RESEARCH AND PRACTICE
Incarcerated Youths’ Perspectives on Protective Factors and Risk Factors for Juvenile Offending: A Qualitative Analysis Elizabeth S. Barnert, MD, MPH, MS, Raymond Perry, MD, MSHS, Veronica F. Azzi, MPIA, Rashmi Shetgiri, MD, MSHS, Gery Ryan, PhD, Rebecca Dudovitz, MD, MSHS, Bonnie Zima, MD, MPH, and Paul J. Chung, MD, MS
With 2 million juveniles arrested and over 60 000 detained annually, the United States incarcerates a larger proportion of youths than any other developed country.1---3 Incarcerated adolescents represent a high-risk, vulnerable population with disproportionately high rates of unmet physical, developmental, social, and mental health needs, and higher mortality.4---7 Juvenile offending predicts a higher likelihood of chronic adult offending, as well as adverse adult outcomes such as poor health, substance use, and increased mortality.8 Further, significant disparities exist. African American youths are approximately 5 times more likely, and Latino and American Indian adolescents are 3 times more likely, to be detained than their White counterparts.3 Additionally, adolescents from socially disadvantaged neighborhoods are at higher risk for incarceration.9 These inequities perpetuate future incarcerations. Prior incarceration places youths at greater risk for repeat offending throughout adolescence and adulthood.10 Within 3 years of release, approximately 75% of adolescents are rearrested.2 Identification of protective and risk factors for juvenile offending can inform programs and policies to disrupt youths’ pathways to jail. Quantitative studies identify low school achievement, poor mental health, substance use, parental incarceration, large family size, single-parent families, poor parental supervision, delinquent peer groups, and residing in high-crime neighborhoods as risk factors for juvenile offending.11,12 The modest literature on protective factors for juvenile incarceration highlights the importance of supportive family relationships, prosocial peers, academic achievement, reading ability, and psychological factors such as self-esteem and empathy.13---15 Qualitative research to identify underlying mechanisms for these associations is needed.
Objectives. We sought to understand incarcerated youths’ perspectives on the role of protective factors and risk factors for juvenile offending. Methods. We performed an in-depth qualitative analysis of interviews (conducted October–December 2013) with 20 incarcerated youths detained in the largest juvenile hall in Los Angeles. Results. The adolescent participants described their homes, schools, and neighborhoods as chaotic and unsafe. They expressed a need for love and attention, discipline and control, and role models and perspective. Youths perceived that when home or school failed to meet these needs, they spent more time on the streets, leading to incarceration. They contrasted the path through school with the path to jail, reporting that the path to jail felt easier. All of them expressed the insight that they had made bad decisions and that the more difficult path was not only better but also still potentially achievable. Conclusions. Breaking cycles of juvenile incarceration will require that the public health community partner with legislators, educators, community leaders, and youths to determine how to make success, rather than incarceration, the easier path for disadvantaged adolescents. (Am J Public Health. 2015; 105:1365–1371. doi:10.2105/AJPH.2014.302228)
For effective implementation, predictive factors need to be understood in the context of youths’ situations, goals, and ideas about pathways to jail within their communities. Yet adolescent voices on pathways to jail are notably lacking in this literature. To date, only 1 published study has examined incarcerated youths’ perspectives on protective and risk factors for incarceration. The study, which focused on barriers and protective factors during community reentry after juvenile incarceration, identified social connectedness and having a future-oriented perspective as the main predictors of success.16 Adolescents’ views of the pathways to jail across the entire trajectory of juvenile offending—from initiation of delinquency and entry into the juvenile justice system, to repeat arrests and, ultimately, their expected endpoints for these trajectories—remain unknown. To address these gaps, we interviewed incarcerated youths to elucidate their perspectives on pathways to jail across the trajectory
July 2015, Vol 105, No. 7 | American Journal of Public Health
of juvenile offending. We explored their perceptions of protective and risk factors in their communities, with the ultimate goal of strengthening programs that prevent juvenile offending and disrupt cycles of incarceration.
METHODS We performed an in-depth analysis of key informant interviews (conducted October--December 2013) with incarcerated youths on protective and risk factors for juvenile offending. This community-partnered study17 was done in collaboration with the Los Angeles County Juvenile Court, Probation Department, and Department of Health Services, and with the University of California, Los Angeles.
Participants There were a total of 20 participants, 12 males and 8 females; we oversampled females as they represent a rising proportion of juvenile
Barnert et al. | Peer Reviewed | Research and Practice | 1365
RESEARCH AND PRACTICE
offenders.1 Thirteen participants were Latinos and 7 were African Americans. This was representative of the demographics of the detention center, as these groups account for 95% of the minors held in Los Angeles County juvenile detention facilities. We used purposive sampling. Physicians in the juvenile hall recruited youths for the study after the intake physical examination. Inclusion criteria were (1) age 12 to 17 years, (2) no severe cognitive delay, and (3) fluency in English or Spanish. If a youth indicated potential interest in study participation, a member of the research team contacted the youth’s parent or guardian via telephone to obtain verbal informed consent. Participants provided assent. Two parents and 4 potentially eligible youths declined study participation.
Procedure We developed the semistructured interview guide on the basis of a literature review and input from community partners, including pilot testing with formerly incarcerated youths. Interviews probed participants’ perceptions of protective factors and risk factors for juvenile offending in the domains of home, school, and neighborhood environments; peer- and individual-level factors; and recommended solutions. For each domain, participants were asked about influences that promote or prevent pathways to jail and about potential gender differences in these pathways, since this represents a literature gap.18 (For sample interview questions see the appendix, available as a supplement to the online version of this article at http://www.ajph.org). Participants were asked to speak about the role of protective factors and risk factors for youths in their communities. This was done to extend the data beyond the individual’s personal experience, to allow adolescents the experience of speaking as experts on their own communities, and to protect them from potentially incriminating themselves by revealing details about their criminal cases. Oneon-one interviews (conducted by E. B.) took place in a private clinic examination room within the juvenile hall and lasted 30 to 60 minutes.
Data Analysis We used a 6-step thematic content analysis to identify themes representative of participants’ perspectives on pathways to jail.19 Interviews were
audio recorded and subsequently transcribed verbatim. Using ATLAS.ti software (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany), 3 coders reviewed the transcripts to discuss initial themes. After a subsequent round of independent coding, the team met to compare initial themes and reached consensus themes. Interviews and iterative analyses continued until saturation of major themes was achieved.
RESULTS The youths described their environments in terms of home, school, neighborhoods, and jail, and the social pressures that permeate these places. They discussed their internal needs, which we categorized as a need for love and attention, discipline and control, and role models and perspective. They also detailed the cyclical pattern that leads youths to jail (Figure 1) and solutions for preventing juvenile offending. Direct quotations from participants can be found in the box on the next page.
Participants’ Descriptions of Their Environments Home. Participants expressed the idea that the home should be the most important
protective environment. By contrast, most described homes in their communities as unstructured, chaotic places characterized by fighting and lack of family cohesiveness. They reported that many youths feel neglected by parents perceived as “absent,” because the parents worked late hours, were single parents, were addicted to drugs, or were incarcerated. A few participants described potential negative influences from gang-affiliated family members. They said that financial difficulties at home might promote criminal behavior, either because youths want items that their families cannot afford or because they want to help their parents with finances. School. Participants described an ideal school as a safe place that teaches practical skills for achieving success in life. Most, however, reported that their schools felt unsafe because of gang activity and bullying, leading many youths in their communities to protect themselves by joining gangs, carrying weapons, or avoiding school. Several participants stated that poor school performance sets youths on a “bad pathway” because they feel frustrated, resulting in poor attendance or dropping out. They also cited peer pressure as a negative aspect of
Note. Youths’ perceptions of pathways to juvenile detention were ascertained through qualitative analysis of one-on-one interviews conducted with 20 incarcerated adolescents (12 males and 8 females). Of the 20 participants, 13 were Latinos and 7 were African Americans. Participants’ ages ranged from 12 to 17 years. Participants explained that youths regularly move between home and school (inner arrows). When home or school environments are dysfunctional, youths spend more time on the streets of their neighborhoods (bottom 2 arrows). The neighborhoods are rampant with negative influences, which then lead the youths on a seemingly inevitable pathway to incarceration (large arrow at right). Eventually, the youths are released from juvenile hall back to their home environments (upper arrow).
FIGURE 1—A conceptual map showing youths’ perceptions of pathways to jail: Los Angeles County, California, 2013.
1366 | Research and Practice | Peer Reviewed | Barnert et al.
