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Background: We investigated the percentage of insufficiently active adolescents who became young adults meeting moderate to vigorous physical activity (MVPA) guidelines. We also explored adolescent psychosocial and environmental factors that predicted MVPA guideline adherence in young adulthood. Methods: Participants included N = 1001 adolescents (mean age = 14.1 y) reporting < 7 hours per week of MVPA and followed (8 y later) into young adulthood through Project EAT. We examined mean weekly hours of MVPA, MVPA change between adolescence and young adulthood, and the proportion of participants meeting MVPA guidelines in young adulthood. With sex-stratified logistic regression, we tested 11 adolescent psychosocial and environmental factors predicting meeting MVPA guidelines in young adulthood. Results: Overall, 55% of insufficiently active adolescents became young adults meeting MVPA guidelines. On average, participants reported 3.0 hours per week of MVPA, which improved to 3.8 hours per week in young adulthood. Among female participants, higher MVPA in adolescence and stronger feelings of exercise compulsion predicted greater odds of meeting adult MVPA guidelines (odds ratioMVPA = 1.18; odds ratiocompulsion = 1.13). Among female and male participants, perceived friend support for activity in adolescence predicted greater odds of meeting adult MVPA guidelines (odds ratiofemale = 1.12; odds ratiomale = 1.26). Conclusions: Insufficiently active adolescents can later meet adult guidelines. Interventions that increase perceived friend support for activity may benefit individuals across development. [ABSTRACT FROM AUTHOR]

Objective: Limited research incorporates an intersectional approach when evaluating disordered eating behaviors among those holding minoritized social positions, such as lesbian, gay, bisexual, queer, questioning, and/or transgender/gender diverse (LGBTQ) adolescents. The current study assessed stigma experiences from peers at school, self‐esteem, LGBTQ pride, and overlapping social positions as they relate to disordered eating behaviors among LGBTQ adolescents. Method: Participants included 11,083 adolescents (Mage = 15.6, SD = 1.3; 34.8% transgender/gender diverse) from a large national survey study of LGBTQ adolescents from 2017. Exhaustive Chi‐square Automatic Interaction Detection analysis was used to identify bias‐based bullying experiences (i.e., weight‐based, identity‐based), self‐esteem, LGBTQ pride, and overlapping social positions (i.e., gender identity, sexual identity, race/ethnicity, body mass index (BMI) percentile) associated with the highest prevalence of unhealthy weight control behaviors, extreme unhealthy weight control behaviors, and past year binge eating. Results: Adolescents in the 28 identified groups with a high prevalence of disordered eating behavior held at least one structurally marginalized social position (e.g., high BMI), bias‐based bullying experience, low self‐esteem, or low LGBTQ pride in addition to being LGBTQ. Weight‐based bullying was a salient risk‐factor for disordered eating across social positions. Among adolescents with the same social positions, levels of self‐esteem, LGBTQ pride, but no bias‐based bullying experience, prevalence estimates of disordered eating were, on average, 23% lower. Discussion: LGBTQ adolescents with multiple marginalized social positions and related factors engage in disproportionately high prevalence disordered eating. Findings underscore the importance of addressing intersecting experiences of stigma to reduce disordered eating and promote health equity among adolescents. Public significance: Multiply marginalized LGBTQ adolescents, most of whom also reported experiencing bias‐based bullying from peers at school, reported disproportionately high prevalence disordered eating. In comparison groups of adolescents with no bias‐based bullying experience, prevalence of disordered eating was, on average, 24% lower. Findings underscore the importance of addressing intersecting experiences of stigma to reduce disordered eating and promote health equity among adolescents. [ABSTRACT FROM AUTHOR]

Objective: To examine: (1) cross-sectional and longitudinal associations between measures of food insecurity (FI; household status and youth-reported) and intuitive eating (IE) from adolescence to emerging adulthood; and (2) the association between FI persistence and IE in emerging adulthood. Design: Longitudinal population-based study. Young people reported IE and FI (two items from the US Household Food Security Module) in adolescence and emerging adulthood. Parents provided data on household FI via the six-item US Household Food Security Module in adolescence. Setting: Adolescents (M age = 14·3 ± 2 years) and their parents, recruited from Minneapolis/St. Paul public schools in 2009–2010 and again in 2017–2018 as emerging adults (M age = 22·1 ± 2 years). Participants: The analytic sample (n 1372; 53·1 % female, 46·9 % male) was diverse across race/ethnicity (19·8 % Asian, 28·5 % Black, 16·6 % Latinx, 14·7 % Multiracial/Other and 19·9 % White) and socio-economic status (58·6 % low/lower middle, 16·8 % middle and 21·0 % upper middle/high). Results: In cross-sectional analyses, youth-reported FI was associated with lower IE during adolescence (P = 0·02) and emerging adulthood (P < 0·001). Longitudinally, household FI, but not adolescent experience of FI, was associated with lower IE in emerging adulthood (P = 0·01). Those who remained food-insecure (P = 0·05) or became food-insecure (P = 0·02) had lower IE in emerging adulthood than those remaining food-secure. All effect sizes were small. Conclusions: Results suggest FI may exert immediate and potentially lasting impacts on IE. As evidence suggests IE is an adaptive approach conferring benefits beyond eating, it would be valuable for interventions to address social and structural barriers that could impede IE. [ABSTRACT FROM AUTHOR]

