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During the corona pandemic, youths were confronted with substantial challenges and in urgent need of information on how to prevent mental health problems. This experimental pre-post-follow-up study examined the efficacy and reception of an innovative website (www.corona-und-du.info) containing evidence-based information for youths on how to overcome psychological distress during the pandemic. 34 youths aged 11–18 years were presented domains of the website in the laboratory. Standardized questionnaires were applied to assess changes in knowledge, the reception of the website, and changes in behavioral intention to seek psychological help. For all content domains, we found a significant knowledge gain with large effect sizes from pre to post, and from pre to follow-up. The reception of the website was very positive, and participants indicated increased intention to seek psychological support when needed. The results constitute an important basis for future attempts to promote mental health information in youths in times of crisis. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are serious, deadly disorders that emerge in adolescence and early adulthood. Further, reported incidences of EDs are increasing worldwide. As such, accessible, affordable, and effective early intervention and prevention efforts are critical. The Body Project is a well-established ED prevention program with demonstrated success at reducing ED symptom severity and the risk of onset of EDs in young females. However, it has not yet been formally evaluated in an Australian population, nor have the benefits of the treatment for young people of all genders been thoroughly investigated. This protocol paper outlines the design for a study which aims to investigate the outcomes and feasibility of the Body Project as a brief ED prevention program within an Australian youth mental health service: headspace Camperdown. This pragmatic trial will compare outcomes between a Body Project treatment group and a Treatment-as-usual control group. Primary outcomes include body image concerns, ED symptomatology and general psychological distress, measured pre- and post-treatment, and at one-month follow-up. All young people attending headspace Camperdown for care are eligible for participation in the trial. The Body Project program is comprised of four group-based 1.5 h sessions run over 4 consecutive weeks. Overall, a trial of the Body Project as an ED prevention program is warranted to investigate the outcomes of the intervention in this sample and will provide valuable information about the feasibility for widespread implementation of the treatment as part of a stepped-care approach to intervention for EDs at youth mental health service locations across Australia. ANZCTR Trial Registration Number: ACTRN12623000695606 (registered 29 June 2023). [ABSTRACT FROM AUTHOR]

Background: As mental health in adulthood is related to mental status during adolescence, school-based interventions have been proposed to improve resilience. The objective of this study was to build a simulation model representing the natural history of mental disorders in childhood, adolescence and youth to estimate the cost-effectiveness of the UPRIGHT school-based intervention in promoting resilience and mental health in adolescence. Methods: We built a discrete event simulation model fed with real-world data (cumulative incidence disaggregated into eight clusters) from the Basque Health Service database (609,381 individuals) to calculate utilities (quality-adjusted life years [QALYs]) and costs for the general population in two scenarios (base case and intervention). The model translated changes in the wellbeing of adolescents into different risks of mental illnesses for a time horizon of 30 years. Results: The number of cases of anxiety was estimated to fall by 5,125 or 9,592 and those of depression by 1,269 and 2,165 if the effect of the intervention lasted 2 or 5 years respectively. From a healthcare system perspective, the intervention was cost-effective for all cases considered with incremental cost-utility ratios always lower than €10,000/QALY and dominant for some subgroups. The intervention was always dominant when including indirect and non-medical costs (societal perspective). Conclusions: Although the primary analysis of the trial did not did not detect significant differences, the UPRIGHT intervention promoting positive mental health was dominant in the economic evaluation from the societal perspective. Promoting resilience was more cost-effective in the most deprived group. Despite a lack of information about the spillover effect in some sectors, the economic evaluation framework developed principally for pharmacoeconomics can be applied to interventions to promote resilience in adolescents. As prevention of mental health disorders is even more necessary in the post-coronavirus disease-19 era, such evaluation is essential to assess whether investment in mental health promotion would be good value for money by avoiding costs for healthcare providers and other stakeholders. [ABSTRACT FROM AUTHOR]

Actively engaging adolescents in meaningful program evaluation is a topic of growing interest. One possibility for such engagement is the use of photographs as part of visual evaluation, so that youth can directly engage with the research process. In this Method Note, we describe the development and implementation of a participatory, photo-based evaluation method for youth health promotion/prevention programs. Youth in this study were participants in a gender-transformative healthy relationships program for boys. We present literature supporting the use of photographs as a visual research method and for involving youth as active participants in evaluation, and explore the feasibility, utility, and acceptability of this innovative application of existing methods based on researcher experience and youth feedback. We conclude with implications for photo-based evaluation of health promotion/prevention programs, highlighting the promise of this method for promoting critical youth engagement in evaluation and the creation of meaningful knowledge translation tools. [ABSTRACT FROM AUTHOR]