American Journal of Public Health | July 2015, Vol 105, No. 7
RESEARCH AND PRACTICE
Thematic Quotations From In-Depth Interviews With Incarcerated Youths: Los Angeles County, California, 2013 Views on Environment: Home “If the family is supporting the kid in what he does, then there is no need for the kid to go into the environment to look for support.” “If a kid’s family doesn’t support him, then they’ll go into the environment looking for a false family.” “Mostly parents work at night because they’re undocumented. They don’t have papers. Janitors is the only job they can get. And in the night, that’s when the action happens in the streets.” Views on Environment: School “Some schools are in an enemy’s gangs. Kids have to go there because it’s the only free school around and then they can get jumped in. . . . It’s like a set-up.” “If you feel like your life is at stake, or just don’t feel comfortable being there [at school], you won’t want to go. You’re going to want to stay home. You’re going to ditch. And then when you ditch, you’re going to end up getting into trouble.” “Some teachers are like, ‘I see you in jail.’ ” Views on Environment: Neighborhoods “It’s just something about the neighborhood that brings kids back to the neighborhood. It’s a pattern. Once we get out, if we get out, we’re free. But then kids start doing drugs and drinking again. So it’s just into the neighborhood.” “If you live in a ghetto neighborhood, then you get so used to seeing ghetto so you start acting like it. That’s how you start becoming bad. . . . You’re following others because people don’t like to be different.” “If you live in a good neighborhood, you’re going to be like, ‘I’m going to be good because everyone else is good and I don’t want to be different.’ But in a bad neighborhood, you don’t want to be the good one because everyone’s bad.” Views on Environment: Jail “People say ‘I’m never going to come back in,’ but they always do. There’s something that keeps them coming back. Maybe they find the love that they don’t have at home from the staff. Hey, we get 3 hot plates a day, we go to school here. They give you everything here; shower, toothbrush, everything.” “Probably 20% of the kids maybe do feel loved [in jail] because they don’t have parents, father figures. They just never had them at all. They always have been DCFS [child welfare] or, you know, foster kids. So they decide to come to jail. Instead of being out there where they don’t have no one.” “I don’t really think kids like coming in and out of jail. Why? Because you really need your family out there. . . . It really does hurt when you’re here.” Views on Environment: Social Pressures Peer pressure “The problem is the whole social life. Kids can’t really focus on getting an education. They get into gangs to have the latest clothes, news shoes. Gangs, drugs, and then that leads to more and more.” “Sometimes kids just choose the wrong crowds to hang around with. They think about the wrong things like what other people think about them and they have low self-esteem. So they choose the wrong way and end up in the wrong places.” “If they really are truly good friends, you will succeed in life along with them. But if not, you’ll fall with them just like everybody else.” Desire for money “A kid with no money, he’ll probably steal to get what he needs, like he’ll steal from the store to eat or he’ll rob a house to eat or to provide for his family.” Gender roles “Boys are more involved with gangs, fights, guns, drugs. Girls end up in here for prostitution—drugs too—because they’re all looking for that love that they can’t find.” “There’s just more expected for a boy. Especially if your father isn’t there, you have to take on a lot of responsibility. Some boys feel like, ‘Well, I could put money in.’ With girls, it’s more of a peer pressure. You’re trying to fit in. Maybe stuff at home isn’t right and you’re looking for a coping mechanism.” Role of race/ethnicity “With Blacks and Hispanics, usually you live in ghetto neighborhoods. . . . You could be Black, Asian, Hispanic living in a ghetto neighborhood and be a criminal, or you could be Black, Asian, or Hispanic and live in the good neighborhood and actually become someone. It just depends on the neighborhood.” Inner Need: Love and Attention “They always say that babies need lots of love. But that never ends. Even growing up into a teenager, you still need love. And you need attention. I feel that positive reinforcement—paying attention to the child—that helps a lot.” “It’s very easy to get on the bad path because you like it. You like that somebody’s paying attention to you. You like that somebody’s actually caring for you. But in reality they’re just hurting you. You’re looking for that love that you can’t find at home, so you go to the streets.” Inner Need: Discipline and Control “As soon as parents start to lose discipline, that’s when that one kid starts messing up and most likely the whole family’s going to be downward on the floor.” “If it’s 2 parents and they’re both at home, it’s going to be better because both of them have the situation in control so they both say, ‘Yes, you’re not going out.’ ” “Too much, pressure, being strict—that causes a rebel kid. . . . I picture good parents as strict people. Strict, but not too strict.” Continued
July 2015, Vol 105, No. 7 | American Journal of Public Health
Barnert et al. | Peer Reviewed | Research and Practice | 1367
RESEARCH AND PRACTICE
Continued Inner Need: Role Models and Perspective “Every adult is a role model in a child’s eyes. Even when adults don’t see it, we’ll catch it and we’ll repeat it in our own way.” “What kids see, they think is right. If the parents are going in jail, they just follow what they see. The kids think that it’s cool. Like my dad or my mom do that, I can do that too. They’re thinking it’s right when it’s not.” “If a kid thinks he’s not going to live long—like 21 and 25—then in his head he’s like, I might as well do all that I want to do while I’m alive because I know I might end up dead or in jail somewhere.” Trajectory to Jail: No Easy Way Out “Probation’s not making it easier because now we have more pressure. You don’t have a C or above, that’s a violation. You miss school, violation; late to school, violation; not listening, violation. Anything you do, you come back.” “From here, you can only graduate. I mean, from here Juvenile Hall, then county jail [for adults], and you end up making your way to the Big House [state or federal prison].” “You could break that cycle . . . but most people would rather take the easy route: messing up. Being a hard worker and living a good life is a hard life.” Solutions “There are people out there willing to change. So I encourage mothers, fathers, teachers, doctors to try to show them a different way of living and not the lifestyle they like to live. Try to help them understand that the decisions they’re making are not right.” “We need to be able to know that someone does care, that someone just doesn’t want to throw us away and put us away because we’re running amok outside of these walls.” Note. Quotes were extracted from interviews on protective factors and risk factors for juvenile offending conducted with 20 incarcerated youths (12 males and 8 females). Of the 20 participants, 13 were Latinos and 7 were African Americans. Participants’ ages ranged from 12 to 17 years.
the school environment, stating that efforts to fit in often lead to delinquency. Overall, although they recognized that teachers could play a prominent role in promoting positive behaviors, most felt that teachers gave up on them too easily. Neighborhood. Participants described their ideal neighborhood as peaceful and quiet, with abundant nature and parks, and where community members were friendly and attentive to one another. However, they described their own neighborhoods as “ugly,” a “ghetto,” with “lots of gangs, shootings, and murder going around.” They explained that neighborhoods strongly promote crime, since, when not at home or in school, youths spend most of their time there. As one participant expressed it, “If home is bad and school is bad,” youths will end up on the streets, and inevitably, “then you’re going to end up in jail.” Neighborhoods were believed to represent the final space that adolescents inhabit before jail (Figure 1). Several participants also described an interrelationship between race/ethnicity and neighborhoods that they felt promoted pathways to jail. They explained that neighborhoods predominantly composed of families from ethnic minorities have a greater police presence and thus a higher likelihood of arrest for youths of color. Additionally, adolescents gravitate
toward others with similar ethnic backgrounds, which facilitates gang affiliations because youths within gangs often share similar ethnicity. Overall, however, most expressed the idea that neighborhood poverty was the more important determinant for predicting juvenile offending because in poor neighborhoods, negative influences were more rampant. Jail. Participants felt that incarceration was both seemingly inevitable and a consequence of poor decisions. They explained that since youths cycle between juvenile detention and their neighborhoods so frequently, jail represented an extension of the neighborhood. Participants had mixed feelings about detention. Many said that youths find it painful to be separated from their families and resent restrictions on freedom while in jail. However, several also said that jail feels safe and structured, and provides respite from their chaotic lifestyles. Social pressures. The major social pressures described included peer pressure, a desire to attain money or material goods, racism, and pressure to fulfill gender roles. Male and female respondents both stated that boys felt pressured to exhibit a “macho” persona, which promoted fighting, theft, gangbanging, and drug and gun possession and use. Conversely, they said that girls, driven by a desire for popularity or to please a boyfriend, were more
1368 | Research and Practice | Peer Reviewed | Barnert et al.
likely to be detained for fighting, prostitution (i.e., child sex trafficking), or carrying drugs or weapons for a boy.
