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There is a need for librarians to find ways to provide service to the youth population regarding mental health. Building on prior research about co-design and virtual reality in public libraries, the research team aimed to create a positive teen mental health experience by co-designing a virtual reality space through the library system. Eight librarians/library staff representing three participating sites were interviewed at the beginning and the end of the project. We discuss various opportunities and difficulties that emerged in this project to better understand the role and perspective of librarians and then examine implications for those who are considering implementing similar youth programs at their institutions. On the basis of the findings, we propose a recipe-based co-design model to better support librarians by allowing flexibility while clarifying which core elements need to be preserved in the co-design process. [ABSTRACT FROM AUTHOR]

Background: Thers is limited research examining modifiable cardiometabolic risk factors with a single-item health behavior question obtained during a clinic visit. Such information could support clinicians in identifying patients at risk for adverse cardiometabolic health. We investigated if children meeting physical activity or screen time recommendations, collected during clinic visits, have better cardiometabolic health than children not meeting recommendations. We hypothesized that children meeting either recommendation would have fewer cardiometabolic risk factors. Methods and findings: This cross-sectional study used data from electronic medical records (EMRs) between January 1, 2013 through December 30, 2017 from children (2–18 years) with a well child visits and data for ≥1 cardiometabolic risk factor (i.e., systolic and diastolic blood pressure, glycated hemoglobin, alanine transaminase, high-density and low-density lipoprotein, total cholesterol, and/or triglycerides). Physical activity and screen time were patient/caregiver-reported. Analyses included EMRs from 63,676 well child visits by 30,698 unique patients (49.3% female; 41.7% Black, 31.5% Hispanic). Models that included data from all visits indicated children meeting physical activity recommendations had reduced risk for abnormal blood pressure (odds ratio [OR] = 0.91, 95%CI 0.86, 0.97; p = 0.002), glycated hemoglobin (OR = 0.83, 95%CI 0.75, 0.91; p = 0.00006), alanine transaminase (OR = 0.85, 95%CI 0.79, 0.92; p = 0.00001), high-density lipoprotein (OR = 0.88, 95%CI 0.82, 0.95; p = 0.0009), and triglyceride values (OR = 0.89, 95%CI 0.83, 0.96; p = 0.002). Meeting screen time recommendations was not associated with abnormal cardiometabolic risk factors. Conclusion: Collecting information on reported adherence to meeting physical activity recommendations can provide clinicians with additional information to identify patients with a higher risk of adverse cardiometabolic health. [ABSTRACT FROM AUTHOR]

Introduction: Children living in rural, regional and remote locations experience challenges to receiving services for mental illness and challenging behaviours. Additionally, there is a lack of clarity about the workforce characteristics to address the needs of this population. Objective: To scope the literature on the rural, regional and remote child mental health and behavioural workforce and identify barriers and enabling mechanisms to mental health service provision. Design: A scoping review utilising the Joanna Briggs Institute methodology. A database search was undertaken using Medline, CINAHL, PsycINFO, ProQuest and Scopus to identify papers published 2010–2023. Research articles reporting data on mental health workforce characteristics for children aged under 12 years, in rural, regional or remote locations were reviewed for inclusion. Findings: Seven hundred and fifty‐four papers were imported into Covidence with 22 studies being retained. Retained studies confirmed that providing services to meet the needs of children's mental health is an international challenge. Discussion: The thematic analysis of the review findings highlighted four workforce strategies to potentially mitigate some of these challenges. These were: (1) The use of telehealth for clinical services and workforce upskilling; (2) Role shifting where non mental health professionals assumed mental health workforce roles; (3) Service structure strategies, and (4) Indigenous and rural cultural factors. Conclusion: A range of potential strategies exists to better meet the needs of children with mental health and behavioural issues. Adapting these to specific community contexts through co‐design and production may enhance their efficacy. [ABSTRACT FROM AUTHOR]

Children, adolescents, and young adults are experiencing increases in mental, emotional, and social health (MESH) challenges including anxiety and depression. Out-of-school time (OST) program providers such as summer camps rely on effective communication with parents and other stakeholders to provide for these MESH needs, and the development of before and after program communication processes are viewed as a promising strategy for MESH response across youth program settings. In addition, OST program providers seek human and educational resources for meeting the MESH needs of program participants, and they also try to match available MESH resources to the work demands of their frontline staff who are tasked with responding to youth MESH needs when they arise. The importance of these topics is not reflected in available research informing recommended OST provider practices. Thus, this study examined program provider communications with parents about their youth’s MESH needs as well as program provider MESH resource utilization. Our three research questions were as follows: (1) What parent communication approaches do camp providers use to support youth MESH needs?; (2) What information is communicated to parents, teachers, or healthcare providers regarding youth MESH before and after camp?; and (3) What supports and resources do camp providers need to better manage MESH issues? Findings from this research highlight camp provider MESH-related parent communications and resource utilization. Notably, while respondents indicated requesting general MESH information on the health history form, further assessment and documentation of these identified MESH issues within- and across camp seasons was lacking. Respondents also indicated camp nurses as the most prevalent human resource. Collectively, these results indicate that camp providers and out-of-camp stakeholders acknowledge the benefit of health history reporting and communication with regard to MESH challenges as well as providing MESH resources to meet employee job demands. [ABSTRACT FROM AUTHOR]

Transgender and gender diverse (TGD) youth, individuals whose gender identity is different from the sex that was assigned at birth, report higher rates of mental health and emotional challenges and are approximately twice as likely to access psychiatric inpatient services compared with cisgender peers. 1 Existing research has suggested that the minority stress that TGD youth face from having to navigate transphobic cultural contexts and systems (eg, unsupportive parents/caregivers, school staff, peers) may play a key factor in mental health disparities, such as increased risk of depression, anxiety, suicidal ideation, suicide attempts, and nonsuicidal self-harm. 1,2 These higher rates of mental health challenges among TGD youth offer an explanation as to why these youth access inpatient services significantly more frequently than cisgender peers. Research has found that TGD youth often experience discrimination during psychiatric inpatient admissions (eg, being misgendered during admission intake, facing stigmatization for an evolving gender identity, and receiving care from staff who have not been trained to provide gender-affirming care), 3 despite professional organizations, such as the American Academy of Child and Adolescent Psychiatry, underscoring the importance of TGD youth receiving psychiatric care that is inclusive and affirming. 4 Given that the inpatient setting offers a unique opportunity to facilitate positive and affirming changes for TGD youth, it is essential for providers to have a strong understanding of what affirmative care looks like within this context to best support this vulnerable patient population and reduce experiences of discrimination. [ABSTRACT FROM AUTHOR]

Risk factors for psychological distress among help-seeking youth are poorly understood. Addressing this gap is important for informing mental health service provision. This study aimed to identify risk factors among youth attending Jigsaw, a youth mental health service in Ireland. Routine data were collected from N = 9,673 youth who engaged with Jigsaw (Mean age = 16.9 years, SD = 3.14), including presenting issues, levels of psychological distress, age, and gender. Confirmatory Factor Analysis identified thirteen factors of clustering issues. Several factors, including Self-criticism and Negative Thoughts, were strongly associated with items clustering as psychological distress, however these factors were poorly predictive of distress as measured by the CORE (YP-CORE: R2 = 14.7%, CORE-10: R2 = 6.9%). The findings provide insight into associations between young people's identified presenting issues and self-identified distress. Implications include applying appropriate therapeutic modalities to focus on risk factors and informing routine outcome measurement in integrated youth mental health services. [ABSTRACT FROM AUTHOR]

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]