Background: Age is a critical factor in substance use and related outcomes, with adolescence being a particularly sensitive period. Early initiation of substance use has been linked with higher risk for developing substance use disorders. In Ontario, Canada, substance use is common among youth, yet treatment is underutilized, suggesting the potential for an unmet need in terms of substance use care. Despite these challenges, there is limited research examining factors that contribute to youth substance use and youth-specific barriers to substance use care. To fill this knowledge gap, this study sought to include the unique perspectives of service providers who work directly with youth to examine these issues.Methods: We used a cross-sectional mixed-methods design to examine factors that contribute to substance use among youth and identify youth-specific barriers to substance use among a sample of 54 Ontario-based youth service providers. Data collection included an online survey completed by all study participants followed by qualitative interviews of a subsample of 16 participants. Data analysis included basic frequency tabulations for survey results and thematic qualitative analyses to identify common themes.Results: Licit substances were identified as the most commonly used among youth, where 94% of respondents identified cannabis use and 81% identified alcohol use. Thematic analyses identified the role of dominant substance use discourses in normalizing certain substances (i.e., cannabis and alcohol) while also endorsing stigmatizing beliefs and sentiments. According to youth service providers, the intersection of these two discourses simultaneously lead to an increase in substance use while deterring youth from seeking substance use care.Conclusions: Normalization and stigmatization are two dominant discourses around youth substance use, with important implications for public health interventions. Key public health strategies, as identified by participants, to reduce the overall negative effect of these factors include the need to reframe substance use discourse, from a moral failing to a public health issue and to educate youth about the impacts of use. To accomplish this goal educational campaigns to raise awareness around the health effects of use and address stigmatization are needed. Educational reforms are also needed to ensure that these programs are integrated into the school system. [ABSTRACT FROM AUTHOR]

Despite growing evidence and support for co-locating behavioral services in primary care to prevent risky health behaviors, implementation of these services has been limited due to a lack of reimbursement for services and negative perceptions among providers. We investigated potential to overcome these barriers based on new developments in healthcare funding and screening and referral to prevention (SRP) in primary care based on the Consolidated Framework for Implementation Research (CFIR), which could guide future SRP implementation strategies. To investigate the economic need for healthcare-based SRP, we quantified hospital charges to healthcare payors for services arising from adolescent risky behaviors (e.g., substance use, risky sex). Annual North Carolina (NC) hospital charges for these services exceeded $327 M (2019 dollars), suggesting high potential for cost savings if SRP can curb hospital services associated with risky behaviors. To investigate provider barriers and facilitators, we surveyed 151 NC pediatricians and 230 NC family therapists about their attitudes regarding a recently developed well-child visit SRP with family-based prevention. Both sets of professionals reported widespread need for and interest in the SRP but cited barriers of lack of reimbursement, training, and referrals to/from each other. Physicians, but not family therapists, reported concerns with poor patient or parent compliance. Many barriers could be resolved by co-locating family therapists in pediatric clinics to conduct well-child SRP. Our results support further research to develop business models for payor-funded SRP and CFIR-guided research to develop implementation strategies for primary care SRP to prevent adolescent risky health behaviors. [ABSTRACT FROM AUTHOR]

There are few psychosocial support programs specifically designed to meet the unique developmental and health needs of LGBTQ youth. Even when available, many youth face significant barriers to accessing LGBTQ-specific services for fear of being "outed" to parents, peers, and community members. The current study assessed the utility, feasibility, and acceptability of a synchronous, adult-facilitated, chat-based Internet community support program for LGBTQ youth aged 13–19. Chat transcripts were analyzed to examine how LGBTQ youth used the chat-based platform to connect with peers and trusted adults. A separate user satisfaction survey was collected to assess the personal (e.g., sexual orientation, gender identity, age) and contextual (e.g., geography, family environment) characteristics of youth engaging in the platform, their preferred topics of discussion, and their satisfaction with the program focus and facilitators. Qualitative data analysis demonstrated the degree to which LGBTQ youth were comfortable disclosing difficult and challenging situations with family, friends, and in their community and in seeking support from peers and facilitators online. Youth also used the platform to explore facets of sexual and gender identity/expression and self-acceptance. Overall, users were very satisfied with the platform, and participants accurately reflect the program's desired populations for engagement (e.g., LGBTQ youth of color, LGBTQ youth in the South). Together, findings support the feasibility and acceptability of synchronous, adult-facilitated, chat-based Internet programs to connect and support LGBTQ youth, which encourage future research and innovation in service delivery. [ABSTRACT FROM AUTHOR]

