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

Objective: 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]

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]

Objective: The present study aimed to describe the experience of, and factors associated with, disordered eating in a population‐based sample of emerging adults during the COVID‐19 outbreak. Method: Participants in the EAT 2010–2018 (Eating and Activity over Time) study were invited to complete the C‐EAT (COVID‐19 EAT) survey in April–May 2020. There were 720 respondents to the survey (age: 24.7 ± 2.0 years). Psychological distress, stress, stress management, financial difficulties, and food insecurity during the COVID‐19 pandemic were examined as cross‐sectional correlates of disordered eating in 2020. Open‐ended questions assessed the perceived impact of the pandemic on eating behaviors. Results: Low stress management was significantly associated with a higher count of extreme unhealthy weight control behaviors (UWCBs). Food insecurity, higher depressive symptoms, and financial difficulties were significantly associated with a higher count of less extreme UWCBs. Higher stress and depressive symptoms were significantly associated with greater odds of binge eating. Six themes pertaining to disordered eating during the pandemic emerged: (a) mindless eating and snacking; (b) increased food consumption; (c) generalized decrease in appetite or dietary intake; (d) eating to cope; (e) pandemic‐related reductions in dietary intake; and (f) re‐emergence or marked increase in eating disorder symptoms. Discussion: Psychological distress, stress management, financial difficulties, and abrupt schedule changes may have contributed to disordered eating during the COVID‐19 pandemic. Interventions that target stress management, depressive symptoms, and financial strain and provide tools to develop a routine may be particularly effective for emerging adults at risk of developing disordered eating during public health crises. [ABSTRACT FROM AUTHOR]

Objective: Sociocultural theories hold that family and peer weight‐related teasing increases the risk for unhealthy weight control behaviors (UWCBs) by negatively impacting body image. Although much cross‐sectional support exists for these pathways, longitudinal data are lacking. This study tested the longitudinal relationships among peer and family teasing (occurrence and perceived impact) in early adolescence, body satisfaction in late adolescence, and UWCBs in young adulthood among a racially/ethnically and socioeconomically diverse population. Method: Data were drawn from three waves of Project EAT over a 15‐year period (Eating and Activity in Teens and Young Adults), and included responses from 1,902 young adults (57% female). Results: Among female participants, a mediated indirect pathway emerged with family weight‐related teasing predicting increased engagement in UWCBs in early adulthood via poorer body image in late adolescence. In contrast, peer teasing did not predict body image or UWCBs. Among boys, the mediated indirect pathways were not significant. However, poor body image in late adolescent males predicted higher likelihood of engaging in UCWBs in early adulthood. Discussion: These findings support the long‐term impact of family weight‐related teasing on greater risk for UWCBs among girls and young women, and poor body image as a mechanism accounting for this relationship. Moreover, the results highlight the poor body image among adolescent boys as a factor for increased risk of engaging in UWCBs in early adulthood. Pending replication in current cohorts, health promotion and prevention involving family members of early adolescents that address family weight teasing and body image are needed. [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]

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

Objective: The purpose of the current study was threefold: (a) compare rates of self‐reported anorexia nervosa (AN), self‐reported bulimia nervosa (BN), and eating pathology‐specific academic impairment (EAI) by gender identity (cisgender men, cisgender women, transgender or genderqueer) and sexual orientation (gay or lesbian, bisexual, unsure, other), (b) examine associations between gender identity, sexual orientation, and eating outcomes, and (c) identify for whom rates of eating disorder diagnosis and impairment is greatest. Method: The study includes a sample of Minnesota students (n = 13,906) who participated in the College Student Health Survey from 2015 to 2018. Chi‐square tests with bootstrapping examined differences in eating pathology rates between groups. Adjusted logistic regressions tested the association between gender identity, sexual orientation, and self‐reported eating outcomes. Results: Chi‐square results revealed heightened rates of self‐reported AN, self‐reported BN, and EAI in cisgender women, transgender or genderqueer, and sexual minority (e.g., lesbian or bisexual) students. Logistic regression analyses in cisgender men and cisgender women revealed higher odds of self‐reported AN, self‐reported BN, and EAI in sexual minority students relative their heterosexual peers. Chi‐square analyses indicated that bisexual cisgender women reported heightened rates of all three eating pathology measures relative to other sexual and/or gender (e.g., transgender) minority students. Discussion: Individuals with marginalized gender and/or sexual orientation identities report heightened rates of eating pathology, with cisgender bisexual women reporting the poorest outcomes relative to individuals from other marginalized identities. Preventive efforts and more research are needed to understand the mechanisms driving this disparity and to reduce prevalence among marginalized groups. [ABSTRACT FROM AUTHOR]

