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Suicide is the fourth leading cause of death among adolescents, globally. Though post-primary, school-based suicide prevention (PSSP) has the potential to be a key strategy for preventing adolescent suicidal thoughts and behaviours (STBs), there are persisting challenges to translating PSSP research to practice. Intervention and contextual factors relevant to PSSP are likely key to both PSSP effectiveness and implementation. As such, this systematic review aimed to summarise the effectiveness of PSSP for adolescent STBs and highlight important intervention and contextual factors with respect to PSSP. PsycINFO, Medline, Education Source, ERIC, Web of Science, and the Cochrane Central Register of Controlled Trials were searched to identify randomised and non-randomised studies evaluating the effectiveness of interventions located in post-primary, school-based settings targeting adolescent STBs. PSSP effectiveness and intervention and contextual factors were synthesised narratively. Twenty-eight studies were retained, containing nearly 47,000 participants. Twelve out of twenty-nine trials comparing intervention and independent control comparators reported statistically significant reductions in STBs postintervention, and 5/7 trials comparing preintervention and postintervention scores demonstrated significant reductions in STBs over time. Reporting and analysis of intervention and contextual factors were lacking across studies, but PSSP effectiveness and intervention acceptability varied across type of school. Although school personnel commonly delivered PSSP interventions, their input and perspectives on PSSP interventions were lacking. Notably, adolescents had little involvement in designing, inputting on, delivering and sharing their perspectives on PSSP interventions. Twenty out of twenty-eight studies were rated as moderate/high risk of bias, with non-randomised trials demonstrating greater risks of bias and trial effectiveness, in comparison to cluster randomised trials. Future research should prioritise complete reporting and analysis of intervention and contextual factors with respect to PSSP, involving key stakeholders (including adolescents and school personnel) in PSSP, and investigating key stakeholders' perspectives on PSSP. Given the inverse associations between both study quality and study design with PSSP effectiveness, particular consideration to study quality and design in PSSP research is needed. Future practice should consider PSSP interventions with universal components and PSSP which supports and involves key stakeholders in engaging with PSSP.

There has been a growing commitment to the inclusion of students with Intellectual Disability (ID) on college campuses which has resulted in approximately 271 college programs in the United States. Although there is great variability on program structure and supports of these programs, their overall purpose is to assist students to prepare for productive and satisfying adult lives. The purpose of this study was to examine the inclusion of fitness and exercise components in the context of inclusive postsecondary education (IPSE) programs within the United States. Obesity is a major health concern, and people with ID are more than twice as likely to be obese than people without. Non-random purposeful sampling was used to interview nine staff members from different IPSE programs. Data indicated that both IPSE program factors and individual student characteristics may impact the role of exercise and fitness in IPSE. These findings can help guide the development of effective exercise and fitness programs for young adults with ID within the context of postsecondary education.

Objective: Exercise is increasingly used as adjunct treatment for alcohol use disorder (AUD). Evidence suggests that moderate-to-high-intensity exercise can ameliorate cravings. We explored the potential mediating effects of changes in mood states in the relationship between exercise intensity and alcohol cravings. Method: Secondary analyses of a nested single-arm trial within a randomized controlled trial (FitForChange). In total, 117 sedentary adults (68.4% female, M = 52 ± 12 years) with clinician diagnosed (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) AUD and indications of craving (Desire for Alcohol Questionnaire) completed a 12-min submaximal cardiorespiratory fitness test on a cycle ergometer. Assessments of craving, mood states (POMS), and state anxiety (STAI-Y1) were taken immediately before, after, and 30 min after exercise. Ratings of perceived exertion (RPE) were included as indirect measures of exercise intensity. The med4way command in Stata was used to explore mediating and interaction effects of improvements in total mood disturbance (TMD) and state anxiety. Results: Improvements in mood and anxiety did not mediate the effect of higher exercise intensity on reductions in alcohol craving. A significant reference interaction was found between "hard" (or greater) exertion and anxiety improvements (β = −1.06, 95% CI [−1.50, −0.61]). Participants whose anxiety reduced during exercise had two times higher odds of reduced cravings when exercising at a higher intensity than participants whose anxiety worsened (OR = 2.04, 95% CI [1.12, 3.72]). Conclusions: Reductions in anxiety may partly explain the positive effect of higher exercise intensity on alcohol cravings. The findings are preliminary and require replication in future studies. Public Health Significance Statement: Alcohol use disorder (AUD) is prevalent and associated with poor somatic and psychiatric health. Exercise interventions are shown to reduce cravings for alcohol in those with AUD, but the underlying mechanisms are unclear. This study found that decreases in state anxiety in those reporting higher exercise intensity were associated with reductions in postexercise alcohol cravings. Findings can inform future exercise-based interventions for AUD. [ABSTRACT FROM AUTHOR]

The Mental Health of Youth Story (MYSTORY) study is a community-university partnership study which involved photovoice and consultation with young people. The MYSTORY study aimed to: (1) better understand adolescents’ perspectives on youth and school mental health and suicide prevention, and (2) communicate insights to schools and the wider community. In this article, we explored adolescents’ experiences of engaging with the MYSTORY study. Reflexive thematic analysis supports the MYSTORY study as a youth-centered study, which involved reflection, discussion and sharing of mental health perspectives and experiences within the study and community contexts. Study engagement was associated with feelings of pride, accomplishment, and connection. This study makes a novel contribution to understanding adolescents’ engagement in photovoice research exploring youth and school mental health, from the perspective of adolescents. Findings are relevant to researchers in wider mental health fields and practitioners interested in mental health promotion and suicide prevention in applied settings. [ABSTRACT FROM AUTHOR]