Objective: To assess health-related concerns of youth in detention and to determine specific needs and priorities in health education/intervention in juvenile detention.

Methods: The subjects were from a medium-sized urban community being admitted to the Youth Detention Center for the first time. At the time of admission medical assessment, a convenience sample of male detainees were interviewed. The structured interview was conducted in a private setting after informed consent was obtained and confidentiality assured. The instrument asked for demographic information and contained an experimentalAdolescent Worry Scale consisting of 15 Likert-type items, framed in the context of: “In the past 3 months how often have you worried about....” (1=”Not at All”, 4=”Worried a Lot”; coefficient alpha 0.87). The last section included 6 questions about experience with violence and 8 questions about sexual experience. 460 subjects were interviewed (mean age 15.4; 85% African-American, 15% white).

Results: The top item of concern was “someone close to you being killed” (64% chose “worried a lot”). This was followed by “getting AIDS” (54%), “Getting STDs” (48%),“dying young” (42%), and “may not be able to get a good job” (32%). Subjects were least concerned with “too much drinking among friends” (13%) although alcohol use was prevalent among this target group.

28% were dropped out of school. 89% were sexually experienced and 15% had a history of STD. 11% admitted they were members of youth gangs. 50% of those who are not in a gang were worried about getting involved with the gangs. 45% reported “being shot at,” (73% of those within the last 12 months; 41% by an acquaintnace, friend or family), 89% saw a teenager carrying a gun to school or on the street, 35% said that firearms were in their household and 53% witnessed someone being stabbed or shot.

Conclusion: Efficacy of health promotional and educational programs is greater if the programs meet the needs of the target population. Our study using the Adolescent Worry Scale illustrated the primary concerns of our subjects and highlighted the importance of intervention programs dealing with interpersonal violence and HIV/STD issues.