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Healthy Passages: A Community-Based Longitudinal Study of Adolescent Health


Host Institution
University of Texas Health Science Center at Houston (previous center): University of Texas Prevention Research Center

Health Topics
Healthy youth

The Texas PRC’s researchers, community advisory group, and collaborators from the University of Alabama and the University of California at Los Angeles studied the adoption of health-related habits of adolescents, such as engaging in risky sexual behavior; making poor dietary choices; experimenting with alcohol, tobacco, drugs, and other substances; and getting insufficient physical activity. The researchers also studied the relationship between these behaviors and school performance as well as how parenting can influence a child’s behavior and academic achievement during adolescence. Promoting healthy habits among young people may help them complete high school, avoid delinquency and sexually transmitted infections as well as reduce their risk of developing diabetes, heart disease, obesity, and some forms of cancer later in life.
The 10-year Healthy Passages study began in November 2004 by recording individual, community, family, and peer factors that influence behavior among teens and pre-teens. More than 5,100 5th-grade students from approximately 75 schools in Houston, Birmingham, and Los Angeles were surveyed every-other year, beginning at age 10. Their primary caregivers completed surveys about their own health, parenting style, and their children’s behavior. Principals, teachers, and other school staff completed surveys about their training as well as the educational opportunities, discipline issues, and community support available at the participating schools.

The Houston PRC recruited 1,783 of the participants for the study and sent survey data to technical advisors at CDC. Results were combined with those collected from the other two participating centers and reviewed. The combined data were then returned to the three sites for analysis. Representatives from all three centers collaborated on individual research articles, based on the combined data. The contributions to this study from Houston represent the center’s core research project. Houston PRC staff chaired the study’s steering committee, executive committee, and measurement committee.

Initial findings from the combined survey results suggested that early puberty (girls only), dissatisfaction with body image, and several other factors could raise the risk of delinquency, mental health conditions, substance abuse, and other health issues in the students. Risk of these outcomes increased if youth reported they did not receive meaningful guidance from parents, teachers, and medical professionals. Preliminary findings also suggested that parents could reduce these risks by providing nurturance, supervision, and clear expectations.3 Researchers plan to follow participants every 3–5 years afterward, and the researchers are hoping to analyze changes in participants’ behavior, identify the factors that influence their behavior over time, and compare behaviors with participants’ health outcomes.

Windle M, Grunbaum JA, Elliot M, Tortolero S, Berry S, Gilliland J, Kanouse DE, Parcel GS, Wallander J, Kelder S, Collins J, Kolbe L, Schuster M. Healthy Passages: a multilevel, multimethod longitudinal study of adolescent health. American Journal of Preventive Medicine 2004:27(2):164-72.

Gilliland JM, Windle M, Grunbaum J, Yancey A, Hoelscher D, Tortolero SR, and Schuster MA.
Body image and children’s mental health related behaviors: results from the Healthy Passages study. Journal of Pediatric Psychology 2007:32:30-41.

Mrug S, Elliott M, Gilliland MJ, Grunbaum J, Tortolero SR, Cuccaro P, Schuster M. Positive parenting and early puberty in girls: protective effects against aggressive behavior. Archives of Pediatrics & Adolescent Medicine 2008:162(8):781-6. 

Related Information:
Healthy Passages Overview
Research Setting
City/Town | School or school district | Urban area
Race or Ethnicity
Black or African American | Hispanic or Latino | White
No specific focus
Age Group
Children (4-11 years) | Adolescents (12-17 years) | Adults (25-49 years)
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Principal Investigator
Susan Tortolero

Project Identifier
Healthy Passages - Core Project (2004-2009)

Funding Source
PRC Program

Project Status
Not active