Center for Adolescent Health Blog

Dr. Renee M. Johnson has been appointed Vice Chair of Diversity, Equity, Incusion (DEI) for the JHSPH Mental Health Department.

"In her new role, Renee will lead our department’s diversity, equity and inclusion activities, including chairing our department committee for diversity, equity, and inclusion (which is yet to be officially named, but may follow the school’s IDARE initiative label (Inclusion, Diversity, Anti-Racism, and Equity)). In addition, she will serve on the School’s IDARE committee to help implement unified school-level strategies, joined by diversity leaders from other departments of the School. Importantly, in her role as a Vice Chair, she will help us hold the department accountable to IDARE principles in all activities and decision making," the Mental Health Department Chair Dr. Margaret Daniele Fallin said in announcing the appointment.

Dr. Johnson is the Training Core Lead in the Center for Adolescent Health, as well as working in the Center for Mental Health and Addiction Policy Research, the Johns Hopkins Center for Injury Research and Policy and the Bloomberg American Health Initiative.

Terri Powell, a faculty associate of the Center for Adolescent Health, partners with community organizations, churches, and schools to improve adolescent health. In recent years, she noticed that parental substance use disorder kept coming up in conversations with young people.

This led Powell to look up articles and ask colleagues about substance use prevention for youth whose parents had a substance use disorder (SUD). She wondered, "What's being done with the kids who are also in families where there are parents who are abusing drugs?" While research on substance use prevention has grown in recent years due to the opioid crisis, she felt like the children whose parents have a SUD were left out of the conversation.

More than six million youth in America live with at least one parent with a SUD. In Baltimore, which has nearly 19,000 heroin users annually, familial drug use is not uncommon. Many parents with SUDs cannot adequately care for their children because of incarceration, homelessness or housing instability, extended periods of drug use and disengagement from responsibilities, or enrollment in an intensive drug treatment program. As a result, their children experience neglect, family conflict and violence, leading to higher risks for emotional and behavioral problems. These youth are also at high risk for a range of negative outcomes later in life, including substance use, interruptions in educational attainment, incarceration and disconnection from the workforce (see references at end of post). “There seemed to be a gap in what was available for kids to directly affect their wellbeing and help them. So I [decided], ‘Okay, I want to create something.’”

Powell received a career development award from the National Institute on Drug Abuse (Grant #: 1K01DA042134-01A1) in 2017 to develop new expertise in substance use among urban African-American families, and partner with churches to prevent substance use and sexual health risk behaviors among urban African-American adolescents with a drug-abusing parent. Powell named this project, Better Together because she believes that there is strength in collaborations and we are all better together. Her research teams consists of one research assistant (Morgan Prioleau) and two graduate students (Asari Offiong and Quiana Lewis).

The goal of this research is to prevent drug abuse among youth and help provide useful resources and services. Prioleau, the team’s research assistant, added that the team wants to offer support to vulnerable adolescents that promotes their health and well-being in a sustainable way.

During its first phase, Powell and her team are interviewing young people (ages 18-25) in Baltimore who have been affected by drug abuse and adults (25 and older) who work with or care for a young person who has been affected by drug abuse. In the second and third phases of the project, Powell and her team planned to revise an evidence-based intervention to benefit adolescents with a drug-abusing parent and test the efficacy of the redesigned intervention with Black churches. However, Powell’s aims have shifted due to what participants have discussed during their interviews. “We’ve found that both parents who use drugs and their kids are saying, ‘I have a lot of basic needs that are not met,’” she said. Powell believes these basic needs like food access, housing security and safety must be addressed first before working on the adaption of the evidence-based intervention.

“I believe if we're able to create a sense of safety and stability now, then we will effectively change the trajectory. As we are helping young people meet basic needs, we can also still educate them about their susceptibility,” she explained. As the team finishes Phase 1, they are brainstorming how they can make their resource hub come to life.

“It could be an actual place. It could be an app. It could be a person to coordinate the things that already are there. Maybe we don't need a something new, maybe we just need to figure out a good way to disseminate it to young people who need it,” said Powell. As the project moves along, the study team will identify how to track health and educational outcomes as well as well-being in the young people who use the Better Together services.

