Testicular adrenal rest tumours (TARTs) are benign intratesticular lesions occurring in males with classic congenital adrenal hyperplasia (CAH), with a prevalence ranging from 0% to 94% depending on age, disease severity and screening method. Although TARTs are non-malignant, their characteristic location can lead to compression of seminiferous tubules causing infertility. Adolescence represents a critical and particularly vulnerable window for TART development and progression. Besides ACTH chronic stimulation, which remains the main pathogenic driver, several other converging factors can contribute to suboptimal hormonal control and promote adrenal rest cell proliferation during adolescence. The aim of this minireview is to provide a comprehensive and updated overview of TARTs in the adolescent population, focusing on three key areas: prevalence across different CAH aetiologies, risk factors driving development and progression during puberty and emerging therapeutic approaches with potential impact on this complication.
BackgroundMenstrual health is a critical component of overall health. The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend routine menstrual health screening and care during pediatric visits, yet this topic remains under-addressed in clinical encounters. The study aimed to explore how a diverse group of pediatric-facing providers engage with menstrual health during the pediatric clinical encounter and to identify existing barriers and facilitators for integrating menstrual health into routine care.Materials and methodsThis qualitative research study included in-depth interviews (N = 46) with pediatric-facing providers across four geographic regions of the United States. Providers were recruited from a range of states, practice settings, urban, suburban, and rural contexts. The interviews sought to understand engagement with the topic of menstrual health within the pediatric encounter, barriers and facilitators to the conversation, and procedures and content when obtaining the menstrual history. Thematic analysis was used to analyze the interview transcripts.ResultsParticipants represented 22 states across the four major geographic regions of the United States, with an approximately even distribution across practice types. The sample consisted primarily of Medical Doctors (78%), but also included Doctors of Osteopathy, Nurse Practitioners, and Physician Assistants. Roughly half of participants practiced in urban centers, with the remainder divided between suburban and rural settings. Analysis yielded three central themes: (1) formal training and experiential learning shape provider engagement with menstrual health; (2) structural and relational factors influence the extent to which menstrual health is integrated into clinical encounters; and (3) biological, quality-of-life, and condition-specific menstrual health questions affect clinical care.ConclusionThese findings have important implications for the clinical encounter, including potential policy and practice implications to facilitate increased inclusion of attention to menstrual health in pediatric care. Integrating menstrual health questions that address both biological and quality of life issues into the clinical encounter is vital to addressing patient menstrual health holistically.
IntroductionYouth substance use preventive interventions are needed which are culturally adaptable, replicable, and designed for individuals with limited literacy. A previous trial of Global Resilience Oral Workshops (GROW), a 6-month spiritually-based character strengths/resilience training curriculum, was associated with increased hope and resilience and decreased alcohol use among Zambian youths ages 10–13. Herein, we describe feasibility, acceptability and preliminary signals of efficacy of GROW Hopes for Life-Schools (GROW-HFLS), a 12-month curriculum for older youths ages 13–17.MethodsGROW-HFLS combines a character strengths/resilience component with a substance use prevention component delivered in 36 weekly 90-min after-school sessions by trained community members. Leaders use storytelling and positive psychology exercises to teach 25 character strengths and 12 practices for preventing/overcoming unhealthy substance use. Cultural adaptation was accomplished through iterative consultation with cultural informants, local branding, and integrating community members as interventionists. Feasibility/acceptability were assessed using attendance and retention rates. Efficacy measures were changes in character strengths/virtues (CSV), substance use, risky sexual behaviors, and school attendance/performance, assessed using a multi-site, cluster-randomized, wait-list minimal intervention control design. Eighth-grade students from eight urban and rural secondary schools were cluster-randomized to waitlist control (WLC, n = 226) or intervention (INT, n = 234) arms. CSVs, substance use, and sexual behaviors were assessed using computerized audio-assisted self-report questionnaires at baseline, 6-months and 12-months. School records on student attendance and performance were collected pre- and post-intervention.ResultsMedian GROW-HFLS attendance was high (34/36 classes) with little decline over time. After 12 months, INT vs. WLC participants demonstrated significantly greater increases in school attendance and performance and in measures of hope, self-regulation, resilience, and perceived self-efficacy to refuse offers of alcohol. After 12-months, past 6-month alcohol use rates were low (3.7% INT, 5.6% WLC) with adjusted relative risk ratios [95% CI] for alcohol use, other substance use, and any sexual partners of 0.57(0.16–2.12), 0.45(0.12–1.69), and 0.43(0.13–1.43), respectively.ConclusionGROW-HFLS shows promise as a feasible, acceptable positive youth development program associated with improved school functioning and increases in multiple character strengths. Efficacy for substance use and risky sexual behaviors require further study. Training community members as group leaders offers a promising scalable prevention model.
