Leaf:  pleaf@jhu.edu

CAH Data Sets

If you are interested in working with CAH data, please fill out the CAH Data Request Form.