In a cohort of young people referred to an Australian mental health court diversion service over a 7-year period, 46.5% of those deemed eligible (n = 523) were granted diversion and the following were identified as barriers to being granted diversion: identifying as Aboriginal and/or Torres Strait Islander, having substance use problems, prior offending, and no record of prior diversion. Young people granted diversion were significantly less likely to reoffend, even after adjustment for a range of other covariates. This study highlights the need to address barriers to mental health court diversion for young people, particularly in light of the evidence of its effectiveness in reducing risk of reoffending. [ABSTRACT FROM AUTHOR]

Background: Little is known about healthcare providers' (HCPs) contraceptive views for adolescents in Haiti, who experience high rates of unintended pregnancy. We sought to describe HCPs' perspectives on barriers and facilitators to contraceptive care delivery in rural Haiti. Methods: We conducted a cross-sectional survey and qualitative interviews with HCPs in two rural communities in Haiti from 08/2021–03/2022. We assessed demographics, clinical practice behaviors and explored contraception perspectives according to Theory of Planned Behavior constructs: attitudes, subjective norms, and perceived behavioral control (e.g., people's perceptions of their ability to perform a given behavior, barriers and facilitators of a behavior).15–17 We used descriptive statistics to report proportions and responses to Likert scale and multiple-choice questions. Guided by content analysis, we analyzed interview transcripts through thematic inductive coding and team debriefing. Results: Among 58 respondents, 90% (n = 52) were female and 53% (n = 31) were nurses. Most reported always (n = 16, 28%) or very often (n = 21, 36%) obtaining a sexual history for adolescents. A majority agreed/strongly agreed that clinicians should discuss pregnancy prevention (n = 45, 78%), high-risk sexual behaviors (n = 40, 69%), and should prescribe contraception (n = 41, 71%) to adolescents. The most frequently cited provider-level barriers (i.e., significant or somewhat of a barrier) included insufficient contraception knowledge (n = 44, 77%) and time (n = 37, 64%). HCPs were concerned about barriers at the patient-level (e.g. adolescents' fear of parental notification [n = 37, 64%], adolescents will give inaccurate information about sexual behaviors [n = 25, 43%]) and system-level (e.g. resistance to providing care from administration [n = 33, 57%]). In interviews (n = 17), HCPs generally supported contraception care for adolescents. Many HCPs echoed our quantitative findings on concerns about privacy and confidentiality. HCPs reported concerns about lack of contraception education leading to misconceptions, and community and parental judgement. HCPs expressed interest in further contraception training and resources and noted the importance of providing youth-friendly contraceptive care. Conclusions: While HCPs support contraceptive care, we identified actionable barriers to improve care for adolescents in rural Haiti. Future efforts should include increasing HCP knowledge and training, community and parent coalition building to increase contraception support and offering youth-friendly contraceptive care to offset risk for related adverse health outcomes in adolescents in rural Haiti. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a serious public health concern and overrepresented among justice-involved populations. An emerging area of research focuses on the complex, interrelated and unmet health and social needs of justice-involved women and youth with TBI. Evidence of these needs continues to grow, yet the health and justice systems continue to underperform in supporting the health and social care of justice-involved women and youth. This commentary is a call to action to begin to redress these gaps. We first provide an overview of the needs of women and youth with TBI that affect their transition from custody to community, including those related to victimization, trauma, mental health, substance use, and homelessness. We then highlight the current gaps in knowledge and practice with respect to interventions for women and youth with TBI at transition from custody. The available evidence for the impact of interventions on people with head injury who are justice-involved is sparse, especially studies of interventions focused on women and youth. We conclude with a call for implementation science studies to support translation from research to practice, emphasizing that researchers, practitioners, policy makers, and women and youth at transition should collaborate to develop, implement, and evaluate accommodations and interventions for TBI. To have meaningful, positive impacts on the systems that serve these women and youth, interdisciplinary service delivery approaches should aim to prevent, raise awareness, identify, and provide timely support and services for the varied needs of women and youth with TBI in transition. [ABSTRACT FROM AUTHOR]

Even before the COVID-19 pandemic, mental health challenges were the leading cause of disability and poor health outcomes in youth. Challenges are even greater for youth from racially and ethnically minoritized groups in the United States. Racially and ethnically minoritized youth are more vulnerable to mental health problems than White adolescents, yet are less likely to use mental health services. In late 2021, the National Institutes of Health (NIH) sponsored a virtual conference to examine the state of the science around youth mental health disparities (YMHD), focusing on youth from racially and ethnically minoritized populations and the intersection of race and ethnicity with other drivers of mental health disparities. Key findings and feedback gleaned from the conference have informed strategic planning processes related to YMHD, which has included the development of a strategic framework and funding opportunities, designed to reduce YMHD. This commentary briefly describes the collaborative approach used to develop this framework and other strategies implemented across the NIH to address YMHD and serves as an urgent call to action. [ABSTRACT FROM AUTHOR]

The article discusses the need to reconsider the best practice models of substance use care for young people. It highlights the vulnerability of young people to the negative effects of substance use and the importance of early intervention. The article identifies barriers that young people face in accessing treatment services and suggests strategies to enhance the benefits young people can gain from engagement with services. These strategies include addressing socio-structural determinants of health, providing youth-friendly and flexible treatment services, improving the culture of existing mainstream services, addressing service gaps, promoting better service linkage and collaborative care models, implementing integrated and community-based approaches, and focusing on preventative care and harm reduction services. The article emphasizes the need for a comprehensive and holistic approach to substance use care for young people. [Extracted from the article]

In this paper we explore how 15-16-year-old Norwegians experience social and cultural norms that shape their relationship with health and physical activity (PA) in a country where participation in PA is normative, in the sense that it is not only a widely shared practice but, in having significant cultural traction, is commonly understood as a 'normal' part of Norwegian daily life. The study draws upon qualitative data generated from 31 focus groups involving 148 10th graders (15-16-year-olds) in eight secondary schools in Norway. A key finding was that health was primarily viewed as synonymous with physical health and physical health as closely related to PA. A symbolic marker for physical condition - and, by extension, physical health - was physical appearance and 'looks' (in other words, physical attractiveness), revolving around gender normative bodily 'shape'. In this vein, the youngsters tended towards individualistic views of health - seeing health as a responsibility that lay largely in their hands. We argue that the significance of growing up and living in a wealthy, social democratic nation-state, with high living standards and high social and cultural expectations, can have profound implications for youngsters' perceptions of health and PA, the impact of neoliberalism notwithstanding. [ABSTRACT FROM AUTHOR]

Africa faces a significant burden of infectious diseases, including Malaria and HIV/AIDS, along with an increasing prevalence of non-infectious diseases such as diabetes and cancer. This dual health challenge is amplified by socioeconomic difficulties, restricted access to healthcare, and lifestyle changes, thus present unique scientific needs. Effectively addressing these issues requires a skilled scientific workforce adept in comprehensive healthcare strategies. This analysis explores the critical landscape of health research in Africa, emphasizing the unique opportunity presented by the continent's youthful population, projected to reach almost 1 billion by 2050. The youth's innovative potential and fresh perspectives offer a chance to overcome development barriers in health research. Nevertheless, challenges such as under-resourced education, limited research training, inadequate mentorship, and funding difficulties persist. This paper urgently calls upon African leaders, international partners, and stakeholders to prioritize health research, mobilize funding, forge strategic partnerships, and empower the youth as essential steps to capitalize on the continent's dynamic youth for breakthrough health outcomes. Such investments are vital not just for health but for the overall economic, social, and strategic growth of the continent. Through shared responsibility and a united effort, the potential of African youth can be harnessed, leading to transformative research, improved health outcomes, and a prosperous future. This perspective represents the collective voice of passionate young researchers and advocates across Africa, calling for a new era of health research on the continent. [ABSTRACT FROM AUTHOR]

