Anupam Sharma, Priya Shankar, Ricky Sharma, Nelabh Krishna, Nanditha Jayakumar, Samruddhi Nalawade, Avani Doshi, Aruna Nannapaneni, Vandana Krishnan, Mohammed Danish, Kym Ahrens, Sarah Golub, Rajib Dasgupta, Latha Ravichandran, Padma Srikanth, Sarala Premkumar, Jason M Nagata, Vaishali Keswani, Isabel Allen, Julia Seaman, Harish Pemde
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.
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.