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Background and Aims: Increasing numbers of school‐based drug surveys are transitioning data collection to electronic tablets from paper‐and‐pencil, which may produce a survey mode effect and consequent discontinuity in time trends for population estimates of drug prevalence. This study tested whether (a) overall, self‐reported drug use prevalence is higher on electronic tablets versus paper‐and‐pencil surveys, (b) socio‐demographics moderate survey mode effects and (c) levels of missing data are lower for electronic tablet versus paper‐and‐pencil modes. Design A randomized controlled experiment. Setting: Results are nationally representative of students in the contiguous United States. Participants: A total of 41 866 8th, 10th and 12th grade students who participated in the 2019 Monitoring the Future school‐based survey administration. Intervention and comparator: Surveys were administered to students in a randomly selected half of schools with electronic tablets (intervention) and with paper‐and‐pencil format (comparator) for the other half. Measurements Primary outcome was the total number of positive drug use responses. Secondary outcomes were the percentage of respondents completing all drug questions, percentage of drug questions unanswered and mean number of missing drug items. Findings The relative risk (RR) for total number of positive drug use responses for electronic tablets versus paper‐and‐pencil surveys were small and their 95% confidence intervals (CI) included the value of one for reporting intervals of life‐time (RR = 1.03; 95% CI, 0.93–1.14), past 12 months (RR = 1.01; 95% CI, 0.91–1.11), past 30 days (RR = 1.05; 95% CI, 0.93–1.20) and for heavy use (RR = 1.10; 95% CI, 0.93–1.29). Multiplicative interaction tests indicated no moderation of these relative risks by race (white versus non‐white), population density, census region, public/private school, year of school participation, survey version or non‐complete drug responses. Levels of missing data were significantly lower for electronic tablets versus paper‐and‐pencil surveys. Conclusions: Adolescent drug prevalence estimates in the United States differed little across electronic tablet versus paper‐and‐pencil survey modes, and showed little to no effect modification by socio‐demographics. Levels of missing data were lower for electronic tablets. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To conduct a systematic review and meta‐analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past‐month marijuana use prevalence among adolescents. Methods: A total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta‐analyzed. Estimates of MML effects on any past‐month marijuana use prevalence from included studies were obtained from comparisons of pre–post MML changes in MML states to changes in non‐MML states over comparable time‐periods. These estimates were standardized and entered into a meta‐analysis model with fixed‐effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F‐test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Results: None of the 11 studies found significant estimates of pre–post MML changes compared with contemporaneous changes in non‐MML states for marijuana use prevalence among adolescents. The meta‐analysis yielded a non‐significant pooled estimate (standardized mean difference) of −0.003 (95% confidence interval = −0.012, +0.007). Four studies compared MML with non‐MML states on pre‐MML differences and all found higher rates of past‐month marijuana use in MML states pre‐MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non‐significant results, although limited heterogeneity may warrant further study. Conclusions: Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to explore what is known about food literacy programmes targeting adolescents, including identification of the constituents of food literacy addressed, assessment of programme effectiveness, and description of programme design or delivery specific to adolescents. Methods A review of the peer-reviewed literature surrounding adolescent food literacy was conducted using scholarly electronic databases. Programme reports were identified in the grey literature using online searching and cross-referencing to support the research aim. Programmes from 2000 to 2012 targeting adolescents aged 13-17 years were included. Results A total of 19 peer-reviewed papers and four grey literature programmes met the search criteria. Interventions focused on practical cooking and/or food preparation skills and targeted younger adolescent age groups. Programmes were most commonly held in schools and community settings. The majority of programmes (n = 16/23) did not use a theoretical basis for their development. Programme evaluation encompassed the use of pre- and post-intervention questionnaires and focus groups. Only nine studies included a dietary behaviour-based outcome measure. Although 19 of the 23 studies reviewed reported positive changes related to the intervention, these did not include significant changes in diet quality or cooking frequency at home. Conclusions Few existing adolescent food literacy programmes have demonstrated a positive impact on dietary behaviours to date. Adolescent target groups present unique challenges in programme development and delivery. However, the physical, social and emotional health needs of this age group and potential to influence lifelong behaviours highlight the need to design effective and age-appropriate adolescent food literacy programmes. [ABSTRACT FROM AUTHOR]