Internal Needs Expressed by Participants We identified 3 internal needs expressed by the participants: a need for love and attention, discipline and control, and role models and perspective. Love and attention. All of the participants said that love and attention are essential to helping youths stay out of trouble. Receiving love from parents motivates them to please their parents and succeed. By contrast, adolescents who feel unloved or neglected see no reason to spend time with their families or to perform well in school, and ultimately they end up on the streets or in jail. Additionally, participants clearly stated that love alone is insufficient; youths desire attention as well. Several participants said that exhibiting delinquent behaviors could be a way of seeking attention from family members. To youths, parents’ “being there” means not only providing love and understanding, but also being attentive and guiding them through adolescence. Discipline and control. Several participants said that adolescents in their communities needed more discipline and control to counterbalance their chaotic, unsafe environments.
American Journal of Public Health | July 2015, Vol 105, No. 7
RESEARCH AND PRACTICE
They described good parents as “strict, but not too strict.” According to participants, parents should regulate youths’ activities and, given the dangers in their neighborhoods, should try to keep them at home; this form of control means that parents care for them. Participants’ statements about positive aspects of juvenile detention, which mostly centered on valuing the structure and routine of the facilities, further indicate that youths appreciate adults’ enforcing discipline and control. Role models and perspective. Participants expressed the idea that older family members are youths’ most important role models. They said that parents should guide adolescents “through a positive road,” encouraging a positive, future-orientated perspective. Most participants said that having parents who are bad examples, such as ex-convicts or gang members, negatively influences youths, as parental criminality normalizes adolescents’ delinquency. In contrast, a few participants said that having parents who are negative role models can be protective because adolescents may consciously avoid repeating parents’ mistakes. Friends also significantly affect youths’ perspectives. Whereas participants defined “bad friends” as ones who encourage criminal behavior, “good friends” deter peers from committing crimes, have plans for the future, and help guide youths on a path to success. Finally, as one participant stated, “Every adult is a role model in a child’s eyes.” Participants cited teachers, probation officers, judges, and health care providers as potential role models who, even in brief encounters, could provide valuable future-oriented perspective.
No Easy Way Out Participants expressed the belief that when home and school fail to meet their inner needs, male and female youths spend more time on the streets. “Blinded” by gangs, drugs, and other negative influences in their neighborhoods, adolescents make wrong choices and end up following a bad pathway. They then become trapped in a pattern of delinquency and incarceration. Once youths have a history of arrest, the threshold for rearrest becomes much lower. Participants explained that when youths are on probation, factors such as truancy, disrespecting parents, or being at the scene of a crime without having committed a crime easily lead
to a downhill cycle of rearrest and incarceration. Furthermore, upon release, they return to unstable homes and schools and to neighborhoods that promote delinquency. Participants indicated that the bad pathway of ending up in jail is the easiest choice given the environments that youths live in. In contrast to this “easy” path, they defined the “hard way” as staying in school and out of trouble. Many participants spontaneously referred to an adolescent on the bad pathway as a “follower.” In contrast, being a “leader” meant defying the norm by attending school, earning good grades, and ultimately attaining lifelong success. All of the participants said that the harder path is preferable. Participants said that this cycle extends beyond juvenile delinquency to adult criminality. Several participants viewed juvenile hall as “training” or “school” that youths “graduate” from before landing in “the Big House” (state or federal prison) as adults. Further, they said that because adolescents in their communities believe their life expectancy to be low—25 years or less—they have limited expectations for the future. Instead of striving for success, many adolescents act for survival. Participants said that this hastens the downward spiral, with many youths engaging in activities that increase their chances of ending up incarcerated or dead by early adulthood.
security guards to schools. Another proposed school uniforms to reduce social competition among girls. Many participants said that teachers should be attentive and supportive. This is especially important when the home environment is unstable. One participant said, “Even if it’s just maybe that math problem, inside we’re screaming ‘Really help me, because I don’t get this problem because I’m stressing out at home and out on the streets.’ ” After family members, teachers were mentioned as the most influential adults in youths’ lives. Several participants suggested afterschool programs, including tutoring, vocational, and sports programs, to keep adolescents occupied and out of the streets while building life skills and fostering a sense of belonging. To enhance the appeal of the programs for adolescents, a few participants suggested implementing gender-specific programs. Many noted the importance of programs that last until nighttime to eliminate time spent on the neighborhood streets. Field trips, several participants suggested, give youths an opportunity to see beyond their neighborhoods. Other adults who interact with adolescents, such as doctors, judges, and police officers, could help instill a positive, future-oriented perspective. Participants said they would be most receptive to receiving information from adults with similar backgrounds, especially adults from their neighborhoods.
Solutions Participants described potential solutions for juvenile offending in the home, school, and neighborhood environments that were consistent with the themes of youths’ needs for love and attention, discipline and control, and role models and perspective. Participants said that homes should be a safe haven. Parents should be positive role models who act lovingly and attentively and participate in their children’s lives. Older relatives, especially grandparents, can instill a future-oriented perspective. In effect, by providing love, support, discipline, perspective, and encouragement, families can help fulfill youths’ need to have structure and attachment. Schools were deemed key for overcoming the incarceration cycle and achieving long-term success. Participants said that for schools to be productive environments for youths, they should be safer. One participant suggested adding more
July 2015, Vol 105, No. 7 | American Journal of Public Health
DISCUSSION Overall, the incarcerated adolescent participants in our study expressed the belief that youths in their communities live in environments that are chaotic, unsafe, and unstructured. Juvenile detention may provide respite from the chaos and dangers of daily life, but serving time also perpetuates a cycle of rearrest and incarceration that follows adolescents into adulthood.5 Youths of both genders struggled to fulfill their innate emotional needs for love and attention, control and discipline, and positive role models who instill a positive future orientation. When these needs are not met, going to jail becomes the easier or more likely pathway. Participants demonstrated insight into the cycle of high-risk delinquent behaviors and criminality, and they desired help in breaking
Barnert et al. | Peer Reviewed | Research and Practice | 1369
RESEARCH AND PRACTICE
this cycle. They looked to adults to help them accomplish this. Influential adults include parents, other relatives, teachers, principals, counselors, police officers, judges, and health care providers. Listening to youths and responding to their needs may be an important starting point for successful interventions. Regarding the home, youths expressed a need for parents to be more loving, attentive, and regulating, and to provide positive role modeling. These characteristics are consistent with an authoritative parenting style, which is associated with less delinquent behavior.20,21 This finding is also consistent with prior research on incarcerated adolescents undergoing reentry, which demonstrated the protective influence of family connectedness.16 Furthermore, the youths’ perspectives align with previous meta-analyses on program efficacy, which have demonstrated that interventions that strengthen family interactions are the most effective in improving the trajectories of youths involved in the juvenile justice system.22 Family-based therapies such as Functional Family Therapy and Multisystemic Therapy, administered by an in-home therapist to a family, have been shown to be particularly effective. These programs have demonstrated reductions in recidivism of 16% and 7%, respectively. The programs are likely successful because they build skills among the adults who are best able to influence these vulnerable youths.22 Programs that help parents and adolescents negotiate challenges, build parenting skills, and encourage supportive environments at home may be especially effective. Although the literature suggests that a “school-to-prison pipeline” exists, the perspectives of the participants indicated that although schools can catalyze the pathway to jail, they also have an important protective influence.23 Academic programs that support school performance offer an opportunity to help adolescents avoid or overcome trajectories of delinquency and incarceration.22 Participants recognized the importance of academic achievement, and expressed the idea that feeling unsafe at school was the primary barrier to school attendance and a main contributor to juvenile offending. School safety, including freedom from bullying, is an important determinant of physical24 and mental health.25,26 Ensuring safe schools may be a key strategy for
preventing juvenile offending. Teachers have a profound ability to influence youths. Strategies to encourage meaningful relationships between school staff and students, such as small-learning communities and lower total student load, might further boost the protective influence of teachers and education.27 Our study indicated that juvenile justice--involved youths do not currently perceive their communities as a source of stability and support. Instead, they see their neighborhoods as a trap, leading them down an inevitable pathway to incarceration. Participants expressed the need for safe, structured, caring environments outside of their homes and schools. Thus, there is an opportunity for faith-based and other community leaders to fill this void and help make neighborhoods safer. The fact that faithbased organizations, considered vitally important in many neighborhoods of color, seemed irrelevant to these youths’ lives suggests untapped potential that could become a focus for research and intervention. Participants expressed belief in the value of interacting with adults who have themselves broken the cycle of incarceration present in many socially disadvantaged neighborhoods. Given youths’ perceptions of absent parents and teachers who give up on them, they seem to be seeking inspiration and guidance from other adults who can demonstrate how people make it out of their neighborhoods. This is consistent with previous studies that demonstrated the effectiveness of mentoring programs in decreasing recidivism, and it suggests an important area for intervention.22 The finding that the majority of the African American and Latino youths that we interviewed do not perceive racism as significantly affecting the pathway to jail was unexpected. The few who pointed to racism as such a factor described racial profiling by police and others. Although institutionalized racism within the education and juvenile justice systems is well documented,28,29 many adolescents may be unaware of it or dismiss its impact. Additionally, all of the participants emphasized the strong influence of economic deprivation, which they perceived as a more significant contributor to juvenile incarceration than racism. They explained that African Americans and Latinos are more likely to live in high-poverty neighborhoods with negative influences that facilitate
1370 | Research and Practice | Peer Reviewed | Barnert et al.
a pathway to jail. This highlights the need to address underlying social determinants of health, such as childhood poverty. As the participants suggested, making violent neighborhoods safer by cultivating safe, green spaces and afterschool programs may prove valuable in gradually shifting the trajectories of entire communities.
