Mental health and teen pregnancy-related outcomes are both important to young people’s overall well-being, and often intersect in ways that matter for research, policy, and practice. Examining these areas together, as related factors, can help identify critical protective factors—relationships, resources, or supports that promote positive outcomes for youth. For young people who homelessness, disconnection from school and work, or involvement with the child welfare or justice systems, connections with supportive adults are meaningful protective factors for well-being across multiple areas of their lives. For the youth-supporting professionals who work with these young people, the questions of how and why to be a supportive adult are highly relevant.
This research summary examines the intersections between mental health, teen pregnancy, and related sexual and reproductive health outcomes, describes how nonfamilial supportive adults are a well-documented protective factor across multiple areas of well-being for young people’s mental health and sexual and reproductive health, and highlights additional ways youth-supporting professionals can support the well-being of young people. This resource provides an overview of recent research and is meant to complement Activate’s tool, A Practice Guide for Promoting Youth Mental Health and Sexual and Reproductive Health as a Supportive Adult, which provides research-informed strategies for youth-supporting professionals to apply the findings discussed here.
Overview
- Young people’s mental health and sexual and reproductive health, including teen pregnancy, are connected in nuanced ways.
- Supportive adults may include youth-supporting professionals, formal mentors, and informal or “natural” mentors.
- Young people who are connected to supportive adults tend to have improved sexual and reproductive health and mental health outcomes, relative to young people who do not have supportive adults in their lives.
- Supportive adults can help young people navigate common challenges that can affect their well-being and help ensure that young people have access to basic resources and supports (such as health care) that are closely tied to health.
Intersections Between Mental Health and Teen Pregnancy
Mental health and mental illness are not the same thing. Mental health includes positive emotions and strengths like emotion management, coping with stress, and life satisfaction, as well as feelings of distress or mental health conditions such as a depressive or anxiety disorder.[1] Everyone has mental health, and it is one important component of overall well-being. Further, mental health and sexual and reproductive health (including outcomes like early and unintended pregnancy) are often correlated. This is true for young people as well as adults. The relationship between teen pregnancy and mental health is nuanced, and these two aspects of health can influence one another in a variety of ways.[2] Young people who have positive perceptions of their sexual and reproductive health, for example, are more likely to have good mental health.[3] At the same time, those who experience challenges with their mental health (e.g., depression, anxiety) have been found to have adverse sexual and reproductive health experiences (e.g., unintended pregnancy, delays in accessing contraception).[4] Likewise, adverse experiences like unintended pregnancies can trigger mental distress.[5],[6]
Previous Activate research summaries have described why pregnancy prevention is particularly important for young people experiencing homelessness, the justice system, the child welfare system, or disconnection from school and work. Broadly, experiencing adversity early in life, such as maltreatment or family disruption, is associated with increased likelihood of teen pregnancy.[7],[8] Similarly, adverse experiences like maltreatment or housing instability, for example, can also strain young people’s mental well-being.[i],[9],[10],[11],[12]
Why sexual and reproductive health outcomes beyond teen pregnancy are considered in this research summary
Teen pregnancy is not an event that occurs in a vacuum. It is shaped by sexual health knowledge,[13] contraceptive and condom use,[14][15] how long youth have been sexually active,[16] access to clinical services,[17] pregnancy intentions and desires,[18][19] and other factors. For this reason, we consider a spectrum of sexual and reproductive health outcomes to gain a broader understanding of the protective influence of supportive adults.
Connections With Supportive Adults
Positive connections with other people—such as peers, family members, and supportive adults—can be critical protective factors for young people. This resource focuses on positive influences in the form of supportive adults, including connections with mentors, youth-supporting professionals, and other caring and trusted adults. Other types of interpersonal connections (e.g., peer, family) are not the focus of this resource, but are discussed in other Activate resources such as Exploring the Dual Experiences of Parenting While Being Parented.
Relationships with supportive adults have often been studied in the context of mentoring relationships. Mentoring relationships may be formal, like those established as part of a structured mentoring program. Young people may also have “natural mentors”—non-parent adults who are a part of a young person’s life (e.g., a coach, teacher, or religious leader) and who provide mentorship outside of a formal mentoring program.[20],[21],[22] Natural mentorships typically develop organically between a young person and a non-parental adult, rather than through formal structure.
In addition to mentorship, relationships with youth-supporting professionals in the context of a program or service can also be highly protective when the professional’s approach is evidence-based and builds connection and knowledge.[23],[24],[25] Research has identified the importance of young people’s connections with caring, non-judgmental, informed adult service providers.[26] Studies show that young people who experience systems such as child welfare or juvenile justice need supportive adults who provide reassurance, informed advice, and age-appropriate boundaries and expectations while also taking youth voice into account.[27] Young people seek connections with youth-supporting professionals who are attuned to their needs and are willing to engage in ongoing conversations.[28]
Given the important role of supportive adults, the following sections summarize existing evidence for supportive adults as protective factors for young people’s sexual and reproductive health (including prevention of unintended teen pregnancy) and mental health.