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

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

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

We examined the variations of adolescent health status and risk involvement- prevalence of mental health disabilities, chronic health conditions, substance use, and exposure to tobacco-between 6 family structures in a school-based sample of Latino, Somali, Hmong, and White students and whether ethnicity moderated these associations. Data were collected from the 2013 Minnesota Student Survey, comprising a sample of 29,345 from 8th, 9th, and 11th grades. Logistic regression investigated relationships between family structure and health variables. Adolescents in nuclear families reported better health outcomes in most models; odds of mental disabilities were 1.64 for single parent and 2.45 for other family structures. Significant effect modification was noted for all health outcomes; extended families were consistently protective for Hmong youth and offered some protection for Latino and Somali youth. Policies and programs that support parents and guardians are essential, and may be especially beneficial for ethnic minority youth in single-parent, grandparent-only, and other family structures. [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]

Objective: Examine relationships between weight-related factors and weight status, body dissatisfaction, chronic health conditions, and quality of life across sexual orientation and gender.Methods: Two- and four-year college students participated in the College Student Health Survey (n = 28,703; 2009-2013). Risk differences were calculated to estimate relationships between behavioral profiles and weight status, body satisfaction, diagnosis of a chronic condition, and quality of life, stratified by gender and sexual orientation. Four behavioral profiles, characterized as "healthier eating habits, more physically active," "healthier eating habits," "moderate eating habits," and "unhealthy weight control," were utilized based on latent class analyses, estimated from nine weight-related behavioral survey items.Results: Sexual orientation differences in weight and quality of life were identified. For example, sexual minority groups reported significantly poorer quality of life than their heterosexual counterparts (females: 22.5%-38.6% (sexual minority) vs. 19.8% (heterosexual); males: 14.3%-26.7% (sexual minority) vs. 11.8% (heterosexual)). Compared with the "healthier eating habits, more physically active" profile, the "unhealthy weight control" profile was associated with obesity, poor body satisfaction, and poor quality of life in multiple gender/sexual orientation subgroups.Conclusions: Interventions are needed to address obesity, body dissatisfaction, and poor quality of life among sexual minority college students. [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]

Objective Many emerging adults (18-25 year olds) report unmet health needs and disproportionately experience problems such as sexually transmitted infections. This study was conducted to examine college students' perceptions of health care providers, specifically in the context of accessing sexual health resources. Design and Sample Students ( N = 52) were recruited from five diverse colleges in one state to participate in a one-to-one interview that involved walking and virtually exploring resources on and near campus. Interviews were conducted from May to November 2010. Measures Open-ended one-to-one interview questions. Results Inductive qualitative analysis yielded six themes summarizing students' perceptions of provider characteristics, health care resources, the role of their peers, and students' suggestions for strengthening health care services. Importantly, students consider a variety of staff-and their student peers-to be resources for sexual health information and services. Conclusions Findings emphasize the importance of collaboration between health service staff and broader campus staff because students often turn to campus staff initially. Postsecondary students welcome opportunities to know a provider through interactive websites that include details about providers on campus; their decisions to seek sexual health care services are influenced by their perceptions of providers' characteristics and interpersonal skills. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Binge eating is prevalent among adolescents, but little is known about how parents and friends may influence such behaviors. This study examined associations between adolescent binge eating behaviors, and similar behaviors in their parents and friends. Method Participants were 2,770 target adolescent boys and girls who had at least one friend and/or parent who also participated. Logistic regression, stratified by gender, examined associations between parents' and friends' self-reported binge eating, and similar behaviors in target adolescents. Results Girls' binge eating was associated with their male friends' (odds ratio = 2.33; p = 0.03) and fathers' binge eating (odds ratio = 3.38; p = 0.02), but not with their female friends' or mothers' binge eating ( p > 0.05). For boys, binge eating was not associated with parents' or friends' behavior. Discussion Adolescent girls' binge eating is associated with similar behaviors in their other-sex parents and friends. Results should be replicated, and mechanisms explaining this relation should be further explored. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:325-328) [ABSTRACT FROM AUTHOR]