Background: Most mental health issues develop during adolescence, therefore identifying youth mental health needs and pathways to care is critical to improve prevention. To date, studies have typically focused on Western samples, while the impact of cultural diversity on perception of health and illness, and pathways to care, remain poorly understood. To address the shortage of studies conducted in the Arab world, and particularly in the United Arab Emirates (UAE), the present investigation aims to identify the characteristics of youth accessing mental health services in Dubai. Methods: Data was collected retrospectively from patients' records at Rashid Hospital Child Psychiatry Service. Information collected included demographics, life stressors, symptoms duration, main diagnosis, and presence/absence of psychotic features in patients' symptomatology. The relationship between demographic and clinical variables was explored using Chi-square tests and negative binomial regression models. Results: The sample included 99 treatment-seeking young patients (mean age 15.3; SD = 1.7); 47.5 % were Emirati (UAE national) and 52.5 % were non-Emirati patients. In our treatment-seeking youth sample Depressive disorders represented the most frequent diagnosis, followed by Bipolar and related disorders, Anxiety and stress related disorders, and Schizophrenia and psychotic disorders. Compared to Emirati patients, non-Emirati patients were more likely to report relationships with friends as a source of stress. Female help-seekers, compared to males, were more likely to report stressful relationships with family members, and to receive a diagnosis of Depressive disorders. The duration of symptoms before seeking help was significantly predicted by family stress, gender, self-harm behavior, a symptomatology with psychotic features, and a diagnosis of Anxiety disorders. Conclusions: The present study contributes to characterizing youth accessing mental health services at Rashid Hospital's Child Psychiatry service in Dubai. An overall prevalence of poor family functioning among help-seeking youth, and the importance of peer support for expatriate youth were highlighted. Gender differences in perceived stressors, diagnoses and help-seeking behavior suggest the need to promote help-seeking among young boys. While presentation with psychotic features seems to lead to quicker access to medical care, self-harm and anxiety appear to delay help-seeking. The potential implications of our results for promoting youth wellbeing in the region are discussed. [ABSTRACT FROM AUTHOR]

Using a social determinants of health framework, we argue that the majority of evidence-based interventions focused on child and adolescent mental health are limited by their focus on individual youth (and sometimes families). While necessary, these interventions are insufficient for addressing the midstream- and upstream/macro-level determinants of mental health in society. We illustrate our perspective through four examples from youth mental health and related services, in which midstream and upstream interventions—i.e., at the community and public policy levels—need to be prioritized along with downstream treatments to improve population mental health and reduce social inequalities in mental health outcomes. [ABSTRACT FROM AUTHOR]

Little is known regarding the specific types of service models and collaborations that are necessary to support diverse populations of youth in transition out of homelessness. Transitional supports addressing the complex needs of this population are needed to stabilize the array of housing arrangements that youth access. This study was a pilot randomized controlled trial of one such critical time intervention, called the Housing Outreach Program-Collaboration (HOP-C). HOP-C is a multicomponent, multidisciplinary intervention that provides 6 months of mental health and peer support, along with transitional case management to youth who have transitioned into some form of stable housing out of homelessness. In this trial, 65 youth were randomized to receive HOP-C plus treatment as usual or transitional case management plus treatment as usual. Outcome assessments were completed by 30 treatment and 28 control participants. The findings suggest that this intervention is feasible with mental health, employment or education, and housing metrics favoring HOP-C with odds ratios ranging from 2.28 to 3.18 and better subjective housing stability. Other indicators showed less change. HOP-C appears feasible and should be tested in a fully powered trial, providing the intervention for a duration longer than 6 months. Overall, these data suggest the potential benefit in fostering city-level, multidisciplinary teams sourced from several organizations to support youth transitioning out of homelessness. Pragmatic trial method considerations for this population are also addressed as are the ethical considerations pertinent to engaging highly marginalized youth in clinical trials. (PsycInfo Database Record (c) 2020 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

The emergence of information and communication technologies (ICT) has generated a number of research questions, related to their use and potential risk, but also potentials for prevention or health promotion. Online social networks have become an important source of information for users as well as a tool for social relations. As traditional social networks, they can act as vehicles to improve the health of adolescents and youth, as well as play a key role in an educational context. The aim of this work is then to explore the theoretical relevance of ICT, particularly on online social networks, on disease prevention and health promotion of communicable diseases. Literature review points out the role of online social networks, particularly in the field of sexual health, body image, especially eating habits and overweight, as well as smoking and alcohol dependence. Data allow us to understand how online social network behavior and interaction is related to their burden and interventions developed in sexual health and addiction show positive results. More efforts in body image are needed in order to use these tools for prevention and promotion of health from early age. [ABSTRACT FROM AUTHOR]

Background: Similar to other health care sectors, mental health has moved towards the secondary prevention, with the effort to detect and treat mental disorders as early as possible. However, converging evidence sheds new light on the potential of primary preventive and promotion strategies for mental health of young people. We aimed to reappraise such evidence. Methods: We reviewed the current state of knowledge on delivering promotion and preventive interventions addressing youth mental health. Results: Half of all mental disorders start by 14 years and are usually preceded by non-specific psychosocial disturbances potentially evolving in any major mental disorder and accounting for 45% of the global burden of disease across the 0–25 age span. While some action has been taken to promote the implementation of services dedicated to young people, mental health needs during this critical period are still largely unmet. This urges redesigning preventive strategies in a youth-focused multidisciplinary and trans-diagnostic framework which might early modify possible psychopathological trajectories. Conclusions: Evidence suggests that it would be unrealistic to consider promotion and prevention in mental health responsibility of mental health professionals alone. Integrated and multidisciplinary services are needed to increase the range of possible interventions and limit the risk of poor long-term outcome, with also potential benefits in terms of healthcare system costs. However, mental health professionals have the scientific, ethical, and moral responsibility to indicate the direction to all social, political, and other health care bodies involved in the process of meeting mental health needs during youth years. [ABSTRACT FROM AUTHOR]

