Methods: Using structural equation modeling (SEM), four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) data were utilized to examine the mediating role of social support and high service utilization (Wave 2) connecting risk behaviors (Wave 1) and CJI (Wave 3 & 4). Guided by the Comprehensive Health Seeking and Coping Paradigm, we constructed three latent variables, namely risky behaviors (alcohol use, drug use, and risky sexual behaviors), service utilization (substance abuse and mental health services), and social support (parents, friends, and teachers). The outcome variable, CJI, was dichotomous (yes/no). The weighted least square (WLSMV) estimation corrected for categorical indicators. For missing data, we used multiple imputation with 20 imputed data sets. The Bootstrap procedure aided in obtaining the mediation effect. We controlled for gender, race, birth year, and parental income in all analyses.
Results: The structural model indicated that model fit the data well (CFI = 0.935, TLI = 0.902, RMSEA = 0.031). Results showed that risk behaviors were positively associated with service utilization (b=0.71) but negatively associated with social support (b=-0.49). Further, risk behaviors (b=0.752; exp(b)=2.12) and service utilization (b=0.125; exp(b)=1.13) significantly increased the odds of CJ involvement, but the effect of support was not significant (b=-0.019; exp(b)=0.98). A significant indirect effect (b=0.092) was observed on service utilization but not social support, suggesting that risky behaviors increase service utilization, which in turn, lead to higher CJI. The indirect effect explained 12% of the total effect connecting risk behaviors to CJI.
Conclusions & Implications: Adolescence marks a key developmental stage where prevention efforts could be targeting risky behaviors and CJI. While the results of this study do not fully support the proposed hypothesis, results suggest an opportunity to advance existing prevention models to increase naturally occurring social supports for high-risk youth, as well as improve service utilization models to protect against CJI. More research is needed given the preliminary and foundational results of this study to further understand the impact social support and service utilization can have to decrease adolescent CJI.