1
|
Sun M, Scherffius A, Sun M, Chen C, Wang D. Insomnia symptoms as a mediator between school connectedness and suicidal ideation in Chinese adolescents: A three-wave longitudinal model. Early Interv Psychiatry 2024. [PMID: 38783351 DOI: 10.1111/eip.13579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 04/02/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
AIM School connectedness is related to suicidal ideation (SI) in adolescents. However, little is known about the mediating role of insomnia symptoms in the school connectedness-SI link. This study aimed to examine the longitudinal mediating effect of insomnia symptoms on the relationship between school connectedness and SI as well as the moderating effect of sex using a three-wave longitudinal design. METHODS A total of 3110 adolescents completed three online surveys. Data were collected over the course of 1 year, in three waves 6 months apart. Participants completed the School Connectedness Scale, Youth Self-Rating Insomnia Scale, Self-rating Idea of Suicide Scale, Beck Depression Inventory and a self-compiled demographic questionnaire. Linear regressions and mediation analyses were performed to examine the associations between school connectedness, insomnia symptoms and SI. RESULTS School connectedness had a significant mediating effect on SI through insomnia symptoms (βa×b = -.03, 95% confidence interval = -0.04, -0.02) after controlling for demographics and depressive symptoms. Mediation analyses showed that insomnia symptoms accounted for 23.1% of the total effects in the entire sample, with 13.3% in males and 27.3% in females. Sex had no significant moderating effect on the school connectedness-SI link association. CONCLUSIONS The association between school connectedness and SI appears to be mediated by insomnia symptoms. Assessing and promoting school connectedness, as well as intervening and treating distress associated with insomnia, may have important clinical implications for reducing the risk of SI in adolescents.
Collapse
Affiliation(s)
- Mingze Sun
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Andrew Scherffius
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| |
Collapse
|
2
|
Miao R, Li Z. Cumulative ecological risk and cyberbullying among college students: a chain mediation model. Front Psychol 2024; 15:1302200. [PMID: 38469218 PMCID: PMC10925665 DOI: 10.3389/fpsyg.2024.1302200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction Cyberbullying among college students has been receiving increased research attention. Previous studies have focused primarily on the impact of a single risk factor on cyberbullying among college students. However, individual behavior is influenced by multiple ecosystems simultaneously, including family, school, and peers. To explore the effects of a single risk factor alone is not in line with the reality of everyday life, and the effect of the single risk factor can often be overestimated. Therefore, this study aimed to explore the impact of multiple risk factors, namely cumulative ecological risk, on cyberbullying, while analyzing the mediating roles of belief in a just world and moral disengagement. Methods A survey was conducted among 805 college students from two universities in Hebei Province, China, using the cumulative ecological risk questionnaire, the cyberbullying scale, the belief in a just world scale, and the moral disengagement scale. Results The results showed that: (a) Cumulative ecological risk was positively correlated with moral disengagement and cyberbullying, and negatively correlated with belief in a just world. Belief in a just world was negatively correlated with moral disengagement and cyberbullying. Moral disengagement was positively correlated with cyberbullying; (b) Belief in a just world partially mediated the relationship between cumulative ecological risk and cyberbullying; (c) Moral disengagement partially mediated the relationship between cumulative ecological risk and cyberbullying; (d) Belief in a just world and moral disengagement played a chain mediating role between cumulative ecological risk and college students' cyberbullying. Discussion This study provides valuable insight for the reduction of cyberbullying behavior among college students, and offers suggestions on how to create a more favorable online environment.
Collapse
Affiliation(s)
- Ruikai Miao
- Mental Health Education and Guidance Center, Shijiazhuang Tiedao University, Shijiazhuang, China
| | | |
Collapse
|
3
|
Pulavarthi TS, Fabio A, Miller E, Culyba AJ. Examining Associations Between School Connectedness, Social Support, Violence, and Firearm Carrying. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241233267. [PMID: 38379210 DOI: 10.1177/08862605241233267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Firearms are the leading cause of pediatric deaths. Few studies have identified protective factors that reduce the risk of firearm violence. Interpersonal factors, including school connectedness and social support, protect against multiple health-affecting risk behaviors. Therefore, this study examines associations of school connectedness and social support with firearm and weapon violence involvement. Data were gathered through an anonymous survey conducted across 13 high schools within an urban school district in 2018 (n = 2,604) modeled on the Centers for Disease Control and Prevention Youth Risk Behavior Surveillance Survey. Separate hierarchical logistic regression models examined associations between school connectedness and social support, and the outcomes of firearm carrying and engaging in violence with a weapon on school property in the past 12 months. Models were adjusted for age, race, and covariates representing basic needs, education, and mental health. The mean age was 15.7 years, and 57.5% of youth were female. 5.8% of youth had carried firearms and 5.5% engaged in violence with a weapon on school property in the past 12 months. School connectedness was significantly inversely associated with engaging in violence with a weapon on school property (odds ratio [OR] 0.225, 95% confidence interval [CI] [0.080, 0.632] and high levels of social support were significantly inversely associated with firearm carrying (OR 0.522, 95% CI [0.313, 0.870]). School connectedness and social support may be important in protecting youth from firearm and weapon-related violence. Interventions that strengthen safe and supportive interpersonal relationships within school environments and broader support systems across contexts may help reduce firearm and weapon violence involvement.
Collapse
Affiliation(s)
| | - Anthony Fabio
- Epidemiology Data Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Elizabeth Miller
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alison J Culyba
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
4
|
Kertes DA, Clendinen C, Duan K, Rabinowitz JA, Browning C, Kvam P. The Social Environment Matters for Telomere Length and Internalizing Problems During Adolescence. J Youth Adolesc 2024; 53:21-35. [PMID: 37747680 PMCID: PMC10761382 DOI: 10.1007/s10964-023-01848-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023]
Abstract
Depression and anxiety symptoms are on the rise among adolescents. With increasing evidence that cellular aging may be associated with depressive and anxiety symptoms, there is an urgent need to identify the social environment context that may moderate this link. This study addresses this research gap by investigating the moderating role of the social environment on the relation between telomere length and emotional health among adolescents. Participants were 411 non-Hispanic (88.56%) Black (100%) adolescents (M = 14.23 years, SD = 1.85, female = 54%) in a major metropolitan city. Youth and parents reported on an array of social risk and protective factors, and youth provided DNA samples for telomere length measurement. Results demonstrated that the association of telomere length and anxiety symptoms was stronger among youth with higher perceived stress or lower school belongingness, and the association of telomere length with depressive symptoms was stronger under conditions of higher parent inter-partner psychological aggression. The results enhance our understanding of the complex associations between biological aging, the social environment, and mental health in adolescence.
Collapse
Affiliation(s)
- Darlene A Kertes
- Department of Psychology, University of Florida, 945 Center Drive, Gainesville, FL, 32611-2250, USA.
- Genetics Institute, University of Florida, 945 Center Drive, Gainesville, FL, 32611-2250, USA.
| | - Cherita Clendinen
- Department of Psychology, University of Florida, 945 Center Drive, Gainesville, FL, 32611-2250, USA
| | - Ke Duan
- Department of Psychology, University of Florida, 945 Center Drive, Gainesville, FL, 32611-2250, USA
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
| | - Christopher Browning
- Department of Sociology, Ohio State University, 1885 Neil Ave, Columbus, OH, 43210, USA
| | - Peter Kvam
- Department of Psychology, University of Florida, 945 Center Drive, Gainesville, FL, 32611-2250, USA
| |
Collapse
|
5
|
Chu M, Lee CY, Li X, Zhao Z, Gao M, Chiang YC. Association of Friendly School and Family Contexts and Reducing Health Risk Behaviors Among Adolescents: A Cross-National Study in Europe, North America, and China. THE JOURNAL OF SCHOOL HEALTH 2024; 94:57-68. [PMID: 36967472 DOI: 10.1111/josh.13331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/18/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Social factors play an important role in adolescents' behaviors. This study aims to understand percentages of health risk behaviors across country in Europe, North America, and China; explore the associations between friendly school and family contexts and involvement for several health risk behaviors among adolescents. METHODS Data derived from health behavior in school-aged children cross-sectional surveys and China Education Panel Survey in 2014-2015. Hierarchical generalized linear modeling was used to analyze data. RESULTS The highest percentages of health risk behaviors including unhealthy diet, smoking or alcohol, screen-based sedentary behaviors, and violent behaviors across country ranged from 28.62% to 65.24%. National classmate friendliness was negatively associated with 5 out of 9 health risk behaviors prevalence rates in 41 countries (p < 0.05). Adolescents' perceived peer friendly and helpful were common protective factor for engaging in several health risk behaviors (p < 0.01). Individual family contexts were associated with 3 types of health risk behaviors involvement (p < 0.001). SCHOOL HEALTH POLICY IMPLICATIONS Health risk behaviors among adolescents reducing was associated with the implementation of friendly school and family contexts, emphasizing the significance of the goals of embedding friendly adolescents, along with the home-school collaboration. CONCLUSIONS Public health strategies should promote national climate of friendship and individual perceived friendly school contexts to reduce health risk behaviors.
Collapse
Affiliation(s)
- Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Chun-Yang Lee
- School of International Business, Xiamen University Tan Kah Kee College, Zhangzhou, China
| | - Xian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Min Gao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| |
Collapse
|
6
|
Oberle E, Ji XR, Alkawaja M, Molyneux TM, Kerai S, Thomson KC, Guhn M, Schonert-Reichl KA, Gadermann AM. Connections matter: Adolescent social connectedness profiles and mental well-being over time. J Adolesc 2024; 96:31-48. [PMID: 37740505 DOI: 10.1002/jad.12250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/14/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
INTRODUCTION This study examined profiles of social connectedness among early adolescents in grade 7 before the COVID-19 pandemic was declared (Winter 2020), and in grade 8 during the second Wave of the pandemic (Winter 2021). METHOD Linked data from 1753 early adolescents (49% female) from British Columbia, Canada who completed the Middle Years Development Instrument survey in grades 7 and 8 were used. Participants reported on life satisfaction, depressive symptoms, and connectedness with peers and adults at home, school and in the community. We used Latent Profile Analysis to identify connectedness profiles at both time points, and Latent Transition Analysis to examine transitions in connectedness profiles over time. Multiple regression analyses examined the associations between profile membership in grade 7 and mental well-being in grade 8, and the associations between transitions in profile membership (i.e., increase vs. decrease in connectedness over time) and mental well-being. RESULTS Connectedness in multiple domains in grade 7 was related to significantly higher levels of mental well-being in grade 8, controlling for demographics, well-being in grade 7, and COVID-related mental health worries. Well-being was highest when students felt highly connected in all domains and lowest when they felt lower levels of connection. Increases in connectedness were associated with improvements in mental well-being and decreases with a decline in well-being over time. CONCLUSIONS Experiencing connectedness with peers and adults is critical for the mental well-being in early adolescence. Providing opportunities to connect is important in the context of major societal challenges such as the COVID-19 pandemic.
Collapse
Affiliation(s)
- Eva Oberle
- School of Population and Public Health, The Human Early Learning Partnership, Faculty of Medicine, The University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Xuejun Ryan Ji
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Maram Alkawaja
- School of Population and Public Health, The Human Early Learning Partnership, Faculty of Medicine, The University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Tonje M Molyneux
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Salima Kerai
- School of Population and Public Health, The Human Early Learning Partnership, Faculty of Medicine, The University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Kimberly C Thomson
- Faculty of Health Science, Children's Health Policy Centre, Simon Fraser University, Burnaby, Canada
| | - Martin Guhn
- School of Population and Public Health, The Human Early Learning Partnership, Faculty of Medicine, The University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | | | - Anne M Gadermann
- School of Population and Public Health, The Human Early Learning Partnership, Faculty of Medicine, The University of British Columbia (UBC), Vancouver, British Columbia, Canada
| |
Collapse
|
7
|
Mygatt MG, Smith MC, Opalinski A. Adolescent Relatedness Through the Lens of Unitary Caring Theory. Nurs Sci Q 2024; 37:48-55. [PMID: 38054313 DOI: 10.1177/08943184231207372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Caring as a central focus within nursing has evolved into a relational ontology to guide practice and enhance well-being. Caring praxis has the potential to address the complexities of adolescent development and to allow for authentic engagement, breaking down the barriers of resistance to care. It is clear from the alarming statistics related to the prevalence of anxiety and depression in adolescents that teens are in distress. The authors in this article examine the construct of relatedness in adolescence through the lens of the theory of unitary caring and propose a trans-theoretical transdisciplinary model of relatedness that informs adolescent practice.
