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Background: Adolescent dating violence (ADV) continues to be a health concern. Most previous research has examined physical and or sexual ADV with little attention to verbal violence. Methods: Drawing on the social-ecological framework, the current study examined the moderating influence of school adult connectedness on experiences of verbal only, physical and/or sexual violence (combination ADV), and mental health outcomes among 11th graders (n = 31,459) in one Midwestern state. Results: Overall, 24.0% and 28.8% of adolescents met thresholds for depression and anxiety symptoms, respectively. Rates of mental health symptoms were higher among adolescents reporting ADV compared to those who did not report experience of ADV. In logistic regressions, higher level of school adult connectedness was associated with lower odds of depressive and anxiety symptoms, respectively. In moderation analyses, school adult connectedness was protective for mental health outcomes regardless of ADV experience. Conclusion: Adolescent dating violence--including verbal violence alone--can be traumatic for young people. Schools can leverage the protective nature of school adult connection to promote mental health for all students, including adolescents who have experienced ADV. Incorporating trauma-informed education practice of providing unconditional positive regard toward adolescents might be 1-way schools can support adolescents in cultivating healthy relationships and well-being.

Hispanic/Latina students face difficulties engaging in physical activity, but schools can help by integrating activity into accrue the school day and offering sport and activity-based extracurriculars. In this study, we examined physical activity (PA) and school-related factors among adolescent Hispanic/Latina students. Participants (N = 5,539) were eighth, ninth, and eleventh grade females identifying as Hispanic/Latina on the 2016 Minnesota Student Survey. We used descriptive statistics and a generalized linear model to examine relationships between school-related variables and days of [greater than or equal to] 60 minutes of PA in the past week. Many participants engaged in no physical education (44%), sports (61%), PA lessons (84%), or after-school activities (76%). More days of physical education, sport, and PA lessons associated with higher PA levels (p < 0.001), as did more days of non-sport activities (p [less than or equal to] 0.01) and feeling safer going to/from school (p [less than or equal to] 0.05). Significant interactions demonstrated the effect of physical education on PA was strongest for eighth grade students. Hispanic/Latina students' PA and engagement in school activities are limited, and schools' practices and policies should intentionally support these adolescents' PA early and throughout their educational careers.

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

This study examines the intersection of sexual and gender identities among adolescents, including the prevalence of these groups and rates of emotional distress and bullying victimization. Data come from a large population-based sample; two measures of sexual orientation and gender identity create eight identity groups. Youth who report identifying both as lesbian, gay, bisexual or queer/questioning (LGBQ) and as transgender/gender diverse (TGD) had significantly higher levels of two measures of emotional distress and four measures of bullying victimization than those who report only identifying as LGBQ non-TGD or straight TGD. Implications for research and practice are discussed.

