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Sexual and gender minority (SGM) populations experience extensive health disparities compared to their straight and cisgender counterparts. The importance of addressing these disparities is paramount, as SGM groups often encounter significant barriers to accessing comprehensive healthcare, including societal stigma, provider bias, and financial constraints. This study utilizes a community-based system dynamics approach to understand and visualize the barriers to and facilitators of healthcare engagement for SGM groups across their life course. It aims to identify core constructs, relationships, and dynamic feedback mechanisms related to the experiences of connection/disconnection with physical, mental, and dental healthcare of SGM individuals. Barriers to access, such as discriminatory practices and the limited availability of SGM-informed healthcare professionals, exacerbate these disparities, underscoring the urgency of developing targeted interventions. System dynamics, a complex systems science (CSS) methodology, was used for this research. Group model building sessions were conducted with diverse SGM groups, including youth, older adults, and trans and gender-expansive community members. Causal loop diagrams were developed according to an iterative process, and a meta-model of their collective experiences was created. The study revealed extensive, dynamic, and shifting structural barriers for SGM community members accessing healthcare. Societal and structural stigma, provider bias, and pathologization were identified as significant barriers throughout their life course. Community-led interventions and SGM-focused holistic healthcare were identified as critical facilitators of SGM healthcare connection. The findings highlight the need for SGM-affirming and culturally responsive healthcare settings. This paper calls for a concerted effort from SGM health researchers to use CSS in developing interventions to reduce SGM health disparities. [ABSTRACT FROM AUTHOR]

The article discusses the call for social work professionals to develop their Disability cultural competence with priorities on inclusion and antiableism as of January 2023. Topics covered include social work's alignment with the intersectional Disability Justice movement, ableism integration with social work education, and four steps to realize antiableism. Also noted are the steps of ableism recognition, generation of relevant data, supporting leadership, and promoting partnerships.

Sexual and gender minority youth (SGMY) are overrepresented in the foster care system and experience greater foster-care-related stressors than their non-SGM peers. These factors may further elevate their risk of anxiety/depressive, post-traumatic stress disorder, self-harm, and suicidality. The system currently produces unequal and disproportionate adverse mental health outcomes for SGMY and needs points of intervention to disrupt this status quo. This article provides an empirically grounded conceptual–theoretical model of disproportionate representation and burden of psychological comorbidities experienced by SGMY in the foster care system. We apply findings from an integrated literature review of empirical research on factors related to overrepresentation and mental health burden among SGMY to minority stress theory to explicate how and why the foster care system exacerbates mental health comorbidities for SGMY. Searches were conducted in June 2020 in PubMed using MeSH terms and title/abstract terms for foster care, sexual or gender minorities, and psychological comorbidities. Inclusion criteria are studies conducted in the United States, published in English, focused on mental illness, and published between June 2010 and 2020. Developmental/intellectual and eating disorders were excluded. The initial search returned 490 results. After applying inclusion criteria, 229 results remained and are utilized to build our conceptual–theoretical model. We assert that the phenomenon of disproportionate psychological comorbidities for SGMY in foster care is best represented as a complex and dynamic system with multiple feedback loops. Extant empirical and theoretical literature identifies three critical areas for intervention: family acceptance, community belonging and queer chosen/constructed family, and affirming and nondiscriminatory child welfare policy. [ABSTRACT FROM AUTHOR]

The quality of adolescent dating relationships is an outcome of developmental importance for young people exposed to intimate partner violence (IPV) in childhood. As adolescents explore romantic interests for the first time, it is important to consider whether youth who have witnessed IPV have an increased likelihood of adolescent dating violence (ADV) victimization and/or perpetration. This systematic review seeks to synthesize empirical literature on ADV victimization and perpetration outcomes in youth exposed to IPV, examine mechanisms that may explain ADV outcomes in IPV-exposed youth, and summarize methodological factors that influence interpretation of findings. Seven bibliographic databases were searched through August 2020 for a broader evidence and gap mapping (EGM) project examining published empirical studies on child outcomes of IPV exposure. Following de-duplication, 350 empirical studies on child IPV exposure outcomes were identified and categorized into child outcome themes, including 29 studies that examine ADV victimization and/or perpetration among IPV-exposed youth. The association between IPV exposure and ADV perpetration and victimization varies widely, with factors such as gender, mental health symptoms, beliefs about violence, and emotion regulation differentially influencing outcomes. Inconsistencies in measurement of IPV, ADV, and sample ages make cross-study comparisons challenging. Practice and research implications are addressed, including the importance of examining strengths-based youth assets and resilient trajectories of healthy dating relationships among IPV-exposed youth. [ABSTRACT FROM AUTHOR]