Congenital adrenal hyperplasia (CAH) secondary to 21-hydroxylase deficiency is the commonest inherited cause of primary adrenal insufficiency. Adolescents living with CAH have unique challenges extending beyond hormonal control. This review summarises the diagnostic, therapeutic and psychosocial challenges facing adolescents living with CAH.Diagnostic challengesDuring puberty, diagnosing causes of hyperandrogenism may be complicated by activation of the hypothalamic-pituitary-gonadal axis, and distinguishing the other causes of hyperandrogenism is required.Therapeutic challengesManagement of CAH requires a careful balance between suppressing adrenal androgen excess and avoiding glucocorticoid overtreatment, while preserving growth, fertility, bone, cardiovascular and metabolic health. Individualised treatment regimens are required with optimal doses guided by clinical response and biomarkers. During puberty, changes in cortisol metabolism and clearance, insulin resistance and androgen synthesis may complicate disease control, underlining the importance of frequent clinical review and dose adjustments. Novel therapeutic options are becoming available. Addressing the impact of prior childhood feminising genitoplasty on the adolescent girl living with CAH is essential.Psychosocial challengesAlthough overall health-related quality of life may be preserved, impairments in emotional, social and school functioning have been reported. Treatment burden, body image concerns, fertility-related anxiety, disclosure challenges and stigma may contribute to adverse lived experience and increased psychiatric morbidity. Transition and support towards self-management is a central part of adolescent care. Poor transition planning may worsen adherence, increase disease burden and further compromise psychosocial wellbeing. Recognition by clinicians of these diverse management challenges is important to direct multidisciplinary patient-centred care to optimise outcomes.
Congenital adrenal hyperplasia (CAH) comprises a group of autosomal recessive disorders requiring lifelong glucocorticoid (GC) therapy. Skeletal health remains incompletely characterized, particularly during adolescence. The pubertal transition represents a critical window for peak bone mass acquisition, during which chronic GC exposure, altered pubertal timing and abnormal sex steroid exposure may exert lasting effects on bone density, and quality. This mini-review examines current evidence on bone health in adolescents with CAH, focusing on the complex interplay among GC therapy, alterations in androgen levels and pubertal maturation. Most available data derive from patients with 21-hydroxylase deficiency and reveal heterogeneous bone mineral density outcomes, largely influenced by cumulative GC exposure, bone age advancement and body composition. Notably, studies adjusting bone density for age demonstrate impaired bone accrual masked by accelerated skeletal maturation. Emerging longitudinal data suggest that puberty does not fully compensate for early skeletal deficits and that divergence from reference populations may progress. Evidence regarding rarer CAH forms remains scarce. In 11β-hydroxylase deficiency, pronounced androgen excess is associated with advanced bone maturation, yet data on bone density and fracture risk are lacking. Conversely, 17α-hydroxylase/17,20-lyase deficiency is characterized by profound sex steroid deficiency, delayed puberty and distinct alterations in bone microarchitecture. Overall, adolescents with CAH are at risk of suboptimal peak bone mass acquisition. Optimizing skeletal outcomes requires individualized GC replacement, careful monitoring of pubertal progression and bone age-adjusted assessment of bone density. Longitudinal, phenotype-specific studies incorporating advanced imaging are needed to better define fracture risk and guide evidence-based management across the lifespan.
