Peer-reviewed article
Presence of a trusted adult and adolescent health outcomes in Urban India.
Sharma A, Shankar P, Sharma R, Krishna N, Jayakumar N et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how having a trusted adult influences health outcomes for adolescents aged 10-19 in urban India during the COVID-19 pandemic. Among 784 surveyed adolescents, 85% reported having a trusted adult, and those with trusted adults were significantly more likely to access healthcare providers and receive health information about mental health, nutrition, and COVID-19. Adolescents with trusted adults also experienced lower psychological distress both during and before the pandemic. However, the presence of a trusted adult did not significantly affect telehealth use or access to sensitive health information such as sexual and reproductive health.
Key points
- 85.2% of urban Indian adolescents reported having a trusted adult
- Adolescents with a trusted adult had nearly twice the odds of accessing a healthcare provider (AOR=1.98)
- Presence of a trusted adult was associated with 2.38 times higher odds of receiving mental health information
- Trusted adults were strongly associated with lower psychological distress (AOR=0.40 during pandemic, AOR=0.43 before)
- No significant association found between trusted adults and telehealth use or access to sensitive health topics
Limitations
This is a cross-sectional study that cannot establish causation between trusted adults and health outcomes. The sample is limited to school-enrolled adolescents in urban areas, so findings may not represent rural adolescents or those out of school.
Abstract
Background Adolescents in urban India face significant challenges in accessing healthcare and reliable health information, particularly during crises such as the COVID-19 pandemic. However, the role of trusted adults in shaping adolescent health remains underexplored. Objectives This study examined healthcare access, health information exposure, and the influence of trusted adults among urban Indian adolescents during the COVID-19 pandemic. Methods A cross-sectional online survey was conducted with 784 adolescents aged 10-19 years across urban India during the second wave of COVID-19 (May-October 2021). The survey assessed mental health, healthcare access, sources of health information, and the presence of trusted adults. Multivariable logistic regression models were used to examine associations between trusted adults and key health (and related) outcomes, adjusting for age, gender, and type of school. Results Most adolescents (85.2%) reported having a trusted adult. Adolescents with a trusted adult had significantly higher odds of accessing a healthcare provider (AOR = 1.98, p = 0.001) and receiving information on mental health (AOR = 2.38, p < 0.001), nutrition (AOR = 1.79, p = 0.005), and COVID-19 (AOR = 1.91, p = 0.003). The presence of a trusted adult was strongly associated with lower psychological distress during (AOR = 0.40, p < 0.001) and before (AOR = 0.43, p < 0.001) the pandemic. No significant association was found with telehealth use or access to sensitive health information such as sexual and reproductive health. Conclusions In this cross-sectional sample of urban, school-enrolled Indian adolescents surveyed during COVID-19, reporting a trusted adult was associated with greater healthcare access, wider exposure to general health information, and lower psychological distress, though not with telehealth use or with information on sensitive topics. These associations cannot establish causation, but they suggest that the supportive relationships adolescents already have merit closer attention, and better measurement, alongside the infrastructural focus of current adolescent health programs. Supplementary information The online version contains supplementary material available at https://doi.org/10.1186/s12982-026-02849-3.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Presence of a trusted adult (naturally occurring relationship, not an intervention program)
- Population
- 784 urban Indian adolescents aged 10-19 years, school-enrolled, surveyed during second wave of COVID-19 (May-October 2021)
Key finding
Adolescents with trusted adults had AOR=1.98 for accessing healthcare provider (p=0.001)
A et al. · Europe PMC · 22 Sept 2026