Objectives: To reveal whether an accessible open floorplan Multisensory Stimulation Environment (MSSE) room design has a positive impact as a nonpharmacologic intervention for episodes of Behavioral and Psychological Symptoms of Dementia (BPSD) in older adults living in a Memory Care Assisted Living (MCAL) facility as well as reducing the need for direct care supervision. Methods: Retrospective pre/post cohort design of 24 residents living in a Midwest MCAL facility in the United States with a diagnosis of dementia and over 65 years of age, analyzed by secondary medical chart review for 12 months to assess impact of an accessible open floorplan MSSE room design. The pre/post design analyzed secondary data over two periods of time; 6 months prior to the MSSE installation and 6 months following the MSSE installation. Results: Following the installation of an open floorplan MSSE, the number of observed BPSD episodes changed from 367 (17%) pre-test to 298 (10%) post-test over a 12-month time period. The Comparison of Proportions test determined that the difference in the proportion of BPSD episodes documented was statistically significant with clinical implications. Conclusions: The accessible open floorplan MSSE room design, located within a singlesite MCAL facility, utilized as a nonpharmacological intervention for BPSD, was found in this explorative study to be effective and potentially clinically meaningful in improving behavioral episodes for older adults diagnosed with dementia in MCAL settings. [ABSTRACT FROM AUTHOR]

Aim/Purpose This descriptive study examines indicators of well-being and sources of emotional connection for social work doctoral students at American institutions during the COVID-19 pandemic, including symptoms of depression, anxiety, work-related burnout, emotional connection to others, and changes in child care among parent respondents. This study also explores if particular groups of doctoral students experience heightened risks to well-being during the pandemic. Background Social isolation strategies associated with the COVID-19 pandemic present challenges for doctoral student well-being, mental health, professional relationships, and degree persistence. Of particular concern is the potentially disproportionate impact the pandemic may have on the well-being of students who already face additional barriers to degree completion, such as parents and caregivers, as well as those who face obstacles associated with structural oppression, including persons of color, women, and sexual minority (SM) students. Methodology Baseline data was used from a longitudinal survey study conducted by the authors on social work doctoral student well-being during the COVID-19 pandemic. Participants (N = 297) were recruited through the Group for the Advancement of Doctoral Education in Social Work's (GADE's) publicly available list of 89 member institutions in the United States. The majority of respondents identified as women (80.1%), 35% of the sample identified as a person of color and/or non-White race, 30% identified as a sexual minority, and 32% were parents of children under 18 years of age. Contribution This study contributes to the larger body of literature on factors associated with risk, resilience, and well-being among doctoral students, and it offers a specific exploration of these factors within the context of the COVID-19 pandemic. This study deepens our understanding of social work doctoral students in particular, who have higher rates of doctoral enrollment by women and persons of color than many other academic disciplines. Findings Emotional connection to loved ones was significantly correlated with lower levels of depressive symptoms, anxiety symptoms, and work-related burnout. Outcomes varied by race, with Black and Asian respondents indicating higher levels of emotional connection to loved ones as compared to White respondents, and Black respondents indicating lower levels of anxiety and depression compared to White respondents. SM respondents indicated significantly lower levels of emotional connection and higher levels of depression and anxiety, as compared to heterosexual respondents. Parents reported receiving substantially less child care assistance than they were before the pandemic, but also reported lower levels of anxiety, depression, and work-related burnout compared to childless respondents. Recommendations for Practitioners Recommendations for doctoral program directors and chairs include implementing a purposive communication strategy, faculty modeling self-care and boundaries, creating opportunities for connection, scheduling value-added activities driven by student interest and needs, approaching student needs and plans of study with flexibility, and creating virtual affinity groups to help students connect with those facing similar challenges. Recommendations for Researchers Outcome evaluation studies of doctoral program initiatives and policies to promote student well-being--both during and in the aftermath of the COVID-19 pandemic--is warranted. Impact on Society The COVID-19 pandemic presents complex financial, interpersonal, and programmatic challenges for doctoral faculty and program directors, many of which affect the well-being and mental health of their students. Findings and recommendations from this study may be used to address the needs of doctoral students and support their path to doctoral degree completion. Future Research Future studies should include measures that tap a broader range of indicators of depression, anxiety, and emotional connection, and additional domains of well-being. Multivariate analyses would permit predictive conclusions, and follow-up qualitative analyses would offer deeper insights into doctoral students' well-being, coping skills, and experiences within the context of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Few studies have explored the outcomes of adolescent mothers leaving foster care, especially using person‐oriented methods. The current study employed a cluster analysis to identify unique patterns of functioning among adolescent mothers aged 19 (n = 777). Data from the National Youth in Transition Database and the Adoption and Foster Care Analysis and Reporting System were utilized. Findings revealed five subpopulations characterized by distinct constellations of outcomes at age 19. The largest group (43%) exhibited competent functioning across all the domains studied—its members were connected to school and/or employment and did not experience homelessness, substance abuse referrals, or incarceration during the past 2 years (i.e., "resilient"). A relatively small group (12%) exhibited challenges across all the above‐referenced domains, whereas the remaining groups presented challenges in some domains, but not in others. Follow‐up analyses revealed that adolescent mothers classified as resilient at age 19 had the lowest rates of congregate care placements and the highest rates of nonrelative foster care placements at age 17. Moreover, they had lower placement instability and higher rates of extended foster care as compared with members of the other clusters. Implications for practice, policy, and research are discussed. [ABSTRACT FROM AUTHOR]

