Healthy Passages                                                                                       

This is a longitudinal cohort study that tracked influences on health and development in adolescence, by following over 5,000 from age 10 to 15. This project allows us to examine changes in health status and quality of life (QOL) over time, including in the development of the major health risk behaviors of adolescence, such as tobacco, alcohol, and drug use; sexual risk behaviors; violence and aggressive behaviors; emotional dysfunction and suicide; injury risk; and dietary intake and physical activity. A unique feature of this project is the inclusion of about equal numbers of African American, Hispanic/Latino, and White youth.

The data collection is now completed. A broad range of potential influences on health, QOL, and health risk behaviors were examined through assessment of both the child and a parent over 3 waves (at ages 10-11, 12-13, and 15-16. We collected information about the child, parents and the family, social environment, neighborhood environment, school environment, and broader culture especially as reflected in the child's exposure to media.

My specific interests in this project are in disparities in and influences on health and QOL broadly. Together with graduate student collaborators we also currently examine obesity and weigh loss behaviors, depression and emotional well-being, substance use, and sexual activity.

An overview of this study is provided in: 

  • Windle, M., Grunbaum, J., Elliott, M., Tortolero, S., Berry, S., Gilliland, J., Parcel. G., Wallander, J. Kelder, S. Collins, J, Kolbe, L., Schuster, M. (2004). Healthy Passages: A multilevel, multimethod longitudinal study of adolescent health. American Journal of Preventive Medicine, 27, 164-172. [article]

 Selected publication include:

  • Schuster, M.A., Elliott, M.N., Kanouse, D.E., Wallander, J.L., Tortolero, S.R., Ratner, J.A., Klein, D.J., Cuccaro, P.M., Davies, S.L., & Banspach, S.W. (2012). Racial and ethnic health disparities among fifth-graders in three cities. The New England Journal of Medicine, 367,735-745. DOI: 10.1056/NEJMsa1114353.
  • Wallander, J.L., *Fradkin, C., Chien, A.T., Mrug, S., Banspach, S.W., Davies, S., Elliott, M.N., Franzini, L., & Schuster, M.A. (2012). Racial/ethnic disparities in health-related quality of life and health in children are largely mediated by family contextual differences. Academic Pediatrics, 12, 532-538. DOI: 10.1016/j.acap.2012.04.005.
  • Wallander, J.L., *Kerbawy, S., Toomey, S., Lowry, R., Elliott, M.N., Escobar-Chaves, S.L., Franzini, L., & Schuster, M.A. (2013). Is obesity associated with reduced health-related quality of life in Latino, black and white children in the community? International Journal of Obesity, 37,920-925. DOI: 10.1038/ijo.2013.31.
  • *Epperson, A. E., Song, A.V., Wallander, J.L., Markham, C., Cuccaro, P., Elliott, M.N., & Schuster, M.A. (2014). Associations among body size, body image perceptions, and weight loss attempts among African American, Latino, and White youth. Journal of Pediatric Psychology, 39, 394-404. DOI: 10.1093/jpepsy/jst144
  • *McDade-Montez, E., Wallander, J.L., Elliott, M., Grunbaum, J.A. Tortolero, S., Cuccaro, P. & Schuster, M. (2014). TV viewing, perceived similarity, coviewing, and mental well-being among African American, Latino, and White children. Journal of Early Adolescence 35, 329-352. DOI: 10.1177/0272431614531655
  • Schuster, M., Elliott, M., Bogart, L., Klein, D., Feng, J., Wallander, J., Cuccaro, P., & Tortolero, S. (2014). Changes in obesity between fifth & tenth grades: A longitudinal study in three metropolitan areas Pediatrics, 134, 1051-1058. DOI: 10.1542/peds.2014-219
  • *Fradkin, C., Wallander, J.L., Elliott, M.N., Tortolero, S., Cuccaro, P. & Schuster, M.A. (2015). Associations between socioeconomic status and obesity in diverse, young adolescents: Variation across race/ethnicity and gender. Health Psychology, 34, 1-9.
  • *Fradkin, C., Wallander, J.L., Elliott, M.N., Cuccaro, P., & Schuster, M.A. (in press). Regular physical activity has differential association with reduced obesity among diverse youth in the U.S. Journal of Health Psychology. DOI: 10.1177/1359105314559622
  • *Scott, S.M., Wallander, J.L., Depaoli, S., Elliott, M.N., Grunbaum, J.A., Tortolero, S.R., Cuccaro, P.M., & Schuster, M.A. (in press). Gender role orientation is associated with health-related quality of life differently among African American, Hispanic, and White youth. Quality of Life Research, 24, 2139-2149. DOI 10.1007/s11136-015-0951-5
  • *Scott, S.M., Wallander, J.L., Elliott, M.N., Chien, A.T., Tortolero, S., Cuccaro, P., & Schuster, M. (in press). Do social resources protect against lower quality of life among diverse young adolescents? Journal of Early Adolescence. DOI: 10.1177/0272431615588367


The full name of this project is Brain Research to Ameliorate Impaired Neurodevelopment-Home-based Intervention Trial. It has now been completed, but for possibly publishing one or two more papers. It was a randomized controlled trial of a home-based developmental stimulation program to prevent neurodevelopmental disability in infants that experienced birth complications in developing countries. The research was done in collaboration with colleagues in Belgaum, India; Karachi, Pakistan; and Lusaka, Zambia and at University of Alabama at Birmingham and RTI International. It is thus far the largest RCT of developmental stimulation conducted in low/low-middle resource countries and the only one conducted simultaneously in more than one country.

Funded by NIH, The intervention was delivered in home visits every two weeks by parent trainers from about 2 weeks after birth until age 36 months. The primary outcome of the trial was cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and treatment adherence are evaluated as moderating factors. Over 430 children were enrolled in this trial and their development was evaluated at 12, 24, and 36 months of age. The intervention produced a modest and significant positive effect on cognitive development, which appears related to how well the family could follow the treatment.

BRAIN-HIT is described in more detail in this article:

  • Carlo, W.D., Goudar S.S., Pasha, O., Chomba, E., Wallander, J.L., Biasini, F.J.,  McClure, E.M., Thorsten, V., Chakraborty, H., Shearer, D.L., Wright, L.L., & the BRAIN-HIT Committee and the NICHD Global Network for Women's and Children's Health Research (2013). Randomized trial of early developmental intervention in children after birth asphyxia in developing countries. Journal of Pediatrics, 162, 705-712.

Selection Publication Include:

  • Wallander, J.L., Bann, C.M., Biasini, F.J., Goudar, S.S., Pasha, O., Chomba, E., McClure, E., & Carlo, W.A. (2014). Development of children at risk for adverse outcomes participating in early intervention in developing countries: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 55, 1251-1259. DOI: 10.1111/jcpp.12247
  • Wallander, J.L., Biasini, F.J., Thorsten, V., Dhaded, S.M., de Jong, D.M., Chomba, E., Pasha, O., Goudar, S., Wallace, D., Chakraborty, H., Wright, L.L., McClure, E., Carlo, W.A. (2014). Dose of early intervention treatment during children’s first 36 months of life is associated with developmental outcomes: An observational cohort study in three low/low-middle income countries. BMC Pediatrics14:281. DOI: 10.1186/1471-2431-14-281
  • Bann, C., Wallander, J.L., Do, B., Thorsten, V. Pasha, O., Biasini, F. Roopa, B., Goudar, S., Chomba, E., McClure, E., & Carlo, W. (2016). Home-based early intervention and the influence of family resources on cognitive development. Pediatrics