Collapse
Affiliation(s)
- Marla G Mygatt
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Marlaine C Smith
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Andra Opalinski
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| |
Collapse
|
8
|
Unhjem L, McWey LM, Ledermann T, Farley TM. Quality of the Parent-Child Relationship as a Moderator of Witnessing Violence and Youth Trauma Symptoms. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:869-879. [PMID: 38045838 PMCID: PMC10689639 DOI: 10.1007/s40653-023-00535-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 12/05/2023]
Abstract
Traumatic event exposure affects two in every three adolescents in the United States and there is the potential for numerous deleterious effects including higher levels of youth depression, anxiety, posttraumatic stress symptoms, and emotional and behavioral problems. Witnessing violence is one of the more common experiences associated with trauma exposure. Despite the ample research on mental health outcomes associated with witnessing violence, less is known about the extent to which parent-child relationships play a role in youth mental health outcomes when youth are exposed to violence. With a clinically relevant, diverse sample of 806 youth ages 12 years old who experienced maltreatment or were at risk of being maltreated, we tested hypotheses that the parent-child relationship quality would moderate the associations between witnessing violence and youth mental health outcomes. Results supported hypotheses for youths' symptoms of anxiety, depression, dissociation, and posttraumatic stress. The study contributes to the trauma literature by determining that the quality of the parent-child relationship moderated the effects of witnessing violence on trauma outcomes.
Collapse
Affiliation(s)
- Lexie Unhjem
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL USA
| | - Lenore M. McWey
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL USA
| | - Thomas Ledermann
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL USA
| | - Tatjana M. Farley
- Department of Human Development and Psychological Counseling, Appalachian State University, Boone, NC USA
| |
Collapse
|
9
|
Vidal C, Jun HJ, Latkin C. The Effects of Social Rank and Neighborhood and School Environment on Adolescent Depression and Suicidal Ideation: A Structural Equation Modeling Approach. Child Psychiatry Hum Dev 2023; 54:1425-1437. [PMID: 35347499 PMCID: PMC10120529 DOI: 10.1007/s10578-022-01347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/29/2022]
Abstract
Depression and suicide constitute major public health problems, and their prevalence has been increasing among adolescents in the United States. More research is needed to understand the association between multilevel risk factors and depression and suicidal ideation in adolescents, particularly factors related to perceived social rank and environmental stress. The present study examined relationships among family mental history of mental illness, in-utero and perinatal complications, social rank factors, environmental factors, and depression and suicidal ideation in the past month in a clinical population of adolescents. A cross-sectional survey was administered in outpatient clinics to 197 adolescents ages 12-18 who were primarily Black and female. Findings from structural equation modeling showed the largest effects for the social rank factor on depression and suicidal ideation in the past month. These findings highlight the importance of preventive interventions for coping with social hierarchies to prevent depression and suicidal ideation.
Collapse
Affiliation(s)
- Carol Vidal
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street/Bloomberg 12N, Baltimore, MD, 21287-3335, USA.
| | - Hyun-Jin Jun
- Graduate School, University of Maryland Baltimore, Baltimore, MD, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
10
|
Murphy JL, Kim Y. The Utilization Profiles of Comprehensive School Mental and Behavioral Health Needs Among Adolescents. THE JOURNAL OF SCHOOL HEALTH 2023; 93:537-546. [PMID: 36825483 DOI: 10.1111/josh.13302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/01/2022] [Accepted: 02/05/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Schools have become a primary access point for mental health services to cover the gap between need and service utilization that has long existed, particularly among vulnerable populations. This study aims to identify the profiles of comprehensive school mental and behavioral health system (CSMBHS) needs and examine related characteristics. METHODS We used the 2019 National Survey of Drug Use and Health (NSDUH) collected from a nationally representative sample in the United States. The sample included 6th through 12th-grade adolescents who had received CSMBHS services in the last 12 months (N = 1346). The study conducted latent class analysis and multinomial logistic regression using Vermunt's 3-step approach. RESULTS The analysis identified 3 profiles of student CSMBHS service need: depression needs (42%), multiple endorsements in most needs (depressed, friend, and school problems; 6.5%), and low endorsement (51.4%). Findings suggest that the profiles differed by age, a lifetime major depressive episode, family income, and use of other mental health services. IMPLICATIONS FOR SCHOOL HEALTH, POLICY, PRACTICE, AND EQUITY Emphasis should be placed on proactively identifying student needs and advocating for appropriate interventions based on student needs. CONCLUSIONS The study reveals important information regarding how schools best support students in need and in seeking services.
Collapse
Affiliation(s)
- Jennifer L Murphy
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Avenue, Richmond, VA, 23284
| | - Youngmi Kim
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Avenue, Richmond, VA, 23284
| |
Collapse
|
11
|
Pizzoli SFM, Monzani D, Conti L, Ferraris G, Grasso R, Pravettoni G. Issues and opportunities of digital phenotyping: ecological momentary assessment and behavioral sensing in protecting the young from suicide. Front Psychol 2023; 14:1103703. [PMID: 37441331 PMCID: PMC10333535 DOI: 10.3389/fpsyg.2023.1103703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 06/09/2023] [Indexed: 07/15/2023] Open
Abstract
Digital phenotyping refers to the collection of real-time biometric and personal data on digital tools, mainly smartphones, and wearables, to measure behaviors and variables that can be used as a proxy for complex psychophysiological conditions. Digital phenotyping might be used for diagnosis, clinical assessment, predicting changes and trajectories in psychological clinical conditions, and delivering tailored interventions according to individual real-time data. Recent works pointed out the possibility of using such an approach in the field of suicide risk in high-suicide-risk patients. Among the possible targets of such interventions, adolescence might be a population of interest, since they display higher odds of committing suicide and impulsive behaviors. The present work systematizes the available evidence of the data that might be used for digital phenotyping in the field of adolescent suicide and provides insight into possible personalized approaches for monitoring and treating suicidal risk or predicting risk trajectories. Specifically, the authors first define the field of digital phenotyping and its features, secondly, they organize the available literature to gather all the digital indexes (active and passive data) that can provide reliable information on the increase in the suicidal odds, lastly, they discuss the challenges and future directions of such an approach, together with its ethical implications.
Collapse
Affiliation(s)
- Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Heart,, Milan, Italy
| | - Dario Monzani
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Lorenzo Conti
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Ferraris
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Grasso
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
| |
Collapse
|
12
|
Brathwaite R, Mutumba M, Nanteza J, Filiatreau LM, Migadde H, Namatovu P, Nabisere B, Mugisha J, Mwebembezi A, Ssewamala FM. Assessing the Feasibility of Economic Approaches to Prevent Substance Abuse Among Adolescents: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e46486. [PMID: 37314844 PMCID: PMC10337321 DOI: 10.2196/46486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/05/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Adolescent alcohol and drug use (ADU) is a significant public health challenge. Uganda, one of the poorest countries in Sub-Saharan Africa (SSA), has the second-highest rate of per capita alcohol consumption in SSA, and over one-third of Ugandan adolescents have used alcohol in their lifetime (over 50% of them engage in heavy episodic drinking). These estimates further increase in fishing villages, a key HIV-vulnerable population, where ADU is normative. However, few studies have assessed ADU among adolescents and youths living with HIV despite their increased risk for ADU and its impact on engagement in HIV care. Moreover, data on risk and resilience factors for ADU are scarce as only few studies evaluating ADU interventions in SSA have reported positive outcomes. The majority have been implemented in school settings, potentially excluding adolescents in fishing communities with high school dropout rates, and none have targeted risk factors including poverty and mental health, which are rampant among adolescents and youths living with HIV and their families, undermine their coping skills and resources, and have been associated with increased risk for ADU among them. OBJECTIVE We propose a mixed methods study with a sample of 200 adolescents and youths living with HIV (aged 18-24 years) seen at 6 HIV clinics in southwestern Uganda's fishing communities to (1) examine the prevalence and consequences of ADU and identify the multilevel risk and resilience factors associated with ADU among them and (2) explore the feasibility and short-term effects of an economic empowerment intervention on ADU among them. METHODS This study comprises four components: (1) focus group discussions (FGDs) with adolescents and youths living with HIV (n=20) and in-depth qualitative interviews with health providers (n=10) from 2 randomly selected clinics; (2) a cross-sectional survey with 200 adolescents and youths living with HIV; (3) a randomized controlled trial with a subgroup of adolescents and youths living with HIV (n=100); and (4) 2 postintervention FGD with adolescents and youths living with HIV (n=10 per group). RESULTS Participant recruitment for the first qualitative phase has completed. As of May 4, 2023, ten health providers from 6 clinics have been recruited, provided written consent to participate, and participated in in-depth qualitative interviews. Two FGDs was conducted with 20 adolescents and youths living with HIV from 2 clinics. Data transcription, translation, and analysis of qualitative data has commenced. The cross-sectional survey will commence shortly after and dissemination of the main study findings is targeted for 2024. CONCLUSIONS Our findings will advance our understanding of ADU among adolescents and youths living with HIV and inform the design of future interventions to address ADU among them. TRIAL REGISTRATION ClinicalTrials.gov NCT05597865; https://clinicaltrials.gov/ct2/show/NCT05597865. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/46486.
Collapse
Affiliation(s)
- Rachel Brathwaite
- Brown School, Washington University in St. Louis, St Louis, MO, United States
| | - Massy Mutumba
- Department of Health Behavior & Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | | | - Lindsey M Filiatreau
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Herbert Migadde
- International Center for Child Health and Development, Masaka, Uganda
| | - Phionah Namatovu
- International Center for Child Health and Development, Masaka, Uganda
| | - Betina Nabisere
- International Center for Child Health and Development, Masaka, Uganda
| | | | | | - Fred M Ssewamala
- Brown School, Washington University in St. Louis, St Louis, MO, United States
| |
Collapse
|
13
|
Brar P, Shramko M, Taylor S, Eisenberg M. The Moderating Influence of School Adult Connectedness on Adolescent Dating Violence and Mental Health. THE JOURNAL OF SCHOOL HEALTH 2023; 93:297-304. [PMID: 36382738 DOI: 10.1111/josh.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Adolescent dating violence (ADV) continues to be a health concern. Most previous research has examined physical and or sexual ADV with little attention to verbal violence. METHODS Drawing on the social-ecological framework, the current study examined the moderating influence of school adult connectedness on experiences of verbal only, physical and/or sexual violence (combination ADV), and mental health outcomes among 11th graders (n = 31,459) in one Midwestern state. RESULTS Overall, 24.0% and 28.8% of adolescents met thresholds for depression and anxiety symptoms, respectively. Rates of mental health symptoms were higher among adolescents reporting ADV compared to those who did not report experience of ADV. In logistic regressions, higher level of school adult connectedness was associated with lower odds of depressive and anxiety symptoms, respectively. In moderation analyses, school adult connectedness was protective for mental health outcomes regardless of ADV experience. CONCLUSION Adolescent dating violence-including verbal violence alone-can be traumatic for young people. Schools can leverage the protective nature of school adult connection to promote mental health for all students, including adolescents who have experienced ADV. Incorporating trauma-informed education practice of providing unconditional positive regard toward adolescents might be 1-way schools can support adolescents in cultivating healthy relationships and well-being.