Young adults with a history of foster care have higher risk for substance use disorders. Social systems can deliver substance use prevention to youth; however, the timing of intervention delivery and how needs differ for youth in foster care are unclear. To compare initiation and rates of substance use among adolescents in foster care to demographically similar adolescents never in foster care as identified by the healthcare system, and identify factors associated with increased substance use. Youth in foster care (n = 2787, ages 10–20, inclusive) and demographically matched youth never in foster care (n = 2787) were identified using linked child welfare and electronic health records from a single pediatric children's hospital and county over a five-year period (2012–2017). All healthcare encounters were reviewed and coded for substance use by type (alcohol, tobacco, cannabis, other). Age of first reported or documented substance use was also captured. Demographic and child welfare information was extracted from administrative records. Survival and logistic regression models were estimated. In adjusted models, youth in foster care initiated substance use at earlier ages (HR = 2.50, p <.01) and had higher odds of engaging in use (AOR = 1.54; p <.01) than youth never in care. By age 12, substance use initiation was more likely while youth were in foster care than when they were not in foster care (HR = 1.42, p <.01). Placement stability and family care settings reduced odds of lifetime substance use. Foster care placement is associated with substance use. Screening may be important for prevention. • Foster youth disclose past and current substance use to healthcare providers. • Foster youth initiate substance use by age 12 more frequently than non-foster youth. • Providers detect more substance use and use of multiple substances for foster youth. • Healthcare providers could deliver substance use prevention to youth in foster care. [ABSTRACT FROM AUTHOR]

The objectives of this systematic review were to: 1) identify evidence-based youth (i.e., infancy, pre-school age, school age, and adolescence) mental and behavioral health disorder preventive interventions conducted in or offered by primary care settings, and 2) describe these interventions' characteristics, efficacy, and clinical involvement. Randomized controlled trials that targeted the prevention of mental or behavioral health outcomes for youth and had a connection to primary care were included. The PRISMA guidelines were utilized for two phases: 1) searching PubMed, EMBASE, PsycInfo, CINAHL, and Cochrane databases in January 2017; and 2) searching United States Preventive Services Task Force (USPSTF) Systematic Reviews in November 2017. The two phases revealed 504 and 58 potential articles, respectively. After removal of duplicates, screening of abstracts, and full-text reviews, 19 interventions (infancy: n = 2, pre-school age: n = 3, school age: n = 6, adolescence: n = 8) were included: 1) 10 interventions described in 17 articles from the databases, and 2) 9 interventions described in 11 articles from the USPSTF reviews. The included interventions capitalized on primary care settings as a natural entry point to engage youth and families into interventions without requiring a large amount of clinic involvement. Commonalities of efficacious interventions and recommendations for future research are discussed. The authors encourage primary care providers, mental and behavioral health providers, and/or public health researchers to continue developing and testing preventive interventions, or adapting existing interventions, to be implemented in primary care. [ABSTRACT FROM AUTHOR]

Educational institutions have been identified as ideal locations to implement health promotion strategies that aim to prevent and treat youth obesity. However, the tertiary training of future health promoters currently lacks health and nutrition instruction. This study sought to investigate attitudes towards youth obesity and perceptions of the roles of schools and educators in strategies to treat and prevent youth obesity. Participants (n = 155) were tertiary students who enrolled in a general-level health and nutrition elective that housed an intervention to increase awareness of obesity. Baseline and post-intervention responses to the Perceptions of Youth Obesity and Health Education questionnaire were collected and compared spanning the 12 weeks. Agreement that health is linked to being of normal weight and that general educators should have a major role in school strategies did not waver over the course of the intervention. The belief that schools are ideal places for obesity prevention strategies was higher at baseline than post-intervention. It was desired that obesity awareness would increase but perceived importance of involvement of school staff in youth obesity strategies did not increase. Further research is required to investigate the influence of attitudes and perceptions held by future health promoters towards their roles in prevention and treatment strategies on professional practice. [ABSTRACT FROM AUTHOR]