To examine: (1) if youth who have mental health disorders receive needed services after they leave detention—and as they age; and (2) inequities in service use, focusing on demographic characteristics and type of disorder. We used data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois in 1995. Participants were re-interviewed up to 13 times through 2015. Interviewers assessed disorders using structured diagnostic interviews and assessed service use using the Child and Adolescent Service Assessment and the Services Assessment for Children and Adolescents. Less than 20% of youth who needed services received them, up to median age 32 years. Female participants with any disorder had nearly twice the odds of receiving services compared with male participants (OR: 1.82; 95% CI: 1.41, 2.35). Compared with Black participants with any disorder, non-Hispanic White and Hispanic participants had 2.14 (95% CI: 1.57, 2.90) and 1.50 (95% CI: 1.04, 2.15) times the odds of receiving services. People with a disorder were more likely to receive services during childhood (< age 18) than during adulthood (OR: 2.29; 95% CI: 1.32, 3.95). Disorder mattered: participants with an internalizing disorder had 2.26 times and 2.43 times the odds of receiving services compared with those with a substance use disorder (respectively, 95% CI: 1.26, 4.04; 95% CI: 1.49, 3.97). Few youth who need services receive them as they age; inequities persist over time. We must implement evidence-based strategies to reduce barriers to services. [ABSTRACT FROM AUTHOR]

According to the attachment theory, early experiences with primary caregivers are the foundation of the expectations and beliefs about the self, others, and the world. It becomes particularly relevant in youth living in Residential Care (RC) settings, due to their past adversities. In this context, care workers can provide emotional healing experiences by acting as secure base figures and fostering conditions for youth's revision of their internal working models. The main aim of the present study was to explore the relationship between youth attachment dimensions and satisfaction with the residential caregiving environment, as well as, to analyze the potential mediator effect of the relationship quality with care workers in RC settings in the prior association. The sample was composed of youth, aged 12 to 18 (M = 15.54; SD = 1.66) living in RC settings in Porto district, Portugal (N = 248), that responded to three self-report measures. Results showed that attachment dimensions were associated with youth satisfaction with their caregiving environment, being this association mediated by the relationship quality with care workers. This study highlights the importance of investing in good relational experiences for youth satisfaction with the RC caregiving environment. [ABSTRACT FROM AUTHOR]

There has been an increase in youth psychiatric emergencies and psychiatric inpatient hospitalizations in recent years. Mobile crisis response (MCR) services offer an opportunity to meet acute youth mental health needs in the community and to provide linkage to care. However, an understanding of MCR encounters as a care pathway is needed, including how patterns of subsequent care may vary by youth race/ethnicity. The current study examines racial/ethnic differences in the rates of inpatient care use following MCR among youth. Data included Los Angeles County Department of Mental Health (LACDMH) administrative claims for MCR in 2017 and psychiatric inpatient hospitalizations and outpatient services from 2017-2020 for youth aged 0 to 18 years. In this sample of 6,908 youth (70.4% racial/ethnic minoritized youth) who received an MCR, 3.2% received inpatient care within 30 days of their MCR, 18.6% received inpatient care beyond 30 days of their MCR, and 14.7% received repeated inpatient care episodes during the study period. Multivariate models revealed that Asian American/Pacific Islander (AAPI) youth were less likely to receive inpatient care, whereas American Indian/Alaska Native (AI/AN) youth were more likely to receive inpatient care following MCR. Youth age, primary language, primary diagnosis, and insurance status also predicted future inpatient episodes. Findings highlight differential rates of inpatient use following MCR among AAPI and AI/AN youth relative to youth from other groups. Alternative interpretations for the findings are offered related to differential levels of need and disparate penetration of community-based outpatient and prevention-focused services. The study investigates racial and ethnic differences in the rates of inpatient care receipt after youth experience a psychiatric emergency in Los Angeles County. A total of 6,908 youth received mobile crisis response services and participated in the study. No racial/ethnic differences emerged in inpatient care use within the first month of receiving mobile crisis response services, but in the longer-term, Asian American/Pacific Islander youth were the least likely to receive inpatient care, and American Indian/Alaska Native youth were the most likely to receive inpatient. No differences in inpatient care use were observed for Black and Latinx youth relative to other youth in the study. Given the high costs for inpatient care, it remains critical to connect high-risk minoritized youth to less costly community-based care. [ABSTRACT FROM AUTHOR]

Background: The onset of the COVID-19 pandemic has had an adverse impact on children, youth, and families with eating disorders (EDs). The COVID-19 pandemic exacerbated pre-existing personal and financial costs to youth, caregivers, and health professionals accessing or delivering ED services. The objectives of this mixed methods study were to (1) understand the indirect, direct medical and non-medical costs reported by youth, caregivers, and clinicians; (2) understand how the COVID-19 pandemic may have impacted these costs, and (3) explore implications of these costs with regards to barriers and resources to inform future decisions for the ED system of care. Methods: Youth (aged 16–25 years) with lived/living experience, primary caregivers, clinicians, and decision-makers were recruited with support from various partners across Canada to complete group specific surveys. A total of 117 participants responded to the survey. From those respondents, 21 individuals volunteered to further participate in either a discussion group or individual interview to provide additional insights on costs. Results: Youth and primary caregivers reported costs relating to private services, transportation and impacts of not attending school or work. Additionally, primary caregivers reported the top direct medical cost being special food or nutritional supplements (82.8%). In discussion groups, youth and caregivers elaborated further on the challenges with long waitlists and cancelled services, impact on siblings and effect on family dynamics. Clinicians and decision-makers reported increased work expectations (64.3%) and fear/isolation due to COVID-19 in the workplace (58.9%). Through discussion groups, clinicians expanded further on the toll these expectations took on their personal life. Approximately 1 in 3 health professionals reported contemplating leaving their position in 1–2 years, with greater than 60% of this group stating this is directly related to working during the pandemic. Conclusions: Findings demonstrate the need for increased support for youth and caregivers when accessing ED services both during crisis and non-crisis times. Additionally, attention must be given to acknowledging the experience of health professionals to support better retention and resource management as they continue to navigate challenges in the health care system. Plain English summary: The COVID-19 pandemic has had significant impacts for children, youth and families with eating disorders (EDs) and those who care for them. The objective of this study was to understand the impacts on financial and personal costs to youth, caregivers and clinicians when either accessing or delivering ED services during the pandemic. This study consisted of an online survey and discussion groups with youth (16-25 years old) with lived experience of an ED, primary caregivers, clinicians and decision-makers delivering ED services to understand the costs they experienced. Although many reported costs were financial, including direct medical costs (i.e. private therapy) and direct non-medical costs (i.e. transportation, accommodation costs), there were also significant personal costs to individuals and their families. Healthcare professionals also reported extensive challenges with resources and increased work expectations due to the pandemic context. Acknowledging the costs experienced by young people, families and healthcare professionals during the pandemic allows for the discussion of how we can better support those accessing or delivering ED services in times of crisis and non-crisis. [ABSTRACT FROM AUTHOR]

