Search Results (149)

Background/Objectives: Sexual health research involving young adolescents remains scarce despite rising rates of early sexual debut, pregnancies, and sexually transmitted infections (STIs) in this population. We explored community stakeholders’ perspectives on engaging young adolescents in sexual health research in Western New York to inform strategies for engaging young adolescents in sexual health research. Methods: This qualitative descriptive study was conducted from April 2022 to June 2023. Seventeen community stakeholders, including health education teachers, youth counselors, and adolescent health providers, participated in semi-structured in-depth interviews. Data were analyzed using conventional content analysis, managed by MAXQDA 2020. The rigor and trustworthiness of the data were ensured through triangulation with observations, peer debriefing, team analysis, and respondent validation. Results: Participants were predominantly female (94.1%), 52.9% Black/African American, 41.2% White, and 5.9% Caucasian–Indian American, and aged 23–59 years. Four themes emerged: perspectives on conducting sexual health research with young adolescents, recruitment strategies, sexual health questions appropriate for young adolescents, and building readiness for participation in sexual health research. Participants reported the need for sexual health research with young adolescents and recommended building a trusting relationship and involving schools, parents, and trusted community organizations in the research process. Suggested research questions included those related to awareness of sex, STIs, available resources, experiences with sexual education, and desired support. The findings also revealed the need to initiate sexual health conversations early when children start asking questions, as a foundation for meaningful participation in sexual health research. Conclusions: The findings suggest that sexual health research with young adolescents is feasible and necessary, with implications for the design of developmentally appropriate sexual health research and interventions grounded in trust and community collaboration. Future research should explore the perspectives of caregivers and young adolescents to inform studies and programs that are attuned to young adolescents’ developmental needs. Full article

Based on ecological systems theory, adolescents’ school climates can influence family interactions. In this study, it was tested whether associations between adolescents’ and parents’ perceptions of school climate in 7th grade (Wave 1) and adolescents’ later psychological functioning in 11th grade (Wave 4) were partially mediated by parental self-efficacy and parenting practices when the adolescents were in 8th grade (Wave 3). Path analyses were conducted in MPlus v. 7.4. Among 660 Black American families from the Maryland Adolescent Development in Context Study, adolescents’ positive perceptions of school climate were directly related to fewer internalizing and externalizing symptoms, higher resourcefulness, and higher self-esteem. Adolescents’ perceptions of school climate were also indirectly related to their externalizing symptoms through parent–adolescent communication and conflict. Adolescents who reported more positive school climates reported higher parent–adolescent communication and lower parent–adolescent conflict. Adolescents’ reports of school climate were also indirectly associated with self-esteem. Parents’ perceptions of school climate were not directly related to adolescents’ psychological functioning but were directly related to parental self-efficacy and parent–adolescent communication. They were also indirectly related to adolescents’ externalizing symptoms through parental self-efficacy. Parental self-efficacy was positively related to parent–adolescent communication and parents’ home-based school involvement. Overall, the findings highlight the role of school context in adolescents’ psychological functioning and family processes. Full article

Background: This study examined treatment outcomes for cannabis use disorder (CUD) among adolescents (12–17 years old) in the United States. Methods: Data from the 2018–2021 Treatment Episode Data Set-Discharges (TEDS-D) included 40,054 adolescents diagnosed with CUD. Descriptive statistics, Chi-square tests, and multivariable logistic regression assessed treatment outcomes and factors associated with treatment completion. Results: Only 36.8% of adolescents completed treatment. The most common reasons for not completing treatment were dropping out (28.4%) and transferring to another facility/program (17.0%). Males and Black non-Hispanic adolescents had lower odds of completing treatment (OR = 0.79, 95%CI: 0.75–0.84), while Hispanic (OR = 1.13, 95%CI: 1.08–1.18), Asian (OR = 1.56, 95%CI: 1.3–1.86) and Native Hawaiian/Pacific Islander adolescents (OR = 2.31, 95%CI: 2.04–2.61) had higher odds of completion compared to their White counterparts. Independent living arrangements, homelessness, arrests in the past 30 days and younger age (<15 years old) decreased the likelihood of treatment completion. Adolescents with co-occurring mental health and substance use disorders also had lower completion rates (OR = 0.79, 95%CI: 0.77–0.86). Referral from schools/employers and treatment settings were associated with a higher success, particularly with stays of 4–6 months and 7–12 months. Conclusion: This study highlights the need for targeted CUD treatment programs that support at-risk adolescents, especially those experiencing homelessness or facing legal issues. High dropout and transition rates suggest a need for continuity of care and program integration between facilities. Strengthening coordination among public health officials, community organizations, and stakeholders is essential to developing culturally responsive treatment interventions that address social determinants of health, substance use, and mental health in this vulnerable population. Full article

