Search Results (145)

Background: Adolescents in Ethiopia, particularly in rural areas, face significant barriers to accessing comprehensive sexual and reproductive health (SRH) services, resulting in poor health outcomes. The youth-friendly health services (YFHS) initiative addresses these challenges by training Health Extension Workers (HEWs) to deliver tailored, age-appropriate care at the primary care level. This study evaluates the cost-effectiveness of YFHS implementation in rural health posts in the Jimma Zone, Ethiopia. Methods: Using an ingredient-based costing approach, costs were analyzed across six health posts, three implementing YFHS and three offering routine services. Health outcomes were modeled using disability-adjusted life years (DALYs) averted, and incremental cost-effectiveness ratios (ICERs) were calculated. Results: Results showed that YFHS reached 9854 adolescents annually at a cost of USD 29,680, compared to 2012.5 adolescents and USD 7519 in control sites. The study showed the ICER of USD 25.50 per DALY averted. The intervention improved health outcomes, including a 27% increase in antenatal care uptake, a 34% rise in contraceptive use, and a 0.065% reduction in abortion-related mortality, averting 52.11 DALYs versus 26.42 in controls. Conclusions: The ICER was USD 25.50 per DALY averted, well below Ethiopia’s GDP per capita, making it highly cost-effective by WHO standards. Scaling YFHS through HEWs offers a transformative, cost-effective strategy to advance adolescent SRH equity and achieve universal health coverage in Ethiopia. Full article

This study presents a systematic review regarding the use of augmented reality and virtual reality in exergaming by analyzing studies published during 2010–2025. This study focuses on providing an overview of the field and on examining and synthesizing the findings of related studies to identify the contexts, applications, and domains in which extended reality exergames are being used and the related implications, benefits, and challenges. Based on the results, augmented reality and virtual reality exergames offer immersive, enjoyable, engaging, and personalized experiences that support physical, cognitive, and emotional well-being, while enhancing physical performance, cognitive functioning, psychological outcomes, and mental health. They promote motivation, active lifestyles, and sustainable health behaviors across diverse populations, including older adults, individuals with disabilities, and neurological groups, as well as the general adult and youth populations. Although emphasis is placed on their use in physical and cognitive rehabilitation and treatment, they also show great potential to be effectively used in different domains, including education. Among the technologies examined, the significant majority of studies focused on virtual reality exergames, a limited number of studies involved augmented reality, and only a few studies examined mixed reality, extended reality, and the metaverse. Finally, nine main topics were identified through topic modeling, providing a clear representation of the core themes within the literature. Full article

Background: Adolescent girls and young women (AGYW) who engage in alcohol and substance abuse face more significant health and social consequences compared to the general population. This study evaluated the prevalence and associated factors of alcohol abuse and substance use among AGYW in Namibia. Methods: We conducted a retrospective analysis of programmatic data from AGYW aged 10–24 who participated in the Determined, Resilient, Empowered AIDS-free, Mentored, and Safe (DREAMS) component of the Reducing HIV Vulnerability: Integrated Child and Youth Health (REACH) Project HOPE Namibia from March to December 2024. Data analysis was conducted employing chi-squared tests alongside binomial and multinomial logistic regression. Results: Among the 19,662 participants included in this analysis, 2068 (10.5%) abused alcohol and/or substances in the previous six months. Participants who were HIV-negative or did not know their status (AOR = 1.57, 95% CI (1.15–2.14), and AOR = 1.50, 95% CI (109–2.07), respectively), from outside Windhoek, those who had failed or repeated school in the previous year (COR = 1.77, 95% CI (1.54–2.05)), those not disabled (AOR = 1.27, 95% CI (1.06–1.52)), those who had dropped out of school or had completed their studies, and those with no adult emotional support (AOR = 1.25, 95% CI (1.11–1.40)), were more likely to have abused alcohol and/or substances recently. In contrast, participants who were not depressed were less likely to have recently abused alcohol and substances. Conclusions: The prioritization of strategies to identify AGYW experiencing depression and to provide them with treatment is essential. Moreover, it is important to encourage parents and guardians to provide emotional support to AGYW, as it prevents them from abusing alcohol and substances. Full article

