September 9, 1997
The National Longitudinal Study of Adolescent Health (Add Health) is a survey designed to measure the effects of adolescents' families, peer groups, schools, neighborhoods, and communities on behaviors that promote good health. The project also sought information on health risks such as tobacco use, sexual activity, sun exposure, and drug and alcohol use.
Aren't adolescents generally healthy? It's true that young people make fewer doctor's visits than do people in other age groups. But a 1991 Office of Technology Assessment report noted "...perhaps one out of five of today's 31 million adolescents have at least one serious health problem." Furthermore, behaviors that don't appear to have any immediate effects--like tobacco use--can have far reaching effects in later years, such as the development of cancer or heart disease.
Why do we need another one? Unlike other national studies of adolescent health and behavior, Add Health is uniquely designed to measure the determinants of health. The main premise is that social context--such as relationships with families, friends, and peers and community characteristics--influences the health and health-related behaviors of young people. One of the hallmarks of the study is the independent measurement of such contextual influences on adolescent health through surveys of school administrators, students, and parents, and through collection of data on community-level characteristics.
The National Opinion Research Center (NORC) at the University of Chicago used statistical techniques to select a random sample of 7th to 12th grade students from schools across the country. In this way, about 90,000 young people participated by filling out a brief questionnaire at school. Next, in-depth, at-home interviews were conducted with students and their parents. The students were interviewed again in their homes one year later.
First, parents were informed about the school survey and their permission was obtained using procedures approved by each school before their children could participate. Before any home interview was conducted, signed consent was obtained from both the parent and the young person. Second, one parent of each young person interviewed was also interviewed. This is because parents are often better sources of information on certain details of their children's health than their children are. For example, most parents know more about their children's health insurance than do their children. Parents can also provide important information about their own health practices and behaviors that may have an impact on their children's health practices and behaviors.
To encourage prospective study volunteers to answer all questions honestly, they were assured that all their responses would be kept confidential. For this reason, their identities, and the identities of their schools and communities, will never be released.
Survey questions sought information on height and weight, depression, self-ratings of health, use of health services, hospitalizations, days lost from school because of illness, emergency room visits, injuries, and physical disabilities.
Add Health asked about substance abuse (alcohol, tobacco, and illicit drugs), violence, prevention of HIV and other sexually transmitted diseases, sexual behavior, contraceptive use, dietary habits, exercise, seat belt and helmet use, and sun exposure.
The data are being made available to researchers all over the world to use for scientific studies and policy analysis about adolescent behavior. These studies will supplement those conducted by the scientists who who were originally funded to collect the data. Analyzing the large volume of information obtained will occupy researchers for the next decade and beyond.
Before the material is released for analysis, information that makes it possible to identify the study respondents will be removed. In fact, not even the principal investigators will be able to tell who provided the answers to the survey questions.
The Adolescent Health Study
Response Statement: JAMA article on the Adolescent Health Study