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This paper explores teenage girls' responses to general advice, and formal prevention messages, designed to reduce sexting-related risk and prevent harm. We conducted workshops with seven groups of girls (28 in total), aged 16-17 years, in a New Zealand city. Each group participated in a series of three workshop sessions. Drawing on a Freirean 'problem-posing' approach, we designed the workshops as spaces in which girls were invited to observe and critically discuss norms related to sharing nudes as well as harm prevention messages. Girls noticed the problematic gender and sexual politics that shape abstinence-based models that target girls (implicitly) to not send nudes, but which leave boys who distribute or otherwise misuse them out of the picture. Participants navigated a careful path between attending to risk and protection on the one hand, and endorsing their right to freedom of expression on the other. We argue for a subtle, but significant, shift away from a focus on sexting safety to a focus on the prevention of image-based sexual coercion, harassment and abuse. This reframing would help to direct prevention efforts to the gendered drivers and dynamics of harm perpetration, and the ways in which they are problematically socially ignored or condoned.

Purpose: The COVID-19 pandemic has provided us a striking demonstration that the future is dynamic, unpredictable, complex and volatile. It is increasingly important that those working in the field of school-based health education reimagine the possibilities and potential of the subject to rise to the challenges presented and make a difference in learners' worlds. In this paper we explore the potential of health education learning to contribute to aspects of the Organization for Economic Co-operation and Development's (OECD's) Learning Compass 2030 from our perspective in Aotearoa New Zealand. This is a learning framework that uses the metaphor of navigation to demonstrate the competencies young people need in order to thrive in the world and has a significant focus on wellbeing for people and society (OECD, 2019). Design/methodology/approach: We explore the links between the learning compass and a socio-critical approach to secondary school-based health education learning opportunities by producing and refining our own knowledge of the learning contexts and experiences that could potentially contribute to the elements of compass. We present this as dialogue produced through asynchronous online conversations between the paper's two authors across a three-month period in 2020 -- a method befitting our COVID-19 times. Findings: After employing a deductive thematic analysis we found extensive links between health education learning and aspects of the compass which are congruent with the notion that it is more about how the subject is taught than what is covered in a socio-critical health education. We communicate our findings by organising them into three themes that arose for us in analysis: learners' capability to understand the world, navigate the world and change the world. Originality/value: We conclude the paper with key questions to consider if we are to reimagine school-based health education in order for learning experiences in the subject to enrich learners' understanding of how to navigate the complex and uncertain times they will face across their lives.

Background: A focus on equity, democracy and social justice in HPE is pertinent in an era where there are growing concerns about the impact of neoliberal globalisation and precariousness of society (Kirk 2020). Although there is advocacy for teaching approaches in HPE that address issues of social justice, there is limited empirical research of teachers enacting critical pedagogies in HPE classrooms. Purpose: To identify school HPE teaching practices that promote social justice through practical enactment across three different participating countries. Participants and Setting: The investigation involved classroom observations of and post-lesson interviews with 13 purposively selected high school health and physical education teachers from three different countries. A total of 20 HPE lessons were observed. The participants included seven male and six female teachers ranging in age from 25 to 55 years with between 3- and 25-years teaching experience. The setting for data collection was compulsory co-educational practical HPE classes with 13-15-year-old students in four schools in New Zealand, four schools in Sweden and three schools in Norway. Data Collection and Analysis: This study employed Critical Incident Technique (CIT) methodology (Flanagan 1954), involving data collection through exploratory observations and stimulated-recall interviews (Lyle 2003). The classroom observations focused on identifying incidents that appeared to be addressing issues of social justice. The use of a multi-national observer team was a key principle of the study and was based on the proposition that local researchers familiar with context come with taken-for-granted assumptions about teachers' practices. Data were analysed through a six-phase thematic analysis approach (Braun and Clarke 2013). This involved three stages: individually, collectively by the researchers in each country, and finally through the whole multi-national research team. Findings: The data analysis resulted in three primary themes; (1) relationships, (2) teaching for social cohesion, and (3) explicitly teaching about and acting on social inequities. This paper uses critical pedagogy as a lens to report on the third theme. In this paper, we present three subthemes; (1) Teaching as 'equity not equality', (2) promoting marginalised groups (3) and teacher critical reflection as examples of explicit critical pedagogies taking action for social justice in HPE. Conclusions/Implications: Although, the findings presented in this paper are examples of explicit teacher actions that aim to address social inequity, we suggest that teaching for social justice requires teachers to "take action" on social inequities and also to "teach about social injustice" to prepare students to become agents for change and act on social inequities themselves, beyond HPE.

Is it possible to track the revitalization of the Maori language statistically? Different large-scale statistical collections (censuses and surveys) in New Zealand effectively have different definitions of speaker because they ask different questions. This paper compares trends in numbers of Maori speakers as estimated from responses to questions about conversational ability, first language, and level of speaking proficiency, with particular reference to the 2013 Census and Te Kupenga (Maori social survey) 2013. One might expect estimates based on these responses to align closely, but they do not. This paper explores the relationships between the different estimates for different birth cohorts. Data on first language from at least four surveys provide strong evidence of a resurgence in intergenerational language transmission, which is not clearly apparent from the other indicators. Patterns of response to conversational ability and speaking proficiency questions are found to vary according to first language and birth cohort. It is argued that the apparent inconsistencies between the indicators reflect the real complexity of revitalization processes, as well as varying interpretations of the language questions, and that the New Zealand census language question on conversational ability is of questionable value as an indicator for tracking Maori language revitalization.

Attunement, connectedness and an 'in tune-ness' with places have repeatedly been proposed to be central to sustainable, reciprocal human-environment relations and in turn, wellbeing. In this paper, I examine young people's emplaced and embodied attunements with local beaches bordering the neighbourhoods in which they live. More specifically, the possibilities of participatory photo-talk approaches for sensing and accessing people's attunements to beachplaces are proposed. Participants' views on using photo-talk approaches are foregrounded, including the prompt and momentum given to exploring embodied feelings and experiences. The ways that photo-talk supported a shared exploration of the diverse relational entanglements of human and more-than-human beach entities are also considered. In turn, the value of such approaches for helping to 'show' and 'feel' place-specific understandings and practices of beaching, including mutually constituted wellbeing a/effects, is proposed. Following in the footprints of others, I suggest the methodological and pedagogical potential of photo-talk approaches to researchers and educators in sport, health, physical education and leisure settings when examining embodied and emplaced experiences of wellbeing.