Background: As national and international reports reveal, significant health care transition (HCT) service disparities exist for youth and young adults with intellectual and developmental disabilities (YYAs with IDD). The development of the HCT model necessitates informed perspectives from a broad constituency, including consumers and families. Parents’ retrospective perspectives of their sons’ or daughters’ HCT experiences are presented to enlarge the understanding of the service need. Methodology: Eleven parents were recruited virtually from parent support/disability advocate groups via an email distribution list of the Children’s Hospital Los Angeles University Center for Excellence in Developmental Disabilities. Parents who consented to participate were interviewed by phone using an interview guide with 11 open-ended items. Three questions focused on the barriers and facilitators associated with the HCT experience are reported. Findings: Four major themes were generated from the analysis of data gathered from parents pertaining to their sons’ or daughters’ health care transition experiences, focusing on the transfer of care. Two major themes were related to HCT barriers—Pediatric Care Contrasted with Adult-Focused Care and Transfer of Care Barriers—and two were related to HCT facilitators—Transfer of Care Facilitators and Transfer of Care Recommendations. Each of the major themes included subthemes. Conclusions: Parents openly shared their sons’ or daughters’ HCT experiences, which illuminated the scope of their challenges and the assistance received. These insights provide rich descriptions of the barriers they and their adult children faced as they proceeded with navigating new systems of health care. The reported data find support in other previously conducted studies. Full article

Background/Objectives: Physical activity is generally recommended, but youth with disabilities present increased sedentary behaviors. This is often due to limited or inaccessible exercise options. The aim of this systematic review was to report on the state of knowledge about the role of adapted physical activity (APA) in improving gross motor performance (query 1), participation and QoL (query 2) of children and adolescents with neurological motor disability. Methods: Pubmed, Scopus and Cinahl databases were enquired in October 2023 and updated in May 2025. Inclusion criteria were the following: any type of physical activity; pediatric subjects with any neuromotor disease; and any type of outcome measure regarding gross motor performance, participation or QoL. The risk of bias (RoB) was assessed by means of ROB 2, Robins-I and JBI tools. Results were synthetized focusing on the outcome measures and the type of activity proposed. Results: Thirteen and seven studies were included relative to queries 1 and 2, respectively. They all were RCTs, and some presented randomization RoB. Several types of APA (e.g., resistance, high-intensity circuit, running, cycling, aquatic and dance training) and of outcome measures were enquired, mostly focusing on subjects with cerebral palsy or Down syndrome. An increased time of moderate-to-vigorous physical activity, improvement in timed functional tests, muscle strength and stability were observed. Conclusions: APA may improve functioning, social participation and promote active lifestyle in pediatric persons with neuromotor disabilities, without adverse effects. In the future, more specific indications based on the functioning profile are advisable to orient professionals to define individualized safe training programs. Full article

Individuals with CHARGE syndrome often experience motor delays impacting their balance, flexibility, and hand–eye coordination. Due to the medical complications associated with CHARGE syndrome, 40% of children will not develop functional communication skills and many more will have difficulty with speech and oral communication. Family caregivers play a critical role in the care of children and youths with disabilities, especially CHARGE syndrome. However, there is minimal research on the parental experiences of children and youth with CHARGE syndrome. The purpose of this study was to understand the family caregiver experiences and needs of parents of children and youth with CHARGE syndrome and related disabilities. Six family caregivers of children and youth living with CHARGE syndrome in the United States were interviewed to understand their current quality of life, factors influencing their quality of life, and the coping strategies they use. The interviews were transcribed verbatim and then analyzed using qualitative content analysis. The themes generated from the qualitative analyses of interviews showed that family caregivers experienced significant challenges in their quality of life and faced barriers as they navigated a complex system of care. However, family caregivers described robust approaches such as social support for coping with some of the stresses. Full article

Background/Objectives: Constraint-induced movement therapy (CIMT) and bimanual training (BIT) have been commonly used to improve upper limb (ULF) in paediatric populations. This study aimed to compare the efficacy of CIMT and BIT for the recovery of ULF in youth with unilateral cerebral palsy (CP) in the immediate, short, and long term. Methods: A systematic review with a meta-analysis of randomised controlled trials (RCTs) from the PubMed/Medline, Scopus, Web of Science, and PEDro databases was conducted. The primary outcomes were the immediate, short-, and long-term effects on ULF, and the secondary outcomes were related to occupational performance and disability. The risk of bias was assessed using the Cochrane RoB 2.0 tool by two researchers independently. Meta-analyses were performed using RevMan 5.3. Results: From the 174 records obtained, 10 RTCs comprising 418 participants were included. Favourable results were observed immediately after intervention for CIMT regarding unimanual ULF using the Quality of Upper Extremity Test (QUEST) (SMD = 1.08; 95% CI = (0.66;1.50)) and Jebsen–Taylor Hand Function Test (JTHFT) (SMD = −0.62; 95% CI = (−1.23;0.00)). These results were maintained in the short term for the QUEST for dissociated movements (SMD = 1.19; 95% CI = (0.40;1.99)) and in the long term for the JTHFT (SMD = −0.38; 95% CI = (−1;0.24)). Conversely, favourable results were obtained immediately after the intervention for BIT regarding bimanual ULF using the Assisting Hand Assessment (SMD = −0.42; 95% CI = (−0.78–0.05)). Conclusions: CIMT could be more effective for improving unimanual ULF and BIT in youth with unilateral CP. The differences between the interventions decreased in the long term. Nevertheless, these findings should be interpreted with caution due to the variability in the intervention programmes. Further research with standardised protocols is needed. Full article