Limitations This exploratory study was limited to a small sample of youths in 1 urban area. Thus, the interviewed participants were not necessarily representative of all incarcerated or otherwise high-risk adolescents. Two of the authors, however, are involved in an analogous study of violent, nonincarcerated youths. Findings from both studies are strikingly consistent, suggesting that similar protective and risk factors may affect lower-risk, delinquent adolescents (R. Shetgiri, S. Lee, C. Wilson, et al., unpublished data, 2013).
Conclusions The incarcerated youths that we interviewed demonstrated insight into their lives and communities, and many indicated readiness to strive for positive change. The relative paucity of research and attention paid to this vulnerable population may be a factor impeding their success. Ultimately, the public health community will need to partner with legislators, educators, community leaders, and the adolescents themselves to clarify how to make success, rather than incarceration, the easier path for vulnerable youths in disadvantaged communities. j
About the Authors At the time of the study, Elizabeth S. Barnert was with the Robert Wood Johnson Foundation Clinical Scholars Program, Los Angeles, CA. Veronica F. Azzi was with the Department of Medicine, University of California, Los Angeles. Bonnie Zima was with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Rebecca Dudovitz and Paul J. Chung were with the Department of Pediatrics, University of California, Los Angeles. Raymond Perry was with Juvenile Court Health Services, Los Angeles County Department of Health Services. Rashmi Shetgiri was with the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas. Gery Ryan was with the RAND Corporation, Santa Monica, CA. Correspondence should be sent to Elizabeth Barnert, Mattel Children’s Hospital, UCLA, 10833 Le Conte Ave, Room 12-358, Los Angeles, CA 90095 (e-mail: [email protected]). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link. This article was accepted July 24, 2014.
American Journal of Public Health | July 2015, Vol 105, No. 7
RESEARCH AND PRACTICE
Contributors E. S. Barnert, R. Perry, R. Shetgiri, G. Ryan, R. Dudovitz, B. Zima, and P. J. Chung worked on the study design, analysis, and writing of the article. V. F. Azzi contributed to the analysis and writing of the article.
Acknowledgments This project was funded by the Robert Wood Johnson Foundation Clinical Scholars Program (grant 70039) and by an Academic Pediatric Association Young Investigator Award. R. Shetgiri was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (K23HD068401). We thank our community partners—the Los Angeles County Juvenile Court Health Services, Probation Department, and Juvenile Court. C. M. Mangione, R. H. Brook, and S. Berry contributed to the conceptual development of this project. Note. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National Institutes of Health.
Human Participant Protection This study was approved by the institutional review boards of the RAND Corporation and the Los Angeles County Department of Human Services. To maximize protection of participants, a Certificate of Confidentiality was obtained from the National Institutes of Health.
References
11. Farrington DP. Developmental and life-course criminology: key theoretical and empirical issues—the 2002 Sutherland Award Address. Criminology. 2003; 41(2):221---255. 12. Tarolla SM, Wagner EF, Rabinowitz J, Tubman JG. Understanding and treating juvenile offenders: a review of current knowledge and future directions. Aggress Violent Behav. 2002;7(2):125---143. 13. Hoge RD, Andrews DA, Leschied AW. An investigation of risk and protective factors in a sample of youthful offenders. J Child Psychol Psychiatry. 1996; 37(4):419---424. 14. Beaver KM, Nedelec JL, Wilde M, Lippoff C, Jackson D. Examining the association between MAOA genotype and incarceration, anger and hostility: the moderating influences of risk and protective factors. J Res Pers. 2011; 45(3):279---284. 15. Harper CC, McLanahan SS. Father absence and youth incarceration. J Res Adolesc. 2004;14(3):369---397. 16. Unruh D, Povenmire-Kirk T, Yamamoto S. Perceived barriers and protective factors of juvenile offenders on their developmental pathway to adulthood. J Correctional Educ. 2009;60(3):201---225. 17. Jones L, Wells K. Strategies for academic and clinician engagement in community-participatory partnered research. JAMA. 2007;297(4):407---410. 18. Acoca L. Investing in Girls: A 21st Century Strategy. Washington, DC: Office of Juvenile Justice and Delinquency Prevention; 1999. 19. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77---101.
1. Snyder HN, Sickmund M. Juvenile Offenders and Victims: 2006 National Report. Rockville, MD: US Dept of Justice, Office of Juvenile Justice and Delinquency Prevention; 2006.
20. Hoeve M, Dubas JS, Eichelsheim VI, van der Laan PH, Smeenk W, Gerris JRM. The relationship between parenting and delinquency: a meta-analysis. J Abnorm Child Psychol. 2009;37(6):749---775.
2. Reducing Youth Incarceration in the United States. Baltimore, MD: Annie E. Casey Foundation; 2013.
21. Steinberg L, Mounts M, Lamborn S, Dornbusch S. Authoritative parenting and adolescent adjustment across varied ecological niches. J Res Adolesc. 1991;1(1):19---36.
3. Sickmund M, Sladky T, Kang W, Puzzanchera C. Easy access to the Census of Juveniles in Residential Placement. 2013. Available at: http://www.ojjdp.gov/ ojstatbb/ezacjrp. Accessed July 18, 2014.
22. Greenwood P, Turner S. Juvenile crime and juvenile justice. In: Wilson J, Petersilia J, eds. Crime and Public Policy. Oxford, UK: Oxford University Press; 2011:88---129.
4. Committee on Adolescence. Health care for youth in the juvenile justice system. Pediatrics. 2011;128(6): 1219---1235. 5. Teplin LA, McClelland GM, Abram KM, Mileusnic D. Early violent death among delinquent youth: a prospective longitudinal study. Pediatrics. 2005;115(6): 1586---1593. 6. Teplin LA, Abram KM, McClelland GM, Dulcan MK, Mericle AA. Psychiatric disorders in youth in juvenile detention. Arch Gen Psychiatry. 2002;59(12):1133---1143.
23. Wald J, Losen DJ. Defining and redirecting a schoolto-prison pipeline. New Dir Youth Dev. 2003;(99):9---15. 24. Swahn MH, Bossarte RM. The associations between victimization, feeling unsafe, and asthma episodes among US high-school students. Am J Public Health. 2006; 96(5):802---804. 25. Nijs MM, Bun CJ, Tempelaar WM, et al. Perceived school safety is strongly associated with adolescent mental health problems. Community Ment Health J. 2014;50(2): 127---134.
7. Hein K, Cohen MI, Litt IF, et al. Juvenile detention: another boundary issue for physicians. Pediatrics. 1980;66(2):239---245.
26. Ozer EJ, Weinstein RS. Urban adolescents’ exposure to community violence: the role of support, school safety, and social constraints in a school-based sample of boys and girls. J Clin Child Adolesc Psychol. 2004;33(3):463---476.
8. Coffey C, Veit F, Wolfe R, Cini E, Patton GC. Mortality in young offenders: retrospective cohort study. BMJ. 2003;326(7398):1064.
27. Miles KH, Darling-Hammond L. Rethinking the allocation of teaching resources: some lessons from highperforming schools. Educ Eval Policy Anal. 1998;20(1):9-- 29.
9. Shader M. Risk factors for delinquency: an overview. Available at: https://www.ncjrs.gov/pdffiles1/ojjdp/ frd030127.pdf. Accessed July 18, 2014.
28. Spears AK. Institutionalized racism and education of blacks. Anthropol Educ Q. 1978;9(2):127---136.
10. Patterson EJ. The dose---response of time served in prison on mortality: New York State, 1989---2003. Am J Public Health. 2013;103(3):523---528.
29. Brewer RM, Heitzeg NA. The racialization of crime and punishment: criminal justice, color-blind racism, and the political economy of the prison industrial complex. Am Behav Sci. 2008;51(5):625---644.