All children have the right to an education and a voice, to be heard and to influence aspects of their lives and their education. Children and young people in foster care face unique and often challenging experiences that can make them vulnerable to having these basic rights eroded. This paper presents the findings from an in-depth study exploring the educational experiences and self-determined educational successes of young people who spent time in foster care in New Zealand. Findings from semi-structured interviews with seven young people reflected broad and holistic experiences of educational success. Relationships with teachers, foster caregivers and friends were key supports to success, along with having a voice, influence over decisions and having an advocate. Young people demonstrated marked resilience throughout the challenges they faced, which was both supportive to success, and a success in itself. Given the unique life experiences of children and young people in foster care, there is an imperative to create space for their voices to determine and define what educational success means. They need their rights to share these perspectives to enhance their own educational experiences, and to influence both the policy and practice agendas around foster care and education.

Young people in physical isolation because of significant illness experience disconnection from social and educational contexts. A ground-breaking intervention in New Zealand aimed to foster social inclusion for young people who are hospital-or-home-bound due to cancer treatment. A formative assessment of five young people aged 13-18, their parents, and their teachers was undertaken to determine the efficacy of telepresence technology to connect young persons to a chosen educational environment. Results indicate that the use of this technology enabled young people to experience being there in familiar educational environments and provided early evidence of the effectiveness of this intervention in helping to disrupt isolation, increase connectedness, and lift participants' moods. This paper highlights the implications for teachers, social workers, and counsellors.

Since the evolution of the internet in 1969 and the inception of the personal computer in the early 1970s, a significant body of research has emerged that highlights the impacts of digital technology on education, health and human development. This paper reviews research in this area and examines the physical, mental, and social health effects on children and adolescents (10- to 19-year-olds), as well as the impacts of digital technology on educational achievements. The aim of this literature review, to examine the psychological impact of digital technology, was prompted in part by the widespread use of digital technologies in schools including Bring Your Own Device (BYOD) policies. BYOD asks students to bring personal laptop or iPad/tablet computers to school. Outcomes of this study may be surprising in the quantity of research available that provides red flag alerts. This fact alone will be of interest to school leaders as policy makers. There is a need for trustworthy information on which to base reviews and revisions of school policy to reduce the risks from the use of digital technology.

This paper discusses the results of an anonymous survey completed by 239 Australian piano teachers in relation to the teaching materials and practices used by teachers with piano students aged 12-17, older beginners. The survey, which is part of a broader study investigating constructivism in music education, explores teacher choices and opinions of published teaching materials and teacher practice when teaching older beginner piano students. Research investigating older beginner piano students, teaching materials and teaching practice is scant. Studies investigating studio piano teaching has primarily focused on children (under 11 years of age), tertiary students and adult learners with a significant proportion of these conducted outside Australia. The survey asked participants, who were all studio piano teachers within Australasia, a range of questions related to the choice of, and reasons for using different teaching materials when teaching older beginners. Teaching practices were explored through specific questions that included the teacher's assessment of the strengths and weaknesses of various teaching materials, approaches to teaching older beginners and the areas of curriculum missing from currently published resources. Analysis of the survey results found that the choices of teaching materials and teaching practices of Australian studio piano teachers were motivated by a deep commitment to student progress, a strong desire for the continued enjoyment of learning and an awareness of effective pedagogy.

Existing literatures have discussed both ethical issues in visual research with young people, and the problems associated with applying 'universal' ethical guidelines across varied cultural contexts. There has been little consideration, however, of specific issues raised in projects where visual research is being conducted with young people simultaneously in multiple national contexts. This paper contributes to knowledge in this area. We reflect on our experiences of planning and conducting the International CYCLES project involving photo elicitation with young people in Bangladesh, Brazil, India, Japan, New Zealand, South Africa and the UK. While some issues such as varying access to technology for taking and sharing photos and diverse cultural sensitivities around the use of photography were anticipated in advance, others were more unexpected. Balancing the need for methods to be appropriate, ethical and feasible within each setting with the desire for sufficient consistency across the project is challenging. We argue that an 'ethics in context' approach and an attitude of 'methodological immaturity' is critical in international visual research projects with young people.

In 2013, schools in New Zealand stood-down nearly 12,000 students as a result of behavioural difficulties. Research indicates that rather than improving behaviour, stand-downs can reinforce inappropriate behaviour and potentially put students at-risk. This paper overviews the use of stand-downs in New Zealand schools, discussing the nature and extent of their use. Using examples from a small case study based around two secondary school students who had recently been stood-down, the potential adverse effects and impacts of school stand-down are discussed, and arguments put forward for finding alternatives to the practice.

Fetal Alcohol Spectrum Disorder (FASD) is the term to describe the range of adverse effects that can occur when a fetus is exposed to alcohol. At present in New Zealand there are no definitive statistics on the extent of FASD as a prevalence study has not been undertaken. However, as reported in the New Zealand Fetal Alcohol Spectrum Disorder Working Party Report (2016), at least one in two pregnancies are exposed to alcohol, with 10 per cent of these being exposed to high-risk levels. The life-long difficulties that people with FASD experience are becoming clearer as more is learnt about FASD and its effects. This paper describes the recent experience of two Year 11 teens attending different schools in New Zealand. The aim is to highlight the diversity of experience each had, due to the differing approach their school took towards them and their diagnosis of FASD.