BackgroundDespite the recent surge in cohort studies examining the long-term effects of physical activity (PA) during adolescence on health in adulthood, no recent literature review summarizes this relationship. We systematically reviewed the literature on the associations between PA in adolescence and health markers in early adulthood, including PA, physical health, mental health, quality of life, and general health.Main bodyWe searched the AMED, Medline, CINAHL, APA PsycINFO and Embase databases with a combination of keywords representing five concepts: PA, adolescence, health status, early adulthood, and longitudinal. We considered only articles in English or French, included participants aged 12–29 years, and measured the association between adolescent PA and young adults' health. Of the 5,188 articles identified, we retained 44. Sixteen of the 18 studies that assessed the association between PA levels or participation over time, from adolescence to early adulthood, supported a low-to-moderate positive association. In 17 studies examining physical health as an outcome, 11 found a positive relationship, and 6 found no association. The results of 16 out of 18 studies using mental health outcomes suggest that PA in adolescence is beneficial to mental health in early adulthood. Only three studies have examined adolescent PA and quality of life in early adulthood, with two reporting positive associations. In all five studies that assessed this relationship, more PA in adolescence was associated with better general health in early adulthood.ConclusionsThis review highlights that PA during adolescence is associated with improved health outcomes in early adulthood.
BackgroundYouth Opioid Recovery Support (YORS) is a multi-component behavioral treatment approach for youth with opioid use disorder (OUD) with known efficacy on adherence to injectable medications for OUD (MOUD) in young adults. YORS has not been tested in adolescents or youth on sublingual buprenorphine, the most common medication choice among youth. Indicators of recovery capital (RC) are also underexplored outcomes, as previous research has focused on MOUD adherence and opioid use metrics.MethodsAdolescents (N = 11) aged 13–17 seeking treatment for OUD were recruited from inpatient or outpatient addiction treatment, and designated family members were recruited as treatment significant others (TSOs, N = 10), for a 16-week uncontrolled feasibility pilot trial that adapted YORS for adolescents. The primary outcome was self-reported days of MOUD adherence, and secondary outcomes included opioid abstinence, days of opioid use, feasibility and acceptability of the intervention, and change in RC indicators. Seven adolescents and five TSOs were retained to complete measures for acceptability and recovery capital variables.ResultsParticipants reported MOUD adherence for 70.3% of days in the intervention and opioid use for 4.8% of days with available data. All YORS components were implemented successfully, with variable uptake, and participants averaged high ratings of satisfaction. Pre/post-intervention preliminary signals of RC were examined and showed positive change over time in the subset of retained participants.ConclusionsOur findings suggest that YORS is an appropriate treatment approach for adolescents with OUD and their families, with promising preliminary results that should be further explored in randomized studies with larger samples.
IntroductionCannabis is the most widely used illicit drug among young people and is frequently associated with mental health problems. Emotion regulation, the ability to monitor, evaluate, and modulate emotional responses, has been proposed as a mechanism linking cannabis use with psychopathology, but evidence remains inconsistent.ObjectivesThis review systematically examined studies investigating the association between cannabis use and self-reported emotion regulation in adolescents and young adults using validated self-report measures.MethodsThe review was registered with PROSPERO (CRD42024562206) and funded by the Health Research Board. Six electronic databases were searched to June 2025. Eligible studies included participants aged 12–30 years, included a comparison group of non-users or infrequent users, and reported at least one validated measure of emotion regulation (Emotion Regulation Questionnaire, Difficulties in Emotion Regulation Scale, or Cognitive Emotion Regulation Questionnaire). Risk of bias was assessed using the ROBINS-E tool, and findings were narratively synthesised.ResultsOnly four cross-sectional studies (N = 3,801) met inclusion criteria. Cannabis use was associated with greater emotion regulation difficulties, although results were limited and heterogeneous, with one paper contributing largely to the overall sample size. The most consistent domains implicated were impulse control, goal-directed behaviour, and non-acceptance of emotions, with one study identifying effects limited to females.DiscussionPreliminary evidence, whilst limited, suggests that cannabis use during adolescence and early adulthood is associated with specific emotion regulation difficulties rather than global dysregulation. However, given the limited sample of eligible studies, results should be observed with caution. Longitudinal and neurocognitive studies are needed to clarify causal mechanisms and inform prevention and intervention efforts.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024562206, PROSPERO CRD42024562206.