Background/Objectives: Children at Gross Motor Function Classification System (GMFCS) levels IV and V experience severe motor impairments, yet the effects of passive wheelchair rides on their physiological parameters remain unexplored. This study aimed to examine the acute physiological response to passive bike in non-ambulant children with physical disabilities. Methods: This quasi-experimental study included 24 non-ambulant participants with cognitive impairments (6–21 years old, 50% female). After a 10-min rest, participants underwent a 10-min passive wheelchair bike. Muscle activity, oxygen consumption, and heart rate variability were assessed. Results: Passive bike rides significantly increased muscle activity in the right upper (p = 0.050), left upper (p = 0.008), and left lower trapezius (p = 0.038), with increases of 97–112%. However, no significant changes were observed in oxygen consumption or cardiorespiratory parameters. Conclusions: This study suggests that passive wheelchair bike rides increase trapezius muscle activity in children with severe disabilities at GMFCS levels IV and V, offering potential benefits for this population. Full article

Youth sport has been recognized as a unique learning context for positive youth development (PYD); yet, as society’s critical consciousness continues to progress, limitations of PYD have been acknowledged. Thus, youth sport scholars have begun to embrace critical perspectives to interrogate the systems and institutions of sport and society that influence the healthy development of all youth. This has included researchers and practitioners alike, adopting critical PYD (CPYD) as a means to empower young people to question and challenge their histo-contemporary experiences and support collective action towards social change. Our article explores the concept of CPYD and social justice life skills within ‘non-traditional’ sport spaces, including practice examples from the fields of youth disability sport and sport in youth justice. The first practice example provides an in-depth discussion of the theoretical principles of CPYD and their applicability within youth disability sport. The second practice example outlines the practical use of social justice life skills in sport programs within the youth justice system. Together, the practice examples from the field highlight both the theoretical and practical applications of CPYD and social justice life skills within real-world settings, and valuable implications are identified for research and practice moving forward. Full article

Background/Objective: Children with disabilities experience greater participation restrictions in life activities than children without disabilities. This study aimed to explore differences in participation of children/youth with and without cerebral palsy (CP) across home, school, and community settings, and examine participation of children with CP across gross motor function levels, age groups, gender, and income levels. Methods: This was a cross-sectional survey study of parents of children with CP (n = 20) and without CP (n = 20) over a three-month period to investigate the frequency of participation/level of involvement across settings. Participation was assessed using the Participation and Environment Measure for Children and Youth© (PEM-CY), a parent-report measure for children and youth, ages 5 to 17 that explores communication in home, school, and community environments. Results: Significantly greater frequency of participation at home and in the community was found in children without CP. Participation at school was not significantly different between the groups and there were no differences in level of involvement, gender, or income. In children with CP, motor function impacted participation in home and school, and age significantly influenced school participation. Conclusions: Participation in life activities is important for overall child development, health, and well-being; however, children with CP participate less than their typically developing peers. The ability to collect and analyze the frequency of participation and level of involvement across home, school, and community environments using one outcome measure provides valuable information for programming, intervention planning, and potential environment modifications that could improve participation in children with CP. Full article

An “employment ecosystem” approach acknowledges that factors affecting employment are never the result of one singular factor but are the product of multiple, intersecting, and mutually reinforcing factors at the individual level (personal attributes and immediate circumstances), relationships and wider community, the workplace, and the wider macro-level (societal and structural factors, such as legislation, government policies, and macro-economic trends). Originally conceptualised within the context of employment for people with disabilities, the employment ecosystem approach provides an ecological perspective that can be used to understand the ingredients of inclusive employment more generally. This entry applies an employment ecosystem analytical lens to explore and identify enablers and barriers to youth employment in the Australian context, based on reviews of published research and reports of initiatives and programs targeting youth employment. Findings include the need to recognise the centrality of support from broader community resources, including family and community-based support, employers and co-workers, policy, and legislation. It provides evidence-based insights for practitioners and researchers interested in the development and implementation of inclusive employment practices. Full article