Objective: Digital storytelling and other methods of self-expression and autobiography have become an increasingly important tool for those working with young people, including those from migrant, refugee or other 'culturally diverse' backgrounds. A structured scoping review was undertaken to better understand the potential value and challenges of using digital stories to promote the health and well-being of these diverse groups of young people and to identify key knowledge gaps. Design: The review process comprised a systematic search of the literature and strategic consultations with professionals working with young people in the area of sexual and reproductive health promotion and care. A descriptive-analytic method was used to collate and synthesise the literature and apply narrative and thematic analyses. Results: In total, 28 papers were deemed eligible for inclusion. Findings are presented as two analyses: what is known from the literature and key knowledge gaps. Identified themes included the use of digital stories as social activism and as research intervention, recognition of digital stories as complex terrain and recommendations for good practice. Three key gaps of particular relevance to our research aims were identified. These were (1) the lack of digital stories on sexual health and relationships by 'culturally diverse' young people in Australia, (2) the need for discussion of the ethical considerations of using digital storytelling and related methods in sexual health fields and (3) the value of exploring opportunities to employ digital methods as self-representation and autobiography to generate new knowledge and build organisational capacity. Conclusion: As confirmed in discussions with professionals working in the youth, migrant and sexual health sectors, the literature highlighted the many potential applications of digital storytelling to promoting the sexual health and well-being of young people from diverse backgrounds. Additional research is required to understand the particular ethical and contextual issues shaping, and at times constraining, this engagement in specific cultural contexts.

Mixed methods research requires integration of qualitative and quantitative data. However, there is debate about how to define integration and what is required for integration to occur. This paper describes a mixed methods research project which revisits datasets from different eras, which were originally instigated for different purposes and had different theoretical frameworks. Using selected results about the relationship between teenagers' vocational aspirations and adult occupations we show how the research topic and question integrated the projects within a constructivist theoretical position. We argue that reanalysing and comparing historical datasets can provide new insights into a topic even with minimal integration of the data. We recommend a broad definition of integration and reflexive research practice to encourage innovation and diversity in mixed methods research, particularly with regard to reanalysis of datasets from different eras.

Digital technology is changing every aspect of life from how we communicate to the way we learn. International trends would suggest that digital access is becoming increasingly widespread in developed countries. But general trends may hide the fact that some households still do not have access to the internet for a variety of reasons. Differences in digital access and use, particularly along socio-economic lines, may be less visible but are still present. This paper reports on a two-phase study that explores home digital access and use of young people (16-17-years-old) from a range of socio-economic backgrounds across New Zealand. Phase one sought to establish what home access is available, while the second phase explores what kinds of digital technologies are used and for what purpose among a subset of young people. Results indicate that differences in digital access do exist among young people from different socio-economic backgrounds. These differences include the number of digital devices in the home, the types of devices available, and whether the device(s) are shared or individually owned. These findings are particularly important in light of the finding that these young people perceived that digital access and use at school is inadequate and lagging behind everyday use. This suggests that there is still a considerable way to go to ensure equal digital opportunities for all.

Purpose: The purpose of this paper is to determine the extent to which youth have ready access to alcohol and the extent to which immediate family influence affects consumption. Design/methodology/approach: This qualitative descriptive exploratory study undertook semi-structured peer-group interviews with 20 participants from four New Zealand high schools. The interviews centred on exploring the "general" experiences of youth related to alcohol access--but with a focus on alcohol access "at home" and the parental role. Findings: The study confirmed that the home unit was the main source of alcohol for most youth and parents were the most common source of provision. Parents provided financial access to alcohol by giving their child money to purchase it themselves through older family members or friends. It was also found that youth used negotiation strategies with their parents to influence their consumer purchases of alcohol. Research limitations/implications: Youth frequently used strategies such as pressure tactics, exchange tactics, ingratiating tactics and consultation tactics to influence their family's decision-making process and to pressure their parents into supplying them with alcohol. Practical implications: It is important to recognise the role that family play as "gatekeepers" for readily allowing access and supplying youth with alcohol--and the reasons for doing so. Social implications: Alcohol plays an important part in many societies. It is important to understand how young people consume and access alcohol--particularly when the family plays a major role in access and consumption. Originality/value: Many studies have been conducted in relation to youth and alcohol consumption. Very few, as far as we can tell, explore the role of the family from the young consumers' perspective and especially from a qualitative narrative perspective.

This paper focuses on a major theme, identity negotiation, that arose from a qualitative study exploring the experiences of school for a group of gifted and talented adolescents in Aotearoa New Zealand. The perceptions and beliefs of the group of adolescent participants were prioritised within the phenomenological study. Findings highlight the complexities of the identities and identity negotiations of gifted and talented adolescents. Porous identity profiles within an Aotearoa New Zealand context were developed from the stories collected from the participants. These are summarised into a model which illustrates the tensions that can evolve around developing identities. The search for a "fit" in their particular socio-cultural milieu and in the world of school was a predominant concern for this diverse group of young people. The model and discussion are intended to assist educators in understanding the social and emotional vulnerabilities of gifted and talented adolescents and in critically considering the type of support needed to address their academic and social needs.

The world is changing: both a conventional and a vaccine passport are now needed to travel internationally. Mask mandates, and social distancing are the new norm in a rapidly changing society. These measures were put in place to control the spread of the highly infectious and often fatal Covid-19, caused by a viral agent, a microorganism, a zoonosis, and the cause of death for over 6 million people around the world. Considering this, maintaining biosecurity is important around the world to ensure public health. Biosecurity in New Zealand supposes that people including young people understand different pests and diseases that can harm public health. This qualitative study was conducted to gauge the biosecurity knowledge of 171 young people (14-15-year-olds). Young people were tested on their knowledge about biosecurity related plants, animals, and microorganisms. This paper reports specifically on the results of knowledge of microorganisms of young people. Results show that negative anthropocentric views dominate adolescents understanding of microorganisms and anthropomorphism is widely used to explain microorganism activity. An educational programme, targeted at developing a conceptual understanding about microorganisms starting at primary education may help develop a more educated global citizen, one versed in understanding the biology of microorganisms. [ABSTRACT FROM AUTHOR]