IntroductionIncreased cannabis use in young adults may influence brain health and neurodevelopment. In the context of chronic HIV-associated neuroinflammation, however, mild cannabis use may attenuate negative outcomes through anti-inflammatory effects. More frequent cannabis use may remain deleterious to both young adults with HIV (YWH) and without HIV (YWoH). We explored cross-sectional associations between cannabis use frequency and cognitive performance in YWH and YWoH.MethodParticipants aged 18–24 included 38 YWH and 61 YWoH (32% White) who completed cognitive tests of verbal memory, processing speed, working memory, executive functions, and overall fluid cognition. Timeline follow-back interviews assessed days of cannabis use (past 30, 180 and 365 days). Primary analyses focused on 30-day use, categorized as: no use, mild/moderate (1–<5 days used/week) and heavy (≥5 days used/week). Generalized estimating equations modeled associations of HIV, cannabis use category, and their interaction with cognitive outcomes; trend analyses used cannabis frequency as a continuous variable. Due to group differences in proportion of females, sex differences could not be addressed.ResultsYWH had worse performance than YWoH in fluid cognition, memory, processing speed, and executive functioning. Adjusting for HIV status, heavy 30-day use, vs. no use, was associated with worse performance on fluid cognition, immediate and delayed word list recall, processing speed and executive functions. Relative to mild/moderate use, heavy use was associated with worse immediate and delayed story recall and executive functions. Results were similar for 180- and 365-day use. Interactions between HIV status and 30-day cannabis use category were not significant, although exploratory analyses employing cannabis use as a continuous measure suggested a linear relationship for YWoH of greater use with worse cognitive performance, while for YWH, non-linear relationships suggested better performance with mild/moderate use on some memory and executive functioning measures.ConclusionsThese results suggest ongoing heavy cannabis use is associated with worse cognitive performance among young adults. For YWH, however, mild to moderate levels of cannabis use may have a protective effect possibly through altering chronic neuroinflammation, although causality cannot be determined in this cross-sectional study. Understanding differential, population-specific effects of cannabis use frequency may be important in setting use guidelines.
IntroductionThis study aimed to analyze the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on the plasma concentrations of brain-derived neurotrophic factor (BDNF) and executive function in physically inactive adolescents with overweight and obesity.MethodsFiftythree participants (14.01 ± 2.09 years, 27 girls and 26 boys) were allocated to a HIIT program (n = 15), MICT (n = 14) or a control group (CG; n = 24). Exercise sessions were conducted on stationary bikes three times a week for 12 weeks. The MICT session lasted 60 min and the HIIT session lasted approximately 35 min. The variables included plasma BDNF concentrations and measures of executive function, specifically cognitive flexibility and inhibitory control, assessed using the Trial-Making Test and Stroop Test.ResultsThere was a significant increase in BDNF level for HIIT (Δ = 70.43 pg/mL, p = 0.003), but not for MICT (Δ = 21.17 pg/mL, p = 0.391) and CG (Δ = −3.09 pg/mL, p = 0.865). Thus, we observed a significant improvement in cognitive flexibility for HIIT group (Δ = −59.62″, p < 0.001), but not in the MICT (Δ = −9.32″; p = 0.806) and CG (Δ = 3.15″; p = 0.834). For inhibitory control, there was a significant improvement in both HIIT (Δ = −39.88″, p < 0.001) and MICT (Δ = −31.55″, p = 0.001).ConclusionIn conclusion, both MICT and HIIT programs can benefit the cognitive function in physical inactive adolescents with overweight and obesity. We observed a significant increase in BDNF only in HIIT training,while MICT did not show significant changes compared to the CG.