Background: Few methodologically rigorous international comparisons of student-reported antisocial behavior have been conducted. This paper examines whether there are differences in the frequency of both antisocial behavior and societal responses to antisocial behavior in Victoria, Australia and Washington State, United States. These 2 states were chosen due to their similarities on sociodemographic characteristics and their differences in policy frameworks around problem behavior including antisocial behavior and substance use. Methods: State representative samples of students (N = 5769) in school grades 5, 7, and 9 in Victoria and Washington State completed a modified version of the Communities That Care self-report survey of behavior and societal responses to behavior. Chi-square analyses compared frequencies of antisocial behavior, school suspensions, and police arrests in the 2 states. Multivariate logistic regression analyses were conducted for each outcome measure to examine the effect of state, controlling for sample design, clustering of students within schools, age, socioeconomic status, and urbanicity. Results: Few state differences in student-reported antisocial behavior were found, although frequencies varied across behavior type and grade level. Differences in societal responses were observed across grade levels with grade 5 Washington students reporting higher rates of school suspension. Older Washington students reported more arrests. Conclusions: Rates of student antisocial behavior appear similar in these 2 states in Australia and the United States. However, youth in the United States relative to Australia may experience greater societal consequences for problem behavior. Further research is required to examine the impact of these consequences on subsequent behavior. [ABSTRACT FROM AUTHOR]

Objective: Assess the prevalence of headache in transgender and gender‐diverse adolescents, comparing prevalence with and without exposure to gender‐affirming hormone therapy. Background: Transgender and gender‐diverse youth are an understudied group in whom we can study the effects of sex steroids on adolescents' development of headache. We hypothesized that transfeminine adolescents treated with estrogen would have higher odds of headache than those not treated, and that transmasculine adolescents treated with testosterone would have lower odds of headache than those not treated. Methods: This retrospective case–control study analyzed all patients seen at the Boston Children's Hospital Gender Multispecialty Service clinic from 2007 to 2017. Cases were defined as patients with headache, controls as those without headache, and exposure as treatment with gender‐affirming hormone therapy (i.e., estrogen or testosterone). A computerized search identified cases that were then validated by chart review. Results: Fifty‐two of the 763 transgender and gender‐diverse patients seen were confirmed to have headache. Of 273 transfeminine patients 45% (123/273) received estrogen treatment. Transfeminine patients receiving estrogen were more likely to have headache than those not receiving estrogen (7% [9/123] vs. 1% [2/150]; odd ratio [OR] 5.84 (95% confidence interval [CI] 1.24–27.6), p = 0.026). Of 490 transmasculine patients, 46% (227/490) received testosterone. Transmasculine patients receiving testosterone were more likely to have headache than those not receiving testosterone (12% [28/227] vs. 5% (13/263); OR 2.71 (95% CI 1.37–5.4), p = 0.005). Conclusion: Among transfeminine and transmasculine youth, those who received gender‐affirming hormone therapy had higher odds of headache compared to those not taking gender‐affirming hormone therapy. Further prospective studies to guide headache care of transgender and gender‐diverse youth and adults are needed. Our results could be generalizable to other pediatric gender management clinics and may be worth discussing with patients considering treatment. [ABSTRACT FROM AUTHOR]

Objective: The COVID‐19 pandemic hastened a transition to treatment delivery via telehealth. While barriers still exist, the increased uptake of telehealth has the potential to increase access to mental health treatment for all diagnoses, including eating disorders. Delivery of evidence‐based treatment as well as adjunctive treatments, including those that are hard to find in‐person, have been modified to virtual format to increase accessibility and allow for continuity of care for adolescents with anorexia nervosa. Method: We describe how to modify and deliver Cognitive Remediation Therapy for youth with anorexia nervosa (CRT‐AN) via a telehealth platform. Preliminary and practical guidance for best practice for both group and individual delivery is established. Results: With minimal modifications, CRT‐AN can be delivered via telehealth for both individual and group delivery. More disengagement in group delivery was noted; however, overall application of the treatment via a remote platform was observed. Discussion: As more treatment moves to a telehealth format, highlighting how an adjunctive treatment like CRT‐AN can combined with other treatments in a telehealth format has the potential to increase research in its implementation and furthermore increase its dissemination. Public Significance: Cognitive Remediation Therapy for Anorexia Nervosa (CRT‐AN) requires significant manipulation of materials and supplementary human guidance. Suggestions for how to modify CRT‐AN for remote delivery via telehealth are provided. Modifications grew out of immediate changes made during the beginning of the COVID‐19 pandemic and can be used to inform changes therapists and programs can make to continue to or begin to use CRT‐AN in a remote fashion. [ABSTRACT FROM AUTHOR]