Youth sexual and reproductive health
Research has repeatedly found supportive adult relationships to be a protective factor for a number of sexual and reproductive health outcomes during adolescence and young adulthood. Ojukwu and colleagues conducted a review of research on teen pregnancy, with a focus on studies that engaged mostly Black adolescents. The review found that across multiple studies, supportive neighborhood environments and experiencing mentorship from adults were associated with a decreased likelihood of experiencing pregnancy during adolescence.[29]
Supportive adult connections may be particularly important for young people with challenging circumstances, such as involvement with the child welfare or justice systems. Researchers have found that young people involved with the child welfare system or in foster care had a lower likelihood of having new sexual partners when their caregivers were knowledgeable about their lives, including their whereabouts and activities.[30] Supportive adults can help connect young people involved with the child welfare system with information about contraceptives and how to access them.[31] For young people experiencing homelessness, connections with natural mentors may increase the likelihood that they will use contraception and reduce the odds of engaging in risky sexual behaviors.[32]
Connections with supportive adults within their communities and schools are associated with young people being less likely to initiate sexual activity, having fewer sexual partners, and being less likely to be diagnosed with a sexually transmitted infection.[33],[34] A systematic review of qualitative research on how school experiences affect young women’s decisions about pregnancy and parenthood found that teachers were notable influences: Students whose teachers set high expectations for educational attainment may be more likely to continue in school and, in turn, less likely to experience pregnancy as a teenager or young adult.[35]
Youth mental health
Research has consistently found that relationships between young people and safe, supportive adults are protective of mental health.[36],[37],[38],[39] For young people who are already experiencing mental health challenges, adults who act as mentors can support their mental health by being a consistent presence who listens and “shows up.”[40] Mentors are associated with lower depressive symptoms and social anxiety for young people.[41] Young people who have a natural mentor in their life experience higher levels of positive mental health outcomes than those who do not have a natural mentor, including positive social-emotional development and satisfaction with social support.[42],[43],[44]
Connections with adults that support mental health can also go beyond mentor-style relationships. For young people still in school, positive relationships with teachers and a higher sense of “connectedness” to school are associated with less loneliness, decreased emotional distress, and lower odds of suicidal ideation.[45],[46] Analysis of data from nearly 15,000 middle- and high-school students in California found that students who had closer, more supportive teacher connections reported higher levels of mental well-being and slightly lower levels of depressive symptoms. The study also found that having supportive relationships with non-family adults in the community was similarly associated with better mental health.[47]
The benefits of being connected to supportive adults may be long-lasting. Bethell and colleagues analyzed survey data from adults and found that the odds of experiencing depression or poor mental health in adulthood were roughly 40 percent lower for those who had at least two non-parental adults who took a genuine interest in them when they were younger compared with those who did not have such supportive adult connections when they were younger.[48]
Ways Supportive Adults Can Protect Young People’s Well-being
The above sections explore the links between supportive adults and youth mental health and sexual and reproductive health. There are a variety of ways that supportive adults can protect the sexual and reproductive health and mental health of young people, and the most important ways may be different for each young person, depending on their individual needs. The sections below describe two broad types of support that can be beneficial: helping young people navigate common challenges and risks, and helping young people access critical services, resources, and social connections that promote well-being.
Helping young people navigate challenges and risks
To date, much of the research about teen pregnancy and mental health in young people has focused on risk factors. Although this research summary focuses on supportive adult connections as a protective factor, youth-supporting professionals should be aware of common risk factors that can affect both sexual and reproductive health and mental health for youth. For instance, many adverse life experiences have been linked with negative outcomes related to both sexual and reproductive health and mental health in adolescence and emerging adulthood. In particular, childhood experiences of maltreatment (abuse and neglect) have been linked with lower levels of flourishing (defined as “perceived success in relationships, self-esteem, meaning, purpose, and optimism”), higher rates of teen pregnancy, and a number of other adverse mental health and sexual and reproductive health outcomes.[49],[50],[51],[52] Other risk factors include being bullied or experiencing peer violence, which have been linked with loneliness;[53] depression, anxiety, and other mental health outcomes;[54] a higher number of recent sexual partners;[55] and earlier sexual initiation.[56] Experiencing relationship-based violence also poses significant risks to young people’s mental health, likelihood of teen pregnancy, and other sexual and reproductive health outcomes.[57],[58],[59]
Young people who experience the child welfare or juvenile justice system, homelessness, and disconnection from school and work may face higher-than-average odds of experiencing the challenges described above,[ii] which in turn can pose risks to their sexual and reproductive health and mental health. Importantly, youth-supporting professionals can help reduce the impacts of various risk factors and support young people’s mental health and sexual and reproductive health. Research has found that when young people are connected to supportive adults, they are more likely to have access to other resiliency-promoting factors such as having supportive friends or access to community resources.[60]
Supportive adults have been found to diminish students’ fears about being bullied in school and may help mitigate the relationship between bullying and suicide attempts.[61],[62] Research has also found that young people are more likely to tell adults in their lives about bullying experiences if those adults have communicated an intolerance for bullying, suggesting that supportive adults can act in concrete ways that may make young people more likely to disclose their bullying experiences.[63]
Supportive adults can also be helpful in instances of relationship violence. Adolescents who have supportive adults who they feel comfortable talking with about relationship violence are more likely to be open to seeking help about intimate partner violence from others.[64] Steiner and colleagues found that school connectedness, which includes closeness with school staff, was associated with reduced likelihood of experiencing various forms of relationship violence in adulthood, indicating that supportive adult connections may have long-term protective benefits for youth.[65]
While adverse childhood experiences such as abuse or neglect are associated with a substantially elevated risk of depression in adulthood, Lee et al. found that having high levels of social support in childhood, which includes connections to trusted adults, cuts this risk increase roughly in half.[66] Similarly, having a higher degree of connectedness to school, including to school staff, may lessen the influence of early adversities on sexual and reproductive health outcomes – reducing the likelihood of outcomes including sexual initiation and teen pregnancy.[67]
Supporting the basic conditions for well-being
Supportive adults can help young people by connecting them to the basic services, resources, and social connections that support well-being, such as stable housing,[68] coordinated care,[69] and placement stability if in foster care.[70] Compared with their peers, young people who experience homelessness, the child welfare system, the justice system, or disconnection from school and work may experience more interruptions to stable housing, coordinated care, placement stability, and other supports that shape well-being.[71],[72] As such, these young people may need additional support for their sexual and reproductive health and their mental health.