Twenty years ago the National Council of Juvenile and Family Court Judges published Effective Intervention in Domestic Violence and Child Maltreatment: Guidelines for Policy and Practice, which became known as the Greenbook because of its green cover. This article presents the social science research leading up to the Greenbook and the 20 years beyond the publication of this seminal document, including examination of the effect of co‐occurrence of child maltreatment and exposure to domestic violence on child outcomes, the interventions for families to improve the safety of both child and adult victims, and future directions for research. [ABSTRACT FROM AUTHOR]

Neighborhood context, including the physical and social environment, has been implicated as important contributors to positive youth development. A transactional approach to neighborhood asserts that place and people are mutually constitutive; negative perceptions of place are intrinsically bound with negative portrayals of stigmatized groups, including youth. Adult perceptions of neighborhood youth may contribute to an increased sense of alienation and youth antisocial behavior. This study uses street‐intercept interviews with adults (N = 408) to examine the relationship between neighborhood conditions and adult support for neighborhood youth. A path model was used to examine the direct and indirect relationship of neighborhood constructs (safety, aesthetic quality, and walkability) on adult support for neighborhood youth. Neighborhood aesthetic quality and the walking environment were directly associated with adult support for youth, whereas perceived safety was indirectly associated. Collective efficacy partially explained these relationships. Findings support theorized relationships between people and places; improvements to neighborhood physical environment may directly impact resident adults' perceptions of neighborhood young people. Highlights: How adult residents perceive their neighborhood environment impacts neighbors' support for youth.Neighborhood collective efficacy amplifies positive neighborhood support for youth.Place‐based neighborhood initiatives hold promise for impacting residents' support for youth. [ABSTRACT FROM AUTHOR]