The need to transition away from the current car-dominated transport system is well documented in sustainability, health and transportation literatures. Despite growing interest in active and public transport modes, the car still dominates travel preferences for most age groups. There is, however, some evidence of declining preferences for car-based travel for younger generations. In this paper, we use empirical material gathered through a mixed methods study of high school students in Dunedin, New Zealand, to explore the aspirations of adolescents for private car-based transport. We present and interpret findings from a quantitative survey of high school students (n = 1240) and qualitative focus groups (n = 10 focus groups, 54 participants). Contrary to somewhat optimistic reports of reduced aspiration for driving and cars, we find evidence of ongoing preference for car-based transport, and intentions to learn to drive amongst the cohort of young urban millennials. The findings signal the importance of socialisation processes and everyday travel decisions (e.g. mode choice) for long term aspirations to replicate practices of automobility. Such findings have important implications for interventions to increase non-motorised mobilities, and reduce dependence on private vehicles across the transport system. [ABSTRACT FROM AUTHOR]

Background: Secondary schools are important settings for promoting varied physical activity (PA) opportunities for adolescents to promote PA throughout life. However, research on the effect of secondary school-based interventions on future PA is limited. This study examined the potential impact of secondary school-based interventions on the determinants of future PA participation of Aotearoa New Zealand (NZ) adolescents using simulated modelling. Methods: We used data from a nationally representative sample of secondary school students (n = 5035) aged 12–17 between 2017 and 2020 in NZ. We modelled four secondary school-based interventions and their projected impact on five determinants of future PA. Modelled interventions were the technological augmentation of physical education (TAPE), a peer-led PA mentoring programme (PL), physically active learning (PAL) and the inclusion of a natural environment play area (NE). Results: Total weekly PA increased the most from the NE intervention (+ 0.2 h/week), followed by TAPE (+ 0.08 h/week), PAL (+ 0.05 h/week) and PL (-0.06 h/week). Current number of PA settings increased the most in NE (+ 1.75 settings/week), followed by TAPE (+ 1.29 settings/week), PAL (+ 1.21 settings/week) and PL (+ 0.73 settings/week). Current number of PA types increased the most in NE (+ 1.57 types/week), followed by PL (+ 1.05 types/week), TAPE (+ 0.34 types/week) and PAL (+ 0.15 types/week). Physical literacy scores increased the most from PL (+ 3.6%), followed by PAL (+ 3.3%), TAPE (+ 0.43%) and NE (+ 0.12%). Social support scores increased the most from PAL (+ 5%), followed by PL (+ 1.9%), TAPE (+ 1.46%) and NE (+ 0.57%). Conclusions: On average, all interventions benefitted determinants of future PA participation to a small degree. Results show differing magnitudes of the intervention effect by determinant, indicating the complexities surrounding the promotion of PA adherence. Future interventions could be improved through detailed consultation alongside, and involving, adolescents and stakeholders within schools. Researchers should also prioritise the collection of longitudinal PA data and explore its connection with sociodemographic differences between adolescents. [ABSTRACT FROM AUTHOR]

High adolescent pregnancy rates in New Zealand (NZ) are influenced by limited access to contraception. In this paper, we discuss using a proactive contraception provision (PCP) model to overcome barriers that prevent effective contraceptive uptake. After outlining steps taken to assess acceptability of PCP in NZ, we cover three issues to consider with PCP: the range of contraceptives that should be offered, the age range that should be approached, and finally whether to include adolescents without uteruses. We conclude that PCP is an approach worth considering in the NZ context and should be piloted to assess feasibility and effectiveness. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to focus on the development of Keep Safe, a manualised group intervention for adolescents with intellectual disabilities (ID) who display harmful sexual behaviour (HSB) as the initial phase of a feasibility study. National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. Aims included taking account of adolescents’ and families’ needs, motivations and practical commitments, integrating best- practice and being accessible and appropriate across different types of services.Design/methodology/approach Keep Safe development progressed from the practitioner/researcher collaborative young sex offender treatment services collaborative-ID through a project team, Keep Safe development group, comprising a range of practitioners with a variety of clinical expertise across services and an Advisory Group of people with ID. An expert-consensus methodology based on the Delphi method was used. The iterative process for the manual draws on the slim practice-based evidence from UK, New Zealand, North America and Australia.Findings Keep Safe comprises six modules distributed through 36 term-time young people’s sessions, alongside 16 concurrent parental/ carer sessions (some joint). The main focus of Keep Safe is to enhance well-being and reduce harm. Four initial sites volunteered as feasibility leads, and two more were added as recruitment was more difficult than foreseen.Originality/value National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. This study is innovative and valuable given the recognition that research and practice is significantly lacking in this area. [ABSTRACT FROM AUTHOR]

Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74-91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth. [ABSTRACT FROM AUTHOR]

Introduction: Pacific adolescents in New Zealand (NZ) are three to four times more likely than NZ European adolescents to report suicide attempts and have higher rates of suicidal plans. Suicidal thoughts, plans, and attempts, termed suicidality in this study, result from a complex dynamic interplay of factors, which emerging methodologies like network analysis aim to capture. Methods: This study used cross‐sectional network analysis to model the relationships between suicidality, self‐harm, and individual depression symptoms, whilst conditioning on a multi‐dimensional set of variables relevant to suicidality. A series of network models were fitted to data from a community sample of New Zealand‐born Pacific adolescents (n = 550; 51% male; Mean age (SD) = 17 (0.35)). Results: Self‐harm and the depression symptom measuring pessimism had the strongest associations with suicidality, followed by symptoms related to having a negative self‐image about looks and sadness. Nonsymptom risk factors for self‐harm and suicidality differed markedly. Conclusions: Depression symptoms varied widely in terms of their contribution to suicidality, highlighting the valuable information gained from analysing depression at the symptom‐item level. Reducing the sources of pessimism and building self‐esteem presented as potential targets for alleviating suicidality amongst Pacific adolescents in New Zealand. Suicide prevention strategies need to include risk factors for self‐harm. [ABSTRACT FROM AUTHOR]