Context: Asian Americans are a diverse racial group, yet little research has described how adolescent tobacco use varies among Asian ethnic groups and how protective factors for tobacco use among general adolescent populations apply to these groups. Objective: To describe tobacco use patterns and protective factors in a statewide sample of Asian American adolescents by ethnicity. Setting/Dataset: 2019 Minnesota Student Survey. Population Studied: 8th, 9th, and 11th grade Asian Americans in Minnesota (n=10,482). Outcome measures: Dichotomized past 30-day use of cigarettes, cigars, e-cigarettes, hookah, chewing tobacco, dual/poly (>2), and any tobacco. Study Design & Analysis: Descriptive statistics examined tobacco use differences by ethnicity. Multivariable logistic regression modelled associations between 6 protective factors (internal developmental assets, positive student-teacher relationships, peer and parent anti-smoking norms, college aspirations, family caring) and e-cigarette use, adjusting for sex, grade, metro residence, and economic hardship. An interaction model (protective factor x ethnicity) assessed differences by ethnicity. Results: Among respondents, 9.0% identified as Indian, 0.3% Burmese, 7.9% Chinese, 2.5% Filipino, 25.0% Hmong, 3.2% Karen, 4.6% Korean, 2.7% Laotian, 8.2% Vietnamese, 7.5% other, 7.5% multiple Asian ethnicities, and 21.6% multiracial. E-cigarettes were the predominant form of tobacco use across groups. Laotian and multi-racial groups reported the highest e-cigarette use (16.6% and 16.3%), whereas Chinese and Asian Indian groups reported the lowest levels (4.7% and 5.0%). All 6 protective factors were significantly associated with lower odds of e-cigarette use across groups with significant interactions for internal developmental assets and peer anti-smoking norms. Higher developmental asset scores were associated with lower e-cigarette use in Asian Indian, Chinese, Hmong, Vietnamese, and multi-racial respondents. Peer antismoking norms were associated with lower e-cigarette use in Asian Indian, Chinese, Hmong, Vietnamese, and other respondents. Conclusions: E-cigarettes are the most prevalent tobacco product used by Asian adolescents in Minnesota. Protective factors from the general population appear to function similarly for these youth. Heterogeneity in e-cigarette use by ethnicity underscores the importance of disaggregating tobacco use by ethnicity to inform tailored tobacco prevention and control strategies., Presenters April Wilhelm, MD, MPH, Patrick Hammett, Steven Fu, Rebekah Pratt, PhD, Marla Eisenberg, Michele Allen, MD, MS, [...]

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

Background: National Health Education Standards in the U.S. focus on key concepts and skills around health issues, including sexuality. However, little is known about the extent to which classroom teachers are trained to deliver sexuality education. Purpose: The purpose is to explore pre-service training experiences and needs of sexuality educators in Minnesota. Methods: Seven focus groups were conducted with a diverse sample of 41 sexuality educators, and qualitative analysis was used to detect themes across groups. Results: Results indicate a wide variety of pre-service teaching experience, ranging from no instruction to extensive training. Teachers had numerous suggestions for ways their training could have better prepared them to teach sexuality education, such as ways of working with culturally diverse students. Teachers described many ways in which they were unprepared in their first year of teaching sexuality education. Discussion: Training programs to prepare sexuality educators are not adequately preparing teachers for their multifaceted role. Findings point to the need to train sexuality educators differently than teachers for other subjects. Translation to Health Education Practice: Findings indicate that pre-service training programs should greatly expand their offerings, tighten requirements and hone methodologies in sexuality education to meet the needs of today's teachers and students.

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.

This study aims to identify the relationships between Individualized Education Program (IEP) status and substance use. More than 122,000 eighth-, ninth-, and eleventh-grade students provided survey data in 2013. Analyses tested associations between IEP status and tobacco, alcohol, and marijuana use, accounting for emotional distress and demographic covariates. Approximately 10% of participants reported having an IEP; students with IEPs were significantly more likely to use substances than students without IEPs. In adjusted models, odds of cigarette smoking remained significantly elevated among students with IEPs. Education professionals may need to provide tailored substance use prevention programs to students with IEPs.

To address gaps in the literature on bisexual youth, we used the first nationally representative sample of high school students from the United States to determine profiles of behaviors related to depressive symptoms, a suicide attempt, and a medically-serious attempt. We examined the data from 922 bisexual students in grades 9-12 who completed the Centers for Disease Control and Prevention's 2015 National Youth Risk Behavior Survey. Latent class analysis derived three classes reflecting unique patterns of 10 risk and protective behaviors. For both the sexes: one group was high on all the risk behaviors and demonstrated the greatest risk of depression, a suicide attempt, and a medically-serious attempt; another was below average on all the risk and protective behaviors and demonstrated average/moderate risk of the outcomes; and the last demonstrated the highest levels of protective behaviors and the lowest risk of depression and suicidal behavior. Bisexual students are not homogenous with regard to the risk of mental health problems. Greater involvement in several risk behaviors and less involvement in protective behaviors, rather than merely a bisexual identity, might contribute to bisexual adolescents' increased risk of depression and suicidal behavior. Findings have implications for prevention programming, clinical interventions, and future research.