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Adolescent Health


Members of the Division have supported numerous research initiatives that have been developed and funded within the Division of Adolescent Health. Previous research focused on the On TRAC program, Transition from Pediatric to Adult Care.

In 2004 Professor Elilzabeth Saewyc was recruited to the University of British Columbia, the Child and Family Research institute and the Division of Adolescent Medicine. Professor Saewyc’s research focuses on health issues of youth, with a particular emphasis on understanding how certain groups of young people are targeted and stigmatized, how this influences their coping and risk behaviors, and what protective factors in their relationships and environments can help buffer this risk and influence their health. The vulnerable groups targeted by stigma include: sexual minority youth (gay, lesbian, bisexual and transgender teens), homeless and runaway youth, sexually-abused and sexually-exploited teens, pregnant and parenting adolescents, youth in custody, immigrant and refugee populations, and indigenous young people in Canada and other countries.  

The McCreary Centre Society is a small non-profit organization concerned with the health of young people in British Columbia. Since 1977 McCreary has conducted community-based research and projects addressing current youth health issues. Dr. Elizabeth Saewyc is the Research Director at the centre.  


Selected current projects

Enacted stigma, gender, and risk behaviours of school youth - Saewyc, EM 
(funded by the US National Institute on Drug Abuse) 
A multi-site international study exploring the ways young people are targeted and stigmatized in school settings, such as being excluded, teased, or being threatened with or experiencing actual physical violence—this is what is meant by “enacted stigma.” While our focus is primarily on stigma related to sexual orientation, we are also looking at stigma among youth with disabilities and chronic conditions, and obese teens. Further, we are looking at the link between being targeted for stigma and HIV risk behaviours and problem substance abuse, as well as identifying protective factors that appear to reduce the risk behaviours, even in the presence of being targeted for stigma. After the primary analyses, we will conduct focus groups with youth, and people who work with teens, to identify strategies to reduce enacted stigma and to promote healthier behaviours among stigmatized youth. As part of this international study, we will be conducting cross-national comparisons within three different ethnic groups, in three different countries: European-heritage youth, Asian-heritage youth, and indigenous youth, in Canada, the US, and New Zealand.

Stigma And Resilience Among Vulnerable Youth Consortium- Saewyc, EM
(funded by the Canadian Institutes of Health Research)
This interdisciplinary capacity enhancement grant brings together a new team of experienced researchers, new investigators, trainees and community partners to advance a program of research into the influences of stigma and trauma on health disparities of sexually-exploited and at-risk youth. This team of biomedical, clinical, health services and social science researchers is developing innovative, cross-cutting, complementary approaches to understanding stigmas influence on health at several levels: from individual biological traits and responses that affect behavioural choices for coping with stigma; to interpersonal and environment risk and protective factors that worsen or improve health outcomes for youth; to community- and population- level influences of stigma on health access and health policy for vulnerable groups. We will explore how to create ethically sensitive studies of this elusive population, and test new techniques for gathering data, including the use of computer and web technology. The goal of this program is to identify how stigma contributes to health disparities, as well as strengths and protective factors that can be changed which buffer youth from the effects of stigma, and then to develop and test effective interventions at the individual, family, community, and policy levels to reduce stigma and decrease health disparities for sexually-exploited and vulnerable youth.

BC Adolescent Health Survey IV- Saewyc, EM
(Funded by the BC Inter-Ministry Committee, Child Health BC, and in part by CIHR)
This is the 2008 cluster-stratified province-wide school-based anonymous pencil-and-paper health survey of students in grades 7-12 in BC (N=29,000+). The largest survey of its kind in Canada, measures include health & risk behaviors, risk exposures, and protective factors. The data will provide a 4th cohort for health trends among youth in BC (earlier surveys completed in 1992, 1998, and 2003). These data also form the basis for a series of funded reports for provincial and federal government health bodies, including a focus on substance use, mental health issues, physical activity and obesity, Aboriginal health issues; they also are the key source of information for several projects that are funded as part of the CIHR/PHAC Chair in Public Health Research, including a focus on trends in violence exposure and various risk behaviours, effects of school-based policies around homophobic bullying, and trends in sexual health.

