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INTRODUCTION: Transgender and gender diverse (TGD) individuals, comprised of those whose gender identity does not correspond with the sex they were assigned at birth, represent approximately 1.4 million people in the U.S., with a higher prevalence among those 18-24 years old. TGD individuals experience high levels of intimate partner violence (IPV), which leads to disproportionately negative mental and physical health outcomes for this population. As a result, there is a resounding need to connect TGD populations to health-promoting services, supports and resources. Med-Peds and Family Medicine clinics may be particularly well-positioned to support these efforts due to physicians focus on transitional-aged youth and young adults under 30. METHODS: The current manuscript reports on processes and outcomes related to a quality improvement (QI) initiative that aimed to test the feasibility and acceptability of implementing IPV screening within both a Med-Peds and a Family Medicine specialty clinic serving TGD populations in Los Angeles, CA. This QI initiative included screeners that capture IPV in cisgender/non-TGD populations (Humiliation, Afraid, Rape, Kick [HARK]) as well as in TGD populations specifically (IPV-T). We utilized a mixed-methods approach to both quantify and qualify responses to existing IPV screening as well as informal feedback from clinic champions in each clinic. RESULTS: Quantitative and qualitative findings from this QI initiative, featuring both general and TGD-specific IPV screening measures with 140 TGD individuals, elucidated several important processes that can support effective IPV screening and referral to supports and services. These include the importance of interdisciplinary teams, the utility of an iterative approach to screener roll-out, and the essential role of solidifying a referral process in these efforts. This project additionally shed light on the potential utility and challenges of implementing both general and TGD-specific IPV screening measures. Our pilot test did not support the necessity of a TGD-specific IPV screener for identifying and responding to IPV in this population, yet additional data is critical to generate more conclusive recommendations. CONCLUSION: We recommend larger-scale data collection efforts to evaluate the utility of integrating general and TGD-specific screeners into clinic workflows to ensure optimal health promotion for the TGD population in Med-Peds and Family Medicine clinics.

The writing skills of autistic university students have received very little empirical attention. Previous research has suggested that autistic people may struggle with writing, in part, due to challenges with Theory of Mind. However, other research indicates that Theory of Mind difficulties are far from universal in autism, varying across developmental and social contexts. Through a participatory research approach, autistic university students contributed to the current study examining the writing strengths and challenges of autistic (n = 25) and nonautistic (n = 25) university students. Autistic participants demonstrated more advanced writing skills, more perfectionistic attitudes about writing, and heightened nonverbal intelligence relative to nonautistic students. Autistic students did not exhibit reduced Theory of Mind skills. Although heightened nonverbal intelligence and being autistic were both initially predictive of writing quality, autism was no longer associated with writing quality after accounting for nonverbal intelligence. Findings suggest that autistic university students may often have enhanced cognitive and writing skills but may face challenges overcoming perfectionism. This research highlights the value of participatory collaborations with autistic students for identifying strengths that can help autistic students succeed in college. [For the corresponding grantee submission, see ED607171.]

OBJECTIVES: To report on first steps toward building a Life Course Intervention Research Framework (LCIRF) to guide researchers studying interventions to improve lifelong health. METHODS: The Life Course Intervention Research Network, a collaborative national network of >75 researchers, service providers, community representatives and thought leaders, participated in an iterative review process. Building on the revised Medical Research Council Guidance for Developing and Evaluating Complex Interventions, they identified 12 additional key models with features for inclusion in the LCIRF, then incorporated the 12 characteristics identified by the Life Course Intervention Research Network as actionable features of Life Course Interventions to produce the new LCIRF. RESULTS: The LCIRF sets out a detailed step-wise approach to intervention development: (1) conceptualization and planning, (2) design, (3) implementation, (4) evaluation, and (5) spreading and scaling of interventions. Each step is infused with life course intervention characteristics including a focus on (1) collaborative codesign (2) health optimization, (3) supporting emerging health development capabilities (4) strategic timing, (5) multilevel approaches, and (6) health equity. Key features include a detailed transdisciplinary knowledge synthesis to inform intervention development; formation of strong partnerships with family, community, and youth representatives in intervention codesign; a means of testing the impact of each intervention on biobehavioral processes underlying emerging health trajectories; and close attention to intervention context. CONCLUSIONS: This first iteration of the LCIRF has been largely expert driven. Next steps will involve widespread partner engagement in framework refinement and further development. Implementation will require changes to the way intervention studies are organized and funded.