Background: Simultaneous use of alcohol and cannabis to enhance each other's effect can cause potential harm. Time trends are diverging in adolescent use of alcohol, which is declining, and cannabis, which is increasing among certain subgroups. However, little is known about trends in their simultaneous and non‐simultaneous use. Racial and socioeconomic disparities are emerging in cannabis use, which may portend consequences to public health. Methods: The 2000 to 2020 Monitoring the Future surveys included approximately 38,000 U.S. 12th‐grade students with information on simultaneous use and pertinent demographic factors. A 5‐level alcohol/cannabis measure included past‐year simultaneous use (i.e., alcohol and cannabis use at the same time), non‐simultaneous alcohol and cannabis use, alcohol‐use‐only, cannabis‐use‐only, and no use. Multinomial logistic regressions estimated associations (adjusted relative risk ratios; aRRR) with time period (2000 to 2004, 2005 to 2009, 2010 to 2014, 2015 to 2020). Models were adjusted and included interactions with sex, race/ethnicity, and parental education. Results: Between 2000 and 2020, simultaneous alcohol/cannabis use among 12th graders decreased from 24.4% to 18.7%. From 2015 to 2020 compared to 2000 to 2004, the odds of simultaneous use (adjusted relative risk ratio (aRRR) vs. no use = 0.57, 95% CI [0.50, 0.66]) and alcohol‐use‐only (aRRR = 0.55, 95% CI [0.49, 0.61]) decreased, while cannabis‐use‐only odds increased (aRRR = 2.59, 95% CI [1.87, 3.59]). Notably, the prevalence of cannabis‐use‐only more than doubled from 2011 to 2019. The odds of simultaneous use, alcohol‐use‐only, and non‐simultaneous use of alcohol and cannabis declined more rapidly among males than females, whereas the odds for cannabis‐use‐only increased faster for females than males. Increases in cannabis‐use‐only were faster for non‐white adolescents. Conclusion: Simultaneous use of alcohol and cannabis is declining among U.S. adolescents, but the decline is slower among females than males. Declines in simultaneous use are largely concomitant with historical declines in alcohol use, indicating that a continued focus on reducing alcohol use among adolescents and young adults has extended benefits to other adolescent substance use. However, cannabis use without any reported past‐year alcohol use more than doubled in the last decade, a concerning trend. [ABSTRACT FROM AUTHOR]

BACKGROUND Being bullied online is associated with being bullied in school. However, links between online bullying and violence‐related experiences are minimally understood. We evaluated potential disparities in these associations to illuminate opportunities to reduce school‐based violence. METHODS: We used five cohorts of Youth Risk Behavior Survey national cross‐sectional data (2011‐2019, Ntotal = 73 074). We used survey‐weighted logistic and multinomial models to examine links between online bullying and five school‐based violence‐related experiences: offline bullying, weapon carrying, avoiding school due to feeling unsafe, being threatened/injured with a weapon, and physical fighting. We examined interactions by sex, race/ethnicity, and sexual identity. RESULTS: Being bullied online was positively associated with all offline violence‐related behaviors. Groups with stronger associations between online bullying and physical fighting, including boys, adolescents whose sexual identity was gay/lesbian or unsure, and many adolescents of color (Black, Hispanic/Latino, and Asian/Pacific Islander adolescents), had stronger associations between online bullying and either weapon carrying or avoiding school. CONCLUSIONS: Online bullying is not an isolated harmful experience; many marginalized adolescents who experience online bullying are more likely to be targeted in school, feel unsafe, get in fights, and carry weapons. Reduction of online bullying should be prioritized as part of a comprehensive school‐based violence prevention strategy. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Project Connect Health Systems Intervention (Project Connect) uses a systematic process of collecting community and healthcare infrastructure information to craft a referral guide highlighting local healthcare providers who provide high quality sexual and reproductive healthcare. Previous self-report data on healthcare usage indicated Project Connect was successful with sexually experienced female youth, where it increased rates of human immunodeficiency virus (HIV) and sexually transmitted disease (STD) testing and receipt of contraception. This adaption of Project Connect examined its effectiveness in a new context and via collection of clinic encounter-level data. METHODS: Project Connect was implemented in 3 high schools. (only 2 schools remained open throughout the entire project period). Participant recruitment and data collection occurred in 5 of 8 participating health clinics. Students completed Youth Surveys (N=608) and a Clinic Survey (paired with medical data abstraction in 2 clinics [N=305]). RESULTS: Students were more likely than nonstudents to report having reached a clinic via Project Connect. Nearly 40% of students attended a Project Connect school, with 32.7% using Project Connect to reach the clinic. Students were most likely to have been referred by a school nurse or coach. CONCLUSIONS: Project Connect is a low-cost, sustainable structural intervention with multiple applications within schools, either as a standalone intervention or in combination with ongoing efforts. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Despite previous research indicating an adolescents' alcohol, tobacco, and other drug ( ATOD) use is dependent upon their sex and the sex composition of their social network, few social network studies consider sex differences and network sex composition as a determinant of adolescents' ATOD use behavior. METHODS This systematic literature review examining how social network analytic studies examine adolescent ATOD use behavior is guided by the following research questions: (1) How do studies conceptualize sex and network sex composition? (2) What types of network affiliations are employed to characterize adolescent networks? (3) What is the methodological quality of included studies? After searching several electronic databases ( PsycINFO, EBSCO, and Communication Abstract) and applying our inclusion/exclusion criteria, 48 studies were included in the review. RESULTS Overall, few studies considered sex composition of networks in which adolescents are embedded as a determinant that influences adolescent ATOD use. Although included studies all exhibited high methodological quality, the majority only used friendship networks to characterize adolescent social networks and subsequently failed to capture the influence of other network types, such as romantic networks. CONCLUSIONS School-based prevention programs could be strengthened by (1) selecting and targeting peer leaders based on sex, and (2) leveraging other types of social networks beyond simply friendships. [ABSTRACT FROM AUTHOR]