Background: Theory and correlational research indicate organizational leadership and climate are important for successful implementation of evidence-based practices (EBPs) in healthcare settings; however, experimental evidence is lacking. We addressed this gap using data from the WISDOM (Working to Implement and Sustain Digital Outcome Measures) hybrid type III effectiveness-implementation trial. Primary outcomes from WISDOM indicated the Leadership and Organizational Change for Implementation (LOCI) strategy improved fidelity to measurement-based care (MBC) in youth mental health services. In this study, we tested LOCI's hypothesized mechanisms of change, namely: (1) LOCI will improve implementation and transformational leadership, which in turn will (2) mediate LOCI's effect on implementation climate, which in turn will (3) mediate LOCI's effect on MBC fidelity. Methods: Twenty-one outpatient mental health clinics serving youth were randomly assigned to LOCI plus MBC training and technical assistance or MBC training and technical assistance only. Clinicians rated their leaders' implementation leadership, transformational leadership, and clinic implementation climate for MBC at five time points (baseline, 4-, 8-, 12-, and 18-months post-baseline). MBC fidelity was assessed using electronic metadata for youth outpatients who initiated treatment in the 12 months following MBC training. Hypotheses were tested using longitudinal mixed-effects models and multilevel mediation analyses. Results: LOCI significantly improved implementation leadership and implementation climate from baseline to follow-up at 4-, 8-, 12-, and 18-month post-baseline (all ps <.01), producing large effects (range of ds = 0.76 to 1.34). LOCI's effects on transformational leadership were small at 4 months (d = 0.31, p =.019) and nonsignificant thereafter (ps >.05). LOCI's improvement of clinic implementation climate from baseline to 12 months was mediated by improvement in implementation leadership from baseline to 4 months (proportion mediated [pm] = 0.82, p =.004). Transformational leadership did not mediate LOCI's effect on implementation climate (p = 0.136). Improvement in clinic implementation climate from baseline to 12 months mediated LOCI's effect on MBC fidelity during the same period (pm = 0.71, p =.045). Conclusions: LOCI improved MBC fidelity in youth mental health services by improving clinic implementation climate, which was itself improved by increased implementation leadership. Fidelity to EBPs in healthcare settings can be improved by developing organizational leaders and strong implementation climates. Trial registration: ClinicalTrials.gov identifier: NCT04096274. Registered September 18, 2019. [ABSTRACT FROM AUTHOR]

In March 2021, the Governor of Washington declared a youth mental health crisis. State data revealed high rates of youth suicide and inadequate access to services. This study aims to ascertain the kinds of support across the mental health care continuum recommended by young people and key stakeholders who could assist with implementation in Seattle. We interviewed 15 key informants to identify the contextual, structural, and individual-level factors that increase the risk of poor mental health and deter access to care among youth. We complimented these data with a 25-item survey of 117 participants in King County to assess the feasibility and acceptability of interventions for youth mental health. We conducted a deductive thematic qualitative analysis of the interviews and performed descriptive analyses of the quantitative data, using t-tests and χ2 tests to summarize and compare participant characteristics stratified by age group. Qualitative informants attributed challenges to youth mental health to social isolation and relational problems. Example interventions included creating environments that increase belonging and implementation of culturally congruent mental health services. Quantitative study participants rated all evidence-based mental health interventions presented as highly acceptable. However, youth preferred interventions promoting social connectedness, peer support, and holistic approaches to care, while non-youth preferred interventions focused on suicide, and substance abuse prevention. Key informants and survey participants identified schools as the most important setting for mental health interventions. There were no significant differences among quantitative outcomes. Our findings highlight the need for interventions that reduce isolation and increase social connectedness to support youth mental health. As the city designs youth responsive interventions, schools and digital platforms should be prioritized. Engaging multiple stakeholders, particularly young people, tackling cultural stigma surrounding mental health, and improving access to safe community spaces are important considerations for youth mental health interventions. [ABSTRACT FROM AUTHOR]

Background: Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system. Methods: We conducted 42 interviews (November 2020 to March 2022) with health and social care professionals and managers in the youth mental health system in Sweden. Interviews explored participants' experience and understanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergent study design using reflexive thematic analysis. Results: The analysis produced three themes. The first shows that collaboration is considered as essential and important, and that it serves diverse purposes and holds multiple meanings in relation to professionals' roles and responsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, and target levels, and the third captures the challenges and criticisms in collaborating across the youth mental health landscape, but also in growing possibilities for future development. Conclusion: We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system. [ABSTRACT FROM AUTHOR]

Community co-production is intended to improve public democracy as well as welfare economy. This single case study is a 'most likely' case for success and explores how experiences of equal participation among youth with mental health problems take place in a partnership between a social enterprise and a Danish municipality. I explore how the democratic dimension is configured in relation to a focus on service production and efficiency. Applying the multidimensional model of 'the collaborative turn' I find that equal participation of vulnerable citizens can be enhanced through co-production when youth with mental health problems equally partake in activities including supervisors from the municipality and a blended group of local participants. This, however, provide a dilemma. As part of their thriving, young people need to take an independent stand on things and interact in different transforming roles. But for the municipality, participation is a means to achieve municipal goals and supervisors can set standards for the participation of young people that contribute to stigma and inhibits the equal participation. [ABSTRACT FROM AUTHOR]

Background:Child and youth mental health problems represent a substantial burden of illness in Canada, with appropriate services only inconsistently available. Charitable organizations, such as Kids Help Phone (KHP), are, therefore, crucial to filling system gaps by offering 24/7 phone, chat, texting, and peer-to-peer services. Methods:We describe the services provided by KHP, the volume of use for each service, and compare usage across Canada's provinces and territories for a 5-year period from January 2018 to December 2022. Trends seen during the COVID-19 pandemic are highlighted. Results:More than 1.5 million total number of conversations were held across texting, chat, and phone services over 5 years. Considerable growth is demonstrated between 2018 and 2022, and many of the highest peaks in volume occurred in March or April of 2020, the onset of the COVID-19 pandemic. The highest proportional volumes were consistently from the northern territories. Discussion:KHP cannot provide specialized or repeat services, nor can it alone meet the scale of unmet youth mental health needs across the country. Nonetheless, KHP plays a pivotal role in the Canadian mental health system. Efforts to understand the role that KHP and other e-mental health services like it play within the national mental health landscape should be intensified to aid in understanding unmet needs, identify system gaps, and make needed enhancements. [ABSTRACT FROM AUTHOR]

Introduction: Despite widespread recognition of the health and social risks posed by parental incarceration (PI) and homelessness, these challenges are rarely considered in unison. We sought to (a) assess the experiences of homelessness among youth with and without a history of PI and (b) compare the health and healthcare utilization among youth with a combined history of PI and homelessness. Method: Examining data from eighth-, ninth-, and 11th-grade public school participants in the 2019 Minnesota Student Survey (N = 110,904), we calculated univariate and multivariate analyses to characterize the health status and care utilization of youth who have experienced PI, past-year homelessness, or both. Results: We observed higher prevalence of homelessness among youth with a history of PI compared to those without. The group with dual PI-homelessness experience had a higher proportion of youth that were younger, male, and non-White; and living in poverty or urban areas compared to youth with PI history only. Even after accounting for demographic factors, the dual PI-homelessness group evidenced higher expected odds for several physical health conditions (e.g., asthma, diabetes), and differences in care utilization indicators relative to individual PI and homelessness groups. Discussion: Findings suggest that PI may be overrepresented among recently homeless youth and that youth with such dual experience possess distinct, and often elevated, health service needs. Health, education, housing, and other systems may need intersectoral strategies to better identify and support this at-risk subset of youth through clinical and policy approaches. Public Significance Statement: This study found higher rates of recent homelessness among youth who have ever had a parent incarcerated. Both homelessness and parental incarceration tracked with worse health and use of health care services, with a potentially compounding effect. Understanding and acting upon multiple marginalization among youth is a critical task to achieve health equity. [ABSTRACT FROM AUTHOR]

