Future, Volume 4, Issue 2 (June 2026) – 5 articles

Background: Bullying victimization among adolescents is common and has been consistently associated with higher risks of anxiety and depressive symptoms among adolescents exposed to bullying. Breakfast consumption may function as a daily regulatory resource that supports emotional regulation and coping; however, whether breakfast consumption patterns moderate the associations between bullying victimization and mental health outcomes among adolescents remains unclear. This study examined the associations among bullying victimization, breakfast consumption, and anxiety and depressive symptoms among adolescents and tested the moderating role of breakfast consumption. Methods: Using a multistage stratified cluster sampling design, 67,683 adolescents were recruited from 234 schools across 13 cities in Heilongjiang Province, China. Standardized anonymous questionnaires assessed adolescents’ experiences of bullying victimization, breakfast consumption, anxiety and depressive symptoms, and relevant covariates. Multivariable mixed-effects logistic regression models were applied to estimate the associations between bullying victimization and mental health outcomes among adolescents. Linear trend tests and interaction terms between breakfast frequency and bullying frequency were used to examine moderating effects. Results: Except for verbal victimization (items 1 and 6), among adolescents exposed to most forms of bullying victimization, those reporting higher breakfast frequency had lower risks of anxiety and depressive symptoms (all trend p < 0.05). Among adolescents exposed to relational, physical, and cyber victimization, breakfast frequency moderated the associations between bullying frequency and anxiety and depressive symptoms (all p for interaction < 0.05), with sex-stratified sensitivity analyses yielding consistent results. Among adolescents who consumed breakfast daily, greater breakfast diversity (≥3 vs. 1–2 food groups) was associated with lower risks of anxiety and depressive symptoms. Specifically, among adolescents who experienced physical victimization “sometimes,” those consuming breakfast with ≥3 food groups had a 29% lower risk of anxiety symptoms (ROR = 0.71, 95% CI: 0.48–0.98) and a 30% lower risk of depressive symptoms (ROR = 0.70, 95% CI: 0.46–0.97) than those consuming 1–2 food groups. Among adolescents exposed to cyber victimization, those consuming breakfast with ≥3 food groups had a 32% lower risk of depressive symptoms at the “sometimes” frequency (ROR = 0.68, 95% CI: 0.45–0.98) and had a 32% lower risk of anxiety symptoms (ROR = 0.68, 95% CI: 0.42–0.96) and a 35% lower risk of depressive symptoms (ROR = 0.65, 95% CI: 0.40–0.95) at the “often” frequency than those consuming 1–2 food groups. Conclusions: Among adolescents exposed to bullying victimization—particularly relational, physical, and cyber victimization—those reporting higher breakfast frequency had lower risks of anxiety and depressive symptoms than those who skipped breakfast. Greater breakfast diversity was also associated with lower risks, particularly among adolescents exposed to physical and cyber victimization. Full article

Early childhood caries risk is dynamic and can change over relatively short periods, even in the presence of preventive interventions. This study aimed to predict caries risk transitions in preschoolers using longitudinal data from the CAMBRA-kids mobile application. Using machine learning, we identified children whose risk progressed to high or extreme categories over 12 months and clarified the key contributing factors. A Random Forest model was developed using a multidimensional dataset that integrated parent-reported behavioral data and clinical assessments. Model performance was evaluated through ROC and precision–recall (PR) analyses, while SHAP was employed to ensure model interpretability and identify influential variables. Despite improvements in disease indicators and risk factors overall following the intervention, a subset of children transitioned to high or extreme risk. The model demonstrated acceptable discriminative performance with high precision in an imbalanced dataset. Changes in quantitative light-induced fluorescence loss, restored teeth, and red-fluorescent plaque area were identified as key predictors. These findings suggest that caries risk escalation reflects cumulative biological and clinical changes rather than short-term behavioral fluctuations and support the use of longitudinal, explainable machine learning for early risk identification and targeted prevention. Full article

Farm-to-school initiatives, including school gardens, are an increasingly popular strategy to increase student access to healthy produce and nutrition education opportunities. While studies show school garden programs and garden-enhanced nutrition education can positively impact student consumption of fruits and vegetables, there is a gap in evaluation tools that can be used by practitioners across varied school sites, grades, and communities, to assess outcomes of their garden programs. This effort piloted the Student Garden Retrospective Survey (SGR) for grades 4+ in four classrooms in two counties in California. The instrument included items to measure program exposure, garden skill experiences, changes in students’ behaviors, preferences, and attitudes, as well as their perceptions of the program. Student and teacher feedback on the evaluation tool was gathered to determine if students understood the questions being asked, were able to complete the survey, and whether the evaluation questions were pertinent to their school gardening experiences. The results demonstrate that the SGR is suitable for evaluating school garden and garden-enhanced nutrition education programming. In the future, the evaluation tool can be used by practitioners to iteratively improve garden-based education to enhance students’ nutrition and health outcomes. Full article

Objectives: This study aimed to explore whether the association of lifestyle behaviors with mental well-being differed by sports app use among college students, while also examining differences by sex. Methods: A total of 38,738 Chinese college students aged 19–22 years from a nationally cross-sectional survey in 2019 were included in this study. The Warwick Edinburgh Mental Wellbeing Scale was applied to evaluate mental well-being. Clustered lifestyle behaviors were defined as unfavorable (zero to two healthy factors), intermediate (three healthy factors), or favorable (four to five healthy factors). The use of sports apps was classified as dichotomized frequently (sometimes and often) and infrequently (never, rarely, and occasionally). Log-binomial regression was used to investigate the associations. Results: Intermediate (PR = 1.14, 95% CI: 1.11–1.18) and unfavorable (PR = 1.29, 95% CI: 1.26–1.33) lifestyles were positively associated with low mental well-being. Infrequently using sports apps was associated with low mental well-being (PR = 1.08, 95% CI: 1.06–1.10). The magnitude of the association between an unfavorable lifestyle and low mental well-being was smaller among girls who frequently used sports apps (PR = 1.22, 95% CI: 1.16–1.27) than among those who used them infrequently (PR = 1.31, 95% CI: 1.24–1.38). Conclusion: These findings suggest that integrating engagement with digital sports apps into campus health promotion strategies might help support mental well-being, especially for college students with multiple unhealthy lifestyle behaviors. Full article

Background: Individuals with intellectual and developmental disabilities (IDD) experience persistent health disparities that result in poorer health outcomes, reduced quality of life, and inequitable access to healthcare. Objective: This narrative review synthesized existing literature to identify key barriers to health equity and contributors to health disparities among individuals with IDD. Method: This study was a narrative (non-systematic) review that adopted a qualitative synthesis approach. A literature review was conducted across PubMed, CINAHL, PsycINFO, Medline, and Google Scholar to identify peer-reviewed articles published between 2010 and 2025 that address health disparities, health inequities, healthcare barriers, and social determinants of health among individuals with IDD. Thematic analysis was employed to synthesize the included studies and identify recurring patterns and themes. Results: A total of 88 articles were included. Two overarching domains shaping health disparities were identified: barriers to health equity and contributing factors. Seven barrier categories emerged: attitudinal, communication, policy, programmatic, social, physical, and transportation. Five key contributors were also identified: limited access to healthcare, comorbid conditions, low health literacy, adverse social determinants of health, and caregiver burden. Conclusions: Health disparities among individuals with IDD are driven by intersecting social, structural, and healthcare system barriers rather than individual limitations alone. This review informs policymakers, public health professionals, and interventionists on how to advance health equity for individuals with IDD through targeted, person-centered interventions. Full article