Summary: Objective: The objective of this study was to examine the relationship between diet and inflammation, and adiposity in minority youth. Design and Methods: The study was designed as a cross‐sectional analysis of 142 overweight (≥85th body mass index percentile) Hispanic and African–American adolescents (14–18 years) with the following measures: anthropometrics, adiposity via magnetic resonance imaging, dietary intake via 24‐h dietary recalls, and inflammation markers from fasting blood draws utilizing a multiplex panel. Partial correlations were estimated and analysis of covariance (ancova) models fit to examine the relationship among dietary variables, inflammation markers and adiposity measures with the following a priori covariates: Tanner stage, ethnicity, sex, total energy intake, total body fat and total lean mass. Results: Inference based on ancova models showed that the highest tertile of fibre intake (mean intake of 21.3 ± 6.1 g d−1) vs. the lowest tertile of fibre intake (mean intake of 7.4 ± 1.8 g d−1) was associated with 36% lower plasminogen activator inhibitor‐1 (P = 0.02) and 43% lower resistin (P = 0.02), independent of covariates. Similar results were seen for insoluble fibre. No other dietary variables included in this study were associated with inflammation markers. Conclusions: These results suggest that increases in dietary fibre could play an important role in lowering inflammation and therefore metabolic disease risk in high‐risk minority youth. [ABSTRACT FROM AUTHOR]

Background and purpose Our aim was to provide estimates of traumatic brain injury ( TBI) in 2050 for the African population by region, sex and age strata. Methods A literature search was performed in October 2014 in PubMed for population-based studies of TBI in different geographical locations. Articles were selected from Kenya (model 1), New Zealand (model 2) and the USA (model 3). In model 1, rates of road traffic injury in Kenya were used to estimate TBI rates in the African continent. Models 2 and 3 used existing TBI incidence estimates from other locations to estimate the burden of TBI for Africa in 2050. The 2050 African population, as projected by the United Nations, was used as a base population. Results Based on rates from model 1, the estimated total TBI count in Africa in 2050 is 5.98 ± 0.03 million, with the highest count in eastern (2.04 ± 0.01 million) and lowest count in southern (0.15 ± 0.00 million) Africa. A higher TBI count is predicted by models 2 (14.25 ± 0.75 million) and 3 (10.40 ± 0.02 million). Estimated TBI count is highest for males aged 15-34 (5.47 ± 0.55 million in model 2 and 3.21 ± 0.13 million in model 3). Conclusions Projected estimates of TBI in Africa are high, with a burden of anywhere between approximately 6 and 14 million new cases in 2050. This emphasizes the importance of developing accurate surveillance systems of TBI at a population level and public health measures to mitigate the risk and burden of TBI. [ABSTRACT FROM AUTHOR]

