Skip Navigation

Center for Adolescent Health

Center for Adolescent Health Blog

Date: May 2020

As evidence continues to strongly suggest practicing yoga has both physical and mental health benefits for adults it is increasingly used in school settings with adolescents and children.

But does it benefit kids?

A new “Systematic Review of Randomized Controlled Trials Testing the Effects of Yoga with Youth” in the journal Mindfulness suggests there are benefits, but these types of RCTs need more standardization and rigor to produce more definitive results.

“Despite most studies reporting positive program effects, the fact that very few studies assessed the same outcomes reduces the extent to which we can be confident about program impacts on any given outcome,” the authors – Shari Miller, Tamar Mendelson, Angela Lee-Winn, Natalie l. Dyer and Sat Bir S. Khalsa – write.

The authors offer six recommendations researchers should consider when developing RCTs on yoga with youth in order to expand the evidence base:

· Include clearly articulated logic models in their publications that specify intervention core components, outcomes, and mechanisms of intervention effects;

· Larger sample sizes that are designed and powered to test hypothesized mediating mechanisms and moderators of intervention effects;

· Rigorously monitor and report fidelity, including adherence and quality of program delivery as well as program dosage and participant responsiveness;

· Research is needed on the effectiveness of yoga with clinical populations;

· Use well-validated common metrics and measures to assess targeted outcomes and hypothesized mediators so as to facilitate comparison across studies; and

· Studies with no positive effects or negative effects should be reported.

“This review contributes to the literature in important ways, and results provide evidence for the beneficial impact of yoga on a range of youth outcomes,” the authors write.

For more on this systematic review contact lead author Shari Miller

by Jada Johnson

Ed. Note: WIth a deeply reflective look at her life, Jada Johnson offers the first in our Baltimore Youth COVID Diaries, a series of works to document the effects of COVID-19 on Baltimore's young people in their own voices.

Since Corona has come amongst us my biggest fear has been being completely behind and possibly at risk of failing myself, school and others around me because of serious procrastination throughout the years. 

Feeling like I’m behind on everything has been a heavy burden on me and my pockets because it has stopped me from reaching my full potential and lowered my chances of getting the job of my dreams that eventually leads me to the land where financial troubles no longer exist. 

I also tend to self-sabotage. This created a lot of doubt and skepticism in me because I became conditioned to always believe I would never be good enough. To this day I struggle just a little bit. 

Recently there have been many opportunities coming my way which has heightened my level of belief in myself and lowered my tendency to self-sabotage. Overall it’s allowed me to focus on other problems I face within myself. 

With all of the chaos I created within myself, I began to have low self-esteem. I saw everybody else around me succeeding and exceeding expectations, while I wasn’t even walking the speed limit of some of my younger peers. 

It weighed heavily on my mental health. My low self-esteem kept me from seeing my true beauty. I would not post pictures of myself, join in other peoples pictures, or allow people to post pictures of me on social media because I thought that I was not as pretty as my peers. 

Keeping myself in such a tight closet kept me from going outside and enjoying time with my friends, attending events and even participating in any high school memories. 

To this day I regret allowing my self-esteem to hinder me. I’m not saying that it doesn’t still shadow over me, it just isn’t a burden now. 

Procrastination became my strategy for high school. After trying and failing Freshman Year, instead of revamping my plan of attack, I got scared and ran to hide. 

Sometimes as I walked the halls of Western High School I felt like an imposter. I felt like I didn’t belong because the first year was such a struggle. 

As  Sophomore Year approached I tried to learn how to be an effective high school student. Then my grandmother passed away and I decided Sophomore Year wasn't going to be one for the books. 

After a long summer of grief, I decided to go back my Junior Year and fake the happiness until it became true, but that didn't work either because of my home environment. 

Senior Year came and I was completely done taking loss after loss, so I decided to flunk most of my year.

Once January hit Western put me out and I was completely shattered. I transferred to a school that I thought was beneath me and reacted negatively by not going to school at all. 

Then Corona came and I just put my hands up and thought that I should surrender completely and be a failure. 

As time set in and Corona got worse I began to self reflect. I took this time to evaluate my friends and myself. I had recently become a part of Heart Smiles in January, but I wasn’t as serious about being successful so I didn’t really try to get any opportunities. Soon enough I had noticed that not taking HeartSmiles seriously was a bad idea. 