Background: Children and youth experienced marked impacts on day-to-day life in the COVID-19 pandemic that were associated with poorer familial and friend relationships, and greater mental health challenges. Few studies provide self-report data on mental health symptoms from children and youth themselves. We sought to examine the associations between social factors and child and youth self-reported symptoms of worsened mood, anxiety, and irritability during the COVID-19 pandemic. Methods: A nationally representative cross-sectional survey was administered online to collect self-report data across 10 Canadian provinces among children (11–14 years) and youth (15–18 years), April–May 2022. Age-appropriate questions were based on The Partnership for Maternal, Newborn & Child Health and the World Health Organization of the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being consensus framework and the Coronavirus Health and Impact Survey. Associations between a priori defined social factors (e.g., relationship quality) and respondent self-reported mental health were evaluated using ordinal logistic regression models adjusted for age, sex, and geographic location. Results: We analyzed data from 483 (51.7%) children (11–14 years; 227, 47.0% girls) and 450 (48.3%) youth (15–18 years; 204, 45.3% girls). The parents of most children and youth had resided in Canada for over 20 years (678, 72.7%). Over one-quarter of children and youth self-identified as Black, Indigenous, or a Person of Color (134, 27.7%; 134, 29.8%, respectively). Over one-third of children and youth self-reported symptoms of worsened mood (149, 30.9%; 125, 27.8%, respectively), anxiety (181, 37.5%; 167, 37.1%, respectively), or irritability (160, 33.1%; 160, 35.6%, respectively) during, compared to pre-pandemic. In descending order of odds ratios (OR), for children and youth, worsened familial relationships (during compared to pre-pandemic) was associated with the self-reported symptoms of worsened mood (child: OR 4.22, 95%CI 2.51–6.88; youth: OR 6.65 95%CI 3.98–11.23), anxiety (child: OR 4.24, 95%CI2.69–6.75; youth: OR 5.28, 95%CI 3.17–8.86), and irritability (child: OR 2.83, 95%CI 1.76–4.56; youth: OR 6.46, 95%CI 3.88–10.90). Conclusions: Self-reported data from a nationally representative sample of children and youth suggest strong associations between social factors and mental health during the COVID-19 pandemic. Interventions targeting child and youth familial relationships may positively impact child and youth mental health. [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]

Psychogenic nonepileptic seizures (PNES) are a common type of functional neurological disorder in which patients experience seizurelike episodes. Health disparities based on race and socioeconomics, documented in children with epilepsy and adults with PNES, have not been reported in children and adolescents with PNES. We hypothesize that disparities exist in this population, which impact overall care and therefore influence outcomes. We retrospectively analyzed youth referred to our multidisciplinary clinic from 2018 to 2020. All patient charts were screened by social work before the visit to identify potential barriers to care, and a nurse conducted follow-up calls. Patients' race was identified from the electronic health record and compared with several variables. Outcomes were collected via phone follow-up. Descriptive statistics were produced, and comparisons between white patients and patients of other races were completed using Fisher exact tests and multivariable logistic regressions. During the study period, 237 patients were eligible for the analysis. Sixty-eight patients (29%) identified as a race other than white. Only 60%, 56%, and 40% of the cohort were reached for follow-up at one, three, and 12 months, respectively. In general, outcomes were similar between racial groups; however, we found that patients of nonwhite race were more likely to receive support from social work due to barriers identified in screening (P = 0.045). Health disparities based on race may exist in youth with PNES. A multidisciplinary clinic including social work may help mitigate barriers leading to more equitable care and similar outcomes for white and nonwhite youth with PNES. [ABSTRACT FROM AUTHOR]

Studies from multiple countries report that most hospitalized children, especially the youngest and sickest, experience pain that is often severe yet inadequately treated. Evidence suggests this can lead to immediate and lifelong consequences affecting children, families, and communities. Partnership and shared decision-making by children, families, and clinicians is the ideal pediatric healthcare model and can improve care quality and safety, including pain care. A growing evidence base demonstrates that inpatient portals (electronic personal health record applications linked to hospital electronic medical or health records) can improve child and family engagement, outcomes, and satisfaction during hospitalization. This study examined the perspectives of caregivers of hospitalized children and of hospitalized youth about using an inpatient portal to support their engagement in pain care while in hospital. A qualitative descriptive study design was used and 20 participants (15 caregivers and 5 youth) with various painful conditions in one pediatric hospital participated in semistructured interviews. The authors applied a reflexive content analysis to the data and developed 3 broad categories: (1) connecting and sharing knowledge about pain, (2) user-centred designs, and (3) preserving roles. These findings outlined caregiver and youth recommendations for portal configurations that deeply engage and empower children and families in pain care through multidirectional knowledge sharing, supporting caregiver and clinicians' roles without burdening, or replacing human interaction implicit in family-centered pain care. Further research should measure the impact of portals on pain-related outcomes and explore the perspectives of clinicians. [ABSTRACT FROM AUTHOR]

Background: Youth experiencing homelessness (YEH) suffer from poorer physical and mental health outcomes than stably housed youth. Additionally, YEH are forced to navigate fragmented health and social service systems on their own, where they often get lost between systems when transitioning or post-discharge. Inevitably, YEH require support with health system navigation and healthcare coordination. The aim of this study is to understand interactions within and between the emergency youth shelter (EYS) and health systems that affect healthcare coordination for YEH in Toronto, Canada, and how these interactions can be targeted to improve healthcare coordination for YEH. Methods: This study is part of a larger qualitative case study informed by the framework for transformative systems change. To understand interactions in healthcare coordination for YEH within and between the EYS and health systems, we developed a causal loop diagram (CLD) using in-depth interview data from 24 key informants at various levels of both systems. Open and focused codes developed during analysis using Charmaz's constructivist grounded theory methodology were re-analysed to identify key variables, and links between them to create the CLD. The CLD was then validated by six stakeholders through a stakeholder forum. Results: The CLD illustrates six balancing and one reinforcing feedback loop in current healthcare coordination efforts within the EYS and health systems, respectively. Increasing EYS funding, building human resource capacity, strengthening inter and intra-systemic communication channels, and establishing strategic partnerships and formal referral pathways were identified among several other variables to be targeted to spiral positive change in healthcare coordination for YEH both within and between the EYS and health systems. Conclusions: The CLD provides a conceptual overview of the independent and integrated systems through which decision-makers can prioritize and guide interventions to strengthen healthcare coordination within and between the EYS and health systems. Overall, our research findings suggest that key variables such as streamlining communication and improving staff–youth relationships be prioritized, as each of these acts interdependently and influences YEH's access, quality and coordination of healthcare. [ABSTRACT FROM AUTHOR]

Introduction: Research indicates that sexual and gender minority youth [SGMY] may engage more with information communication technologies [ICTs] more than their non-SGMY counterparts Craig SL et al. 2020. While scholarship generally explores youth's use of ICTs, there are gaps in scholarship that connect SGMY, their ICT engagement and influences to mental health. This scoping review will synthesize the literature that connects these core concepts in order to better understand the influence ITCs have on the mental health of SGMY and to develop a more fulsome understanding of this emerging area of literature. Methods and analysis: Following the scoping review framework of Arksey and O'Malley, the search will be conducted in the PsycINFO [Ovid interface, 1980-], MEDLINE [Ovid interface, 1948-], CINAHL [EBSCO interface, 1937-], Sociological Abstracts [ProQuest interface, 1952-], Social Services Abstracts [ProQuest interface, 1979-], and Scopus. Descriptive summaries and thematic analysis will summarize the articles that meet the inclusion criteria using an extraction table. Ethics and dissemination: The review outlined in this paper provides an overview of information that exists on the technology use of SGMY, ICTs and the interconnection with mental health. Results will be disseminated through peer reviewed journals and national and international conferences. As information collected for this paper as is retrieved from publicly available sources, ethics approval is not required. [ABSTRACT FROM AUTHOR]