Background: Young people who engage in substance use are at risk for becoming infected with HIV and diseases with similar transmission dynamics. Effective disease prevention programs delivered by prevention specialists exist but are rarely provided in systems of care due to staffing/resource constraints and operational barriers-and are thus of limited reach. Web-based prevention interventions could possibly offer an effective alternative to prevention specialist-delivered interventions and may enable widespread, cost-effective access to evidence-based prevention programming. Previous research has shown the HIV/disease prevention program within the Web-based therapeutic education system (TES) to be an effective adjunct to a prevention specialist-delivered intervention. The present study was the first randomized, clinical trial to evaluate the comparative effectiveness of this Web-based intervention as a standalone intervention relative to a traditional, prevention specialist-delivered intervention.Methods: Adolescents entering outpatient treatment for substance use participated in this multi-site trial. Participants were randomly assigned to either a traditional intervention delivered by a prevention specialist (n=72) or the Web-delivered TES intervention (n=69). Intervention effectiveness was assessed by evaluating changes in participants' knowledge about HIV, hepatitis, and sexually transmitted infections, intentions to engage in safer sex, sex-related risk behavior, self-efficacy to use condoms, and condom use skills.Findings: Participants in the TES intervention achieved significant and comparable increases in HIV/disease-related knowledge, condom use self-efficacy, and condom use skills and comparable decreases in HIV risk behavior relative to participants who received the intervention delivered by a prevention specialist. Participants rated TES as easier to understand.Conclusion: This study indicates that TES is as effective as HIV/disease prevention delivered by a prevention specialist. Because technology-based interventions such as TES have high fidelity, are inexpensive and scalable, and can be implemented in a wide variety of settings, they have the potential to greatly increase access to effective prevention programming. [ABSTRACT FROM AUTHOR]

Many interventions seeking to reduce problem behaviors and promote healthy youth development target both risk and protective factors, yet few studies have examined the effect of preventive interventions on overall levels of protection community wide. In a community-randomized controlled trial, this study tested the effect of Communities That Care (CTC) on protective factors in 24 communities across seven states. Data on protective factors were collected from a panel of 4407 youths in CTC and control communities followed from grade 5 through grade 8. Hierarchical linear modeling compared mean levels of 15 protective factors derived from the social development model in CTC and control communities in grade 8, adjusted for individual and community characteristics and baseline levels of protective factors in grade 5. Global test statistics were calculated to examine effects on protection overall and by domain. Analyses across all protective factors found significantly higher levels of overall protection in CTC compared to control communities. Analyses by domain found significantly higher levels of protection in CTC than control communities in the community, school, and peer/individual domains, but not in the family domain. Significantly higher levels of opportunities for prosocial involvement in the community, recognition for prosocial involvement in school, interaction with prosocial peers, and social skills among CTC compared to control youth contributed to the overall and domain-specific results. This is consistent with CTC's theory of change, which posits that strengthening protective factors is a mechanism through which CTC prevents behavior problems. [ABSTRACT FROM AUTHOR]

Introduction: Sufficient first aid equipment is essential to treat injuries on football fields. Deficits in first aid on field are still present in youth football. Methods: Injury pattern in youth football over one season and first aid equipment in youth football were analyzed, retrospectively. PRICE and ABC procedure served as basic principles in emergency management to assess the need for first aid equipment on field. Considering financial limits and adapted on youth football injuries, sufficient first aid equipment for youth football was configured. Results: 84 % of 73 participating youth football teams had their own first aid kit, but the majority of them were insufficiently equipped. Team coaches were in 60 % of all youth teams responsible for using first aid equipment. The injury evaluation presented 922 injuries to 1,778 youth players over one season. Frequently presented types of injury were contusions and sprains of the lower extremity. Based on the analyzed injury data in youth football, first aid equipment with 90 € is sufficient for 100 % of all occurred youth football injuries. Conclusion: Current first aid equipment in youth football is insufficient. Scientific-based first aid equipment with 90 € is adequate to serve all injuries. Football coaches need education in first aid management. [ABSTRACT FROM AUTHOR]

Abstract: This study examined the longitudinal effects of out-of-school time (OST) activities on youth weight-status through mid-to-late adolescence. First, using pattern-centered methods, we identified the prominent ways in which youth allocate their OST across 12 common active and sedentary activities available to them. Second, through multi-level modeling procedures we examined the relation of OST activity patterns to: 1) BMI-status during the 11th grade, and; 2) within-person change in BMI-status across the adolescent years. After accounting for race, gender, SES, pubertal-status, and gaming, youth who participated in a sports-dominant activity pattern for 2 or more years had significantly lower 11th grade odds of being at-risk for overweight/obesity compared to youth in all other activity patterns. Youth of all other activity patterns had similar odds of being at-risk as Low-Activity youth and each other. Understanding the relations of OST to youth healthy weight is a critical first step in developing healthy OST settings. [Copyright &y& Elsevier]