Introduction:Adolescence is a period notable for increased risk-taking behaviors, including substance use (SU). Longitudinal work has linked behavioral disinhibition, particularly impulsive dispositions and externalizing tendencies with SU, but the underlying neurobiological manifestations remain less well-defined. This study examined whether individual differences in reward-related striatal activity and impulsivity predicted mental health (externalizing symptoms) and SU outcomes (cannabis, nicotine, alcohol) over a year later. Methods:Adolescents (n = 140; M age = 14.9 years) from a larger longitudinal cohort completed a Monetary Incentive Delay (MID) fMRI task at baseline along with a measure of self-reported impulsivity. At follow-up, they reported externalizing symptoms and days of cannabis, e-cigarette, and alcohol use. Task behavior [response times [RTs], hit rates [HRs]] and striatal responses to anticipatory gain cues were extracted. Serial mediation models tested whether impulsivity and externalizing mediated an association between striatal activity and subsequent SU. Results:Behaviorally, gain cues elicited faster target-related RTs and higher HRs (vs. loss or neutral trials), and performance scaled with incentive magnitude. Gain (vs. neutral) cues elicited greater bilateral caudate activity where more left caudate activity correlated with faster RTs and lower impulsivity. Serial mediation revealed that less left striatal activity during reward anticipation linked with higher impulsivity, which predicted more subsequent externalizing symptoms that, in turn, linked with more cannabis [indirect effect = -0.01, 95%CI (-0.04, -0.001)] and e-cigarette use days [indirect effect = -0.02, 95% CI (-0.05, -0.004)]. No indirect or direct effects emerged for alcohol use. Conclusions:These findings suggest blunted striatal activity may reflect reduced motivational drive for lower-intensity rewards (e.g., fictitious MID monetary gains), which contribute to SU vulnerability via heightened behavioral disinhibition in pursuit of higher-intensity stimulation. Intervention strategies that upregulate everyday reward value and strengthen self-regulation may offer utility in reducing teen SU.
IntroductionRegular cannabis use is associated with attenuated neural reward signaling, primarily measured through monetary or drug-cue tasks. Yet, minimal research has studied functional positive face processing in inhibitory control contexts, particularly amongst cannabis-using adolescent and young adults. The present study seeks to investigate functional response differences in whole-brain and ventral striatal activation, and ventral striatal functional context-dependent connectivity during positive (i.e., happy) face conditions during an emotional Go/No-go task in abstinent regular cannabis-using adolescent and young adults compared to controls.MethodsParticipants (age 16-26; cannabis-using=35; control=33) underwent at least two-weeks of monitored abstinence before completing an emotional Go/No-go fMRI task. Whole-brain analyses examined blood-oxygen-level-dependent (BOLD) differences for positive (minus neutral) face conditions between groups. Bilateral ventral striatal activity was investigated in region-of-interest and task-dependent functional connectivity analysis.ResultsCannabis-using participants displayed increased left middle cingulum and decreased left supplemental motor area BOLD response during positive Go conditions. Decreased BOLD response was seen in left superior frontal region during positive No-go for cannabis-using participants. Ventral striatum activity was increased during Go and decreased during No-go conditions for cannabis-using group, with null connectivity findings.DiscussionClusters of aberrant functional response within cannabis-using adolescents and young adults aligns with previous, but sparse, literature on positive face engagement and inhibition. Here, we demonstrate variable ventral striatum activity consistent with reward-eliciting BOLD investigations—representing importance of reward-related affective investigations—yet no connectivity differences in this sample. These findings may represent a risk for or consequence of cannabis use, as differences are still notable after two-weeks of abstinence.