OBJECTIVES: To develop an initial list of characteristics of life course interventions to inform the emerging discipline of life course intervention research. METHODS: The Life Course Intervention Research Network, a collaborative national network of >75 researchers, service providers, community representatives, and thought leaders, considered the principles, characteristics, and utility of life course interventions. After an in-person launch meeting in 2019, the steering committee collaboratively and iteratively developed a list of life course intervention characteristics, incorporating a modified Delphi review process. RESULTS: The Life Course Intervention Research Network identified 12 characteristics of life course interventions. These interventions (1) are aimed at optimizing health trajectories; (2) are developmentally focused, (3) longitudinally focused, and (4) strategically timed; and are (5) designed to address multiple levels of the ecosystem where children are born, live, learn, and grow and (6) vertically, horizontally, and longitudinally integrated to produce a seamless, forward-leaning, health optimizing system. Interventions are designed to (7) support emerging health development capabilities; are (8) collaboratively codesigned by transdisciplinary research teams, including stakeholders; and incorporate (9) family-centered, (10) strengths-based, and (11) antiracist approaches with (12) a focus on health equity. CONCLUSIONS: The intention for this list of characteristics of life course interventions is to provide a starting point for wider discussion and to guide research development. Incorporation of these characteristics into intervention designs may improve emerging health trajectories and move critical developmental processes and pathways back on track, even optimizing them to prevent or reduce adverse outcomes.

In the United States, autistic individuals experience disproportionate physical and mental health challenges relative to non-autistic individuals, including higher rates of co-occurring and chronic conditions and lower physical, social, and psychological health-related quality of life. The Autism Intervention Research Network on Physical Health (AIR-P) is an interdisciplinary, multicenter research network for scientific collaboration and infrastructure that aims to increase the life expectancy and quality of life for autistic individuals, with a focus on underserved or vulnerable populations. The current paper describes the development of the AIR-P Research Agenda. Development of the research agenda involved an iterative and collaborative process between the AIR-P Advisory Board, Steering Committee, and Autistic Researcher Review Board. The methodology consisted of 3 phases: (1) ideation and design, (2) literature review and synthesis; and (3) network engagement. Six core research priorities related to the health of autistic individuals were identified: (1) primary care services and quality, (2) community-based lifestyle interventions, (3) health systems and services, (4) gender, sexuality, and reproductive health, (5) neurology, and (6) genetics. Specific topics within each of these priorities were identified. Four cross-cutting research priorities were also identified: (1) neurodiversity-oriented care, (2) facilitating developmental transitions, (3) methodologically rigorous intervention studies, and (4) addressing health disparities. The AIR-P Research Agenda represents an important step forward for enacting large-scale health-promotion efforts for autistic individuals across the lifespan. This agenda will catalyze autism research in historically underrepresented topic areas while adopting a neurodiversity-oriented approach to health-promotion.

Author(s): Emily Hotez [sup.1] , Shanice Hudson [sup.2] Author Affiliations: (1) grid.19006.3e, 0000 0000 9632 6718, Department of General Internal Medicine / Health Services Research, University of California, Los Angeles [...]

Emerging adulthood (ages of 18-30 years) is a critical developmental period characterized by mental health challenges, particularly for college students who experience distinct mental health issues. Mindfulness-based approaches have been associated with mental health benefits. This study aimed to assess the mental health and wellbeing of college students with qualitative data obtained via their participation in a mindfulness exercise. We analyzed the sentiments and concerns of college students nearly a year into the coronavirus disease 2019 (COVID-19) pandemic. The results led to the development of four major themes: a source code of the COVID-19 pandemic, assessments of mindfulness and wellbeing, emergent concerns, and coping strategies. The findings from this paper can inform combined internal medicine and pediatrics (Med-Peds) providers' efforts to improve the mental and physical health outcomes among emerging adults.

