BACKGROUND:The objectives were to 1) Examine the prevalence of mental health diagnoses, symptom severity and flourishing among children aged 6-17, 2) Examine the prevalence of household and community-based adverse childhood experiences (ACEs) and positive childhood experiences (PCEs), 3) Examine the relationship between ACEs, mental health diagnosis and symptom severity, and 4) Investigate how PCEs moderate the relationship between ACEs and mental health diagnoses. METHODS:We utilized the cross-sectional, 2021-2022 combined National Survey of Children's Health (NSCH) data. Caregiver responses for persons aged 6-17 years were included (N = 60,809). Logistic regression and moderation models were tested to assess relationships between ACEs, PCEs and different mental health diagnoses. RESULTS:Having 1+ ACE was associated with higher odds of anxiety (OR: 2.23), depression (OR: 2.67), ADHD (OR: 1.31), and behavior/conduct problems (OR: 1.84). In contrast, high PCEs were linked to lower odds of anxiety (OR: 0.67), depression (OR: 0.73), ADHD (OR: 0.87), and behavior/conduct problems (OR: 0.50). Community-based ACEs had a greater impact on mental health diagnoses than household-based ACEs. PCEs moderated the association between ACEs and mental health, attenuating dose-response relationships in all models. DISCUSSION:Our study provided more insight into the importance of examining how PCEs influence the relationship between ACEs and mental health diagnoses with the consideration of diagnosis severity. This can help to inform researchers and providers on how to develop and improve mental and behavioral health treatment interventions that are tailored to children and adolescents.

Declining adolescent mental health is a significant public health concern during the COVID-19 pandemic. Social distancing and stay-at-home orders have led to missed social connections with peers and adults outside households, and this has increased the risk of mental health problems in children and adolescents, particularly those with adverse childhood experiences (ACEs). Studies have shown that strong interpersonal support improves adolescent mental health. We examined the association between ACEs and poor mental health (including stress, anxiety, and depression) and how the presence of interpersonal support from caring adults and friends and school connectedness can mitigate this relationship among adolescents in Arizona. This study analyzed data from the 2021 Arizona Youth Risk Behavior Survey (YRBS; n = 1181), a population-based survey conducted biennially across the United States. The Arizona sample included high school students in grades 9–12 who were enrolled in public and charter schools. This study revealed that nearly three of four adolescents experienced an ACE, and one of five experienced ≥4 ACEs. Compared with adolescents who experienced zero ACEs, those with ≥4 ACEs experienced less interpersonal support from caring adults, friends, and school and more frequently reported poor mental health and suicidal thoughts. However, adolescents with interpersonal support consistently reported lower rates of mental health issues, even with exposure to multiple ACEs. Post-pandemic programs to improve social relationships with adults, peers, and schools are critical, especially for adolescents with multiple adversities.

PURPOSE:Mobile health (mHealth) technology has increased dramatically in the wake of the pandemic. Less research has focused on people with mobility impairing (PMI) disabilities. This study determined the prevalence of mHealth use among PMI adults during the COVID-19 escalation and examines demographic, health and COVID-19 concerns correlates. METHODS:PMI adults (N = 304) completed an online survey investigating mHealth use and COVID-19 concerns related to food access in June of 2020. Smartphone and mHealth use were measured with an adapted version of the survey used in the Pew Internet & American Life project. Descriptive and multivariable analyses were conducted to determine associations of demographics, health status, and COVID-19 concerns with mHealth use. About two-thirds (N = 201) of the sample were mHealth users (owned a smartphone and engaged in health-promoting behaviors with the smartphone; e.g., sought online information, tracked health behaviors, used patient portals). RESULTS:Having hypertension was associated with higher mHealth use, and having higher COVID-19 concerns about food access was associated with higher mHealth use. Those who used mHealth were also more engaged with smartphone apps for communication, services, and entertainment. Only the association between educational attainment and mHealth use remained significant after adjusting for other covariates in multivariable logistic regression models. DISCUSSION:PMIs continue to need support in the use of mHealth technology to help maximize access to potentially important tools for rehabilitation and health management. There is a need to continue to investigate mHealth and its applications for people with disabilities.Implications for RehabilitationMany people with mobility impairing disabilities may be missing opportunities for mHealth rehabilitation and healthcare.COVID-19 has widened existing gaps in access and use of mHealth technology among people with mobility impairing disabilities.Focused education is needed to help people with disabilities exploit the full range of services of their smartphones to increase access to care, social connectivity, and other important goods and services to enhance rehabilitation and health management.

