Search Results (87)

Background/Objectives: Youth with type 1 diabetes (T1DM) face unique challenges in balancing dietary choices, physical health outcomes, and social–emotional well-being in school settings. This cross-sectional exploratory pilot study examined the associations of diet with physical health and teacher-reported social–emotional functioning in students with T1DM. Methods: Students with T1DM (mean age = 13.42; 47 female, 50 male; 50% White, Non-Hispanic, 50% minority) self-reported their nutritional habits using the KBlock Dietary Screener for Children when school was in session. Teacher-rated school-related behaviors were assessed through the Behavior Assessment Scale for Children-2nd Edition (BASC-2). Canonical correlation analysis was conducted to determine whether the variable sets (diet with physical health and school-related behavioral health) shared a significant multivariate relationship. Results: Youth with lower glycemic loads and consuming more sugar, dairy, and meat/poultry/fish but fewer legumes, fruit, and less saturated fat exhibited fewer externalizing symptoms and higher BMI. Diet uniquely accounted for modest variance in combined social–emotional and physical health, controlling for demographics and T1DM duration. Findings support increasing the availability of whole, nutrient-rich foods, integrating comprehensive nutrition education into curricula, and ensuring access for all students, regardless of socioeconomic status. Conclusions: Comprehensive dietary assessments and school-based randomized control trials are needed to enact more evidence-based dietary recommendations or interventions for youth, aiming for a balanced approach that addresses both mental and physical health outcomes. Full article

Background: Mental health conditions are a growing public health concern among U.S. adolescents, particularly high school students. Emerging data show a strong link between exposure to neighborhood violence and increased risk of poor mental health outcomes, such as depression, anxiety, and persistent sadness. Objective: This study examined the relationship between neighborhood violence exposure and mental health outcomes among high school students. Method: This is a cross-sectional study using the 2023 Youth Risk Behavior Survey. The sample included 19,910 students in grades 9–12 across gender and race. Mental health status and exposure to neighborhood violence were analyzed using chi-square tests and logistic regression models. Results: Students exposed to neighborhood violence had significantly higher odds of reporting poor mental health outcomes (AOR = 1.789, 95% CI: 1.573–2.035, p < 0.001) than the unexposed. Additionally, female, Hispanic/Latino, and multiracial students reported higher rates of mental health disorders than the male students. Conclusions: Neighborhood violence exposure was significantly associated with poor mental health outcomes among high school students. These findings signify the need for targeted interventions to support affected students and reduce neighborhood violence exposure, particularly in marginalized communities. The findings will inform public health professionals, educators, and policymakers to make targeted school-based mental health interventions and community-centered policies addressing neighborhood safety and adolescent mental health. Full article

Background: Adolescent sleep problems are a public health concern, as roughly 60–70% of U.S. teens obtain less sleep than is recommended. Negative affect is a risk factor for adolescent sleep problems. However, factors explaining this association, to our knowledge, have not been explored in Hispanic/Latino(a) (H/L) adolescents. Acculturation gap conflict and low self-control may act as mediators linking negative affect to sleep problems. Methods: A sample of 223 H/L adolescents was assessed at three time points. We hypothesized that acculturation gap conflict and low self-control assessed at Wave 2 would mediate the association between negative affect at Wave 1 and sleep problems at Wave 3. Results: Negative affect predicted higher acculturation gap conflict, which in turn was associated with less self-control, and less self-control then predicted more sleep problems. Conclusions: These findings highlight acculturation gap conflict and low self-control as processes through which negative affect can impact later sleep problems in H/L adolescents. Elucidating modifiable factors impacting sleep health among H/L youth may inform intervention strategies. Targeting affect regulation, as well as improving parent-adolescent relationship quality within the context of acculturative differences, may help reduce sleep problems among this demographic group. Full article

