Youth in Transition

Background: Afterschool programs (ASPs) funded under the 21st Century Community Learning Center (CCLC) Act were designed to provide a safe environment for students to engage in extracurricular programming. COVID-19 disrupted the school environment leading to numerous negative outcomes for students and parents, as well as teachers and school administration. The effects of COVID-19 continue to be felt as educational disparities persist, creating opportunities for afterschool programming to help lessen the gaps. Methods: Based on the lasting impact of COVID-19 and the lack of literature on ASPs, the purpose of this study is to compare the effectiveness of a 21st CCLC ASP from spring 2019 to spring 2020 to account for the initial effects of the global COVID-19 pandemic. Our aims were to (1) examine the differences in student ratings of various ASP outcomes the semester before and semester during which COVID-19 began, and (2) determine if student grade level impacts ratings of various ASP outcomes. Findings: Results showed that family involvement significantly increased from before to during COVID-19 and that early adolescents had significantly worse outcomes related to family, friends, grades, and overall opinions of the ASP during the pandemic than those in younger grades. Conclusions and Implications: Recommendations for ways to increase engagement in ASPs for both families and youth transitioning to higher grade levels are discussed. Full article

(1) Background: Adolescents living with HIV (ALHIVs) experience significant challenges in adhering to treatment and remaining engaged in care as they transition from pediatric to adult HIV care programs. The aim of this qualitative evidence synthesis (QES) was to review qualitative studies that describe how ALHIVs experience transition practices in low- and middle-income countries. (2) Methods: The following databases were searched: PubMed, Wiley Library Online, EbscoHost (PsychARTICLES, MEDLINE, Scopus, CINAHL), the WHO database, Google Scholar, and reference mining of the included studies. The inclusion criteria were as follows: ALHIV 10–19 years old, interventions on the transition period or studies describing transition practices, published between 2012 and 2023, conducted in low- and middle-income countries, English language, and qualitative and mixed-method studies. This review adheres to the PRISMA guidelines. CASP and MMAT were used for methodological quality assessment, and GRADE CERQual was used for the confidence in review findings. (3) Results: Seven articles were included in the final review. The five overarching themes described: (1) transition readiness during the pre-transition phase; (2) structural (health systems) barriers and treatment literacy as challenges during the transition period; and (3) provided accounts of successful post-transition experiences and recommendations for improving the transition process (when these were not experienced as positive), while also describing the individual and collective contexts in which transition took place, as they outlined (4) individual (psychological) barriers and the facilitative role that (5) a supportive environment played in the outcome of the transition process. There was a high level of confidence in transition readiness, while the other themes were assessed as having moderate confidence due to methodological limitations and minor concerns about adequacy or relevance. (4) Conclusions: There is a dearth of qualitative studies on the transition experiences of ALHIVs and on how the transition process impacts adherence, retention in care, and mental well-being. We recommend the development of interventions in the form of a guided transition protocol to improve the transition experiences of ALHIVs. Full article