After joining HeartSmiles and attending Winning Wednesdays, which is led by a mother full of love, it helped me love myself a little more and move toward success. In Winning Wednesdays I started to focus on what I was good at instead of what I was not good at. 

That's when I came across journalism and writing. But not only did I see my full potential, people around me began to see it as well. One person who saw me was Ms.Joni, who has given me endless opportunities to show my true talent.

Honestly, even though all of these things happened to me before Corona, I feel like these things made my quarantine become a successful time of self-reflection and repair. I am actually quite thankful for Corona and all of the people who have assisted me in this time period. It has really helped open my eyes and see the clearer side of things. 

Even though I still struggle a little day by day with procrastination; having nothing but time on my hands has allowed me to turn what I saw as a  burden into a small worry. 


By Terrinieka Powell

Over two million youth in the United States are directly affected by parental opioid use, especially in the city with the highest overdose fatality rate in the country – Baltimore.

The JHSPH Center for Adolescent Health’s Better Together Project research study led by Dr. Terrinieka Powell, seeks to prevent early substance use and promote safety among youth affected by parental drug use.

The following video from the project allows families and providers to tell the story of the opioid epidemic in Baltimore in their own voices.


This work remains important as the negative effects of parental drug use on youth are significant and have been well documented. Youth affected by parental drug use who are at risk for suffering physical or emotional harm as a result of their caregiver’s substance use, possession, manufacturing, cultivation or distribution.

Parents engaged in unhealthy substance use are often unable to provide developmentally-appropriate monitoring and are also unlikely to make needed changes to the home to prevent injuries. Parental drug use could also lead to a host of unintentional injuries, such as falls, poisoning, cuts/scrapes; children may be also exposed to medications, lighters and other equipment that can cause injury. As a result, children who are exposed to parental drug use are at greater risk for maltreatment and neglect.

Learn more about the Better Together Project here.

Ed. Note: This study was published before the COVID-19 Pandemic, which has made food insecurity worse in Baltimore and across the country.

Baltimore youth are well aware that they lack reliable access to food, and that the stigma and embarrassment associated with food insecurity often leads teens to engage in risky and dangerous behaviors just to eat.

They also have solutions, according to a new qualitative study from researchers at the Johns Hopkins Bloomberg School of Public Health.

The 53 young people from six disadvantaged neighborhoods across the city who participated in the study – half of whom qualified as food insecure – told researchers that they, or peers they know, resort to prostitution, drug dealing and theft to ensure they have food.

These adolescents were clear that the stigma of food insecurity and the embarrassment of participating in food programs keep them from relying on social safety nets.

“I think mostly people are embarrassed if they don’t have a lot of food they don’t talk or don’t even try, like don’t even go to these little donations because they are embarrassed, they don’t expect people to understand, they expect people to judge them and all that,” said one young woman who participated in the study.

Many of the teens (ages 14 to 19) who participated pointed out that the food options they do have access to, primarily fast food outlets and convenience stores, are low quality and unhealthy. They compare food served at their local schools with “jail food,” and describe it as nearly inedible. Some have even observed that major grocery stores sell low quality foods at outlets in their neighborhoods as compared to the same outlets in more well-off suburbs.

“I will say like they also have like a Target up on Mondawmin and like that . . . I’ll say that even the products that they got at the Target they weren’t like Target quality, like if you go out on Towson like they had better fruit selection, better food selection in general and I just didn’t think that is so fair,” one study participant said. [Ed. Note: Since this study concluded the Mondawmin Target in West Baltimore has closed.]

In addition to agreeing that healthier, better quality food needs to be available, participating youth suggest that food assistance programs should include other services young people need – such as job training and employment programs that go beyond traditional “summer jobs” programs.

“That can help me like throughout the rest of my life. Not just something that just going to benefit me just for this time period in my life. That is going to help me get another job,” another study participant said.

Participants suggested to researchers that including food assistance as part of a broader suite of services youth need can go a long way toward avoiding the stigma and embarrassment of participating in these programs, making it more likely that food insecure young people will take part.

With an estimated 6.8 million young people ages 10- to 17-years-old in the United States facing food insecurity, the study’s researchers conclude that not only should food insecurity among adolescents be a high priority for researchers, but youth voices are essential to developing successful strategies and solutions.