Background: Adolescence is a critical period of rapid physical and psychological change, yet it is also when many health and well-being problems first emerge, often setting limits on lifelong opportunities and achievements as youth transition into adulthood. The ground-breaking adverse childhood experiences (ACEs) study has significantly shaped the development of programs and policies aimed at fostering adolescent health. Nonetheless, there has been limited exploration into the heterogeneity among individuals experiencing a high number of ACEs, such as four or more. This study employs Latent Profile Analysis (LPA) to examine the diverse outcome profiles of adolescents who have been exposed to a substantial number of ACEs. Method: The data were from participants who experienced at least four ACEs by age 9 in the Future of Families and Child Wellbeing Study (N = 1427; 54% male; 59% Black; 15.3% Hispanic; 2.4% other). We applied LPA using the manual three-step method within Mplus 8 to establish profiles based on six developmental indicators at age 15. These indicators included optimism, perseverance, academic performance, internalizing and externalizing behavioral competence, and social skills. The full information maximum likelihood method was used to handle missing data. Results: The study identified three distinct profile groups according to model fit indices and interpretability: Multidimensional Competence Group (61.0%), Low Personality and Social Competence Group (23.8%), and Low Behavioral Competence Group (15.2%). Racial and ethnic backgrounds were significant predictors of membership in these different profile groups. Conclusions: In a research landscape often focused on the cumulative harm of ACEs, our study underscores the heterogeneity of trauma profiles among adolescents with substantial ACE exposure. Given that adolescence is a critical stage when health and well-being challenges emerge, tailored early interventions are important to supporting a successful transition into adulthood. We advocate for the importance of comprehensive screening for social-cognitive and behavioral health difficulties in trauma-affected youth, enabling practitioners to implement timely prevention strategies and tailored interventions that foster resilience and long-term well-being. Full article

Background/Objectives: Youth perceptions of their environments provide critical insight into the social and physical determinants of health. This study investigated how Hispanic and African American children conceptualize health within their neighborhood and school settings. Methods: A total of 44 participants (29 Hispanic, 15 African American; Mean age = 9.27 years, SD = 1.28 years) participated in a photovoice project, capturing photographs and quotes in response to two guiding prompts: (1) “What does your dream of a healthy community look like?” and (2) “What should we do to make your community healthier?” Results: Thematic analysis of participants’ quotes and photographs yielded four overarching themes across both neighborhood and school environments: (1) access to nutritious food options, (2) opportunities for physical activity and recreation, (3) clean and safe spaces, and (4) access to extracurricular and community-based programs. A fifth theme, emergency preparedness and response, emerged uniquely within school context. Participants also proposed context-specific solutions to address identified health concerns. Conclusions: These findings emphasize the importance of environmental context in shaping child and preadolescent health perceptions and priorities. The results support the development of children and adolescent-informed, community-level interventions aimed at improving environmental health conditions, particularly in underserved communities disproportionately affected by poverty and structural inequities. Full article

Background/Objectives: Hispanic adolescents experience elevated rates of disordered eating behaviors and body dissatisfaction, yet limited research has examined how gender and weight status interact to shape these risks within this population. Methods: A cross-sectional survey was conducted among 680 Hispanic adolescents (ages 9–15) from a predominantly Mexican-American middle school. Participants completed the Modified Kids Eating Disorder Survey (M-KEDS), and height and weight were objectively measured to determine BMI-for-age percentile. Chi-square tests, Mann–Whitney U tests, and logistic regression were used to assess differences by gender and weight status, including interaction effects. Bonferroni correction was applied for multiple comparisons. Effect sizes (Cramér’s V, odds ratios with 95% CI) were reported. Results: Approximately 73% of participants reported body dissatisfaction, with significant differences observed by gender and weight status. Adolescents with overweight/obesity reported significantly higher negative weight attitudes and extreme weight control behaviors than healthy-weight peers (p < 0.001), with large effect sizes. Females endorsed more disordered attitudes and behaviors, except for exercise to lose weight, which was more common among overweight/obese males. Conclusions: These findings underscore the high prevalence and significance of disordered eating behaviors in Hispanic adolescents, including those at a healthy weight. Results highlight the importance of culturally tailored, gender-sensitive screening and prevention strategies. Schools serve as critical settings for early identification, and tools like the M-KEDS can help address disparities in care access and improve outcomes among Hispanic youth. 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

Hispanic youth have one of the highest rates of unmet physical and mental health needs. This study aims to examine how child and adolescent healthcare access creates pathways to behavioral/mental health among a national sample of 1711 U.S. Hispanic youth. Using psychometric network analysis, unique pathways in which child healthcare access (i.e., transportation and health service-related factors) and behavioral/mental health were identified. Findings indicate relationships among depression, anxiety, school settings, and friendships. These associations offer a starting point for interventionists and policymakers to ensure that interventions are not targeted individually but from an ecological systems framework. This study may raise awareness of Hispanic youth’s barriers and better equip scientists to plan and implement approaches to address identified barriers. Full article