Collapse
Affiliation(s)
- Pooja Brar
- Department of Family Studies and Community Development, Towson University, MD, Towson, USA
| | - Maura Shramko
- Center for Advanced Studies in Child Welfare, School of Social Work, University of Minnesota, MN, Minneapolis, USA
| | - Sarah Taylor
- Department of Family and Consumer Sciences, California State University, Long Beach, CA, USA
| | - Marla Eisenberg
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota, MN, Minneapolis, USA
| |
Collapse
|
14
|
Teferra AA, Alalwan MA, Keller-Hamilton B, Roberts ME, Lu B, Paskett ED, Chrzan K, Curran H, Ferketich AK. Adherence to COVID-19 Protective Measures in a Longitudinal Sample of Male Youth. Int J Behav Med 2023; 30:268-278. [PMID: 35543861 PMCID: PMC9091545 DOI: 10.1007/s12529-022-10090-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Adherence to COVID-19 protective measures is lowest for young people and males. The current study investigated characteristics associated with adherence to COVID-19 protective measures among male youth during the early months of the pandemic. METHOD The study used data from a prospective cohort study among male youth with baseline assessment in 2015/2016 and follow-up measurements in 2019 and summer 2020. Attrition-weighted multivariable ordinal logistic and log-binomial regression models were used to assess factors associated with adherence to overall and specific adherence measures, respectively. RESULTS Among 571 male youth (mean age 18.5), overall adherence was higher for those who were older (OR: 1.15; 95% CI: 1.03-1.30), non-White (OR: 1.96; 95% CI: 1.20-3.32), and residing in an urban area (OR: 2.06; 95% CI: 1.46-3.01). Overall adherence was lower for those who had a history of being drunk (OR: 0.65; 95% CI: 0.42-0.99). For outdoor mask-wearing, adherence was higher for youth with attention-deficit disorder or attention-deficit/hyperactivity disorder (RR: 1.58; 95% CI: 1.16-1.97) and lower for youth who currently used tobacco products (RR: 0.42; 95% CI: 0.21-0.70). Before a statewide mask mandate was issued, non-White youth were more likely to report wearing masks in outdoor spaces than their non-Hispanic White peers (RR: 2.34; 95% CI: 1.75-3.23). CONCLUSION The study identified demographic, psychosocial, and behavioral factors associated with adherence to COVID-19 protective behaviors among male youth. The findings illustrate characteristics that could be leveraged for targeted preventive efforts during the ongoing pandemic and future outbreaks in a low-compliance group.
Collapse
Affiliation(s)
- Andreas A Teferra
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA.
| | - Mahmood A Alalwan
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
| | - Brittney Keller-Hamilton
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, USA
| | - Megan E Roberts
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, USA
| | - Bo Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, USA
| | - Electra D Paskett
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, USA
| | - Kirsten Chrzan
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
| | - Hayley Curran
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, USA
| | - Amy K Ferketich
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
- Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University, Columbus, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, USA
| |
Collapse
|
15
|
Caballero E, Minnis A, Parmar D, Zerofsky M, Comfort M, Raymond-Flesch M. Labeling in a Latinx Community: Public Health Implications for Youth and Role in Community Narratives. RESEARCH SQUARE 2023:rs.3.rs-2626181. [PMID: 36993344 PMCID: PMC10055544 DOI: 10.21203/rs.3.rs-2626181/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Background Youth of color are disproportionately subjected to negative formal and informal labels by parents, peers, and teachers. This study examined the consequences of such labels on health-protective behaviors, wellbeing, peer networks and school engagement. Methods In-depth interviews were conducted with 39 adolescents and 20 mothers from a predominantly Latinx and immigrant agricultural community in California. Teams of coders completed iterative rounds of thematic coding to identify and refine key themes. Results Dichotomous labeling of "good" and "bad" was pervasive. Youth labeled as "bad" experienced limited educational opportunities, exclusion from peers, and community disengagement. Additionally, preservation of "good kid" labels compromised health protective-behaviors including foregoing contraception. Participants pushed back on negative labeling when it was applied to close family or community acquaintances. Discussion Targeted interventions that foster social belonging and connection rather than exclusion may facilitate health protective behaviors and have positive implications for future trajectories among youth.
Collapse
|
16
|
Ibrahim N, Hassler C, Jousselme C, Barry C, Lefèvre H, Falissard B, Bouyer J, Rouquette A. Chronic conditions, subjective wellbeing and risky sexual behaviour among adolescents and young adults. Eur J Pediatr 2023; 182:1163-1171. [PMID: 36602622 DOI: 10.1007/s00431-022-04784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023]
Abstract
The purpose of this study is to clarify the relationship between having a chronic condition (CC) and several types of risky sexual behaviour (RSB) among adolescents and young adults. We used data from a multicentre cross-sectional study carried out on 14,431 adolescents from 137 French schools. Logistic regression was used to assess the association between several types of RSB and CCs among the 2680 participants aged 17 years or over who reported sexual intercourse. Survival analysis was conducted to assess the association between CCs and age at first sexual intercourse across the whole sample. Analyses were conducted separately by gender with and without adjustment for the parents' education level, early menarche and subjective wellbeing (relationship with mother and father, depression, perceived health status and liking school). Among boys, having a CC was associated with a higher risk of RSB in both univariate (OR: 1.58 [95% CI: 1.10-2.27]) and multivariate analyses (aOR: 1.62 [95% CI: 1.11-2.38]). Among girls, the association between chronic condition and RSB in univariate analysis was non-significant (OR: 1.30 [95% CI: 0.97-1.76]) and disappeared after adjustment on subjective wellbeing (aOR: 1.08 [95% CI: 0.78-1.49]). There was no association between CC and age at first sexual intercourse. Conclusion: There were major gender differences. Boys with a CC were more prone to engage in RSB independent of their subjective wellbeing, whereas in girls, subjective wellbeing seemed to mediate the relationship between CC and RSB. Clinicians should be aware of those gender differences in order to deliver preventive strategies regarding sexuality that target both genders. What is Known: • Young people with chronic conditions have a higher likelihood of engaging in risky sexual behaviour. • Engaging in such behaviours can be much more costly, as it can weaken their underlying state of health. What is New: • We found major gender differences. Boys were more prone to engage in risky behaviour independent of their subjective wellbeing, whereas in girls, it seemed to play an important role. • By understanding how risky sexual behaviour differs according to gender, clinicians can deliver prevention messages that target both genders.
Collapse
Affiliation(s)
- Nour Ibrahim
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France.
- French Research Group in Adolescent Health (GRMSA), Maison de Solenn, 97 Boulevard de Port Royal, Paris, France.
| | | | - Catherine Jousselme
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Fondation Vallée, Paris-Saclay University, Gentilly, France
| | - Caroline Barry
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
| | - Hervé Lefèvre
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- French Research Group in Adolescent Health (GRMSA), Maison de Solenn, 97 Boulevard de Port Royal, Paris, France
- AP-HP, Hôpital Cochin, Maison de Solenn, 97 Boulevard de Port-Royal, 75014, Paris, France
| | - Bruno Falissard
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
| | - Jean Bouyer
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
| | - Alexandra Rouquette
- Paris-Saclay University, UVSQ, CESP, Inserm U1018, Paris, France
- Public Health and Epidemiology Department, AP-HP, Hôpital du Kremlin Bicêtre, Le Kremlin Bicêtre, France
| |
Collapse
|
17
|
London-Nadeau K, Chadi N, Taylor AB, Chan A, Pullen Sansfaçon A, Chiniara L, Lefebvre C, Saewyc EM. Social Support and Mental Health Among Transgender and Nonbinary Youth in Quebec. LGBT Health 2023; 10:306-314. [PMID: 36787477 DOI: 10.1089/lgbt.2022.0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Purpose: Transgender and nonbinary (TNB) youth face elevated levels of discrimination, stigma, mental health disorders, and suicidality when compared with their cisgender counterparts. Family and school support may mitigate some of the effects of the stressors facing TNB youth. This study aimed to better understand the impact of each of these sources of support on TNB youths' mental health and wellbeing. Methods: We used data collected between 2018 and 2019 as part of the Canadian Trans Youth Health Survey, a bilingual online survey to measure social support, physical health, and mental health in a sample of 220 TNB youth aged 14-25 living in Québec, Canada. We examined the relationships among different sources of support, and mental health and wellbeing outcomes using logistic regression. Analyses were conducted on the full sample and according to linguistic groups (French and English). Results: Participants reported high levels of mental health symptoms, self-harm, and suicidality, and mental health symptoms were higher in the English-speaking group (p = 0.005). In models controlling for age, family connectedness was associated with good/excellent self-reported mental health (odds ratio [OR] = 2.62, p = 0.001) and lower odds of having considered suicide (OR = 0.49, p = 0.003) or attempted suicide (OR = 0.43, p = 0.002), whereas school connectedness was associated with higher odds of good/very good/excellent general (OR = 2.42, p = 0.013) and good/excellent mental (OR = 2.45, p = 0.045) health. Conclusion: Family and school support present consistent associations with TNB youths' health and may constitute key areas for intervention for those supporting them.
Collapse
Affiliation(s)
- Kira London-Nadeau
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,CHU Sainte-Justine Research Center, Montréal, Québec, Canada
| | - Nicholas Chadi
- CHU Sainte-Justine Research Center, Montréal, Québec, Canada.,Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada.,Division of Adolescent Medicine, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
| | - Ashley B Taylor
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ace Chan
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Annie Pullen Sansfaçon
- Canada Research Chair on Transgender Children and their Families, School of Social Work, Université de Montréal, Montréal, Québec, Canada.,School of Social Work, Stellenbosch University, Stellenbosch, South Africa
| | - Lyne Chiniara
- Division of Endocrinology, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
| | - Claire Lefebvre
- Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
| | - Elizabeth M Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
18
|
Tellier PP, Ataman R, Zaccagnini M, Gore G, Rodriguez C. Adolescent medicine training in postgraduate family medicine education: a scoping review. Int J Adolesc Med Health 2023; 35:119-129. [PMID: 36584348 DOI: 10.1515/ijamh-2022-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/07/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Adolescents and young adults require age-appropriate healthcare services delivered by clinicians with expertise in adolescent medicine. However, resident family physicians report a low perceived self-efficacy and under-preparedness to deliver adolescent medical care. We conducted a scoping review to map the breadth and depth of the current evidence about adolescent medicine training for family medicine residents. CONTENT We followed Arksey and O'Malley's framework and searched seven electronic databases and key organizations' webpages from inception to September 2020. Informed by the CanMEDS-FM, we analyzed the extracted data concerning basic document characteristics, competencies and medical topics using numerical and qualitative content analysis. SUMMARY We included 41 peer-reviewed articles and six adolescent health competency frameworks (n=47). Most competencies taught in family medicine programs were organized under the roles of family medicine expert (75%), communicator (11.8%), and professional roles (7.9%). Health advocate and leader were rarely included (1.3%), and never scholar. OUTLOOK The omission of multiple competency roles in family medicine resident education on adolescents is insufficient for family physicians to deliver optimal care to adolescents. The combined efforts of family medicine stakeholders to address adolescent medicine competency gaps may positively impact the perceived competence reported by family medicine residents.
Collapse
Affiliation(s)
| | - Rebecca Ataman
- The School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Laval, QC, Canada
| | - Marco Zaccagnini
- The School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Laval, QC, Canada
| | - Geneviève Gore
- McGill Schulich Library of Physical Sciences, Life Sciences and Engineering, McGill University, Montréal, QC, Canada
| | - Charo Rodriguez
- Department of Family Medicine, McGill University, Montréal, QC, Canada.,The Institute of Health Sciences Education, McGill University, Montréal, QC, Canada
| |
Collapse
|
19
|
Zervos AP, Hensel DJ, James R, Hunt A, Ott MA. The role of trauma and positive youth development in polysubstance use among rural middle school students: a latent class analysis. BMC Public Health 2022; 22:2350. [PMID: 36517786 PMCID: PMC9753425 DOI: 10.1186/s12889-022-14795-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Rural youth often begin developing polysubstance use and other risk behaviors during middle school. However, little polysubstance use research focuses on rural middle school youth. Our research uses Latent Class Analysis to understand existing patterns of rural middle school polysubstance use and risk and protective factors associated with polysubstance use. METHODS We used survey data from a rural middle school pregnancy prevention program (N = 2,708). The survey included measures of demographics, lifetime substance use, trauma (adverse childhood experiences and bullying victimization) and aspects of youth development (parent communication on drugs and alcohol, parent connectedness and school connectedness). We used latent class analysis to produce participant polysubstance use profiles and multinomial regression to examine associations between polysubstance use, demographics, trauma and aspects of youth development. RESULTS We categorized our participants into four latent classes. Our analysis classified 2.2% of participants as Regular Polysubstance users, 6.9% as Polysubstance experimenters, 19% as Vape + Alcohol experimenters and 71.9% as Non-Users. More adverse childhood experiences were associated with greater risk of polysubstance use and experimentation. Bullying was positively associated with greater risk of vape and alcohol experimentation. Higher reported parental and school connectedness were associated with lower risk of high frequency polysubstance use. Higher reported school connection was also associated with lower risk of polysubstance experimentation. CONCLUSION Rural substance use prevention programs should begin during middle school, as polysubstance use development is common among rural middle schoolers. These programs should be trauma informed and focus on connectedness as a modifiable factor to reduce risk of polysubstance use development. TRIAL REGISTRATION This article does not report results of a health care intervention on human participants.
