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Future Research and Other Opportunities

The presentations and discussions summarized throughout this document attest to the research that exists on the health, safety, and well-being of young adults, but many participants also discussed future research in this area. A sound, critically formulated framework for research is needed, said Patrick Tolan of the University of Virginia in his closing remarks. Presentations at the workshop illustrated the complexity of the factors that are relevant to research aimed at understanding and improving the lives, health, safety, and well-being of young adults, including

• Age considerations, for example, considerations general to young adults, and differences within this group (e.g., age 18 versus 26);
• The different trajectories that young adults are on, for example, employment, unemployment, 2- or 4-year college education, the military, the justice system, homelessness;
• Factors such as race, ethnicity, culture, lesbian, gay, bisexual, transgender, and queer/questioning status, and immigration status; and
• The diversity of opportunities and support structures available to young adults.

Young adults fall into multiple groups on this list. To advance scientific understanding of the nature of problems, of needs, and of risk and response in this age group, Tolan suggested the development of a framework that has a developmental within context orientation.

The speakers at the workshop identified many questions for future research. Although it was not a central focus of the workshop, participants

also highlighted some areas where changes to policies, programs, and systems would be beneficial. These are compiled here to illustrate the range of suggestions made. The suggestions have been grouped by categories to provide a sense of the areas that participants raised as deserving attention, but suggestions may fit appropriately into multiple categories. This list does not represent a prioritized list of research questions or a comprehensive research agenda. The suggestions are identified with the speaker who made them and should not be construed as reflecting consensus from the workshop or endorsement by the National Academies.

UNDERSTANDING THE VARIED EXPERIENCES AND TRAJECTORIES OF YOUNG ADULTS

Researchers, policy makers, and others need to understand more about young adults’ experiences, lives, and trajectories to inform policies, programs, and systems development, said some participants. Specific suggestions included the following:

• Researchers need to develop a basic developmental and contextual understanding of the young adult years, focusing on youth as active in directing their development. They need to understand the nature of young adults’ needs, the risks they take, and the responses they use to challenges. (Tolan)
• Longitudinal cohort studies of young adults making the transition from school to work are needed that allow for the analyses of subgroups, including subgroups defined by social class. (Schneider)
• More research is needed to reveal the experiences of underrepresented racial and ethnic groups and the kinds of signals they get that can affect their future trajectories. (Rivas-Drake)
• Issues of gender and the problems that disproportionately affect males need renewed attention. (Settersten)
• Additional research is needed to study the impact of trauma on boys and men of color over the lifespan. (Corbin)
• Additional research should be done on turning points, on the potential to intervene in young adulthood, and on whether effective existing programs aimed at adults in general are effective specifically among young adults. (Oesterle)
• Researchers need to look specifically at the “missing half”—those students who do not go on to 4-year colleges, including those who drop out of high school, get only a high school degree, or receive some college education, perhaps earning a certificate or a 2-year degree. (Bonnie)

• College retention and graduation rates, the debt incurred in pursuing college degrees, and the connection between higher education and workplaces, neighborhoods, and social networks need further study. (Settersten)
• Increased research into pathways out of the juvenile and adult justice systems could help reduce the risk that previous offenders will reenter those systems. (Mulvey)
• How research on brain development should impact policy choices, including age lines in policy, should be considered. (Bonnie)

RESILIENCE, PROTECTIVE FACTORS, AND WELL-BEING

In thinking about young adults’ health, safety, and well-being, it is important to examine and emphasize positive factors and areas of success, said some participants. Specific suggestions included the following:

• The protective factors that buffer young people from negative experiences and processes should be investigated. (Rivas-Drake)
• More research is needed on community engagement, the life course, and resiliency and protective factors. (Coyne-Beasley)
• Psychosocial research should look at the development of self-regulatory competence, the ability to function successfully, and the renegotiation of relationships with adults. (Steinberg)
• The psychosocial needs and social supports of young adults should be assessed so they can be better connected to a trusted adult or community. (Coyne-Beasley)
• Researchers need to investigate the practices and the relational and emotional health components that enable young adults to emerge from the foster care system as resilient, healthy, and hopeful. (Samuels)
• Researchers should investigate the role of storytelling in creating self-identity and enhancing well-being. (Clark)

MENTAL HEALTH CARE, MENTAL HEALTH INTERVENTIONS, AND SUBSTANCE ABUSE

Additional research is needed on mental health and substance abuse, particularly in the areas of intervention and service delivery, said some participants. Their specific suggestions included the following:

• Researchers should investigate how interventions for mental health disorders can appeal to young adults, how to get young adults into treatment, and how to help them stay in treatment. (Davis)

• Tailored interventions and services need to be tested on a large scale. (Davis)
• Health care and mental health care systems for juveniles and adults need to be better coordinated. (Davis)
• Young adults should be prioritized for mental health services. (Copeland)
• Awareness of the warning signs of schizophrenia, early referral, and intervention can prevent cognitive loss and violence. (Seidman)
• New interventions for drug and alcohol use are needed for both college and noncollege students. (White)