Importantly, youth-supporting professionals may advocate for young people to receive evidence-based services that can support both sexual and reproductive health and mental health. Existing research suggests that a range of supportive services and interventions can help promote positive sexual and reproductive health outcomes for young people. For instance, Multidimensional Treatment Foster Care placement has been associated with lower rates of pregnancy over time for youth in foster care, with researchers emphasizing the role of mentorship, guidance, and attention in supporting the well-being of teen mothers and their infants.[73] A systematic review of 23 studies focused on preventing rapid repeat pregnancy among adolescents in foster care also found that the most promising approaches were those that included a case management component, possibly suggesting benefits of relationships with youth-supporting professionals like caseworkers.[74]
Access to care is also critical for young people’s sexual and reproductive health.[75],[76] Offiong and colleagues describe different dimensions of access to sexual and reproductive health care in detail and offer a tool for assessing the landscape of sexual and reproductive health care providers in communities.[77] A systematic review of five studies on preventing rapid repeat pregnancies for broader groups of young people found that access to evidence-based health care services was protective, and promoted the use of contraception or family planning.[78] Other research has found that access to school-based sex education can have positive impacts on sexual and reproductive health behaviors, such as delaying sexual initiation and increasing condom use,[79] including for young people impacted by the juvenile justice or child welfare systems.[80] Supportive adults may also provide young people with encouragement to access health care, or even go with them to medical appointments.[81]
Regarding mental health, researchers have found success with school-based interventions to reduce self-harm and suicidal behaviors.[82] Researchers who reviewed 17 studies found mixed evidence for effectiveness of psychosocial interventions to boost mental health for pregnant and parenting adolescents, finding small but positive benefits for general mental health and school attendance,[83] which may be particularly relevant for youth-supporting professionals who work with young people who are disconnected from work and school. Overall, however, the researchers concluded that there is a critical need for more research in this area.[84] Other gaps in research include best practices for promoting mental health among youth incarcerated in detention facilities.[85] While limited, available evidence suggests that youth-supporting professionals who work with young people involved in the juvenile justice system should be informed about mental health broadly and also promote collaboration between juvenile justice and mental health care systems.[86]
Finally, youth-supporting professionals may be able to support young people in developing or maintaining other social connections that may support their well-being (e.g., positive family members, peers, or community members). Hardy and colleagues, for example, studied the social support networks of youth experiencing homelessness. They found that those youth who were frequently in contact with their support network, and whose networks could provide high quality support, had greater resilience and felt more relief from engaging their networks for help.[87] Similarly, a study of young people experiencing homelessness who had a mental illness found having supportive social relationships and a sense of belonging in the community contributed to mental health recovery.[88]
Conclusion
Together, the research summarized here suggests that supportive adult connections can be an important protective factor for young people’s mental health and sexual and reproductive health. Supportive adults can help young people feel connected, access needed services and resources, and navigate risks that may affect their well-being.
We developed this research summary using a multi-step, iterative literature search process, described below.
Step 1: Preliminary academic literature search
First, we conducted searches using PubMed and Google Scholar to identify research published since 2015 on 1) risk and protective factors for mental health and teen pregnancy and 2) studies that assessed both mental health and teen pregnancy. These searches prioritized review articles (e.g., systematic reviews, meta-analyses, conceptual models). An example search is as follows:
("teen pregnancy" OR "adolescent pregnancy" OR "teen birth" OR "adolescent birth" OR "teen childbearing" OR "adolescent childbearing") AND (("risk factor" OR "protective factor") OR ("conceptual framework" OR "conceptual model" OR "systematic review" OR "scoping review" OR "meta-analysis"))
We also conducted searches using simple terms related to Activate’s focal populations (e.g., “pregnancy and juvenile justice”) in Google Scholar.
Altogether, the academic literature search resulted in 466 articles being considered for possible relevance. We screened titles of all articles and excluded 71 articles, resulting in 394 potentially relevant articles. Next, we reviewed abstracts of each article and excluded: 1) biomedical research, 2) research focused on countries outside of the U.S. or Canada, and 3) articles lacking relevance to influences on adolescent mental health or sexual and reproductive health, or the interrelationship between mental health and sexual and reproductive health. This abstract screening process eliminated 295 articles. We then conducted full-text reviews of the remaining 99 articles, ultimately keeping 51 articles. Of these, 35% (18 articles) focused on or discussed supportive adult connections, leading to this research summary being narrowed to focus on this key protective factor.
Step 2: Supplemental academic literature search
We supplemented the broad search of academic literature with additional targeted searches as needed throughout the writing process. These included searches using specific terminology (e.g., mentor “mental health” adolescent), reviews of reference lists in other studies, and identifying studies already known to the authors. These supplemental activities resulted in the identification of 36 potentially relevant studies. Of these, 26 received full-text review, and 15 were relevant to this research summary’s focus on supportive adult connections.
Step 3: Gray literature search
We reviewed reports, briefs, and other resources from federal, non-governmental, and practitioner-oriented organizations, such as Casey Family Programs, National Network for Youth, the National Mentoring Resource Center, and the Office of Juvenile Justice and Delinquency Prevention. We conducted a high-level scan of 28 resources published by 18 organizations; of these, eight resources were relevant to the research summary’s focus on supportive adult connections.
Acknowledgements
The authors would like to thank the many contributors to this resource. Experts who informed the resource include Amandalyn Stallings and Katie Massey Combs, PhD. We also thank other Activate project team members who assisted in the development of this resource, including Mindy Scott (Principal Investigator), Amy Dworsky (co-Principal Investigator), and April Wilson (Project Director). We are grateful for the support of Child Trends staff who contributed to this resource, including Matthew Rivas-Koehl, Karlee Naylon, Rowan Hilty, Kristen Harper, Alana Ward, Marta Alvira-Hammond, Olga Morales, Catherine Nichols, Brent Franklin, and Stephen Russ.