Background/Objectives: Despite the striking prevalence of pediatric chronic pain (20% of youth), its impact on culturally diverse populations, particularly Asian families, remains underexplored. The existing literature on parent protective behaviors predominantly focuses on Non-Hispanic White (NHW) families, where such behaviors often exacerbate pain outcomes, therefore informing a core treatment target in clinical practice. This study aims to explore the role of parent protective behaviors in relation to global and pain-related distress in Asian families in comparison to NHW counterparts. Methods: A sample of 1415 youth (Asian: n = 236; NHW: n = 1179) aged 8 to 17 completed a survey prior to their evaluation at a tertiary pain clinic. Bivariate correlations and independent-sample t-tests were conducted to assess differences in anxiety, depression, pain-related distress, and parent protective behaviors between groups. Multiple regression analyses were used to determine whether parent protective behaviors moderated the relationship between global distress and pain-related outcomes. Results: Asian youth reported significantly lower pain intensity and pain interference than NHW youth, while Asian parents reported significantly higher protective behaviors. Parent protective behaviors moderated the association between global distress (depression and anxiety) and pain catastrophizing for Asian families only. A three-way interaction (ethnicity x parent protective behaviors, global distress, B = −0.22, p < 0.001; B = −0.18, p < 0.01) revealed that protective behaviors influenced the distress–pain catastrophizing link differently by ethnicity. Conclusions: Differences were observed in the Asian youth’s experience of pain in comparison to their NHW counterparts. This study highlights the importance of considering culturally nuanced approaches in treating pediatric chronic pain, particularly when working with Asian families. Full article

Measures of sexual orientation and family functioning are widely used among sexual minority populations. However, data on whether these measures are culturally syntonic and responsive to the needs of a particular population, such as Hispanic sexual minority youth (HSMY), are lacking. Therefore, this study assessed whether HSMY understand measures of sexual orientation and family functioning as intended. Authors conducted individual interviews with five HSMY to evaluate the face validity of a measure of sexual orientation (i.e., Klein Sexual Orientation Grid) and measures of family functioning (i.e., Parent–Adolescent Communication Scale, Parenting Practices Scale, Parental Monitoring of Peers). Data were analyzed using a general inductive approach. For the sexual orientation measure, five themes were identified related to the: (1) clarity of questions, (2) challenging nature of questions, (3) difficulty of responses, (4) suggestions to improve response options, and (5) need for questions to include gender identity. For family functioning, three themes were identified: (1) relevance of the measures to sexual minority youth, (2) the importance of understanding family history and cultural context, and (3) capturing the context of how sexual minority status and disclosure impact family functioning. HSMY had generally positive feedback regarding these measures; however, they also suggested specific changes associated with wording and specificity of the measures to make them more relevant to HSMY’s unique needs. Full article

Background/Objectives: Time spent in sedentary pursuits is associated with adverse metabolic profiles. Adolescents spend 65–75% of their day in sedentary pursuits; however, evidence among youth is less conclusive. This study examined the effects of an acute 4 h bout of sedentary behaviors on cardiometabolic outcomes and energy expenditure in Hispanic adolescents (12–16 years old) with obesity (BMI% ≥ 95th). Methods: This study used a randomized cross-over design to engage participants (N = 12) in two sedentary conditions, an active condition where youth were engaged in two hours of ‘active’ sitting activities (e.g., reading and puzzles) and two hours of passive movie-watching. Whole-room calorimetry was used to assess energy expenditure. Fasting measures of insulin, adiponectin, leptin, and TNF-alpha were collected, followed by post-prandial measures 30 min, 2 h, and 4 h after a standardized meal. Adiposity was assessed using DXA. Results: There was no overall impact of the 4 h sedentary bout on energy expenditure or cardiometabolic risk factors; however, energy expenditure in the active sedentary condition was higher compared to the passive sedentary condition (p = 0.0635, ß estimate = 0.1538). Sex and adiposity did not moderate the relationships among sedentary time, cardiometabolic outcomes, and energy expenditure. Conclusions: Due to power limitations, these results are exploratory; however, they suggest that different types of sedentary behaviors may be more deleterious than others. More studies are needed to understand the context in which sedentary activities occur and the mechanisms by which sedentary pursuits contribute to the development of cardiometabolic disease. Full article