Bias-based bullying (e.g., bullying related to race, weight, sexual orientation) is a common experience among youth, yet few school-based prevention programs explicitly address this type of bullying. This study explores whether schools that offer diversity education activities have lower rates of bias-based bullying among students compared to schools that do not offer these activities. Data came from two sources: the 2018 CDC School Profiles Survey (N = 216 schools) and the 2019 Minnesota Student Survey (N = 64,510 students). Multilevel logistic regression tested associations between diversity education activities (diversity clubs, lessons, or special events) and eight types of bias-based bullying among students, with attention to effect modification by relevant demographic characteristics. Students attending schools that offer a wider variety of diversity education opportunities had significantly lower odds of bullying about race, ethnicity, or national origin among boys of color (OR = 0.89, CI: 0.80, 1.00), about sexual orientation for gay, bisexual, and questioning boys (OR = 0.81, CI: 0.67, 0.97), and about disability for boys with a physical health problem (OR = 0.86, CI: 0.76, 0.99). Attending a school with more types of diversity education activities may protect vulnerable students against specific types of bias-based bullying and advance health equity. A diversity education is recommended as a key component of antibullying efforts and policy. [ABSTRACT FROM AUTHOR]

The authors examined whether team athletic involvement is related to sexual violence victimization and perpetration among male and female high school students. A secondary data analysis was conducted with Minnesota Student Survey data gathered from 122,501 Minnesota eighth-grade, ninth-grade, and 11th grade students. Multivariable logistic regression indicates that sport-involved youth are more likely to be involved in sexual violence than peers not involved in sports. For example, highly sport-involved males are significantly more likely to coerce a partner into sex (odds ratio [OR] = 1.35, 95% confidence interval [CI] = [1.01, 1.67]) and be coerced (OR = 1.19, 95% CI = [1.02, 1.38]) than nonsport peers. The results suggest high school sport programs could be an important site to implement comprehensive sexual violence prevention programs targeted at individual actions as well as harmful cultural norms and systematic inequities. [ABSTRACT FROM AUTHOR]

Objective: This study assessed cross‐sectional and longitudinal relationships between weight teasing and disordered eating in an ethnically/racially and socioeconomically diverse sample of young people and examined these relationships across sociodemographic characteristics. Method: The EAT 2010–2018 study surveyed adolescents (n = 1,534) in the Minneapolis/St. Paul public schools (mean age = 14.4 years) and 8 years later (mean age = 22.2 years). Results: Weight teasing was prevalent in adolescence (34.1%) and young adulthood (41.5%). In analyses adjusted for sociodemographic characteristics and body mass index, weight teasing was cross‐sectionally associated with a higher prevalence of all disordered eating behaviors during both adolescence and young adulthood. For example, 64.5% of young adults who reported being teased about their weight engaged in unhealthy weight control behaviors, compared with 47.9% among those not teased (p <.001). There were fewer observed associations in longitudinal analyses, although weight teasing still predicted prevalent overeating and both prevalent and incident dieting (incident dieting—teased: 48.4% vs. not teased: 38.0%, p =.016). Weight teasing and disordered eating were more prevalent among Black, Indigenous, and People of Color (BIPOC) young people and those from low socioeconomic backgrounds, and the relationship between weight teasing and disordered eating was similar across ethnic/racial, socioeconomic, and gender demographic groups. Discussion: Results indicate that weight teasing is strongly correlated with disordered eating in both adolescence and young adulthood regardless of ethnicity/race, socioeconomic status, or gender. Finding suggest that future research and policy interventions should address weight stigma and prioritize the needs of BIPOC young people and young people from low socioeconomic backgrounds. [ABSTRACT FROM AUTHOR]

Weight teasing from family members is common during adolescence. However, little is known about parental factors that increase adolescents' risk for family weight teasing and its adverse health sequelae. Using multi-informant data from adolescents, mothers and fathers, the current longitudinal study examined how parental concerns about their child's weight and their own weight contribute to family weight teasing in adolescence and its long-term health consequences. Data were collected in the population-based Project EAT 2010–2018 (Eating and Activity over Time) study, following a longitudinal cohort of young people (N = 2,793). Parental weight concerns for their adolescent and themselves were reported by mothers (N = 2,298) and fathers (N = 1,409) at baseline and examined as a predictor of family weight teasing in adolescence as well as a moderator of family weight teasing effects on health eight years later. Mothers' and fathers' concerns about their child's weight, as well as mothers' dieting frequency, increased the likelihood of adolescents experiencing family weight teasing. Longitudinal analyses revealed that adolescents teased about their weight by family had higher levels of stress (β =.21, 95% confidence interval [CI] =.09–.33) and substance use (β =.16, 95% CI =.04–.28), and lower self-esteem (β = −.16, 95% CI = −.28 to −.05) in young adulthood. Findings highlight parent weight concern, particularly concern for their child's weight, as a risk factor for family weight teasing. These findings underscore the importance of encouraging parental attention to health, rather than weight, in family-based treatment and public health initiatives. [ABSTRACT FROM AUTHOR]