Sexual risk behaviors are common among college students, but differences between 2- and 4-year students have not been explicitly tested. Survey data from 9,748 unmarried sexually active Minnesota college students (in 2010 or 2011) were used multilevel logistic regression models to test differences in eight high risk sexual health behaviors and outcomes between students attending 2- vs. 4-year colleges. Odds of sex without a condom, sex without reliable birth control, unplanned pregnancy, and STIs were significantly lower among 4-year students than 2-year students, after adjusting for demographic covariates. Health promotion approaches targeted to the needs of 2- or 4-year students may be needed. For example, messaging and outreach efforts encouraging condom use may be especially beneficial for sexual health programs at 2-year colleges. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Context Sexual risk behaviors are common among college students, and research examining the environmental context of these behaviors is important for prevention. The presence of college sexual health resources is a potentially important part of that context. Methods In a 2010-2011 survey, 6,318 undergraduates from 28 two- and four-year Minnesota college campuses provided data on their sexual health behaviors. In addition, a specially designed inventory was used to assess the sexual health resources available on each campus. Multilevel regression was used to test the associations of four types of resources with students' condom use, birth control use, STD or HIV testing, and unplanned pregnancy. Results In models that controlled for students' personal and demographic characteristics, the higher the level of sexual health resources at a college, the lower the likelihood that students had had intercourse without birth control, intercourse without a condom and involvement in unplanned pregnancy. For example, students attending colleges with the maximum number of general clinic resources had a lower predicted probability of reporting nonuse of reliable birth control at last intercourse than students attending colleges with no resources (7% vs. 14%). After college characteristics were adjusted for, most measures of resources remained significant, although associations were reduced; two measures became significant in unexpected directions. Conclusions Colleges' provision of sexual health resources may be associated with students' sexual health behaviors. Research using quasi-experimental or experimental designs is needed to assess the mechanisms underlying these associations; such work could lead to interventions that might help reduce students' risky behaviors. [ABSTRACT FROM AUTHOR]

Objective To examine longitudinal trends from 1999-2010 in weight-related teasing as adolescents transition to young adulthood and to examine secular trends in teasing among early and middle adolescents over the same time period. Design and Methods To examine longitudinal changes we used data from 2,287 participants in Project EAT-III, an ongoing cohort that followed two age cohorts of adolescents from 1999 to 2010. Over the study period the younger cohort transitioned from early adolescence to early young adulthood and the older cohort transitioned from middle adolescence to middle young adulthood. To examine how levels of teasing among early and middle adolescents changed from 1999-2010 (secular trends), we compared baseline data from EAT-I to cross-sectional data from a new cohort of early and middle adolescents that was established in 2010. Results In 1999, 29% of early adolescent and 23% of middle adolescent females reported being teased. Approximately 18% of males in both age groups reported being teased in 1999. Longitudinal trends suggest that weight-related teasing remained stable among all subgroups as they transitioned to young adulthood, except among early adolescent males where teasing increased to 27% in early young adulthood. Analyses of age-matched secular trends show that teasing decreased by 10.4% among early adolescent females and by 7.6% among middle adolescent males from 1999-2010. Conclusion Results suggest that interventions that focus on reducing weight-based discrimination are needed throughout adolescence and young adulthood. The secular decrease in weight-related teasing is promising, but the high prevalence of teasing remains a public health concern. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Sexuality education teachers' perspectives are important to gain a full understanding of the issues surrounding teaching this subject. This study uses a statewide sample of public school teachers to examine what sexuality education content is taught, what barriers teachers face, and which barriers are associated with teaching specific topics. METHODS Participants included 368 middle and high school teachers with sexuality education assignments in Minnesota. Survey data included topics they teach, what they think they should teach, and barriers they face. Logistic regression was used to examine associations between barriers and teaching each of 9 sexual health topics, among those who believed the topic should be taught. RESULTS Almost two thirds of participants faced structural barriers; 45% were concerned about parent, student, or administrator response; and one quarter reported restrictive policies. Structural barriers were inversely associated with teaching about communication ( OR = 0.20), teen parenting ( OR = 0.34), and abortion ( OR = 0.32); concerns about responses were associated only with teaching about sexual violence ( OR = 0.42); and restrictive policies were inversely associated with teaching about abortion ( OR = 0.23) and sexual orientation ( OR = 0.47). CONCLUSIONS Addressing teachers' barriers requires a multipronged approach, including curriculum development and evaluation, training, and reframing the policy debate to support a wider range of sexuality education topics. [ABSTRACT FROM AUTHOR]