IntroductionGerm Cell Tumors (GCT) are the second most common malignancy in adolescence. Extracranial malignant GCT (eGCT) are much more common among adolescents, representing approximately 15% of cancer diagnoses in this age group. Treatment for these tumors involves surgery, chemotherapy, and radiotherapy. Total tumor resection is a primary prognostic factor. The most common treatment regimen consists of bleomycin, etoposide, and cisplatin. In Latin America, data are scarce. Some reports show that the most frequent age of presentation is in adolescents aged 15–19 years.Material and methodsA retrospective study was conducted from January 2014 to December 2024, accepting 60 newly diagnosed patients with malignant eGCT at a tertiary care hospital in Mexico. The chemotherapy regimens used were CISCA II and BEP. We performed descriptive statistics, as well as Kaplan–Meier survival analysis.ResultsThe mean patient age was 10.5 + 4.5 years. The adolescent group was the most significant (48.3% of the total of all patients). The most common histology was mixed tumor in 35% of patients. The most frequent primary site was the gonadal region in 95% of patients; 53.3% of patients presented in advanced stages III and IV. The overall survival rate was 94.9%, and the relapse-free survival rate was 88.5%. Three deaths were recorded in 10 years. Five patients with hypoacusis were recorded, and in one case, a decrease in the LVEF was observed, with no change in functional class.ConclusionsIn conclusion eGCT are highly curable diseases. In this series of cases, good long-term results were observed.
Heuristic models of adolescent development posit that differences in the maturational trajectories of reward vs. executive control systems influence propensities toward adolescent risk-taking, including alcohol use engagement. However, most studies measure reward and control processes in isolation and do not consider their joint influences on outcomes of interest through the course of adolescent development. This theoretical review summarizes recent additive, interaction-based, and within-person models that have investigated the joint contributions of reward and executive control systems to adolescent alcohol use patterns. Importantly, based on theoretical and methodological grounds, longitudinal within-person assessments appear to provide the most valid assessment of the developmental imbalance between reward and executive control systems and its impacts on risk-taking behaviors. Findings indicate that developmental trajectories, in conjunction with individual variations in the extent and developmental change of imbalances, are associated with adolescent alcohol involvement. The literature is characterized by various limitations, including heterogeneity in construct conceptualization, measurement of predictors and outcomes, and age range of participants, which complicates interpretation. Moreover, there are numerous methodological constraints of additive and interaction models in the measurement of reward-control differences. Future research that carefully considers study design, construct measurement, and modeling approaches is needed. It is recommended that these studies use within-person designs to quantify developmental imbalances and their associations with concurrent and prospective alcohol use patterns and that special effort be given to teasing apart the influences of developmental vs. individual difference factors.
Recovery capital is important to substance use recovery among general populations and among college students in recovery. Demographic factors and various psychosocial variables have been associated with recovery capital in studies including adults in the general population. However, recovery capital has received limited research attention in the context of collegiate recovery, and there has been little empirical evaluation of factors that might be linked with recovery capital among college students. As more collegiate recovery programs are developed to support students in recovery, these programs should implement features to augment students’ recovery capital. We conducted a needs assessment on a campus with a newly developing collegiate recovery program. Students in recovery (n = 86) were asked to complete the 28-item Multidimensional Inventory of Recovery Capital (MIRC). They were also asked about sociodemographic and recovery-related factors including length of time in recovery, recovery pathway, perceived discrimination, mental health challenges, quality of relationships, and financial well-being. A multiple regression analysis was conducted to assess relationships between these variables and recovery capital. Students reported a moderate level of recovery capital (M = 82.55, SD = 13.64). Students who reported fewer mental health challenges in the past 30 days (β = −.25, t = −2.79, p = .006), better quality of relationships in the past week (β = .27, t = 3.41, p = .001), and greater financial well-being (β = .38, t = 4.69, p < .001) had greater recovery capital. Sociodemographic variables, recovery length, recovery pathway, and perceived discrimination were not associated with recovery capital. To our knowledge, this is the first study to identify associations between recovery capital as measured by the MIRC and various sociodemographic and recovery-related factors among a sample of college students in recovery. As such, this study extends previous work with updated knowledge of how students can be supported in their efforts to increase recovery capital. Future research can build on this study by utilizing the MIRC on various types of campuses and by assessing recovery capital among college students longitudinally.