Background: Suicidal ideation among adolescents remains a major public health challenge. Exposure to neighborhood violence is associated with increased risk of mental health distress and school-related vulnerabilities. This study investigates the predictors of suicidal ideation among U.S. adolescents who have witnessed neighborhood violence. Methods: Data were drawn from the 2023 Youth Risk Behavior Survey (YRBS), a nationally representative survey of high school students in the United States. A subsample of 3495 adolescents who reported witnessing neighborhood violence was analyzed. Key variables included sociodemographic characteristics, mental health symptoms, perceived school safety, and experiences of victimization. Multivariable logistic regression was used to identify factors associated with suicidal ideation, defined as seriously considering suicide in the past year. Analyses were conducted using Jamovi (version 2.6), with statistical significance set at p < 0.05. Results: The prevalence of suicidal ideation in the sample was 34.2%. Bisexual adolescents had significantly higher odds of suicidal ideation compared to heterosexual peers (OR = 2.34, p < 0.001). Depressive symptoms were the strongest predictor (OR = 7.51, p < 0.001). Both perceived lack of safety at school and differences in ethnic and population backgrounds were significant. Black and Hispanic/Latino adolescents had lower odds compared to White peers. Conclusions: Findings highlight sexual identity, depressive symptoms, school safety concerns, and ethnic and population background differences as key correlates of suicidal ideation. Culturally responsive, trauma-informed interventions are urgently needed for youth exposed to community violence. Full article

A growing knowledge base highlights the importance of accounting for a variety of social and structural determinants of health (SDOH) when understanding mental and behavioral health among adolescents and young adults. The objective of the current study is to examine patterns of self-reported SDOH deficits and characterize participant health indicators and social identity across classes. Data is from a cross-sectional national study of young people who were recruited through study advertisements on social media and surveyed online. Data were collected between June 2022 and October 2023. Eligibility included (1) ages 13–22 years, (2) living in the United States, and (3) proficient in English. Health indicators included suicide attempts, suicidal ideation, drug overdose, perceived likelihood of living to age 35, non-suicidal self-injury, recent alcohol use, and depression. Five classes of SDOH deficits were identified: (1) Economic Instability, (2) Low Overall SDOH Deficits, (3) High Social SDOH Deficits (adversity and discrimination), (4) High Economic SDOH Deficits, and (5) High Overall SDOH Deficits. Differences across class by health indicators and marginalized identity were found, with high proportions of gender minority and sexual minority youth in both the High Overall SDOH Deficit group and the High Social SDOH Deficit classes. Black youth were more likely to be part of the High Economic SDOH Deficits class. The findings encourage a public health approach that recognizes that improving the health of today’s young people must be connected to policies that reduce poverty, improve neighborhoods, and increase access to basic goods, services, and healthcare. Full article

Background/Objectives: The COVID-19 pandemic has been associated with significant increases in mental-health-related concerns in adolescents, including eating disorders. Disparities in screening, diagnosis, and treatment impact adolescents with eating disorders. This study aimed to describe the patterns in the prevalence and the associations between eating disorder diagnoses and demographic factors in adolescent patients since the start of the COVID-19 pandemic. Methods: We performed a retrospective cohort study examining adolescent patients (aged 12 to 21) with an eating disorder (ED) diagnosis documented between January 2019 and July 2023 using Epic Systems Corporation’s Cosmos, a de-identified dataset aggregated from electronic health record (EHR) data. We examined the differences in demographic factors by utilizing chi-square and Kruskal–Wallis rank sum tests. Results: A total of 82,435 distinct adolescent and young adult patients with eating disorder diagnoses were included in the analytical dataset. The overall prevalence of EDs has increased since 2019. The median age of patients with an ED decreased between 2019 and 2023. There was a decrease in other eating disorder diagnoses and an increase in avoidant-restrictive food intake disorder (ARFID) during the study period. There was a decrease in the proportion of individuals who identified as White and an increase in the proportion of adolescents from historically minoritized racial and ethnic groups (i.e., African American or Black and Hispanic). There was also an increase, during this study period, in the proportion of adolescents with an ED diagnosis who were from more socially vulnerable communities. Conclusions: Our study describes the changes in the prevalence of sociodemographic factors in adolescent patients with EDs since the start of the COVID-19 pandemic. Further studies should address screening, diagnostic, and treatment barriers for EDs in historically underserved communities. Full article

