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McNamara M, Barondeau J, Brown J. Mental Health, Climate Change, and Bodily Autonomy: An Analysis of Adolescent Health Policy in the Post-Pandemic Climate. Pediatr Clin North Am 2024; 71:729-744. [PMID: 39003013 DOI: 10.1016/j.pcl.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
The COVID-19 pandemic exacerbated the vulnerability of adolescents and young adults (AYAs) who face economic disadvantage, depend on social safety net resources, have politically targeted identities, are geopolitically displaced, and/or are racially or ethnically marginalized. A rapid change in social safety net policies has impacts that reverberate throughout interrelated domains of AYA health, especially for vulnerable AYAs. The authors analyze policy-related changes in mental health, climate change, and bodily autonomy to offer a paradigm for an equitable path forward.
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Affiliation(s)
| | - Jesse Barondeau
- University of Nebraska Medical Center, Children's Nebraska, 8200 Dodge Street, Omaha, NE 68114, USA
| | - Joanna Brown
- Boston Children's Hospital, 333 Longwood Avenue, Boston, MA 02115, USA
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2
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Hoover SA. Investing in School Mental Health: Strategies to Wisely Spend Federal and State Funding. Psychiatr Serv 2024; 75:801-806. [PMID: 38566559 DOI: 10.1176/appi.ps.20230553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
In the context of the current youth mental health crisis, it is prudent to reconsider how resources are allocated to facilitate the delivery of effective and comprehensive supports and services to children and adolescents. Schools are the main delivery sites for youth mental health services. Many districts have adopted comprehensive school mental health systems (CSMHS) to provide a multitiered approach comprising mental health promotion, prevention, and intervention to students via partnerships between school and community health and behavioral health providers. COVID-19 relief funding and other new federal and state investments in school mental health have led to expansions of school mental health programming in most states. An impending federal funding cliff necessitates an examination of how to wisely invest now to achieve the greatest positive future impact on youth mental health. To capitalize on opportunities to sustain effective school mental health and maximize return on investment, states may consider four strategies: leverage cross-sector partnerships to advance school mental health policies and funding, strengthen and expand Medicaid coverage of CSMHS, establish and enhance data systems, and create state technical assistance and professional development support for CSMHS implementation through local education agencies.
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Affiliation(s)
- Sharon A Hoover
- Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, Baltimore
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3
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Close J, Arshad SH, Soffer SL, Lewis J, Benton TD. Adolescent Health in the Post-Pandemic Era: Evolving Stressors, Interventions, and Prevention Strategies amid Rising Depression and Suicidality. Pediatr Clin North Am 2024; 71:583-600. [PMID: 39003003 DOI: 10.1016/j.pcl.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
Prior to COVID-19, there were already increasing rates of youth with mental health concerns, including an increase in youth presenting to medical emergency departments (EDs) with mental health chief complaints and limited access to treatment. This trend worsened during the pandemic, and rates of youth presenting to medical EDs with suicidal ideation and self-harm increased 50% from 2019 to 2022. This resulted in a "boarding" crisis, in part, due to a lack of inpatient psychiatric hospitalization beds, and many youth were left without access to adequate treatment. Additional study of innovations in health care delivery will be paramount in meeting this need.
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Affiliation(s)
- Jeylan Close
- National Clinician Scholars Program, Department of Psychiatry and Behavioral Sciences, Child & Family Mental Health & Community Psychiatry Division, Duke University School of Medicine, 710 West Main Street, Durham, NC 27701, USA; Duke Margolis Center for Health Policy, Duke University, 710 West Main Street, Durham, NC 27701, USA.
| | - Sarah H Arshad
- Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine and UC Irvine School of Medicine, The Hub for Clinical Collaboration, DCAPBS, Floor 12, 3500 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Stephen L Soffer
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 4601 Market Street, 3rd Floor, Philadelphia, PA 19139, USA
| | - Jason Lewis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 4601 Market Street, 3rd Floor, Philadelphia, PA 19139, USA
| | - Tami D Benton
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 4601 Market Street, 3rd Floor, Philadelphia, PA 19139, USA
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4
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Khazanchi R, Rader B, Cantor J, McManus KA, Bravata DM, Weintraub R, Whaley C, Brownstein JS. Spatial Accessibility and Uptake of Pediatric COVID-19 Vaccinations by Social Vulnerability. Pediatrics 2024; 154:e2024065938. [PMID: 39028301 DOI: 10.1542/peds.2024-065938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Geographic accessibility predicts pediatric preventive care utilization, including vaccine uptake. However, spatial inequities in the pediatric coronavirus disease 2019 (COVID-19) vaccination rollout remain underexplored. We assessed the spatial accessibility of vaccination sites and analyzed predictors of vaccine uptake. METHODS In this cross-sectional study of pediatric COVID-19 vaccinations from the US Vaccine Tracking System as of July 29, 2022, we described spatial accessibility by geocoding vaccination sites, measuring travel times from each Census tract population center to the nearest site, and weighting tracts by their population demographics to obtain nationally representative estimates. We used quasi-Poisson regressions to calculate incidence rate ratios, comparing vaccine uptake between counties with highest and lowest quartile Social Vulnerability Index scores: socioeconomic status (SES), household composition and disability (HCD), minority status and language (MSL), and housing type and transportation. RESULTS We analyzed 15 233 956 doses administered across 27 526 sites. Rural, uninsured, white, and Native American populations experienced longer travel times to the nearest site than urban, insured, Hispanic, Black, and Asian American populations. Overall Social Vulnerability Index, SES, and HCD were associated with decreased vaccine uptake among children aged 6 months to 4 years (overall: incidence rate ratio 0.70 [95% confidence interval 0.60-0.81]; SES: 0.66 [0.58-0.75]; HCD: 0.38 [0.33-0.44]) and 5 years to 11 years (overall: 0.85 [0.77-0.95]; SES: 0.71 [0.65-0.78]; HCD: 0.67 [0.61-0.74]), whereas social vulnerability by MSL was associated with increased uptake (6 months-4 years: 5.16 [3.59-7.42]; 5 years-11 years: 1.73 [1.44-2.08]). CONCLUSIONS Pediatric COVID-19 vaccine uptake and accessibility differed by race, rurality, and social vulnerability. National supply data, spatial accessibility measurement, and place-based vulnerability indices can be applied throughout public health resource allocation, surveillance, and research.
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Affiliation(s)
- Rohan Khazanchi
- Harvard Internal Medicine-Pediatrics Residency Program at Brigham and Women's Hospital, Boston Children's Hospital, and Boston Medical Center, Boston, Massachusetts
- Departments of Internal Medicine
- Pediatrics
- FXB Center for Health and Human Rights, Harvard University, Boston, Massachusetts
| | - Benjamin Rader
- Computational Epidemiology Laboratory, Boston Children's Hospital, Boston, Massachusetts
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | | | - Kathleen A McManus
- Division of Infectious Diseases and International Health, Department of Internal Medicine, University of Virginia, Charlottesville, Virginia
| | - Dena M Bravata
- Castlight Health, San Francisco, California
- Center for Primary Care & Outcomes Research, and Stanford University, Palo Alto, California
| | - Rebecca Weintraub
- Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
- Ariadne Laboratories, Boston, Massachusetts
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, Massachusetts
| | - Christopher Whaley
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
- Brown University, Providence, Rhode Island
| | - John S Brownstein
- Pediatrics
- Computational Epidemiology Laboratory, Boston Children's Hospital, Boston, Massachusetts
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Benton TD, Beers L, Carlson G, Kee Ng WY. The Declaration of the National Emergency in Child and Adolescent Mental Health: It Takes a Village. Child Adolesc Psychiatr Clin N Am 2024; 33:277-291. [PMID: 38823803 DOI: 10.1016/j.chc.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Abstract
Recognition of the high prevalence of children's mental health conditions and challenges to accessing needed care faced by children and their families have been long-standing concerns, emerging well before the onset of the COVID-19 pandemic. Global data examining the prevalence of at least one mental health and/or substance-use disorder for 2516 million people aged 5 to 24 years in 2019 found that at least 293 million people were affected by at least one mental health disorder and 31 million affected by a substance-use disorder.
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Affiliation(s)
- Tami D Benton
- The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, The Hub for Clinical collaboration, 12th floor, Philadelphia, PA 19104, USA.
| | - Lee Beers
- The Child Health Advocacy Institute, Childrens National Hospital, Washington, DC 20010, USA; Children's National Medical Center Child Health Advocacy Institute, 111 Michigan Avenue, NW, Washington, DC 20010, USA
| | - Gaye Carlson
- Professor of Psychiatry and Pediatrics, Renaissance School of Medicine at Stony Brook, Stony Brook, NY 11794-8790, USA
| | - Warren Yiu Kee Ng
- Outpatient Behavioral Health, Psychiatry, CUMC/New York-Presbyterian, Morgan Stanley Childrens Hospital, 3959 Broadway, New York, NY 10032, USA
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Delaney KR, Gomes M, Browne NT, Jordan D, Snethen J, Lewis-O'Connor A, Horowitz JA, Cogan R, Duderstadt KG. The mental and behavioral health crisis in youth: Strategic solutions post COVID-19 pandemic: An American Academy of Nuring consensus paper. Nurs Outlook 2024; 72:102177. [PMID: 38901064 DOI: 10.1016/j.outlook.2024.102177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/15/2024] [Accepted: 04/20/2024] [Indexed: 06/22/2024]
Abstract
The COVID-19 pandemic wrought significant negative impacts on youth well-being, particularly among Black, Hispanic, American Indian, Alaska Native, and LGBTQ+ (Lesbian, gay, bisexual, transgender, queer or questioning) youth. The pandemic disrupted connections to family, school, and community, which are essential supports for youth mental health. Lessons learned from the pandemic suggest the role of stress and windows of opportunity to build resiliency. Drawing from a policy dialog on the youth mental health crisis conducted by 4 American Academy of Nursing Expert Panels, we present approaches to the current increase in youth mental health problems. Included is emerging literature on building youth resilience, particularly via re-establishing school and community connections. The role of families, schools, and community support is emphasized, particularly by creating a healing school environment and the pivotal role of school nurses. Recommendations include increased support for families, engaging the school nurse role, and developing school-based innovative programs to build connections and youth wellness.