Suggested Citation
Beckwith, S., Mihalec-Adkins, B. P., Huang, L. A., Smith, S., & Tallant, J. (2026). Supportive adult connections, teen pregnancy, and youth mental health. Child Trends. DOI
About the Authors
Samuel Beckwith is a research scientist at Child Trends.
Brittany P. Mihalec-Adkins is a research scientist at Child Trends.
Lee Ann Huang is a senior researcher at Chapin Hall.
Shaniah Smith is a senior project manager at Child Trends and the project manager of Activate.
Julia Tallant is a research analyst at Child Trends and the Research Explorer lead for Activate.
This project is supported by the Office of Population Affairs of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $4,584,000 with 100 percent funded by OPA/OASH/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, OPA/OASH/HHS or the U.S. government. For more information, please visit opa.hhs.gov.
Notes
[i] Research on protective factors for young people in Activate’s focal populations remains limited. This research summary draws from literature based on broader populations of youth but indicates when studies have included one or more of Activate’s focal populations in the samples to describe population-specific findings.
[ii] For more information and practice-oriented guidance, please refer to Activate resources such as Sexual cyberbullying research summary, Healthy romantic relationships and youth well-being, A research-based question and answer resource on intimate partner and teen dating violence for youth-supporting professionals, and Seven dimensions of access to sexual and reproductive health care for youth.
References
[1] Centers for Disease Control and Prevention [CDC]. (2026). About mental health. CDC. https://www.cdc.gov/mental-health/about/index.html
[2] Lucas, G., Olander, E. K., Ayers, S., & Salmon, D. (2019). No straight lines–young women’s perceptions of their mental health and wellbeing during and after pregnancy: A systematic review and meta-ethnography. BMC Women's Health, 19(1), 152. https://doi.org/10.1186/s12905-019-0848-5
[3] Hensel, D. J., Nance, J., & Fortenberry, J. D. (2016). The association between sexual health and physical, mental, and social health in adolescent women. Journal of adolescent health, 59(4), 416-421. https://doi.org/10.1016/j.jadohealth.2016.06.003
[4] Hinoveanu, D., Enatescu, I., Dumitru, C., Mazilu, P. O., Popa, D., Popa, C. A., Badea, M.-A., Marc, F., & Gluhovschi, A. (2025). Adolescent mental health, contraceptive knowledge, and teen pregnancy risk: A systematic review. Healthcare, 13(21), 2660. https://doi.org/10.3390/healthcare13212660
[5] Abdul Rahim, K., Egglestone, N. J., Tsagareli, I. G., Usmani, W., Meherali, S., & Lassi, Z. S. (2024). Mental health outcomes beyond the post-partum period among adolescent mothers: A systematic review and meta-analysis. Health Psychology and Behavioral Medicine, 12(1), 2305741. https://doi.org/10.1080/21642850.2024.2305741
[6] Begun, S. (2015). The paradox of homeless youth pregnancy: A review of challenges and opportunities. Social Work in Health Care, 54(5), 444-460. https://doi.org/10.1080/00981389.2015.1030058
[7] Fasula, A. M., Chia, V., Murray, C. C., Brittain, A., Tevendale, H., & Koumans, E. H. (2019). Socioecological risk factors associated with teen pregnancy or birth for young men: A scoping review. Journal of Adolescence, 74, 130-145. https://doi.org/10.1016/j.adolescence.2019.06.005
[8] Garwood, S. K., Gerassi, L., Jonson-Reid, M., Plax, K., & Drake, B. (2015). More than poverty: The effect of child abuse and neglect on teen pregnancy risk. Journal of Adolescent Health, 57(2), 164-168. https://doi.org/10.1016/j.jadohealth.2015.05.004
[9] Russotti, J., Font, S. A., Toth, S. L., & Noll, J. G. (2023). Developmental pathways from child maltreatment to adolescent pregnancy: A multiple mediational model. Development and Psychopathology, 35(1), 142-156. https://doi.org/10.1017/S0954579421001395
[10] Straka, K., Blacketer, A. R., Martinez, R. L., Glover, A., Winiarski, D. A., Karnik, N. S., ... & Zalta, A. K. (2022). Rates and correlates of well‐being among youth experiencing homelessness. Journal of Community Psychology, 50(8), 3746-3759. https://doi.org/10.1002/jcop.22869
[11] Manoni-Millar, S., Distasio, J., Latimer, E., Somers, J., Stergiopoulos, V., Kerman, N., ... & Aubry, T. (2023). Examining risk factors and protective resources as predictors of recovery among youth with mental illness and lived experience of homelessness. Youth & Society, 55(5), 924-946. https://doi.org/10.1177/0044118X221140929
[12] National Network for Youth. (2023). The mental health + well being of young adults experiencing homelessness. National Network for Youth. https://nn4youth.org/resource-center/mental-health-report/
[13] Combs, K. M., Aparicio, E. M., Prince, D. M., Grinnell-Davis, C., Marra, L., & Faulkner, M. (2019). Evidence-based sexual health programs for youth involved with juvenile justice and child welfare systems: Outcomes across settings. Children and Youth Services Review, 100, 64-69. https://doi.org/10.1016/j.childyouth.2019.02.032
[14] Ojukwu, E., Bawafaa, E., McKay, E., Grewal, H., Afsah, S., Singh, S., & Saewyc, E. (2024). Teen pregnancy involvement among African, Caribbean and Black adolescent boys and girls: A scoping review. BMJ Open, 14(6), e078085. https://doi.org/10.1136/bmjopen-2023-078085
[15] Charlton, B. M., Nava-Coulter, B., Coles, M. S., & Katz-Wise, S. L. (2019). Teen pregnancy experiences of sexual minority women. Journal of Pediatric and Adolescent Gynecology, 32(5), 499-505. https://doi.org/10.1016/j.jpag.2019.05.009
