Empowering the Underserved and At-Risk

When Danielle Parrish, Ph.D., sees young women in the juvenile justice system, she sees young people whose challenges place them at risk for a variety of negative health outcomes.

Parrish serves as professor in the Diana R. Garland School of Social Work at Baylor University’s Houston campus, conducting research that springs from early experiences as a young mental health clinician at a California juvenile justice system. In her role with crisis intervention across all units of the detention center, Parrish began to notice that the girls' unit had unmet needs.

"Through my work conducting mental health assessments, I learned their stories. I recognized that these young women had complex overlapping health, mental health and family histories. They were experiencing abuse and neglect that was not being recognized nor addressed,” Parrish says. “The scant services that were provided for this population were in silos — it was substance abuse, or pregnancy prevention or family intervention, but those things were never provided in an efficient, accessible way where you could address overlapping issues."

Despite decades of opportunity to develop these services, they have remained elusive for the populations that need them. A recent national survey of probation staff conducted by Parrish indicates a continued lack of effective gender-responsive services for young women. But thanks to years of dedicated focus, she is helping to turn the tide.

Parrish is studying a new approach to risk reduction intervention efforts for young women age 14-17 in the juvenile justice system. Her project, titled CHOICES-TEEN: Efficacy of a Bundled Risk Reduction Intervention for Juvenile Justice Females, was awarded a $3.1 million grant by the National Institutes of Health.

SERVICE AND LEADERSHIP

Parrish’s current project continues her longstanding work with an interdisciplinary research team on CHOICES, an evidence-based intervention program aimed at reducing alcohol-exposed pregnancies in women aged 18-44. CHOICES has been implemented by the CDC in various settings, including sexually transmitted infection clinics, community health centers, family planning clinics and more. Her efforts have forged a reputation as a leading expert and advocate for young women in juvenile justice. Today, she serves as editor-in-chief of the influential Journal of Social Work Education, and her highly regarded research has drawn substantial external funding.

She joined the Baylor faculty in 2018, compelled by a Christian research university whose high-level research is motivated by a heart of service.

"What drew me to join the Baylor faculty was the ability to work in a setting that recognized all of me, including my spirituality, as well as the commitment to research. It’s a transformational setting that draws excellent students, values high quality education and provides excellent research support as I pursue my calling to enhance the health and wellbeing of individuals who are vulnerable.”

That calling has led her to stand in the gap for others through research.

A TRANSFORMATIVE APPROACH TO HEALTH NEEDS

Research shows that young women involved in the juvenile justice system are 3.5 times more likely to have a child compared to non-delinquent youth, and nearly a third have been pregnant one or more times. Additionally, this population experiences higher rates of marijuana and alcohol use than their non-justice involved peers as well as high rates of sexually transmitted infections. If the needs and issues of these young women are not fully addressed, they can continue into adulthood and have significant impacts on their long-term health and quality of life.

"I think it's important that it is clear that this is a very high-risk, underserved population," Parrish said. "We just haven't made many gains in offering services that are empirically supported that actually improve the wellbeing of these young women and their health. Our short-term goals will be to look at the outcomes of the intervention to see if it's efficacious."

Parrish, today, continues to works with young women in community settings referred by the Harris County Juvenile Justice Probation Department. Those experiences help motivate the project's main focus—reducing health behaviors associated with substance-exposed pregnancy, which includes marijuana and alcohol-exposed pregnancies. Her work aims to improve the wellbeing of the population in a holistic manner.

CHOICES-TEEN involves four intervention sessions provided by a master's level clinician and a medical doctor specializing in adolescent care, both trained in motivational interviewing. The first session is provided in person, while the subsequent sessions are delivered in a tele-health capacity, accompanied by a mobile health app.

"With this particular intervention — in addition to looking at multiple health risk behaviors at once — we will add a hybrid tele-health aspect to the intervention,” Parish said. “I think this can have some major implications for learning about increasing the feasibility of service delivery for a population that might be typically inaccessible because of transportation or living in a rural area."

FILLING WIDESPREAD GAPS

The research is an integrated and collaborative approach to behavioral health, with the possibility to provide transformative service for young women in the juvenile justice system everywhere. If the research finds the intervention program to be effective, CHOICES-TEEN could be implemented by a variety of professionals and organizations.

"My hope is that it would be rolled out into settings where a young woman might be coming into contact with the juvenile justice system and diverted into the community setting or on community probation. I think this prevention approach could also be translated into other settings like teen health clinics or services provided in partnership with Child Protective Services,” Parrish says.

“I'm really excited and honored to have this opportunity to pursue research that I've had on my heart for many, many years. Baylor gives me the support to pursue my calling to enhance the health and wellbeing of individuals who are vulnerable and often forgotten in society."