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Objective: Human papillomavirus vaccination coverage is suboptimal, especially among males. Social networks influence young adults' health behaviors and could be leveraged to promote vaccination. We sought to describe how young sexual minority men communicate about human papillomavirus (HPV) vaccination with their sexual partners. Participants: National (U.S.) sample of sexual minority men ages 18-26 (n = 42) from January 2019. Methods: We conducted four online focus groups and identified salient themes using inductive content analysis. Results: Across groups, participants described that HPV vaccination is not a focus of their conversations with sexual partners. Other key themes related to HPV vaccine communication included: varying discussions based on relationship type, and valuing conversations with partners about safer sex. Conclusions: Findings provide novel insight into how young sexual minority men communicate with their sexual partners about HPV vaccination and identify potential areas for interventions to promote communication. Future research is needed to investigate associations between partner communication and HPV vaccine uptake.

Extensive media coverage and potential controversy about COVID-19 vaccination during the pandemic may have affected people's general attitudes towards vaccination. We sought to describe key psychological antecedents related to vaccination and assess how these vary temporally in relationship to the pandemic and availability of COVID-19 vaccination. As part of an ongoing online study, we recruited a national (U.S.) sample of young gay, bisexual and other men who have sex with men (N = 1,227) between October 2019 and June 2021, and assessed the '4Cs' (antecedents of vaccination; range = 1-5). Overall, men had high levels of confidence (trust in vaccines; M = 4.13), calculation (deliberation; M = 3.97) and collective responsibility (protecting others; M = 4.05) and low levels of complacency (not perceiving disease risk; M = 1.72). In multivariable analyses, confidence and collective responsibility varied relative to the pandemic phase/vaccine availability, reflecting greater hesitancy during later stages of the pandemic. Antecedents also varied by demographic characteristics. Findings suggest negative effects of the COVID-19 pandemic on key antecedents of general vaccination and identify potential targets for interventions., Author(s): Annie-Laurie McRee [sup.1] [sup.4] , Amy L. Gower [sup.1] , Dale E. Kiss [sup.2] [sup.3] , Paul L. Reiter [sup.2] [sup.3] Author Affiliations: (1) grid.17635.36, 0000000419368657, Department of Pediatrics, [...]

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.

Few studies have examined whether dimensions of school engagement are differentially associated with bullying victimization and perpetration, behaviors that undermine the capacity to achieve academically and increase risk for depression and school dropout. We investigated associations between affective, cognitive, and behavioral engagement upon entry into middle school and four types of bullying behaviors (i.e., relational and physical victimization and perpetration) 6 months later. Our sample was comprised of an ethnically diverse cohort of students attending middle schools characterized by lower than state average standardized test scores and located in socioeconomically vulnerable communities. Results from multivariable logistic regression models that included all three measures of engagement suggest that affective engagement reduced the odds of the three types of bullying behaviors that increased over the study period, regardless of sex or ethnic group. Tests of moderation by sex yielded some differences in the association between behavioral engagement and bullying behaviors. Findings highlight the potential promise of strengthening bonds between students and teachers as a strategy to reduce bullying and encourage healthy development in under resourced contexts.

Background: Violence and bullying perpetration among boys are major public health problems. We address gaps in the literature by examining: (1) how risk and protective factors co-occur, and (2) how different risk/protection profiles are associated with violence and bullying perpetration among adolescent boys. Methods: Data came from the population-based 2016 Minnesota Student Survey. The analytic sample included boys in grades 8, 9, and 11 (N = 63,818). Latent profile analyses identified patterns of 22 behavioral, intrapersonal, family, and school and community risk/protective factors. Logistic regression analyses examined how these patterns related to violence and bullying perpetration. Results: We identified 5 groups: Class 1: "Low risk, high safety, high connectedness;" Class 2: "Low risk, moderate safety, moderate connectedness;" Class 3: "Moderate risk, high safety, moderate connectedness;" Class 4: "High risk, moderate safety, low connectedness;" and Class 5: "High risk, low safety, low connectedness." Compared to Class 1, Class 5 students had the highest odds of all for violence and bullying perpetration. Class 4 students also demonstrated high odds of violence and bullying, compared to Class 1. Though not as high as Classes 4 or 5, Class 2 and 3 students showed higher odds for both outcomes, compared to Class 1. Conclusions: Substantive variations exist in boys who engage in violence and bullying. We highlight cumulative, co-occurring risk factors, connectedness to parents and other prosocial adults (eg, teachers), and school and neighborhood safety as important factors to address in school health programs seeking to prevent violence and bullying perpetration among boys.