July 2015, Vol 105, No. 7 | American Journal of Public Health
Barnert et al. | Peer Reviewed | Research and Practice | 1371
Incarcerated Youths’ Perspectives on Protective Factors and Risk Factors for Juvenile Offending: A Qualitative Analysis Elizabeth S. Barnert, MD, MPH, MS, Raymond Perry, MD, MSHS, Veronica F. Azzi, MPIA, Rashmi Shetgiri, MD, MSHS, Gery Ryan, PhD, Rebecca Dudovitz, MD, MSHS, Bonnie Zima, MD, MPH, and Paul J. Chung, MD, MS
With 2 million juveniles arrested and over 60 000 detained annually, the United States incarcerates a larger proportion of youths than any other developed country.1---3 Incarcerated adolescents represent a high-risk, vulnerable population with disproportionately high rates of unmet physical, developmental, social, and mental health needs, and higher mortality.4---7 Juvenile offending predicts a higher likelihood of chronic adult offending, as well as adverse adult outcomes such as poor health, substance use, and increased mortality.8 Further, significant disparities exist. African American youths are approximately 5 times more likely, and Latino and American Indian adolescents are 3 times more likely, to be detained than their White counterparts.3 Additionally, adolescents from socially disadvantaged neighborhoods are at higher risk for incarceration.9 These inequities perpetuate future incarcerations. Prior incarceration places youths at greater risk for repeat offending throughout adolescence and adulthood.10 Within 3 years of release, approximately 75% of adolescents are rearrested.2 Identification of protective and risk factors for juvenile offending can inform programs and policies to disrupt youths’ pathways to jail. Quantitative studies identify low school achievement, poor mental health, substance use, parental incarceration, large family size, single-parent families, poor parental supervision, delinquent peer groups, and residing in high-crime neighborhoods as risk factors for juvenile offending.11,12 The modest literature on protective factors for juvenile incarceration highlights the importance of supportive family relationships, prosocial peers, academic achievement, reading ability, and psychological factors such as self-esteem and empathy.13---15 Qualitative research to identify underlying mechanisms for these associations is needed.
Objectives. We sought to understand incarcerated youths’ perspectives on the role of protective factors and risk factors for juvenile offending. Methods. We performed an in-depth qualitative analysis of interviews (conducted October–December 2013) with 20 incarcerated youths detained in the largest juvenile hall in Los Angeles. Results. The adolescent participants described their homes, schools, and neighborhoods as chaotic and unsafe. They expressed a need for love and attention, discipline and control, and role models and perspective. Youths perceived that when home or school failed to meet these needs, they spent more time on the streets, leading to incarceration. They contrasted the path through school with the path to jail, reporting that the path to jail felt easier. All of them expressed the insight that they had made bad decisions and that the more difficult path was not only better but also still potentially achievable. Conclusions. Breaking cycles of juvenile incarceration will require that the public health community partner with legislators, educators, community leaders, and youths to determine how to make success, rather than incarceration, the easier path for disadvantaged adolescents. (Am J Public Health. 2015; 105:1365–1371. doi:10.2105/AJPH.2014.302228)
For effective implementation, predictive factors need to be understood in the context of youths’ situations, goals, and ideas about pathways to jail within their communities. Yet adolescent voices on pathways to jail are notably lacking in this literature. To date, only 1 published study has examined incarcerated youths’ perspectives on protective and risk factors for incarceration. The study, which focused on barriers and protective factors during community reentry after juvenile incarceration, identified social connectedness and having a future-oriented perspective as the main predictors of success.16 Adolescents’ views of the pathways to jail across the entire trajectory of juvenile offending—from initiation of delinquency and entry into the juvenile justice system, to repeat arrests and, ultimately, their expected endpoints for these trajectories—remain unknown. To address these gaps, we interviewed incarcerated youths to elucidate their perspectives on pathways to jail across the trajectory
July 2015, Vol 105, No. 7 | American Journal of Public Health
of juvenile offending. We explored their perceptions of protective and risk factors in their communities, with the ultimate goal of strengthening programs that prevent juvenile offending and disrupt cycles of incarceration.
METHODS We performed an in-depth analysis of key informant interviews (conducted October--December 2013) with incarcerated youths on protective and risk factors for juvenile offending. This community-partnered study17 was done in collaboration with the Los Angeles County Juvenile Court, Probation Department, and Department of Health Services, and with the University of California, Los Angeles.
Participants There were a total of 20 participants, 12 males and 8 females; we oversampled females as they represent a rising proportion of juvenile
Barnert et al. | Peer Reviewed | Research and Practice | 1365
RESEARCH AND PRACTICE
offenders.1 Thirteen participants were Latinos and 7 were African Americans. This was representative of the demographics of the detention center, as these groups account for 95% of the minors held in Los Angeles County juvenile detention facilities. We used purposive sampling. Physicians in the juvenile hall recruited youths for the study after the intake physical examination. Inclusion criteria were (1) age 12 to 17 years, (2) no severe cognitive delay, and (3) fluency in English or Spanish. If a youth indicated potential interest in study participation, a member of the research team contacted the youth’s parent or guardian via telephone to obtain verbal informed consent. Participants provided assent. Two parents and 4 potentially eligible youths declined study participation.
Procedure We developed the semistructured interview guide on the basis of a literature review and input from community partners, including pilot testing with formerly incarcerated youths. Interviews probed participants’ perceptions of protective factors and risk factors for juvenile offending in the domains of home, school, and neighborhood environments; peer- and individual-level factors; and recommended solutions. For each domain, participants were asked about influences that promote or prevent pathways to jail and about potential gender differences in these pathways, since this represents a literature gap.18 (For sample interview questions see the appendix, available as a supplement to the online version of this article at http://www.ajph.org). Participants were asked to speak about the role of protective factors and risk factors for youths in their communities. This was done to extend the data beyond the individual’s personal experience, to allow adolescents the experience of speaking as experts on their own communities, and to protect them from potentially incriminating themselves by revealing details about their criminal cases. Oneon-one interviews (conducted by E. B.) took place in a private clinic examination room within the juvenile hall and lasted 30 to 60 minutes.
Data Analysis We used a 6-step thematic content analysis to identify themes representative of participants’ perspectives on pathways to jail.19 Interviews were
audio recorded and subsequently transcribed verbatim. Using ATLAS.ti software (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany), 3 coders reviewed the transcripts to discuss initial themes. After a subsequent round of independent coding, the team met to compare initial themes and reached consensus themes. Interviews and iterative analyses continued until saturation of major themes was achieved.
RESULTS The youths described their environments in terms of home, school, neighborhoods, and jail, and the social pressures that permeate these places. They discussed their internal needs, which we categorized as a need for love and attention, discipline and control, and role models and perspective. They also detailed the cyclical pattern that leads youths to jail (Figure 1) and solutions for preventing juvenile offending. Direct quotations from participants can be found in the box on the next page.
Participants’ Descriptions of Their Environments Home. Participants expressed the idea that the home should be the most important
protective environment. By contrast, most described homes in their communities as unstructured, chaotic places characterized by fighting and lack of family cohesiveness. They reported that many youths feel neglected by parents perceived as “absent,” because the parents worked late hours, were single parents, were addicted to drugs, or were incarcerated. A few participants described potential negative influences from gang-affiliated family members. They said that financial difficulties at home might promote criminal behavior, either because youths want items that their families cannot afford or because they want to help their parents with finances. School. Participants described an ideal school as a safe place that teaches practical skills for achieving success in life. Most, however, reported that their schools felt unsafe because of gang activity and bullying, leading many youths in their communities to protect themselves by joining gangs, carrying weapons, or avoiding school. Several participants stated that poor school performance sets youths on a “bad pathway” because they feel frustrated, resulting in poor attendance or dropping out. They also cited peer pressure as a negative aspect of
Note. Youths’ perceptions of pathways to juvenile detention were ascertained through qualitative analysis of one-on-one interviews conducted with 20 incarcerated adolescents (12 males and 8 females). Of the 20 participants, 13 were Latinos and 7 were African Americans. Participants’ ages ranged from 12 to 17 years. Participants explained that youths regularly move between home and school (inner arrows). When home or school environments are dysfunctional, youths spend more time on the streets of their neighborhoods (bottom 2 arrows). The neighborhoods are rampant with negative influences, which then lead the youths on a seemingly inevitable pathway to incarceration (large arrow at right). Eventually, the youths are released from juvenile hall back to their home environments (upper arrow).
FIGURE 1—A conceptual map showing youths’ perceptions of pathways to jail: Los Angeles County, California, 2013.
1366 | Research and Practice | Peer Reviewed | Barnert et al.