Aims To investigate whether the effects of family conflict on adolescent drinking differed as a function of 5-hydroxy tryptamine transporter-linked polymorphic region ( 5- HTTLPR) genotype cross-sectionally and prospectively in two independent samples of adolescents. Design Path analysis and multi-group analysis of two prospective datasets were conducted. Settings United States and United Kingdom. Participants Sample 1 was 175 adolescents in the United States (mean age = 15 at times 1 and 2 with a 6-month interval); Sample 2 was 4916 adolescents in the United Kingdon (mean age = 12 at time 1 and 15 at time 2). Measurements In both samples, demographics, tri-allelic 5- HTTLPR genotype and perceived family conflict were assessed at time 1. Alcohol use (frequency of drinking) and alcohol misuse (frequency of intoxication, frequency of drinking three or more drinks, maximum number of drinks) were assessed at times 1 and 2. Findings A significant gene-environment interaction on alcohol misuse at time 1 was found in both sample 1 (β = 0.57, P = 0.001) and sample 2 (β = 0.19, P = 0.01), indicating that the 5- HTTLPR low-activity allele carriers exposed to higher levels of family conflict were more likely to engage in alcohol misuse than non-carriers. A significant gene-environment interaction effect on change in alcohol misuse over time was found only in sample 1 (β = 0.48, P = 0.04) but not in sample 2. Conclusions Compared with non-carriers, adolescents carrying the 5- HTTLPR low-activity allele are more susceptible to the effects of family conflict on alcohol misuse. [ABSTRACT FROM AUTHOR]

Background and Aims The time to first cigarette ( TTFC) of the day is an indicator of nicotine intake in adults and adolescents. However, the relation between TTFC and biological markers of nicotine addiction and health risk in youths has not been well described. The current study examined whether an earlier TTFC predicts higher levels of a tobacco-specific carcinogen, 4-(methylnitrosamino)-1-(3-pyridal)-1 ( NNAL), in regular and intermittent adolescent smokers and if this relation is mediated by nicotine intake (measured by cotinine) or cigarettes per day ( CPD). Design A cross-sectional analysis of a nationally representative subsample of adolescents. Setting A general community sample from the 2007-08 and 2009-10 National Health and Nutrition and Examination Survey. Participants A total of 215 adolescents in the United States between the ages of 12 and 19 years who reported smoking at least once in the 5 days prior to data collection. Measurements The primary outcome measure was urinary levels of NNAL. Findings In both regular and intermittent smokers, earlier TTFC was associated dose-dependently with higher levels of NNAL ( P < 0.03 in both cases). TTFC had an indirect effect on NNAL, mediated by nicotine intake (cotinine) in both regular [β = −0.08, standard error ( SE) = 0.03, 95% confidence interval ( CI) = −0.15, −0.03] and intermittent (β = −0.02, SE = 0.01, 95% CI = −0.05, −0.002) smokers. CPD was not found to be an important mediator of the relation between TTFC and NNAL. Conclusions Time between waking and the first cigarette of the day is correlated in daily and non-daily adolescent smokers with overall nicotine and therefore carcinogen intake. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Studies of the relationship between social norms and marijuana use have generally focused on individual attitudes, leaving the influence of larger societal-level attitudes unknown. The present study investigated societal-level disapproval of marijuana use defined by birth cohort or by time-period. Design Combined analysis of nationally representative annual surveys of secondary school students in the United States conducted from 1976 to 2007 as part of the Monitoring the Future study. Setting In-school surveys completed by adolescents in the United States. Participants A total of 986 003 adolescents in grades 8, 10 and 12. Measurements Main predictors included the percentage of students who disapproved of marijuana in each birth cohort and time-period. Multi-level models with individuals clustered in time-periods of observation and birth cohorts were modeled, with past-year marijuana use as the outcome. Findings Results indicated a significant and strong effect of birth cohort disapproval of marijuana use in predicting individual risk of marijuana use, after controlling for individual-level disapproval, perceived norms towards marijuana and other characteristics. Compared to birth cohorts in which most (87-90.9%) adolescents disapproved of marijuana use, odds of marijuana use were 3.53 times higher in cohorts where fewer than half (42-46.9%) disapproved (99% confidence interval: 2.75, 4.53). Conclusions Individuals in birth cohorts that are more disapproving of marijuana use are less likely to use, independent of their personal attitudes towards marijuana use. Social norms and attitudes regarding marijuana use cluster in birth cohorts, and this clustering has a direct effect on marijuana use even after controlling for individual attitudes and perceptions of norms. [ABSTRACT FROM AUTHOR]