Background: Adolescents are in a unique developmental stage, ideal for initiating healthy behaviors and benefiting from health promotion interventions. In this study, we used positive youth development and resilience frameworks, to investigate the role of internal assets as a protective factor for bullying and emotional distress among early adolescents, with attention to whether those associations vary by sex. Methods: This is a secondary analysis of the 2013 Minnesota Student Survey, a cross-sectional, population-based survey of Minnesota youth. Participating eighth grade students (N = 42,841) reported on internal assets, physical, relational and cyberbullying involvement, and emotional distress. Results: Logistic regression analyses, stratified by sex and controlling for sociodemographic characteristics, revealed that students with higher internal assets had lower odds of all forms of bullying victimization and perpetration than those with lower internal assets. Higher levels of internal assets were also associated with lower odds of emotional distress. All associations were significant for boys and girls, but appeared stronger for girls. Conclusions: Findings indicate that internal assets may buffer young teens from bullying and from the emotional distress that may result from bullying involvement. Approaches bolstering internal assets may be beneficial for combating bullying and emotional distress during early adolescence.

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.

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.

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.

Background: Although nearly all states in the United States require school districts to adopt anti-bullying policies, little research examines the effect of these policies on student bullying and health. Using a statewide sample, we investigated associations between the quality of school district anti-bullying policies and student bullying involvement and adjustment. Methods: School district anti-bullying policies (N = 208) were coded for their quality based on established criteria. District-level data were combined with student reports of bullying involvement, emotional distress, and school connectedness from a state surveillance survey of 6th, 9th, and 12th grade students (N = 93,437). Results: Results indicated that policy quality was positively related to bullying victimization. Furthermore, students reporting frequent perpetration/victimization who also attended districts with high-quality policies reported more emotional distress and less school connectedness compared with students attending districts with low quality policies. Although statistically significant, the magnitude of these associations was small. Conclusions: Having a high-quality school district anti-bullying policy is not sufficient to reduce bullying and protect bullying-involved young people. Future studies examining policy implementation will inform best practices in bullying prevention.

BackgroundGay, bisexual, and other men who have sex with men experience several disparities related to human papillomavirus (HPV) infection, including high incidence rates of anal cancer. Although the HPV vaccine is currently recommended for young adults, HPV vaccine coverage is modest among young gay, bisexual, and other men who have sex with men (YGBMSM). ObjectiveWe describe the design and methods for a randomized controlled trial (RCT) to rigorously evaluate Outsmart HPV, a population-targeted, individually tailored, Web-based HPV vaccination intervention for YGBMSM. The RCT is designed to determine the efficacy of the intervention, the mechanism by which the intervention has an effect (ie, mediation), and whether efficacy varies by participant characteristics (ie, moderation). MethodsOutsmart HPV was previously developed and pilot-tested. This study is a 3-arm prospective RCT that will enroll a projected 1995 YGBMSM who are aged 18 to 25 years, live in the United States, and have not received any doses of the HPV vaccine. Participants will be recruited by means of paid advertisements on social media sites and randomized to receive (1) standard information on the Web about HPV vaccine (control group), (2) Outsmart HPV content on the Web with monthly unidirectional vaccination reminders sent via text messages, or (3) Outsmart HPV content on the Web with monthly interactive vaccination reminders sent via text messages. Participants will complete Web-based surveys at 4 time points during the study: baseline, immediately after engaging with Web-based content, 3 months after randomization, and 9 months after randomization. Primary outcomes will include both HPV vaccine initiation (ie, receipt of 1 or more doses of the HPV vaccine) and completion (receipt of all 3 doses recommended for this age range). We will examine constructs from the intervention’s theoretical framework as potential mediators and demographic and health-related characteristics as potential moderators of intervention effects. ResultsThe institutional review board at The Ohio State University has approved the study. Materials have been developed and finalized for all study groups. Recruitment for the RCT began in fall 2019. ConclusionsIf shown to be efficacious, Outsmart HPV has the potential to fill an important gap by promoting HPV vaccination among a population at increased risk of HPV infection and HPV-related disease. Trial RegistrationClinicalTrials.gov NCT04032106; http://clinicaltrials.gov/show/NCT04032106 International Registered Report Identifier (IRRID)PRR1-10.2196/16294

Go-along interviews, which are interviews conducted while being in and moving within participant selected spaces, were conducted with 66 lesbian, gay, bisexual, transgender, and queer adolescents (14-19 years old) in their self-identified communities to explore perceived community attributes, including safe spaces, resources, and supports; this article highlights methodological lessons learned. Successful recruitment in 2 countries and varied community settings required partnership with local lesbian, gay, bisexual, transgender, and queer supporting agencies, including school-based gay--straight alliances. Youth chose to walk, use public transportation, and drive to community locations, identifying numerous formal and informal resources in their communities. Participant reflections highlighted that go-along interviews can be conducted in safe ways that encourage lesbian, gay, bisexual, transgender, and queer youth to express themselves about communities in which they live, study, work, play, and relax.