The interviews have caused Powell to reflect on her career as a researcher. Nearly 15 years ago, Powell wrote in her graduate school application essay that she wanted to normalize success. “Over time, [the focus of her research] has looked different. Now it's the same for young people who have substance abusing parents. I want more kids to feel well adjusted and supported than those who don't,” she said.

We do too and are excited to see what the Better Together team develops. Stay tuned!

For more information or to participate, please call or text the team at the Better Together Project (410-925-7573). You can also send them an email (projectbetter2gether@gmail.com). They’d love to hear from you!

References

Skinner ML, Fleming CB, Haggerty KP, Catalano RF. Sex risk behavior among adolescent and young adult children of opiate addicts: Outcomes from the focus on families prevention trial and an examination of childhood and concurrent predictors of sex risk behavior. Prevention Science. 2014;15(S1):70-77.

Ross SL, McBride BJ. Baltimore mayor’s heroin treatment & prevention task force report. July 2015.

Grant BF. Estimates of US children exposed to alcohol abuse and dependence in the family. Am J Public Health. 2000;90(1):112-115.

Barnard M. Between a rock and a hard place: The role of relatives in protecting children from the effects of parental drug problems. Child & Family Social Work. 2003;8(4):291-299.

Klee H. Drug-using parents: Analysing the stereotypes. International Journal of Drug Policy. 1998;9(6):437-448.

Barnard M, McKeganey N. The impact of parental problem drug use on children: What is the problem and what can be done to help? Addiction. 2004;99(5):552-559.

Ronel N, Levy-Cahana M. Growing-up with a substance-dependent parent: Development of subjective risk and protective factors. Subst Use Misuse. 2011;46(5):608-619.

Velleman R, Templeton LJ. Impact of parents’ substance misuse on children: An update. BJPsych Advances. 2016;22(2):108-117.

Adamson J, Templeton L. Silent voices: Supporting children and young people affected by parental alcohol misuse. 2012.

Suchman NE, McMahon TJ, Zhang H, Mayes LC, Luthar S. Substance-abusing mothers and disruptions in child custody: An attachment perspective. J Subst Abuse Treat. 2006;30(3):197-204.

Silverman K, Schonberg SK. Adolescent children of drug-abusing parents. Adolesc Med. 2001;12(3):485-491.

Kang S-, Magura S, Shapiro JL. Correlates of cocaine/crack use among inner-city incarcerated adolescents. Am J Drug Alcohol Abuse. 1994;20(4):413-429.

Nan Astone, a former Johns Hopkins School of Public Health professor and Center for Adolescent Health researcher, passed away June 15. Nan was dedicated to improving the lives of young people in Baltimore and the world. She was a cherished mentor, teacher, colleague, wife, mother, friend, Girl Scout leader and Sunday school teacher.

Nan was passionate about designing programs to benefit adolescents experiencing homelessness and housing instability. “Some of the solutions that are proposed to serve homeless people who are older might not fit. Homeless young people are quite invisible,” she explained in a video interview. Through surveys, Nan sought to learn more about the day-to-day experiences of youth experiencing homelessness so interventions could be developed to better suit their actual needs.

Nan earned a PhD in sociology from the University of Chicago in 1988. Following a post-doctoral fellowship at University of Wisconsin, she joined the Department of Population, Family and Reproductive Health at the Bloomberg School. Nan was a PFRH faculty member for 24 years. She later worked at The Urban Institute’s Center for Labor, Human Services and Population as a Senior Fellow.

As a researcher, Nan’s skills were unique in that she designed both surveys of small community based groups and large nationally representative samples.  

Nan published over 75 manuscripts in a variety of journals on a range of subjects including: the transition to adulthood, school dropout, and family demography. An expert in demographic and statistical methods used for longitudinal data analysis, Nan received the W.T. Grant Faculty Scholars Award in 1991. For several years, Nan was the deputy editor of the Population Association of America’s official journal, Demography.

“I do what I do so that all young people make the transition to adulthood as full of hope and confidence in the future as I did,” she said.  

Nan is survived by her husband, Nick Burbank; her children, Daniel and Katie Burbank; and her father, Buck Astone. The family asks that in lieu of flowers, donations be made to Youth Empowered Society and Girl Scouts of America.