Background: Telehealth became more widely used when the global COVID-19 pandemic restricted access to in-person consultations for primary care during periods of 'lockdown'. Methods: In 2021 (August–September), 15-to 25-year-olds in the Wellington region of Aotearoa New Zealand were invited to participate in an online survey that aimed to find out about telehealth experiences, perceived advantages and disadvantages, and willingness to use it for receipt of primary care. Results: Surveys were completed by 346 participants, 133 of whom had ever used telehealth (38%). Overall, 73% (84/115) were happy with health care received via telehealth, but only 26% preferred it to in-person consultations. Perceived benefits related to convenience and time efficiency, but participants had concerns about the inability to be physically examined, technological issues, clarity around follow-up actions, payment and lack of privacy. All participants had access to a phone or device, yet almost half reported challenges with connectivity, coverage or data that might limit their ability to access telehealth (47.3%, 159/336). Half of participants wanted to use telehealth in future (preferring phone over video (160/315)). Conclusions: Young people surveyed acknowledged the convenience of telehealth, but many were hesitant about receiving primary care in this way. Understanding young people's reservations and provision of detailed information about what telehealth entails will help prepare and support them to use telehealth in future. Telehealth has become more widely used since the COVID-19 pandemic began, but little is known about how young people view this method for receipt of routine primary care. In this online survey, young people appreciated the convenience aspects of telehealth, but had a range of concerns that made them hesitant to access health care this way. To prepare and support young people to use telehealth, their reservations need to be understood and addressed with information about the processes provided in advance of the consultation. [ABSTRACT FROM AUTHOR]

School neighbourhood built environment (BE) characteristics are related to active transport to school (ATS) among adolescents. This study examined objectively measured and perceived school neighbourhood BE correlates of ATS in adolescents and compared school neighbourhood BE features in rural versus small-to-medium urban areas. We analysed data from adolescents (n = 95; 68.4% under 16 years of age; 58.9% female) from 11 schools located in small-to-medium urban areas and rural settings in Otago, New Zealand, who were familiar with their school neighbourhood environment and lived within 4.8 km from school. Adolescents reported perceptions of their school neighbourhood using a modified version of Neighbourhood Environment Walkability Scale for Youth (NEWS-Y) questionnaire. Objectively measured BE features were generated using Geographic Information Systems (GIS). In a multivariate analysis, perceived residential density (odds ratio (95% CI): 0.17 (0.04, 0.82)) and traffic safety concerns (0.13(0.02, 0.95)) were negatively associated with adolescents’ ATS rates, but those associations were no longer significant once distance to school was taken into account. Compared to small-to-medium urban area schools, perceived land use mix diversity and recreational facilities and objectively measured intersection density in school neighbourhoods were higher, whereas perceived residential density and land use mix accessibility and objectively measured neighbourhood walkability were lower in rural schools (all p < 0.05). Future initiatives should address both perceived and objectively measured school neighbourhood BE to promote ATS among adolescents. [ABSTRACT FROM AUTHOR]

Background: Most studies assessing pathophysiological heterogeneity in asthma have been conducted in high-income countries (HICs), with little known about the prevalence and characteristics of different asthma inflammatory phenotypes in low-and middle-income countries (LMICs). This study assessed sputum inflammatory phenotypes in five centres, in Brazil, Ecuador, Uganda, New Zealand (NZ) and the United Kingdom (UK).Methods: We conducted a cross-sectional study of 998 asthmatics and 356 non-asthmatics in 2016-20. All centres studied children and adolescents (age range 8-20 years), except the UK centre which involved 26-27 year-olds. Information was collected using questionnaires, clinical characterization, blood and induced sputum.Results: Of 623 asthmatics with sputum results, 39% (243) were classified as eosinophilic or mixed granulocytic, i.e. eosinophilic asthma (EA). Adjusted for age and sex, with NZ as baseline, the UK showed similar odds of EA (odds ratio 1.04, 95% confidence interval 0.37-2.94) with lower odds in the LMICs: Brazil (0.73, 0.42-1.27), Ecuador (0.40, 0.24-0.66) and Uganda (0.62, 0.37-1.04). Despite the low prevalence of neutrophilic asthma in most centres, sputum neutrophilia was increased in asthmatics and non-asthmatics in Uganda.Conclusions: This is the first time that sputum induction has been used to compare asthma inflammatory phenotypes in HICs and LMICs. Most cases were non-eosinophilic, including in settings where corticosteroid use was low. A lower prevalence of EA was observed in the LMICs than in the HICs. This has major implications for asthma prevention and management, and suggests that novel prevention strategies and therapies specifically targeting non-eosinophilic asthma are required globally. [ABSTRACT FROM AUTHOR]

Young people are known to face challenges when accessing healthcare and generally have low rates of health service utilisation. Use of telehealth might be one way to improve access, but evidence is needed from young people as to how acceptable it is. This online survey of 15‐ to 25‐year olds in the greater Wellington region of New Zealand sought young people's views on telehealth (phone and videocalls) as a means of accessing primary care. The survey included both forced‐choice questions and free‐text options. We report here on the free‐text data from open‐ended questions that were qualitatively analysed using template analysis. A total of 346 participants took part between August 6 and September 21, 2021, of whom 60% were female, 12% Māori (indigenous) ethnicity, and 38% had used telehealth methods of consulting previously. Analysis was undertaken of the free‐text comments that were provided by 132 participants (38%). Although those contributing comments described both benefits and drawbacks to using telehealth, more drawbacks were cited, with specific examples given to illustrate a range of concerns and potential limitations of telehealth including privacy, communication difficulties and compromised quality of care. Participants thought telehealth could be used successfully in specific situations, for example by people concerned about leaving the house due to anxiety, illness or being immunocompromised and for simple consultations or when the person knows exactly what they need. Respondents expressed a strong desire to be offered the choice between in‐person and telehealth consultations. Providing young people with a choice of consultation mode together with clear information about all aspects of a telehealth consultation is important if clinicians want young people to engage with this method of primary care service delivery. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral pain (PFP) affects one-quarter of adolescents, yet there are few evidence-informed recommendations to treat PFP in this population. HAPPi Kneecaps! is a randomised, controlled, participant- and assessor-blind, parallel-group feasibility trial of shoe inserts for adolescents with PFP. The aim of this qualitative study was to explore adolescents' perspectives of participating in HAPPi Kneecaps!. Methods: All 36 adolescents with PFP from the HAPPi Kneecaps! study were invited to participate in semi-structured interviews. We used a descriptive qualitative methodology underpinned by a relativist framework to investigate adolescents' perspectives on participating in the trial. Inductive thematic analysis was used to examine patterns regarding how each adolescent experienced the HAPPi Kneecaps! study within their social, cultural, and historical contexts. Results: 14 out of 36 HAPPi Kneecaps! participants provided consent and participated in interviews (12 females; mean [SD] age 14.9 [2.4] years). Overall, most adolescents responded positively when discussing their experience, such as improvements in their knee pain and satisfaction with how the study was run. Major themes that were generated from the analysis and feedback were: (1) shoe inserts require little effort to use; (2) perceptions of the program were generally positive; (3) participation in the trial could be made easier; (4) warm weather matters; and (5) life happens. Conclusion: Adolescents with PFP who participated in the HAPPi Kneecaps! study found that shoe inserts were easy to wear. Most adolescents experienced an improvement in their symptoms and enhanced participation in sport and exercise. Adolescents with PFP prefer an option for warmer climates (e.g. flip flops or sandals), access to online logbooks, and clinicians who are easily accessible. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000957190. Date registered: 8/07/2019. [ABSTRACT FROM AUTHOR]