Collapse
Affiliation(s)
- Andrew P. Zervos
- grid.257413.60000 0001 2287 3919Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, 410 W. 10thStreet, Suite 1001, Indianapolis, IN 46202 USA
| | - Devon J. Hensel
- grid.257413.60000 0001 2287 3919Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, 410 W. 10thStreet, Suite 1001, Indianapolis, IN 46202 USA
| | - Rebecca James
- Health Care Education and Training, Inc, 1630 N. Meridian Street, Suite 430, Indianapolis, IN 46202 USA
| | - Abby Hunt
- Health Care Education and Training, Inc, 1630 N. Meridian Street, Suite 430, Indianapolis, IN 46202 USA
| | - Mary A. Ott
- grid.257413.60000 0001 2287 3919Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, 410 W. 10thStreet, Suite 1001, Indianapolis, IN 46202 USA
| |
Collapse
|
20
|
Heinrichs N, Brühl A. Preventing Revictimization Through a Web-Based Intervention for Primary Caregivers of Youth in Care (EMPOWERYOU): Protocol for a Randomized Factorial Trial. JMIR Res Protoc 2022; 11:e38183. [DOI: 10.2196/38183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/05/2022] [Accepted: 08/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Children in foster care are at a higher risk for relationship problems than their counterparts raised by their biological family because of higher exposure to or prevalence of neglect or maltreatment early in life. Consequently, these children may also show more challenging behavior in their foster families, which in turn increases the parental stress experience of foster caregivers. Furthermore, the children may engage in a vicious cycle of risky relationship behaviors and expectations that put them at a greater risk for revictimization.
Objective
To support foster caregivers in reducing the risk for revictimization, several intervention modules delivered via the internet were developed using a consumer-based approach (phase 1 of the multiphase optimization strategy). This project (phase 2 of the multiphase optimization strategy) aimed to develop a sustainable intervention by selecting promising intervention components based on their contribution to the outcome.
Methods
In a 24 factorial trial, a total of 317 foster caregivers with children aged 8 to 13 years are randomly assigned to 1 of 16 conditions. The primary outcome is the rate of revictimization from baseline to 3 months after intervention. Secondary outcomes include risk-taking and functional behaviors in relationships. All caregivers will receive access to all the intervention components after the follow-up assessment. The participants assigned to the condition with all component levels on are expected to show the best improvement in the primary and secondary outcomes.
Results
Recruitment and data collection for the factorial trial started in March 2022 and is ongoing. As of October 2022, we recruited 181 families. Although it is difficult to predict the exact study timeline owing to COVID-19 pandemic–related delays, results are expected in February 2024.
Conclusions
There is a need for easily accessible information related to raising children in foster care who have experienced early life adversities to interrupt the cycle of violence and enhance the developmental pathway of health and emotional stability. It might be useful, in addition to generally useful parenting information (eg, parental self-care or emotion regulation management), to specifically focus on the needs of these caregivers (eg, how to support the child to reduce dysfunctional relationship behaviors that may have developed because of early adverse experiences).
Trial Registration
ClinicalTrials.gov NCT05235659; https://clinicaltrials.gov/ct2/show/NCT05235659
International Registered Report Identifier (IRRID)
DERR1-10.2196/38183
Collapse
|
21
|
Blackburn B, Handcock MS. Practical Network Modeling via Tapered Exponential-family Random Graph Models. J Comput Graph Stat 2022; 32:388-401. [PMID: 37608920 PMCID: PMC10441622 DOI: 10.1080/10618600.2022.2116444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/17/2022] [Indexed: 10/17/2022]
Abstract
Exponential-family Random Graph Models (ERGMs) have long been at the forefront of the analysis of relational data. The exponential-family form allows complex network dependencies to be represented. Models in this class are interpretable, flexible and have a strong theoretical foundation. The availability of powerful user-friendly open-source software allows broad accessibility and use. However, ERGMs sometimes suffer from a serious condition known as near-degeneracy, in which the model exhibits unrealistic probabilistic behavior or a severe lack-of-fit to real network data. Recently, Fellows and Handcock (2017) proposed a new model class, the Tapered ERGM, which circumvents the issue of near-degeneracy while maintaining the desirable features of ERGMs. However, the question of how to determine the proper amount of tapering needed for any model was heretofore left unanswered. This paper develops a new methodology for how to determine the necessary level of tapering and as such provides a new approach to inference for the Tapered ERGM class. Noting that a Tapered ERGM can always be made non-degenerate, we offer data-driven approaches for determining the amount of tapering necessary. The mean-value parameter estimates are unaffected by tapering, and we show that the natural parameter estimates are numerically weakly varying by the level of tapering. We then apply the Tapered ERGM to two published networks to demonstrate its effectiveness in cases where typical ERGMs fail and present the case for Tapered ERGMs replacing ERGMs entirely.
Collapse
Affiliation(s)
- Bart Blackburn
- University of California, Los Angeles, Statistics, Los Angeles, United States
| | - Mark S Handcock
- University of California, Los Angeles, Statistics, Los Angeles, United States
| |
Collapse
|
22
|
Wilson K, Ramella K, Poulos A. Building School Connectedness Through Structured Recreation During School: A Concurrent Mixed-Methods Study. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1013-1021. [PMID: 35871538 DOI: 10.1111/josh.13222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/24/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND School connectedness (SC) is associated with improved health and academic outcomes. The purposes of this study were to explore factors contributing to students' perceptions of SC and if participation in structured recreation at school was associated with SC. METHODS We used concurrent mixed-methods including cross-sectional qualitative data to explore factors contributing to SC among fifth- and sixth-grade students at 2 schools in Phoenix, AZ, USA (N = 330), and quantitative measures to explore the association between SC and recreation participation (N = 129). Students completed a journaling activity to identify factors contributing to feelings of SC. Responses were analyzed using both deductive and inductive approaches. Student surveys were analyzed using 1-way analyses of variance to assess differences between participation level and SC. RESULTS Eight themes contributing to SC emerged: Relationships (peer, adult), Competence (competence), Autonomy (choice), Relax (relax), Recreation (structured, play), Fun (fun), Academics (academic learning), and Environment (food and safety). Participation in structured recreation programming in the classroom and at recess were associated with higher levels of SC (p < .05). CONCLUSIONS School practitioners can integrate opportunities for structured recreation in the classroom and at recess as a fun and engaging strategy to foster adult support and peer relationships, enhancing SC.
Collapse
Affiliation(s)
- Kylie Wilson
- College of Health Solutions, Arizona State University, 550 N 3rd Street, Phoenix, AZ, 85004, USA
| | - Kelly Ramella
- School of Community Resources & Development, Arizona State University, 411 N Central Avenue, Phoenix, AZ, 85004, USA
| | - Allison Poulos
- College of Health Solutions, Arizona State University, 550 N 3rd Street, Phoenix, AZ, 85004, USA
| |
Collapse
|
23
|
Zhang W, Zhou F, Zhang Q, Lyu Z. Attachment anxiety and smartphone addiction among university students during confinement: Teacher–student relationships, student–student relationships and school connectedness as mediators. Front Public Health 2022; 10:947392. [PMID: 35991041 PMCID: PMC9388001 DOI: 10.3389/fpubh.2022.947392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
Learning at home during the COVID-19 confinement might affect students' relationships with their peers, teachers, and schools and increase the possibility of smartphone addiction. We hypothesized that attachment anxiety directly and indirectly affects smartphone addiction, with teacher–student relationships, student–student relationships, and school connectedness as mediators. The participants were 999 university students from different regions of China. The results showed that six of the paths were significant except the one between student–student relationships and smartphone addiction. Also, the association between attachment anxiety and smartphone addiction was mediated by teacher–student relationships and school connectedness not but student–student relationships. The current study highlights the mediating effect of school connectedness and teacher–student relationships in the multiple mediation model, and suggests that universities can alleviate the risk of smartphone addiction in distance teaching by cultivating good teacher–student relationships and strengthening students' sense of belonging to their schools.
Collapse
Affiliation(s)
- Wen Zhang
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, Wuhan, China
- *Correspondence: Wen Zhang
| | - Fangzhou Zhou
- Institute of Communication Studies, Communication University of China, Beijing, China
| | - Qingyu Zhang
- School of Accounting, Zhongnan University of Economics and Law, Wuhan, China
| | - Zhixuan Lyu
- School of Journalism and Communication, Xiamen University, Xiamen, China
| |
Collapse
|
24
|
Vazsonyi AT, Ksinan AJ, Javakhishvili M, Scarpate JM, Kahumoku-Fessler E. Links Between Parenting and Internalizing and Externalizing Problems: Cross-Cultural Evidence from Ten Countries. Child Psychiatry Hum Dev 2022; 53:667-683. [PMID: 33751285 DOI: 10.1007/s10578-021-01153-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 11/28/2022]
Abstract
The present study tested the links between perceived maternal and paternal parenting and internalizing and externalizing problems across ten cultures (China, Czech Republic, Hungary, the Netherlands, Slovenia, Spain, Switzerland, Taiwan, Turkey, and the United States). Self-report data were collected from N = 12,757 adolescents (Mage = 17.13 years, 48.4% female). Multigroup confirmatory factor analyses and structural equation models tested whether: (1) the six parenting processes (closeness, support, monitoring, communication, peer approval, and conflict; Adolescent Family Process, Short Form (AFP-SF, 18 items) varied across cultures, and (2) the links between parenting processes and measures of internalizing and externalizing problems varied across cultures. Study findings indicated measurement invariance (configural and metric) of both maternal and paternal parenting processes and that the parenting-internalizing/externalizing problems links did not vary across cultures. Findings underscore the ubiquitous importance of parenting processes for internalizing and externalizing problems across diverse Asian, European, Eurasian, and North American cultures.
Collapse
Affiliation(s)
| | - Albert J Ksinan
- University of Kentucky, Lexington, USA.,Masaryk University, Brno, Czech Republic
| | - Magda Javakhishvili
- University of Kentucky, Lexington, USA.,The City University of New York (CUNY), New York, USA
| | | | | |
Collapse
|
25
|
Gan X, Li H, Xiang GX, Lai XH, Jin X, Wang PY, Zhu CS. Cumulative Family Risk and Cyberbullying Among Chinese Adolescents: The Chain Mediating Role of School Connectedness and Cyber Victimization. Front Public Health 2022; 10:898362. [PMID: 35832277 PMCID: PMC9271664 DOI: 10.3389/fpubh.2022.898362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022] Open
Abstract
Abundant evidence has demonstrated that cumulative family risk is associated with cyberbullying. However, few studies to date have investigated how cumulative family risk links to cyberbullying. To fill in these gaps, the present study examined the mediating role of school connectedness and cyber victimization in the relation between cumulative family risk and cyberbullying. A sample of 1,804 Chinese adolescents was recruited to complete measures of cumulative family risk, cyberbullying, school connectedness, cyber victimization, and demographic variables through convenience sampling. There were 813 boys and 991 girls, aged from 13 to 18, with an average age of 16 years (SD = 1.71). Correlational analyses and SPSS macro PROCESS (Model 6) were used for major data analysis. Results indicated that cumulative family risk was positively associated with cyberbullying, and this link could be mediated by school connectedness and cyber victimization. The present study identifies the potential underlying mechanism by which cumulative family risk is associated with adolescent cyberbullying, which has important implications for theory and prevention.
