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Background: The association between early childhood psychosocial problems and poorer educational outcomes is well-documented, but the extent to which this association persists is less understood. The current study assessed the correlations between first-grade psychosocial functioning and educational outcomes through eighth grade in a large longitudinal sample of Chilean students. Methods: The Pediatric Symptom Checklist-Chilean (PSC-CL) and Teacher Observation of Classroom Adaptation Re-Revised (TOCA-RR) assessed psychosocial functioning for 9736 students who were screened four times from first through eighth grade through the Skills for Life program. Adjusted linear mixed effects models assessed the association between first grade PSC-CL and TOCA-RR risk and third, sixth, and eighth grade GPA and school attendance. Results: First-grade PSC-CL and TOCA-RR risk both significantly predicted lower third, sixth, and eighth grade GPAs; all p < 0.001. The relationships between first-grade psychosocial functioning and later school attendance rates were less consistent but still significant at certain time points. Conclusions: First-grade psychosocial risk was persistently associated with lower academic performance in a longitudinal sample of Chilean students followed through elementary and middle school. Implications for School Health Policy, Practice, and Equity: Early school-based psychosocial screening and follow-up interventions have the potential to improve students' long-term educational outcomes.

Background: Chile's national school-based mental health program, "Skills for Life" (SFL), has demonstrated effectiveness in improving behavioral and academic outcomes in first- through third-grade students. The current study assessed the feasibility and outcomes of SFL's program for sixth- through eighth-grade students. Methods: We assessed the percentage of students who participated in the program and longitudinal changes on teacher-reported Teacher Observation of Classroom Adaptation Re-Revised (TOCA-RR) scores, youth-reported Pediatric Symptom Checklist-Chile (PSC-Y-CL) scores, grade-point average, and school attendance from sixth to eighth grade (2016-2018) for SFL's workshop intervention. Linear mixed effects models analyzed the association between outcome variables and workshop attendance. Results: Of the 30,649 sixth graders who attended the 754 participating schools in 2016, 28,204 (92.0%) were screened with the TOCA-RR. Of the 1829 students who screened at risk, 1344 had available workshop data for seventh grade, with 86.9% of them participating in most ([greater than or equal to] 7) workshop sessions. Workshop attendance was significantly associated with improvements in school attendance and peer relationships (a TOCA-RR subscale) in eighth grade. Conclusions: With high rates of behavioral health screening and workshop attendance, this study demonstrated the feasibility of implementing SFL's middle school program on a national scale. Higher workshop attendance by at-risk students was associated with better school attendance and peer relationships in eighth grade, as well as better but not significantly different outcomes on other measures (e.g., teacher-rated school performance and aggressive behavior in the classroom). Overall, these findings provide preliminary evidence of the feasibility and benefits of SFL's middle school program.

The impact of an 8.8 magnitude Chilean earthquake on elementary school students' psychosocial functioning was assessed along with exposure to adverse childhood experiences (ACEs). Skills for Life, a national school-based mental health program in Chile, routinely assesses first- and third-grade students' psychosocial functioning and classroom adaptation. Students (N = 19,627) were screened before (2009) and after (2011) the 2010 earthquake with parent- and teacher-report measures and with a parent-report of four ACEs (family psychopathology, child chronic illness, family social isolation, father absence). Earthquake exposure was categorized as mild, moderate, or severe for Chile's 15 regions. Multilevel models analyzed the unadjusted and adjusted impacts of earthquake exposure and ACEs on functioning while clustering for school- and district-level effects. In covariate-adjusted models, earthquake exposure and three ACEs were significantly associated with worsened psychosocial functioning; earthquake exposure and all four ACEs were significantly associated with worsened classroom adaptation. New family psychopathology, B = 1.90, p < .001; chronic illness, B = 2.25, p < .001; and severe earthquake impact, B = 1.29, p < .001, held the strongest negative effects on psychosocial well-being. Moderate, B = 3.04, p = .011, and severe earthquake exposure, B = 2.53, p = .047, and new family psychopathology, B = 1.99, p < .001, were associated with the worst classroom functioning 1-year postdisaster. Findings suggest that both exogenous and home-based stressors can have significant consequences for children's psychosocial functioning and classroom adaptation, and routine screening helps quantify how individual students are affected by chronic versus acute stressors.