Research on enacted stigma, or stigma- and bias-based victimization, including bullying and harassment, among lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth often focuses on one context (e.g., school) or one form (e.g., bullying or microaggressions), which limits our understanding of these experiences. We conducted qualitative go-along interviews with 66 LGBTQ adolescents (14–19 years) in urban, suburban, town, and rural locations in the United States and Canada identified through purposive and snowball sampling. Forty-six participants (70%) described at least one instance of enacted stigma. Three primary themes emerged: (1) enacted stigma occurred in many contexts; (2) enacted stigma restricted movement; and (3) second-hand accounts of enacted stigma shaped perceptions of safety. Efforts to improve well-being among LGBTQ youth must address the diverse forms and contexts of enacted stigma that youth experience, which limit freedom of movement and potential access to opportunities that encourage positive youth development. School nurses can play a critical role in reducing enacted stigma in schools and in collaboration with community partners. [ABSTRACT FROM AUTHOR]

CONTEXT: Transgender and gender‐diverse youth experience significant health disparities across numerous domains of health, including sexual health. Among general populations, parent connectedness has been strongly associated with youth sexual health. METHODS: The relationships between parent connectedness and sexual health indicators were investigated among 2,168 transgender and gender‐diverse youth who participated in the 2016 Minnesota Student Survey, a statewide population‐based survey of ninth‐ and 11th‐grade students. Multivariate logistic regression models, stratified by sex assigned at birth, tested associations between parent connectedness—youth's perceptions of parent caring and parent–youth communication—and eight sexual health indicators: ever having had sex, having multiple sexual partners in the past year, pregnancy involvement, substance use at last sex, partner communication about STI prevention, partner communication about pregnancy prevention, condom use at last sex and pregnancy prevention methods at last sex. RESULTS: The level of parent connectedness was inversely associated with ever having had sex, regardless of sex assigned at birth (odds ratios, 0.6–0.8). Although level of connectedness was inversely associated with having multiple sexual partners in the past year and pregnancy involvement among transgender and gender‐diverse youth assigned male at birth (0.6–0.7), these relationships were nonsignificant among transgender and gender‐diverse youth assigned female at birth. Further differences in associations between parent connectedness and four sexual risk–reduction behaviors were found between youth assigned male at birth and those assigned female. CONCLUSIONS: As with other populations, parent connectedness promotes sexual health among transgender and gender‐diverse youth and may provide a point of intervention. [ABSTRACT FROM AUTHOR]

Research has identified discrimination and a lack of knowledgeable providers as major barriers for transgender and gender diverse (TGD) individuals seeking care, which contributes to greater stress and significant health disparities affecting this population. However, research involving TGD youth is limited. The aim of this study, therefore, was to describe TGD adolescents' experiences, concerns and needs in healthcare settings, including their feedback on themes previously identified by healthcare providers (i.e. discomfort with gender‐related topics, reasons for not asking patients about gender and previous training regarding gender diversity). The authors conducted semi‐structured interviews with 12 TGD‐identified adolescents aged 14–17, living in Minnesota, USA in 2017–2018. Inductive thematic analysis was used to summarise participant comments into themes and subthemes. Two main themes were directly relevant to concerns and needs of TGD youth in healthcare settings and their views on healthcare providers' concerns: (a) asking about gender and pronouns and (b) training for healthcare providers. Findings suggest the need for revisions to clinic materials, infrastructure and protocols. Adding training to all general medical and nursing education to increase knowledge, comfort and competence around gender identity would further improve care and ultimately reduce healthcare disparities affecting TGD youth. [ABSTRACT FROM AUTHOR]

Background and purpose: The World Health Organization has developed standards for youth-friendly health services to support adolescents and encourage health care utilization among youth. Necessary building blocks for youth-friendly care include strong interpersonal relationships between youth and health care providers. Nurse practitioners (NPs) may be particularly well positioned to form these relationships. This study explored a core aspect for building youth-provider relationships. The study examined how lesbian, gay, bisexual, transgender, and queer (LGBTQ) adolescents discussed use of personal pronouns (e.g., he, she, they, ze) in relation to transgender and gender diverse (TGD) people. Methods: A secondary qualitative analysis of 66 in-depth interviews with LGBTQ youth from across Minnesota, Massachusetts, and British Columbia, Canada was conducted. Results were sorted into four main themes describing different aspects of personal pronoun use as related to TGD individuals. Conclusions: Stories and experiences shared by participants illustrate how to assess which pronouns to use for a given person, how to use pronouns in different contexts, why respecting pronouns is important to TGD people, and flexibility as an integral component of the learning process when it comes to appropriate pronoun use. Implications for practice: Understanding how youth discuss personal pronouns could improve practice with TGD youth. Each of the four themes can be applied to clinical encounters to ensure culturally sensitive care. Practice recommendations include asking adolescents what pronouns they prefer clinic staff to use on intake forms and having NPs and clinic staff provide their own pronouns to patients in introductions. [ABSTRACT FROM AUTHOR]

The aim of the study was to identify whether parent encouragement to diet as an adolescent predicts subsequent encouragement to diet from significant others/romantic partners as an adult and examine longitudinal associations between cumulative encouragement to diet from close relationships (i.e., parent and significant other) and later weight, weight-related, and psychosocial well-being outcomes in adulthood. Data from Project EAT I-IV, a 15-year longitudinal population-based study of socioeconomically and racially/ethnically diverse adolescents followed into adulthood (n = 1,116; mean age = 31.1 years; 61% female), were used for this study. Surveys and anthropometric measures were completed at school by adolescents in 1998–1999, and follow-up mailed and online surveys were completed at approximately 5-year intervals between 2003 and 2016. Adolescents who experienced encouragement to diet from their parents were more likely to have a significant other as an adult who also encouraged them to diet. In addition, there was a significant (p <.05) cumulative effect of encouragement to diet, such that experiencing more encouragement to diet from both a parent(s) and significant other was associated with higher weight status, more unhealthy weight-control behaviors (e.g., dieting, binge eating, and unhealthy weight control behaviors), and lower psychosocial well-being (e.g., lower body satisfaction and self-esteem and higher depressive symptoms) as a young adult. Encouragement to diet tracked from one close relationship to another and had a cumulative effect on adult weight, weight-related, and psychosocial well-being outcomes. Future interventions, clinical work, and research should be aware of these patterns and cumulative effects of encouragement to diet to target key relationships to reduce these harmful interpersonal patterns. [ABSTRACT FROM AUTHOR]

