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OBJECTIVES: To apply an intersectional lens to disparities in emotional distress among youth, including multiple social positions and experiences with bias-based bullying. METHODS: Data are from the 2019 Minnesota Student Survey (n 5 80 456). Social positions (race and ethnicity, sexual orientation, gender) and 2 forms of bias-based bullying (racist, homophobic or transphobic) were entered into decision tree models for depression, anxiety, self-injury, suicidal ideation, and suicide attempts. Groups with the highest prevalence are described. Rates of emotional distress among youth with matching social positions but no bias-based bullying are described for comparison. RESULTS: LGBQ identities (90%) and transgender, gender diverse, and questioning identities (54%) were common among the highest-prevalence groups for emotional distress, often concurrently; racial and ethnic identities rarely emerged. Bias-based bullying characterized 82% of the highest-prevalence groups. In comparable groups without bias-based bullying, emotional distress rates were 20% to 60% lower (average 38.8%). CONCLUSIONS: Findings highlight bias-based bullying as an important point for the intervention and mitigation of mental health disparities, particularly among lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning adolescents. Results point to the importance of addressing bias-based bullying in schools and supporting lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning students at the systemic level as a way of preventing emotional distress. [ABSTRACT FROM AUTHOR]

Given emerging adulthood is a period of increased independence, it is unclear how much contact emerging adults have with their parents, how this communication occurs, and how frequency of communication differs across sociodemographic characteristics. The main aim of this study was to examine communication patterns and modalities between emerging adults and their parents. Data are from an 8-year longitudinal, population-based study of socio-economically and racially/ethnically diverse adolescents followed into emerging adulthood (n = 1539; mean age = 22.1; 53.1% female). Latent profile analysis results supported a 5-class model, in which classes were characterized by patterns of frequency of communication with parents across different modalities. The most common communication modality included medium levels of engagement (i.e., few times/week), with both parents, and was in-person or via the phone (i.e., calls, text messages, email). Results differed by race/ethnicity. Findings from this exploratory study may be useful for supporting positive communication patterns between emerging adults and their parents and may inform what intervention delivery format (e.g., phone, social media-based, in-person) may be more effective for certain parent/emerging adult subgroups engaging in family-based interventions. Highlights: Emerging adults and their parents were communicating regularly, several times per week. Preferred communication modality was phone (i.e., texting, emailing, calling). The most common pattern of communication was medium engagement with both parents. Emerging adults who also had high connectedness with their mothers reported the most frequent communication. [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]

Background: Weight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioeconomically diverse sample of young people. We also assessed whether ethnicity/race and adolescent socioeconomic status (SES) operated as effect modifiers in these relationships. Methods: Adolescents (n = 1568) were enrolled in EAT 2010–2018 (Eating and Activity over Time) and followed into young adulthood. Weight teasing; screen time; moderate-to-vigorous physical activity (MVPA); sleep duration; breakfast frequency; fruit, vegetable, sugar-sweetened beverage (SSB), and fast-food intake; and body mass index (BMI) were assessed at baseline (mean age = 14.4 years) and eight-year follow-up (mean age = 22.2 years). Multivariate linear regression estimated marginal means and 95% confidence intervals. All analyses adjusted for BMI and sociodemographic characteristics. Results: Weight teasing was cross-sectionally associated with longer screen time, shorter sleep duration, and higher BMI during adolescence; and cross-sectionally associated with shorter sleep duration, lower breakfast frequency, higher fast-food intake, higher SSB intake, and higher BMI during young adulthood. In the longitudinal analyses, weight teasing was not associated with health behaviors but did predict higher BMI (teased: 28.2 kg/m2, not teased: 26.4 kg/m2, p < 0.001). White and higher adolescent SES subgroups had higher MVPA, more frequent breakfast intake, lower fast-food intake, and lower BMI than their respective counterparts. The relationships between weight teasing and health behaviors and weight status were largely consistent across ethnic/racial and adolescent SES subgroups. Conclusions: Findings add to growing evidence that weight-based mistreatment poses a threat to weight-related health and that young people across ethnic/racial and SES subgroups are vulnerable to the negative effects of weight teasing. Limitations include attrition at follow-up and the self-reported nature of many measures. Results suggest a need for increased attention to existing recommendations to reduce weight stigma in young people from diverse ethnic/racial and socioeconomic backgrounds including training for healthcare providers to better equip them to address the harms of weight teasing and foster more compassionate care to promote health-supporting behaviors in young people. [ABSTRACT FROM AUTHOR]