We examined the reciprocal relationships among positive future expectations, expected threats to future safety, depression, and individual substance use and delinquency using 4 waves of data (N = 248-338) from African American and Latino adolescent male participants in the Chicago Youth Development Study. Individual positive future expectations and expected threats to safety were assessed at each wave and modeled as latent constructs. Individual substance use and delinquency were assessed at each wave and represented as ordinal variables ranging from low to high. Categorical autoregressive cross-lagged structural models were used to examine the hypothesized reciprocal relationships between both aspects of future expectations construct and risk behavior across adolescence. Analyses show that future expectations has important effects on youth substance use and involvement in delinquency, both of which in turn decrease positive expectations and increase expectation of threats to future safety across adolescence. Similarly, low positive expectations for the future continued to predict increased substance use and involvement in delinquency. The expected threats to safety construct was significantly correlated with delinquency within time. These effects are observed across adolescence after controlling for youth depression and race. Findings support the reciprocal effects hypothesis of a negative reinforcing cycle in the relationships between future expectations and both substance use and involvement in delinquent behavior across adolescence. The enduring nature of these relationships underscores the importance of future expectation as a potential change mechanism for intervention and prevention efforts to promote healthy development; vulnerable racial and ethnic minority male adolescents may especially benefit from such intervention. [ABSTRACT FROM AUTHOR]

Multiply disadvantaged youths exhibit worse health and academic success than their less disadvantaged peers, possibly due to greater exposure to social status–based discrimination. Models that capture the additive burden of disadvantage in tandem with multiple forms of discrimination are needed to explicate the unique and combined impact of these factors on adolescent health and academic outcomes. In addition, protective factors like positive family and peer relationships may attenuate these relationships. This study used data from the Beyond High School Study (N = 9,658), which looked at the transition to adulthood among senior class cohorts from 12 high schools in western Washington state, to investigate the influence of multiple disadvantage, four types of discrimination, and protective resources on student physical and mental health and school grades. Results show that both increased multiple disadvantage statuses and experienced discrimination are associated with decrements across outcomes; however, effects are attenuated when protective resources are considered. Yet, as disadvantages mount, the buffering effect of peer and family resources are dampened. No interaction was found between experienced discrimination and protective resources on outcomes. [ABSTRACT FROM AUTHOR]

Perceptions of neighborhood safety are positively associated with perceptions of neighborhood violence. However, research has yet to examine whether this relationship is moderated by specific types of violence, such as sexual violence, that are more salient for women. Using street-intercept interviews with 343 adults in 9 neighborhoods of a U.S. city with high rates of poverty, unemployment, and crime, we examine the relationship of perceived neighborhood violence to perceived safety in the context of gender while controlling for neighborhood assets that moderate perceptions of neighborhood safety and violence. We hypothesized that gender would moderate the relationship between perceived neighborhood violence and safety, and that women's perceptions of neighborhood safety would be significantly influenced by neighborhood sexual violence, but not other types of violence. Although women and men in these high crime, urban neighborhoods did not differ in their perceptions of neighborhood safety or violence, perceived sexual violence did significantly moderate safety by gender; women's perceptions of neighborhood sexual violence predicted perceived safety in their neighborhood. Importantly, gender did not moderate perceived safety for other types of violence. These results illustrate the importance of taking gender and perceived sexual violence into account to understand neighborhood safety in adults, particularly women. [ABSTRACT FROM AUTHOR]

Future expectations, a subset of overall orientation, represent youths' most realistic appraisals of future outcomes, and has been demonstrated to be associated with a range of health risk behaviors and wellbeing. The current study extends previous measurement efforts to operationalize and measure future expectations by estimating a multidimensional model of future expectations encompassing both positive and survival-based expectations, and using longitudinal data to test the consistency of these constructs over time. The current work uses data from six waves of the Chicago Youth Development Study (n = 338), a sample of African American and Latino young men from low income neighborhoods in an urban center, to test a hypothesized multidimensional structure of future expectations across adolescence. Test retest confirmatory factor analyses from six waves of data covering the mean age range of 12-19 years reveal good model fit for the hypothesized multidimensional model of future expectations at each wave. Strong measurement invariance based on race/ethnicity is established for the multidimensional model. Implications for a latent construct approach to future expectations with low-income racial/ethnic minority young men are discussed. [ABSTRACT FROM AUTHOR]