Young Black males (YBM), ages 15–17, experience disproportionately high rates of firearm violence and related structural disadvantages, shaping both their psychological and practical responses to violence-related stressors. These intersecting exposures influence their coping strategies, mental health, help-seeking behaviors, and broader social functioning. Generational shifts in how young males conceptualize identity, mental health, help-seeking, and masculinity, combined with increasing exposure to firearm violence, underscore the need for a closer examination of contemporary coping strategies. This qualitative study applies Thorne’s Interpretive Description (ID) to explore coping patterns among YBM navigating violence exposure in physical and online environments. Drawing from two focus groups of 33 YBM (M = 15.8, SD = 1.19) from a Midwest high school, we conducted a thematic analysis grounded in the interpretive description tradition. Integrating the Phenomenological Variant of Ecological Systems Theory (PVEST) and the Transactional Model of Stress and Coping (TMSC), we examined how structural and interpersonal factors shape YBM agency and coping responses. Four coping patterns emerged: (1) Problem-Focused Adaptive, (2) Problem-Focused Maladaptive, (3) Emotion-Focused Adaptive, and (4) Emotion-Focused Maladaptive. The findings underscore the dynamic interaction between environmental stressors, available resources, and cognitive appraisals, indicating that for Black adolescent males, coping strategies are neither static nor inherently adaptive or maladaptive. Full article

This study aimed to investigate the association between protective factors, marijuana use, and suicidal behavior among Black LGBQ U.S. adolescents. Methods: A subsample of 991 Black LGBQ adolescents was derived from the 2019 Combined High School YRBSS dataset. Suicidal behavior was measured as suicidal planning and/or previous suicide attempts. Marijuana usage gauged lifetime consumption. The protective factors included sports team participation, physical activity, eating breakfast, hours of sleep, and academic performance. Age and sex were entered as covariates. Multiple imputation by chained equations (MICE) was used to address missing data, and pooled binary logistic regression analyses were conducted. Results: Academic performance and hours of sleep were significantly associated with lower odds of suicidal behavior and lifetime marijuana use. Sports team participation was associated with higher odds of lifetime marijuana use. Being female was linked to higher odds of marijuana use, while older age was associated with lower odds. Discussion: For Black LGBQ youth, academic performance and sufficient sleep may function as protective factors. Participating in sports was associated with greater odds of risk behaviors, highlighting the need to assess the experiences of Black LGBQ youth in sports. Implications and Contributions: Our findings inform school programming, policy, and practice by identifying academic support and sleep health as intervention areas. Full article

Brazilian jiu-jitsu engagement has been found to positively impact psychological variables in children, adolescents, and adult athletes. Psychological variabilities have previously been shown among belt ranks in Brazilian jiu-jitsu athletes. Background/Objectives: This study aimed to explore the differences in mental strength, resilience, grit, self-efficacy, self-control, aggression, life satisfaction, and mental health disorders among the Brazilian jiu-jitsu belt ranks. Methods: A sample of 420 Brazilian jiu-jitsu athletes (78.8% male), including 121 white belts, 118 blue belts, 78 purple belts, 46 brown belts, and 57 black belts, between 18 and 60 years of age, completed the Mental Strength Scale, Brief Resilience Scale, Grit Scale, General Self-Efficacy Scale, Brief Self-Control Scale, Brief Aggression Questionnaire, Satisfaction with Life Scale, and Mental Health Disorders Screening Instrument for Athletes. Results: Results showed that Brazilian jiu-jitsu black belts presented significantly higher mental strength, resilience, self-efficacy, self-control, life satisfaction, and lower mental health disorders than white belts. No significant differences were found between white and black belts in aggression (total, physical aggression, anger, verbal aggression, and hostility). Brazilian jiu-jitsu training experience positively correlated (small effect) with mental strength, resilience, grit, self-efficacy, self-control, physical and verbal aggression, and life satisfaction. Conclusions: In conclusion, the results are suggestive that Brazilian jiu-jitsu black belts are generally more likely to present higher mental strength, resilience, grit, self-efficacy, self-control, life satisfaction, and better mental health than white belts, with no differences in aggression. More experienced Brazilian jiu-jitsu athletes were more likely to present higher mental strength, resilience, grit, self-efficacy, self-control, physical and verbal aggression, and life satisfaction than less experienced athletes. Future studies are encouraged to investigate whether the effects found in the current study would remain after controlling for the athlete’s age. Full article