American Journal of Public Health | July 2015, Vol 105, No. 7
RESEARCH AND PRACTICE
Thematic Quotations From In-Depth Interviews With Incarcerated Youths: Los Angeles County, California, 2013 Views on Environment: Home “If the family is supporting the kid in what he does, then there is no need for the kid to go into the environment to look for support.” “If a kid’s family doesn’t support him, then they’ll go into the environment looking for a false family.” “Mostly parents work at night because they’re undocumented. They don’t have papers. Janitors is the only job they can get. And in the night, that’s when the action happens in the streets.” Views on Environment: School “Some schools are in an enemy’s gangs. Kids have to go there because it’s the only free school around and then they can get jumped in. . . . It’s like a set-up.” “If you feel like your life is at stake, or just don’t feel comfortable being there [at school], you won’t want to go. You’re going to want to stay home. You’re going to ditch. And then when you ditch, you’re going to end up getting into trouble.” “Some teachers are like, ‘I see you in jail.’ ” Views on Environment: Neighborhoods “It’s just something about the neighborhood that brings kids back to the neighborhood. It’s a pattern. Once we get out, if we get out, we’re free. But then kids start doing drugs and drinking again. So it’s just into the neighborhood.” “If you live in a ghetto neighborhood, then you get so used to seeing ghetto so you start acting like it. That’s how you start becoming bad. . . . You’re following others because people don’t like to be different.” “If you live in a good neighborhood, you’re going to be like, ‘I’m going to be good because everyone else is good and I don’t want to be different.’ But in a bad neighborhood, you don’t want to be the good one because everyone’s bad.” Views on Environment: Jail “People say ‘I’m never going to come back in,’ but they always do. There’s something that keeps them coming back. Maybe they find the love that they don’t have at home from the staff. Hey, we get 3 hot plates a day, we go to school here. They give you everything here; shower, toothbrush, everything.” “Probably 20% of the kids maybe do feel loved [in jail] because they don’t have parents, father figures. They just never had them at all. They always have been DCFS [child welfare] or, you know, foster kids. So they decide to come to jail. Instead of being out there where they don’t have no one.” “I don’t really think kids like coming in and out of jail. Why? Because you really need your family out there. . . . It really does hurt when you’re here.” Views on Environment: Social Pressures Peer pressure “The problem is the whole social life. Kids can’t really focus on getting an education. They get into gangs to have the latest clothes, news shoes. Gangs, drugs, and then that leads to more and more.” “Sometimes kids just choose the wrong crowds to hang around with. They think about the wrong things like what other people think about them and they have low self-esteem. So they choose the wrong way and end up in the wrong places.” “If they really are truly good friends, you will succeed in life along with them. But if not, you’ll fall with them just like everybody else.” Desire for money “A kid with no money, he’ll probably steal to get what he needs, like he’ll steal from the store to eat or he’ll rob a house to eat or to provide for his family.” Gender roles “Boys are more involved with gangs, fights, guns, drugs. Girls end up in here for prostitution—drugs too—because they’re all looking for that love that they can’t find.” “There’s just more expected for a boy. Especially if your father isn’t there, you have to take on a lot of responsibility. Some boys feel like, ‘Well, I could put money in.’ With girls, it’s more of a peer pressure. You’re trying to fit in. Maybe stuff at home isn’t right and you’re looking for a coping mechanism.” Role of race/ethnicity “With Blacks and Hispanics, usually you live in ghetto neighborhoods. . . . You could be Black, Asian, Hispanic living in a ghetto neighborhood and be a criminal, or you could be Black, Asian, or Hispanic and live in the good neighborhood and actually become someone. It just depends on the neighborhood.” Inner Need: Love and Attention “They always say that babies need lots of love. But that never ends. Even growing up into a teenager, you still need love. And you need attention. I feel that positive reinforcement—paying attention to the child—that helps a lot.” “It’s very easy to get on the bad path because you like it. You like that somebody’s paying attention to you. You like that somebody’s actually caring for you. But in reality they’re just hurting you. You’re looking for that love that you can’t find at home, so you go to the streets.” Inner Need: Discipline and Control “As soon as parents start to lose discipline, that’s when that one kid starts messing up and most likely the whole family’s going to be downward on the floor.” “If it’s 2 parents and they’re both at home, it’s going to be better because both of them have the situation in control so they both say, ‘Yes, you’re not going out.’ ” “Too much, pressure, being strict—that causes a rebel kid. . . . I picture good parents as strict people. Strict, but not too strict.” Continued
July 2015, Vol 105, No. 7 | American Journal of Public Health
Barnert et al. | Peer Reviewed | Research and Practice | 1367
RESEARCH AND PRACTICE
Continued Inner Need: Role Models and Perspective “Every adult is a role model in a child’s eyes. Even when adults don’t see it, we’ll catch it and we’ll repeat it in our own way.” “What kids see, they think is right. If the parents are going in jail, they just follow what they see. The kids think that it’s cool. Like my dad or my mom do that, I can do that too. They’re thinking it’s right when it’s not.” “If a kid thinks he’s not going to live long—like 21 and 25—then in his head he’s like, I might as well do all that I want to do while I’m alive because I know I might end up dead or in jail somewhere.” Trajectory to Jail: No Easy Way Out “Probation’s not making it easier because now we have more pressure. You don’t have a C or above, that’s a violation. You miss school, violation; late to school, violation; not listening, violation. Anything you do, you come back.” “From here, you can only graduate. I mean, from here Juvenile Hall, then county jail [for adults], and you end up making your way to the Big House [state or federal prison].” “You could break that cycle . . . but most people would rather take the easy route: messing up. Being a hard worker and living a good life is a hard life.” Solutions “There are people out there willing to change. So I encourage mothers, fathers, teachers, doctors to try to show them a different way of living and not the lifestyle they like to live. Try to help them understand that the decisions they’re making are not right.” “We need to be able to know that someone does care, that someone just doesn’t want to throw us away and put us away because we’re running amok outside of these walls.” Note. Quotes were extracted from interviews on protective factors and risk factors for juvenile offending conducted with 20 incarcerated youths (12 males and 8 females). Of the 20 participants, 13 were Latinos and 7 were African Americans. Participants’ ages ranged from 12 to 17 years.
the school environment, stating that efforts to fit in often lead to delinquency. Overall, although they recognized that teachers could play a prominent role in promoting positive behaviors, most felt that teachers gave up on them too easily. Neighborhood. Participants described their ideal neighborhood as peaceful and quiet, with abundant nature and parks, and where community members were friendly and attentive to one another. However, they described their own neighborhoods as “ugly,” a “ghetto,” with “lots of gangs, shootings, and murder going around.” They explained that neighborhoods strongly promote crime, since, when not at home or in school, youths spend most of their time there. As one participant expressed it, “If home is bad and school is bad,” youths will end up on the streets, and inevitably, “then you’re going to end up in jail.” Neighborhoods were believed to represent the final space that adolescents inhabit before jail (Figure 1). Several participants also described an interrelationship between race/ethnicity and neighborhoods that they felt promoted pathways to jail. They explained that neighborhoods predominantly composed of families from ethnic minorities have a greater police presence and thus a higher likelihood of arrest for youths of color. Additionally, adolescents gravitate
toward others with similar ethnic backgrounds, which facilitates gang affiliations because youths within gangs often share similar ethnicity. Overall, however, most expressed the idea that neighborhood poverty was the more important determinant for predicting juvenile offending because in poor neighborhoods, negative influences were more rampant. Jail. Participants felt that incarceration was both seemingly inevitable and a consequence of poor decisions. They explained that since youths cycle between juvenile detention and their neighborhoods so frequently, jail represented an extension of the neighborhood. Participants had mixed feelings about detention. Many said that youths find it painful to be separated from their families and resent restrictions on freedom while in jail. However, several also said that jail feels safe and structured, and provides respite from their chaotic lifestyles. Social pressures. The major social pressures described included peer pressure, a desire to attain money or material goods, racism, and pressure to fulfill gender roles. Male and female respondents both stated that boys felt pressured to exhibit a “macho” persona, which promoted fighting, theft, gangbanging, and drug and gun possession and use. Conversely, they said that girls, driven by a desire for popularity or to please a boyfriend, were more
1368 | Research and Practice | Peer Reviewed | Barnert et al.
likely to be detained for fighting, prostitution (i.e., child sex trafficking), or carrying drugs or weapons for a boy.