Background: Youth healthcare services in Norway include a public health nurse (PHN) at school and local youth health centres (YHCs). They provide health services for all adolescents free of charge, focusing on health promotion and disease prevention. The present study aimed to assess possible associations between health-related quality of life (HRQoL), physical and mental health, over-the-counter analgesics (OTCA) use and use of youth healthcare services among 13–19-year-old adolescents. Methods: This study was based on national, cross-sectional data from the Ungdata Survey conducted in 2022. The sample was comprised of 16 482 adolescents. Multiple logistic regression was used to analyse the associations between HRQoL, headaches, selected physical symptoms, psychological distress, use of OTCA, PHN availability, sociodemographic variables, and use of the PHN at school or at a YHC. The KIDSCREEN-10 was used to measure HRQoL, and the Hopkins Symptoms Checklist 10 was used to measure symptoms of psychological distress. Results: Girls used the youth healthcare services more frequently than boys. Better HRQoL was significantly associated with fewer visits to the PHN at school. Girls reported lower HRQoL and mental health, and more pain and frequent OTCA use than boys. When having symptoms of psychological distress, boys had greater odds of visiting the PHN at school than girls. For girls in senior high school, headaches and OTCA use were strongly associated with visiting the PHN at school and the YHC. In senior high school, boys with an immigration background had greater odds of visiting the YHC than native Norwegian boys, while girls with an immigration background were less likely to visit the YHC than native Norwegian girls. Conclusions: Our results show that more girls than boys use youth healthcare services. When adolescents experience pain, have mental problems, use OTCA, or report low levels of HRQoL, they have greater odds of using youth healthcare services. Youth healthcare services offer excellent opportunities to support and follow up with adolescents. The findings provide important insights into youth healthcare services used by adolescents for various stakeholders, including PHNs and policy makers, with potential implications for future public health efforts. [ABSTRACT FROM AUTHOR]

The devastating impact of youth mental health concerns is increasingly evident on a global scale. This crisis calls for innovative solutions that are sufficiently accessible, scalable, and cost-effective to support diverse communities around the world. One such solution involves engagement in the arts: incorporating and building upon existing local resources and cultural practices to bolster youth mental health. In this article, we describe the global youth mental health crisis and note major gaps in the knowledge and resources needed to address it. We then discuss the potential for arts- and culture-based strategies to help meet this challenge, review the mounting evidence regarding art's ability to support mental health, and call for action to undertake critical research and its translation into accessible community practices. Four steps are suggested: (1) elevate and prioritize youth voice, (2) develop core outcome measures, (3) identify and analyze successful models around the globe, and (4) generate clear funding pathways for research and translational efforts. Worldwide implementation of arts- and culture-based strategies to address youth mental health will provide critical resources to support the health, wellbeing and flourishing of countless youth across the globe. [ABSTRACT FROM AUTHOR]

Background: Children from multi-problem families have an increased risk for experiencing mental health problems. These families face problems in several domains that are often found to be chronic and intergenerational. Yet, the effects of mental health care for youths from multi-problem families are small at best, urging research on new treatment programs. The InConnection approach is an integrated care program to improve resilience of youths with mental health needs from multi-problem families by connecting professional expertise from multiple disciplines with the informal social network of the youth. Youths are asked to nominate a youth-initiated mentor (YIM) from the supportive adults in their network. Methods: This quasi-experimental study compared the effectiveness of the InConnection approach to treatment as usual in a sample of 107 families (n = 66 intervention group, n = 41 control group) with n = 115 youths receiving treatment (cases). Youths (n = 102 reports, Mage = 15.59 years), parents (n = 85 reports) and case managers (n = 107 reports) responded to questionnaires four times over 15 months. Using these data, we measured youth resilience as the primary outcome, seven secondary outcomes, and three intermediate outcomes. Results: Latent growth models showed only one significant change in outcomes over time across conditions, namely a decrease in case manager-reported child unsafety, and only two condition effects, which were both parent-reported. Parents in the InConnection group reported improvements over time in youth's emotional and behavioral problems and their own positive parenting, whereas control parents reported no changes (ps ≤ 0.013). Discussion: The treatment conditions were not effective in improving most of the youth and parental outcomes over time, except for child safety reported by the case manager. The InConnection approach only outperformed care as usual on two parent-reported outcomes. Future research should examine for whom and under what circumstances the InConnection approach works more convincingly. Trial registration: Netherlands Trial Register NL7565. Retrospectively registered on 05/03/2019. [ABSTRACT FROM AUTHOR]

Structural racism inflicts a disproportionate burden of stress and trauma within Black communities, resulting in physical and mental health inequities that impact Black youth. Yet few multilevel interventions exist to address these deeply rooted inequities from a preventive standpoint, and even fewer are informed by the participatory input of the impacted communities. To bridge these gaps, we developed a community-based prevention strategy that promotes agency and active resistance to structural racism, Youth Empowered Advocating for Health (YEAH), and implemented it across various settings. We outline the development, implementation, and expansion of YEAH as a tool for promoting optimal health among Black communities. Lastly, we discuss lessons learned and offer a framework outlining key principles for prevention scientists to partner with Black youth and engage them in translational science to address structural racism. This framework is aimed at driving policies, practices, and procedures that promote equitable and sustainable change for and with Black communities. [ABSTRACT FROM AUTHOR]

Youth in the juvenile legal system (JLS) evidence high rates of behavioral health concerns but struggle to access services. Given that caregivers are often tasked with helping their child to initiate and persist with services, it seems important to understand how their own well‐being impacts their experiences of barriers to treatment participation for their child. The present study examined the link between caregiver (N = 196; 89% female) psychiatric concerns and experiences of treatment barriers among a sample of youth involved in the JLS. A cluster analysis revealed a cluster of caregivers with clinically significant levels of psychiatric distress and a cluster with low levels of psychiatric distress. Hierarchical regression analyses revealed that belonging to the high‐distress cluster was predictive of experiencing certain types of barriers to treatment participation. These findings have implications for interventions for addressing barriers to treatment participation for caregivers of legally involved youth. [ABSTRACT FROM AUTHOR]

Peer support, defined as the social and emotional support offered and received by individuals with a shared experience of mental health difficulties, is gaining popularity in youth mental health settings. This systematic scoping review aimed to collate and synthesise the evidence on key aspects of peer support interventions within integrated youth services and educational settings. Specifically, it synthesised evidence on the (1) assessed mental health outcomes in peer support interventions, (2) key characteristics and associated roles of peer support workers (PSWs) and (3) barriers and facilitators to implementation. A search of peer reviewed articles from January 2005 to June 2022 across five electronic databases (PsychINFO, Pubmed, Scopus, ERIC and CINAHL) was conducted. A total of 15 studies retrieved in the search met the inclusion criteria and were included in the review. This review supports previous research indicating that peer support has potential for improving recovery related outcomes. While a variety of interventions and PSW roles were reported, studies could be strengthened by providing more in‐depth information on intervention content. Examples of barriers to implementation included staff concerns around confidentiality of peer support relationships as well as PSWs' confidence in their roles. Facilitators included positive support from staff members and role clarity. [ABSTRACT FROM AUTHOR]

Youth are vulnerable to mental health challenges. Social media presents an opportunity to evaluate disinhibited mental health discourse and self-disclosure. The objective of this study was to explore reported experiences and information needs related to youth seeking support for mental health on the social media platform, Reddit.com. We searched two subreddits: r/mental health and r/teenagers on Reddit.com for posts made by youth (13–24 years) relating to mental health help-seeking behaviors and information needs. Posts were screened and relevant data were extracted, coded, and analyzed using thematic analysis. Thematic analysis of relevant posts yielded four themes: (1) navigating mental health issues, (2) disclosing to others, (3) barriers to seeking care, and (4) experiences seeking care. Youth may have a diverse range of mental health help-seeking-related information needs and may face several barriers throughout the process of seeking care. [ABSTRACT FROM AUTHOR]