Cocktails Website: A web-based application focusing on drug interactions between medications and substances of abuse for youth with complex medical conditions and health care providers -UBC Elbe D, Gill S and Whitehouse S 
Funded by Dept of Mental Health, Cocktails, a handbook published in 2002 by the BC Children’s Hospital Pharmacy Department and Youth Health Program, was written to provide information about the risks associated with combination use (“cocktails”) of prescription medication and substances of abuse. Cocktails is a successful and popular resource for youth with complex medical conditions, and as an educational tool used by health care providers (HCPs).
A web-based version of Cocktails would allow easier access for youth and HCPs alike, and the ability to update emerging medication-substance interaction information rapidly.
Conceptually, we want to: (a) improve health literacy among Canadians (within the area of safe medication use) and (b) foster knowledge mobilization among HCPs by improving access to this important practice resource. Thus, the goals of the current project are to implement, evaluate and revise a web-based version of Cocktails through focus group and on-line evaluations to prepare it for broad dissemination among youth and HCPs.

Intoxicated adolescents presenting to the Pediatric Emergency Department - Clarke M, Whitehouse S, Saewyc EM 
Youth presenting with intoxication due to alcohol ingestion consume a significant proportion of health care resources. In addition intoxicated adolescents can be challenging to care for as they may be aggressive and oppositional. There are no standardized recommended guidelines regarding medical management. Adolescents are usually discharged from PED as soon as they are medically stable to free up a much needed bed. There are few reports on the general mental health or psychosocial risks factors of this specific population. 
The purpose of this study is to characterize the demographics, clinical features, associated psychosocial risk factors, medical management and medical burden of adolescents who present to the Pediatric emergency department (PED) with alcohol ingestion. This descriptive, hypothesis-generating study may serve to determine the extent of the problem, suggest effective streamlined management guidelines, highlight which adolescents are at higher future risk and facilitate the implementation of prevention and intervention strategies when adolescents are brought to medical attention for alcohol intoxication. Results will be submitted for publication as well as distributed locally in different formats to youth and caregivers and school counselors.

Development of Hospital Intranet site - Whitehouse S, Gill S
There are many staff at BCCH who interact with adolescents on a regular basis but are not part of the Division of Adolescent Health. The intranet site provides access to clinical tools, recent research, referral documents, information on clinical services and community links as well as a calendar of events related to Adolescent Medicine. It is anticipated that each Division in the Hospital will have a designated staff person to ambassador Adolescent Health for their area. These staff members will use the intranet site for materials as required. 

For further information about any of these initiatives, please contact the Youth Health Program Secretary.

Youth Health Program Office
Phone: (604) 875-3472


Team members' publications

Dr. Sheila K. Marshall

Journal Articles: 

Hejazi, S., Dahinten, V.S., Marshall, S.K., & Ratner, P.A. (2009). Developmental pathways leading to obesity in childhood. Health Reports, 20, 1-7.

Charles, G., Stainton, T. & Marshall, S. (2009). Young careers: Mature before their time. Reclaiming Children and Youth, 18, 29-41.

Marshall, S. K., Young, R. A., & Tilton-Weaver, L. C. (2008). Balancing acts: Adolescents' and mothers' friendships projects.Journal of Adolescent Research, 23, 544-565.

Marshall, S. K., Young, R. A., Domene, J., Zaidman-Zait, A. (2008). Adolescent possible selves as jointly constructed in parent-adolescent career conversations and related activities. Identity:An International Journal of Theory and Research, 8, 185-204.

Young, R. A., Marshall, S. K., Domene, J., Graham, M., Logan, C., Zaidman-Zait, A., Templeton, L. (2008). Transition to adulthood as a family project: Governance transfer, career promotion and relationship. Journal of Counseling Psychology, 55, 297-307.

Charles, G., Stainton, T., & Marshall, S.K. (2008). Young careers in Canada: An invisible population. Relational Child & Youth Care Practice, 21, 5-12.

Ponzetti, J.J., Charles, G., Marshall, S.K., & Hare, J. (2008). Family-centered early intervention in North America: Have home-based programmes lived up to their promise for high-risk families?Irish Journal of Applied Social Studies, 8, 13-20.

Dr. Elizabeth Saewyc

Journal Articles: 

Saewyc EM, Solsvig W, Edinburgh L. (2008). The Hmong Youth Task Force: Evaluation of a coalition to address the sexual exploitation of young runaways. Public Health Nursing, 25(1), 69-76.

Saewyc, E. (2009). Alcohol and other drug use among BC students: Myths and realities. Visions, BC’s Mental Health and Addictions Journal, 5(2), 8-9.

Chen W, Bottorf J, Johnson J, Saewyc E, Zumbo B. (2008). Susceptibility to smoking among White and Chinese non-smoking adolescents in Canada. Public Health Nursing, 25(1),18-27.

Saewyc E, Tonkin R. (2008). Surveying adolescents: Focusing on positive development. Paediatrics & Child Health, 13(1), 43-47.