Objective: This study examines the prevalence of weight-based teasing by family members and associations with unhealthy weight control behaviors, body satisfaction, self-esteem, and depressive symptoms among adolescents from three immigrant communities (Latinx, Hmong, and Somali).Methods: Data come from EAT 2010, a population-based study of weight and related behaviors (N = 1577, mean age = 14.5 years). Adjusted models tested associations between weight-based teasing and well-being, controlling for BMI and ethnic group; effect modification by ethnic group and acculturation were also explored.Results: Family weight-based teasing was common (12.1%-42.9% reporting this experience across gender and ethnic groups) and was associated with all four measures of well-being in the expected direction. Associations were statistically equivalent in all ethnic groups and were not modified by acculturation.Conclusion: Youth from immigrant communities experience family weight-based teasing and associated threats to well-being. Additional research is needed to further understand the cultural context of weight-based teasing and develop relevant prevention messages. [ABSTRACT FROM AUTHOR]

Nurses and physicians receive minimal training about providing competent care to transgender and gender-diverse (TGD) patients, and training specific to TGD youth is particularly lacking. This qualitative study examined health care providers' experiences and attitudes about working with TGD youth to identify specific training needs. Semistructured interviews were conducted with 14 nurses and physicians who work with adolescents. Thematic analysis was used to characterize participants' responses. Five themes summarized participants' responses to interview questions: Training Regarding Gender Diversity, Discomfort With Gender-Related Topics, Reasons for Not Asking About Gender, Talking About Gender With Patients , and Need for Resources. Findings highlight multiple opportunities to improve provider education and care experiences of TGD youth. Specific training is needed to help providers manage discomfort with gender-related topics and simultaneously develop their knowledge of and skills for discussing gender issues. [ABSTRACT FROM AUTHOR]

This study sought to identify factors distinguishing transgender/gender non-conforming (GNC) adolescents across three groups: no self-harm, non-suicidal self-injury (NSSI) only, and NSSI and suicide attempt (NSSI + SA). Data were from the 2016 Minnesota Student Survey. The final analytic sample included 1,635 transgender/GNC students in grades 9 and 11. Logistic regression analyses determined factors that best distinguished transgender/GNC students who reported self-harm (NSSI only or NSSI + SA) from those who reported no self-harm, and transgender/GNC adolescents who reported NSSI + SA from those who reported NSSI only. Final models were developed over 3 stages of analysis that tested associations of variables within risk factor, protective factor, and health-risk behavior domains to self-harm. Over half (51.6%) of transgender/GNC adolescents reported past-year self-harm behavior. Factors that consistently distinguished transgender/GNC youth who reported self-harm from those who reported no self-harm included reports of a mental health problem, depression, running away from home, and substance use (alcohol or marijuana use). Factors that distinguished the NSSI + SA group from the NSSI only group were reports of a mental health problem, physical or sexual abuse, relationship violence, bullying victimization, less parent connectedness, lower grades, lower levels of perceived school safety, and running away from home. Clinicians and school personnel need to be prepared to address risk factors and enhance protective factors that may reduce the likelihood this population of vulnerable youth will engage in NSSI and/or attempt suicide. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the root causes of the substantial disparities in risk and protective factors among transgender and gender diverse (TGD) adolescents is essential to the development and expansion of resources and supports for this vulnerable population. This study examines differences in emotional distress, bullying victimization, and protective factors among TGD high school students in city, suburban, town, and rural locations. Methods: Data come from a statewide school‐based survey conducted in Minnesota in 2016 (n = 2,168 TGD youth). Analysis of covariance models were used to predict the prevalence of multiple indicators of emotional distress, bullying victimization, and protective factors across the 4 location categories, with multiple adjustments. Findings: Significant linear trends were observed for 2 emotional distress outcomes and 2 bullying victimization outcomes, with urban TGD students having the lowest rates and rural having the highest prevalences. Additional significant differences in emotional distress were noted, with unexpectedly high rates of depressive symptoms and suicidal ideation among suburban students. Conclusions: Helping TGD adolescents in all types of locations identify resources and supportive professionals is critical to supporting this population. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the relative importance of dissatisfaction, overvaluation, and preoccupation with body weight and shape in predicting increases in disordered eating behaviors and depressive symptoms from adolescence through to early adulthood. Method: The study involved 1,830 participants (60% female) who completed the Project EAT survey during adolescence (mean age = 14.90 years, SD = 1.65 years) and again, 15 years later, in early adulthood. Participants provided assessments of dissatisfaction, overvaluation and preoccupation with weight and shape, as well as disordered eating and depressive symptoms at both time points. Results: The three aspects of body image had distinct patterns of association with the outcomes both concurrently and longitudinally. Dissatisfaction predicted depressive symptoms as well as a wide range of disordered eating outcomes, including dieting, unhealthy weight control behaviors (UWCBs), and binge eating, particularly in female participants. Preoccupation was associated with all of these disordered eating behaviors (but not with depressive symptoms) and was notably the strongest predictor of dieting and UWCBs in female participants. Overvaluation was associated with both disordered eating and depressive symptoms, although typically was a less potent predictor of difficulties than the other aspects of body image. Discussion Dissatisfaction, overvaluation, and preoccupation are related but make distinct contributions to clinically significant outcomes. Models of eating disorders should move beyond focusing exclusively on dissatisfaction or overvaluation toward a broader conceptualisation of body image. Findings from this study particularly suggest the importance of considering preoccupation with weight and shape. [ABSTRACT FROM AUTHOR]