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Affiliation(s)
| | - Melissa Gomes
- Psychiatric, Mental Health, and Substance Use Expert Panel; Health Equity Expert Panel
| | | | - Dorothy Jordan
- Psychiatric, Mental Health, and Substance Use Expert Panel
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7
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Del Monte M, Edwards AR, Waldron DB, Aird LD, Airhart CK, Robinson LB, Bright D, Calabrese TM, Diederich S, Fitzpatrick H, Frantz J, Haro TM, Hegland A, Ingstrup K, Jenco M, Kim S, Martin SS, Mazziotti D, Phillips M, Poslosky J, Salmon J, Walsh MC, White ML. Successes and Lessons Learned in Responding to the Needs of Pediatricians, Children, and Families During the COVID-19 Pandemic. Pediatrics 2024; 153:e2024066634. [PMID: 38485704 DOI: 10.1542/peds.2024-066634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 06/02/2024] Open
Abstract
The coronavirus disease 2019 pandemic has presented tremendous challenges to the United States health care system, as well as to individual physicians, communities, and families. Throughout the pandemic, the American Academy of Pediatrics (AAP) has striven to elevate the needs of infants, children, and adolescents, as well as the pediatricians who care for this population. Historically, these communities have often been overlooked and deprioritized in health care systems, and these deficits persisted into the pandemic. To fill this gap, the AAP took on an essential role in leading the national response for pediatrics. This article details the AAP pandemic response and includes the perspectives of multiple AAP leaders involved in the response and details on Academy advocacy with high-level staff and officials at federal agencies and the executive branch. The AAP provided initial guidance to pediatricians that predated the World Health Organization's declaration of a public health emergency. The Academy then developed entirely new approaches to meet the unprecedented needs of its practicing members and families by providing timely, rigorous information endorsed by pediatric experts. When coronavirus disease 2019 vaccines were developed, the AAP strongly advised the inclusion of those younger than 18 years in vaccine trials and advocated for equitable distribution plans. The AAP provided its members with strategies for combating misinformation. The Academy was at the forefront of advocating for the safe return to in-person schooling, recognizing that social isolation was contributing to the growing mental health crisis among youth. In 2021, the AAP, the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association declared a national emergency in child and adolescent mental health. In addition, the AAP implemented educational and training opportunities for clinicians and developed resources for youth and their families. After the end of the public health emergency, AAP members continue to use innovations and efficiencies developed as part of their pandemic response. The successes of the AAP pandemic response, alongside lessons learned, help define an important model for responding to future pandemics and public health emergencies in ways that support children, families, and the pediatric workforce.
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Suleman S, Chamberlain LJ. Impact of COVID-19 on the Health of Migrant Children in the United States: From Policy to Practice. Pediatr Clin North Am 2024; 71:551-565. [PMID: 38754941 DOI: 10.1016/j.pcl.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
In this article, the authors provide an overview how the COVID-19 pandemic impacted the health and wellbeing of migrant children in conflict zones, in transit and post-settlement in the United States. In particular, the authors explore how policies implemented during the pandemic directly and indirectly affected migrant children and led to widening disparities in the aftermath of the pandemic. Given these circumstances, the authors provide recommendations for child health care providers caring for migrant children to mitigate and bolster resilience and health.
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Affiliation(s)
- Shazeen Suleman
- Department of Pediatrics, Stanford University School of Medicine, Center for Academic Medicine, 453 Quarry Road, MC 5459, Palo Alto, CA 94304-1419, USA.
| | - Lisa J Chamberlain
- Department of Pediatrics, Stanford University School of Medicine, Center for Academic Medicine, 453 Quarry Road, MC 5459, Palo Alto, CA 94304-1419, USA
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9
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Adams DR, Pérez-Flores NJ, Mabrouk F, Minor C. Assessing Access to Trauma-Informed Outpatient Mental Health Services for Adolescents: A Mystery Shopper Study. Psychiatr Serv 2024; 75:402-409. [PMID: 38018150 PMCID: PMC11062805 DOI: 10.1176/appi.ps.20230198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVE The authors aimed to examine how access to trauma-informed mental health services in safety-net health centers varies by insurance type and race-ethnicity of the care seeker. METHODS In this mystery shopper study, three women (White, Latina, and Black voice actresses) called community mental health centers (CMHCs) and federally qualified health centers (FQHCs) (N=229) in Cook County, Illinois, posing as mothers requesting a mental health appointment for their traumatized adolescent child. Each health center was called twice-once in the spring and once in the summer of 2021-with alternating insurance types reported (Medicaid or private insurance). Ability to schedule an appointment, barriers to access, wait times, and availability of trauma-specific treatment were assessed. RESULTS Callers could schedule an appointment in only 17% (N=78 of 451) of contacts. Reasons for appointment denial varied by organization type: the primary reasons for denial were capacity constraints (67%) at CMHCs and administrative requirements to switch to in-network primary care providers (62%) at FQHCs. Insurance and organization type did not predict successful appointment scheduling. Non-White callers were significantly less likely (incidence rate ratio=1.18) to be offered an appointment than the White caller (p=0.019). The average wait time was 12 days; CMHCs had significantly shorter wait times than FQHCs (p=0.019). Only 38% of schedulers reported that their health center offered trauma-informed therapy. CONCLUSIONS Fewer than one in five contacts resulted in a mental health appointment, and an apparent bias against non-White callers raises concern that racial discrimination may occur during scheduling. For equitable access to care, antidiscrimination policies should be implemented.
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Affiliation(s)
- Danielle R Adams
- Center for Mental Health Services Research, Brown School of Social Work, Washington University in St. Louis, St. Louis (Adams, Pérez-Flores); Silver School of Social Work, New York University, New York City (Mabrouk); American Blues Theater, Chicago (Minor)
| | - Nancy Jacquelyn Pérez-Flores
- Center for Mental Health Services Research, Brown School of Social Work, Washington University in St. Louis, St. Louis (Adams, Pérez-Flores); Silver School of Social Work, New York University, New York City (Mabrouk); American Blues Theater, Chicago (Minor)
| | - Fatima Mabrouk
- Center for Mental Health Services Research, Brown School of Social Work, Washington University in St. Louis, St. Louis (Adams, Pérez-Flores); Silver School of Social Work, New York University, New York City (Mabrouk); American Blues Theater, Chicago (Minor)
| | - Carolyn Minor
- Center for Mental Health Services Research, Brown School of Social Work, Washington University in St. Louis, St. Louis (Adams, Pérez-Flores); Silver School of Social Work, New York University, New York City (Mabrouk); American Blues Theater, Chicago (Minor)
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10
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Hoppe R, Winter MA, Williams CD, Sandler I. When a parent dies: A scoping review of protective and risk processes for childhood bereavement. DEATH STUDIES 2024:1-11. [PMID: 38619445 DOI: 10.1080/07481187.2024.2340729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
The death of a parent can have profound effects on child development. Yet, little is known about the individual and environmental processes that contribute to heterogeneity in child bereavement outcomes. A scoping review was conducted in samples of parentally bereaved children to identify key processes, synthesize results, and determine research gaps. This scoping review identified 23 studies (mainly from the United States), published between 1990 and 2023, that reported child (ages 3-22 years) individual and/or environmental protective and/or risk processes that contributed to bereavement outcomes. Individual processes (i.e., how children manage stressors and think about themselves/their environment) included child coping and perception of themselves and/or their environment. Environmental processes (i.e., contextual resources) included family, mentorship, and stress exposure. Findings can be used to apprise clinicians, families, and policymakers of the unique nature of childhood bereavement and to identify malleable processes to target in interventions designed to prevent problematic outcomes in bereaved children.
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Affiliation(s)
- Rebecca Hoppe
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Marcia A Winter
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Chelsea D Williams
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Irwin Sandler
- Department of Psychology, Arizona State University, Arizona, Phoenix, USA
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11
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Hinojosa MS, Hinojosa R. Positive and adverse childhood experiences and mental health outcomes of children. CHILD ABUSE & NEGLECT 2024; 149:106603. [PMID: 38141478 DOI: 10.1016/j.chiabu.2023.106603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 11/07/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVE Researchers and policymakers have identified adverse childhood experiences (ACEs) like abuse, neglect, and household dysfunction as a contributing factor to poor mental health outcomes for children. Positive childhood experiences (PCEs) like open family communication styles, having the ability to live and play in a safe, stable, and protective environment, having constructive opportunities for social engagement, and receiving mentorship from adults have been found to improve the mental health of children. PURPOSE This paper explores the role of ACEs and PCEs on the mental health outcomes of children. METHOD A sample of 22,628 children ages 6-17 from the National Survey of Children's Health (2017-2020) was used to explore the relationship between PCEs and ACEs and the mental health of children. Logistic regression analysis is used to model the effect of PCEs and ACEs on the odds of child mental health diagnoses. RESULTS Findings indicate that with each additional ACE, there was a significant increase in the odds of reporting a MH condition (OR = 1.25, 95 % CI 1.09-1.43). Conversely, with each additional PCE, there is a significant decrease in the odds or reporting a MH condition (OR = 0.76, 95 % CI 0.68-0.84). There was also evidence that PCEs moderate the relationship between ACEs and reports of mental health conditions. When counts of ACEs are low, PCEs provide a protective effect on reports of mental health. But when the count of ACEs are high, children with higher numbers of PCEs have similar reports of mental health conditions. SUMMARY This study provides information about the moderating effect of PCEs on the relationship between ACEs and child mental health diagnosis with the goal of informing policies and interventions focused on ameliorating the growing crisis of children's negative mental health and well-being. WHAT IS KNOWN?: Adverse childhood events (ACEs) like abuse, neglect and household dysfunction are known to negatively impact the mental health and well-being of children. Positive childhood experiences (PCEs), on the other hand, can positively influence the mental health and well-being of children. WHAT DOES THIS ARTICLE ADD?: This study examines the association between adverse and positive childhood experiences to understand how they impact the mental health outcomes of children ages 6-17. Findings indicate that when ACEs are lower, the impact of PCEs are positive, but when ACEs are higher, PCEs do not make much difference in reports of mental health problems.
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Affiliation(s)
- Melanie Sberna Hinojosa
- University of Central Florida, College of Sciences, Department of Sociology, 4297 Andromeda Loop N., Orlando, FL 32816, United States of America.
| | - Ramon Hinojosa
- University of Central Florida, College of Sciences, Department of Sociology, 4297 Andromeda Loop N., Orlando, FL 32816, United States of America.