Objective: Digital technology use and muscle‐building behaviors reflect a wide range of behaviors with associated health risks. However, links between digital technology use and muscle‐building behaviors remain unknown and this study aimed to address this gap. Method: Data were collected from a diverse sample of 1,483 young adults (mean age 22.2 ± 2.0 years) participating in the population‐based Eating and Activity over Time 2018 study. Gender‐stratified‐modified Poisson regression models were used to determine cross‐sectional associations between three types of digital technology use (screen time, social media, weight‐related self‐monitoring apps) and five types of muscle‐building behaviors (changing eating, exercise, protein powders/shakes, pre‐workout drinks, steroids/growth hormone/creatine/amino acids) in young adulthood, adjusted for sociodemographic characteristics and body mass index. Results: Screen time and social media were either not found to be associated with muscle‐building behaviors or in a few instances, associated with less use of these behaviors (e.g., screen time and pre‐workout drinks in men). In contrast, the use of weight‐related self‐monitoring apps was positively associated with all muscle‐building behaviors, including steroids/growth hormone/creatine/amino acids in men (prevalence ratio [PR] = 1.83; 95% confidence interval [CI]: 1.13–2.97) and women (PR = 4.43; 95% CI: 1.68–11.68). Discussion: While most recreational screen time may represent sedentary behaviors not related to muscle‐building behaviors, weight‐related self‐monitoring apps are highly associated with more muscle‐building behaviors and could be a future target for interventions to discourage the use of steroids and other harmful muscle‐building substances. [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]

Objectives: Community, school, family, and individual factors protect against mental illness in general samples of adolescents. How these assets apply to Somali youth resettled to the United States (U.S.), a group with significant trauma exposure, remains unclear. We aimed to quantify which protective factors are associated with lower prevalence of depressive symptoms, suicidality, and self-injury among Somali youth in the U.S. compared with their non-Hispanic white peers. Design: Participants consisted of 8th, 9th, and 11th grade respondents to the 2016 Minnesota Student Survey, an anonymous school-administered statewide survey with 85.5% school district participation, who identified as Somali ethnicity (n = 1552) or as non-Hispanic white (n = 80,583). Multivariable logistic regression assessed odds of depressive symptoms, suicidal ideation and attempts, and self-harm, using eight protective factors (i.e. internal developmental assets, school engagement, empowerment, and family and teacher connectedness, caring adults and after-school activity frequency and quality) as independent variables. Models were run separately for Somali and white youth. Results: Somali youth reported similar rates of depressive symptoms, but lower levels of suicidal ideation or attempts and self-harm behaviors than their white peers (p < 0.001). All eight protective factors were associated with outcomes in the expected direction for white youth. For Somali youth, internal developmental assets (aOR 0.79, 95% CI: 0.65–0.97), empowerment (aOR 0.58, 95% CI: 0.45–0.73), family connectedness (aOR 0.60, 95% CI: 0.51–0.71), perception of caring adults in the community (aOR: 0.84, 95% CI: 0.76–0.92), and quality of after-school activities (aOR: 0.72, 95% CI: 0.61–0.86) were protective against depressive symptoms, with similar patterns for other outcomes. Other school factors protected Somali youth less consistently. Conclusions: Previously established protective factors against mental illness, particularly school factors, do not universally apply to Somali youth. Interventions that strengthen individual, family, or community factors, or that increase the relevance of school factors, should be explored for these youth. [ABSTRACT FROM AUTHOR]