Introduction: Early adolescence is a critical risk period for initiation of substance use. Internal assets (IAs), which are individual qualities guiding positive choices, and adverse childhood experiences (ACEs) are important protective and risk factors, respectively, against substance use. The purpose of this study is to investigate whether IAs modify associations between ACEs and early initiation of alcohol and marijuana use. Method: Data were from 9th and 11th graders who completed the 2013 Minnesota Student Survey (n = 79,339). Students reported on experiences of abuse, household dysfunction, and substance use. Multivariable logistic regressions examined associations between different types of ACEs and substance use. Interactions between IAs and ACEs were added to models to test effect modification. For significant interactions, main effects models were re-estimated at different percentiles of IAs. Result: IAs moderated associations of both abuse and household dysfunction with early initiation of marijuana (p <.003) and alcohol (p =.007) for females but not for males. For females with low IAs, odds of early initiation of marijuana were approximately twice as high as students without any ACEs. A similar pattern was detected for females' initiation of alcohol use. No effect modification was detected for IAs and experiencing only abuse or household dysfunction on initiation. Conclusion: Special attention should be paid to improving IAs among girls who have already experienced ACEs. Future research should examine protective factors that buffer the effects of ACEs for boys. [ABSTRACT FROM AUTHOR]

ABSTRACT: BACKGROUND: Sexual minority young people have demonstrated higher rates of emotional distress and suicidality in comparison to heterosexual peers. Research to date has not examined trends in these disparities, specifically, whether there have been disparity reductions or increases and how outcomes have differed over time by sex and sexual orientation group. METHODS: Minnesota Student Survey data, collected from 9th and 12th graders in 3 cohorts (1998, 2004, 2010) were used to examine emotional distress and suicidality rates. Logistic regression analyses were completed to examine outcome changes over time within and across sexual orientation/sex groups. RESULTS: With few exceptions, sexual minority youth are at increased risk of endorsing emotional distress and suicidality indicators in each surveyed year between 1998 and 2010. Young people with both‐sex partners reported more emotional distress across all health indicators compared to their opposite‐sex partnered peers. With a few exceptions, gaps in disparities between heterosexual and sexual minority have not changed from 2004 to 2010. CONCLUSIONS: Disparities in emotional health persist among youth. Research is needed to advance understanding of mental health disparities, with consideration of sexual orientation differences and contextualized to sociocultural status and changes over time. Personalized prevention strategies are needed to promote adolescent mental health. [ABSTRACT FROM AUTHOR]

In this study, we examine how lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth, who tend to experience greater feelings of isolation and discrimination than heterosexual youth, find and become integrated into supportive activities and resources. As part of a larger study on supportive lesbian, gay, bisexual, transgender, and queer youth environments, 66 go-along interviews with LGBTQ youth, from Massachusetts, Minnesota, and British Columbia were conducted. Analysis of these interviews identified important cues that prompt selfagency and integration into supportive environments and affirmative identities. In particular, we argue indirect links or cues such as media and print advertisements increase awareness of supports and resources, while personal links, such as referrals from trusted friends, adults, and regularly attended programs, can help youth form denser networks of support. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Gay-Straight Alliances ( GSAs) are school-based clubs that can contribute to a healthy school climate for lesbian, gay, bisexual, transgender, and questioning ( LGBTQ) youth. While positive associations between health behaviors and GSAs have been documented, less is known about how youth perceive GSAs. METHODS A total of 58 LGBTQ youth (14-19 years old) mentioned GSAs during go-along interviews in 3 states/provinces in North America. These 446 comments about GSAs were thematically coded and organized using Atlas.ti software by a multidisciplinary research team. RESULTS A total of 3 themes describe youth-perceived attributes of GSAs. First, youth identified GSAs as an opportunity to be members of a community, evidenced by their sense of emotional connection, support and belonging, opportunities for leadership, and fulfillment of needs. Second, GSAs served as a gateway to resources outside of the GSA, such as supportive adults and informal social locations. Third, GSAs represented safety. CONCLUSIONS GSAs positively influence the physical, social, emotional, and academic well-being of LGBTQ young people and their allies. School administrators and staff are positioned to advocate for comprehensive GSAs. Study findings offer insights about the mechanisms by which GSAs benefit youth health and well-being. [ABSTRACT FROM AUTHOR]