[16] Fasula, A. M., Chia, V., Murray, C. C., Brittain, A., Tevendale, H., & Koumans, E. H. (2019). Socioecological risk factors associated with teen pregnancy or birth for young men: A scoping review. Journal of Adolescence, 74, 130-145. https://doi.org/10.1016/j.adolescence.2019.06.005
[17] Frederiksen, B. N., Rivera, M. I., Ahrens, K. A., Malcolm, N. M., Brittain, A. W., Rollison, J. M., & Moskosky, S. B. (2018). Clinic-based programs to prevent repeat teen pregnancy: A systematic review. American Journal of Preventive Medicine, 55(5), 736-746. https://doi.org/10.1016/j.amepre.2018.08.001
[18] Offiong, A., Powell, T. W., Gemmill, A., & Marcell, A. V. (2021). “I can try and plan, but still get pregnant”: The complexity of pregnancy intentions and reproductive health decision-making for adolescents. Journal of Adolescence, 90, 1-10. https://doi.org/10.1016/j.adolescence.2021.05.007
[19] Begun, S. (2015). The paradox of homeless youth pregnancy: A review of challenges and opportunities. Social Work in Health Care, 54(5), 444-460. https://doi.org/10.1080/00981389.2015.1030058
[20] Dang, M. T., Conger, K. J., Breslau, J., & Miller, E. (2014). Exploring protective factors among homeless youth: The role of natural mentors. Journal of Health Care for the Poor and Underserved, 25(3), 1121-1138. https://doi.org/10.1353/hpu.2014.0133
[21] Van Dam, L., Smit, D., Wildschut, B., Branje, S. J. T., Rhodes, J. E., Assink, M., & Stams, G. J. J. (2018). Does natural mentoring matter? A multilevel meta‐analysis on the association between natural mentoring and youth outcomes. American Journal of Community Psychology, 62(1-2), 203-220. https://doi.org/10.1002/ajcp.12248
[22] Fitzpatrick, M., Ford, J. L., & Slesnick, N. (2023). Application of the ecobiodevelopmental model for research among youth experiencing homelessness. Public Health Nursing, 40(4), 543-549. https://doi.org/10.1111/phn.13183
[23] So, M., Kaja, S. M., Brar, P., Mehus, C. J., Woodlee, C., & Gewirtz O’Brien, J. R. (2024). Protective factors among pregnant and parenting youth experiencing homelessness in shelter: A qualitative exploratory study. Adversity and Resilience Science, 5(3), 267-281. https://doi.org/10.1007/s42844-024-00127-2
[24] Huq, M. R., Phillips, D. R., Childers, C., Chavez, R., Tellei, J., Blakely, L., & Aparicio, E. M. (2023). Opportunities and challenges to linkage to housing in the context of a sexual and reproductive health program for youth experiencing homelessness. Prevention Science, 24(S2), 241-250. https://doi.org/10.1007/s11121-023-01560-y
[25] Seiter, L. (2017). Mental health and juvenile justice: A review of prevalence, promising practices, and areas for improvement. National Technical Assistance Center for the Education of Neglected or Delinquent Children and Youth. https://neglected-delinquent.ed.gov/sites/default/files/NDTAC-MentalHealth-JJ-Brief-508.pdf
[26] Begun, S. J. (2017). A mixed methods examination of pregnancy attitudes and HIV risk behaviors among homeless youth: The role of social network norms and social support [Doctoral Dissertation, University of Denver Graduate School of Social Work]. ProQuest Dissertations & Theses Global.
[27] Center for the Study of Social Policy [CSSP]. (2022). Protective factors for youth involved in systems of care. Center for the Study of Social Policy. https://cssp.org/resource/1-protective-factors-for-youth-involved-in-systems-of-care/
[28] Ball, B., Hoefer, S., Faulkner, M., Requenes, A., Brooks, T., Munoz, G., ... & Zelaya, A. B. (2023). Innovation in sexuality and relationship education in child welfare: Shifting toward a focus on ongoing conversations, connection, and consent. Prevention Science, 24(S2), 163-173. https://doi.org/10.1007/s11121-022-01476-z
[29] Ojukwu, E., Bawafaa, E., McKay, E., Grewal, H., Afsah, S., Singh, S., & Saewyc, E. (2024). Teen pregnancy involvement among African, Caribbean and Black adolescent boys and girls: A scoping review. BMJ Open, 14(6), e078085. https://doi.org/10.1136/bmjopen-2023-078085
[30] Potter, M. H., & Font, S. A. (2019). Parenting influences on adolescent sexual risk-taking: Differences by child welfare placement status. Children and Youth Services Review, 96, 134-144. https://doi.org/10.1016/j.childyouth.2018.11.038
[31] Combs, K. M., Racz, S. J., Finigan-Carr, N. M., & Taussig, H. N. (2026). Are non-parental supportive adults associated with indicators of contraceptive access for youth with child welfare involvement? Child Abuse & Neglect, 178, 108172. https://doi.org/10.1016/j.chiabu.2026.108172
[32] Dang, M. T., Conger, K. J., Breslau, J., & Miller, E. (2014). Exploring protective factors among homeless youth: The role of natural mentors. Journal of Health Care for the Poor and Underserved, 25(3), 1121-1138. https://doi.org/10.1353/hpu.2014.0133
[33] Forrester, E. J., Henke, J., Knab, J., & Cole, R. (2025). Promising predictors of adolescent sexual behavior outcomes: A systematic review of longitudinal research. Journal of Adolescent Health, 77(1), 29-40. https://doi.org/10.1016/j.jadohealth.2024.12.002
[34] Steiner, R. J., Sheremenko, G., Lesesne, C., Dittus, P. J., Sieving, R. E., & Ethier, K. A. (2019). Adolescent connectedness and adult health outcomes. Pediatrics, 144(1), e20183766. https://doi.org/10.1542/peds.2018-3766
[35] Peterson, A. J., & Bonell, C. (2018). School experiences and young women's pregnancy and parenthood decisions: A systematic review and synthesis of qualitative research. Health & Place, 53, 52-61. https://doi.org/10.1016/j.healthplace.2018.07.003