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12
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Richards MC, Benson NM, Kozloff N, Franklin MS. Remodeling Broken Systems: Addressing the National Emergency in Child and Adolescent Mental Health. Psychiatr Serv 2024; 75:291-293. [PMID: 37711021 DOI: 10.1176/appi.ps.20220283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
A national emergency in child and adolescent mental health was declared in the United States in 2021 in the wake of the COVID-19 pandemic. This Open Forum discusses potential solutions to better support child and adolescent mental health by improving or expanding school-based mental health services, child psychiatry access programs, virtual mental health services, and new models of care (e.g., integrated youth services hubs and crisis stabilization units). The success of such programs is dependent on stable funding, strong leadership and accountability, robust and well-trained workforces, systems integration, and attention to health equity.
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Affiliation(s)
- Misty C Richards
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Richards); McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Benson); Department of Psychiatry, Faculty of Medicine, University of Toronto, and Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto (Kozloff); Department of Psychiatry and Behavioral Sciences and Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina (Franklin)
| | - Nicole M Benson
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Richards); McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Benson); Department of Psychiatry, Faculty of Medicine, University of Toronto, and Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto (Kozloff); Department of Psychiatry and Behavioral Sciences and Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina (Franklin)
| | - Nicole Kozloff
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Richards); McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Benson); Department of Psychiatry, Faculty of Medicine, University of Toronto, and Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto (Kozloff); Department of Psychiatry and Behavioral Sciences and Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina (Franklin)
| | - Michelle S Franklin
- Department of Psychiatry, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Richards); McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Benson); Department of Psychiatry, Faculty of Medicine, University of Toronto, and Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto (Kozloff); Department of Psychiatry and Behavioral Sciences and Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina (Franklin)
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Song M, Bessette HC, Musil CM, Lyons KS, Winters-Stone KM, Hayman LL. Assessing Life's Essential 8 and Adverse Childhood Experiences in Grandparent-Grandchild Co-residing Dyads. J Cardiovasc Nurs 2024; 39:E44-E50. [PMID: 37278650 DOI: 10.1097/jcn.0000000000001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We assessed a subset of behavioral indicators from the American Heart Association Life's Essential 8 cardiovascular health (CVH) construct-diet, physical activity, sleep, and nicotine exposure-and quantified associations in scores between members of 12 grandparent-grandchild dyads (grandparents, 52-70 years old; children, 7-12 years old). We also assessed the number of adverse childhood experiences from the dyads. Using the Life's Essential 8 scoring algorithm (0-100, with 100 as optimal), we calculated averages and used Spearman's ρ correlation to quantify associations. Mean score was 67.5 (±12.4) for grandparents and 63.0 (±11.2) for grandchildren. Mean scores for the dyad members were significantly correlated ( r = 0.66, P < .05). The mean numbers of adverse childhood experiences were 7.0 and 5.8 for the grandparents and grandchildren, respectively. The results indicate that CVH in these dyads was suboptimal and interrelated. Adverse childhood experiences in this analysis surpass levels reported as high risk for poor CVH. Our findings suggest that dyadic-based interventions to improve CVH are warranted.
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Baker NS, VanHook C, Ziminski D, Semenza D, Lassiter T, Garmon J, Bonne S. What's missing? Violently injured Black men's narratives around Adverse Childhood Experiences (ACEs). CHILD ABUSE & NEGLECT 2024; 149:106644. [PMID: 38237241 DOI: 10.1016/j.chiabu.2024.106644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/14/2023] [Accepted: 01/09/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Adverse childhood experiences have been associated with future outcomes; however, Felitti's 1998 ACEs questionnaire fails to capture the experiences of Black populations living in disinvested neighborhoods making it necessary to expand the ACEs questionnaire to examine the life experiences of violently injured Black men. OBJECTIVE The aim of the study was to advance the understanding of ACEs among Black male firearm violence survivors using the ACEs questionnaire and semi-structured interviews. PARTICIPANTS AND SETTING Ten Black male firearm violence survivors were recruited from an urban HVIP. Case managers conducted recruitment using the HVIP's REDcap database; active and previous HVIP participants were eligible for the study. METHODS A qualitative study design was used to understand the childhood experiences of Black male firearm violence survivors using Felitti's ACEs questionnaire and a semi-structured interview examining perceptions of their childhood experiences. Due to the COVID-19 pandemic, recruitment and interviews were conducted over the phone. RESULTS All participants experienced at least one ACE. Three themes arose from the interviews: youth incarceration, family separation and loss, and housing transition. Men at risk for violent injury experience ACEs beyond those measured in the current instrument.
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Affiliation(s)
- Nazsa S Baker
- New Jersey Gun Violence Research Center, 683 Hoes Ln W, Piscataway, NJ 08854, United States.
| | - Cortney VanHook
- University of Illinois- Urbana-Champaign, School of Social Work, 1010 W Nevada St, Urbana, IL 61801, United States
| | - Devon Ziminski
- Rutgers University-New Brunswick, School of Social Work, 120 Albany St, New Brunswick, NJ 08901, United States
| | - Daniel Semenza
- New Jersey Gun Violence Research Center, 683 Hoes Ln W, Piscataway, NJ 08854, United States; Rutgers University-Camden, Department of Sociology, Anthropology, and Criminal Justice, 405-7 Cooper Street, Camden, NJ 08102, United States
| | - Teri Lassiter
- Rutgers University-Newark, School of Public Health, 1 Riverfront Plaza, Newark, NJ 07102, United States
| | - Jeannie Garmon
- Rutgers University-Camden, 303 Cooper St, Camden, NJ 08102, United States
| | - Stephanie Bonne
- Hackensack University Medical Center, Department of Surgery, 30 Prospect Ave, Hackensack, NJ 07601, United States
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15
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Perry IA. Assessment, Policy Development, and Assurance: Evolving the Core Functions of Public Health to Address Health Threats. AJPM FOCUS 2024; 3:100172. [PMID: 38249788 PMCID: PMC10797537 DOI: 10.1016/j.focus.2023.100172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Ijeoma A. Perry
- Administration for Strategic Preparedness and Response, HHS, Washington, District of Columbia
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16
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Haller SP, Archer C, Jeong A, Jaffe A, Jones EL, Harrewijn A, Naim R, Linke JO, Stoddard J, Brotman MA. Changes in Internalizing Symptoms During the COVID-19 Pandemic in a Transdiagnostic Sample of Youth: Exploring Mediators and Predictors. Child Psychiatry Hum Dev 2024; 55:206-218. [PMID: 35794298 PMCID: PMC9816351 DOI: 10.1007/s10578-022-01382-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2022] [Indexed: 01/11/2023]
Abstract
The COVID-19 pandemic is a chronically stressful event, particularly for youth. Here, we examine (i) changes in mood and anxiety symtpoms, (ii) pandemic-related stress as a mediator of change in symptoms, and (ii) threat processing biases as a predictor of increased anxiety during the pandemic. A clinically well-characterized sample of 81 youth ages 8-18 years (M = 13.8 years, SD = 2.65; 40.7% female) including youth with affective and/or behavioral psychiatric diagnoses and youth without psychopathology completed pre- and during pandemic assessments of anxiety and depression and COVID-related stress. Forty-six youth also completed a threat processing fMRI task pre-pandemic. Anxiety and depression significantly increased during the pandemic (all ps < 0.05). Significant symptom change was partially mediated by pandemic stress and worries. Increased prefrontal activity in response to neutral faces pre-pandemic was associated with more intense parent-reported anxiety during the pandemic (all Fs(1.95,81.86) > 14.44, ps < 0.001). The present work extends existing knowledge on the mediating role of psychological stress on symptoms of anxiety and depression in youth.
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Affiliation(s)
- Simone P Haller
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA.
| | - Camille Archer
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Annie Jeong
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Allison Jaffe
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Emily L Jones
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Anita Harrewijn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Reut Naim
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Julia O Linke
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
| | - Joel Stoddard
- Department of Psychiatry & Neuroscience Program, Children's Hospital Colorado, Pediatric Mental Health Institute, University of Colorado, Anschutz Medical Campus, 13123 East 16th Avenue, Aurora, CO, 80045, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institutes of Mental Health, 9000 Rockville Pike, Bldg. 15K, Bethesda, MD, 20892-2670, USA
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17
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Leite RO, Brodar KE, Saab PG, Marchetti D, Jaramillo M, Sanchez J, Davis E, Delamater AM, La Greca AM. Diabetes Care and Mental Health During the COVID-19 Pandemic: Perspectives of Adolescents with Diabetes, Parents, and Providers. J Clin Psychol Med Settings 2024:10.1007/s10880-023-09995-9. [PMID: 38281304 DOI: 10.1007/s10880-023-09995-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/30/2024]
Abstract
This study explored ways in which the COVID-19 pandemic impacted adolescents' diabetes management and psychosocial functioning, and how adolescents, parents, and providers viewed telemedicine. We present data from three studies: (1) a comparison of psychosocial functioning and glycemic levels before and after pandemic onset (n = 120 adolescents; 89% with type 1 diabetes), (2) an online survey of parents about pandemic-related stressors (n = 141), and (3) qualitative interviews with adolescents, parents, and medical providers about the pandemic's impacts on adolescents' diabetes care and mental health (n = 13 parent-adolescent dyads; 7 medical providers). Results suggested some adverse effects, including disrupting routines related to health behaviors and psychosocial functioning and impairing adolescents' quality of life. Despite these challenges, most participants did not endorse significant impacts. Some even noted benefits, such as increased parental supervision of diabetes management that can be leveraged beyond the pandemic. Furthermore, telemedicine offers benefits to continuity of diabetes care but presents challenges to care quality. These findings underscore the varied and unique impacts of the COVID-19 pandemic on adolescents with diabetes.
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Affiliation(s)
- Rafael O Leite
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA.
| | | | - Patrice G Saab
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
| | - Daniella Marchetti
- Psychology Service, Bruce W. Carter Medical Center, Miami VA Healthcare System, Miami, FL, USA
| | - Manuela Jaramillo
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
| | - Janine Sanchez
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eileen Davis
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Annette M La Greca
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Flipse Building 420, Coral Gables, FL, 33136, USA
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18
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Jones M, Jetelina KK. More to Offer Than Direct Clinical Benefit: FDA's Vaccine Licensure Process Ignores Population Health and Social Determinants of Disease. Am J Epidemiol 2024; 193:1-5. [PMID: 37527824 DOI: 10.1093/aje/kwad161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/19/2023] [Accepted: 07/12/2023] [Indexed: 08/03/2023] Open
Abstract
The current US Food and Drug Administration (FDA) licensure process underestimates the potential benefits of vaccines at both the individual and population levels by considering only direct clinical outcomes of vaccination. While all approved vaccines do protect the person who takes them from poor clinical outcomes for a specific infectious disease, many vaccines also have the potential to offer measurable, direct nonclinical benefits. For example, coronavirus disease 2019 (COVID-19) vaccinations for school-aged children may prevent school absenteeism. Also, by preventing infection or reducing its length and severity, some vaccines also protect-to some extent-the patient's immediate contacts from contracting the same disease. These nonclinical and population-level benefits are not considered as part of the FDA's current vaccine approval process, but they could be. We argue that the FDA's structured benefit-risk assessment framework, used for vaccine approvals, can and should consider both clinical and nonclinical benefits of vaccination when sufficient evidence exists to make an informed assessment. Including them could incentivize vaccine developers to measure additional vaccination effects, inform population health, and address health inequalities-including inequalities in the social determinants of health.