Healthcare payment reform has not produced incentives for investing in place-based, or population-level, upstream preventive interventions. This article uses economic modeling to estimate the long-term benefits to different sectors associated with improvements in population health indicators in childhood. This information can motivate policymakers to invest in prevention and provide guidance for cross-sector contracting to align incentives for implementing place-based preventive interventions. A benefit-cost model developed by the Washington State Institute for Public Policy was used to estimate total and sector-specific benefits expected from improvements to nine different population health indicators at ages 17 and 18. The magnitudes of improvement used in the model were comparable to those that could be achieved by high-quality implementation of evidence-based population-level preventive interventions. Benefits accruing throughout the lifecycle and over a ten-year time horizon were modelled. Intervention effect sizes of 0.10 and 0.20 demonstrated substantial long-term benefits for eight of the nine outcomes measured. At an effect size of 0.10, the median lifecycle benefit per participant across the ten indicators was $3080 (ranged: $93 to $14,220). The median over a 10-year time horizon was $242 (range: $14 to $1357). Benefits at effect sizes of 0.20 were approximately double. Policymakers may be able to build will for additional investment based on these cross-sector returns and communities may be able to capture these cross-sector benefits through contracting to better align incentives for implementing and sustaining place-based preventive interventions. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of lamb consumption (Protected Geographical Indication (PGI), Ternasco de Aragón) on health indicators including body composition and cardiovascular risk indicators of healthy young Spanish students living in the area of Aragón, Spain. Methodology: A randomized-controlled and cross-over trial (two periods of 8 weeks duration) assessing changes on body composition (body mass index and skinfold thicknesses) and cardiovascular risk indicators of 50 participants randomly assigned to follow a normocaloric diet with lamb (Ternasco de Aragón) or chicken. Body composition and serum cardiovascular risk profiles were measured both at baseline and follow-up. Results: Healthy men (n = 22) and women (n = 28), aged 19.43 ± 0.85 years were studied. Suprailiac skinfold thickness and waist circumference significantly decreased (p < 0.05) in the lamb-consumption group compared to the chicken based diet group. No significant changes were observed in the rest of the variables in either group. Tryacilglicerol and insulin serum concentrations significantly decreased (p < 0.05) in the lamb-consumption group compared to the chicken based diet group. Conclusions: The results suggest that regular consumption of lamb (Ternasco de Aragón) can be integrated into a healthy, varied and well-balanced diet, as body composition and cardiovascular risk profile changes are similar or even healthier to those observed following chicken consumption. [ABSTRACT FROM AUTHOR]

Abstract: The National Center for Injury Prevention and Control (NCIPC) has a focus on preventing interpersonal violence against children and youth. Prevention of violence against children and youth involves fostering healthy relationships and building healthy environments in which young people can flourish. We review NCIPC''s work over the past 20years that has contributed to this goal by highlighting surveillance systems that identify the magnitude of violence, etiological research that identifies risk and protective factors that are associated with violence, evaluation research that has expanded the evidence base of what works to prevent violence, and comprehensive, broad-based programs that engage and empower communities to prevent violence. NCIPC''s work demonstrates that violence is preventable and the Center is working to move the promise of effective prevention into practice. These efforts all work toward protecting the health and well-being of children and youth and set the stage for NCIPC''s future work. [Copyright &y& Elsevier]

Physical activity is crucial for optimal bone development. Cross-sectional studies have shown a strong association between physical activity (PA) and areal bone mineral density (aBMD), especially when comparisons are made between youth engaged in activities that elicit significant ground reaction forces (GRF) versus inactive youth and youth engaging in activities with low GRF. Far fewer longitudinal trials have been completed; while the results also support the importance of PA for bone development, increases in aBMD are less than would be predicted from cross-sectional studies. Retrospective analyses of aBMD and other bone parameters in females in racquet sports and gymnasts suggest a 'window of opportunity' for maximal adaptation in girls who begin regular training early in life. This proposition has not been adequately tested in longitudinal trials with strong design and methodology. Reliance on dual-energy X-ray absorptiometry (DXA) and aBMD has been a problem. DXA estimates of aBMD are confounded by changes in bone size with growth and only partially reflect bone strength. Structural adaptations, such as increases in bone width, may confer lasting increases in bone strength. While there are plausible reasons to believe this may be true, longitudinal trials in children and youth in different stages of maturation, using imaging methods that can accurately assess bone geometry are lacking. [ABSTRACT FROM AUTHOR]

Purpose. The association between physical activity (PA) and inflammation has been established in adults, yet little is known about this relationship in youth. This study examined the relationship between vigorous PA and C-reactive protein (CRP) in adolescents. Methods. Data were available for 1 520 adolescents, aged 13 and 16 years, in a province-wide survey of a representative sample of youth in Québec, Canada. Participants completed questionnaires assessing VPA, pubertal stage, body image, and health problems; they provided a fasting blood sample for CRP; and they had height and weight measured. Results. In sex-specific multivariable logistic regression models, VPA was protective of elevated CRP in boys (OR=0.60, 95%CI=0.37-0.99) independent of weight status, pubertal stage, anti-inflammatory/antibiotic medication, and smoking. CRP and physical activity were not related in girls (OR=1.12, 95%CI=0.69-1.82). Conclusions. In addition to many known health benefits of VPA, the current findings provide evidence that VPA may protect against low-grade systemic inflammation in boys. These data provide further support for the importance of promoting healthy PA levels in youth. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the authors discuss various reports within the issue on topics including the policy development in lower-middle income countries, the implementation of pre-exposure prophylaxis (PrEP) for HIV, and role played by PrEP among young people.