Objective. To determine if adolescent obesity is associated with parenting characterized by lower sensitivity and lower monitoring of adolescent activities. Methods. We used data from 744 adolescents in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Height and weight were measured at age 15½ years and obesity defined as body mass index ≥ 95th percentile for age and sex. Maternal and paternal sensitivity were assessed by direct observation of a parent-adolescent interaction task. Maternal and paternal monitoring were assessed by parent report. Lower sensitivity and lower monitoring were each defined as the lowest quartiles. Two separate multivariate logistic regression models were created to evaluate, individually for mothers and fathers, associations of sensitivity and monitoring with adolescent obesity, controlling for adolescent sex and race, family income-to-needs ratio, and parental obesity. Results. Fourteen percent of the adolescents were obese. Lower sensitivity was associated with adolescent obesity in the maternal parenting model (adjusted odds ratio [AOR] 2.36, 95% confidence interval [CI] 1.44-3.86, n = 709), but not paternal parenting model (AOR = 0.79, 95% CI 0.38-1.63, n = 460). Neither maternal nor paternal monitoring was associated with adolescent obesity (AOR = 1.03, 95% CI 0.63-1.68; AOR = 1.07, 95% CI 0.52-2.22, respectively). Conclusion. Lower maternal sensitivity, measured by direct observation of parent-adolescent interactions, was associated with adolescent obesity. Efforts to prevent and treat childhood obesity, both at the practitioner level and the community level, may be enhanced by educating parents that their reactions to their children's behaviors may have consequences related to obesity. [ABSTRACT FROM AUTHOR]

Background. While obesity prevalence in the US has been increasing, adiposity shifts may vary across socio-demographic groups, and various adiposity measures may reveal different patterns. Methods. To study changes over time in adiposity measures, distributional shifts in body mass index (BMI, kg/m2), BMI-percentile, waist circumference (WC) and triceps skinfold thickness (TST), and compare between-group differences, National Health and Nutrition Examination Surveys (NHANES) III 1988-94 and 1999-2004 from children aged 2-19 years old data were analyzed. Annual shift in adiposity measures across percentiles were shown as Tukey's mean-difference plots, with percentile-specific mean differences being divided by 10.5 years. Overall and quintile-specific adjusted shifts were estimated from multivariate ordinary least square (OLS) regression models. Results. Mean 10.5-year increases in adiposity were statistically significant, higher in older groups, more pronounced in some sex-ethnic groups (e.g., black girls) and at upper percentiles (more obese groups) for most measures and sex-age-ethnic groups. Adjusted increase in mean BMI was 0.60 in girls and 0.64 in boys; BMI percentile, 3.02 and 3.15 units; WC, 2.85 and 2.42 cm; and TST, 0.81 and 1.18 mm, for girls and boys, respectively. Ethnic, age and sex disparities in mean BMI became wider over time. Several significant ethnic differences in adjusted adiposity shifts within the lowest (Q1) and uppermost (Q5) quintiles of adiposity measure distributions were noted. Conclusions. The increase in adiposity among American children was unequally distributed across groups and varied across the spectrum of various adiposity measures. Overweight groups gained more adiposity over time, especially WC. Solely examining prevalence shifts masks pattern complexity. [ABSTRACT FROM AUTHOR]

merican Indian/Alaska Native youth represent the strength and continued survival of many Nations and Tribes. However, they currently experience numerous health disparities and challenges, including the highest rate of suicide among 15-24 year-olds in the United States. Our comprehensive review of the literature on the mental health of AI/AN youth highlighted seven focal causes of behavioral health disparities: (1) high levels of violence and trauma exposure and traumatic loss, (2) past and current oppression, racism, and discrimination, (3) underfunded systems of care, (4) disregard for effective indigenous practices in service provision, policy, and funding, (5) overreliance on evidence-based practices, (6) lack of cultural competence among systems of care and providers, and (7) barriers to care. Seven policy recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures are presented, supported, and discussed. [ABSTRACT FROM AUTHOR]

