A New Foundation: Advancing Adolescent Neglect Science through Measurement Development - PROJECT SUMMARY
The neglect of children and adolescents, a form of maltreatment along with abuse, is a significant problem
that impairs health and well-being throughout the lifespan. The long-term goal of this
exploratory/developmental research grant (R21) is to lay the groundwork for a larger research grant (R01) to
examine the multilevel antecedents of adolescent neglect, information that is critical to the development of
interventions. The objective is to conceptualize, develop and initially validate a multidimensional youth self-
reported measure of adolescent neglect. Neglect is conceptualized as inadequately met adolescent needs that
present actual or potential harm. This shifts from previous definitions which have focused on parental
omissions in care. This adolescent-centered conceptualization helps reconcile neglect's definition with growing
scientific evidence of its complex multilevel etiology. By untangling unmet needs from parental omissions, the
adolescent-centered conceptualization allows for more rigorous research examining neglect's multilevel
antecedents. Importantly, it offers a more constructive frame that should improve parent and youth
engagement in intervention. Aim 1 is to conceptualize, develop and pilot test a youth self-report measure of
adolescent neglect, defining it as critical unmet adolescent needs. It will apply rigorous qualitative methods per
state-of-the-art Patient-Reported Outcome Measurement Information System (PROMIS) scientific standards
for establishing content validity. Guided by an initial conceptual framework, this will include a scoping literature
review, a two-round modified Delphi expert panel (N = 12) and cognitive and concept elicitation interviews with
adolescents (N = 18). The second aim is to establish initial psychometric properties of the new neglect
measure. We will explore the measure's dimensional structure and assess its reliability (internal consistency,
test-retest), validity (criterion, concurrent and predictive convergent), and invariance in a sample of 12-17-year-
olds in Philadelphia who are at risk for neglect (N = 400). The outcome of the proposed research will be a
rigorously developed, novel measure of adolescent neglect with a sound conceptualization that incorporates
input from diverse experts and youths (Aim 1) and evidence of psychometric properties (Aim 2). The measure
has the potential for significant impact, paving the way for a new generation of neglect scholarship with a
sound conceptual and operational basis that will illuminate the scope, multi-level contributors, and sequelae of
adolescent neglect, informing policy and intervention that can overcome this intractable and pernicious
problem.