Background: Patellofemoral pain (PFP) affects one-third of adolescents and can persist into adulthood, negatively impacting health and quality of life. Foot orthoses are a recommended treatment for adults with PFP, but have not been evaluated in adolescents. The primary objective was to determine the feasibility of conducting a full-scale randomised controlled trial (RCT) evaluating effects of contoured, prefabricated foot orthoses on knee pain severity and patient-perceived global change, compared to flat insoles. The secondary objective was to describe outcomes on a range of patient-reported outcome measures. Methods: We recruited adolescents aged 12–18 years with PFP of ≥2 months duration into a double-blind, randomised, parallel-group feasibility trial. Participants were randomised to receive prefabricated contoured foot orthoses or flat shoe insoles, and followed for 3 months. Participants and outcome assessors were blinded to group allocation. Primary outcomes were feasibility of a full-scale RCT (number of eligible/enrolled volunteers; recruitment rate; adherence with the intervention and logbook completion; adverse effects; success of blinding; drop-out rate), and credibility and expectancy of interventions. Secondary outcomes were patient-reported measures of pain, symptoms, function, quality of life, global rating of change, patient acceptable symptom state, and use of co-interventions. Results: 36 out of 279 (12.9%) volunteers (27 female, mean (SD) age 15 (2) years, body mass 60 (13) kg) were eligible and enrolled, at a recruitment rate of 1.2 participants/week. 17 participants were randomised to receive foot orthoses, and 19 to flat insoles. 15 participants returned logbooks; 7/15 (47%) adhered to the intervention. No serious adverse events were reported. 28% (10/36, 4 pandemic-related) of participants dropped out before 3 months. Blinding was successful. Both groups found the inserts to be credible. Conclusions: Based on a priori criteria for feasibility, findings suggest that a full-scale RCT comparing contoured foot orthoses to flat insoles in adolescents with PFP would not be feasible using the current protocol. Prior to conducting a full-scale RCT, feasibility issues should be addressed, with protocol modifications to facilitate participant retention, logbook completion and shoe insert wear. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000957190. Date registered: 8/07/2019. [ABSTRACT FROM AUTHOR]

Family-based treatment (FBT) has become well established as the first-line evidence-based treatment for adolescents with anorexia nervosa. However, fidelity to the FBT model can be poor, and treatment is often augmented or modified in various untested forms in the hope of increasing its effectiveness and acceptability. The New Zealand Eating Disorders Clinic, a private specialist outpatient clinic in New Zealand, has been seeing increasing numbers of families presenting for treatment reporting an experience of "failed FBT". All of the families who presented with a child under the age 19 living at home agreed to restart FBT with the author when re-engaging in treatment. This essay summarizes the experience of the author in repeating FBT with previously "failed" FBT cases over 20 months between 2017 and 2019. Common themes of the first course of FBT were identified that raised questions for the author as to whether FBT had been implemented with sufficient fidelity and proficiency the first time around. This clinical perspective essay describes how these identified issues were addressed when FBT was administered again. It does not intend to make broad claims, but instead is intended to be helpful to clinicians who are implementing FBT, to assist them in carefully examining and assessing whether key FBT principles and procedures have been exhausted before evaluating the need for modification or augmentation. Furthermore, this perspective provides suggestions as to how the identified common themes can be addressed if families re-present for FBT treatment after having had a course of "failed FBT". [ABSTRACT FROM AUTHOR]

Aim: To understand the experiences of young people with anorexia admitted to hospital for brief stays and to inform the design of contemporary inpatient treatment to better suit their needs in the context of a significant shift in practice from longer hospital admissions to shorter stays.Methods: A qualitative study was undertaken with young people within a few months of discharge from a specialist inpatient eating disorder service, Auckland, New Zealand. Audiotaped, semi-structured interviews were conducted with participants within a few months of their discharge from hospital and transcribed for coding.Results: Nine young people, all female, of mixed ethnicity (seven New Zealand European and two Asian) and aged between 15 and 17 years participated in the study. Five main themes were identified from the data, namely: (i) benefits of admission; (ii) sources of stress; (iii) control and power; (iv) having a voice and being heard; and (v) comparison of oneself with others.Conclusions: Although many of the benefits and challenges associated with brief treatment were similar to those during longer inpatient care, the impact of certain issues was more strongly experienced by participants and highlighted the need for greater attention to be paid to making young people feel better supported and included during predominantly medically focused admissions. [ABSTRACT FROM AUTHOR]