Objective: To examine associations between participating in mind-body activities (yoga/Pilates) and body dissatisfaction and disordered eating (unhealthy and extreme weight control practices and binge eating) in a population-based sample of young adults. Method: The sample included 1,030 young men and 1,257 young women (mean age: 25.3 years, SD 5 1.7) who participated in Project EAT-III (Eating and Activity in Teens and Young Adults). Results: Among women, disordered eating was prevalent in yoga/Pilates participants and nonparticipants, with no differences between the groups. Men participating in yoga/Pilates were more likely to use extreme weight control behaviors (18.6% vs. 6.8%, p 5 .006) and binge eating (11.6% vs. 4.2%, p 5 .023), and marginally more likely to use unhealthy weight control behaviors (49.1% vs. 34.5%; p 5 .053), than nonparticipants after adjusting for sociodemographics, weight status, and overall physical activity. Discussion: Findings suggest the importance of helping yoga/Pilates instructors recognize that their students may be at risk for disordered eating. [ABSTRACT FROM AUTHOR]

CONTEXT: Speculation in public discourse suggests that sexual encounters outside a committed romantic relationship may be emotionally damaging for young people, and federal abstinence education policy has required teaching that sexual activity outside of a marital relationship is likely to have harmful psychological consequences. METHODS: In 2003–2004, a diverse sample of 1,311 sexually active young adults (mean age, 20.5) participating in a longitudinal study in Minnesota completed a survey including measures of sexual behavior and psychological wellbeing. Chi-square tests were used to compare the prevalence of recent casual partnerships by selected demographic and personal categories. General linear modeling was then used to compare mean levels of each psychological wellbeing measure between those reporting recent casual partners and those reporting committed partners; partner type was measured both dichotomously and categorically. RESULTS: One-fifth of participants reported that their most recent sex partner was a casual partner (i.e., casual acquaintance or close but nonexclusive partner). Casual partnerships were more common among men than among women (29% vs. 14%), and the proportions of male and female respondents reporting a recent casual partner diff ered by race or ethnicity. Scores of psychological well-being were generally consistent across sex partner categories, and no significant associations between partner type and well-being were found in adjusted analyses. CONCLUSIONS: Young adults who engage in casual sexual encounters do not appear to be at greater risk for harmful psychological outcomes than sexually active young adults in more committed relationships. [ABSTRACT FROM AUTHOR]

BACKGROUND: Increasing correct and consistent condom use among sexually active adolescents continues to be a critical public health goal, with schools serving as key agents for achieving this goal through sexuality education and condom use provision. This research aims to describe the views of parents regarding school-based condom distribution and education programs, and examines how these views differ across demographic groups. METHODS: Parents of school-age children in Minnesota were surveyed in telephone interviews (N = 1605; 63% participation) regarding their beliefs about condom availability and education. Chi-square tests of significance were used to detect differences in agreement with each statement for 10 demographic and personal characteristics. RESULTS: A majority of respondents held supportive views about condom availability and education programs. Strongest support centered on statements in the survey about teenagers needing information about condoms (86%) and showing actual condoms during classroom lessons (77%). Approximately two thirds of the parents agreed that school-based instruction about condoms should be “allowed” at the high school level (65%), and one fifth (21%) believed that this type of education should be “required.” Support for condom availability and education programs differed significantly according to certain personal characteristics, with less supportive views from self-identified Born Again Christians and politically conservative parents. CONCLUSIONS: Public discourse regarding school-based sexuality education should include the viewpoints of parents of school-aged children as key stakeholders. Parents' perspectives provide unique and critical insights that school administrators and educators should consider as they develop educational and programmatic offerings regarding condoms. [ABSTRACT FROM AUTHOR]