Despite growing concern, there is limited comprehensive and up-to-date research on the burden, disparities, and inequalities of depressive disorders in the Western Pacific region. We obtained data from the Global Burden of Disease Study (GBD; 2021) for the Western Pacific region. We reported the prevalence and disability-adjusted life years (DALYs) rates of depressive disorders from 1990 to 2021. Our results showed that the prevalence of depressive disorders in the Western Pacific region was 1723.1 per 100,000 people (95% UI: 1359.2–2164.9), contributing to 1057.3 DALYs per 100,000 (95% UI: 683.0–1551.8). From 1990 to 2021, the burden of depressive disorders initially decreased but then increased, with Japan, Malaysia, and South Korea seeing the most significant rise. The burden grew with age, especially in the 10–14 age group, and exhibited significant sex disparities, especially in this age group. Among 31 countries, those with higher UHC scored had higher prevalence rates, but the gap between high- and low-UHC countries has decreased over time, indicating that countries with lower UHC might face greater challenges in the future. Our results highlight the differences in burden by sex and age call for targeted policies and interventions to promote youth mental health. Accelerating universal health coverage could be a key strategy to further reduce this high burden. Full article

Although Zimbabwe has made significant progress regarding the development of a policy framework that caters to the needs of people with disabilities through various pieces of legislation, such as the Disabled Peoples Act (DPA), ratifying the Convention on the Rights of Persons with Disabilities (CRPD) and adopting a new Constitution which has provisions for disability rights, people with disabilities in Zimbabwe are yet to benefit from these policies, as they are not fully implemented. Focus group discussions and semi-structured interviews were conducted with 20 youth aged between 18 and 35 with disabilities, and 5 key informants in Gweru, to analyze their perceptions regarding the disability policy framework in Zimbabwe. Most of the youth with disabilities lacked knowledge on the various policies regarding disabilities. This was attributed to poor implementation of such policies and a general negative attitude of society towards disability rights. Youth with disabilities are not fully benefiting from the current disability policies due to a lack of knowledge and some implementation gaps. The participants suggested full implementation of such policies and involvement of youth with disabilities in policy formulation and implementation. Full article

While male youths with mild intellectual disabilities (MIDs) display similar sexual development as their peers without MIDs, they experience higher rates of sexual and dating violence (SDV) and sexual risk behavior. Yet, little is known about effective gender-specific prevention for this population. Therefore, we conducted a cluster-randomized controlled trial of a Dutch group-counseling program promoting psychosexual health and preventing SDV among male youths with MIDs aged 14–21 years—Make a Move+. The 120 participating male youths completed three questionnaires (baseline, post-test, 3-month follow-up; 77.5% retention). A subsample of 14 male youths and 5 trainers were interviewed pre- and post-program. With these multi-method, multi-informant data, we evaluated the program’s effectiveness on the six intended outcomes (attitudes (primary outcome), global self-esteem, skills, knowledge, SDV use and victimization, and sexual risk behavior) by (1) statistically comparing the self-reports of the intervention and control groups and (2) thematically analyzing interview data. We found limitations in the program’s integrity, and mixed evidence for the program’s effectiveness on attitudes, knowledge, skills, SDV use, and sexual risk behavior, and no evidence for effectiveness on global self-esteem or SDV victimization. We also found indications of adverse effects on SDV use and victimization. We offer suggestions for program refinement and future program evaluations. Full article

Sports participation among young people with disabilities offers significant physical, psychological, and social benefits, yet participation rates remain lower than among their non-disabled peers. This study, conducted in Hungary, explores how value orientations, health perceptions, and disability characteristics interact to shape sports engagement. Using a cluster analysis approach, we identified three distinct groups based on how young individuals with disabilities prioritize various life aspects. Data were collected through a survey of 771 participants aged 8–18, including individuals with diverse disability types. K-means clustering revealed three profiles: (1) a low sports activity group with moderate health consciousness, (2) a health-conscious group with broad life engagement but lower sports participation, and (3) a sports-oriented group that demonstrated strong interest in sports despite reporting lower self-rated health. The findings suggest that personal value orientation is a stronger predictor of sports participation than disability type or perceived health status. Furthermore, access to sports facilities alone does not guarantee participation, emphasizing the need for motivational and psychological interventions. These results highlight the importance of tailored, value-driven strategies in promoting physical activity among young people with disabilities, shifting focus from disability-specific adaptations to broader engagement-based approaches. Full article