HEALTH CARE

Enhancing access to health care, ensuring appropriate insurance, improving coordination of care, and providing care that is culturally competent and effective for young adults were emphasized by a number of speakers. Specific suggestions included the following:

• Young adults need better access to health care, including screening for diseases, for mental health issues, and for risk behaviors, and the provision of necessary services. (Coyne-Beasley)
• The health care system should engage more multidisciplinary providers, family and community members, and young adults in prevention. (Coyne-Beasley)
• Health care and mental health care systems for juveniles and for adults need to be better coordinated. (Davis, repeated from above)
• Health care guidelines and protocols for young adults that are developmentally based need to be developed. (Irwin, Tolan)
• Future clinicians should have a discipline-specific young adult rotation. (Irwin)
• The implementation of the ACA should be closely monitored to inform policy makers and advocates about future steps needed. (English)
• Insurance for young adults needs to be comprehensive rather than focused on catastrophic events. (Neinstein)

FAMILIES, PARENTS, AND RELATIONSHIPS

The influence and roles of families, parents, and relationships in young adults’ lives needs additional study, said some participants. Their suggestions included the following:

• The roles of race, ethnicity, culture, immigration status, and religion in parenting need further investigation. (Conger)
• The resources families devote to young adults need to be studied. (Settersten)
• The effects of the Great Recession on the parenting of young adults needs to be better understood. (Conger)

COMMUNICATIONS, MEDIA, AND DECISION MAKING

Communications, media, and decision making are important areas for future research and policy making to improve young adults’ health, noted some participants. Their suggestions included the following:

• Studies are needed on the effects of social media on the lives of parents employed full- or part-time. (Clark)
• Research on marketing to young adults is needed, including subgroups such as underrepresented racial and ethnic groups and rural young adults. (Halpern-Felsher)
• Policies on marketing need to focus on the images being conveyed, restrict misleading ads, and pursue regulatory efforts such as countermarketing. (Halpern-Felsher)
• Better development of the science of split-second decision making is needed to inform health-related messages. (Jaccard)

YOUNG ADULTS’ HEALTH, SAFETY, AND WELL-BEING WITHIN SYSTEMS AND ORGANIZATIONS

More research is needed on how young adults are functioning within various systems and organizations and how these systems and organizations could better support young adults’ health, safety, and well-being. Specific suggestions highlighted by some participants included the following:

• Gaps in health services on college campuses need to be identified and addressed. (Bailie)
• Researchers should investigate how alcohol abuse in the military can be reduced and prevented. (Hutchinson)
• The effects of military service and of the military health care system on the health of young adults should be studied. (Hutchinson)
• How the education levels and physical fitness of young adults can be increased so that more people are eligible to join the military should be studied. (Hutchinson)

• The success rates for people in the military who receive waivers for physical conditions should be investigated. (Hutchinson)
• Whether some people who are denied the chance to enlist succeed in the military despite a health condition should be studied. (Hutchinson)
• Treatments for stress-related disorders among members of the military, including female service members, need to be studied further. (Ritchie)
• Research is needed on the comparative effectiveness of interventions to prevent and reduce homelessness, including interventions aimed at such subgroups as young adults with mental health problems or homeless young parents. (Courtney)
• Researchers need to investigate how welfare programs and services for young adults can work together more effectively to provide them with needed skills and supports. (Lower-Basch)
• The continuity and discontinuity of care afforded to young offenders as they transition in and out of institutions need to be studied. (Mulvey)
• Much more information is needed on the health status and care of prisoners. For example, what are their rates of sexually transmitted infections, risk behaviors, and mental illness? Their suicide rates, nutrition, immunity, and chronic diseases all need to be monitored, and data are needed on the effectiveness of risk reduction, the minimization of harm, and the continuity of care upon release. (Greifinger)

RESEARCH METHODS AND APPROACHES

The methods used to study young adults’ health, safety, and well-being need careful consideration, emphasized some participants. Their suggestions for research methodology included the following:

• New studies on young adults are needed, including multiple cohort historical tracking, cross-national comparisons, longitudinal trajectory/pathway studies, collapsed cohort age-graded comparisons, intervention studies, and cost/service system analyses. The reanalysis of existing longitudinal datasets would also be valuable. (Tolan)
• Longitudinal cohort studies of young adults making the transition from school to work are needed that allow for the analyses of subgroups, including subgroups defined by social class. (Schneider)
• More randomized trials of health-related interventions should be conducted to evaluate the effects of interventions. (Schneider)

• Self-reports of health services need to be verified and supplemented through administrative records and other kinds of information. (Schneider)
• Technologies such as smartphones should be used to learn more about subjective well-being and physical health. (Schneider)
• The individualization of health-related messages and the integration of behavior-specific and common-cause intervention design principles need to be studied. (Jaccard)
• Research, policy, and applications need to be linked as much as possible. (Conger)

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