Introduction: Implementing sex education programs during adolescence is crucial for addressing the risks associated with sexuality. However, some of these interventions lack proper incorporation of a gender perspective and maintain a heteronormative and biologically-focused approach, potentially resulting in inequitable outcomes for adolescents. In response, comprehensive sex education is most effective due to its multidimensional view of sexuality. However, integrating a comprehensive perspective on sexuality and a gender lens that contributes to adolescent health equity presents challenges, especially in low and middle-income countries. This study aimed to develop a comprehensive and gender-transformative sex education program for adolescents in a middle-income country of Latin America, utilizing the Intervention Mapping Approach. Methods: This exploratory sequential mixed-method study comprised two phases. In the first phase, a literature review, nine focus groups with high school students, and 14 interviews with school professionals were conducted to inform program design. Subsequently, the program underwent validation through expert judgment. In the second phase—as part of program development—a preliminary evaluation was conducted by implementing the program in two high schools with 30 students from public high schools, who were administered a pre-post ad hoc survey. Results: A comprehensive and gender-transformative sex education program was designed based on literature review findings and input from students and school workers. The ad hoc survey revealed a statistically significant increase in protective skills in sexuality (W = 59, p =.01) among all participants. Discussion: Designing a sex education intervention through Intervention Mapping allowed for the integration of evidence and the needs of the target population. The results of the preliminary evaluation suggest the potential of the developed program to enhance protective skills in sexuality and promote health equity through gender-equitable outcomes in adolescent sex education. [ABSTRACT FROM AUTHOR]

Environmental adversity and subclinical symptoms of psychopathology in adolescents increase their risk for developing a future psychiatric disorder, yet interventions that may prevent poor outcomes in these vulnerable adolescents are not widely available. To develop and test the feasibility and acceptability of a prevention-focused program to enhance resilience in high-risk adolescents. Adolescents with subclinical psychopathology living in a predominantly low-income, Latinx immigrant community were identified during pediatrician visits. A group-based intervention focused on teaching emotion recognition and regulation skills was piloted in three cohorts of adolescents (n = 11, 10, and 7, respectively), using a single arm design. The second and third iterations included sessions with parents. Eighty-eight percent of participants completed the program, which was rated as beneficial. Also, from baseline to end of treatment, there was a significant decrease in subclinical symptoms and a significant increase in the adolescents' positive social attribution bias (all p < 0.05). A resilience-focused intervention administered to high-risk adolescents was found to be feasible and acceptable to participants. Future work is needed to determine whether such a program can reduce the incidence of negative outcomes, such as the development of psychiatric disorders and related disability, in this population. [ABSTRACT FROM AUTHOR]

Aim: Investigate associations between religion and spirituality (R&S) and DNA methylation of four HPA-axis genes (i.e. 14 CpG sites) among 992 adults from the Hispanic Community Health Study/Study of Latinos cohorts., Methods: We assessed 1) the association between R&S measures and mean percent methylation overall and stratified by nativity status (US-born or immigrant) and 2) if interactions between R&S and methylation differed by nativity status., Results: Among individuals with the FKBP5 CC genotype, increased spirituality scores were associated with significantly lower methylation levels among immigrants, compared to US-born participants. Organizational religiosity (e.g. service attendance) was associated with increased FKBP5 (CC genotype) methylation among immigrants., Conclusion: R&S may influence HPA-axis functioning differently based on nativity status; a finding that could offer insight into mechanisms leading to health disparities.

Background: South Asians (SA) represent the fastest growing US immigrant group, and previous studies have indicated that they face disproportionately high burden of cardiometabolic disease. Cardiometabolic disease manifests as a syndemic or synergistic epidemic encompassing multiple disease clusters influenced by biological, social, and psychological factors stemming from the acculturative process. This process may exacerbate morbidity within immigrant subgroups. Our aim was to identify cardiometabolic risk profiles among SA using indicators of acculturation., Methods: We conducted a latent class analysis on data from the Mediators of Atherosclerosis in South Asians Living in America study ( N =771). A composite cardiometabolic disease outcome was constructed using prevalent hypertension, type 2 diabetes, and body mass index. Acculturation indicators included years living in the US, English language proficiency, dietary behaviors, preservation of cultural traditions, social and neighborhood support, maintenance of social relationships (i.e., friendships), and experiences of discrimination, along with proxies of acculturative stress (i.e., depressive symptomology, trait anxiety and anger). Social and environmental determinants of health, health behaviors, religiosity and spirituality served as covariates to further assess latent class membership., Results: Four cardiometabolic risk profiles emerged: (1) lowest risk [73.8% of sample] characterized by high integration into both SA and US cultures; (2) the modest risk [13.4% of sample], exhibiting elevated levels of mental health distress and experiences of discrimination, and distancing themselves from both cultures; and the (3) moderate risk [8.9% of sample] and (4) highest risk [3.9% of sample], demonstrating greater assimilation into US culture. Compared to the lowest risk profile: the modest risk profile was associated with low-income and conflicting attitudes about religion/spirituality, while the moderate risk profile was characterized by lower income and educational attainment with positive behaviors and attitudes toward religion/spirituality., Conclusion: Findings expand our understanding of immigrant cardiometabolic health as a syndemic issue wherein multiple co-occurring and interacting processes synergize to produce negative outcomes in already at-risk subpopulations. Furthermore, acculturation emerges as a crucial factor in understanding health disparities among immigrant and refugee groups in the US., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Montiel Ishino, Canenguez, Cohen, Kent, Villalobos, Needham, Kandula, Kanaya, Shields and Williams.)