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19
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Causadias JM, Neblett EW. Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Latinx Children, Youth, and Families: Clinical Challenges and Opportunities. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:1-9. [PMID: 38330266 DOI: 10.1080/15374416.2024.2304143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Latinx children, youth, and families in the United States have been disproportionally affected by the COVID-19 pandemic compared to non-Latinxs, experiencing a higher burden of deaths, economic adversity, parental stress, and mental health problems. At the same time, Latinx children, youth, and families in the United States have rich cultural and community resources that serve as a source of protection and promotion. To our knowledge, no special issue has been devoted to the impact of the pandemic on Latinx children, youth, and families, which limits opportunities to examine its implications for clinical theory, research, assessment, policy, and practice. To address this gap, we present this special issue entitled "Understanding the impact of the COVID-19 pandemic on the mental health of Latinx children, youth, and families: Clinical challenges and opportunities," a collection of nine articles written by Latinx scholars. In this introduction, we explain why it is important to center Latinx children, youth, and families and why we need to use a structural-intersectional approach. We summarize the articles in this collection by grouping them by themes: immigration and family separation; the impact of family economic adversity; school and family contexts of mental health; the pandemic experience of Latinx LGBTQ and AfroLatinx youth; and a model to imagine the future of Latinx children, youth, and families. We conclude with a brief summary and suggestions for future research.
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20
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Causadias JM, Neblett EW. PARQUES: Dreaming a Future for Our Latinx Children, Youth, and Families. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:129-140. [PMID: 38330265 DOI: 10.1080/15374416.2024.2304140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
A growing body of evidence suggests that the COVID-19 pandemic has disproportionally affected Latinx children, youth, and families in the United States by increasing the prevalence and incidence of mental health problems. While it is important to document the repercussions of the pandemic, it is also necessary to articulate what a future of wellbeing and positive mental health will look like for Latinx children, youth, and families. To address this need, we propose PARQUES, a framework to dream about the future of Latinx children, youth, and families in the United States. We imagine PARQUES as communal spaces for connection, joy, play, rest, and healing that result from activism and collective action. We use the Spanish word for parks as an acronym "PARQUES," which stands for políticas (policies), alegría (joy), reparación (healing and reparations), querencia (love and belonging), unión (unity), empleo (employment), and seguridad (safety). These components work together to create an ecosystem to foster the physical and mental wellness and wholeness of Latinx children, youth, and families.
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21
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Dumitriu D, Lavallée A, Riggs JL, Frosch CA, Barker TV, Best DL, Blasingame B, Bushar J, Charlot-Swilley D, Erickson E, Finkel MA, Fortune B, Gillen L, Martinez M, Ramachandran U, Sanders LM, Willis DW, Shearman N. Advancing early relational health: a collaborative exploration of a research agenda. Front Pediatr 2023; 11:1259022. [PMID: 38143537 PMCID: PMC10748603 DOI: 10.3389/fped.2023.1259022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/07/2023] [Indexed: 12/26/2023] Open
Abstract
Here, we introduce the Early Relational Health (ERH) Learning Community's bold, large-scale, collaborative, data-driven and practice-informed research agenda focused on furthering our mechanistic understanding of ERH and identifying feasible and effective practices for making ERH promotion a routine and integrated component of pediatric primary care. The ERH Learning Community, formed by a team of parent/caregiver leaders, pediatric care clinicians, researchers, and early childhood development specialists, is a workgroup of Nurture Connection-a hub geared toward promoting ERH, i.e., the positive and nurturing relationship between young children and their parent(s)/caregiver(s), in families and communities nationwide. In response to the current child mental health crisis and the American Academy of Pediatrics (AAP) policy statement promoting ERH, the ERH Learning Community held an in-person meeting at the AAP national headquarters in December 2022 where members collaboratively designed an integrated research agenda to advance ERH. This agenda weaves together community partners, clinicians, and academics, melding the principles of participatory engagement and human-centered design, such as early engagement, co-design, iterative feedback, and cultural humility. Here, we present gaps in the ERH literature that prompted this initiative and the co-design activity that led to this novel and iterative community-focused research agenda, with parents/caregivers at the core, and in close collaboration with pediatric clinicians for real-world promotion of ERH in the pediatric primary care setting.
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Affiliation(s)
- Dani Dumitriu
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
- Division of Developmental Neuroscience, Department of Psychiatry, Columbia Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Andréane Lavallée
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
| | - Jessica L. Riggs
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, United States
| | - Cynthia A. Frosch
- Department of Human Development and Family Science, Auburn University, Auburn, AL, United States
| | - Tyson V. Barker
- Science and Innovation Strategy, Institute for Child Success, Greenville, SC, United States
| | - Debra L. Best
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Duke University School of Medicine, Durham, NC, United States
| | | | - Jessica Bushar
- HealthySteps, ZERO TO THREE, Washington, DC, United States
| | | | - Elizabeth Erickson
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Duke University School of Medicine, Durham, NC, United States
| | - Morgan A. Finkel
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
| | - Bryn Fortune
- Fortune Consulting, Early Relational Health-Family Network Collaborative, Royal Oak, MI, United States
| | - Leah Gillen
- Department of Research and Innovation, Reach out and Read, Boston, MA, United States
| | - Marty Martinez
- Chief Executive Officer, Reach Out and Read, Boston, MA, United States
| | - Usha Ramachandran
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Lee M. Sanders
- Department of Pediatrics, Division of General Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - David W. Willis
- Center for the Study of Social Policy, Washington, DC, United States
| | - Nikki Shearman
- Department of Research and Innovation, Reach out and Read, Boston, MA, United States
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22
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Abu-Ras W, Ashraf AbuLaban A, Talat AlQaisi S, AlQaisi MTH, Decker E. Orphans in Syria and Iraq Juggling Balls: Wars, COVID-19, and the NGO's financial crisis. Int J Qual Stud Health Well-being 2023; 18:2170010. [PMID: 36744740 PMCID: PMC9904298 DOI: 10.1080/17482631.2023.2170010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The COVID-19 pandemic's impact varies between and within nations, causing new forms of inequality. Refugee and orphan children in conflicted areas are more likely to suffer due to poverty, vulnerability, and limited access to essential services including reduction in donor funding. This qualitative study is the first to assess the effects of the COVID-19 pandemic and the financial crisis on Iraqi and Syrian orphaned children and their mothers. The Modified Grounded Theory was used for the preliminary analysis to expand the range of themes. This study has identified five major themes: financial crisis, low educational attainment, child labour, mental health issues, violence, and social problems. The impact of COVID-19 children and adolescents' mental health is of great concern. These multiple crises may significantly impact orphan children and adolescents' cognitive, mental health, and physical development. It is critical to address mental health issues during the current crisis and to plan for possible future pandemics and their intersecting outcomes. A Holistic approach requires providers to be aware of their clients' intersecting circumstances and needs using a range of lenses, including the person in the environment, family dynamics, culture, politics, and structural challenges. Offering food, medical supplies, and housing are considered basic needs.
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Affiliation(s)
- Wahiba Abu-Ras
- Adelphi School of Social Work, Garden City, NY, United States,CONTACT Wahiba Abu-Ras Adelphi School of Social Work, One South Avenue Garden City, Garden City, New York11530
| | | | | | | | - Eliza Decker
- MSW Candidate Adelphi School of Social Work, Garden City, NY, United States of America
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23
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Delaney KR. Taking a broad view of COVID-19, stressors and youth mental health. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:267-268. [PMID: 37814944 DOI: 10.1111/jcap.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Kathleen R Delaney
- Rush College of Nursing, Chicago, Illinois, USA
- Department of Community Mental Health and Systems, Chicago, Illinois, USA
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24
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Santos T, Steinway C, Mastrogiannis A, Chen J, Woodward J, Riddle I, Spicer B, Berens J, Davis T, Cornacchia M, Wright C, Lindquist LA, Jan S. Caregiver support, burden, and long-term planning among caregivers of individuals with intellectual and developmental disabilities: A cross-sectional study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1229-1240. [PMID: 37530520 DOI: 10.1111/jar.13141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Long-term care planning (LTCP) is critical for individuals with intellectual/developmental disabilities. Objectives of this study were to investigate progression through LTCP, and associations between social support and: (1) LTCP and (2) burden among family caregivers. METHODS A cross-sectional survey was distributed to caregivers of individuals with intellectual/developmental disabilities in NY, OH, PA, and TX, exploring demographics, supports, burden, and LTCP behaviours. Bivariate and linear multiple regression analyses were used to investigate study objectives. RESULTS Caregivers (n = 405) were predominantly parents, female, non-Hispanic, and in the 'learning to plan' stage of LTCP. Caregiver-identified social support was associated with further progression in LTCP (p = .020) and lower caregiver burden (p < .001). CONCLUSION Social support was associated with further progression in LTCP, and associated with less burden, however fewer than 40% of caregivers reported having social support. Ongoing exploration of emotional/social needs of caregivers is necessary to better support these families.