Background: Depression frequently first emerges during adolescence, and one in five young people will experience an episode of depression by the age of 18 years. Despite advances in treatment, there has been limited progress in addressing the burden at a population level. Accordingly, there has been growing interest in prevention approaches as an additional pathway to address depression. Depression can be prevented using evidence-based psychological programmes. However, barriers to implementing and accessing these programmes remain, typically reflecting a requirement for delivery by clinical experts and high associated delivery costs. Digital technologies, specifically smartphones, are now considered a key strategy to overcome the barriers inhibiting access to mental health programmes. The Future Proofing Study is a large-scale school-based trial investigating whether cognitive behaviour therapies (CBT) delivered by smartphone application can prevent depression.Methods: A randomised controlled trial targeting up to 10,000 Year 8 Australian secondary school students will be conducted. In Stage I, schools will be randomised at the cluster level either to receive the CBT intervention app (SPARX) or to a non-active control group comparator. The primary outcome will be symptoms of depression, and secondary outcomes include psychological distress, anxiety and insomnia. At the 12-month follow-up, participants in the intervention arm with elevated depressive symptoms will participate in an individual-level randomised controlled trial (Stage II) and be randomised to receive a second CBT app which targets sleep difficulties (Sleep Ninja) or a control condition. Assessments will occur post intervention (both trial stages) and at 6, 12, 24, 36, 48 and 60 months post baseline. Primary analyses will use an intention-to-treat approach and compare changes in symptoms from baseline to follow-up relative to the control group using mixed-effect models.Discussion: This is the first trial testing the effectiveness of smartphone apps delivered to school students to prevent depression at scale. Results from this trial will provide much-needed insight into the feasibility of this approach. They stand to inform policy and commission decisions concerning if and how such programmes should be deployed in school-based settings in Australia and beyond.Trial Registration: Australian and New Zealand Clinical Trial Registry, ACTRN12619000855123. Registered on 31 May 2019. Clinical Trial Notification Scheme (CTN), CT-2019-CTN-02110-1-v1. Registered on 30 June 2019. [ABSTRACT FROM AUTHOR]

Social capital influences adolescents' licenses for active transport and independent mobility, through parental decision making and safety concerns, and may contribute to increasing adolescents' physical activity. Drawing on 20 parental interviews and 11 focus groups (73 adolescents) from rural New Zealand, this paper shows the importance of social capital and social trust for active transport and independent mobility in an under researched rural context. Change over time in social capital, social trust and parental safety concerns limited adolescents' active transport and independent mobility. Health policy should incorporate social capital measures to increase adolescents' active transport, independent mobility and physical activity. [ABSTRACT FROM AUTHOR]

New Zealand has one of the highest youth suicide rates in the developed world and dominant approaches to prevention do not always take into account the views of young people. The purpose of this research was to update our understanding of young people's explanations of suicide in order to inform suicide prevention efforts. Focus groups were conducted with 38 young people, including 30 young women and 8 young men aged 15-22. The data was analysed thematically to identify the range of explanations young people ascribe to youth suicide. Five themes were identified by the analysis including that suicide could be explained by inescapable difficulties, constant pressure, emotional distress and could also be seen as a cry for help. In contrast to these normalised experiences, participants also expressed the view that mental illness might also account for suicide. The findings suggest that young people recognise suicide as a complex problem with multiple causes. While they recognised mental health problems as contributing, youth suicide was primarily understood by young people as a normal response to emotional distress and pressure. Prevention programmes should address the full range of explanations that young people give for suicide in order to promote their engagement in prevention programmes. [ABSTRACT FROM AUTHOR]

Objectives: Self-harm is common in New Zealand (NZ) young people and can have short-term and long-term consequences, including suicide. This study was undertaken to examine the extent to which evidence-based approaches for addressing self-harm are offered by Infant, Child and Adolescent Mental Health Services (ICAMHS).Methods: A national survey of ICAMHS practitioners working with young people who self-harm was undertaken between May and July 2016.Results: Responses from 23 out of 30 ICAMHS confirmed self-harm was a familiar presentation and most commonly associated with diagnoses of depression, anxiety and borderline personality disorder. Cognitive behavioural therapy (47.1%, n = 8), dialectical behaviour therapy (47.1%, n = 8) and acceptance and commitment therapy (5.9%, n = 1) were the treatments of choice, but variably delivered. There were significant training gaps for all types of therapy.Conclusions: Although it is reassuring that many ICAMHS are using evidence-based approaches to address self-harm in young people, there is concerning variability in the way these therapies are delivered. Improvement in training in key modalities, further research into therapist performance and continuous evaluation of workforce development are needed to maximise the effectiveness of proven interventions and provide NZ young people with the state-of-the-art service they deserve. [ABSTRACT FROM AUTHOR]

Objectives: It is accepted practice in Australia and New Zealand for psychiatric impairment rating scales to be applied for persons claiming psychiatric injury. These scales were derived for adults, not children. There is less clarity as to whether and how these scales may be applied for children claiming psychiatric injury.Methods: We review Australian and New Zealand guidelines and methods for assessing permanent psychiatric impairment, as they apply to children and adolescents.Results: With significant caution, psychiatric impairment rating scales can be administered for children. Guidance and recommendations in this regard are provided. For some, the effects of psychiatric injury may not be stable, and permanent impairment assessment should be delayed until sufficient maturity occurs.Conclusions: Psychiatric impairment rating scales are widely applied for adults claiming psychiatric injury, however caution must be exercised when these scales are used in children. [ABSTRACT FROM AUTHOR]

Erik Erikson's theoretical writings on identity have provided a rich foundation upon which decades of research on identity development have been built. However, literature is lacking regarding adolescents who are aware that they lack knowledge about the self (i.e., values, likes, and dislikes) to the extent that they are stuck and directionless, and therefore unable to engage in the process of identity formation, what we refer to as a state of 'lostness.' Furthermore, while it has been established that supportive relationships facilitate identity development, less is known about whether various domains of social connectedness may diminish 'lostness' over time, and if so, what may be the specific processes or conditions within each connectedness domain that supports this aspect of identity development. To address this gap in the literature, this study drew upon self-report data collected from New Zealand adolescents who provided data for two out of three annual time points of measurement ( N = 1996; 52% female; 52% European New Zealanders, 30% Māori, and 18% Pacific Islanders and Asian New Zealanders) to examine the longitudinal relationships among three domains of social connectedness (i.e., family, school, and peers), 'lostness,' and a potential mediator, confidence. The results showed that all three domains of social connectedness predicted diminished 'lostness' over time, and confidence mediated these relationships. An examination of the opposite direction of influence showed that 'lostness' predicted a decrease in confidence and the three domains of social connectedness, as well. Gender, age, and ethnic group were shown to be moderators of different parts of the model. This study addresses the paucity of research examining 'lost' adolescents, while providing insight into the underlying processes through which three key social contexts-family, school, and peers-exert their influence, and are influenced by, identity processes through confidence. [ABSTRACT FROM AUTHOR]

The article assesses the clustering of healthy and unhealthy behaviors among adolescents from Dunedin, New Zealand. Healthy behaviors identified included physical activity (PA), screen time, fruit and vegetable (F&V) intake. It also examined all three guidelines including PA, screen time and F&V intake's association with healthy weight.