This study examines therapist and caregiver report of evidence-based intervention (EBI) strategy use in the context of a community effectiveness trial of An Individualized Mental Health Intervention for Autism (AIM HI), a caregiver and child skill-building mental health intervention for school-aged children with autism. This study explores whether child, caregiver, or therapist characteristics or therapist training are associated with agreement between caregiver and therapist raters. Data were drawn from a cluster randomized effectiveness trial of AIM HI, in which therapists were trained and delivered AIM HI or treatment as usual. Therapists and caregivers completed assessments at baseline. At 6 months post baseline, therapists and caregivers reported on perceptions of therapist EBI delivery across sessions. Caregiver-therapist agreement on therapist EBI strategy use was generally high, with both reporters indicating trained therapists used more extensive EBI strategies than usual care therapists. When there were significant differences between therapists and caregivers, caregivers tended to rate therapists higher on EBI strategy delivery. The presence of an internalizing co-occurring mental health diagnosis and higher levels of child behavior problems were associated with lower caregiver-therapist agreement. Therapists with more years of experience and those with self-identified autism expertise had higher levels of therapist-caregiver disagreement. Results suggest that therapist EBI training results in increased report of therapist EBI strategy delivery from multiple reporters. There was general agreement between therapists and caregiver reporters. Examination of strategy ratings provides critical information about how stakeholders experience the delivery of EBI strategies in routine mental health services. [ABSTRACT FROM AUTHOR]

This document is a list of authors and their affiliations for an article titled "Perspectives" published in the Journal of Graduate Medical Education in June 2024. The article discusses the importance of protecting graduate medical education and providing gender-affirming care for gender-diverse youth. It highlights the impact of recent legal decisions on reproductive health care and the need for medical training programs to provide access to abortion care. The authors emphasize the importance of training in gender-affirming care for transgender and gender-diverse youth, as well as the need for accrediting and certifying bodies to mandate this training. They call for clear requirements and guidelines to ensure comprehensive education in gender-affirming care for trainees. [Extracted from the article]

On June 24, 2022, the Supreme Court of the United States overturned Roe v Wade and Planned Parenthood v Casey , ending a woman's constitutional right to access abortion. Child and adolescent psychiatrists should be gravely concerned about these decisions. Youth with mental health disorders are an at-risk population. Lack of access to reproductive care, including abortion, will adversely impact the physical and mental health of teens,2 exerting a disproportionate impact on Black and Brown youth, many of whom experience systemic racism and are in systems that leave them structurally vulnerable (ie, in foster care or legal system). These decisions will have a lasting, negative impact on medical, social, and economic outcomes of youth for generations to come. Thus, we make the case that access to reproductive care is a matter of reproductive and racial justice. [ABSTRACT FROM AUTHOR]

Youth homelessness remains a major public health issue in the USA, and youth experiencing homelessness (YEH) are still one of the more understudied and underserved groups. Comprehensive sexual and reproductive health (SRH) programs for YEH are rare. Yet, such programs are potentially effective settings through which to link YEH with housing services. Wahine ("woman") Talk is one such comprehensive program for YEH, and is a multilevel intervention delivered out of a youth drop-in center in Honolulu, Hawai 'i. One of Wahine Talk's core components is addressing basic needs, including providing linkages to housing services. Little research exists on SRH programs' opportunities and challenges to providing linkage to housing for YEH. The current study is an exploratory study asking, "What are opportunities and challenges to linking young women experiencing homelessness to housing services through a comprehensive sexual and reproductive health program?" The study team collected in-depth qualitative data through seven focus groups and 25 individual interviews with Wahine Talk staff and youth participants aged 14–22 years. Multiple team members analyzed the data using template analysis. The analysis revealed that while comprehensive SRH programs may have some opportunities and challenges to linking YEH to housing services that are consistent with traditional housing assistance programs, there are also factors specific to SRH programs. In particular, opportunities would be SRH programs employing a housing staff person and bolstering staff-youth meetings and communication. A challenge specific to SRH programs would be prioritizing youth's reproductive justice (i.e., choice) in lieu of solely prioritizing pregnancy reductions and delays; thus, it is recommended to train staff to prioritize youth's reproductive justice. The findings highlight the importance of SRH programs having staff focused on housing, sufficient opportunities for youth and staff to communicate with each other, and staff trained to prioritize youth's reproductive justice. [ABSTRACT FROM AUTHOR]

We conducted formative research to inform the creation of innovative new tools and strategies to engage professionals in communicating with youth with intellectual disabilities about sexual health. The research was guided by a multidisciplinary network of experts and an advisory board of self-advocates with intellectual disabilities and caregivers that make up Project SHINE: the Sexual Health Innovation Network for Equitable Education. A cross-sectional mixed-methods study utilized survey data from 632 disability support professionals who provide services to youth ages 16–24 with intellectual disabilities (ID). We then conducted focus groups with 36 professionals to obtain more in-depth information related to organizational support needs and suitable contexts, methods, and tools for sexuality education. Participants included licensed/credentialed direct service professionals (social workers, nurses, teachers), non-licensed direct service providers (case managers, supportive care specialists, residential care line staff), and program administrators. Quantitative and qualitative data analyses triangulated the findings across four content areas: attitudes about providing sexual health information to youth with ID, preparedness to communicate about sexuality, current communication practices, and professional needs in the field for new teaching tools and methods. We discuss how findings can be used to guide the creation and successful implementation of innovative new sexual health learning tools for youth with intellectual disabilities. [ABSTRACT FROM AUTHOR]

New evidence on a classic sociological debate allows for a test of the consequences of self-labeling with mental illness. While a medicalized "insight" perspective emphasizes the importance of self-labeling for psychological well-being and recovery, a sociologically informed "outsight" perspective draws from modified labeling, self-labeling, and stigma resistance theories to suggest that self-labeling can generate negative consequences for self-esteem. We engage this debate by examining the effects of mental illness self-labels on a crucial component of psychological well-being for persons with mental health problems—self-esteem—by using longitudinal data that followed 427 sixth-grade youth over two years. Our findings support an outsight perspective whereby adopting a self-label led to decreased self-esteem, while those who dropped a self-label experienced increased self-esteem. This conclusion calls for revisions to prevailing public mental health models that overlook how self-labels can impede rather than enhance psychological well-being and recovery efforts. [ABSTRACT FROM AUTHOR]

Introduction: Young people in a regional Central Queensland community identified concerns related to their health and health behaviours, but have limited access to health information. Objective: To explore the youth health perspectives and priorities of young people in regional Queensland and identify how young people prefer to access health information. Design: A participatory action research approach, using applied theatre methods and technology. Findings: The key challenges to youth health in regional Queensland identified by participants were substance use, in particular vaping, and bullying. Short‐form social media videos are an effective channel for communicating youth health information, but to do so must closely align with the predominant formats and trends on social media platforms. Discussion: Young people are not likely to read health information in printed form. Effective communication is the key to empowering young people to make decisions regarding their health behaviours. Our research shows that young people tend to share with other young people, and they are less likely to listen to older people and those in positions of authority. Health concerns raised ranged from cyberbullying and peer pressure to vaping, alcohol and chroming. Conclusion: Young people are more likely to engage with information that reflects their lived experience. The research concludes that we need to reconsider how information is provided for young people. Ways to empower young people and their voices via their preferred genre and format, not only to inform their health behaviours but also other aspects of their lives, is imperative. [ABSTRACT FROM AUTHOR]