Collapse
Affiliation(s)
- Xiong Gan
- Department of Psychology, College of Education and Sports Sciences, Yangtze University, Jingzhou, China
- *Correspondence: Xiong Gan
| | - Hao Li
- Department of Psychology, College of Education and Sports Sciences, Yangtze University, Jingzhou, China
| | - Guo-xing Xiang
- Department of Psychology, College of Education and Sports Sciences, Yangtze University, Jingzhou, China
| | - Xin-hua Lai
- Department of Psychology, College of Education and Sports Sciences, Yangtze University, Jingzhou, China
| | - Xin Jin
- Department of Psychology, College of Education and Sports Sciences, Yangtze University College of Technology and Engineering, Jingzhou, China
| | - Pin-yi Wang
- Department of Psychology, College of Education and Sports Sciences, Yangtze University, Jingzhou, China
| | - Cong-shu Zhu
- Department of Psychology, College of Education and Sports Sciences, Yangtze University, Jingzhou, China
| |
Collapse
|
26
|
Feng T, Wang X, Chen Q, Liu X, Yang L, Liu S, Zhang Y. Sympathy and active defending behaviors among Chinese adolescent bystanders: A moderated mediation model of attitude toward bullying and school connectedness. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tingting Feng
- Department of Educational Technology, School of Smart Education Jiangsu Normal University Xuzhou China
| | - Xinyi Wang
- Department of Educational Technology, School of Smart Education Jiangsu Normal University Xuzhou China
| | - Qiuxu Chen
- Department of Educational Technology, School of Smart Education Jiangsu Normal University Xuzhou China
| | - Xingchang Liu
- Department of Educational Technology, School of Smart Education Jiangsu Normal University Xuzhou China
| | - Lihong Yang
- Department of Educational Technology, School of Smart Education Jiangsu Normal University Xuzhou China
| | - Simeng Liu
- Department of Educational Technology, School of Smart Education Jiangsu Normal University Xuzhou China
| | - Yuchi Zhang
- Department of Educational Technology, School of Smart Education Jiangsu Normal University Xuzhou China
- Jiangsu Engineering Research Center of Educational Informatization Jiangsu Normal University Xuzhou China
| |
Collapse
|
27
|
Graham LJ, Gillett-Swan J, Killingly C, Van Bergen P. Does It Matter If Students (Dis)like School? Associations Between School Liking, Teacher and School Connectedness, and Exclusionary Discipline. Front Psychol 2022; 13:825036. [PMID: 35310270 PMCID: PMC8927887 DOI: 10.3389/fpsyg.2022.825036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/11/2022] [Indexed: 11/13/2022] Open
Abstract
School liking is an important factor in student engagement, well-being, and academic achievement, but it is also potentially influenced by factors external to the individual, such as school culture, teacher support, and approaches to discipline. The present study employed a survey methodology to investigate the associations between school liking and disliking, teacher and school connectedness, and experiences of exclusionary discipline from the perspective of students themselves. Participants included 1,002 students (Grades 7-10) from three secondary schools serving disadvantaged communities. Results indicated clear differences between students who like and dislike school in terms of their preferred school activities and school disciplinary history, with students who disliked school experiencing overall lower school connectedness. Moreover, students who disliked school experienced less positive relationships with their teachers, and this was even more pronounced for students who had been previously suspended. The findings reveal key differences between students who do and do not like school, differences that may be masked by typical research approaches. This research indicates the need for more nuanced, student-informed approaches to inclusive school reform.
Collapse
Affiliation(s)
- Linda J Graham
- Centre for Inclusive Education, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Jenna Gillett-Swan
- Centre for Inclusive Education, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Callula Killingly
- Centre for Inclusive Education, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Penny Van Bergen
- School of Education, Macquarie University, Sydney, NSW, Australia
| |
Collapse
|
28
|
Lai S, Zhou J, Xu X, Li S, Ji Y, Yang S, Tang W, Zhang J, Jiang J, Liu Q. Subjective well-being among AIDS orphans in southwest China: the role of school connectedness, peer support, and resilience. BMC Psychiatry 2022; 22:197. [PMID: 35303813 PMCID: PMC8933895 DOI: 10.1186/s12888-022-03833-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/03/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Few studies have explored the health and development of AIDS orphans using the positive youth development (PYD) framework. Grounded in this framework, the main objective of this study is to examine how internal assets (i.e., resilience) and external assets (i.e., school connectedness, peer support) affect subjective well-being among Yi AIDS orphans in the Liangshan Yi Autonomous Prefecture, Sichuan province, China. METHODS A cross-sectional survey was conducted by interviewing 571 AIDS orphans and 979 non-orphans of Yi ethnic minority from 5th-10th grades. Structural equation models (SEM) were utilized to identify and estimate the direct and indirect effects of internal and external assets on subjective well-being. RESULTS The average score of subjective well-being was significantly lower for AIDS orphans than for in non-orphans (P < 0.05). Resilience, school connectedness, peer support (number of friends, caring friends), and self-rated physical health had significant and positive direct effects on subjective well-being. In addition, the effects of school connectedness, and peer support on subjective well-being were mediated by resilience. CONCLUSIONS Positive individual and school-related contextual assets can bolster subjective well-being among AIDS orphans. The design of health intervention programs for AIDS orphans should incorporate these positive development assets.
Collapse
Affiliation(s)
- Shimin Lai
- grid.13291.380000 0001 0807 1581Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China ,grid.13291.380000 0001 0807 1581Department of Medical Affairs, West China Tianfu Hospital, Sichuan University, Chengdu, China
| | - Junmin Zhou
- grid.13291.380000 0001 0807 1581Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaohe Xu
- grid.215352.20000000121845633University of Texas at San Antonio, San Antonio, USA ,grid.13291.380000 0001 0807 1581Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Shiying Li
- grid.13291.380000 0001 0807 1581Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Yuanyi Ji
- grid.13291.380000 0001 0807 1581Nosocomial Infection Management Department, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Shujuan Yang
- grid.13291.380000 0001 0807 1581Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wanjie Tang
- grid.13291.380000 0001 0807 1581Centre for Educational and Health Psychology, Sichuan University, Chengdu, China
| | - Jianxin Zhang
- grid.13291.380000 0001 0807 1581Department of Maternal, and Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jianjun Jiang
- Department of Palliative Care, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China.
| | - Qiaolan Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China. .,Department of Palliative Care, West China School of Public Health and West China Fourth Hospital, Research Center for Palliative Care, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, China.
| |
Collapse
|
29
|
Krushas AE, Schwartz JA. An Examination of the Components of Toxic Stress in Childhood and Biological Markers of Physical Health in Emerging Adulthood. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:105-119. [PMID: 35222778 PMCID: PMC8837736 DOI: 10.1007/s40653-022-00436-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
Experiencing severe and enduring adversity in childhood without the support of adult figures has been linked to an extensive list of physical health outcomes. This finding is closely tied to the concept of toxic stress, which is regularly studied using a combination of sources, including childhood adversity, unmet basic needs, and unmet social needs. Despite these findings, previous work has typically compiled various sources associated with toxic stress into a single construct, limiting existing knowledge on the contribution of each individual source to physical health. To address these concerns, the current study utilizes data from the National Longitudinal Study of Adolescent to Adult Health to examine the association between independent and collective sources of toxic stress in childhood and individual differences in biomarkers tapping cardiometabolic functioning in emerging adulthood. Results indicate a significant association between a composite measure of sources of toxic stress and cardiometabolic risk, with subsequent models examining the independent influence of each source revealing that this association was largely driven by childhood adversity and unmet basic needs, but not unmet social needs. These findings suggest that the individual sources of toxic stress may differentially contribute to physical health outcomes.
Collapse
Affiliation(s)
- Amber E. Krushas
- School of Criminology and Criminal Justice, University of Nebraska at Omaha, Omaha, NE 68182-0149 USA
| | - Joseph A. Schwartz
- College of Criminology and Criminal Justice, Florida State University, Tallahassee, FL 32312-1273 USA
- Center for Social and Humanities Research, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
30
|
The Intersection of Depressive Symptoms, Adverse Childhood Experiences, and Protective Factors Among Adolescents: Epidemiological Evidence from Minnesota, 2016 and 2019. ADVERSITY AND RESILIENCE SCIENCE 2022; 3:21-36. [PMID: 35098150 PMCID: PMC8790007 DOI: 10.1007/s42844-022-00052-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/25/2022]
Abstract
Prevalence of mental health problems among US youth has increased in recent years, and there is a dearth of epidemiological research at the state level that integrates risk and protective factors into population-based surveillance. We utilized the developmental assets framework to measure protective factors; we assessed (1) prevalence of depressive symptoms, high adverse childhood experiences (ACEs; ≥ 4 ACEs), and few developmental assets (≤ 2 assets) over time, and (2) associations among these three phenomena. Using 2016 and 2019 Minnesota Student Survey data, we utilized descriptive statistics, multivariable logistic regression, and post-estimation analyses (adjusting for school clustering and demographics). Using pooled data, we examined how high ACEs and few assets predicted depressive symptoms and we tested three-way interactions for high ACEs, few assets, and survey year. There were statistically significant increases in prevalence of depressive symptoms, high ACEs, and few assets between 2016 and 2019. High ACEs (AOR = 2.74; 95% CI = 2.61, 2.89) and few assets (AOR = 3.13; 95% CI = 3.00, 3.26) were positively related to depressive symptoms; interactions were statistically significant. Additive interactions showed that, compared to their counterparts, adolescents with high ACEs and few assets had the highest prevalence of depressive symptoms, and this group exhibited the largest increase in prevalence between 2016 and 2019. Depressive symptoms are highest among adolescents with high risk and few protective factors, and recent increases in the prevalence of depressive symptoms appear to have disproportionately occurred among these adolescents. We offer a potential roadmap for following the Centers for Disease Control and Prevention recommendations to integrate ACEs and protective factors into local public health efforts.
Collapse
|
31
|
Minnis AM, Browne EN, Chavez M, McGlone L, Raymond-Flesch M, Auerswald C. Early Sexual Debut and Neighborhood Social Environment in Latinx Youth. Pediatrics 2022; 149:184753. [PMID: 35137189 PMCID: PMC9150543 DOI: 10.1542/peds.2021-050861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To examine whether social aspects of the neighborhood environment are associated with early sexual initiation in a California agricultural community of predominantly Latinx adolescents. METHODS In a prospective cohort study of 599 eighth graders recruited from middle schools in Salinas, California (2015-2019), participants completed five interviews over 2 years. Social environment measures included neighborhood social dynamics (neighborhood disorder, social cohesion, and social network gang exposure); experiences of discrimination; and school connectedness. We estimated associations between baseline social environment and early sexual initiation (<15 years) using Poisson regression with robust standard errors. We compared contraceptive self-efficacy and attitudes by sexual initiation status using ANOVA. RESULTS Most youth were Latinx (94%) and age 13 (70%) at enrollment; 53% were female and 49% had a parent employed in agriculture. Additionally, 14% reported first vaginal sex before age 15. Neighborhood disorder (relative risk [RR], 1.13; 95% confidence interval [CI], 1.05-1.21), social network gang exposure (RR, 2.23; 95% CI, 1.49-3.33), and experiences of discrimination (RR, 1.67 [1-2 events versus none], 95% CI, 1.09-2.55; RR, 2.33 [3+ events versus none], 95% CI, 1.07-4.64) were associated with early sexual initiation. School connectedness was protective (RR, 0.44, 95% CI, 0.29-0.69). Youth who initiated sex before age 15 had more negative birth control attitudes and expressed lower motivation to use contraceptives. CONCLUSIONS Findings underscore opportunities to promote early adolescent sexual health through strengthening supportive and safe neighborhood environments with the promise of addressing disparities in unintended pregnancy and sexually transmitted infection rates in later adolescence.