BackgroundAdolescents recovering from substance use face developmentally specific challenges requiring tailored supports. Recovery capital (RC), defined as internal and external resources sustaining recovery, offers a framework to address these needs. Guided by the Recovery Capital for Adolescents Model (RCAM), this study explored how adolescents and caregivers experienced RC and investigated perceptions of the Recovery Clubhouse as a context for building and sustaining these resources.MethodsMatched semi-structured interviews were conducted with seven adolescent–caregiver pairs. Adolescents aged 16–18 participated, using guides tailored to age and role. Caregivers completed interviews in either English or Spanish. Interviews were thematically analyzed using RCAM as the guiding framework.ResultsAdolescents and caregivers identified multiple internal and external resources as essential to recovery, often framed in relation to Recovery Clubhouse involvement. Within community recovery capital (CRC), both groups emphasized the value of enjoyable, substance-free activities and creative expression offered through the Clubhouse. In human recovery capital (HRC), adolescents described how intrinsic motivation developed over time, replacing initial external pressures such as court mandates or parental requirements, and noted that Clubhouse participation supported this process. Financial recovery capital (FRC) was also influential: caregivers valued Clubhouse-provided resources for easing financial strain, while adolescents saw employment as a motivator and pathway to independence and long-term goals. Social recovery capital (SRC) revealed the most divergence: adolescents emphasized relationships with Clubhouse staff and friendships outside the program, including peers who used substances. Caregivers viewed these external friendships as risks and instead highlighted the protective role of the Clubhouse's peer network. Interconnections across RC domains were evident, with gains in one area reinforcing others (e.g., CRC participation supporting HRC via coping skills). Additional themes included the importance of family involvement and language-accessible services.DiscussionThe RCAM framework provided a comprehensive lens for understanding recovery resources perceived as valuable by adolescents and caregivers. Findings suggest recovery supports should be developmentally tailored, incorporating engaging activities, opportunities for economic empowerment, staff relationships, and culturally responsive family programming. Recovery Clubhouses were perceived not only as access points for these resources, but also as environments where RC was built and sustained.
IntroductionObesity in childhood and adolescence continues to be a major public health challenge. Mindfulness-based interventions (MBIs) can be great adjuvants to multidisciplinary weight management interventions for adolescents. Delivery of MBI via mobile phones can decrease barriers to engagement. Mindfulness increases present-moment awareness, which may promote self-regulation, which is in turn important for weight management. Several studies have shown that delivering mindfulness training for adolescents via mobile devices may be feasible and acceptable, but this is still a growing area of research. The Unified Theory of Acceptance and Use of Technology (UTAUT) is a framework that has been used to understand why individuals choose to use health apps. This study aims to gather adolescent perceptions about an existing mindful eating mobile app designed for adults, via mixed methods research, and to utilize their feedback to design and develop a mindful eating app for adolescents.MethodsThis was a cross-sectional, mixed methods study. Twenty-five adolescents, 13–17 years old, with a BMI ≥ 85th percentile completed a UTAUT-based survey and a semi-structured interview after viewing excerpts from an existing mindful eating mobile app.ResultsAdolescents with overweight/obesity are receptive to using a mindful eating app, with some concerns about Effort Expectancy and Self-Efficacy. Youth endorse that such an app should have reminders, short and colorful videos with captions, and it should be engaging, relatable, and non-judgmental. This information was used to develop a mindful-eating web-based app for adolescents, SAMBA (Study of an Adolescent Mindfulness-Based App).ConclusionsWe developed a mindful eating web-based app for adolescents utilizing feedback from this youth cohort using an existing mobile app as the starting point. Future directions include pilot testing the app and its content.