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Affiliation(s)
- Telmo Santos
- Division of General Pediatrics, Cohen Children's Medical Center of Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Caren Steinway
- Division of General Pediatrics, Cohen Children's Medical Center of Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Ariana Mastrogiannis
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Jack Chen
- Division of General Pediatrics, Cohen Children's Medical Center of Northwell Health, New Hyde Park, New York, USA
| | - Jason Woodward
- Division of Developmental and Behavioral Pediatrics, Cinncinati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
| | - Ilka Riddle
- Division of Developmental and Behavioral Pediatrics, Cinncinati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
| | - Brittany Spicer
- Division of Developmental and Behavioral Pediatrics, Cinncinati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
| | - John Berens
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Thomas Davis
- Division of General Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Michelle Cornacchia
- Division of General Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Charmaine Wright
- Division of Internal Medicine, Division of Pediatrics, Christiana Care, Wilmington, Delaware, USA
| | - Lee A Lindquist
- Division of Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sophia Jan
- Division of General Pediatrics, Cohen Children's Medical Center of Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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25
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Bangham C, Zack RM, Nelson E, Liu X, Codner A, Hicks JM, Greece JA. Assessing the effect of adverse economic events on severity of hunger among food pantry clients. Front Public Health 2023; 11:1286094. [PMID: 38026276 PMCID: PMC10644360 DOI: 10.3389/fpubh.2023.1286094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
This study assessed relationship between adverse economic events (AEE) and hunger level (i.e., little to no, moderate, severe). A cross-sectional survey was conducted from June to August 2018 in 10 food pantries with 616 food pantry users. Hunger level was assessed by the Household Hunger Scale. AEE were evaluated over the past 3 months. Participants (60.55%) experienced unexpected or increased medical expenses (17.69%), job loss (13.64%), pay reduction (11.85%), and death of a family member (9.09%). Pay reduction (OR = 1.87, 95% CI: 1.12, 3.14) and increased debt (OR = 2.71, 95% CI: 1.92, 3.84) were associated with moderate hunger; death of a family member (OR = 2.43, 95% CI: 1.21, 4.90), pay reduction (OR = 2.95, 95% CI: 1.24, 7.04), and increased debt (OR = 3.46, 95% CI: 1.98, 6.04) were associated with severe hunger. Awareness of AEE can inform public health programs and policies for people in need of additional resources, which is essential in times of increased economic instability.
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Affiliation(s)
- Candice Bangham
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
| | - Rachel M. Zack
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Eva Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
| | - Xinyang Liu
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
| | - Alyson Codner
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
| | - Jacqueline Milton Hicks
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States
| | - Jacey A. Greece
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
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26
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Doom JR, Deer LK, Dieujuste N, Han D, Rivera KM, Scott SR. Youth psychosocial resilience during the COVID-19 pandemic. Curr Opin Psychol 2023; 53:101656. [PMID: 37499532 PMCID: PMC10592273 DOI: 10.1016/j.copsyc.2023.101656] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023]
Abstract
Globally, youth have experienced heightened levels of stress due to the COVID-19 pandemic, though many youth showed resilience to mental health problems despite this increased stress. The current review covers emerging literature published in the past three years on resilience factors that promote more positive mental health in youth ages 10-18 years. These factors generally fall into three categories: 1) resilience factors at the level of the individual, 2) social resilience factors, and 3) interventions to enhance youth resilience during the pandemic. We include recommendations for future longitudinal research to better understand and promote resilience given the context of the pandemic, particularly for youth who experienced high levels of adversity.
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Affiliation(s)
| | | | | | - Deborah Han
- Department of Psychology, University of Denver, USA
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Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
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Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
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Burrell TD, Kim S, Mohadikar K, Jonas C, Ortiz N, Horberg MA. Family Structure and Adolescent Mental Health Service Utilization During the COVID-19 Pandemic. J Adolesc Health 2023; 73:693-700. [PMID: 37032208 PMCID: PMC10081921 DOI: 10.1016/j.jadohealth.2023.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 11/19/2022] [Accepted: 01/21/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE This study evaluated the relationship between sociodemographic factors including family structure and mental health service (MHS) utilization before and during the COVID-19 pandemic. We also investigated the moderation effects of the COVID-19 pandemic on MHS utilization. METHODS Our retrospective cohort study analyzed adolescents aged 12-17 years with a mental health diagnosis as identified in the electronic medical record enrolled in Kaiser Permanente Mid-Atlantic States in Maryland and Virginia, a comprehensive integrated health system. We used logistic regression models with an interaction term for the COVID-19 pandemic year to determine the relationship between family structure and adolescent MHS utilization ≥ one outpatient behavioral health visit within the measurement year, while adjusting for age, chronic medical condition (= physical illness lasting > 12 months), mental health condition, race, sex, and state of residence. RESULTS Among 5,420 adolescents, only those in two-parent households significantly increased MHS utilization during COVID-19 compared to the prepandemic year (McNemar's χ2 = 9.24, p < .01); however, family structure was not a significant predictor. Overall, the odds of adolescents using MHS were associated with a 12% increase during COVID-19 (odds ratio 1.12, 95% confidence interval [CI]: 1.02-1.22, p < .01). Higher odds of using MHS was associated with chronic medical condition (adjusted odds ratio = 1.15; 95% CI: 1.05-1.26, p < .01) and with White adolescents compared to all racial/ethnic minorities. The odds ratio of females using MHS compared to their male counterparts increased by 63% (ratio of adjusted odds ratio = 1.63; 95% CI: 1.39-1.91, p < .01) during the COVID-19 pandemic. DISCUSSION Individual-level demographic factors served as predictors of MHS utilization with effects moderated by COVID-19.
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Affiliation(s)
- Tierra D Burrell
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Maryland; Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland; Department of Pediatrics, MAPMG, Rockville, Maryland.
| | - Seohyun Kim
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Maryland; Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland
| | - Karishma Mohadikar
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Maryland; Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland
| | - Cabell Jonas
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Maryland; Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland
| | - Nancy Ortiz
- Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland
| | - Michael A Horberg
- Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, Maryland; Kaiser Permanente Mid-Atlantic Permanente Medical Group, Rockville, Maryland
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Xu Y, Harrison TM. Socioemotional and Behavioral Problems of Grandchildren Raised by Grandparents: The Role of Grandparent-Grandchild Relational Closeness and Conflict. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1623. [PMID: 37892286 PMCID: PMC10605244 DOI: 10.3390/children10101623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
This study examined the associations of grandparent-grandchild relational closeness and conflict with grandchildren's socioemotional and behavioral problems, including emotional symptoms, conduct problems, hyperactivity, peer problems, and abnormal prosocial behaviors. We analyzed primary cross-sectional survey data collected from custodial grandparents in the United States using logistic regression models. The results indicated that grandparent-grandchild relational closeness was significantly associated with lower odds of custodial grandchildren having emotional symptoms, conduct problems, peer problems, and abnormal prosocial behaviors, whereas grandparent-grandchild relational conflict was significantly associated with higher odds of emotional symptoms, conduct problems, hyperactivity, peer problems, and abnormal prosocial behaviors. Implications for increasing grandparent-grandchild relational closeness and decreasing relational conflicts among grandparent-headed families are discussed, which might improve grandchildren's socioemotional and behavioral well-being.
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Affiliation(s)
- Yanfeng Xu
- College of Social Work, University of South Carolina, Columbia, SC 29208, USA
| | - Theresa M Harrison
- Carolina Family Engagement Center, College of Education, University of South Carolina, Columbia, SC 29208, USA
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Tolou-Shams M, Ramaiya M, Lara Salas J, Ezimora I, Shumway M, Duerr Berrick J, Aguilera A, Borsari B, Dauria E, Friedling N, Holmes C, Grandi A. A Family-Based Mental Health Navigator Intervention for Youth in the Child Welfare System: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49999. [PMID: 37698896 PMCID: PMC10523219 DOI: 10.2196/49999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Youth in the child welfare system (child welfare-involved [CWI] youth) have high documented rates of mental health symptoms and experience significant disparities in mental health care services access and engagement. Adolescence is a developmental stage that confers increased likelihood of experiencing mental health symptoms and the emergence of disorders that can persist into adulthood. Despite a high documented need for evidence-based mental health services for CWI youth, coordination between child welfare and mental health service systems to increase access to care remains inadequate, and engagement in mental health services is low. Navigator models developed in the health care field to address challenges of service access, fragmentation, and continuity that affect the quality of care provide a promising approach to increase linkage to, and engagement in, mental health services for CWI youth. However, at present, there is no empirically supported mental health navigator model to address the unique and complex mental health needs of CWI youth and their families. OBJECTIVE Using a randomized controlled trial, this study aims to develop and test a foster care family navigator (FCFN) model to improve mental health service outcomes for CWI adolescents (aged 12-17 years). METHODS The navigator model leverages an in-person navigator and use of adjunctive digital health technology to engage with, and improve, care coordination, tracking, and monitoring of mental health service needs for CWI youth and families. In total, 80 caregiver-youth dyads will be randomized to receive either the FCFN intervention or standard of care (clinical case management services): 40 (50%) to FCFN and 40 (50%) to control. Qualitative exit interviews will inform the feasibility and acceptability of the services received during the 6-month period. The primary trial outcomes are mental health treatment initiation and engagement. Other pre- and postservice outcomes, such as proportion screened and time to screening, will also be evaluated. We hypothesize that youth receiving the FCFN intervention will have higher rates of mental health treatment initiation and engagement than youth receiving standard of care. RESULTS We propose enrollment of 80 dyads by March 2024, final data collection by September 2024, and the publication of main findings in March 2025. After final data analysis and writing of the results, the resulting manuscripts will be submitted to journals for dissemination. CONCLUSIONS This study will be the first to produce empirically driven conclusions and recommendations for implementing a family mental health navigation model for CWI youth with long-standing and unaddressed disparities in behavioral health services access. The study findings have potential to have large-scale trial applicability and be feasible and acceptable for eventual system implementation and adoption. TRIAL REGISTRATION ClinicalTrials.gov NCT04506437; https://www.clinicaltrials.gov/study/NCT04506437. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49999.
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Affiliation(s)
- Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Megan Ramaiya
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Jannet Lara Salas
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Ifunanya Ezimora
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Martha Shumway
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Jill Duerr Berrick
- Berkeley Social Welfare, University of California at Berkeley, Berkeley, CA, United States
| | - Adrian Aguilera
- Berkeley Social Welfare, University of California at Berkeley, Berkeley, CA, United States
| | - Brian Borsari
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veteran Affairs Medical Center, San Francisco, CA, United States
| | - Emily Dauria
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Naomi Friedling
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Crystal Holmes
- Foster Care Mental Health, San Francisco, CA, United States
| | - Adam Grandi
- Foster Care Mental Health, San Francisco, CA, United States
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Thyden NH, Slaughter-Acey J, Widome R, Warren JR, Osypuk TL. Family deaths in the early life course and their association with later educational attainment in a longitudinal cohort study. Soc Sci Med 2023; 333:116161. [PMID: 37595424 PMCID: PMC10529887 DOI: 10.1016/j.socscimed.2023.116161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 07/11/2023] [Accepted: 08/06/2023] [Indexed: 08/20/2023]
Abstract
Due to structural racism and pathways between racism and health, Black and Native American people die at younger ages than white people. This means that those groups are likely to experience deaths of family members at younger ages. Evidence is mixed about whether family deaths affect educational attainment. We aim to 1) estimate the prevalence of family deaths by age and race 2) estimate the effect of a family death on later educational attainment and 3) analyze whether the effect of a family death varies by age, socioeconomic status, gender, and race. The National Longitudinal Study of Adolescent to Adult Health (Add Health) is a nationally representative sample of U.S. adolescents in grades 7-12 at baseline in 1994-1995. Add Health has a large and racially diverse sample and records family deaths across the entire life course starting from birth. Participants were included in this analysis if they reported their educational attainment in Wave IV (N = 14,796). The racial group with the lowest proportion experiencing a sibling or parent death in the first 23 years of their lives was white participants (11.7%), followed by Asian (12.5%), Hispanic (15.0%), Black (24.3%) and Native American participants (30.3%). In adjusted models, those who experienced a family death had 0.60 times the odds (95% CI 0.51-0.71) of achieving a bachelor's degree compared to those without a family death. Mother deaths, father deaths, and sibling deaths were each harmful for obtaining a college degree and their effects were similar in magnitude. The age range when the effect of a family death was strongest was 10-13 years old (OR = 0.52 95% CI 0.40-0.67). The effect of a family death on college degree attainment did not vary by baseline parent education, participant sex, or race/ethnicity.