Collapse
Affiliation(s)
- Alexandra M. Minnis
- Women’s Global Health Imperative, RTI International, Berkeley, California,School of Public Health, University of California, Berkeley, California,Address correspondence to Alexandra M. Minnis, PhD, MPH, Director and Senior Research Epidemiologist, Women’s Global Health Imperative, RTI International, 2150 Shattuck Ave, Ste 800; Berkeley, CA 94704. E-mail:
| | - Erica N. Browne
- Women’s Global Health Imperative, RTI International, Berkeley, California
| | - Marisol Chavez
- Women’s Global Health Imperative, RTI International, Berkeley, California,Children’s Hospital Los Angeles (CHLA), Los Angeles, California
| | - Linda McGlone
- Monterey County Health Department, Salinas, California
| | | | - Colette Auerswald
- School of Public Health, University of California, Berkeley, California
| |
Collapse
|
32
|
Non-Suicidal Self-Injury Among Adolescents: A Structural Model with Socioecological Connectedness, Bullying Victimization, and Depression. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01319-6. [PMID: 35178654 DOI: 10.1007/s10578-022-01319-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 11/03/2022]
Abstract
The objective was to examine the associations of socioecological connectedness with bullying victimization and depressive symptoms in early adolescence and with non-suicidal self-injury (NSSI) in mid-adolescence, and how these might differ between genders. Diverse adolescents (N = 4115; 49.1% girls) in the 7th grade reported on connections with parents/family, peers, school, and neighborhood, as well as bullying victimization and depressive symptoms, and NSSI in 10th grade (Me = 16.1 years). Structural equation modeling with WSLMV indicated that the lower likelihood of NSSI in 10th grade was associated with higher perceptions of connections between adolescents and their families, both directly as well as indirectly through reduced bully victimization and depressive symptoms three years earlier. Higher school connectedness was indirectly associated with the lower likelihood of NSSI through bullying victimization and depressive symptoms. Paths to NSSI varied for girls and boys. Results advance the understanding of developmental pathways leading to NSSI in adolescent girls and boys.
Collapse
|
33
|
Powell TW, Jo M, Smith AD, Marshall BD, Thigpen S, Offiong A, Geffen SR. Supplementing Substance Use Prevention With Sexual Health Education: A Partner-Informed Approach to Intervention Development. Health Promot Pract 2022; 23:109-117. [DOI: 10.1177/1524839920947683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Supplementing substance use prevention with sexual health education would allow educators to address the risk and protective factors that influence both health issues. This streamlined approach may minimize the inefficiencies of multisession, single-purpose interventions. Our team developed a supplemental sexual and reproductive health (SRH) unit to align with an existing evidence-based intervention, LifeSkills Training (LST). This goal of this article is to describe our process, final product, lessons learned, and future directions. Our partner-informed approach took place across three key phases: (1) formative insights, (2) unit development, and (3) pilot implementation. The final supplemental SRH unit is ten, 45-minute sessions offered to seventh- and eighth-grade students and includes a set of learning objectives that are aligned with individual sessions. The supplemental SRH unit also mirrors existing LST modules in length, flow, layout, facilitator instructions, focus on prevention, and utilization of a student workbook. Lessons learned include strategies to effectively incorporate a wide range of ongoing feedback from multiple sources and quickly respond to staff turnover. This partnership approach serves as a model for researchers and practitioners aiming to extend the reach of existing evidence-based programs.
Collapse
Affiliation(s)
| | - Meghan Jo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anne D. Smith
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Beth D. Marshall
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Santha Thigpen
- Maree G. Farring Elementary/Middle School, Baltimore, MD, USA
| | - Asari Offiong
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | |
Collapse
|
34
|
Fosco GM, Sloan CJ, Fang S, Feinberg ME. Family vulnerability and disruption during the COVID-19 pandemic: prospective pathways to child maladjustment. J Child Psychol Psychiatry 2022; 63:47-57. [PMID: 34101185 PMCID: PMC8242729 DOI: 10.1111/jcpp.13458] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study evaluated two risk pathways that may account for increases in child internalizing and externalizing problems during the COVID-19 pandemic: one pathway operating through pre-existing family vulnerability and a second pathway operating through disruption in family functioning occurring in response to the pandemic. We assessed family disruption and family functioning with measures of key family-level and parenting dimensions, including family cohesion, conflict and routines, and parents' harsh discipline, lax discipline and warmth. In all models, pre-pandemic parent emotional distress, financial strain and child maladjustment were included as covariates. METHODS The sample included 204 families, comprised of parents who had children (MAge = 4.17; 45.1% girls). Parents (MAge = 27.43) completed the first survey prior to COVID-19 onset in the United States, a second survey after COVID-19 onset in May 2020 and a third survey two weeks later. RESULTS Analyses were conducted in a model-building fashion, first computing structural equation models for each family and parenting dimension separately, then advancing significant dimensions into one integrated model for the family-level factors and a second model for parenting quality factors. Results provided more support for the family disruption hypothesis across all tests. In the family-level domain, decreases in family cohesion and increases in family conflict each uniquely predicted subsequent child maladjustment. In the parenting domain, increases in harsh discipline and lax discipline each uniquely predicted subsequent child maladjustment. Family routines and parental warmth were not associated with child adjustment. However, parents' emotional distress prior to the pandemic exhibited a robust association with children's internalizing problems. CONCLUSIONS These findings indicate that efforts to support families in adapting to unique conditions of the pandemic will yield the greatest effect for child adjustment. Specifically, interventions should include efforts to help families maintain cohesion and manage conflict, and help parents minimize increases in harsh and lax discipline.
Collapse
Affiliation(s)
| | | | - Shichen Fang
- The Pennsylvania State UniversityUniversity ParkPAUSA
| | | |
Collapse
|
35
|
Kent BV, Bradshaw M. Adolescent Context and Depressive Symptom Trajectories in a National Sample: Ages 13 to 34. Int J Ment Health Addict 2021; 19:1468-1484. [PMID: 34924894 DOI: 10.1007/s11469-020-00236-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Background Group-based trajectory analyses of depressive symptoms are often conducted with convenience samples, over limited developmental periods, or with a limited set of predictors in the adolescent context. Examinations of protective and risk factors in robust national samples are needed. Aim Using an ecological approach, this study's purpose is to identify key relational and contextual factors associated with trajectory groups of depressive symptoms that span ages 13 to 34. Method 12,248 respondents in the National Study of Adolescent to Adult Health (Waves 1, 3, and 4) were analyzed with a group-based, cohort sequential design to identify trajectory classes, shapes, and adolescent (i.e., Wave 1) risk and protective factors for depressive symptom trajectories. Results A four-class quadratic solution was identified. Close attachment to parents was strongly associated with decreased odds of membership on elevated trajectories. No relationship with a mother or father was associated with better mental health than a poor relationship with that parent. Peer support, teacher support, and educational achievement were highly protective. Romantic relationships, increased number of sexual partners, and prayer were modestly associated with higher depressive symptom burden. Pregnancy was associated with increased burden later in life relative to the teenage years. Conclusions Assessing adolescent family, school, peer, and religious contexts indicates several protective and risk factors for depressive symptoms that are persistent over time.
Collapse
|
36
|
McCabe EM, Davis C, Mandy L, Wong C. The Role of School Connectedness in Supporting the Health and Well-Being of Youth: Recommendations for School Nurses. NASN Sch Nurse 2021; 37:42-47. [PMID: 34836466 DOI: 10.1177/1942602x211048481] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The importance of students feeling connected in school cannot be overstated, as this perception is crucial to support their health and well-being. A lack of school connectedness can lead to adverse physical and mental health outcomes, including bully victimization. Numerous factors, including individual, social, and environmental, influence students' perceived sense of school connectedness. School nurses are well positioned to establish and maintain school connectedness due to their knowledge, accessibility to students, and familiarity with the school environment. This article details the importance of school connectedness and describes the associations between school connectedness, bullying, and mental health. In addition, we offer recommendations geared toward school nurses regarding strengthening school connectedness and promoting a culture of care and inclusivity within school environments, especially salient in the context of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Ellen M McCabe
- Assistant Professor, Hunter College, Hunter College School of Nursing, New York, NY
| | | | | | - Cindy Wong
- Hunter College School of Nursing, New York, NY
| |
Collapse
|
37
|
Ehntholt A, Pabayo R, Berkman L, Kawachi I. Race, Adolescent Socioeconomic Status, and Lifetime Non-Medical Use of Prescription Painkillers: Evidence from the National Longitudinal Study of Adolescent to Adult Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12289. [PMID: 34886020 PMCID: PMC8657390 DOI: 10.3390/ijerph182312289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 11/16/2022]
Abstract
The misuse of prescription painkillers is a major contributor to the ongoing drug overdose epidemic. This study investigated variability in non-medical use of prescription painkillers (NMUPP) by race and early-life socioeconomic status (SES) in a sample now at increased risk for opioid overdose. Data from two waves of the National Longitudinal Study of Adolescent to Adult Health (n = 11,602) were used to calculate prevalence of reported NMUPP by Wave 4 (2008; mean age 28), and to assess variation by race and by equivalized household family income at Wave 1 (1994/5). Predicted values for prevalence of NMUPP were modelled, adjusting for age, sex, parental education, and region. Race and SES in adolescence were associated with later reported NMUPP. A gradient was seen in prevalence by SES (adjusted: family income quartile 1 = 13.3%; quartile 2 = 13.8%; quartile 3 = 14.8%; quartile 4 = 16.0%; trend p-value = 0.007). Prevalence was higher among males. Racial/ethnic differences in prevalence were seen (non-Hispanic white (NHW) = 18.5%; non-Hispanic black (NHB) = 5.8%; Hispanic = 10.5%; Other = 10.0%). SES differences were less pronounced upon stratification, with trend tests significant only among females (p = 0.004), and marginally significant among Hispanic males (p = 0.06). Early-life SES was associated with reported lifetime NMUPP: the higher the family income in adolescence, the greater the likelihood of NMUPP by young adulthood. Variations in NMUPP by income paled in comparison with racial/ethnic differences. Results point to a possible long-enduring association between SES and NMUPP, and a need to examine underlying mechanisms.
Collapse
Affiliation(s)
- Amy Ehntholt
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.B.); (I.K.)
| | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Lisa Berkman
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.B.); (I.K.)
- Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (L.B.); (I.K.)
| |
Collapse
|
38
|
Tian J, Zhang M, Zhou H, Wu J. College Satisfaction, Sense of Achievement, Student Happiness and Sense of Belonging of Freshmen in Chinese Private Colleges: Mediation Effect of Emotion Regulation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11736. [PMID: 34831492 PMCID: PMC8620960 DOI: 10.3390/ijerph182211736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022]
Abstract
Sense of belonging constitutes a critical component of college students' retention and academic achievement, especially in disadvantaged higher education institutions such as private colleges in China. Using nationwide survey data (n = 3816) from Chinese private colleges, this study explores how college satisfaction, sense of achievement, and student happiness contribute to freshmen' sense of belonging. Structural equation modeling analyses have identified the significant positive associations between freshmen's emotion regulation and sense of belonging. In particular, emotion regulation plays a mediating role in the relations between college satisfaction, sense of achievement, student happiness, and the sense of belonging. Therefore, private colleges should design and implement orientation programs to improve freshmen's learning experience, especially college satisfaction and student happiness, to enhance their sense of belonging.
Collapse
Affiliation(s)
- Jing Tian
- Zhejiang Academy of Higher Education, Hangzhou Dianzi University, Hangzhou 310018, China;
| | - Mohan Zhang
- Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou 311121, China; (M.Z.); (J.W.)
| | - Haitao Zhou
- Faculty of Education, Beijing Normal University, Beijing 100875, China
| | - Jianfen Wu
- Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou 311121, China; (M.Z.); (J.W.)
| |
Collapse
|
39
|
Wood OR, Garofalo R, Kuhns LM, Scherr TF, Zetina APM, Rodriguez RG, Nash N, Cervantes M, Schnall R. A randomized controlled trial of an mHealth intervention for increasing access to HIV testing and care among young cisgender men and transgender women: the mLab App study protocol. BMC Public Health 2021; 21:1959. [PMID: 34715833 PMCID: PMC8554516 DOI: 10.1186/s12889-021-12015-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The number of youth living with HIV in the United States (US) continues to rise, and racial, ethnic, and sexual minority youth including young men who have sex with men (YMSM) and young transgender women (YTGW) bear a disproportionate burden of the HIV epidemic. Due to social and healthcare system factors, many YMSM and YTGW do not seek HIV testing services and are therefore less likely to be aware that they are infected. Mobile health technology (mHealth) has the ability to increase uptake of HIV testing among these populations. Thus, the mLab App-which combines HIV prevention information with a mobile phone imaging feature for interpreting at-home HIV test results-was developed to improve testing rates and linkage to care among Black, Latino, and other YMSM and YTGW living in New York City and Chicago and their surrounding areas. METHODS This study is a three-arm randomized controlled trial among YMSM and YTGW aged 18-29 years. Participants are randomized to either the mLab App intervention including HIV home test kits and standard of preventive care, standard of preventive care only, or HIV home test kits and standard of preventive care only. DISCUSSION mHealth technology used for HIV prevention is capable of delivering interventions in real-time, which creates an opportunity to remotely reach users across the country to strengthen their HIV care continuum engagement and treatment outcomes. Specifically during the COVID-19 pandemic, mHealth technology combined with at-home testing may prove to be essential in increasing HIV testing rates, especially among populations at high-risk or without regular access to HIV testing. TRIAL REGISTRATION This trial was registered with Clinicaltrials.gov ( NCT03803683 ) on January 14, 2019.