Abstract: Objective: To evaluate the impact of a multifaceted, school-based intervention on inner city youth at high risk for type 2 diabetes mellitus (T2DM) and to determine whether the addition of coping skills training (CST) and health coaching improves outcomes. Method: 198 students in New Haven, CT at risk for T2DM (BMI>85th percentile and family history of diabetes) were randomized by school to an educational intervention with or without the addition of CST and health coaching. Students were enrolled from 2004 to 2007 and followed for 12 months. Results: Students in both groups showed some improvement in anthropometric measures, lipids, and depressive symptoms over 12 months. BMI was not improved by the intervention. Students who received CST showed greater improvement on some indicators of metabolic risk than students who received education only. Conclusion: A multifaceted, school-based intervention may hold promise for reducing metabolic risk in urban, minority youth. [Copyright &y& Elsevier]

Whole-of-community interventions delivered across entire geospatial areas show promise for improving population health for youth cancer prevention. The aims of this scoping review were to synthesize the whole-of-community intervention literature on six modifiable risk factors in youth for cancer prevention (alcohol use, diet, obesity, physical activity, sun exposure, tobacco use) and to develop and apply a typology describing the inclusion of fundamental control system functional characteristics. A systematic search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, and Scopus for studies published to the end of 2019. Eligible studies included a geospatially defined whole-of-community intervention; youth 0-18 years; and at least one of the six cancer risk factor outcomes. An iterative process was undertaken to create a typology describing the functions for whole-of-community interventions guided by systems theory, and the typology was used to code the included interventions. A total of 41 interventions were included. Most interventions (43.9%) assessed multiple cancer risk factors. Few interventions provided fundamental functions necessary for community system coordination: sensor, controller, effector. Although communities are a patchwork quilt of microsystems where individuals interact in geographically bounded places nested within larger whole systems of influence, a control systems approach has not been used to frame the literature. Whole-of-community interventions can be characterized by the fundamental system functions necessary for coordinating population health improvement. Future whole-of-community intervention efforts should draw on fundamental knowledge of how systems operate and test whether adoption of the key functions is necessary for whole-of-community population health improvement. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To show how the interaction of the medical preventive discourse with the changes of children''s position relatively to the adult environment and the discourse on equal opportunities puts young people in a situation of lack of differentiation. This lack of differentiation causes violence. Means: From epidemiologic data on the health of young people, a certain number of behaviors in disfavor of health were put forward. Through techniques either of risk prevention or of health promotion, the medical profession models young people behaviors in terms of “safe” and standard. Unfortunately, this modeling proves relatively ineffective and generates at risk behaviors, for example, in sport. On the other hand, the loss of legitimacy of adults in regard to the rights of children leads the latter to meet difficulties in building their own identity. In these contexts, speaking of equal opportunity of access to goods sets up a series of objects of consumption as signs of the identity (PC, laptops MP3, Ipod, cell phone…). Not to have them is not to exist and this becomes a source of violence. Results: The increase of behaviors at risk and delinquent behaviors is the result of a whole mechanisms which does not any more allow young people to build differences between them. It is these interindividual differences that is at the base of the psychic identity. Conclusion: Promoting health through educating to pleasures, increasing between adults’ coherence and establishing groups of young citizens seem to us as the elements that would make possible the re-establishment of a truly human dimension. [Copyright &y& Elsevier]

The Youth Substance Abuse Service (YSAS) was conceived and developed as a youth alcohol and other drug (AOD) service when few adolescent treatment models existed. Although initially funded to provide drug support and treatment, our developing practice, training and research findings encouraged us to view our role more broadly. Now with 10 years' experience, YSAS increasingly draws on social health concepts and primary health practices to describe our work with young drug users. Through our growing practice and training experience we have developed services to meet client needs. Evaluation of these services and further research has refined our thinking and provided a theoretical basis for our work. This paper sets out to describe the evolution of a youth AOD service, and demonstrate how social health concepts and primary health practices have helped frame and facilitate our responses to young drug users during YSAS' first 10 years. [ABSTRACT FROM AUTHOR]