Background: This study explores cross‐sectional associations between yoga and body image, mindful eating, disordered eating, and muscle‐enhancing behaviors among a population‐based sample of ethnically/racially diverse emerging adults. Method: An ethnically/racially diverse population‐based sample of 1,568 emerging adults (18–26 years) completed surveys as part of EAT 2010–2018 (Eating and Activity over Time). Models were adjusted for sociodemographic characteristics and body mass index (BMI). Results: Practicing yoga at least 30 min/week was reported by 12.7% (n = 210) of the sample. Yoga practitioners had higher levels of mindful eating than those not practicing yoga. Although effect sizes were small, yoga practitioners were more likely than non‐yoga practitioners to use steroids (3.8 vs. 0.7%, p <.001, h = 0.22) or protein powder/shakes (35.1 vs. 25.3%, p <.010, h = 0.21) to increase their muscle size/tone. Body satisfaction, unhealthy weight control behaviors, and binge eating tended to be similar among yoga practitioners and non‐yoga practitioners. There was a significant interaction between BMI and yoga in predicting body satisfaction with a trend toward a positive impact among yoga practitioners at higher BMI values. Interactions between yoga practice and all body image attitudes and behaviors across gender and ethnicity/race were not statistically significant. Discussion: Young people from diverse ethnic/racial backgrounds who practice yoga are more likely to engage in mindful eating but have equal or elevated levels of unhealthy body image attitudes and behaviors as compared to non‐yoga practitioners. Further research should explore how yoga is best taught and practiced to ensure that it is beneficial for body image and related behaviors. [ABSTRACT FROM AUTHOR]

Anti-smoking norms and educational aspirations are established tobacco prevention targets for general United States (U.S.) adolescent populations but protective factors remain poorly characterized for Somali-American youth. Here we describe patterns of past 30-day tobacco use and associated protective factors among eighth, ninth, and eleventh grade Somali adolescent respondents (n = 2009) to the 2016 Minnesota Student Survey using multivariate logistic regressions. E-cigarette (5.7%) and hookah (5.0%) use were most prevalent. Male youth reported higher levels of tobacco use across products. Adjusted odds ratios showed that internal developmental assets (e.g., e-cigarettes aOR 0.37, 95% CI 0.37, 0.79) and parental anti-smoking norms (e.g., e-cigarettes aOR 0.19, 95% CI 0.09, 0.38) protected against use of all tobacco products. E-cigarettes and hookah are prevalent among U.S. Somali youth, highlighting the need for prevention efforts that address emerging tobacco products and leverage protective factors such as internal assets and parental anti-smoking norms. [ABSTRACT FROM AUTHOR]

Research has demonstrated significantly higher rates of sexual assault victimization among lesbian, gay, bisexual and queer (LGBQ) students than heterosexual students, and the overwhelming majority of assaults are not reported to any official system. Given the potential for support services to provide valuable assistance and promote well-being after an assault, the present study explores whether LGBQ students report assaults at similar rates to heterosexual students. As part of the 2015 College Student Health Survey, 10,646 male and female college students at 2- and 4-year colleges in Minnesota provided data regarding sexual assault victimization; reporting to a health care provider, campus authority, police, or social contact; and sexual orientation (two items, including write-in). Chi-square tests were used to detect associations between sexual assault victimization and five sexual orientation groups; and between sexual orientation and assault reporting (for 523 assault incidents). Almost 6% of students reported that they had experienced sexual assault in the previous 12 months. Significant differences in assault experience were seen by sexual orientation groups, for both males and females. For example, rates of sexual assault were 2.5 to over 5 times higher among bisexual and queer/pansexual/other females than among heterosexual females. Reporting of sexual assault to health care providers, campus authorities or police was rare for both heterosexual and sexual minority students, and there were no significant differences in reporting across sexual orientation. LGBQ students and heterosexual students appear to be similarly comfortable accessing health care providers, police, and campus resources, suggesting that these services are not overtly biased or unwelcoming to sexual minorities. However, rates of sexual assault were considerably higher among sexual minority groups, suggesting a need for primary prevention that is appropriate and sensitive to the experiences of LGBQ students. [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]