The authors – Kristin Mmari, Asari Offiong, Susan Gross and Tamar Mendelson – note that while food insecurity has been widely studied among younger children, there is limited knowledge on this issue in relation to adolescents. The results of this study support the findings of a larger, earlier qualitative national study by the Urban Institute and Feeding America.

“In both our study and the Urban Institute/Feeding America study, young people stressed that food insecurity needed to be addressed more broadly, with several youths mentioning the need to combine services with job training,” the authors said.

Study participants came from disadvantaged neighborhoods in Baltimore that border food deserts, including Violetville; Morrell Park; Cecil Kirk (Greenmount East); Oliver (Midway); Coppin Heights/Eastwood (Greater Rosemont); and Forest Park (Park Heights).

The study, “How adolescents cope with food insecurity in Baltimore City: an exploratory study,” was published May 2019 in the journal Public Health Nutrition.

For more information on this research and related work contact Dr. Kristin Mmari at

Stuck at home due to the statewide stay-at-home order, Lamar found a silver lining in the COVID-19 pandemic as he tuned in daily to the HeartSmiles Success Sessions.

The HeartSmiles Success Sessions offer Baltimore youth structured online programming from 10 a.m. to 3 p.m., Monday through Friday, that includes mentoring, academic tutoring and guest speakers.

“One of the biggest challenges that I faced was myself and staying consistent, I could never feel motivated enough to do anything compared to what I’m doing right now,” Lamar said.

These daily sessions are an adaptation and extension of the work HeartSmiles and its founder Joni Holifield were previously doing with Baltimore’s young people in partnership with the Johns Hopkins Bloomberg School of Public Health (JHSPH) Center for Adolescent Health (CAH).


Prior to the JHSPH putting in place restrictions due to the pandemic, HeartSmiles hosted 30 to 50 youth in person for Winning Wednesdays and Thriving Thursdays at CAH, as well as hosting a half hour online session through Instagram on Friday afternoons.

As JHSPH and Baltimore City Public Schools closures took affect and the stay-at-home order was put in place, Holifield and her staff knew they needed to quickly fill the voids being left in the lives of local teens.

“Lots of kids were expressing their need to remain connected and we knew we had to do something and that it had to be more,” Holifield said. “Before we could even miss a day of programming we were up and running online.”

The Success Sessions started on Instagram Live in mid-March, but with 100 plus youth tuning in, the platform quickly became overloaded by the demand. Without missing a beat, the HeartSmiles team switched to using a combination of YouTube and Zoom – a technological match that has served them well.

Center for Adolescent Health Director Tamar Mendelson has been awed by the speed with which the HeartSmiles team was able to get the Success Sessions going and the depth of the programming – which brings the youth back day after day.

Mendelson notes that while schools are giving students packets to complete, the Success Sessions offer five hours of free programming five days a week.

“Youth are able to ask questions and interact with presenters so that the content is relevant to them and they have voice in the process,” Mendelson said. “This gives young people a place to tune in and can help structure their time while schools are closed. HeartSmiles also provides information about local resources, including food sites and other supports, which is helpful for youth who may not be well connected with other sources that describe these resources.”

The sense of support and having input into the process, Lamar said, is what he finds inspiring about the Success Sessions.

“It gives me the support I need to feel like I can’t give up,” Lamar said. “Everyone in HeartSmiles is a family and as family we are destined to push each other and ensure that we are all great as a whole. Having this allows me to feel like I can take risk without being afraid that it won’t work.”

Lamar, Holifield and Mendelson have all been impressed by the guest speakers, who have ranged from Maryland Lt. Gov. Boyd Rutherford and the Blomberg School of Public Health’s Dr. Josh Sharfstein to domestic violence and sexual assault advocate William Kellibrew and Hip-Hop pioneer Doug E. Fresh.

Holifield asks that any “caring adult” sign up for a hour guest speaker spot.

Given her experiences during COVID-19, Holifield believes young people will want and need some version of the Success Sessions to continue once the city begins its return to normal.

“We’re not sure if we’re going to post pre-recorded sessions or find a way to continue a live version, but either way Success Sessions are here to stay and we’ll figure out the consistency once we get past the current need,” Holifield said.