Sexual behaviour change remains a primary goal of HIV prevention efforts globally. It is a complex issue influenced by numerous unpredictable variables such as individual desires, social and cultural relationships, and environmental and economic dynamics. This study in northern Tanzania was conducted in June and July 2004 as part of a baseline survey carried out in 10 districts in eight regions of the country, Using a list of 65 villages in the northern zone, we randomly selected participants from four villages: one village each from three Area Development Programmes within World Vision Tanzania and one village from a high HIV transmission area (HTA). Five hundred and twenty-six respondents aged 15-24 years were selected from in-school and out-of-school groups, Of the total, 41.5% were sexually active. The age of sexual debut ranged from age 5-20 years for boys, and age 7-24 for girls. The mean age of sexual debut was 16 years old for males and 17 years old for females. The factors most strongly associated with sexual experience were: age greater than 16 years (p < 0.001); male gender (62.5% vs. 37.5%; OR = 2.4; 95% CI = 1.58-3.56; p < 0.001); living with both parents (47% vs. 27%; OR = 0.89; 95% CI = 0.84-0.94; p < 0.001); being out-of-school (75.8% vs. 24.2%; OR = 0.83; 95% CI = 0.73-0.94; p < 0.005); and, not using condoms during first sexual intercourse (OR = 1.46; 95% CI = 1.07-1.97; p < 0,02). Low self-efficacy in sexual relationships also predicted being sexually experienced (p < 0.001). High self-efficacy in intention to use condoms did not influence condom-use among sexually experienced youths (p < 0.001; OR = 1.70; 95% CI = 1.43-2.02). The perceived high influence of parents towards youths' intention to use condoms was a predictor of sexual experience (OR = 1.24; 95% CI = 1.05-1.45; p < 0.01). As a generalisation, the sexually experienced youths in the study population had experienced sex at a relatively early age and often had not used a condom at first sexual intercourse. [ABSTRACT FROM AUTHOR]

Discusses two preventive programs that specifically address central nervous system injuries. Traumatic injuries as the greatest health hazard in America; Number of hospitalizations annually as a result of trauma and deaths; Cost of treatment and rehabilitation for patients with severe head injuries; Percentage of funding for basic research used to study trauma.

The article presents a national profile of youth problems and literature review that focuses on the causes of each of the problem areas. As the 21st century approaches, communities across the United States remain concerned, frustrated, occasionally fearful and sometimes outraged by the behavior of some adolescents. Issues of teenage pregnancy, school dropout, substance abuse, juvenile delinquency, and violence persist despite various attempts to deal with them. Poverty, child abuse and neglect, health risks such as teenage pregnancy and Iow-birthweight babies, juvenile crime, and homelessness conspire to erode the real and perceived quality of life of youths. Recent statistics from a variety of sources illustrate the amount and persistence of youth problems in this country. These indicators suggest that childhood poverty, the teenage unmarried birth rate, child abuse and neglect, and juvenile violent crime have increased during the past 20 years.

When the Centers for Disease Control and Prevention published the Best Practices Guide for Comprehensive Tobacco Control - 2014 it provided an opportunity for Vermont's Tobacco Control Program to create a new state plan. Bringing together partner agencies, advocates and health organizations, the workgroup faced a challenge: there wasn't consensus around focusing on e-cigarettes. There was concern that if too much emphasis was placed on addressing this emerging product, it would be at the cost of reducing combustible use. Youth smoking rates were declining while adult smoking prevalence in Vermont remained stagnant and difficult to move downward. Through applying the lens of best practice and examining the data, the workgroup determined that an ambitious state plan was necessary. Adopting a set of principles grounded in public health and performance measurement, the plan's five goals are to reduce use of all tobacco products among youth and adults. The state plan established a vision of a Vermont free of tobacco use for the program and partners to use, emphasizing data-driven interventions and advancing policymaking, including addressing flavored tobacco products. The tobacco control and regulatory framework in Vermont has worked consistently at the state and local level on strategies involving youth engagement, coalition prevention activities, counter marketing and enforcement. Vermont's framework has evolved to recognize that no matter where a Vermonter is living or working, the protections and services provided by a tobacco program should be equitable. Future application of the public health framework includes exploring innovative policy approaches to curtail the vaping epidemic. [ABSTRACT FROM AUTHOR]

Background Prevention of youth sexual risk behaviour among the youth in uMgungundlovu District Municipality continues to be a primary challenge for public health and health promotion. Current prevention interventions are targeted at an individual level, whilst youth behaviour is influenced by many social and environmental factors. Aim The aim of the study was to explore the factors influencing sexual risk behaviours of the youth at different socio-ecological levels in uMgungundlovu District Municipality. Methods An explorative and descriptive qualitative study design was used, using in-depth interviews and focus group discussions for data collection. A framework analysis was used to develop themes derived from the socio-ecological theory. Results Four themes were identified that influence youth to engage in sexual risk behaviours: (1) individual factors, related to role modelling behaviour, gender and negative stereotypes towards females; (2) the microsystem in which youth function including the influence of family and peers; (3) the exo-system comprising the disadvantaged socio-economic status of the communities where the youth live; and (4) the macrosystem where negative social norms were reported to influence youth health outcomes. Conclusion Sexual risk behaviour among youth in uMgungundlovu is influenced by many factors at multiple social levels. Interventions directed at these multiple levels are needed urgently. [ABSTRACT FROM AUTHOR]

Discusses research on mental disorders in young prisoners in psychiatric hospital treatment and general population controls in Finland. Indication juvenile delinquency is linked to psychiatric morbidity; Idea that healthcare systems fail to emphasize the need for early screening in delinquents; Finding that more mentally ill populations aged 15-21 end up in prison as the prison population diminishes.