Introduction: Rural young people have high rates of mental illness and low rates of help‐seeking making it crucial to extend research about service improvement in rural and remote Australia. Objective: To describe what rural young people want from their headspace service, and what rural headspace clinicians understand they provide. Design: This study used a qualitative methodology with reflexive thematic analysis to analyse participant interviews and systematically derive common themes. Findings: Thirteen participants were interviewed comprising young people aged 16 to 18 years who had accessed one of three rural headspace services, together with clinicians working in those services. Key themes for both young people and clinicians comprised accessibility, flexibility, engagement, safety, youth‐focus, and evidence‐based treatment although there were some differences of emphasis amongst themes. There was also an additional theme for young people of awareness, and for clinicians of caring. Discussion: The results supported that what young people were seeking was largely consistent with what headspace clinicians were providing. There were however some specific issues relevant to service provision in a rural context such as increased awareness of services, the need to focus on evidenced based interventions, and better promotion in schools and the local community. Service gaps such as unmet needs for young people with higher risk who might fall outside of agency requirements were also identified. Conclusion: Results of this study help inform better service delivery and increased awareness for mental health of young people in rural communities to improve access and outcomes. [ABSTRACT FROM AUTHOR]

We examine the association between trauma patterns, gender identity, ethnicity, foster care involvement, and mental health needs in a sample of low-income youth. Our community sample included 2,175 clients aged 6 or older (Mage = 11.9), has a closely-even gender ratio (55% female and 45% male and others) and is ethnically diverse (37% Black, 31% Multiracial, 14% Latinx, 9% White, 10% Others). 61% of youth in this sample have involvement with the foster care system. Latent class analysis was used to identify trauma patterns, explore predictors of latent class membership, and estimate the cumulative mental health needs for each trauma class. Results revealed four trauma patterns (Low Trauma, Caregiving Disruption, Community Violence, and Multiple Trauma). Girls were more likely than boys to be in the high-trauma groups. Compared to Black youth, Latinx youth were more likely to be in the Multiple Trauma class, whereas White youth were less likely to be in the high trauma classes. Youth with past or current involvement with the foster care system were more likely than those without to be in the high-trauma classes. Mental health needs for youth in Low Trauma and Caregiving Disruption were comparable, but were highest for those in Community Violence. Contrary to expectation, the Multiple Trauma group did not have the highest-level mental health needs. Interventions for low-income youth can benefit from knowing which trauma patterns are associated with various levels of mental health needs. Newer models of care focusing on building healthy communities may be the way forward. [ABSTRACT FROM AUTHOR]

Early adversity is a major risk factor for the emergence of psychopathology across development. Identifying mechanisms that support resilience, or favorable mental health outcomes despite exposure to adversity, is critical for informing clinical intervention and guiding policy to promote youth mental health. Here we propose that caregivers play a central role in fostering resilience among children exposed to adversity via caregiving influences on children's corticolimbic circuitry and emotional functioning. We first delineate the numerous ways that caregivers support youth emotional learning and regulation and describe how early attachment lays the foundation for optimal caregiver support of youth emotional functioning in a developmental stage-specific manner. Second, we outline neural mechanisms by which caregivers foster resilience—namely, by modulating offspring corticolimbic circuitry to support emotion regulation and buffer stress reactivity. Next, we highlight the importance of developmental timing and sensitive periods in understanding caregiving-related mechanisms of resilience. Finally, we discuss clinical implications of this line of research and how findings can be translated to guide policy that promotes the well-being of youth and families. [ABSTRACT FROM AUTHOR]

This study aims to identify the role of new media platforms in raising awareness of health issues of university youth. the researcher used the survey descriptive approach to achieve this objective. she also used the questionnaire as a tool for gathering data. the study community consisted of 200 male and female students. the study concluded a group of results, notable among these are: most students always get enough following three media platforms of the new media platform, regarding health awareness, i.e. twitter, you tube and instagram. results showed that the new media platforms contributed in raising awareness of the university youth, through guiding them to methods of dealing with the virus in its different stages and to increase their health culture about all information relating to the virus. results showed that the show method preferred by 46.5% of the total study sample and to which they interact, regarding health issues of covid-19, through the new media platforms, are health information images and drawings (infographic). results showed that the study sample individuals responded to “motives behind depending the university youth on new media platforms, regarding health issues. results showed that the most significant motives are (to provide them with new health information about covid-19, and to correct and confirm the information and the protective health behavior with all updates from a reliable source. results showed that the study sample individuals responded with “agree” to the knowledge and behavioral effects resulting from depending on new media platforms by the university youth regarding health issues. results revealed that the study sample individuals responded “nor agree nor disagree” to moral effects. [ABSTRACT FROM AUTHOR]

Summary: Sickle cell disease (SCD) is an inherited red blood cell disorder associated with frequent painful events and organ damage. Hydroxyurea (HU) is the recommended evidence‐based treatment of SCD. However, among patients eligible for HU, prescription rates are low. Utilizing a scoping review approach, we summarized and synthesized relevant findings regarding provider barriers and facilitators to the prescription of HU in youth and adults with SCD and provided suggestions for future implementation strategies to improve prescription rates. Relevant databases were searched using specified search terms. Articles reporting provider barriers and/or facilitators to prescribing HU were included. A total of 10 studies met the inclusion criteria. Common barriers to the prescription of HU identified by providers included: doubts around patients' adherence to HU and their engaging in required testing, concerns about side effects, lack of knowledge, cost and patient concerns about side effects. Facilitators to the prescription of HU included beliefs in the effectiveness of HU, provider demographics and knowledge. Findings suggest significant provider biases exist, particularly in the form of negative perceptions towards patients' ability to adhere to taking HU and engaging in the required follow‐up. Improving provider knowledge and attitudes towards HU and SCD may help improve low prescription rates. [ABSTRACT FROM AUTHOR]

Background: Innovative approaches are needed to increase lay health workers in HIV programs. The Youth Health Africa (YHA) program is a novel approach that places young adults seeking work experience in one-year internships in health facilities to support HIV-related programming (e.g., HIV testing) or administration (e.g., filing). Methods: We implemented a pragmatic, randomized trial among 20 facilities in Ngaka Modiri Molema district in North West province from October 2020-August 2021 to assess impact of YHA interns on HIV testing, treatment initiation, and retention in care. The primary outcome was proportion of patients tested for HIV. Secondary outcomes assessed HIV positivity, initiation in care, retention in care, and HIV testing among males and adolescents/young adults. We conducted an intention-to-treat analysis accounting for variations in baseline outcomes between control and intervention facilities using difference-in-difference and controlled time series approaches. We repeated this using as-treated groupings for sensitivity analyses. Results: Fifty interns were placed in 20 facilities; thirty-four interns remained at 18 facilities through August 2021. Compared to control facilities, intervention facilities had a greater improvement in HIV testing (ΔΔ+5.7%, 95% Confidence Interval (CI): -3.7%-15.1%) and treatment initiation (ΔΔ+10.3%, 95% CI: -27.8–48.5%), but these differences were not statistically significant. There was an immediate increase in HIV testing in intervention facilities after program interns were placed, which was not observed in control facilities; this difference was significant (ΔΔ+8.4%, 95% CI: 0.5–16.4%, p = 0.036). There were no other differences in outcomes observed between intervention and control facilities. Conclusion: This was largely a null trial, but there were signals that program interns may have positive impact on HIV testing and treatment initiation. As implemented in this study, addition of YHA program interns had little impact on facility-based HIV service delivery. A higher number of interns placed per facility may be necessary to affect HIV services. Trial registration: Registration: This trial was registered with the ISRCTN (Registration number: ISRCTN67031403) in October 2022. [ABSTRACT FROM AUTHOR]