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Center for Adolescent Health

Center for Adolescent Health Blog

teachers at the fall LST training

LifeSkills Training is a substance abuse prevention program proven effective by over 30 research studies. The curriculum was created by Dr. Gilbert Botvin, a health behavior and prevention expert. Teachers follow the LST curriculum to provide teens the skills and knowledge needed on to handle changing situations.

The Johns Hopkins Center for Adolescent Health (CAH) is taking big strides to build on the efforts of the already effective LifeSkills Training program by expanding the middle school curriculum to include new modules on sexual risk reduction. The Center began implementing LST and the new modules (LST+) at six Baltimore City public schools in 2014.

“We thought a good way to reach an awful lot of young people in the city would be to work in Baltimore City Schools. One way you can do that is by finding or creating evidence-based programs that fit within a normal school day, while meeting the state and city standards for health education,” said Meghan, the Center for Adolescent Health’s senior research program coordinator.

CAH was awarded funding from the Centers for Disease Control and Prevention for 2014-2019 to implement LST as its core research project. This project was designed to build on City Schools’ and Behavioral Health Systems Baltimore’s Sixth-Grade Expanded School Behavioral Health Initiative, which targets sixth graders at risk of dropping out. The initiative supports implementation of LST in small groups of sixth graders at 35 Baltimore City schools. However, CAH’s strategy focuses on universal implementation. In the project’s third year, all students in 6th-8th grades at the five schools participate in LST and at 3 of the schools, students participate in additional modules focused on sexual and reproductive health.

The additional modules on sexual and reproductive health students receive in 7th and 8th grade follow the same pedagogy and decision making model that is the core of LST. Meghan said what often happens is that there are several health programs, each on a specific risk behavior like smoking or alcohol misuse, in one school. “So young people may be learning three different ways to say ‘no’ to something rather than learning one technique and framework to apply [in] a lot of different health situations,” she said.

LST and the Center’s new modules (LST+) equip young people with skills on how to handle difficult situations related to drugs, alcohol, smoking, violence, and sexual activity. “The school administration itself decides whether it's going to be taught and how, like during the PE class or some schools do it as a part of their science curriculum,” said Courtney, a research assistant at CAH.

Asari trained new teachers who will implement the modified curriculum earlier in the fall. Asari, now a doctoral student at Johns Hopkins Bloomberg School of Public Health, previously implemented LST in schools and community centers in New York City as a Children’s Aid Society prevention specialist. While working for Children’s Aid Society, Asari attended the LifeSkills Training-of-Trainers workshop through National Health Promotion Associates, a research and development firm founded by Botvin.

As an evidence-based program, LST was meant to be taught exactly how the curriculum was written. When taught with fidelity, it has positive results for young people. “We don't really know what happens if a lot of changes start happening. We don’t know if it would be more effective or if it would actually detrimental to young people so the safest bet is to implement as closely as we can to how it was tested,” Meghan said.

To ensure LST is implemented with fidelity, teachers complete fidelity logs after each lesson to track how much material they covered, changes they made and why. Teachers are also observed at least once by CAH staff.

“As our funding cycle winds down, we'll be thinking more about sustainability and being able to continue with the schools,” Meghan said. By the end of the research project, CAH hopes to provide information about feasibility, implementation quality, and feedback from teachers and administrators to staff at other schools who are considering implementing the program. “Part of the way it's set up right now is to look for just feasibility of implementing LifeSkills at a universal level and feasibility and acceptance of the new modules. So the next steps will be to look more into impact,” she said.


youth in discussion

The Youth Leadership and Advisory Network (YLAN) started in 2014 with a call to action from Dr. Philip Leaf, the director of the Johns Hopkins Center for Adolescent Health, to impact a wider net of young people in Baltimore City.

For 22 years prior to YLAN, the Center for Adolescent Health had a Youth Advisory Committee that met weekly—teaching youth about research practices, protocols, and how data is translated into youth programs and services.

CAH’s community relations director Katrina Brooks explained, “Over that period of time, we were able to impact their lives personally because [members] had another level of support beyond family and community. They had folks that could help them with personal goal setting, resources, and supports for academics, and referrals to services needed to improve their health and wellness.”

The Center was unable to offer that level of support to every adolescent in Baltimore City, but staff realized they could bring together youth and youth-serving organizations and provide professional development, technical support, and access to funding resources.

And so, the Youth Leadership and Advisory Network was born.

YLAN was designed to connect youth leaders throughout Baltimore City and help leverage resources to empower their voice in the decision-making processes that impact their wellbeing. There are more than 45 organizations affiliated with YLAN. The Network also collaborates with the Mayor’s Youth Commission, which is a body of youth that represents Baltimore’s 14 city council districts.

YLAN gives youth leaders the opportunity to discuss complex issues and brainstorm solutions in their own way, said Rashad Staton, a program assistant at Family League of Baltimore.