Collapse
Affiliation(s)
- Olivia R Wood
- Division of Scholarship and Research, Columbia University School of Nursing, 516 W. 168th Street, New York, NY, 10032, USA
| | - Robert Garofalo
- Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL, 60611, USA
| | - Lisa M Kuhns
- Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL, 60611, USA
| | - Thomas F Scherr
- Vanderbilt University, 2201 West End Avenue, Nashville, TN, 37235, USA
| | - Ana Paola Mata Zetina
- Division of Scholarship and Research, Columbia University School of Nursing, 516 W. 168th Street, New York, NY, 10032, USA
| | - Rafael Garibay Rodriguez
- Division of Scholarship and Research, Columbia University School of Nursing, 516 W. 168th Street, New York, NY, 10032, USA
| | - Nathanael Nash
- Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL, 60611, USA
| | - Marbella Cervantes
- Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Chicago, IL, 60611, USA
| | - Rebecca Schnall
- Division of Scholarship and Research, Columbia University School of Nursing, 516 W. 168th Street, New York, NY, 10032, USA.
| |
Collapse
|
40
|
Cheng HG, Lizhnyak PN, Knight NA, Vansickel AR, Largo EG. Youth susceptibility to tobacco use: is it general or specific? BMC Public Health 2021; 21:1913. [PMID: 34674687 PMCID: PMC8532300 DOI: 10.1186/s12889-021-11956-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/07/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Susceptibility to tobacco use predicts tobacco use onset among youth. The current study aimed to estimate the extent of overlap in susceptibilities across various tobacco products, investigate sociopsychological correlates with susceptibilities, and examine whether the relationship linking susceptibility with the onset of use is product-specific or is accounted for by a general susceptibility-onset relationship. METHODS The study population consisted of US youth 12-17 years old who had never used a tobacco product, sampled in the longitudinal Population Assessment of Tobacco and Health study wave 4 (Dec. 2016-Jan. 2018; n = 10,977). Tobacco product-specific susceptibility at wave 4 was assessed via questions about curiosity, likelihood to try, and likelihood of use if a best friend offered. The onset of use of various tobacco products was defined as first use occurring between the wave 4 and wave 4.5 (Dec. 2017-Dec. 2018) assessments (n = 8841). Generalized linear regression and structural equation models were used for data analysis. RESULTS There is a large degree of overlap in susceptibilities across tobacco products (65% of tobacco-susceptible youth were susceptible to more than one tobacco product). Tobacco-susceptible youths were more likely to have recently used cannabis, consumed alcohol, or to have been associated with tobacco-using peers. Structural equation models suggest that the susceptibility-onset relationship largely operates in a non-product-specific manner after accounting for the general susceptibility-to-tobacco-onset relationship. CONCLUSIONS Youth susceptibility to tobacco use overlaps widely across different tobacco products and other risky behaviors. Findings from this study support a holistic approach towards the prevention of risk behaviors, supplemented by product-specific strategies when needed.
Collapse
Affiliation(s)
- Hui G Cheng
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA.
| | - Pavel N Lizhnyak
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA
| | - Natasha A Knight
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA
| | | | - Edward G Largo
- Altria Client Services LLC, 601 E. Jackson, Richmond, VA, 23219, USA
| |
Collapse
|
41
|
Auliah A, Thien LM, Kho SH, Abd Razak N, Jamil H, Ahmad MZ. Exploring Positive School Attributes: Evidence From School Leader and Teacher Perspectives. SAGE OPEN 2021; 11:215824402110615. [DOI: 10.1177/21582440211061572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
The extent to which school stakeholders perceive positive school attributes remains unclear in the literature. This study seeks to provide an understanding of positive school attributes from the school leaders and teachers’ perspectives in the Malaysian school context. This study employed a qualitative case study research design with 14 informants selected from seven Malaysian secondary schools. The thematic analysis informed six emerging themes: (1) stimulating positive emotion, (2) promoting positive engagement, (3) fostering positive relationships, (4) cultivating positive meaning, (5) nurturing positive accomplishment, and (6) cultivating spirituality in expressing positive school attributes. Fostering positive relationships were specified as (1) teacher-teacher relationship, (2) teacher-student relationship, and (3) student-student relationship. Cultivating spirituality is a newly emerged theme that is added to the unique positive school attributes. These newly added components of the existing PERMA model can trigger further research in positive education studies.
Collapse
Affiliation(s)
- Avinash Auliah
- School of Educational Studies, Universiti Sains Malaysia, USM Penang, Minden, Malaysia
| | - Lei Mee Thien
- School of Educational Studies, Universiti Sains Malaysia, USM Penang, Minden, Malaysia
| | | | - Nordin Abd Razak
- School of Educational Studies, Universiti Sains Malaysia, USM Penang, Minden, Malaysia
| | - Hazri Jamil
- School of Educational Studies, Universiti Sains Malaysia, USM Penang, Minden, Malaysia
| | - Mohammad Zohir Ahmad
- School of Educational Studies, Universiti Sains Malaysia, USM Penang, Minden, Malaysia
| |
Collapse
|
42
|
Family Economic Empowerment, Family Social Support, and Sexual Risk-Taking Behaviors Among Adolescents Living With HIV in Uganda: The Suubi+Adherence Study. J Adolesc Health 2021; 69:406-413. [PMID: 33812750 PMCID: PMC8403623 DOI: 10.1016/j.jadohealth.2021.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE This study examined the effect of a family economic empowerment (EE) intervention and family support on sexual risk-taking behaviors among adolescents living with HIV in rural Uganda. METHODS We used data from the Suubi + Adherence study, a longitudinal cluster randomized clinical trial of 702 adolescents living with HIV aged 10-16 years. Participants were randomly assigned to either the control arm (n = 358) receiving bolstered standard of care or a treatment arm (n = 344) receiving bolstered standard of care plus the family EE intervention. We used mixed-effects models to examine the effect of the EE intervention and family support on sexual risk-taking behaviors at the baseline, 12 months, and 24 months after intervention initiation. RESULTS Adolescents in both the intervention and control groups did not differ significantly in their sexual risk-taking attitudes at the baseline and over the 24-month follow-up period. Higher levels of caregiver social support were significantly associated with a decrease in attitudes toward sexual risk-taking (ß = -.40, 95%CI = -.51, -.29). More frequent parent-child communication was significantly associated with increased negative sexual risk-taking attitudes (ß = .21, 95%CI = .16, .26). CONCLUSIONS Although we find no direct relationship between family EE and attitudes related to sexual risk-taking behaviors, we find that a supportive family environment can promote positive attitudes related to sexual risk-taking behaviors. The effectiveness of sexual risk reduction interventions would be enhanced by engaging families and strengthening supportive relationships between adolescents and their caregivers.
Collapse
|
43
|
Hunter SC, Russell K, Pagani S, Munro L, Pimenta SM, Marín-López I, Hong JS, Knifton L. A Social-Ecological Approach to Understanding Adolescent Sexting Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2347-2357. [PMID: 33982213 PMCID: PMC8416823 DOI: 10.1007/s10508-021-01988-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 05/10/2023]
Abstract
This study examined the extent to which active and passive sexting behaviors are associated with family-, school-, peer-, and romantic-level variables. Young people (N = 3,322; 49.1% female, 48.3% male, 2.6% other) aged 11 to 15 years old (M = 12.84, SD = 0.89) took part, and all attended mainstream secondary schools in Scotland. Participants completed self-report measures of school connectedness, parental love and support, perceived susceptibility to peer- and romantic-pressure (e.g., to display behaviors just to impress others), and their involvement in active and passive sexting. The importance of both school- and family-level factors was evident, though perceived romantic-pressure had the largest effect. However, neither school- nor family-level variables were moderated by either perceived romantic-pressure or perceived peer-pressure. Efforts to reduce sexting or increase its safety should primarily seek to tackle young people's ability to respond effectively to romantic-pressure. It may also be helpful to develop school connectedness and to help families provide support that is constructive and not intrusive.
Collapse
Affiliation(s)
- Simon C Hunter
- Department of Psychology, Glasgow Caledonian University, Glasgow, G4 0BA, UK.
- Faculty of Education, University of Western Australia, Perth, Australia.
| | - Kirsten Russell
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Stefania Pagani
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Lindsey Munro
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Sofia M Pimenta
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | | | - Jun Sung Hong
- Department of Adult Health, School of Social Work, Wayne State University, Detroit, MI, USA
| | - Lee Knifton
- Dept of Management Science, University of Strathclyde, Glasgow, UK
| |
Collapse
|
44
|
Szoko N, Ragavan MI, Khetarpal SK, Chu KH, Culyba AJ. Protective Factors Against Vaping and Other Tobacco Use. Pediatrics 2021; 148:e2020048066. [PMID: 34312291 PMCID: PMC8344349 DOI: 10.1542/peds.2020-048066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Vaping has gained popularity among adolescents despite negative health consequences. Few studies have focused on factors that may protect against vaping. We sought to determine if future orientation, parental monitoring, school connectedness, and social support are associated with decreased risk of vaping and other forms of tobacco use. METHODS Data were obtained via anonymous school-based health behavior surveys among ninth- through 12th-graders in Pittsburgh, PA (n = 2487). Protective factors were assessed through validated Likert scale instruments. The primary outcome was recent (past 30-day) vaping. Additional outcomes included other forms of tobacco use and intention to quit tobacco products. Poisson regression models examined associations between protective factors and vaping and tobacco use outcomes. RESULTS Mean age was 15.7 years, 1446 (58.1%) respondents were female, and 671 youth (27.0%) reported recent vaping. Positive future orientation and high parental monitoring were associated with significantly lower prevalence of recent vaping (adjusted prevalence ratio: 0.84 [95% confidence interval: 0.73-0.97] and adjusted prevalence ratio: 0.73 [95% confidence interval: 0.62-0.85], respectively). There were no significant relationships between social support or school connectedness and vaping. All 4 protective factors were inversely associated with other forms of tobacco use. No factors were significantly associated with intent to quit tobacco products. CONCLUSIONS Findings reveal significant inverse associations between future orientation, parental monitoring, and vaping but no relationship between protective factors and intent to quit tobacco products. Developing interventions to foster protective factors in youth and their parental supports may inform primary prevention efforts to reduce vaping and other tobacco use.
Collapse
Affiliation(s)
- Nicholas Szoko
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maya I Ragavan
- School of Medicine
- Divisions of General Academic Pediatrics
| | | | - Kar-Hai Chu
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | |
Collapse
|
45
|
Zamora-Kapoor A, Hebert LE, Montañez M, Buchwald D, Sinclair K. Risk Factors in Adolescence for the Development of Elevated Blood Pressure and Hypertension in American Indian and Alaskan Native Adults. J Immigr Minor Health 2021; 23:717-724. [PMID: 33247795 PMCID: PMC8160022 DOI: 10.1007/s10903-020-01130-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2020] [Indexed: 12/12/2022]
Abstract
To examine risk factors for elevated blood pressure and hypertension in American Indians and Alaska Natives (AI/ANs), compared to three other ethnic groups in the US. Weighted relative risk regression models, stratified by race/ethnicity, were used to measure the associations between risk factors and elevated blood pressure and hypertension in AI/ANs, compared to non-Hispanic Whites, non-Hispanic Blacks and Hispanics, with data from the National Longitudinal Study of Adolescent to Adult Health. In all groups, females had a lower risk of both elevated blood pressure and hypertension than males. Increasing body mass index raised hypertension risk in all groups. In AI/ANs, financial instability increased the risk of hypertension by 88% (95% CI: 1.27-2.77), but not in other groups. No other statistically significant associations were found. Future interventions should include socio-economic factors in efforts to prevent hypertension in AI/ANs.