Background Media use has been shown to contribute to poor dietary intake; however, little attention has been paid to programming content. The portrayal of health behaviors in television (TV) programming contributes to social norms among viewers, which have been shown to influence adolescent behavior. Objective This study reports on a content analysis of beverages shown in a sample of TV shows popular with a large, diverse group of adolescents, with attention to the types of beverages and differences across shows and characters. Design Favorite TV shows were assessed in an in-school survey in 2010. Three episodes of each of the top 25 shows were analyzed, using a detailed coding instrument. Key measures Beverage incidents (ie, beverage shown or described) were recorded. Beverage types included milk, sugar-sweetened beverages (SSBs), diet beverages, juice, water, alcoholic drinks, and coffee. Characters were coded with regard to gender, age group, race, and weight status. Shows were rated for a youth, general, or adult audience. Statistical analyses χ 2 tests were used to compare the prevalence of each type of beverage across show ratings (youth, general, adult), and to compare characteristics of those involved in each type of beverage incident. Results Beverage incidents were common (mean=7.4 incidents/episode, range=0 to 25). Alcohol was the most commonly shown (38.8%); milk (5.8%) and juice (5.8%) were least common; 11.0% of incidents included SSBs. Significant differences in all types of beverage were found across characters' age groups. Almost half of young adults’ (49.2%) or adults’ (42.0%) beverage incidents included alcohol. Conclusions Beverages are often portrayed on TV shows viewed by adolescents, and common beverages (alcohol, SSBs) may have adverse consequences for health. The portrayal of these beverages likely contributes to social norms regarding their desirability; nutrition and health professionals should talk with youth about TV portrayals to prevent the adoption of unhealthy beverage behaviors. [ABSTRACT FROM AUTHOR]

Objective: The present study examines whether the prevalence of vulnerable peers in school protects the emotional health of youth who are lesbian, gay, bisexual or questioning (LGBQ), overweight, or have a disability, and if the adverse emotional effects of bullying victimization are mitigated by the presence of these peers.Methods: Survey data come from a large school-based sample of adolescents attending 505 schools. The primary independent variable was the percent of students in school with each vulnerability characteristic. Multilevel logistic regression models estimated the odds of internalizing problems, self-harm, suicidal ideation and suicide attempts among students who were LGBQ, overweight or had a disability. Cross-level interaction terms were added to determine if the association between being victimized and emotional distress was moderated by the presence of vulnerable peers.Results: Greater presence of similar students was, on average, protective against emotional distress for LGBQ girls and overweight boys. In contrast, greater presence of students with a disability was, on average, a risk factor among girls with a disability. Several tests of effect modification indicated that odds of emotional distress for those who had been victimized were lower in schools with a higher proportion of vulnerable youth.Conclusions: The presence of a similar peer group may increase the likelihood that a bystander or witness to bullying will react in a helpful way. School personnel, health care providers and other youth service professionals should inquire about social relationships at school, including experiences of harassment and perceptions of peer support, to buffer negative experiences. [ABSTRACT FROM AUTHOR]

Dating violence among U.S. adolescents is a substantial concern. Previous research indicates that Latino youth are at increased risk of dating violence victimization. This secondary data analysis examined the prevalence of physical and sexual dating violence victimization among subgroups of Latino adolescents and associations of parent communication, parent caring, and dating violence victimization using data from the 2010 Minnesota Student Survey (N = 4,814). Parallel analyses were conducted for Latino-only and multiple-race Latino adolescents, stratified by gender. Multivariate logistic regression models tested associations between race/ethnicity, parent communication, perceived parent caring, and adolescent dating violence experiences. Overall, 7.2% to 16.2% of Latinos reported physical or sexual dating violence. Both types of dating violence were more prevalent among multiple-race Latinos than among Latino-only adolescents, with prevalence rates highest among multiple-race Latino females (19.8% and 19.7% for physical and sexual dating violence victimization, respectively). In multivariate models, perceived parent caring was the most important protective factor against physical and sexual dating violence among males and females. High levels of mother and father communication were associated with less physical violence victimization among males and females and with less sexual violence victimization among females. Results highlight the importance of parent communication and parent caring as buffers against dating violence victimization for Latino youth. These findings indicate potential for preventive interventions with Latino adolescents targeting family connectedness to address dating violence victimization. [ABSTRACT FROM AUTHOR]

Background: Little is known about the exclusive adoption of healthy weight control behaviors in the absence of unhealthy weight control behaviors among adolescents. The current study aimed to determine (i) the prevalence of the exclusive adoption of healthy weight control behaviors, (ii) the pattern of eating behaviors and physical activity reported by those engaging exclusively in healthy weight control behaviors, and (iii) the socio-demographic and psychosocial factors associated with the exclusive use of healthy weight control behaviors among adolescents. Methods: In a large and diverse population-based sample of US adolescents (N = 2793) who participated in EAT 2010 (Eating and Activity in Teens) the current study examined the exclusive use of healthy weight control behaviors, which included healthy eating behaviors (eating more fruits and vegetables, eating less high-fat foods, eating less sweets, drinking less soda, and being aware of portion sizes) and engaging in physical activity for the purpose of weight management. Data were analyzed using multinomial logistic regression in STATA. Results: Overall, 24.0 % of girls and 29.2 % of boys exclusively used healthy weight control behaviors in the absence of unhealthy weight control behaviors. The exclusive use of healthy weight control behaviors was more prevalent among girls who were not overweight (27.5 %) as compared to girls who were overweight (21.0 %) or obese (17.5 %), controlling for age, socio-economic status, and ethnicity/race. In addition, the exclusive use of healthy weight control behaviors was more prevalent among girls and boys who had lower body dissatisfaction, higher self-esteem and lower depressive symptoms. Conclusion: Findings indicate that psychosocial health and body satisfaction may be important targets for promoting the exclusive use of healthy weight control behaviors among adolescents. [ABSTRACT FROM AUTHOR]