Representatives from youth-serving organizations and agencies send representatives, largely youth themselves, to share updates and connect.  The general meetings give a time for members to learn about initiatives and programming all over the city. Brooks serves as an administrator and adult ally to the youth representatives of YLAN.

“It allows a space of young people to learn early to not fall victim to working in silos, but to work collaboratively. It's a shared space of young people learning what other young people are doing,” Staton said. By attending YLAN general meetings, young people can understand what resources are out there and make partnerships with other organizations.

The members of YLAN build from the general meetings to collaboration between the councils or organizations they work for. “You can start seeing these conversations actually start and are ignited in these meetings. The next thing you know, they’re on a panel or they're doing a collaborative event together,” Staton said.

In the upcoming months, YLAN members are collaborating with Rebkha Atnafou, executive director of The After-School Institute, and the Baltimore City Health Department to plan the annual Youth Sexual Health and Leadership Conference, which will be held at UA House on Saturday, December 2. The conference will feature workshops, seminars, and discussions about sexual health, but with an emphasis on holistic wellness and physical activity. Students will have the option of attending a Zumba class, play basketball, or chill out in a trap yoga class in between going to workshops.

“Our partners at UChoose from the Baltimore City Health Department will be leading the sexual health focus at the resource fair and workshops that they provide around healthy relationships and healthy sexual activity,” Brooks said. Following the daytime programming, the conference will end with an evening concert.

“I think this conference will be a model of how it should be done. When you're engaging youth about an issue that can be very, very, very hard to even break through with, but [the conference] allows them to speak up for themselves and give them a voice and platform,” Staton said.

Although she prefers to work behind the scenes, Brooks’ hard work does not go unnoticed. She was recently honored with a Guiding Light Award for her efforts by Empowering Minds of Maryland’s Youth, a nonprofit that establishes youth outreach programs. 

By: Lauren Burns



The Johns Hopkins Center for Adolescent Health and Open Society Institute partnered with YouthWorks to fund the 5-week Summer Youth Leadership Institute for Baltimore City Public School students. Eighty students participated in the program across five BCPS high schools served as host sites: Academy for College and Career Exploration (ACCE), Achievement Academy, Forest Park High School, Frederick Douglass High School, and Patterson High School. Through the Summer Youth Leadership Institute students examined school climate data, held community conversations about school climate, and participated in enrichment workshops.

Following the Institute, a rising senior at ACCE, Jasmine Carter, is empowered to speak out. “What really stuck out to me the most is [learning] about our voice.” Aram Boykins, high school program manager for the Baltimore Debate League, shared valuable advice to the students. “He told us we have a voice, use it. ... So if you want something done you have to use your voice,” Carter explained.  Carter continued, “I want to make a big difference because it’s my last year. I’m going to use my voice as much as I can to improve our school. I’m going to think about what I learned in the program. It’s going to motivate me to do better in school and focus on what I got to do outside of school as well,” Carter, along with each of the groups, will present their findings and recommendations to their school’s principal and School-Family Council as well as the City Schools’ CEO during the 2017-18 school year.

The summer wasn’t all school climate for the students.  They also attended workshops on financial literacy, public speaking, and workforce readiness skills. ACCE student Deondrae Witherspoon liked the variety of the program. “We learned about banking, how to be a leader, how to be professional, and how to speak up for yourself,” he said. Partners from across Baltimore City provided enrichment programs, for the students such as spoken word, music, intensive mentoring, dance and mindfulness.

Katrina Brooks, CAH’s community relations director said, “It gave them the opportunity to test out their public speaking, so they felt confident through spoken word, music, and theatre. They were able to use their voice and practice in a safe space amongst their peers.” Enrichment partners included Baltimore-based organizations such as DewMore Baltimore, New Vision Youth Services, Equal Medium Mentorship Program, and Holistic Life Foundation. Brooks said, “Because the enrichment was focused on areas young people like or had some experience with, it was a good draw to the program. It was a great networking opportunity for schools and students that they could benefit from beyond the summer.”

The Johns Hopkins Center for Adolescent Health thanks its partners in helping to make the Summer Institute a success and looks forward to empowering students in future sessions.

Written by: Lauren Burns


Thirteen Reasons Why is a fictional Netflix series. The show is about a girl who over the course of several years got bullied and raped, which led to her declining mental health. In the series, she leaves tapes for 13 people to describe their role in her decision to end her life. The show was the first exposure to the topic of mental health for some people. However, it is important to acknowledge some key differences between the series and what some people may experience in real life mental health.

                First off, Thirteen Reasons Why was written to be an over dramatized story. What does this mean? Well, it means that the creators were trying to draw watchers into the story. Of course, the truth can be warped to fit within the story and it be used as a cautionary tale, BUT, it might be worthwhile for people to follow up watching this show by doing research on mental health or talking to someone who works in the mental health profession. Doing this will ensure that we are not creating inaccurate stereotypes of folks who may be experiencing trauma in their lives.

