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Updated: Jun 16, 2026

Social Defeat Stress Model for Adolescent C57BL/6 Male and Female Mice
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Predicting Later Adolescent Risk Behaviors: Which Proximal Outcomes Matter?

Julius Anastasio1, Russell Cole2

  • 1Mathematica Inc, 600 Alexander Park, Suite 100, Princeton, NJ, USA. janastasio@mathematica-mpr.com.

Journal of Prevention (2022)
|June 13, 2026
PubMed
Summary
This summary is machine-generated.

Relationship education programs show proximal outcomes predicting adolescent risk behaviors. Risky social media use is a key risk factor, while self-efficacy and self-awareness are protective for sexual behaviors.

Keywords:
AdolescentsPregnancy preventionRisk and protective factorsSexual and reproductive healthSubstance use

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Area of Science:

  • Adolescent Health
  • Behavioral Science
  • Public Health Interventions

Background:

  • Prevention programs often target adolescent risk behaviors, but effectiveness is typically measured by long-term outcomes.
  • There is a need for evidence on proximal outcomes that predict later adolescent risk behaviors.
  • Relationship education programs aim to influence adolescent development before risk behaviors emerge.

Purpose of the Study:

  • To analyze longitudinal data to identify proximal outcomes that predict later adolescent sexual behavior and substance use.
  • To evaluate the effectiveness of relationship education programs by examining intermediate outcomes.

Main Methods:

  • Longitudinal survey data from ~1,100 adolescents (grades 9-12) who participated in a relationship education program.
  • Regression models assessed associations between 30 posttest proximal outcomes and nine later behavioral outcomes (sexual behavior, substance use) over six months.
  • Exploratory analyses focused on effect-size magnitude, directional consistency, and theoretical coherence.

Main Results:

  • Twenty-two proximal outcomes significantly predicted later behavioral outcomes.
  • Risky social media behavior was a consistent cross-domain risk factor.
  • Self-efficacy in relationship skills and self-awareness were protective for sexual behavior; intentions to have sex showed unexpected protective associations.

Conclusions:

  • Proximal outcomes, such as self-efficacy and self-awareness, can serve as useful predictors of adolescent risk behaviors.
  • Findings support the use of proximal outcome assessment in evaluating prevention programs when distal outcomes are difficult to measure.
  • Risky social media behavior is a critical area for intervention and future research in adolescent risk prevention.