ObjectivesDiscrimination has been shown to have profound negative effects on mental and behavioral health and may influence these outcomes early in adulthood. We aimed to examine short-term, long-term, and cumulative associations between different types of interpersonal discrimination (eg, racism, sexism, ageism, and physical appearance discrimination) and mental health, substance use, and well-being for young adults in a longitudinal nationally representative US sample.MethodsWe used data from 6 waves of the Transition to Adulthood Supplement (2007-2017, 1834 participants) of the Panel Study of Income Dynamics. Outcome variables included self-reported health, drug use, binge drinking, mental illness diagnosis, Languishing and Flourishing score, and Kessler Psychological Distress Scale score. We used logistic regression with cluster-robust variance estimation to test cross-sectional and longitudinal associations between discrimination frequency (overall, cumulative, and by different reason) and outcomes, controlling for sociodemographics.ResultsIncreased discrimination frequency was associated with higher prevalence of languishing (relative risk [RR] 1.34 [95% CI 1.2-1.4]), psychological distress (RR 2.03 [95% CI 1.7-2.4]), mental illness diagnosis (RR 1.26 [95% CI 1.1-1.4]), drug use (RR 1.24 [95% CI 1.2-1.3]), and poor self-reported health (RR 1.26 [95% CI 1.1-1.4]) in the same wave. Associations persisted 2 to 6 years after exposure to discrimination. Similar associations were found with cumulative high-frequency discrimination and with each discrimination subcategory in cross-sectional and longitudinal analyses.ConclusionsIn this nationally representative longitudinal sample, current and past discrimination had pervasive adverse associations with mental health, substance use, and well-being in young adults.

Researchers collaborated with undergraduate minority students to quantitatively and qualitatively investigate college students' mental health during the first year of the COVID-19 pandemic. Participants were two convenience samples of diverse college students surveyed in June (n = 128; M age = 21.7, SD = 1.7) and December (n = 242; M age = 20.3, SD = 1.7) of 2020. This study administered items from the California Health Interview Survey and open-ended qualitative items via Qualtrics. Across both waves, students reported significant mental health challenges and psychological distress. Students surveyed in December were three to four times more likely to report depression and anxiety. Female and older students reported heightened odds of mental health challenges. Qualitative findings elaborated on contributing factors. During the pandemic, college students have experienced pronounced mental health challenges, potentially exacerbated by academic, professional, relational, and environmental stressors and uncertainty. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify child characteristics, family demographics, and parent cognitions that may affect access to early intervention, special education, and related services. The sample included 70 families of young children with autism spectrum disorders. All parents were enrolled in a short education program, providing them with basic information and resources on advocating for a young child with autism spectrum disorders (Parent Advocacy Coaching). Longitudinal change in children's intervention program in the community was evaluated over a period of about 27 months, starting 12 months prior to enrollment in Parent Advocacy Coaching. Results revealed large individual differences in the intensity of children's individual and school-based services. Despite this variability, only two child characteristics (age, gender) emerged as independent predictors. In contrast, the intensity of children's intervention programs was independently predicted by a broad range of demographic characteristics, including parental education, child ethnicity and race, and family composition. Finally, even after child characteristics and family demographics were statistically controlled, results revealed associations between specific parental cognitions (parenting efficacy, understanding of child development) and the subsequent rate of change in the intensity of children's intervention programs. Implications for improving educational programs that aim to enhance parent advocacy are discussed.

The editorial in "Frontiers in Education" discusses the challenges faced by neurodivergent individuals in health and education sectors, emphasizing the need for holistic support that aligns with the neurodiversity movement. The research topic presented focuses on innovative approaches to promoting the health, wellbeing, and thriving of neurodivergent individuals across the life course, highlighting the importance of collaboration, lived experience, and individualized supports. The articles in the research topic address various developmental stages, including childhood, adolescence, and emerging adulthood, with a particular focus on the intersection of health and education needs for autistic college students and youth. Cultural relevance and community engagement are emphasized as critical components in developing effective programs for neurodivergent individuals and their families. [Extracted from the article]