Objective: Suicide is associated with full syndromal eating disorders, but it is unclear whether subsyndromal eating disorders carry the same risk. This study examined associations between suicidal behaviors and extreme and less extreme weight control behaviors (EWCB and LWCB, such as fasting, vomiting, meal skipping, etc.), body dissatisfaction, and weight status in adolescents. Method: Data on body dissatisfaction, depressive symptoms, suicidal ideation and attempts, and body mass index (BMI) were drawn from Project EAT, a survey of 4,746 7th–12th grade students. Multivariate logistic regression examined associations between eating- and weight-related variables and suicidality. Results: Suicidal ideation and suicide attempts were more commonly observed in adolescents with EWCB (boys: ideation OR = 2.12, attempts OR = 4.10; girls: ideation OR = 1.66, attempts OR = 2.29), LWCB (boys: ideation OR = 1.33, attempts OR = 1.76; girls: ideation OR = 1.77, attempts OR = 1.80), as well as body dissatisfaction (boys: ideation OR = 1.75, attempts OR = 2.23; girls: ideation OR = 1.77, attempts OR = 1.81), even after controlling for depressive symptoms. No association was observed between BMI and suicidal attempts or ideation. Conclusion: Thus, it appears that suicidal behavior in adolescents is associated even with low-level eating disorder symptoms. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [ABSTRACT FROM AUTHOR]

CONTEXT: Social-psychological theories of health behavior suggest that adolescents' sexual behaviors are influenced by the sexual attitudes and behaviors of their friends. METHODS: Data on 2,436 participants in the National Longitudinal Study of Adolescent Health (Add Health) who were sexually inexperienced at Wave 1 (1994--1995) were analyzed to examine whether friend-related variables predicted initiation of vaginal intercourse by Wave 2 (1996). Analyses also assessed whether predictive relationships varied by level of involvement with friends. Odds ratios were generated by logistic regression analysis. RESULTS: In the 9--18 months between Waves 1 and 2, 18% of participants initiated intercourse. In analyses controlling for gender, family structure and romantic relationships, the higher the proportion of a youth's friends who were sexually experienced, the greater the odds of sexual debut (odds ratio, 1.01); the odds also were elevated among youth who believed that they would gain their friends' respect by having sex (1.2). Relationships between friend variables and sexual initiation did not vary by level of involvement with friends. CONCLUSIONS: To maximize the likelihood of success, programs focused on delaying teenage sexual intercourse should address norms for sexual behavior among adolescents' close friends as well as the perceptions, skills and behaviors of individual youth. [ABSTRACT FROM AUTHOR]

CONTEXT: Parents are encouraged to be the primary sex educators for their children; however, little is known about the accuracy of parents' views about condoms and oral contraceptives. METHODS: Telephone surveys using validated measures provided data on beliefs about the effectiveness, safety and usability of condoms and the pill among 1,069 parents of 13-17-year-olds in Minnesota and Wisconsin in 2002. Pearson chi-square tests and multivariate logistic regression models were used to compare beliefs according to sex, age, race, religion, education, income and political orientation. RESULTS: Substantial proportions of parents underestimated the effectiveness of condoms for preventing pregnancy and sexually transmitted diseases (STDs). Only 47% believed that condoms are very effective for STD prevention, and 40% for pregnancy prevention. Fifty-two percent thought that pill use prevents pregnancy almost all the time; 39% thought that the pill is very safe. Approximately one-quarter of parents thought that most teenagers are capable of using condoms correctly; almost four in 10 thought that most teenagers can use the pill correctly. Fathers tended to have more accurate views about condoms than mothers did; mothers' views of the pill were generally more accurate than fathers'. Whites were more likely than nonwhites to hold accurate beliefs about the pill's safety and effectiveness; conservatives were less likely than liberals to hold accurate views about the effectiveness of condoms. CONCLUSION: Campaigns encouraging parents to talk with their teenagers about sexuality should provide parents with medically accurate information on the effectiveness, safety and usability of condoms and the pill. [ABSTRACT FROM AUTHOR]

