Adolescence involves a complex interplay of biological, relational, and social development which influences successful transitions into adulthood. The intersections of biology, behaviors, and the social environment during critical developmental transitions may significantly affect life course trajectories. As noted in Healthy People 2020, a significant proportion of adolescent morbidity and mortality is associated with behaviors which contribute to poor health.1 Addressing public health problems such as youth violence and teen pregnancy requires innovative strategies to promote protective social environments, increase healthier behaviors, and reduce the impact of health risk behaviors into adulthood. Multilevel, interdisciplinary, and translational approaches are needed to address these challenges in adolescent health.
In May 2012, a group of adolescent health researchers from the University of Pittsburgh, Carnegie Mellon University, and RAND Corporation participated in a 1-day research symposium titled “From Genes to Community: Exploring Translational Science in Adolescent Health Research,” sponsored by the Clinical and Translational Science Institute (CTSI) of the University of Pittsburgh and the Division of Adolescent Medicine, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center. Emerging research in adolescent decision making, emotion regulation, social networks, and epidemiology is identifying critical developmental processes with implications for the design of clinical and community-based interventions and social policies, yet these research findings are slow to translate to relevant practice and policy changes to promote adolescent health. Symposium participants discussed how cutting-edge findings from basic biobehavioral sciences including functional neuroimaging and decision science could be made relevant for the many local community partners invested in promoting adolescent health who were present at the symposium. Underscoring opportunities for bidirectional knowledge transfer, community partners also encouraged researchers to attend to practice-based evidence as well as development of flexible, locally relevant interventions.
The goals of the symposium were twofold: first, to highlight the array of adolescent health research occurring in the region, and second, to encourage interdisciplinary research collaborations. Symposium presenters shared innovative research methods, emphasizing translation from basic behavioral and social sciences to clinical and community-based research (T1 and T2 research as well as T3 practice-based research as suggested by Westfall et al.2) The research symposium offered opportunities for adolescent health researchers to share examples of translational research as well as to identify potential collaborations to promote translational research. Discussion focused on describing mechanistic pathways by which social contextual factors may hinder or promote positive youth development and improve adolescent health outcomes, and on developing targeted interventions using systematic, theory- and evidence-driven approaches.3 The adolescent health research papers that are included in this issue of Clinical and Translational Science as well as those that will follow reflect the dynamic intellectual exchanges and research agendas emerging from this symposium.
Woolf4 has argued for greater attention to the differences in and disproportionate funding for T1 versus T2 research, noting that while translational research appears important to all, what is meant by translational research “means different things to different people.” The symposium presenters grappled with varied definitions of “translation,” ranging from making basic behavioral and neural sciences relevant for common adolescent health concerns such as obesity to identifying strategies for community-partnered knowledge transfer. Works presented included innovative translational approaches to understanding adolescent sexual decision making and behaviors and improving sexual health outcomes—from neuroscientific assessments of how adolescents respond to reward and engagement in risky behaviors to parent–adolescent communication about sexual decision making, application of decision-making science for understanding sexual choices, and integration of decision science into design of behavioral interventions. Also discussed was the emerging research on adolescent self-regulation and how targeting these regulatory processes during critical developmental transitions may lead to improvements in mood and social functioning. Illustrating the integration of such cutting edge neuroscience into clinical research, other researchers focused on sleep dysregulation among sexual minority girls, drawing out implications for improving mental health outcomes for this highly vulnerable population. Farris and Fischhoff (in this issue) employ decision-making science to propose strategies for improving sexual risk reduction interventions for young women at risk for sexual violence victimization.5
In contrast to this emphasis on translating basic neuroscience, behavioral and social sciences for clinical and community-based practice, other papers will examine the processes of community and stakeholder engagement. Another research group presented a creative arts-based approach which encourages younger adolescents to share their perspectives on sensitive topics such as bullying and community violence and to participate in adapting evidence-based practices and programs for their communities. A systematic approach to assisting youth-serving agencies to improve the quality of program implementation, titled “Getting to Outcomes,” focusing on how to evaluate processes of implementation of adolescent health promotion programming was presented.
The mission of the Clinical and Translational Science Institute (CTSI) at the University of Pittsburgh is to “improve the efficiency with which biomedical advances translate to improvements in the health of the community.” This research symposium reflected the CTSI's emphasis on transforming the process of clinical and translational research by enabling scientists to generate and translate new biomedical knowledge. Drawing attention to the opportunities within translational science to improve the health of adolescents, the symposium stimulated novel, concrete interdisciplinary collaborations evidenced by publications and grant proposals prepared since the symposium. In addition, local foundations who participated have been spurred to support youth-serving agencies and academic researchers to come together to improve the health of adolescents through systematic data collection (including shared adolescent health indicators) as well as testing of innovative health promotion programming. Other sites funded through Clinical and Translational Science Awards may find similar benefits from highlighting translational research in a focused area such as adolescent health.