Young peoples' acceptance and use of nontraditional, descriptive identity labels (e.g., pansexual, genderqueer) require nurses to consider moving beyond use of traditional terms (e.g., gay, transgender). This mixed methods study explores (a) labels used by sexual orientation and gender identity (SOGI) minority youth, (b) their expressed importance and meaning of these labels, and (c) differences in label usage. Sixty-six SOGI minority adolescents in British Columbia, Minnesota, and Massachusetts (mean age = 16.6) participated in "go-along" interviews; during interviews, 42 (63.6%) commented on labels. Chi-square and t tests were used to compare traditional versus nontraditional labels across participant demographic categories. Inductive thematic analysis was used to identify representative themes. Approximately, 1/3 of participants used nontraditional sexual orientation identity labels; this finding was associated with a trans identity and nontraditional gender labels. Using terminology that is meaningful and representative to the youth themselves has potential to facilitate representative research and welcoming environments in practice. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Peer harassment can have serious implications for students' success and well-being, and prevention programs need to consider the school context. This study aimed to: (1) identify groups of similar schools based on their risk and protective factors and demographic characteristics and (2) examine associations between school profiles and students' bullying involvement. METHODS Data came from 505 schools and 122,106 students who completed the 2013 Minnesota Student Survey. School-level risk and protective factors and demographic characteristics were included in a latent profile analysis ( LPA) to identify profiles of schools. Multilevel logistic regression was used to assess associations between school profiles and peer harassment. RESULTS Six qualitatively different school profiles were identified. Unadjusted models showed that schools with higher levels of risk had greater odds of peer harassment. However, after controlling for student-level risk and protection, regardless of school-level risk, students in metro-area schools with a more diverse student body reported lower odds of bullying involvement. CONCLUSIONS These findings highlight the importance of the social environment into peer harassment. In addition to addressing student-level risk and protection, larger community factors and norms also need to be taken into account for developing, selecting, and implementing the most effective approaches to bullying prevention. [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]

Aims and objectives To (1) explore college students' perceived sexual orientation-related barriers to engaging in physical activity, eating healthfully and maintaining healthy body images and (2) identify types of campus resources on physical activity, healthy eating and body image available to lesbian, gay and bisexual college students. Background Previous research has highlighted sexual orientation disparities in weight status, physical activity, healthy eating and body image. Despite this, little is known about the context surrounding these disparities. Design Cross-sectional study using individual interviews. Methods Thirty (15 males, 15 females) lesbian, gay, bisexual, queer and pansexual-identified college students, aged 18-30 years participated in the study. Quasi-inductive coding was used to analyse transcribed interview data and an iterative coding process was used to organise data into themes. Results Many felt their sexual orientation helped them be physically active, engage in healthful eating habits and have a positive body image. However, sexual orientation was also identified as a stressor that adversely impacted physical activity and eating habits. Conclusions Lesbian, gay and bisexual students may have to negotiate their sexuality in ways that could adversely influence their physical activity, eating habits and body image. Both clinical and institutional interventions should be inclusive of all people, including lesbian, gay and bisexual, queer, and pansexual students. Further, tailored interventions to meet the specific health needs of sexual minority populations are needed. Relevance to clinical practice Clinicians need to understand the context in which sexual minority young adults experience health promotion messaging and programming. Clinic-based tailored interventions are critical as part of a multi-faceted approach in promoting physical activity and healthier eating habits for all young people, including lesbian, gay, bisexual, queer and pansexual, to more effectively address the prevention of chronic diseases. [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]

ABSTRACT Objective This study provides updated information regarding the prevalence and characteristics of weight stigma in popular adolescent television programming, using a sample of favorite shows named by diverse adolescents. Method Participants in a large, population-based study of Minnesota adolescents ( N = 2,793, mean age = 14.4) listed their top three favorite television shows. A coding instrument was developed to analyze randomly selected episodes from the most popular 10 programs. Weight-stigmatizing incidents were compared across television show characteristics and characters' gender and weight status. Results Half (50%) of the 30 episodes analyzed contained at least one weight-stigmatizing incident. Both youth- and adult-targeted shows contained weight-stigmatizing comments, but the percent of these comments was much higher for youth-targeted (55.6%) than general audience-targeted shows (8.3%). Male characters were more likely than females to engage in (72.7% vs. 27.3%), and be the targets of, weight stigma (63.6% vs. 36.4%), and there was no difference in the amount of weight stigmatizing directed at average weight females compared to overweight females. Targets of these instances showed a negative response in only about one-third of cases, but audience laughter followed 40.9% of cases. Discussion The portrayal of weight stigmatization on popular television shows-including targeting women of average weight-sends signals to adolescents about the wide acceptability of this behavior and the expected response, which may be harmful. Prevention of weight stigmatization should take a multi-faceted approach and include the media. Future research should explore the impact that weight-related stigma in television content has on viewers. © 2014 Wiley Periodicals, (Inc. Int J Eat Disord 2015; 48:759-766) [ABSTRACT FROM AUTHOR]