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Affiliation(s)
- Naomi Harada Thyden
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, United States; University of Minnesota, Minnesota Population Center, United States; University of Illinois Chicago, School of Public Health, Community Health Sciences, United States.
| | - Jaime Slaughter-Acey
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, United States
| | - Rachel Widome
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, United States
| | - John Robert Warren
- University of Minnesota, Minnesota Population Center, United States; University of Minnesota, Department of Sociology, United States
| | - Theresa L Osypuk
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, United States; University of Minnesota, Minnesota Population Center, United States
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King LS, Guyon-Harris KL, Valadez EA, Radulescu A, Fox NA, Nelson CA, Zeanah CH, Humphreys KL. A Comprehensive Multilevel Analysis of the Bucharest Early Intervention Project: Causal Effects on Recovery From Early Severe Deprivation. Am J Psychiatry 2023; 180:573-583. [PMID: 37211832 PMCID: PMC10751847 DOI: 10.1176/appi.ajp.20220672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The Bucharest Early Intervention Project is the first randomized controlled trial of foster care as an alternative to institutional care. The authors synthesized data from nearly 20 years of assessments of the trial to determine the overall intervention effect size across time points and developmental domains. The goal was to quantify the overall effect of the foster care intervention on children's outcomes and examine sources of variation in this effect, including domain, age, and sex assigned at birth. METHODS An intent-to-treat approach was used to examine the causal effects of the randomized controlled trial for 136 children residing in institutions in Bucharest, Romania (baseline age, 6-31 months) who were randomly assigned to either foster care (N=68) or care as usual (N=68). At ages 30, 42, and 54 months and 8, 12, and 16-18 years, children were assessed for IQ, physical growth, brain electrical activity (EEG), and symptoms of five types of psychopathology. RESULTS Participants provided 7,088 observations across follow-up waves. Children assigned to foster care had better cognitive and physical outcomes and less severe psychopathology than did those who received care as usual. The magnitude of these effect sizes remained stable across development. The foster care intervention most influenced IQ and disorders of attachment/social relatedness. CONCLUSIONS Young children benefit from placement in families after institutional care. The benefits of foster care for previously institutionalized children were remarkably stable across development.
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Affiliation(s)
- Lucy S. King
- Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, New Orleans, LA
| | | | - Emilio A. Valadez
- University of Maryland, Department of Human Development and Quantitative Methodology, College Park, MD
| | | | - Nathan A. Fox
- University of Maryland, Department of Human Development and Quantitative Methodology, College Park, MD
| | - Charles A. Nelson
- Boston Children’s Hospital/Harvard Medical School, Boston, MA
- Harvard Graduate School of Education, Cambridge, MA
| | - Charles H. Zeanah
- Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, New Orleans, LA
| | - Kathryn L. Humphreys
- Tulane University School of Medicine, Department of Psychiatry and Behavioral Sciences, New Orleans, LA
- Vanderbilt University, Department of Psychology and Human Development, Nashville, TN
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Arrojo MJ, Bromberg J, Walter HJ, Vernacchio L. Pediatric Primary-Care Integrated Behavioral Health: A Framework for Reducing Inequities in Behavioral Health Care and Outcomes for Children. Pediatr Clin North Am 2023; 70:775-789. [PMID: 37422314 DOI: 10.1016/j.pcl.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
Nearly half of US children and adolescents will suffer a behavioral health (BH) disorder, with substantially higher rates among more disadvantaged children such as racial/ethnic minorities, LGBTQ + youth, and poor children. The current specialty pediatric BH workforce is inadequate to meet the need and the uneven distribution of specialists as well as other barriers to care, such as insurance coverage and systemic racism/bias, further exacerbate disparities in BH care and outcomes. Integrating BH care into the pediatric primary care medical home has the potential to expand access to BH care and reduce the disparities inherent in the current system.
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Affiliation(s)
- Maria J Arrojo
- Pediatric Physicians' Organization at Children's, 112 Worcester Street, Suite 300, Wellesley, MA 02481, USA; Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Jonas Bromberg
- Pediatric Physicians' Organization at Children's, 112 Worcester Street, Suite 300, Wellesley, MA 02481, USA; Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Heather J Walter
- Pediatric Physicians' Organization at Children's, 112 Worcester Street, Suite 300, Wellesley, MA 02481, USA; Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Louis Vernacchio
- Pediatric Physicians' Organization at Children's, 112 Worcester Street, Suite 300, Wellesley, MA 02481, USA; Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
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Hannan C, Mayne SL, Kelly MK, Davis M, Young JF, Powell M, Stephens-Shields A, Dalembert G, McPeak KE, Jenssen BP, Fiks AG. Trends in Positive Depression and Suicide Risk Screens in Pediatric Primary Care During COVID-19. Acad Pediatr 2023; 23:1159-1165. [PMID: 36584938 PMCID: PMC9792424 DOI: 10.1016/j.acap.2022.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 12/08/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Adolescent mental health concerns increased during COVID-19, but it is unknown whether early increases in depression and suicide risk have been sustained. We examined changes in positive screens for depression and suicide risk in a large pediatric primary care network through May 2022. METHODS Using an observational repeated cross-sectional design, we examined changes in depression and suicide risk during the pandemic using electronic health record data from adolescents. Segmented logistic regression was used to estimate risk differences (RD) for positive depression and suicide risk screens during the early pandemic (June 2020-May 2021) and late pandemic (June 2021-May 2022) relative to before the pandemic (March 2018-February 2020). Models adjusted for seasonality and standard errors accounted for clustering by practice. RESULTS Among 222,668 visits for 115,627 adolescents (mean age 15.7, 50% female), the risk of positive depression and suicide risk screens increased during the early pandemic period relative to the prepandemic period (RD, 3.8%; 95% CI, 2.9, 4.8; RD, 2.8%; 95% CI, 1.7, 3.8). Risk of depression returned to baseline during the late pandemic period, while suicide risk remained slightly elevated (RD, 0.7%; 95% CI, -0.4, 1.7; RD, 1.8%; 95% CI, 0.9%, 2.7%). CONCLUSIONS During the early months of the pandemic, there was an increase in positive depression and suicide risk screens, which later returned to prepandemic levels for depression but not suicide risk. Results suggest that pediatricians should continue to prioritize screening adolescents for depressive symptoms and suicide risk and connect them to treatment.
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Affiliation(s)
- Chloe Hannan
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Stephanie L Mayne
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa.
| | - Mary Kate Kelly
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Molly Davis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and PolicyLab, Children's Hospital of Philadelphia (M Davis and JF Young), Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania (M Davis and AG Fiks), Philadelphia, Pa
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and PolicyLab, Children's Hospital of Philadelphia (M Davis and JF Young), Philadelphia, Pa; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (JF Young), Philadelphia, Pa
| | - Maura Powell
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Alisa Stephens-Shields
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania (A Stephens-Shields), Philadelphia, Pa
| | - George Dalembert
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Katie E McPeak
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Brian P Jenssen
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa
| | - Alexander G Fiks
- Clincial Futures (A Research Institute Center of Emphasis) and The Possibilities Project, Children's Hospital of Philadelphia (C Hannan, SL Mayne, MK Kelly, M Powell, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (SL Mayne, G Dalembert, KE McPeak, BP Jenssen, and AG Fiks), Philadelphia, Pa; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania (M Davis and AG Fiks), Philadelphia, Pa
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Simes JT, Cowger TL, Jahn JL. School closures significantly reduced arrests of black and latinx urban youth. PLoS One 2023; 18:e0287701. [PMID: 37494297 PMCID: PMC10370768 DOI: 10.1371/journal.pone.0287701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/09/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND & METHODS Youth of color are surveilled and arrested by police at higher rates than their White peers, contributing to racial inequities across the life course and in population health. Previous research points to schools as an increasingly relevant site for youth criminalization, but existing studies emphasize within-school mechanisms, with limited analysis of policing in surrounding school areas. To fill this gap, we study changes in police arrests of youth after initial COVID-19 school closures in 2020 across four US cities overall and in relation to public school locations. We analyze geocoded arrest records and use interrupted time series negative binomial regression models with city and month fixed effects to estimate change in weekly arrest rates among White, Black, and Latinx youth. We estimate arrest densities within school areas before and after school closures using spatial buffers of 300 feet. RESULTS In the immediate weeks and months following COVID-19 pandemic school closures, youth arrest rates fell dramatically and with lasting impacts compared to other age groups. During the period of remote learning, weekly youth arrest rates declined by 54.0% compared to youth arrests rates in 2019, adjusting for city and seasonality (Incident Rate Ratio 0.46, 95% CI: 0.41, 0.52). We estimate Black youth weekly arrests fell from 43.6 to 16.8 per 100,000, vs. 4.6 to 2.2 per 100,000 among White youth. However, Black youth arrest rates during the remote learning period were still nearly 5 times that of White youth pre-pandemic. We also find that youth arrest rates declined during two school closure periods: at the start of the pandemic in 2020 and during Summer 2019. A spatial analysis shows Black and Latinx youth arrest densities in the surrounding 300 feet of K-12 schools were at least 15 and 8.5 times that of White youth, respectively, in both pre- and remote-learning periods. CONCLUSIONS Black and Latinx youth face a higher likelihood of being arrested near a school than do White youth and older age groups, and racial inequities in arrests remains after school closures. Our findings show school closures significantly reduced arrests of urban youth of color, and policies addressing youth criminalization and structural racism should consider the joint spatial context of schools and policing. Although school closures may have resulted in learning loss and harms to youth wellbeing, closures interrupted comparatively high levels of arrest for Black and Latinx youth.