This study described peer harassment in a large, multiethnic sample of adolescents, and explored the relationship between experiencing peer harassment and both school connectedness and achievement. Survey data came from 4,746 students in grades 7-12 at 31 public schools in ethnically and socioeconomically diverse communities in a Midwestern state. Frequency of five types of harassment were analyzed with data on school connectedness and grades. Multivariate analysis controlled for gender, grade level, race/ethnicity, and socioeconomic status. Results indicate that most students periodically experience mistreatment; 10% to 17% report being treated disrespectfully, having others act superior, or being insulted at least once per week, and an additional 14% to 22% of students report suffering these behaviors a few times per month. Girls, Whites, Native Americans, and middle school students reported more harassment than boys, other ethnic groups, and high school students, respectively. Peer harassment related significantly to both aspects of school life: those who disliked school tended to suffer more mistreatment, and "B" students reported the least harassment on average. Young people mistreated by peers may not want to be in school and may thereby miss out on the benefits of school connectedness as well as educational advancement. The high prevalence of peer harassment and its association with school connectedness and school achievement provide justification for interventions aimed at prevention of peer harassment. A schoolwide approach using educational and policy components may provide an appropriate prevention strategy. [ABSTRACT FROM AUTHOR]

Discusses the perceptions of high school students in Minnesota with regards to human sexuality education. Consensus among students that sexuality education should start early; Concern of students on the presentation of effective sexuality education in the class; Implications of the study on teachers and school policy.

Objective: The current study examined general, peer, and family weight teasing across race/ethnicity and weight status (average weight, overweight, obese) in adolescents. For those participants who reported peer or family weight teasing, the extent to which this teasing bothered them was also reported. Methods and Procedures: Data were from the first wave of Project EAT (Eating Among Teens), a longitudinal study of eating and weight-related variables in 4,746 adolescent boys and girls. Participants completed a survey and their height and weight were measured. Results: Prevalences of general weight teasing were similar across race/ethnicity. Asian-American boys, black boys, and Asian-American girls reported lower prevalences of peer teasing than whites. Hispanic, Asian-American, and mixed/other girls reported higher prevalences of family weight teasing than did white girls. In nearly all racial/ethnic groups for all three teasing variables, obese adolescents were significantly more likely to report having been teased, compared to average-weight adolescents. In some racial/ethnic groups overweight adolescents were also significantly more likely than average-weight adolescents to report having been teased. Among girls who were teased, fewer black and mixed/other girls were bothered by peer teasing, compared to white girls. Similarly, fewer girls from most racial/ethnic groups were bothered by family weight teasing, compared to white girls. Discussion: The results of the current study suggest that weight-based teasing is a problem for all youth, and especially so for overweight and obese youth, regardless of racial/ethnic group. Asian-American adolescents may experience somewhat less weight teasing from peers, and possibly more weight teasing from family members. One-quarter to one-half of those teased by family or peers were bothered by it, and more white girls were bothered than other groups. Efforts to eradicate weight stigmatization could provide benefits to a sizable number of adolescents across a variety of racial and ethnic groups. [ABSTRACT FROM AUTHOR]

Objective: To examine 5-year longitudinal and secular trends in weight-related teasing among adolescents. Methods and Procedures: Project EAT-II (Eating Among Teens-II) followed 2,516 adolescents (females = 1,386, 55.1%) prospectively from 1999 to 2004. EAT-II included two cohorts allowing the observation of longitudinal changes in reported weight-related teasing as participants transitioned from early to mid-adolescence (middle school to high school) and from mid- to late-adolescence (high school to post-high school). EAT-II also allowed the examination of secular trends in reported teasing among middle adolescents in 1999 and 2004. Results: In 1999, approximately one-quarter of adolescents in the total sample (including both overweight and nonoverweight youth) reported being teased about their weight in early adolescence and mid-adolescence. Prevalence rates of teasing were higher among overweight youth (early adolescence: females 42.4%, males 44.6%; mid-adolescence: females 31.2%, males 40.8%). Longitudinal trends suggest that weight-related teasing decreased among overweight males and females in the younger cohort as they transitioned from early adolescence to mid-adolescence. In the older cohort of youth, teasing decreased in the total sample of females as they transitioned from mid-adolescence to older adolescence. Analyses of age-matched secular trends among middle adolescents showed that the prevalence of weight-related teasing remained stable among most adolescent subgroups and declined among overweight males between 1999 and 2004. Discussion: Weight-related teasing is prevalent through the various stages of adolescence. Our findings point to a need for ongoing interventions, throughout adolescence, which focus on reducing weight-related teasing and improving social supports for affected youth. [ABSTRACT FROM AUTHOR]