Objectives. We examined perpetration of bullying among youths in vulnerable groups relative to youths in peer groups not categorized as vulnerable. Methods. Data were collected in 2013 from a large school-based survey of adolescents conducted in Minnesota (n = 122 180). We used the v2 test and logistic regression to compare measures of perpetration of physical and relational bullying, as well as experiences of victimization and perpetration (or both), across categories of sexual orientation, weight status, and disability status. Results. Rates of physical and relational bullying perpetration were significantly higher among youths in vulnerable groups than among those not in vulnerable groups. With respect to context of victimization experiences, young men and women from vulnerable groups were overrepresented in the group comprising both perpetrators and victims. For example, odds of being both a perpetrator and a victim were 1.41 to 3.22 times higher among gay, lesbian, and bisexual youths than among heterosexual youths. Conclusions. Vulnerable youths, who are prone to peer harassment, may also act as perpetrators of bullying. Prevention strategies should address the particular needs of these populations; targeted programming may be appropriate. [ABSTRACT FROM AUTHOR]

Objectives. We assessed disparities in weight and weight-related behaviors among college students by sexual orientation and gender. Methods. We performed cross-sectional analyses of pooled annual data (2007–2011; n = 33 907) from students participating in a Minnesota state-based survey of 40 two- and four-year colleges and universities. Sexual orientation included heterosexual, gay or lesbian, bisexual, unsure, and discordant heterosexual (heterosexuals engaging in same-sex sexual experiences). Dependent variables included weight status (derived from self-reported weight and height), diet (fruits, vegetables, soda, fast food, restaurant meals, breakfast), physical activity, screen time, unhealthy weight control, and body satisfaction. Results. Bisexual and lesbian women were more likely to be obese than heterosexual and discordant heterosexual women. Bisexual women were at high risk for unhealthy weight, diet, physical activity, and weight control behaviors. Gay and bisexual men exhibited poor activity patterns, though gay men consumed significantly less regular soda (and significantly more diet soda) than heterosexual men. Conclusions. We observed disparities in weight-, diet-, and physical activity– related factors across sexual orientation among college youths. Additional research is needed to better understand these disparities and the most appropriate intervention strategies to address them. [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]

Disordered eating and muscle building behaviors are common among emerging adults, and friends may be a particularly salient social influence. Epidemiologic research often includes questions about participants' perceptions of their friends. A less common approach, with greater logistical challenges, is to ask for friend nominations and then survey friends about their actual behaviors. The comparability of these different approaches is unknown. This study addresses the following research questions: 1) What is the feasibility of collecting data from emerging adults' friends in epidemiologic research? 2) Do perceptions of friends' weight- and shape-related behaviors align with friends' actual behaviors? and 3) Are perceptions or friends' actual behaviors more strongly and consistently associated with emerging adults' behaviors? Participants (N = 2383) in the EAT (Eating and Activity over Time)-2018 study in Minnesota, USA, were asked to nominate up to three friends and provide data about those friends' weight- and shape-related behaviors (i.e. perceptions); nominated friends were invited to complete an abbreviated survey and report on their own same behaviors (i.e. actual). Among the invited friends, 191 responded and were linked to the 152 EAT 2018 participants who nominated them. Descriptive statistics, Spearman's correlations, and logistic regression were used to address the research questions. The response rate for nominated friends was very low (9.9%), suggesting this approach may have low feasibility for epidemiologic studies of emerging adults. Emerging adults' perceptions of their nominated friends' weight and shape-related behaviors generally did not align well with the behaviors reported by those friends. Furthermore, analytic models found different associations between friends' behavior and EAT 2018 participant behaviors, depending on the measure of friends' behavior used (perceived or actual). Careful consideration of the pros and cons of each study design is essential to build an evidence base and support interventions regarding emerging adults' weight- and shape-related health. • Friends influence emerging adult disordered eating and muscle building behaviors. • Perceptions of friends' behaviors may not align with friends' actual behaviors. • Perceived and actual behaviors differ in associations with emerging adult behaviors. • Careful methods selection and reporting is needed in friend influence studies. [ABSTRACT FROM AUTHOR]