Internal Needs Expressed by Participants We identified 3 internal needs expressed by the participants: a need for love and attention, discipline and control, and role models and perspective. Love and attention. All of the participants said that love and attention are essential to helping youths stay out of trouble. Receiving love from parents motivates them to please their parents and succeed. By contrast, adolescents who feel unloved or neglected see no reason to spend time with their families or to perform well in school, and ultimately they end up on the streets or in jail. Additionally, participants clearly stated that love alone is insufficient; youths desire attention as well. Several participants said that exhibiting delinquent behaviors could be a way of seeking attention from family members. To youths, parents’ “being there” means not only providing love and understanding, but also being attentive and guiding them through adolescence. Discipline and control. Several participants said that adolescents in their communities needed more discipline and control to counterbalance their chaotic, unsafe environments.
American Journal of Public Health | July 2015, Vol 105, No. 7
RESEARCH AND PRACTICE
They described good parents as “strict, but not too strict.” According to participants, parents should regulate youths’ activities and, given the dangers in their neighborhoods, should try to keep them at home; this form of control means that parents care for them. Participants’ statements about positive aspects of juvenile detention, which mostly centered on valuing the structure and routine of the facilities, further indicate that youths appreciate adults’ enforcing discipline and control. Role models and perspective. Participants expressed the idea that older family members are youths’ most important role models. They said that parents should guide adolescents “through a positive road,” encouraging a positive, future-orientated perspective. Most participants said that having parents who are bad examples, such as ex-convicts or gang members, negatively influences youths, as parental criminality normalizes adolescents’ delinquency. In contrast, a few participants said that having parents who are negative role models can be protective because adolescents may consciously avoid repeating parents’ mistakes. Friends also significantly affect youths’ perspectives. Whereas participants defined “bad friends” as ones who encourage criminal behavior, “good friends” deter peers from committing crimes, have plans for the future, and help guide youths on a path to success. Finally, as one participant stated, “Every adult is a role model in a child’s eyes.” Participants cited teachers, probation officers, judges, and health care providers as potential role models who, even in brief encounters, could provide valuable future-oriented perspective.
No Easy Way Out Participants expressed the belief that when home and school fail to meet their inner needs, male and female youths spend more time on the streets. “Blinded” by gangs, drugs, and other negative influences in their neighborhoods, adolescents make wrong choices and end up following a bad pathway. They then become trapped in a pattern of delinquency and incarceration. Once youths have a history of arrest, the threshold for rearrest becomes much lower. Participants explained that when youths are on probation, factors such as truancy, disrespecting parents, or being at the scene of a crime without having committed a crime easily lead
to a downhill cycle of rearrest and incarceration. Furthermore, upon release, they return to unstable homes and schools and to neighborhoods that promote delinquency. Participants indicated that the bad pathway of ending up in jail is the easiest choice given the environments that youths live in. In contrast to this “easy” path, they defined the “hard way” as staying in school and out of trouble. Many participants spontaneously referred to an adolescent on the bad pathway as a “follower.” In contrast, being a “leader” meant defying the norm by attending school, earning good grades, and ultimately attaining lifelong success. All of the participants said that the harder path is preferable. Participants said that this cycle extends beyond juvenile delinquency to adult criminality. Several participants viewed juvenile hall as “training” or “school” that youths “graduate” from before landing in “the Big House” (state or federal prison) as adults. Further, they said that because adolescents in their communities believe their life expectancy to be low—25 years or less—they have limited expectations for the future. Instead of striving for success, many adolescents act for survival. Participants said that this hastens the downward spiral, with many youths engaging in activities that increase their chances of ending up incarcerated or dead by early adulthood.
security guards to schools. Another proposed school uniforms to reduce social competition among girls. Many participants said that teachers should be attentive and supportive. This is especially important when the home environment is unstable. One participant said, “Even if it’s just maybe that math problem, inside we’re screaming ‘Really help me, because I don’t get this problem because I’m stressing out at home and out on the streets.’ ” After family members, teachers were mentioned as the most influential adults in youths’ lives. Several participants suggested afterschool programs, including tutoring, vocational, and sports programs, to keep adolescents occupied and out of the streets while building life skills and fostering a sense of belonging. To enhance the appeal of the programs for adolescents, a few participants suggested implementing gender-specific programs. Many noted the importance of programs that last until nighttime to eliminate time spent on the neighborhood streets. Field trips, several participants suggested, give youths an opportunity to see beyond their neighborhoods. Other adults who interact with adolescents, such as doctors, judges, and police officers, could help instill a positive, future-oriented perspective. Participants said they would be most receptive to receiving information from adults with similar backgrounds, especially adults from their neighborhoods.
Solutions Participants described potential solutions for juvenile offending in the home, school, and neighborhood environments that were consistent with the themes of youths’ needs for love and attention, discipline and control, and role models and perspective. Participants said that homes should be a safe haven. Parents should be positive role models who act lovingly and attentively and participate in their children’s lives. Older relatives, especially grandparents, can instill a future-oriented perspective. In effect, by providing love, support, discipline, perspective, and encouragement, families can help fulfill youths’ need to have structure and attachment. Schools were deemed key for overcoming the incarceration cycle and achieving long-term success. Participants said that for schools to be productive environments for youths, they should be safer. One participant suggested adding more
July 2015, Vol 105, No. 7 | American Journal of Public Health
DISCUSSION Overall, the incarcerated adolescent participants in our study expressed the belief that youths in their communities live in environments that are chaotic, unsafe, and unstructured. Juvenile detention may provide respite from the chaos and dangers of daily life, but serving time also perpetuates a cycle of rearrest and incarceration that follows adolescents into adulthood.5 Youths of both genders struggled to fulfill their innate emotional needs for love and attention, control and discipline, and positive role models who instill a positive future orientation. When these needs are not met, going to jail becomes the easier or more likely pathway. Participants demonstrated insight into the cycle of high-risk delinquent behaviors and criminality, and they desired help in breaking
Barnert et al. | Peer Reviewed | Research and Practice | 1369
RESEARCH AND PRACTICE
this cycle. They looked to adults to help them accomplish this. Influential adults include parents, other relatives, teachers, principals, counselors, police officers, judges, and health care providers. Listening to youths and responding to their needs may be an important starting point for successful interventions. Regarding the home, youths expressed a need for parents to be more loving, attentive, and regulating, and to provide positive role modeling. These characteristics are consistent with an authoritative parenting style, which is associated with less delinquent behavior.20,21 This finding is also consistent with prior research on incarcerated adolescents undergoing reentry, which demonstrated the protective influence of family connectedness.16 Furthermore, the youths’ perspectives align with previous meta-analyses on program efficacy, which have demonstrated that interventions that strengthen family interactions are the most effective in improving the trajectories of youths involved in the juvenile justice system.22 Family-based therapies such as Functional Family Therapy and Multisystemic Therapy, administered by an in-home therapist to a family, have been shown to be particularly effective. These programs have demonstrated reductions in recidivism of 16% and 7%, respectively. The programs are likely successful because they build skills among the adults who are best able to influence these vulnerable youths.22 Programs that help parents and adolescents negotiate challenges, build parenting skills, and encourage supportive environments at home may be especially effective. Although the literature suggests that a “school-to-prison pipeline” exists, the perspectives of the participants indicated that although schools can catalyze the pathway to jail, they also have an important protective influence.23 Academic programs that support school performance offer an opportunity to help adolescents avoid or overcome trajectories of delinquency and incarceration.22 Participants recognized the importance of academic achievement, and expressed the idea that feeling unsafe at school was the primary barrier to school attendance and a main contributor to juvenile offending. School safety, including freedom from bullying, is an important determinant of physical24 and mental health.25,26 Ensuring safe schools may be a key strategy for
preventing juvenile offending. Teachers have a profound ability to influence youths. Strategies to encourage meaningful relationships between school staff and students, such as small-learning communities and lower total student load, might further boost the protective influence of teachers and education.27 Our study indicated that juvenile justice--involved youths do not currently perceive their communities as a source of stability and support. Instead, they see their neighborhoods as a trap, leading them down an inevitable pathway to incarceration. Participants expressed the need for safe, structured, caring environments outside of their homes and schools. Thus, there is an opportunity for faith-based and other community leaders to fill this void and help make neighborhoods safer. The fact that faithbased organizations, considered vitally important in many neighborhoods of color, seemed irrelevant to these youths’ lives suggests untapped potential that could become a focus for research and intervention. Participants expressed belief in the value of interacting with adults who have themselves broken the cycle of incarceration present in many socially disadvantaged neighborhoods. Given youths’ perceptions of absent parents and teachers who give up on them, they seem to be seeking inspiration and guidance from other adults who can demonstrate how people make it out of their neighborhoods. This is consistent with previous studies that demonstrated the effectiveness of mentoring programs in decreasing recidivism, and it suggests an important area for intervention.22 The finding that the majority of the African American and Latino youths that we interviewed do not perceive racism as significantly affecting the pathway to jail was unexpected. The few who pointed to racism as such a factor described racial profiling by police and others. Although institutionalized racism within the education and juvenile justice systems is well documented,28,29 many adolescents may be unaware of it or dismiss its impact. Additionally, all of the participants emphasized the strong influence of economic deprivation, which they perceived as a more significant contributor to juvenile incarceration than racism. They explained that African Americans and Latinos are more likely to live in high-poverty neighborhoods with negative influences that facilitate
1370 | Research and Practice | Peer Reviewed | Barnert et al.
a pathway to jail. This highlights the need to address underlying social determinants of health, such as childhood poverty. As the participants suggested, making violent neighborhoods safer by cultivating safe, green spaces and afterschool programs may prove valuable in gradually shifting the trajectories of entire communities.