Collapse
Affiliation(s)
- Anna Zamora-Kapoor
- Departments of Sociology and Medical Education and Clinical Sciences, Washington State University, Pullman, WA, USA.
| | - Luciana E Hebert
- Department of Medical Education and Clinical Sciences, Washington State University, Spokane, WA, USA
| | - Morgan Montañez
- Department of Sociology, Washington State University, Pullman, WA, USA
| | - Dedra Buchwald
- Department of Medical Education and Clinical Sciences, Washington State University, Spokane, WA, USA
| | - Ka'imi Sinclair
- College of Nursing, Washington State University, Spokane, WA, USA
| |
Collapse
|
46
|
Boyd DT, Quinn CR, Jones KV, Beer OWJ. Suicidal ideations and Attempts Within the Family Context: The Role of Parent Support, Bonding, and Peer Experiences with Suicidal Behaviors. J Racial Ethn Health Disparities 2021; 9:1740-1749. [PMID: 34331271 PMCID: PMC8324436 DOI: 10.1007/s40615-021-01111-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/01/2022]
Abstract
The rate of suicidality is increasing faster in Black American youth than in any other group in the USA. Researchers have found that family-level factors are important environmental factors for predicting depression and anxiety among Black youth, but less is known about how family- and friendship-level factors are associated with suicidal ideation and attempts among Black youth. This secondary analysis used the data from the National Longitudinal Study of Adolescents to Adult Health with a sample of Black adolescents (N = 4232) with a mean age of 16 years. The predictors included parental and other contextual factors on the outcome, which was suicidal behaviors. A multinomial analysis was employed to assess which factors contributed to or prevented suicidal behaviors. Our results indicated that parental support was significantly and positively associated with reporting suicidal ideation and attempts. The results indicated that Black youth with a decrease in parental support were 41% more likely to report ideation and 68% more likely to report attempting suicide compared to those reporting no parental support. Findings from our study support the assertion that the influence from the familial microsystem is pronounced in modifying suicidal behavior of Black youth.
Collapse
Affiliation(s)
- Donte T Boyd
- College of Social Work, The Ohio State University, Columbus, OH, USA.
| | - Camille R Quinn
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Kristian V Jones
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Oliver W J Beer
- College of Social Work, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
47
|
Velie EM, Marcus LR, Pathak DR, Hamilton AS, DiGaetano R, Klinger R, Gollapudi B, Houang R, Carnegie N, Olson LK, Allen A, Zhang Z, Modjesk D, Norman G, Lucas DR, Gupta S, Rui H, Schwartz K. Theory, methods, and operational results of the Young Women's Health History Study: a study of young-onset breast cancer incidence in Black and White women. Cancer Causes Control 2021; 32:1129-1148. [PMID: 34292440 PMCID: PMC8416838 DOI: 10.1007/s10552-021-01461-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/11/2021] [Indexed: 11/29/2022]
Abstract
Purpose The etiology of young-onset breast cancer (BC) is poorly understood, despite its greater likelihood of being hormone receptor-negative with a worse prognosis and persistent racial and socioeconomic inequities. We conducted a population-based case–control study of BC among young Black and White women and here discuss the theory that informed our study, exposures collected, study methods, and operational results. Methods Cases were non-Hispanic Black (NHB) and White (NHW) women age 20–49 years with invasive BC in metropolitan Detroit and Los Angeles County SEER registries 2010–2015. Controls were identified through area-based sampling from the U.S. census and frequency matched to cases on study site, race, and age. An eco-social theory of health informed life-course exposures collected from in-person interviews, including socioeconomic, reproductive, and energy balance factors. Measured anthropometry, blood (or saliva), and among cases SEER tumor characteristics and tumor tissue (from a subset of cases) were also collected. Results Of 5,309 identified potentially eligible cases, 2,720 sampled participants were screened and 1,812 completed interviews (682 NHB, 1140 NHW; response rate (RR): 60%). Of 24,612 sampled control households 18,612 were rostered, 2,716 participants were sampled and screened, and 1,381 completed interviews (665 NHB, 716 NHW; RR: 53%). Ninety-nine% of participants completed the main interview, 82% provided blood or saliva (75% blood only), and SEER tumor characteristics (including ER, PR and HER2 status) were obtained from 96% of cases. Conclusions Results from the successfully established YWHHS should expand our understanding of young-onset BC etiology overall and by tumor type and identify sources of racial and socioeconomic inequities in BC. Supplementary Information The online version of this article contains supplementary material available (10.1007/s10552-021-01461-x).
Collapse
Affiliation(s)
- Ellen M Velie
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA. .,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA.
| | - Lydia R Marcus
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA.,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA
| | - Dorothy R Pathak
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Wilson Road Room B601, East Lansing, MI, 48824, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St, Los Angeles, CA, 90089-9239, USA
| | | | - Ron Klinger
- Westat Inc., 1650 Research Blvd, Rockville, MD, 20850, USA
| | - Bibi Gollapudi
- Westat Inc., 1650 Research Blvd, Rockville, MD, 20850, USA
| | - Richard Houang
- Department of Education, Michigan State University, 620 Farm Ln, East Lancing, MI, 48824, USA
| | - Nicole Carnegie
- Department of Mathematics, Montana State University, 732 Grant St, Bozeman, MT, 59717, USA
| | - L Karl Olson
- Department of Physiology, Michigan State University, 567 Wilson Rd, East Lansing, MI, 48824, USA
| | - Amani Allen
- Departments of Community Health Sciences and Epidemiology, School of Public Health, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720, USA
| | - Zhenzhen Zhang
- Division of Oncological Sciences, Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code: KCRB-PROS, Portland, OR, 97239, USA
| | - Denise Modjesk
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St, Los Angeles, CA, 90089-9239, USA
| | - Gwendolyn Norman
- College of Liberal Arts and Sciences, Wayne State University, 4841 Cass Avenue, Detroit, MI, 48201, USA
| | - Darek R Lucas
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA.,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA
| | - Sapna Gupta
- Cancer Research Informatics Core, University of Southern California Norris Cancer Center, NRT LG507, 1450 Biggy St, Los Angeles, CA, 90033, USA
| | - Hallgeir Rui
- Department of Pathology, Medical College of Wisconsin, 8701 Watertown Plank RD., Milwaukee, WI, 53226, USA
| | - Kendra Schwartz
- Department of Family Medicine and Public Health Sciences, Wayne State University, 3939 Woodward Ave, Detroit, MI, 48201, USA
| |
Collapse
|
48
|
Bidirectional Effects Between Callous-Unemotional Traits and Student-Teacher Relationship Quality Among Middle School Students. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:277-288. [PMID: 31705349 DOI: 10.1007/s10802-019-00595-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The present study investigated the bidirectional effects between callous-unemotional (i.e., CU) traits, student-teacher relationship quality, and bonds with school. A sample of 301 middle school students (156 girls; M age = 12.96 years, SD = 0.94) completed the Inventory of Callous-Unemotional Traits and the Student-Teacher Relationship Questionnaire, along with measures of both externalizing and internalizing problems, both in the first and second part of the school year (i.e., a time frame of 6 months). They also completed a peer-nominated measure of social preference within their peer group at the beginning of the school year. Results from a cross-lagged panel model suggested that, controlling for measures of both externalizing and internalizing problems, levels of affiliation with teachers were negatively related to levels of CU traits in students with low levels of social preference among peers. Moreover, a synergistic effect of high levels of both bonds with school and social preference emerged in predicting lower levels of CU traits. Similar results emerged with regard to externalizing problems, over and above the role of CU traits and internalizing problems. No effects of CU traits predicting student-teacher relationship quality emerged. Overall, the findings highlighted the teachers' role as emotion socializers and role models for the students who can promote students' emotional and relational prosperity over the development of maladaptive outcomes, including CU traits. They also stressed the importance of considering multiple environmental determinants in examining the pathways to CU traits, suggesting the need to integrate and expand previous research on parenting.
Collapse
|
49
|
Hutten E, Jongen EMM, Verboon P, Bos AER, Smeekens S, Cillessen AHN. Trajectories of Loneliness and Psychosocial Functioning. Front Psychol 2021; 12:689913. [PMID: 34276521 PMCID: PMC8278473 DOI: 10.3389/fpsyg.2021.689913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/25/2021] [Indexed: 12/02/2022] Open
Abstract
The present study examined the relationship between developmental patterns of loneliness and psychosocial functioning among adolescents (9-21 years; N = 110, 52% male). Four-wave longitudinal data were obtained from the Nijmegen Longitudinal Study (NLS) on Infant and Child Development. Loneliness was measured at 9, 13, 16, and 21 years of age and anxiety, depression and self-esteem at 9 and 21 years of age. Using k-means cluster analysis, three trajectories of loneliness were identified as "stable low" (56% of the subjects), "high decreasing" (22% of the subjects), and "low increasing" (22% of the subjects). Importantly, trajectories of loneliness across adolescence significantly predicted psychosocial functioning in young adulthood. Both the "high-decreasing" and "low-increasing" loneliness clusters were associated with higher risk of depression and lower self-esteem compared to the "stable low" loneliness cluster. The "low-increasing" loneliness cluster was associated with higher risk of anxiety compared to the "stable low" loneliness cluster. These results indicate that loneliness in adolescence is a vulnerability that manifests itself in higher levels of anxiety and depression and lower self-esteem in young adulthood.
Collapse
Affiliation(s)
- Elody Hutten
- Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Ellen M. M. Jongen
- Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Peter Verboon
- Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | - Arjan E. R. Bos
- Faculty of Psychology, Open University of the Netherlands, Heerlen, Netherlands
| | | | | |
Collapse
|
50
|
Kwaning K, Wong M, Dosanjh K, Biely C, Dudovitz R. Gender stigma awareness is associated with adolescent risky health behaviors. PLoS One 2021; 16:e0251332. [PMID: 33979392 PMCID: PMC8115797 DOI: 10.1371/journal.pone.0251332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/25/2021] [Indexed: 12/28/2022] Open
Abstract
Objectives Although racial stigma in school is associated with adolescent risky health behaviors, there are no studies investigating how gender stigma relates to adolescent risky health behaviors among low-income, minority youth. We sought to determine whether gender stigma awareness is associated with adolescent risky health behaviors (delinquency, fighting, and substance use) and whether this association is mediated by school disengagement (low perceived teacher support, low school engagement, cutting classes, and breaking school rules) among low-income, minority students. Methods We analyzed cross-sectional survey data, collected from 2017 to 2019, from 412 high school students. Multi-level logistic regressions tested whether gender stigma awareness was associated with delinquency, fighting, and substance use, controlling for covariates, baseline behaviors, and clustering within schools. Mediation analyses tested whether school disengagement (low school engagement, perceived teacher support, cutting class, and breaking school rules) mediated these associations. Secondary analyses explored whether associations differed for male versus female, high-performing versus low-performing, and Latinx versus non-Latinx students. Results In this predominantly Latinx (83%) sample, gender stigma awareness was associated with delinquency (AOR = 1.48, P< 0.001) and fighting (AOR = 1.15, P< 0.001). School engagement, perceived teacher support, breaking school rules, and cutting classes mediated 42.7% of the association between gender stigma awareness and delinquency and 65.42% of the association between gender stigma awareness and fighting. Gender stigma awareness was also associated with substance use for low-performing (AOR = 1.68, P = 0.003) and non-Latinx adolescents (AOR = 3.80, P = 0.03). School disengagement did not mediate the association between gender stigma awareness and substance use for non-Latinx students but mediated 50% of this association for low-performing students. Conclusions Gender stigma awareness is associated with adolescent risky health behaviors. A decreased sense of acceptance in the school community and increased school misbehavior may mediate these associations. School environments that value and accept all students may better support adolescent health.
Collapse
Affiliation(s)
- Karen Kwaning
- David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
- * E-mail:
| | - Mitchell Wong
- UCLA General Internal Medicine and Health Services Research, Los Angeles, California, United States of America
| | - Kulwant Dosanjh
- UCLA General Internal Medicine and Health Services Research, Los Angeles, California, United States of America
| | - Christopher Biely
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| | - Rebecca Dudovitz
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
| |
Collapse
|