ObjectiveTo examine the association between cardiorespiratory fitness and dietary patterns in adolescents.DesignFood choice was assessed using the validated New Zealand Adolescent FFQ. Principal components analysis was used to determine dietary patterns. Trained research assistants measured participants’ height and body mass. Cardiorespiratory fitness was assessed in a subset of participants using the multistage 20 m shuttle run. The level and stage were recorded, and the corresponding VO2max was calculated. Differences in mean VO2max according to sex and BMI were assessed using t tests, while associations between cardiorespiratory fitness and dietary patterns were examined using linear regression analyses adjusted for age, sex, school attended, socio-economic deprivation and BMI.SettingSecondary schools in Otago, New Zealand.SubjectsStudents (n 279) aged 14–18 years who completed an online lifestyle survey during a class period.ResultsPrincipal components analysis produced three dietary patterns: ‘Treat Foods’, ‘Fruits and Vegetables’ and ‘Basic Foods’. The 279 participants who provided questionnaire data and completed cardiorespiratory fitness testing had a mean age of 15·7 (sd 0·9) years. Mean VO2max was 45·8 (sd 6·9) ml/kg per min. The ‘Fruits and Vegetables’ pattern was positively associated with VO2max in the total sample (β=0·04; 95 %CI 0·02, 0·07), girls (β=0·06; 95 % CI 0·03, 0·10) and boys (β=0·03; 95 % CI 0·01, 0·05).ConclusionsThese results indicate that increase in cardiorespiratory fitness was associated with a healthier dietary pattern, suggesting both should be targeted as part of a global lifestyle approach. Longitudinal studies are needed to confirm this association in relation to health outcomes in New Zealand adolescents. [ABSTRACT FROM PUBLISHER]

Onscreen Smoking Is a Form of Tobacco Marketing: Tobacco advertising has been prohibited in New Zealand since 1990, and the government has set a goal of becoming a smokefree nation by 2025. However, tobacco marketing persists indirectly through smoking in motion pictures, and there is strong evidence that exposure to onscreen smoking causes young people to start smoking. We investigated the relationship between exposure to smoking in movies and youth smoking initiation among New Zealand young adults. Data from an online survey of 419 smokers and non-smokers aged 18 to 25 were used to estimate respondents’ exposure to smoking occurrences in 50 randomly-selected movies from the 423 US top box office movies released between 2008 and 2012. Analyses involved calculating movie smoking exposure (MSE) for each respondent, using logistic regression to analyse the relationship between MSE and current smoking behaviour, and estimating the attributable fraction due to smoking in movies. Effect of Smoking in Movies on New Zealand Youth: Exposure to smoking occurrences in movies was associated with current smoking status. After allowing for the influence of family, friends and co-workers, age and rebelliousness, respondents’ likelihood of smoking increased by 11% for every 100-incident increase in exposure to smoking incidents, (aOR1.11; p< .05). The estimated attributable fraction due to smoking in movies was 54%; this risk could be substantially reduced by eliminating smoking from movies currently rated as appropriate for youth. We conclude that exposure to smoking in movies remains a potent risk factor associated with smoking among young adults, even in a progressive tobacco control setting such as New Zealand. Harmonising the age of legal tobacco purchase (18) with the age at which it is legal to view smoking in movies would support New Zealand’s smokefree 2025 goal. [ABSTRACT FROM AUTHOR]

Adolescents who endorse greater levels of future orientation report greater well-being over time, but we do not know the mechanism by which this happens. The present longitudinal study examined whether both adaptive as well as maladaptive coping strategies might explain how future orientation leads to ill-being and well-being over time in young New Zealanders. A sample of 1,774 preadolescents and early adolescents (51.9 % female) aged 10-15 years at Time 1 completed a self-report survey three times with 1 year intervals in between. Longitudinal mediation path models were constructed to determine whether and how maladaptive and adaptive coping strategies at Time 2 functioned as mediators between future orientation at Time 1 and ill-being and well-being at Time 3. Results showed that future orientation predicted lower maladaptive coping, which in turn predicted lower substance use and self-harming behavior. All three well-being outcomes (i.e., happiness with weight, vitality, and sleep) were consistently predicted by future orientation, and all three pathways were mediated by both lower maladaptive and higher adaptive coping strategies (with the exception of happiness with weight, which was mediated only by lower maladaptive coping). The results suggest that several pathways by which future orientation leads to greater well-being occurs through an increased use of adaptive coping, a decreased use of maladaptive coping, or both. [ABSTRACT FROM AUTHOR]

Background: Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes.Method/design: With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12-17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6-8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs.Discussion: The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD.Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether adolescent friendly care, as defined by current best practice, was being provided within a hospital setting.Methods: All patients aged 12-18 presenting to Tauranga Hospital over a 5-week period were invited to complete a questionnaire on their experience of care. Responses were obtained from 319 adolescents (40% response rate).Results: Adolescents reported that staff were generally friendly (>80%) and respectful (>90%) and that they trusted staff to care for them (90%). Explanations were considered clear by 87% of adolescents, but 20% felt uncomfortable asking questions. Confidentiality was discussed with some adolescents (52%). Privacy was provided (93%), and most adolescents (86%) were satisfied with the extent of their involvement in consultations. Adolescents reported that staff did not routinely undertake psychosocial assessments. The physical environment and resources did not always meet the needs of adolescents, with 70% complaining about a lack of access to other adolescents.Conclusion: While adolescents rated the care they received highly, the care did not always align with best practices regarding adolescent friendly care. There is ample opportunity for improvement. [ABSTRACT FROM AUTHOR]