[36] DeCoursey, J., Mihalec-Adkins, B. P., McKlindon, A., Ibarra, A., & Naylon, K. (2026). A summary of research about policy, practice, and systems change related to supporting transition-age youth. Child Trends. DOI: 10.56417/4476o7630s
[37] DeWit, D. J., DuBois, D., Erdem, G., Larose, S., & Lipman, E. L. (2016). The role of program-supported mentoring relationships in promoting youth mental health, behavioral and developmental outcomes. Prevention Science, 17(5), 646-657. https://doi.org/10.1007/s11121-016-0663-2
[38] Van Dam, L., Smit, D., Wildschut, B., Branje, S. J. T., Rhodes, J. E., Assink, M., & Stams, G. J. J. (2018). Does natural mentoring matter? A multilevel meta‐analysis on the association between natural mentoring and youth outcomes. American Journal of Community Psychology, 62(1-2), 203-220. https://doi.org/10.1002/ajcp.12248
[39] Munson, M., Railey, J. (2016). Mentoring for youth with mental health challenges. National Mentoring Resource Center. https://nationalmentoringresourcecenter.org/resource/mentoring-for-youth-with-mental-health-challenges/
[40] Munson, M., Railey, J. (2016). Mentoring for youth with mental health challenges. National Mentoring Resource Center. https://nationalmentoringresourcecenter.org/resource/mentoring-for-youth-with-mental-health-challenges/
[41] DeWit, D. J., DuBois, D., Erdem, G., Larose, S., & Lipman, E. L. (2016). The role of program-supported mentoring relationships in promoting youth mental health, behavioral and developmental outcomes. Prevention Science, 17(5), 646-657. https://doi.org/10.1007/s11121-016-0663-2
[42] Van Dam, L., Smit, D., Wildschut, B., Branje, S. J. T., Rhodes, J. E., Assink, M., & Stams, G. J. J. (2018). Does natural mentoring matter? A multilevel meta‐analysis on the association between natural mentoring and youth outcomes. American Journal of Community Psychology, 62(1-2), 203-220. https://doi.org/10.1002/ajcp.12248
[43] Dang, M. T., Conger, K. J., Breslau, J., & Miller, E. (2014). Exploring protective factors among homeless youth: The role of natural mentors. Journal of Health Care for the Poor and Underserved, 25(3), 1121-1138. https://doi.org/10.1353/hpu.2014.0133
[44] Fitzpatrick, M., Ford, J. L., & Slesnick, N. (2023). Application of the ecobiodevelopmental model for research among youth experiencing homelessness. Public Health Nursing, 40(4), 543-549. https://doi.org/10.1111/phn.13183
[45] Buecker, S., Petersen, K., Neuber, A., Zheng, Y., Hayes, D., & Qualter, P. (2024). A systematic review of longitudinal risk and protective factors for loneliness in youth. Annals of the New York Academy of Sciences, 1542(1), 620-637. https://doi.org/10.1111/nyas.15266
[46] Steiner, R. J., Sheremenko, G., Lesesne, C., Dittus, P. J., Sieving, R. E., & Ethier, K. A. (2019). Adolescent connectedness and adult health outcomes. Pediatrics, 144(1), e20183766. https://doi.org/10.1542/peds.2018-3766
[47] Capp, G., Berkowitz, R., Sullivan, K., Astor, R. A., De Pedro, K., Gilreath, T. D., ... & Rice, E. (2016). Adult relationships in multiple contexts and associations with adolescent mental health. Research on Social Work Practice, 26(6), 622-629. https://doi.org/10.1177/1049731515624967
[48] Bethell, C., Jones, J., Gombojav, N., Linkenbach, J., & Sege, R. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatrics, 173(11), e193007. https://doi.org/10.1001/jamapediatrics.2019.3007
[49] McEvoy, D., Brannigan, R., Cooke, L., Butler, E., Walsh, C., Arensman, E., & Clarke, M. (2023). Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. Journal of Psychiatric Research, 168, 353-380. https://doi.org/10.1016/j.jpsychires.2023.10.017
[50] Russotti, J., Font, S. A., Toth, S. L., & Noll, J. G. (2023). Developmental pathways from child maltreatment to adolescent pregnancy: A multiple mediational model. Development and Psychopathology, 35(1), 142-156. https://doi.org/10.1017/S0954579421001395
[51] Garwood, S. K., Gerassi, L., Jonson-Reid, M., Plax, K., & Drake, B. (2015). More than poverty: The effect of child abuse and neglect on teen pregnancy risk. Journal of Adolescent Health, 57(2), 164-168. https://doi.org/10.1016/j.jadohealth.2015.05.004
[52] Straka, K., Blacketer, A. R., Martinez, R. L., Glover, A., Winiarski, D. A., Karnik, N. S., ... & Zalta, A. K. (2022). Rates and correlates of well‐being among youth experiencing homelessness. Journal of Community Psychology, 50(8), 3746-3759. https://doi.org/10.1002/jcop.22869
[53] Buecker, S., Petersen, K., Neuber, A., Zheng, Y., Hayes, D., & Qualter, P. (2024). A systematic review of longitudinal risk and protective factors for loneliness in youth. Annals of the New York Academy of Sciences, 1542(1), 620-637. https://doi.org/10.1111/nyas.15266
[54] Giuliani, A., Petruccelli, I., & D’Urso, G. (2025). Longitudinal evidence on peer victimisation and persistent mental health outcomes in youth: A systematic review. Behavioral Sciences, 15(12), 1734. https://doi.org/10.3390/bs15121734
[55] Wood Jr, F. R., & Graham, R. (2020). “Safe” and “at-risk”: Cyberbullying victimization and deviant health risk behaviors in youth. Youth & Society, 52(3), 449-468. https://doi.org/10.1177/0044118X18810943
[56] Warner, T. D., & Warner, D. F. (2019). Precocious and problematic? The consequences of youth violent victimization for adolescent sexual behavior. Journal of Developmental and Life-course Criminology, 5(4), 554-586. https://doi.org/10.1007/s40865-019-00122-7