Limitations This exploratory study was limited to a small sample of youths in 1 urban area. Thus, the interviewed participants were not necessarily representative of all incarcerated or otherwise high-risk adolescents. Two of the authors, however, are involved in an analogous study of violent, nonincarcerated youths. Findings from both studies are strikingly consistent, suggesting that similar protective and risk factors may affect lower-risk, delinquent adolescents (R. Shetgiri, S. Lee, C. Wilson, et al., unpublished data, 2013).
Conclusions The incarcerated youths that we interviewed demonstrated insight into their lives and communities, and many indicated readiness to strive for positive change. The relative paucity of research and attention paid to this vulnerable population may be a factor impeding their success. Ultimately, the public health community will need to partner with legislators, educators, community leaders, and the adolescents themselves to clarify how to make success, rather than incarceration, the easier path for vulnerable youths in disadvantaged communities. j
About the Authors At the time of the study, Elizabeth S. Barnert was with the Robert Wood Johnson Foundation Clinical Scholars Program, Los Angeles, CA. Veronica F. Azzi was with the Department of Medicine, University of California, Los Angeles. Bonnie Zima was with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. Rebecca Dudovitz and Paul J. Chung were with the Department of Pediatrics, University of California, Los Angeles. Raymond Perry was with Juvenile Court Health Services, Los Angeles County Department of Health Services. Rashmi Shetgiri was with the Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas. Gery Ryan was with the RAND Corporation, Santa Monica, CA. Correspondence should be sent to Elizabeth Barnert, Mattel Children’s Hospital, UCLA, 10833 Le Conte Ave, Room 12-358, Los Angeles, CA 90095 (e-mail: [email protected]). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link. This article was accepted July 24, 2014.
American Journal of Public Health | July 2015, Vol 105, No. 7
RESEARCH AND PRACTICE
Contributors E. S. Barnert, R. Perry, R. Shetgiri, G. Ryan, R. Dudovitz, B. Zima, and P. J. Chung worked on the study design, analysis, and writing of the article. V. F. Azzi contributed to the analysis and writing of the article.
Acknowledgments This project was funded by the Robert Wood Johnson Foundation Clinical Scholars Program (grant 70039) and by an Academic Pediatric Association Young Investigator Award. R. Shetgiri was supported by a grant from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (K23HD068401). We thank our community partners—the Los Angeles County Juvenile Court Health Services, Probation Department, and Juvenile Court. C. M. Mangione, R. H. Brook, and S. Berry contributed to the conceptual development of this project. Note. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National Institutes of Health.
Human Participant Protection This study was approved by the institutional review boards of the RAND Corporation and the Los Angeles County Department of Human Services. To maximize protection of participants, a Certificate of Confidentiality was obtained from the National Institutes of Health.
References
11. Farrington DP. Developmental and life-course criminology: key theoretical and empirical issues—the 2002 Sutherland Award Address. Criminology. 2003; 41(2):221---255. 12. Tarolla SM, Wagner EF, Rabinowitz J, Tubman JG. Understanding and treating juvenile offenders: a review of current knowledge and future directions. Aggress Violent Behav. 2002;7(2):125---143. 13. Hoge RD, Andrews DA, Leschied AW. An investigation of risk and protective factors in a sample of youthful offenders. J Child Psychol Psychiatry. 1996; 37(4):419---424. 14. Beaver KM, Nedelec JL, Wilde M, Lippoff C, Jackson D. Examining the association between MAOA genotype and incarceration, anger and hostility: the moderating influences of risk and protective factors. J Res Pers. 2011; 45(3):279---284. 15. Harper CC, McLanahan SS. Father absence and youth incarceration. J Res Adolesc. 2004;14(3):369---397. 16. Unruh D, Povenmire-Kirk T, Yamamoto S. Perceived barriers and protective factors of juvenile offenders on their developmental pathway to adulthood. J Correctional Educ. 2009;60(3):201---225. 17. Jones L, Wells K. Strategies for academic and clinician engagement in community-participatory partnered research. JAMA. 2007;297(4):407---410. 18. Acoca L. Investing in Girls: A 21st Century Strategy. Washington, DC: Office of Juvenile Justice and Delinquency Prevention; 1999. 19. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77---101.
1. Snyder HN, Sickmund M. Juvenile Offenders and Victims: 2006 National Report. Rockville, MD: US Dept of Justice, Office of Juvenile Justice and Delinquency Prevention; 2006.
20. Hoeve M, Dubas JS, Eichelsheim VI, van der Laan PH, Smeenk W, Gerris JRM. The relationship between parenting and delinquency: a meta-analysis. J Abnorm Child Psychol. 2009;37(6):749---775.
2. Reducing Youth Incarceration in the United States. Baltimore, MD: Annie E. Casey Foundation; 2013.
21. Steinberg L, Mounts M, Lamborn S, Dornbusch S. Authoritative parenting and adolescent adjustment across varied ecological niches. J Res Adolesc. 1991;1(1):19---36.
3. Sickmund M, Sladky T, Kang W, Puzzanchera C. Easy access to the Census of Juveniles in Residential Placement. 2013. Available at: http://www.ojjdp.gov/ ojstatbb/ezacjrp. Accessed July 18, 2014.
22. Greenwood P, Turner S. Juvenile crime and juvenile justice. In: Wilson J, Petersilia J, eds. Crime and Public Policy. Oxford, UK: Oxford University Press; 2011:88---129.
4. Committee on Adolescence. Health care for youth in the juvenile justice system. Pediatrics. 2011;128(6): 1219---1235. 5. Teplin LA, McClelland GM, Abram KM, Mileusnic D. Early violent death among delinquent youth: a prospective longitudinal study. Pediatrics. 2005;115(6): 1586---1593. 6. Teplin LA, Abram KM, McClelland GM, Dulcan MK, Mericle AA. Psychiatric disorders in youth in juvenile detention. Arch Gen Psychiatry. 2002;59(12):1133---1143.
23. Wald J, Losen DJ. Defining and redirecting a schoolto-prison pipeline. New Dir Youth Dev. 2003;(99):9---15. 24. Swahn MH, Bossarte RM. The associations between victimization, feeling unsafe, and asthma episodes among US high-school students. Am J Public Health. 2006; 96(5):802---804. 25. Nijs MM, Bun CJ, Tempelaar WM, et al. Perceived school safety is strongly associated with adolescent mental health problems. Community Ment Health J. 2014;50(2): 127---134.
7. Hein K, Cohen MI, Litt IF, et al. Juvenile detention: another boundary issue for physicians. Pediatrics. 1980;66(2):239---245.
26. Ozer EJ, Weinstein RS. Urban adolescents’ exposure to community violence: the role of support, school safety, and social constraints in a school-based sample of boys and girls. J Clin Child Adolesc Psychol. 2004;33(3):463---476.
8. Coffey C, Veit F, Wolfe R, Cini E, Patton GC. Mortality in young offenders: retrospective cohort study. BMJ. 2003;326(7398):1064.
27. Miles KH, Darling-Hammond L. Rethinking the allocation of teaching resources: some lessons from highperforming schools. Educ Eval Policy Anal. 1998;20(1):9-- 29.
9. Shader M. Risk factors for delinquency: an overview. Available at: https://www.ncjrs.gov/pdffiles1/ojjdp/ frd030127.pdf. Accessed July 18, 2014.
28. Spears AK. Institutionalized racism and education of blacks. Anthropol Educ Q. 1978;9(2):127---136.
10. Patterson EJ. The dose---response of time served in prison on mortality: New York State, 1989---2003. Am J Public Health. 2013;103(3):523---528.
29. Brewer RM, Heitzeg NA. The racialization of crime and punishment: criminal justice, color-blind racism, and the political economy of the prison industrial complex. Am Behav Sci. 2008;51(5):625---644.
July 2015, Vol 105, No. 7 | American Journal of Public Health
Barnert et al. | Peer Reviewed | Research and Practice | 1371