Research has related child participation in organized activities to health and academic benefits; however, participation may interfere with family meals. Examine whether parents perceive child participation in organized activities to interfere with family meals and how perceptions are related to the household eating environment. A cross-sectional analysis was completed using survey data collected in 2015-2016 as part of the Project EAT (Eating and Activity in Teens and Young Adults) cohort study. Survey participants were originally recruited in Minneapolis–St Paul schools in 1998-1999. The analytic subsample of parents (one per household, n=389, 69% female, 31% nonwhite race, mean age=31) had one or more children involved in an organized activity. Approximately 33% of households included a child aged 2 to 5 and no older child; two thirds of households included school-aged children (6 to 18 years). Parents reported family meal frequency, family meal scheduling difficulties, frequency of at-home meal preparation, and their own intake of fast food, fruit, and vegetables. Analyses compared household environment characteristics reported by parents who perceived low interference between organized activities and family meals to characteristics reported by parents who perceived moderate to high interference from at least one form of activity. Regression models included a dichotomous indicator of interference as the independent variable and were adjusted for parental and household characteristics. Among parents with children at any age, moderate to high interference was associated with lower family meal frequency, greater difficulty scheduling family meals, and more fast-food intake (all P ≤0.01). The perception of moderate to high interference was more common among parents who reported involvement in both sport and nonsport activities (P <0.001) and those with a school-aged child (P <0.001) vs those with only preschool-aged children. Follow-up research, including qualitative studies, is needed to identify the specific aspects of child participation in organized activities (eg, scheduled time of day) that may interfere with family meals. [ABSTRACT FROM AUTHOR]

Objective Investigate the relationship between use of Nutrition Facts labels on packaged foods and weight-related behaviors. Design Cross-sectional survey in 2015–2016. Participants Young adult respondents (n = 1,817; 57% women; average age 31.0 ± 1.6 years) to the Project Eating and Activity in Teens and Young Adults –IV survey, the fourth wave of a longitudinal cohort study. Variables Measured Use of Nutrition Facts labels on packaged foods; healthy, unhealthy, and extreme weight control behaviors; intuitive eating; binge eating. Analysis Linear and logistic regression models were adjusted for age, ethnicity/race, education, income, and weight status. Results In women, greater Nutrition Facts use was associated with a 23% and 10% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a 17% greater chance of engaging in binge eating. In men, greater label use was associated with a 27% and 17% greater likelihood of engaging in healthy and unhealthy weight control behaviors, respectively, and a lower level of intuitive eating. Conclusions and Implications Professionals advising patients and clients on weight management may consider possible gender differences in response to weight loss and management guidance. Since label use was related to engagement in some unhealthy behaviors in addition to healthy behaviors, it is important to consider how individuals may use labels, particularly those at risk for, or engaging in, disordered eating behaviors. Future research investigating potential relationships between Nutrition Facts use, intuitive eating, and binge eating is needed. [ABSTRACT FROM AUTHOR]

While an overwhelming majority of people in the USA support some form of school-based sexual education, the specific content and context for that instruction varies widely, making it difficult to assess support for particular types of programmes. This is particularly the case for evangelical Christians, about whom there is a lack of scholarly consensus concerning support for sexual education. This paper addresses this gap, and examines the assumption that evangelical Christians uniformly support abstinence-only sexual education, using qualitative analysis among a group of evangelical Christians in a medium-sized Texas city. Respondents were asked during interviews to identify the types of sex education-related content they support, and where and how they believe these messages should be taught. Respondents were also asked to identify their rationales for supporting (or opposing) certain elements of sexual education. Interviews revealed a group of evangelical Christian parents who verbalised their explicit opposition to abstinence-based sex education in schools, lamenting the sex-negative messages they believe to be associated with it. It additionally became apparent that these parents believe that their opposition to abstinence-based sexual education aligns with a silent majority of evangelical Christians. [ABSTRACT FROM AUTHOR]

This study builds on existing research into how young people’s emergent sexual development is connected to parent–child sex-related communication through avoidance vs. disclosure. Over the course of one year, a total of 21 young people (age range 12–17.5) reported in longitudinal qualitative diaries their (1) everyday sexual experiences and (2) sex-related conversations with their parents. Using a mixed-methods approach, findings show that less sexually experienced participants reported greater avoidance of parent–child sex-related conversations than more experienced participants. The sex-related conversations of more experienced participants mainly concerned overt experiences in the form of everyday issues with their romantic partner, while the conversations of less experienced participants were characterised by more covert experiences such as opinions about romantic relationships in general. These results suggest that the degree to which young people feel comfortable talking about sexuality with their parents partly depends on when the conversation takes place during a young person’s romantic and sexual development. [ABSTRACT FROM PUBLISHER]

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]