Saewyc E, Taylor D, Homma Y, Ogilvie G. (2008). Trends in sexual health and risk behaviours among adolescent students in British Columbia. Canadian Journal of Human Sexuality, 17(1-2), 1-13.

Edinburgh L, Saewyc EM, Levitt C. (2008). Caring for young sexual abuse victims in a hospital-based children’s advocacy center.Child Abuse & Neglect: the International Journal, 32, 1119-1126.

Parkes S, Saewyc EM, MacKay LJ, Cox D. (2008). The relationship between body image, dieting behaviors, and stimulant use among adolescents in British Columbia. Journal of Adolescent Health, 43(6), 616-618.

Saewyc EM, Poon C, Homma Y, Skay CL. (2008). Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian and bisexual students in British Columbia. Canadian Journal of Human Sexuality, 17(3) 123-131.

Poon C & Saewyc E. (2009). ‘Out’ yonder: Sexual minority youth in rural and small town areas of British Columbia. American Journal of Public Health, 99, 118-124.

Saewyc EM, Homma Y, Skay CL, Bearinger L, Resnick M, Reis E. (2009). Protective factors in the lives of bisexual adolescents in North America. American Journal of Public Health, 99, 110-117.

Edinburgh LD, & Saewyc EM. (2009). A novel, intensive home visiting intervention for runaway sexually exploited girls. Journal of Pediatric Specialists in Nursing, 14(1), 41-48.

Devries K, Free C, Morison L, Saewyc E. (2009). Factors associated with sexual behaviour of Aboriginal youth: Implications for health promotion. American Journal of Public Health, 99, 855-862.

Devries KM, Free C, Morison L, Saewyc E. (2009). Factors associated with pregnancy and STI among Aboriginal students in British Columbia. Canadian Journal of Public Health, 100(3), 226-230.

Saewyc EM, Brown D, Plane M, Mundt MP, Zakletskaia L, Wiegel J, and Fleming MF. (Accepted 24 Mar 2009; available early on-line). Gender differences in violence exposure among university students attending campus health clinics in the U.S. and Canada.Journal of Adolescent Health. 

Certain H, Harahan B, Saewyc E, Fleming M. (accepted 30 March 2009; in press). Condom use in heavy drinking college students: The importance of always using condoms. Journal of American College Health.

Book Chapters: 

1. Phillips, J.C., & Saewyc, E.M. (accepted Feb 16, 2009; in press). Chapter 11: HIV disease and gay, lesbian, bisexual and transgendered persons. To be published in J. Durham & F.R. Lashley (eds.), The Person with HIV/AIDS: Nursing Perspectives, (4th ed.), New York, NY: Springer Publishing.

2. Saewyc, EM. (forthcoming 2009). Sexual abuse: Medical and psychological perspectives. In R.A. Shweder, T.R. Bidell, A.C. Dailey, S.D. Dixon, P.J. Miller, & J. Modell (eds.), The Child: An Encyclopedic Companion. Chicago: University of Chicago Press.

Dr. Curren Warf

Journal Articles:

Warf, C, Eisenstein E, Stahl C. Children, Adolescents and War: The Systematic Engagement of Youth in Collective Violence. Adolescent Medicine Clinics: special issue on International Health Issues in Adolescents; published by the American Academy of Pediatrics, available December 2009.

Clark, LF, Desai, M, Warf, C, Calvo, R, and Rabinovitz, S. (in press) Being young and homeless: Ethnic, implication for HIV risk. In TT Sharpe, J Stallworth, KS Miller, HD Dean, and K Fenton (Eds.) Special issue. HIV/AIDS Prevention in Children and Youth. 2008

Warf C, Clark L, Herz D, Rabinovitz S. Continuity of Care to Nowhere: Poverty, Child Protective Services, Juvenile Justice, Homelessness and Incarceration: the Disproportionate Representation of African American Children and Youth. International Journal of Child and Adolescent Health; special issue on poverty and youth. 2009;2(1)

Book Chapters: 

C Warf, L Clark, D Herz and S Rabinovitz, African American Children and Youth in Poverty, In Poverty and Children: A Public Health Concern. Editors A. Lieberman and J. Merrick, Nova Science Publishers, 2009

C Warf and M Falk, Youth and Gangs, Textbook of Adolescent Medicine, American Academy of Pediatrics (in press)

C Warf, Adolescent Survival Sex, Textbook of Adolescent Medicine, American Academy of Pediatrics (in press)

C Warf, Cults and Adolescents, Textbook of Adolescent Medicine,American Academy of Pediatrics (in press)

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