A substantial amount of the literature has examined the impact of participation in sport-based youth development programming and its global contribution to the lives of young people. In a similar vein, the outcomes of sport-based leadership programs are heavily influenced by the relationships and life skills acquired. One often overlooked demographic in this literature is incarcerated youth, a unique population who’s time spent in juvenile justice is fundamentally designed to prioritize rehabilitation and development. This paper sought to understand youths’ experiences in a sport-based leadership prison program with regards to content, relationship building, and transfer. This study included semi-structured interviews with three, currently incarcerated, adolescent black males, exploring their experiences as participants in their sport leadership program. Results included themes around the program meaning, relationship enhancers, and life skill learnings. Findings explore how sport-based prison programs may consider the importance of physical and psychological safety, relationship building, and life skill teachings as crucial components of a program that remain with participants well into their reintegration within society. Full article

Physical activity interventions and programming for Black American girls often overlook racism and sexism as a fundamental cause of the differences in engagement between their white and male peers. Deficit framing is a standard where Black girls are often compared to the health, physical activity, and beauty standards driven by white feminine or masculine norms, suggesting there is only one way to be fit and healthy. Approaches that lack cultural and historical relevance, including the effects of systemic racism and sexism, are seldom considered before aiming to increase physical activity engagement and favorable health outcomes for Black teenage girls. Aim: This paper presents a brief overview of physical activity programming for Black adolescent girls and young women (aged 14–18) and proposes theoretical frameworks and approaches to consider before implementing physical activity interventions and programs. Concluding Remarks: Voice, intersectionality, misogynoir, representation, and gendered racism as a root cause should inform physical activity programming designed for Black adolescent girls. Culturally equitable approaches for real and sustainable change are required to increase physical activity engagement. Full article

Abstract: Serotonin reuptake inhibitors (SSRIs) are currently the first-line treatment for adolescents suffering from major depressive disorder, even though a black box warning concerns suicidal ideation was put forth in 2004. Numerous trials have been conducted evaluating this risk in adult patients, with less being done surrounding pediatric patients. Trials that have focused on this specific risk in adolescents have shown either a strong connection, conflicting results, or non-significance. Trials comparing other non-SSRI antidepressants have also demonstrated some risk of suicidal ideation, suggesting the risk may not be specific to this class of drugs. Other data have also suggested that the risk is linked to treatment duration, genetics, and/or simply that the adolescent patients with major depressive disorder are an at-risk population. Herein, a review is presented of the trials conducted surrounding SSRIs, their use in adolescents, and their risk in terms of developing suicidal ideation. Full article

Background/Objectives: This study examines the factors associated with U.S. adolescents’ obesity and overweight status. Methods: Using a multivariable logistic regression, we analyzed the data from the 2021 Youth Risk Behavior Surveillance System (YRBSS), comprising 17,232 students. Results: The odds of being obese or overweight were significantly higher (p ≤ 0.05) for the participants who perceived themselves as slightly overweight (AOR, 13.31; 95% CI [11.83, 14.97]) or very overweight (AOR, 39.29; 95% CI [30.12, 51.25]) compared to those who perceived their weight as about right. The participants with significantly higher odds included those aged 14 years (AOR, 2.53) compared to those aged 13 years or younger; male students (AOR, 1.63) compared to female students; and American Indian/Alaska Native and Native Hawaiian/Other Pacific Islander students (AOR, 2.11), Black or African American students (AOR, 2.63), Hispanic/Latino students (AOR, 1.54), and students of multiple races (AOR, 1.56), compared to White students. The odds were also significantly higher for the participants who did not eat breakfast on all seven days of a week (AOR, 1.21) and for the students who did not report their mental health status (AOR, 2.07) compared to those who reported their mental health as mostly or always not good. Conclusions: These findings suggest schools are uniquely positioned to implement strategies for healthier behaviors designed and implemented with a focus on health equity. Full article