[57] Piolanti, A., Waller, F., Schmid, I. E., & Foran, H. M. (2023). Long-term adverse outcomes associated with teen dating violence: A systematic review. Pediatrics, 151(6), e2022059654. https://doi.org/10.1542/peds.2022-059654
[58] Castellví, P., Miranda‐Mendizábal, A., Parés‐Badell, O., Almenara, J., Alonso, I., Blasco, M. J., ... & Alonso, J. (2017). Exposure to violence, a risk for suicide in youths and young adults. A meta‐analysis of longitudinal studies. Acta Psychiatrica Scandinavica, 135(3), 195-211. https://doi.org/10.1111/acps.12679
[59] Hartmann, M., Stoner, M., Ramirez, C. G., Browne, E. N., Jaime-Aguilar, A., Rodriguez, D., ... & Minnis, A. (2025). Technology-facilitated abuse as a risk factor for STI and pregnancy in early adulthood: Evidence from latine adolescents in California. Reproductive Health, 22(1), 166. https://doi.org/10.1186/s12978-025-02128-5
[60] Ashton, K., Davies, A. R., Hughes, K., Ford, K., Cotter-Roberts, A., & Bellis, M. A. (2021). Adult support during childhood: A retrospective study of trusted adult relationships, sources of personal adult support and their association with childhood resilience resources. BMC psychology, 9(1), 101. https://doi.org/10.1186/s40359-021-00601-x
[61] Baek, H., Andreescu, V., & Rolfe, S. M. (2019). Bullying and fear of victimization: Do supportive adults in school make a difference in adolescents’ perceptions of safety? Journal of school violence, 18(1), 92-106. https://doi.org/10.1080/15388220.2017.1387133
[62] Park, I. Y., Walls, N. E., Atteberry-Ash, B., & Kattari, L. (2023). Trusted adults as a protective factor for bullying and suicide attempts among youth across differences in race, sexual orientation, and gender identity. Journal of the society for social work and research, 14(2), 313-336. https://doi.org/10.1086/716241
[63] Blomqvist, K., Saarento‐Zaprudin, S., & Salmivalli, C. (2020). Telling adults about one's plight as a victim of bullying: Student‐and context‐related factors predicting disclosure. Scandinavian journal of psychology, 61(1), 151-159. https://doi.org/10.1111/sjop.12521
[64] Sianko, N., Kunkel, D., Burke, S. R., Duncan, S., & Small, M. A. (2025). Psychosocial determinants of adolescents’ attitudes toward disclosing dating violence. American journal of orthopsychiatry, 95(2), 126–139. https://doi.org/10.1037/ort0000769
[65] Steiner, R. J., Sheremenko, G., Lesesne, C., Dittus, P. J., Sieving, R. E., & Ethier, K. A. (2019). Adolescent connectedness and adult health outcomes. Pediatrics, 144(1), e20183766. https://doi.org/10.1542/peds.2018-3766
[66] Lee, H., Boyd, R., Slack, K. S., Mather, R. S., & Murray, R. K. (2022). Adverse childhood experiences, positive childhood experiences, and adult health. Journal of the society for social work and research, 13(3), 441-461. https://doi.org/10.1086/712410
[67] Song, W., & Qian, X. (2020). Adverse childhood experiences and teen sexual behaviors: The role of self‐regulation and school‐related factors. Journal of school health, 90(11), 830-841. https://doi.org/10.1111/josh.12947
[68] Manoni-Millar, S., Distasio, J., Latimer, E., Somers, J., Stergiopoulos, V., Kerman, N., ... & Aubry, T. (2023). Examining risk factors and protective resources as predictors of recovery among youth with mental illness and lived experience of homelessness. Youth & society, 55(5), 924-946. https://doi.org/10.1177/0044118X221140929
[69] Frederiksen, B. N., Rivera, M. I., Ahrens, K. A., Malcolm, N. M., Brittain, A. W., Rollison, J. M., & Moskosky, S. B. (2018). Clinic-based programs to prevent repeat teen pregnancy: A systematic review. American journal of preventive medicine, 55(5), 736-746. https://doi.org/10.1016/j.amepre.2018.08.001
[70] Dubois-Comtois, K., Bussières, E. L., Cyr, C., St-Onge, J., Baudry, C., Milot, T., & Labbé, A. P. (2021). Are children and adolescents in foster care at greater risk of mental health problems than their counterparts? A meta-analysis. Children and youth services review, 127, 106100. https://doi.org/10.1016/j.childyouth.2021.106100
[71] Rosenberg, R., Woods, N., Naylon, K., & Tallant, J. (2022). Incorporating the social determinants of health in practice to address sexual and reproductive health for young people involved in foster care. Child Trends. Retrieved from https://activatecenter.org/resource/incorporating-social-determinants-of-health-and-in-practice-to-address-sexual-and-reproductive-health-for-young-people-involved-in-foster-care/
[72] Welti, K., Beckwith, S. & Murphy, K. (2022). Understanding the sexual and reproductive health of opportunity youth. Bethesda, MD: Child Trends. Retrieved from https://activatecenter.org/resource/understanding-sexual-reproductive-health-opportunity-youth
[73] Moore, A. N., & Osho, G. S. (2017). An assessment of adolescent pregnancy and social risk factors: Evidence from agencies and organizations in the juvenile justice system. International journal of social work, 4(2), 1-14. http://doi.org/10.5296/ijsw.v4i2.10331
[74] Finigan-Carr, N. M., Murray, K. W., O'Connor, J. M., Rushovich, B. R., Dixon, D. A., & Barth, R. P. (2015). Preventing rapid repeat pregnancy and promoting positive parenting among young mothers in foster care. Social work in public health, 30(1), 1-17. https://doi.org/10.1080/19371918.2014.938388
[75] Singh, S., Verma, U., Singh, I. J. S., & Garg, R. (2025). Meta-analysis on teen age pregnancy and contraception awareness: A systematic review. EC Gynaecology, 14(6), 01-09.