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Affiliation(s)
- Jessica T. Simes
- Department of Sociology, Boston University, Boston, MA, United States of America
| | - Tori L. Cowger
- FXB Center for Health and Human Rights, Harvard University T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Jaquelyn L. Jahn
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Drexel University Dornsife School of Public Health, Philadelphia, PA, United States of America
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Howard AL, Chiang L, Picchetti V, Zhu L, Hegle J, Patel P, Saul J, Wasula L, Nantume S, Coomer R, Kamuingona R, Oluoch RP, Mharadze T, Duffy M, Kambona CA, Ramphalla P, Fathim KM, Massetti GM. Population Estimates of HIV Risk Factors to Inform HIV Prevention Programming for Adolescent Girls and Young Women. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:20-38. [PMID: 37406147 PMCID: PMC11249023 DOI: 10.1521/aeap.2023.35.suppa.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Violence Against Children and Youth Survey (VACS) data from seven countries were analyzed to estimate population-level eligibility for the President's Emergency Plan for AIDS Relief (PEPFAR) Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) HIV prevention program for adolescent girls and young women (AGYW). The prevalence of overall eligibility and individual risk factors, including experiences of violence, social, and behavioral risks differ across countries and age groups. A large proportion of AGYW across all countries and age groups examined have at least one risk factor making them eligible for DREAMS. Experiencing multiple risks is also common, suggesting that researchers and programs could work together to identify combinations of risk factors that put AGYW at greatest risk of HIV acquisition, or that explain most new HIV infections, to more precisely target the most vulnerable AGYW. The VACS provides important data for such analyses to refine DREAMS and other youth programming.
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Affiliation(s)
- Ashleigh L Howard
- U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health, Atlanta, Georgia
| | - Laura Chiang
- CDC, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Viani Picchetti
- CDC, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Liping Zhu
- CDC, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Jennifer Hegle
- U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health, Atlanta, Georgia
| | - Pragna Patel
- U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health, Atlanta, Georgia
| | - Janet Saul
- U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health, Atlanta, Georgia
| | - Lydia Wasula
- Uganda Ministry of Gender, Labor and Social Development, Kampala, Uganda
| | | | | | - Rahimisa Kamuingona
- Namibia Ministry of Gender Equality, Poverty Eradication and Social Services, Windhoek, Namibia
| | | | | | | | | | - Puleng Ramphalla
- CDC, Lesotho Country Office, Maseru, Lesotho. Puleng Ramphalla, MS, is affiliated with the CDC, Côte d'Ivoire Country Office, Abidjan, Côte d'Ivoire
| | | | - Greta M Massetti
- CDC, National Center for Injury Prevention and Control, Atlanta, Georgia
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Edwards J, Stone M, Bartlett H, Wallace M, Ventura A. Grief in School-Aged Youth. NASN Sch Nurse 2023; 38:171-175. [PMID: 36942564 DOI: 10.1177/1942602x231161332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Grief is an expected response to an internalized sense of loss, regardless of age. This response occurs after experiencing the death of a loved one or a drastic life change that creates a sense of loss. Children and adolescents move through the grief process according to their age and stage of development. Proper support is essential to promote healthy coping and acceptance in youth experiencing grief. The interprofessional school team can support students experiencing grief to enhance student learning outcomes and overall health and well-being.
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Affiliation(s)
| | - Misty Stone
- Fayetteville State University, Fayetteville, NC
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DeChants JP, Price MN, Nath R, Davis CK. Losing a Close Friend or Family Member Due to COVID-19 and Mental Health among LGBTQ Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6129. [PMID: 37372716 PMCID: PMC10298429 DOI: 10.3390/ijerph20126129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
This study examines the association between having lost a close friend or family member to COVID-19 and mental health outcomes among lesbian, gay, bisexual, transgender, or queer (LGBTQ) youth. Data come from 33,993 respondents in the United States, ages 13 to 24, who completed an online survey of LGBTQ youth mental health. Multivariate logistic regression was used to determine the adjusted odds of recent anxiety, depression, considering, or attempting suicide in the past year based on whether or not the youth reported having lost a close friend or family member to COVID-19. Among the full sample, experiences of COVID-19 loss were associated with recent anxiety (adjusted odds ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.20-1.40), recent depression (aOR = 1.23, 95% CI [1.15, 1.32]), seriously considering suicide in the past year (aOR = 1.22, 95% CI (1.14, 1.30)), and attempting suicide in the past year (aOR = 1.55, 95% CI (1.41, 1.69)). These findings highlight the urgent need for investment in low-barrier, affirming mental health services for LGBTQ youth who have experienced COVID-19 loss to support their grief, overall mental health, and healthy development.
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Affiliation(s)
- Jonah P DeChants
- The Trevor Project, P.O. Box 69232, West Hollywood, CA 90069, USA
| | - Myeshia N Price
- The Trevor Project, P.O. Box 69232, West Hollywood, CA 90069, USA
| | - Ronita Nath
- The Trevor Project, P.O. Box 69232, West Hollywood, CA 90069, USA
| | - Carrie K Davis
- The Trevor Project, P.O. Box 69232, West Hollywood, CA 90069, USA
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39
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Alvis L, Zhang N, Sandler IN, Kaplow JB. Developmental Manifestations of Grief in Children and Adolescents: Caregivers as Key Grief Facilitators. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:447-457. [PMID: 35106114 PMCID: PMC8794619 DOI: 10.1007/s40653-021-00435-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 05/26/2023]
Abstract
The death of a loved one represents one of the most distressing and potentially traumatic life events in childhood and adolescence. Grief reactions in youth are influenced by ongoing developmental processes and manifest differently depending on the child's age and developmental stage. These grief-related processes unfold within youths' caregiving context, as children and adolescents rely heavily on the adults in their environment to navigate and cope with the death of a loved one. Despite the field's increasing recognition of the potential for maladaptive grief reactions to impede functioning over time, few longitudinal research studies on childhood grief currently exist. In this article, we will (a) provide a brief overview of the childhood bereavement literature; (b) review the new DSM-5 and ICD-11 Prolonged Grief Disorder diagnostic criteria through a developmentally-informed lens; (c) describe how grief reactions manifest in children and adolescents of different ages through the lenses of multidimensional grief theory and relational developmental systems theory; (d) highlight key moderating factors that may influence grief in youth, and (e) discuss a primary moderating factor, the caregiving environment, and the potential mechanisms through which caregivers influence children's grief.
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Affiliation(s)
- Lauren Alvis
- The Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX USA
| | - Na Zhang
- Human Development and Family Sciences, University of Connecticut, Storrs, CT 06269 USA
| | - Irwin N. Sandler
- Department of Psychology, Arizona State University, Tempe, AZ 85281 USA
| | - Julie B. Kaplow
- The Hackett Center for Mental Health, Meadows Mental Health Policy Institute, Houston, TX USA
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40
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Hoskote AR, Rolin D, Rew L, Johnson KE. Effects of COVID-19 on School Nurse Mental Health Intervention Practices. J Sch Nurs 2023:10598405231172758. [PMID: 37158076 PMCID: PMC10183332 DOI: 10.1177/10598405231172758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Mental health issues have been exacerbated by COVID-19; therefore we examined how the school nurses' role in addressing mental health changed during the pandemic. We administered a nationwide survey in 2021, guided by the Framework for the 21st Century School Nurse, and analyzed self-reported changes in mental health interventions by school nurses. Most mental health practice changes after the start of the pandemic occurred in the care coordination (52.8%) and community/public health (45.8%) principles. An overall decrease in students visiting the school nurse's office (39.4%) was seen, yet the frequency of students visiting with mental health concerns had increased (49.7%). Open-ended responses indicated that school nurse roles changed due to COVID-19 protocols, including decreased access to students and changes in mental health resources. These insights into the role of school nurses in addressing student mental health during public health disasters have important implications for future disaster preparedness efforts.
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Affiliation(s)
- Ashwini R Hoskote
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Donna Rolin
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Lynn Rew
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Karen E Johnson
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
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41
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Zhang T, Krysinska K, Alisic E, Andriessen K. Grief Instruments in Children and Adolescents: A Systematic Review. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231171188. [PMID: 37078181 DOI: 10.1177/00302228231171188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Many children and adolescents experience the death of a close person, such as a family member or a friend. However, there is a scarcity of literature on the assessment of grief in bereaved youth. The use of validated instruments is essential to advance our knowledge of grief in children and adolescents. We conducted a systematic review, adhering to PRISMA guidelines, to identify instruments that measure grief in this population and explore their characteristics. Searches in six databases (Medline, PsycINFO, Embase, Emcare, Scopus, and Web of Science) identified 24 instruments, encompassing three categories: general-purpose grief scales, maladaptive grief scales, and specialized grief scales. We extracted data using a predetermined list of descriptive and psychometric properties. Findings indicate a need to direct research towards more stringent validation of existing instruments and the design of new instruments in line with developments in the understanding of grief in this population.
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Affiliation(s)
- Toni Zhang
- Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - Karolina Krysinska
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Eva Alisic
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Karl Andriessen
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Sprang G, Eslinger J, Whitt-Woosley A, Gusler S, Clemans T. Child Traumatic Stress and COVID-19: The Impact of the Pandemic on a Clinical Sample of Children in Trauma Treatment. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023:1-12. [PMID: 37359464 PMCID: PMC10034234 DOI: 10.1007/s40653-023-00531-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 06/28/2023]
Abstract
Given the scope and duration of the COVID-19 pandemic, it is not surprising that research has documented negative effects to youth's mental health. Yet, there is negligible research on the impact of the pandemic among clinical samples of youth receiving treatment for pre-existing trauma exposure and symptoms. The current study investigates COVID-19 as an index trauma, and if prior traumatic stress scores mediate the relationship between pandemic-related exposure and subsequent traumatic stress. METHODS This is a study of 130 youth ages 7-18 receiving trauma treatment at an academic medical center. The University of California Los Angeles Post-traumatic Stress Disorder-Reaction Index (UCLA-PTSD-RI) was completed by all youth during intake as part of routine data collection. From April, 2020 to March, 2022 the UCLA Brief COVID-19 Screen for Child/Adolescent PTSD was also administered to assess trauma exposures and symptoms specifically-related to the pandemic experience. Univariate and bivariate analyses were conducted on all variables of interest to describe response patterns cross-sectionally and longitudinally; a mediational analysis was used to determine if prior trauma symptoms mediate the relationship between COVID-19 exposure and response. Additionally, interviews were conducted with youth using a series of open-ended questions about their perceptions of safety, threat and coping related to the pandemic. RESULTS A quarter of the sample reported COVID-19 related exposures that would meet Criterion A for PTSD. Participants whose UCLA-COVID scores that exceeded the clinical cutoff had lower scores on two items measuring social support. There was no evidence of full or partial mediation. Responses to interview questions revealed low levels of threat reactivity, perceptions of no to little impact, positive changes, varying opinions on social isolation, some evidence of inaccurate messaging and adaptive coping using strategies learned in treatment. IMPLICATIONS The findings broaden our understanding of the impact of COVID-19 on vulnerable children and provide insight into how prior trauma history and the provision of evidence-based trauma treatment impact a youth's response to pandemic conditions.