Previous studies have examined the association between family dysfunction and pubertal timing in adolescent girls. However, the evidence is lacking on the role of family dysfunction during sensitive developmental periods in both boys and girls from racial and ethnic minority groups. This study aimed to determine the effect of family dysfunction on the timing of pubertal maturation among US Hispanic/Latino children and adolescents. Participants were 1466 youths (50% female; ages 8–16 years) from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth). Pubertal maturation was measured using self-administered Pubertal Development Scale (PDS) items for boys and girls. Family dysfunction included measures of single-parent family structure, unhealthy family functioning, low parental closeness, and neglectful parenting style. We used multivariable ordinal logistic and linear regression analyses to examine the associations between family dysfunction and pubertal maturation (individual and cumulative measures), with adjustment for childhood BMI and socioeconomic factors, design effects (strata and clustering), and sample weights. Multivariable models of individual PDS items showed that family dysfunction was negatively associated with growth in height (OR = 0.66, 95% CI: 0.44, 0.99) in girls; no associations were found in boys. In the assessment of cumulative PDS scores, family dysfunction was associated with a lower average pubertal maturation score (b = −0.63, 95% CI: −1.21, −0.05) in boys, while no associations were found in girls. Pubertal timing lies at the intersection of associations between childhood adversity and adult health and warrants further investigation to understand the factors affecting timing and differences across sex and sociocultural background. 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

Background/Objectives: Urinary fluoride (UF) is the most well-established biomarker for fluoride exposure, and understanding its distribution can inform risk assessment for potential adverse systemic health effects. To our knowledge, this study is the first to report distributions of UF among youth according to sociodemographic factors in a nationally representative United States (US) sample. Methods: The study included 1191 children aged 6-11 years and 1217 adolescents aged 12-19 years from the National Health and Nutrition Examination Survey (NHANES) 2015–2016. We examined UF according to sociodemographic variables as well as Spearman correlations between UF and plasma fluoride. Survey-weighted quantile regression examined associations between tap water fluoride and UF levels adjusted for covariates. Results: The average age of participants was 12.5 years. The median (IQR) UF and water fluoride concentrations were 0.52 (0.50) mg/L and 0.39 (0.54) mg/L, respectively. Children had higher UF levels than adolescents and males had higher UF levels than females. UF differed according to race/ethnicity among both children and adolescents. Specifically, non-Hispanic Black youth tended to have higher UF levels than all participants except for those classified as other race/multiracial. UF and plasma fluoride were moderately correlated for children and adolescents. Higher water fluoride levels were associated with higher UF levels, and the magnitudes of association were larger at higher quantiles of UF (β = 0.14, p < 0.001; β = 0.20, p< 0.001 at the 25th and 50th quantiles, respectively). The magnitude of association between water fluoride and UF was the largest for non-Hispanic Black participants (predictive margin = 0.3, p < 0.001). Conclusions: Non-Hispanic Black youth in the US may have greater fluoride exposure and receive more of their fluoride intake from tap water than youth of other races/ethnicities. Factors contributing to potential racial/ethnic disparities in fluoride exposure within the US warrant further investigation so that they can be mitigated to reduce the potential for harm. Full article

Background/Objectives: Suicide in the United States (US) adolescents is a major clinical and public health problem. In this original investigation, we explored trends in suicidal behaviors (ideation, planning, and attempts) among US adolescents from 2011 to 2021. Methods: The study sample included 90,306 adolescents from the 2011–2021 Youth Risk Behavior Surveillance System. Descriptive statistics and the chi-squared test were used to assess differences in suicidal behaviors across gender, race/ethnicity, and grade between 2011 and 2021. Results: The overall percentage of female adolescents reporting suicidal behaviors increased significantly between 2011 and 2021, and it was higher than males. In 2021, females exhibited significantly higher rates of considering suicide (30.0% vs. 14.3%), planning (23.6% vs. 11.6%), and attempts (13.3% vs. 6.6%) compared to their male counterparts. Whites were more likely to report suicidal ideation (22.7%) while Black non-Hispanic youth had a higher likelihood of making a suicide plan (17.7%), attempting suicide (14.5%), or making a suicide attempt requiring medical treatment (4.4%) relative to other racial/ethnic groups. Overall, ninth graders were more likely to report suicide attempts (11.6%) compared to 12th graders (8.6%). Conclusions: The results demonstrate significant increases in suicidal behavior among US adolescents, particularly in females. They suggest the need for gender-sensitive approaches in mental health support and prevention strategies. Overall, given the significant increase in suicidal behaviors, healthcare providers as well as public health professionals should prioritize mental health initiatives, promote awareness, and ensure access to mental health resources for adolescents. Full article