Physical activity and nutrition preschool programming must involve parents in positive long-term healthy habits. This paper describes parent outreach in the Sustainability via Active Garden Education (SAGE) study. Newsletters were sent home with children to promote family opportunities to increase physical activity and fruit and vegetable intake. The content was generated via a community advisory board participatory process. Messages linked SAGE curriculum topics with home and community activities. Parents rated frequency of receipt, helpfulness, satisfaction, and use of content. Most participants were Hispanic (>78%) and women (>95%). Most reported receiving newsletters; nearly all reported that they were helpful. Favorite newsletter components included recipes, pictures of their children and seasonal produce spotlights. Most reported doing physical activities from the newsletters (51.9%). Few reported doing featured physical activity (8.9%) and fruit and vegetable (12.7%) community activities. Newsletter outreach methods are a simple strategy to add value to preschool-based interventions promoting healthy families.

Background Early Care and Education (ECE) sites are critical hubs for social, emotional, and physical learning development of preschool children (ages 3–5). The COVID-19 pandemic has impacted ECE enrollment and participation; until June 2022, preschool children in the US were ineligible for COVID-19 vaccines. It is critical to identify perceptions of teachers/directors and parents to enhance safe return-to-school efforts. Methods Focus groups ( n = 7; 22 participants) were conducted with ECE teachers/directors throughout Arizona to examine perceptions of COVID-19 testing for families and staff at ECE sites, and current and possible COVID-19 mitigation strategies during Summer 2021. Preschool parents from underserved families in Phoenix ( n = 41) completed a brief survey on their perceptions of benefits of ECE for themselves and their children, thoughts on COVID-19 mitigation strategies, and timing for safe return to school during Spring 2021. Focus groups were transcribed and analyzed for themes using constant comparison. Results There were 4 focus group themes: 1) perceptions of saliva-based COVID-19 testing, 2) logistical strategies for COVID-19 testing at ECE sites; 3) successes and challenges with current COVID-19 mitigation strategies; 4) ideas to support improved COVID-19 mitigation, including outdoor gardening. Parents rated peace of mind about the child’s education as the most important benefit for themselves of in-person ECE (74.6%), and social development for children as the most important benefit for their children (54.4%). Over 40% of parents reported it would not be safe to send children back until 2022. Conclusions COVID-19 continues to impact attendance at ECE sites, despite parents reporting key benefits to attending ECE sites. Teachers/directors supported COVID-19 mitigation strategies including saliva-based testing and gardening education to improve safe return to schools.

Purpose: The purpose of this study was to qualitatively analyze meta-communication during the digital storytelling (DST) workshop process for patients undergoing hematopoietic cell transplantation ( HCT). Methods: HCT survivors who had undergone transplant within the past 2 years were recruited at a cancer center in the Phoenix Metropolitan area. Participants (M age = 51.5 years) attended a 3-day DST workshop telling and creating digital stories around their HCT experiences. Using a constructivist grounded theory approach, line by line coding and content analysis were conducted with four research team members. Results: Four themes emerged from the data: (1) communal connection; (2) expressing and processing emotions; ( 3) self-empowerment; and (4) multi-dimensional coping. Participants described telling and sharing their story with other HCT patients as therapeutic. Conclusion: DST shows promise as a potential coping tool and offers multiple dimensions of the role of narrative as a coping technique, in community building, and in patient-centered contexts within HCT.

Objective: Approximately one in ten adults under the age of 65 in the USA has a mobility impairing disability. People with mobility impairment generally have poorer dietary habits contributing to obesity and related negative health outcomes. This article presents the psychometric properties of the Food Environment Assessment Survey Tool (FEAST) instrument that measures barriers to accessing healthy food from the perspective of people with mobility impairment (PMI). Design: The current study presents cross-sectional data from two sequential independent surveys. Setting: Surveys were administered online to a national sample of PMI. Participants: Participants represented PMI living throughout the USA. The pilot FEAST survey involved 681 participants and was used to shape the final instrument; 25 % completed a retest survey. After following empirically and theoretically guided item reduction strategies, the final FEAST instrument was administered to a separate sample of 304 PMI. Results: The final twenty-seven-item FEAST instrument includes items measuring Neighbourhood Environment, Home Environment, Personal Control and Access to Support (Having Help, Food Delivery Services, Parking/Transportation). The final four scales had acceptable intra-class correlations, indicating that the scales could be used as reliable measures of the hypothesised constructs in future studies. Conclusions: The FEAST instrument is the first of its kind developed to assess the food environment from the perspective of PMI themselves. Future studies would benefit from using this measure in research and practice to help guide the development of policy aimed at improving access to healthy food and promoting healthy eating in community-dwelling PMI.