                Second, there are many more options to addressing distressful and traumatic experiences than suicide. In 2014, only 13 people out of every 100,000 people committed suicide. However, there are roughly 18.5% of adults in the US experience some form of mental illness, and many of them are able to live with their illness. Most of them use therapy, medications or other healthy ways to deal with mental illness. The take away point is that people respond differently to mental health challenges and deal with them in different ways.

                Thirdly, suicide is never the survivors fault. The main character in the series blames other people for her committing suicide. Suicide is no one’s fault. Suicide is the result of a person feeling they have no other options. In some ways, the series romanticized suicide through the tapes that she left for others to hear. Suicide is not beautiful, it is upsetting and sad.

There are many things that you can do in life to help yourself or other people who might be having a hard time:

Be there for them as much as you can.

  • Sometimes people feel they are fighting their battles alone. This is often not the case. Simply and constantly showing them they you are here for them can only help.

Listen, and don’t judge.

  • It’s okay if you don’t directly understand what they are going through. Letting them talk to you about how they are feeling can be very cathartic for some people. That’s why you’ll need to be careful how you react to what they tell you, because it is often hard to tell people about this in the first place.

If you believe that they are going to hurt themselves, never wait for them to actually do it.

  • I know that you might want to stay on that person’s good side. This is not the time to think of yourself. If they give signs that they might be self-harming or seriously thinking about suicide, contact an adult or the authorities. They might be angry at you afterwards for stopping them, but connecting them to someone who can help is critical. It has to be more important to you that they are alive and safe rather than them liking you.

If you feel like you can’t handle the information they are giving you, it is OK to take a step back.

  • You can to help without sacrificing your own mental health for them. Both of you should have a person (e.g., a therapist, teacher, parent, other adult figure) to talk to.

When in doubt, take the advice that you are given on a plane in case of an emergency: apply your own mask before helping someone else. So it’s okay to take care of yourself before trying to help others. Stay safe and stay connected.

For more resources, please visit:

By: Ellen Nikirk

Ellen Nikirk attends Garrison Forest High School. As a participant in the Women in Science and Engineering (WISE) Program, she is working with and learning from researchers at the Johns Hopkins Center for Adolescent Health.

teen sleep

Did you know that if you go over 19 hours without sleeping, you have the mental and physical faculties of a person who is legally drunk? Sleep is a very important part of ordinary human life. Sleep helps our brains and bodies to recuperate, and gives us energy for the next day. It affects our learning ability, memory, mood and attention span. It can also affect our reaction time, which means that a sleepy person behind the wheel of a car is just as dangerous as a drunk driver. The majority of people do not have a problem falling asleep, especially young children and older adults. However, the age group that has the hardest time getting sleep is teenagers.

People my age (teens between 13 and 18) are supposed to get roughly eight to ten hours of sleep a night. That’s too bad considering that over 80% of teens get 7 hours or less of sleep each night. Our internal clock might be one reason we miss out on our recommended amount of sleep. A person’s internal clock is how our bodies tell time. Everyone has one, but for teenagers, our internal clocks are wonky, which means that it can make it harder to fall asleep or wake up early. But there’s not much we can do about that now other than live with it.

Here’s the thing…most teenagers have other factors that impact how much and how well they sleep. One biggie is stress. Studies show that between the ages of 14 and 20, life is largely more stressful than any other age of human lives. Maybe because it comes from EVERYWHERE, like school, family dynamics, friends (or frenemies) and even our own hormones sometimes working against us. It can be hard to change or avoid things that can cause us stress. Luckily, I have found some tips for dealing with school and other stress inducing things that affect our sleep negatively.

  1. Prioritize: Give yourself specific times for any type of work, whether it be homework, a job, or chores. Also try to consolidate work time into large chunks.
  2. Be Realistic: Don’t try to take on more work than you know you can. Try focusing on few things so that you can excel in them, instead of being mediocre at a multitude of things. With this in mind, you can eliminate unnecessary activities.
  3. Balance out Stress: Do activities that help to relieve stress, like reading, writing, exercising, talking with friends. Not everyone is the same, so find the healthy thing that works for you and do that to reduce the stress you may be feeling.
  4. Keep a Sleep Schedule (no matter how silly it sounds): Make sure that you consistently get up at the same time every day, even on weekends. It’s ok to sleep in for a little while more when you can, but no more than an hour can mess up an already messed up internal clock.

The most helpful thing that a teen can try doing is getting an extra 60 minutes of sleep each night. This is because an extra hour can help: your mood, your grades, your memory, and your physical health.

By: Ellen Nikirk

Ellen Nikirk attends Garrison Forest High School. As a participant in the Women in Science and Engineering (WISE) Program, she is working with and learning from researchers at the Johns Hopkins Center for Adolescent Health