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Affiliation(s)
- Ginny Sprang
- Department of Psychiatry, Center On Trauma and Children, University of Kentucky, Lexington, USA
| | - Jessica Eslinger
- Department of Psychiatry, Center On Trauma and Children, University of Kentucky, Lexington, USA
| | - Adrienne Whitt-Woosley
- Department of Psychiatry, Center On Trauma and Children, University of Kentucky, Lexington, USA
| | - Stephanie Gusler
- Department of Psychiatry, Center On Trauma and Children, University of Kentucky, Lexington, USA
| | - Tracy Clemans
- Department of Psychiatry, Center On Trauma and Children, University of Kentucky, Lexington, USA
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Xiao Y, Brown TT, Snowden LR, Chow JCC, Mann JJ. COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States. JAMA Netw Open 2023; 6:e232716. [PMID: 36912834 DOI: 10.1001/jamanetworkopen.2023.2716] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
IMPORTANCE The adverse effects of COVID-19 containment policies disrupting child mental health and sleep have been debated. However, few current estimates correct biases of these potential effects. OBJECTIVES To determine whether financial and school disruptions related to COVID-19 containment policies and unemployment rates were separately associated with perceived stress, sadness, positive affect, COVID-19-related worry, and sleep. DESIGN, SETTING, AND PARTICIPANTS This cohort study was based on the Adolescent Brain Cognitive Development Study COVID-19 Rapid Response Release and used data collected 5 times between May and December 2020. Indexes of state-level COVID-19 policies (restrictive, supportive) and county-level unemployment rates were used to plausibly address confounding biases through 2-stage limited information maximum likelihood instrumental variables analyses. Data from 6030 US children aged 10 to 13 years were included. Data analysis was conducted from May 2021 to January 2023. EXPOSURES Policy-induced financial disruptions (lost wages or work due to COVID-19 economic impact); policy-induced school disruptions (switches to online or partial in-person schooling). MAIN OUTCOMES AND MEASURES Perceived stress scale, National Institutes of Health (NIH)-Toolbox sadness, NIH-Toolbox positive affect, COVID-19-related worry, and sleep (latency, inertia, duration). RESULTS In this study, 6030 children were included in the mental health sample (weighted median [IQR] age, 13 [12-13] years; 2947 [48.9%] females, 273 [4.5%] Asian children, 461 [7.6%] Black children, 1167 [19.4%] Hispanic children, 3783 [62.7%] White children, 347 [5.7%] children of other or multiracial ethnicity). After imputing missing data, experiencing financial disruption was associated with a 205.2% [95% CI, 52.9%-509.0%] increase in stress, a 112.1% [95% CI, 22.2%-268.1%] increase in sadness, 32.9% [95% CI, 3.5%-53.4%] decrease in positive affect, and a 73.9 [95% CI, 13.2-134.7] percentage-point increase in moderate-to-extreme COVID-19-related worry. There was no association between school disruption and mental health. Neither school disruption nor financial disruption were associated with sleep. CONCLUSIONS AND RELEVANCE To our knowledge, this study presents the first bias-corrected estimates linking COVID-19 policy-related financial disruptions with child mental health outcomes. School disruptions did not affect indices of children's mental health. These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available.
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Affiliation(s)
- Yunyu Xiao
- Weill Cornell Medicine, NewYork Presbyterian, Department of Population Health Sciences, New York
| | | | | | | | - J John Mann
- Departments of Psychiatry and Radiology, Columbia University Irving Medical Center, Columbia University, New York
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York
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Macyko SJ. The Impact of the COVID-19 Pandemic on Children/Youth With Special Health Care Needs: A School Nurse's Perspective. J Pediatr Health Care 2023; 37:117-121. [PMID: 36588055 PMCID: PMC9729642 DOI: 10.1016/j.pedhc.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
School nurses repeatedly have been stretched to the limits over the past few years with the COVID-19 pandemic-managing not only routine daily care of students but also juggling those unique needs of children and youth with special health care needs, especially for those who also lost a parent/caregiver from COVID-19. This article provides background demographic information on how the COVID-19 pandemic affected these children, along with a specific case report of a middle school student with attention deficit hyperactivity disorder who also experienced the loss of a parent from COVID-19. Specific practical suggestions are discussed on how school nurses proactively and collaboratively can assist these students whose lives were permanently changed by the life-changing event of losing a parent/caregiver from COVID-19.
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Affiliation(s)
- Susan J Macyko
- Susan J. Macyko, XXX, Conway School of Nursing, the Catholic University of America, Washington, DC.
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45
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Rosenbaum JE. Adolescents' Pro-social Behavior During the Early COVID-19 Pandemic. J Adolesc Health 2023; 72:173-174. [PMID: 36604010 PMCID: PMC9810325 DOI: 10.1016/j.jadohealth.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 01/04/2023]
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46
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Henke RM. Knowing Well, Being Well: well-being born of understanding: The COVID-19 Pandemic and Children: Implications for Future Health. Am J Health Promot 2023; 37:263-288. [PMID: 36646664 DOI: 10.1177/08901171221140641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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47
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A roadmap to equitable school mental health screening. J Sch Psychol 2023; 96:57-74. [PMID: 36641225 DOI: 10.1016/j.jsp.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/15/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022]
Abstract
Youth in the United States are experiencing mental health concerns at alarming rates. Considering the nation's legacy of racism and growing recognition of the impact of social determinants of health on educational and mental health inequities, it is imperative to re-envision how we approach mental health screening in schools to center equity. A focus on mental health screening for the sole purpose of identifying individual at-risk students ignores key contextual considerations, is ineffective in addressing health and educational inequities, and has the potential to perpetuate oppressive practices in schools. Equity-focused mental health screening requires a shift from individual- and deficit-focused approaches to systems- and holistic-focused approaches that (a) identify strengths and stressors among individuals, groups, and communities; (b) dismantle structural forms of oppression; and (c) promote positive mental health outcomes for minoritized youth. Integrating recommendations from the educational equity literature and critical school mental health frameworks, this paper identifies core considerations for equitable school mental health screening and provides guiding principles for each phase of the screening process, from screening readiness to execution to follow up. To implement these recommendations and transform school-based mental health care, schools should (a) incorporate multiple perspectives; (b) prioritize student, family, and community voices; and (c) build collaborative partnerships to co-construct a vision for equitable school mental health.
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48
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Habet V, Oliveira CR. Clinical Epidemiology of Pediatric Coronavirus Disease 2019 and its Postacute Sequelae. Semin Respir Crit Care Med 2023; 44:66-74. [PMID: 36646086 PMCID: PMC9926930 DOI: 10.1055/s-0042-1759566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected individuals of all ages across. Although children generally experience a benign illness from COVID-19, the emergence of novel variants of the virus has resulted in significant changes in the morbidity and mortality rates for this age group. Currently, COVID-19 is the eighth leading cause of pediatric deaths in the United States. In addition to acute respiratory illness, some children can develop a severe postinfectious condition known as a multisystem inflammatory syndrome in children, which can progress to rapid-onset cardiogenic shock. Recovery from COVID-19 can also be slow for some children, resulting in persistent or reoccurring symptoms for months, commonly referred to as long COVID. These postinfectious sequelae are often distressing for children and their parents, can negatively impact the quality of life, and impose a considerable burden on the health care system. In this article, we review the clinical epidemiology of pediatric COVID-19 and outline the management considerations for its acute and postacute manifestations.
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Affiliation(s)
- Victoria Habet
- Section of Critical Care, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
| | - Carlos R. Oliveira
- Section of Infectious Diseases and Global Health, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
- Section of Health Informatics, Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut
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Thornton RL, Yang TJ. Addressing population health inequities: investing in the social determinants of health for children and families to advance child health equity. Curr Opin Pediatr 2023; 35:8-13. [PMID: 36301135 PMCID: PMC9803382 DOI: 10.1097/mop.0000000000001189] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW This review provides a critical assessment of recent pediatric population health research with a specific focus on child health equity. The review addresses: the role of the healthcare sector in addressing fundamental social drivers of health, challenges within healthcare organizations in addressing health-related social needs and the social determinants of health, and the rationale for incorporating race and racism in pediatric population health research and practice. RECENT FINDINGS The coronavirus disease 2019 pandemic brought greater attention to the disparities and inequities in American health and healthcare. In response to these stark inequities, many health systems are adopting efforts and initiatives to address social needs, social determinants of health, racism, and health equity. However, empirical evaluation detailing the effectiveness of these interventions and initiatives is limited. SUMMARY While attention to identifying social needs among pediatric populations is increasing, there is limited evidence regarding the effectiveness of these interventions in producing sustained reductions in health disparities. To advance child health equity, researchers should move beyond individual behavior modification and directly examine fundamental drivers of health inequities. These drivers include government and health policies as well as societal forces such as systemic racism.
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Affiliation(s)
| | - Tracy J. Yang
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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50
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Klika JB, Merrick MT, Jones J. Child Maltreatment During the Pandemic. CHILD MALTREATMENT 2023; 28:3-6. [PMID: 36373780 DOI: 10.1177/10775595221140911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
What happened with child abuse and neglect during the pandemic? Emergency department and child welfare data suggest a decline in reports; however other sources of data suggest that risk for abuse and neglect remained high during COVID-19. In this commentary, the authors highlight the complicated, and at times contradictory, evidence as to what occurred with child abuse and neglect during the pandemic. The commentary concludes with suggestions for future research.
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Affiliation(s)
- J Bart Klika
- 141164Prevent Child Abuse America, Chicago, IL, USA
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