Research is needed to confirm that public health recommendations for home/family food environments are equally relevant for diverse populations. This study examined ethnic/racial differences in the home/family environments of adolescents and associations with dietary intake and weight status. The sample included 2374 ethnically/racially diverse adolescents and their parents enrolled in coordinated studies, EAT 2010 (Eating and Activity in Teens) and Project F-EAT (Families and Eating and Activity in Teens), in the Minneapolis/St. Paul metropolitan area. Adolescents and parents completed surveys and adolescents completed anthropometric measurements in 2009–2010. Nearly all home/family environment variables ( n = 7 of 8 examined) were found to vary significantly across the ethnic/racial groups. Several of the home/family food environment variables were significantly associated with one or more adolescent outcome in expected directions. For example, parental modeling of healthy food choices was inversely associated with BMI z-score ( p = 0.03) and positively associated with fruit/vegetable consumption ( p < 0.001). Most observed associations were applicable across ethnic/racial groups; however; eight relationships were found to differ by ethnicity/race. For example, parental encouragement for healthy eating was associated with lower intake of sugar-sweetened beverages only among youth representing the White, African American, Asian, and mixed/other ethnic/racial groups and was unrelated to intake among East African, Hispanic, and Native American youth. Food and nutrition professionals along with other providers of health programs and services for adolescents should encourage ethnically/racially diverse parents to follow existing recommendations to promote healthy eating such as modeling nutrient-dense food choices, but also recognize the need for cultural sensitivity in providing such guidance. [ABSTRACT FROM AUTHOR]

Background Many parents do not live with, or have shared custody of, their adolescent children (i.e., nonresident parents). The degree of their influence on their children, as compared to parents who do live with their children the majority of the time (i.e. resident parents) has not been well-studied. The current study aimed to examine whether and how resident and nonresident parents’ weight and weight-related behaviors are correlated with adolescents’ weight and weight-related behaviors. Results will inform who may be important to include in adolescent obesity prevention interventions. Methods Data from two linked population-based studies, EAT 2010 and F-EAT, were used for cross-sectional analyses. Resident parents (n = 200; 80% females; mean age =41.8), nonresident parents (n =200; 70% male; mean age =43.1), and adolescents (n =200; 60% girls; mean age =14.2 years) were socioeconomically and racially/ethnically diverse. Multiple regression models were fit to investigate the association between resident and nonresident parents’ weight and weight-related behaviors and adolescents’ weight and weight-related behaviors. Results Both resident and nonresident parents’ BMI were significantly associated with adolescents’ BMI percentile. Additionally, resident parents’ sugar-sweetened beverage consumption and fruit and vegetable intake were significantly associated with adolescents’ sugar-sweetened beverage intake and fruit and vegetable intake (p < 0.05), respectively. Furthermore, the association between nonresident parent physical activity and adolescent physical activity was marginally significant (p = 0.067). Neither resident nor nonresident parents’ fast food consumption, breakfast frequency, or sedentary behaviors were significantly associated with adolescents’ same behaviors. Conclusions These preliminary findings suggest that resident and nonresident parents may have slightly different influences on their adolescent children’s weight-related behaviors. Longitudinal follow-up is needed to determine temporality of associations. Additionally, more information is needed on relationships between nonresident parents and their children. [ABSTRACT FROM AUTHOR]

Unhealthy weight control behaviors (UWCBs) often predict future substance use, resulting in a comorbidity that predicts later health consequences. The current study aimed to examine whether weight stigma and its associated harms magnify or attenuate the effect of UWCBs at baseline on substance use at 10-year follow-up among girls and to elucidate factors related to the perceived harms of weight stigma. Data from 1147 adolescent girls from Project EAT (Eating and Activity in Teens and Young Adults) were analyzed at baseline and 10-year follow-up. Participants were split into three groups at baseline: no weight stigma; weight stigma only (being teased by peers or parents); and weight stigma with perceived harms (e.g., being bothered by teasing). Moderation and stratified regression analyses examined the role of weight stigma and its perceived harms on the relationship between UWCBs and substance use. ANOVA models aimed to elucidate factors related to the perceived harms of weight stigma. Moderation analyses revealed marginally significant effects of group membership on the effect of UWCB on substance use (p =.08). Stratified regression results indicated that UWCBs at baseline predicted substance use at 10-year follow-up among girls in the weight stigma with perceived harms group (p =.005), but not in the no weight stigma or weight stigma only groups. Girls in the weight stigma with perceived harms group reported higher weight concern, depressive symptoms and BMIs than girls who report no weight stigma or weight stigma only. Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution. Health initiatives should seek to reduce weight stigma and its associated harms to prevent substance use in girls and women. Clinicians working with adolescent girls with UWCB should inquire about experiences with weight stigma with its harms to assess substance use risk. Due to the marginally significant moderation, results should be interpreted with caution. • Unhealthy weight control behaviors (UWCBs) such as laxative use are common. • UWCBs predict substance use among girls who experience the harms of weight stigma. • UWCBs do not predict substance use in girls who do not experience weight stigma. • Weight concern and depressive symptoms are positively related to harms of stigma. • Harms of stigma may more strongly impact health than experiences of stigma alone. [ABSTRACT FROM AUTHOR]