Introduction: Adolescent/young adult (AYA) patients with metastatic soft tissue sarcoma (STS) typically face a dismal prognosis. However, a subset of patients with incurable disease lives beyond two years. Due to the rarity of diagnoses and inherent heterogeneity within this population, a paucity of data exists regarding the experiences of AYAs with an indolent course (and how to best capture these experiences). With increasing biological insight and clinical experience, including the use of targeted or immune therapies, it is anticipated that more such patients will experience prolonged survival. Our pilot study aimed to describe the clinical characteristics and illness experiences of AYAs with incurable yet indolent metastatic STS who were living two years after their diagnoses. Our exploratory aim was to generate a conceptual framework that could subsequently be tested in a multi-center study with a larger cohort of patients. Materials and Methods: Patients with metastatic incurable STS, aged 15–39 years at diagnosis, and at least two years from diagnosis, were eligible. Patients were recruited over a two-year period at a quaternary children’s hospital with a comprehensive AYA oncology program. Participants completed a demographic form and PROMIS short form questionnaires for seven domains and answered an open-ended question. Responses to open-ended questions were coded independently by two authors and utilized to generate themes. Clinical variables were collected from medical records. Results: Five patients completed questionnaires. Mean age was 29.4 years (18.5–39.8 years) at diagnosis and 34 years (23.2–45.7 years) at study. Three patients were female; two were male; four were White; and one was Black/African American. Diagnoses included ASPSCR1::TFE3 alveolar soft part sarcoma; WWTR1::CAMTA1 epithelioid hemangioendothelioma; INI-1 deficient epithelioid sarcoma; EWSR1::NR4A3 extra-skeletal myxoid chondrosarcoma; and low-grade ARHGAP23::FER spindle cell malignancy, a novel fusion-driven sarcoma. Mean time since diagnosis was 4.5 years (2.6–6 years), and mean treatment duration was 4.2 years (1.5–6 years). On average, patients received 4.8 lines (range 2–8 lines) of antineoplastic therapy. All patients received at least one targeted therapy or immune checkpoint inhibitor. Patients reported increased fatigue and anxiety and decreased physical function compared to the standardized US reference population. Themes emerging from qualitative responses included managing physical symptoms, navigating feelings of guilt and inadequacy, self-reflection generating gratitude, and changing illness experiences over time. Conclusions: AYA patients living with incurable metastatic soft tissue sarcoma for more than two years were treated with multiple lines of antineoplastic therapy longitudinally. PROMIS data identified fatigue, anxiety, and decreased physical function within this population. Exploratory thematic analysis of qualitative responses generated concepts that could be further tested in an expanded cohort of patients. Full article

Background/Objectives: Human papillomavirus (HPV) is linked to multiple cancers that can be prevented through vaccination. While the optimal age for vaccination is in childhood and adolescence, vaccination recommendations include adults through age 26 who missed childhood/adolescent vaccination. There are limited data about disparities among adults eligible for catch-up HPV vaccination. We conducted a comprehensive examination of HPV vaccination among US young adults, disaggregating the group by race/ethnicity and nativity status to identify subgroups that may require additional interventions. Methods: We analyzed 2019 and 2022 data of individuals aged 18–26 years from the National Health Interview Survey. Generalized linear models using Poisson regression with log link were used to examine the receipt of 1+ dose of HPV vaccine, race/ethnicity, and nativity (i.e., US- versus foreign-born) status. Results: The overall receipt of 1+ doses of HPV vaccine was 47.5%. The vaccination rate among the US-born group was 49.7% versus 31.9% among the foreign-born group with an adjusted prevalence ratio (APR) of 0.72; (95% CI, 0.62–0.82). Foreign-born non-Hispanic (NH) Black individuals (APR 0.31; 95% CI, 0.13–0.70) were less likely to be vaccinated against HPV than foreign-born NH White individuals, while US-born NH Asians (APR 1.27; 95% CI, 1.09–1.48) had a higher prevalence of the vaccination than the US-born NH White group. Additionally, foreign-born NH Asian (APR 0.60; 95% CI, 0.46–0.77), NH Black (APR 0.27; 95% CI, 0.12–0.61), and Hispanic (APR 0.76; 95% CI, 0.60–0.97) populations were less likely to be vaccinated than their respective US-born counterparts. Conclusion: Profound HPV vaccination inequalities exist among US young adults with particularly low vaccine coverage among racially and ethnically minoritized immigrant populations. Full article