Among youth from high-achieving schools, adverse childhood experiences (ACEs) were examined in relation to (a) internalizing and externalizing symptoms in adolescence (n = 527), and (b) symptoms plus psychiatric diagnoses-based on multiple annual interviews-in adulthood (n = 316). Also examined were associations for a "Proxy ACEs" (P-ACEs) measure, containing items similar to those on standard ACEs measures without reference to abuse or neglect. Rates of ACEs were comparable with those in other studies; most commonly endorsed were perceived parental depression followed by aspects of emotional neglect. Groups exposed to zero, 1, 2, 3, and 4+ ACEs differed on symptoms in adulthood, with small to moderate effect sizes; in parallel comparisons of P-ACEs groups on Grade 12 symptoms, differences had large effect sizes. In relation to psychiatric diagnoses, comparisons with the zero ACEs group showed that groups with 1, 2, 3 ACEs, versus 4+ ACES, respectively, had twofold and over fivefold greater odds of having any lifetime diagnosis. The odds for internalizing diagnoses specifically were 2-6 times greater for individuals with 1, 2, and 3 ACEs, and 12 times greater for those reporting 4 ACEs. Remarkably, Grade 12 reports of 2, 3, and 4+ P-ACEs were linked to 2-3 times greater odds of a psychiatric disorder in adulthood, and 3-6 times greater odds for internalizing diagnoses specifically. In the future, assessments of ACEs and P-ACEs could facilitate early detection of problems among HAS students, informing interventions to mitigate vulnerability processes and promote resilience among these youth and their families. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Youth in high-achieving schools (HASs) are now declared to be an "at-risk group," largely because of strong, ongoing pressures to achieve. In this study, we sought to disentangle processes that might underlie how achievement pressures might exacerbate distress, considering five dimensions conceptually important in HAS settings: feelings of envy, comparisons with others on social media, negative feedback from others, the ability to maintain supportive friendships with peers, and overall time pressures. Also included were two potential confounds: time spent on social media and attachment to parents. Across three different HAS samples (total N = 1608), these dimensions were examined in relation to anxious-depressed, withdrawn-depressed, and somatic symptoms, and rule-breaking behaviors using multivariate analyses conducted separately by school and gender. Results revealed that associations between social comparisons and internalizing symptoms were consistent in all subgroups, with robust effect sizes throughout. Additionally, negative feedback on social media was linked with rule-breaking behavior in five out of six subgroups. Results indicated the critical value of targeting social comparisons, in particular, followed by negative feedback on social media in future interventions aimed at fostering resilient adaptation among HAS youth.

Background: Adverse childhood experiences (ACEs) are associated with a number of health problems and early mortality. Developmental studies have also shown strong links between parents' contemporaneous negative feelings toward their children and the children's maladjustment. Objectives: The relative, unique contributions of ACEs and parents' feelings of aggravation were examined in predicting to the presence of children's internalizing and externalizing problems, perseverance and emotional regulation. Also tested was the potential moderating roles of personal support and external emotional resources for parents. Participants and setting: Data from the 2016 National Survey of Children's Health were used. A random, nationally representative sample of 35,718 adult caregivers in the United States (US) with children ages 6-17 were included. Methods: Hierarchical multiple regression analyses were performed to explore the patterns of results in predicting to children's maladjustment and adjustment, separately by child sex. Results: Parental aggravation consistently had larger effects on children's maladjustment and adjustment than ACEs (1.47-1.82 timesamong males; 1.31-1.83 time among females, with one exception, i.e. internalizing problems). Personal support for parenting attenuated the relations of both ACEs and parental aggravation with children's outcomes. In the presence of external resources for parenting, children's maladjustments tended to be even more pronounced, suggesting that parents seek external resources when problem behaviors become significant in their children. Conclusion: For children at risk, future interventions should consider the value of refocusing attention from the occurrence ACEs per se, to critical, proximal indices - parents' negative feelings around parenting - that can have stronger links with children's maladjustment and that are more amenable to change.

Background: Acculturative stress is known to contribute to chronic diseases among many immigrants and yet this association in Korean Americans remains unclear. Aim: The study purpose was to examine the level of acculturative stress in Korean Americans and to determine if correlations existed with personal and physiological factors. Methods: An exploratory, cross-sectional, descriptive study was conducted in a sample of 107 Korean American adults. Data on acculturative stress and personal factors were collected using a survey questionnaire in addition to a direct measure of physiological factors (i.e., body mass index and blood pressure). Results: All 107 participants were first-generation Koreans. Most participants were women (66.4%), with a mean age of 53.9 +/- 10.7, married (88.8%), and with a college education (84.2%). Acculturative stress was associated with a number of personal factors (i.e., arrival age, years of U.S education, years of U.S. residency, English proficiency), and the personal factors of gender, age, employment status, and years of U.S. residency were associated with the physiological factors. No statistically significant associations were found between acculturative stress and physiological factors. Conclusions: The mean acculturative stress score in this study was higher than findings from prior studies of Korean immigrants in the United States or Canada, with the rates of obesity and hypertension higher than prior reports of Korean Americans or Koreans residing in Korea. Future study is necessary with a larger sample from a variety of different geographic areas of the United States to examine further the impact of acculturative stress on physiological factors during the process of acculturation.