[76] Hendrick, C. E., Cone, J. N., Cirullo, J., & Maslowsky, J. (2020). Determinants of long-acting reversible contraception (LARC) initial and continued use among adolescents in the United States. Adolescent research review, 5(3), 243-279. https://doi.org/10.1007/s40894-019-00126-w
[77] Offiong, A., Tallant, J., Rust, K., Wulah, A., Huang, L.A., & Dworsky, A. (2024). Seven dimensions of access to sexual and reproductive health care for youth. Child Trends. Retrieved from https://activatecenter.org/resource/seven-dimensions-of-access-to-sexual-and-reproductive-health-care-for-youth
[78] Frederiksen, B. N., Rivera, M. I., Ahrens, K. A., Malcolm, N. M., Brittain, A. W., Rollison, J. M., & Moskosky, S. B. (2018). Clinic-based programs to prevent repeat teen pregnancy: A systematic review. American journal of preventive medicine, 55(5), 736-746. https://doi.org/10.1016/j.amepre.2018.08.001
[79] Marseille, E., Mirzazadeh, A., Biggs, M. A., P. Miller, A., Horvath, H., Lightfoot, M., ... & Kahn, J. G. (2018). Effectiveness of school-based teen pregnancy prevention programs in the USA: A systematic review and meta-analysis. Prevention Science, 19(4), 468-489. https://doi.org/10.1007/s11121-017-0861-6
[80] Combs, K. M., Aparicio, E. M., Prince, D. M., Grinnell-Davis, C., Marra, L., & Faulkner, M. (2019). Evidence-based sexual health programs for youth involved with juvenile justice and child welfare systems: Outcomes across settings. Children and youth services review, 100, 64-69. https://doi.org/10.1016/j.childyouth.2019.02.032
[81] Sterrett-Hong, E. M., DeBow, J., Caton, E., Harris, M., Brewer, R., Roberts, E., ... & Arnold, E. A. (2021). Non-parental adults and sexual Health behaviors among young minority men: A qualitative examination. Frontiers in psychology, 12, 598120. https://doi.org/10.3389/fpsyg.2021.598120
[82] McEvoy, D., Brannigan, R., Cooke, L., Butler, E., Walsh, C., Arensman, E., & Clarke, M. (2023). Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. Journal of psychiatric research, 168, 353-380. https://doi.org/10.1016/j.jpsychires.2023.10.017
[83] Laurenzi, C. A., Gordon, S., Abrahams, N., Du Toit, S., Bradshaw, M., Brand, A., ... & Skeen, S. (2020). Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents: a systematic review. Reproductive health, 17(1), 65. https://doi.org/10.1186/s12978-020-00913-y
[84] Laurenzi, C. A., Gordon, S., Abrahams, N., Du Toit, S., Bradshaw, M., Brand, A., ... & Skeen, S. (2020). Psychosocial interventions targeting mental health in pregnant adolescents and adolescent parents: a systematic review. Reproductive health, 17(1), 65. https://doi.org/10.1186/s12978-020-00913-y
[85] McNeill-Johnson, A. D., Glenn, J., Daniel, N. I., Menon, M., Aboul-Enein, B. H., Kelly, P. J., & Ramaswamy, M. (2025). A scoping review of sexual and reproductive health interventions with youth in US juvenile facilities. Journal of adolescent health, 76(5), 798-806. https://doi.org/10.1016/j.jadohealth.2024.12.012
[86] Seiter, L. (2017). Mental health and juvenile justice: A review of prevalence, promising practices, and areas for improvement. National Technical Assistance Center for the Education of Neglected or Delinquent Children and Youth. Retrieved from https://neglected-delinquent.ed.gov/sites/default/files/NDTAC-MentalHealth-JJ-Brief-508.pdf
[87] Hardy, R. Y., Fitzpatrick, M. M., Pizzulo, A., Arcé, J. E., & Ford, J. L. (2025). Resilience and support networks of youth experiencing homelessness. Journal of adolescent health. https://doi.org/10.1016/j.jadohealth.2025.06.031
[88] Manoni-Millar, S., Distasio, J., Latimer, E., Somers, J., Stergiopoulos, V., Kerman, N., ... & Aubry, T. (2023). Examining risk factors and protective resources as predictors of recovery among youth with mental illness and lived experience of homelessness. Youth & society, 55(5), 924-946. https://doi.org/10.1177/0044118X221140929