Issues. Despite more than a decade of federal sponsorship of 'evidence-based' alcohol/drug education, there has been no consistent downward trend in overall prevalence among youth over the past 15 years. Reasons underlying this situation are examined. Approach. Published technical critiques of initial research supporting widely used evidence-based programs are reviewed along with replication studies conducted later by independent researchers not associated with initial program development. Social and institutional barriers in the US against changes in AOD policy and practice for young people are also suggested. Key Findings. Emerging use of diverted pharmaceuticals (now second to cannabis in prevalence) may underlie moderate recent decline in use of alcohol. Early federal certification standards for 'evidence based' prevention education have been seriously compromised. Technical critiques of initial evaluations and negative replication studies of these programs are consistent with lack of impact. Finally, fidelity of implementation in regular school settings is commonly flawed. Implications. Failure of these mainly pre-secondary educational programs may underlie recent federal support for forced random AOD testing of secondary school students. A new approach to drug education for adolescent students seems warranted as a positive alternative to personally intrusive surveillance. Conclusion. An interactive approach at the secondary school level that incorporates an age-appropriate educational process is proposed. While advising abstinence, this approach also facilitates identifying and assisting problematic AOD users. [Skager R. Replacing ineffective early alcohol/drug education in the United States with age-appropriate adolescent programmes and assistance to problematic users. Drug Alcohol Rev 2007;26:577 - 584] [ABSTRACT FROM AUTHOR]

Background: This study examines the cross-sectional and longitudinal associations among cognitive variables, depressive symptoms and suicidal ideation in Hong Kong Chinese and Caucasian American adolescents. Methods: Community adolescents ( n = 2,044) ages 14–18 years from Hong Kong and the United States provided information regarding their suicidal ideation, depressive symptoms, and cognitions (self-efficacy, cognitive errors and hopelessness), at two surveys, six months apart. Results: Self-efficacy was a weak unique predictor of suicidal ideation in both cultures. Hopelessness was the strongest of cognitive variables in concurrent associations with suicidal ideation in bivariate and multivariate models, in both cultures, and in both boys and girls. Hopelessness continued to offer unique prediction when depressive symptoms were controlled, both concurrently and prospectively. Conclusions: Our results support hopelessness theories of suicidal ideation and behavior in Hong Kong, and extend the cognitive theory of suicidality to a modernized Asian culture. [ABSTRACT FROM AUTHOR]

The objective of this article is to present an overview of the current state of the field of adolescent alcohol treatment research and to discuss several priorities for future research directions.The authors identified trends in adolescent alcohol treatment research from multiple sources, including searches of the National Institutes of Health grantee listings, proceedings from annual meetings of the Research Society on Alcoholism and relevant English-language journal articles available in MEDLINE and PSYCHLIT databases over the past decade.This field must build on its major strength, which has been its success in appreciating the unique developmental characteristics of adolescence and meaningfully incorporating them into adolescent alcohol treatment approaches. Priorities for future research include: empirically investigating the potential value of harm reduction approaches for promoting public health and reducing total harm for adolescents; developing efficacious interventions across a wide range of intensities and settings; increasing the reach and relevance of randomized treatment efficacy trials and their products, with a particular focus on enhancing the recruitment and retention of diverse treatment samples; increasing a focus on key individual difference variables such as co-occurring diagnoses, that may serve as the basis for treatment tailoring; and exploration of the potential benefits of transdisciplinary research. [ABSTRACT FROM AUTHOR]

To review current knowledge about the most effective school-based interventions for child and adolescent problems, and to present dilemmas and potential solutions in mounting and evaluating school-based interventions for adolescent alcohol and other drug (AOD) use problems.Two literature reviews were conducted: (1) a broad and encompassing review of English-language articles published from 1990 to the present concerning school-based interventions for child and adolescent problems and (2) an exhaustive review of articles concerning Student Assistance Programs, which are the most popular approach to school-based AOD intervention in the United States.Ten key components of effective school-based interventions were identified. In addition, six pervasive dilemmas in school-based AOD intervention research were discussed. Examples of potential solutions to these dilemmas were gleaned from an ongoing randomized clinical trial of a Student Assistance Program.School-based AOD interventions have several potential advantages over more traditional clinic-based AOD interventions. Nonetheless, there are many challenges and dilemmas to conducting and evaluating interventions in school settings. With patience and guidance, these challenges can be addressed successfully. [ABSTRACT FROM AUTHOR]