The accumulation of disadvantage has been shown to increase psychosocial stressors that impact life course well-being. This study tests for significant differences, based on disadvantage exposure, on youths' emotional and physical health, as well as family supports, peer assets, and academic success, which hold potential for resilience and amelioration of negative health outcomes. A 12 item cumulative disadvantage summed index derived from surveys of a racially and socioeconomically diverse sample of urban high school seniors (n = 9658) was used to distinguish youth at low, moderate, and high levels. Findings supported hypothesized stepped patterns such that as multiple disadvantages accumulate, a concomitant decline is evident across the assessed outcome variables (except positive academic identity). Post-hoc tests indicated a pattern of groups being significantly different from one another. Overall, results lend support for an additive stress load associated with stacked disadvantage, with implications for continuing trends into adulthood as well as preventive interventions. [ABSTRACT FROM AUTHOR]

Alcohol is the most widely used and abused substance among America' s youths. Understanding patterns of alcohol use over the course of adolescent development, including risk and protective factors related to variation in use, is a central goal of adolescent alcohol research. Authors of this article created a personalized graphic representation of individual drinking, as reported in seven waves of questionnaire data from an ongoing longitudinal study . The graphic served as the basis for a qualitative investigation of 12 young adults' retrospective explanations for increases and decreases in their alcohol consumption during adolescence. A total of 45 changes were assessed: 26 increases and 19 decreases. Three themes for increased alcohol use emerged: (1) adult role modeling, (2) coping with stress or loss, and (3) desiring social inclusion. Five themes for decreased alcohol use emerged: (1) internal motivation, (2) involvement in meaningful activities, (3) prosocial relationships with nonparental adults, (4) increased use of another substance, and (5) becoming a mother. Positive youth development framework was applied to suggest how these findings may be used to inform strategies to reduce underage alcohol use. [ABSTRACT FROM AUTHOR]

Identity research indicates that the development of well-elaborated cognitions about oneself in the future, or one's possible selves, is consequential for youths' developmental trajectories, influencing a range of social, health, and educational outcomes. Although the theory of possible selves considers the role of social contexts in identity development, the potential influence of the physical environment is understudied. At the same time, a growing body of work spanning multiple disciplines points to the salience ofplace, or the meaningful physical environments of people's everyday lives, as an active contributor to self-identity. Bridging these two lines of inquiry, I provide evidence to show how place-based experiences, such as belonging, aversion, and entrapment, may be internalized and encoded into possible selves, thus producing emplaced future self-concept. I suggest that for young people, visioning one's self in the future is inextricably bound with place; place is an active contributor both in the present development of future self-concept and in enabling young people to envision different future possible places. Implications for practice and future research include place-making interventions and conceptualizing place beyond ‘neighborhood effects.’ [ABSTRACT FROM AUTHOR]

The article focuses on the use and meaning of the term "community," including in academic journals and in discussions of public health interventions and research. The representation of "the community" in academic journals is discussed and the part that authors have in the construction of the representation of a community is explored. Particular attention is given to the linguistic construction of the community. The authors call for a more responsible use of language and an acknowledgment of stereotypes used in the personifications of the community.

Young people experience a variety of mental health concerns, including depression, non-suicidal self-injury, and suicidal ideation. These issues are at even higher rates among transgender and gender-diverse (TGD) young people, due to the additional burden of having to navigate a world in which transphobia impacts them at the individual, organizational, and policy levels. However, much of the extant research focuses only on comparing TGD youth to cisgender counterparts. This study explores the nuance within the TDG youth population regarding mental health, examining how gender, race/ethnicity, and sexual orientation change the likelihood of experiencing each of these mental health concerns. Among a sample of over 400 young people, findings indicate that those TGD young people who do not identify themselves within the masculine/feminine binary and those with marginalized sexual orientations were two to three times more likely to experience adverse mental health outcomes, as compared to their peers who are questioning their gender, and who are heterosexual. The implications for mental health professionals and others who work with young people are to recognize that mental health is not a one-size-fits all model for young TGD people, and that the intersection of multiple marginalized identities, must be addressed in order to improve the mental health of this group of young people. Findings can also be used to better understand issues of stigma, discrimination, and victimization in education, health care, and beyond. [ABSTRACT FROM AUTHOR]