Background Bullying and prejudice-based harassment frequently occur in school settings and have significant consequences for the health and wellbeing of young people. Yet far fewer studies have examined the role of the school environment in peer harassment than individual factors. This multilevel study examined associations between a variety of school-level risk and protective factors and student-level reports of bullying and prejudice-based harassment during adolescence. Methods Data come from 8th, 9th, and 11th graders who completed the 2013 Minnesota Student Survey ( N = 122,180 students nested in 505 schools). School-level variables were created by aggregating student report data in five areas: academic orientation to school, internal assets, teacher–student relationship quality, feelings of safety at school, and receipt of disciplinary action. Results Results indicated that youth attending schools with a higher proportion of students with strong internal assets had lower odds of nearly every type of bullying and prejudice-based harassment assessed when compared to youth attending schools with a lower proportion of students with strong internal assets. Additionally, the proportion of students feeling unsafe at school was a fairly consistent risk factor for most types of peer harassment. Conclusion Findings support the idea that prevention programs aimed at improving school-wide internal assets and feelings of safety at school may be key prevention points. [ABSTRACT FROM AUTHOR]

Research addressing the linkages between acculturation and markers of adolescent well-being across multiple ethnic minority groups is limited in scope and breadth, even though children of immigrant origin are the fastest growing population. We examined cross-sectional relationships between acculturation and substance use, socioemotional well-being, and academic achievement. Somali, Latino, and Hmong adolescents in Minnesota provided data as part of the EAT 2010 (Eating and Activity in Teens) cohort study (N = 1,066). Acculturation was based on nativity, language usually spoken at home, and length of residence in the United States. Chi-square, ANOVA, and regression models were used to test for differences in adolescent well-being by acculturation and ethnic group, and interaction terms were added to models to test effect modification by ethnicity. Hmong adolescents had the highest mean acculturation scores (4.4 ± 1.5), whereas Somali adolescents (2.2 ± 1.8) were the least acculturated. Independent of ethnicity, acculturation was positively associated with marijuana (OR: 1.38; CI [1.25, 1.53]) and alcohol use (OR: 1.12; CI [1.02, 1.22]), and was negatively associated with academic achievement, based on grade point average (β = -0.07; CI [-0.12, -0.03]). Interaction effects indicated significant differences by ethnicity only for academic achievement; significant associations between acculturation and academic achievement were evident only for Somali and Latino youth. Prevention programming should include supports for multilingual and multicultural learners and account for cultural assets within immigrant origin families that maintain and nurture protective factors as adolescents acculturate and transition into young adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Weight-based teasing is common among youth, but little is known about its long-term impact on health outcomes. We aimed to 1) identify whether weight-based teasing in adolescence predicts adverse eating and weight-related outcomes 15years later; and 2) determine whether teasing source (peers or family) affects these outcomes. Data were collected from Project EAT-IV (Eating and Activity in Teens and Young Adults) (N=1830), a longitudinal cohort study that followed a diverse sample of adolescents from 1999 (baseline) to 2015 (follow-up). Weight-based teasing at baseline was examined as a predictor of weight status, binge eating, dieting, eating as a coping strategy, unhealthy weight control, and body image at 15-year follow-up. After adjusting for demographic covariates and baseline body mass index (BMI), weight-based teasing in adolescence predicted higher BMI and obesity 15years later. For women, these longitudinal associations occurred across peer and family-based teasing sources, but for men, only peer-based teasing predicted higher BMI. The same pattern emerged for adverse eating outcomes; weight-based teasing from peers and family during adolescence predicted binge eating, unhealthy weight control, eating to cope, poor body image, and recent dieting in women 15years later. For men, teasing had fewer longitudinal associations. Taken together, this study shows that weight-based teasing in adolescence predicts obesity and adverse eating behaviors well into adulthood, with differences across gender and teasing source. Findings underscore the importance of addressing weight-based teasing in educational and health initiatives, and including the family environment as a target of anti-bullying intervention, especially for girls. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) increase risk for suicidality. School connectedness can be protective, whether it buffers the negative effects of ACEs across ethnic backgrounds is understudied. Data came from the 2016 Minnesota Student Survey. The analytic sample included Latino (n = 11,888), Somali (n = 2,302), Hmong (n = 3,503), and non-Hispanic (NH) White (n = 10,968) adolescents. Multivariable logistic regression models, stratified by ethnicity and sex, examined associations between ACEs, school connectedness, and suicide ideation and attempts. More than 40% of students reported ≥1 ACE. Significant differences in suicidality across ethnicity and sex were noted, with Latinas reporting the highest rates and Somali boys and girls reporting some of the lowest. The likelihood of suicidality was significantly higher with each additional ACE (OR range 1.70–2.23), regardless of ethnicity or sex. School connectedness was generally protective against suicidal ideation; e.g., for each unit of school connectedness, the odds of ideation were 29% lower for Latinas (OR = 0.71; 95%, CI: 0.62, 0.80). However, it only buffered the impact of ACEs on suicidality for NH White adolescents. Suicide prevention programs should be designed through an intersectional framework and be adapted and relevant to promote social connectedness to increase access to tangible, emotional social support for youth of diverse ethnic backgrounds. Findings suggest further studies are needed to identify factors that moderate the impact of ACEs for all adolescents. [ABSTRACT FROM AUTHOR]