BACKGROUND:Patient navigation (PN), paired with the safety planning intervention (SPI), may allay mechanisms that theoretically underlie suicide among sexual and gender minorities (SGM). This paper describes (a) the iterative development of a theory-informed PN + SPI intervention (QueerCare) to prevent suicide among at-risk SGM youth and young adults and (b) a case series examining the feasibility and acceptability of study procedures, measures, and QueerCare. METHODS:Seven initial QueerCare modules and a glossary of terms were drafted. Seven participants completed the case series. Feasibility and acceptability over 3 months were examined by triangulating multi-method data. RESULTS:The study procedures and measures in the at-risk population were feasible and sensitive, provided that remote safety monitoring and parental consent waivers were in place. QueerCare was feasible, helpful, and appropriate based on satisfaction ratings and four emerging themes: matched identity care, internalized barriers, support, and flexibility valued. Two additional modules and guardian materials were created. Suicidal crisis management protocols were continuously refined. CONCLUSION:QueerCare was developed as a highly flexible modular intervention to meet the needs of SGM youth and young adults and prevent repeat suicide attempts in this population. Findings indicate study procedures, measures, and QueerCare were feasible and acceptable based on triangulated data. TRIAL REGISTRATION:This study was registered under ClinicalTrials.gov identifier NCT04757649.

Latinx men who have sex with men (MSM) are an at-risk population for new HIV diagnoses. Pre-exposure prophylaxis (PrEP) is a suite of biomedical approaches to prevent HIV infection. Latinx MSM are less likely to take PrEP compared to non-Latinx White MSM. This qualitative study identified interpersonal- and community-level barriers and facilitators of PrEP among young adult Latinx MSM. Using stratified purposeful sampling, 27 Latinx men, ages 19-29 years and living in a US-Mexico border region, completed self-report demographic surveys and participated in semi-structured in-depth interviews assessing barriers and facilitators to PrEP. Directed content analysis was used to identify both a priori and emerging themes. Most participants reported that other people, including peers, friends, partners, and health care providers were both supportive and discouraging of PrEP use. Participants' intersectional identities as members of both Latinx and LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer) communities both hindered and facilitated PrEP use. Los hombres latinx que tienen sexo con hombres (latinx HSH) son una poblacion en riesgo para nuevos diagnosticos de VIH. La profilaxis preexposicion (PrEP) es un conjunto de propuestas biomedicas para prevenir la infeccion por VIH. Los latinx HSH son menos propensos a tomar PrEP en comparacion con hombres blancos no latinx, que tiene sexo con hombres. Este estudio cualitativo identifico barreras interpersonales y comunitarias, asi como facilitadores de la PrEP entre jovenes latinx HSH. Usando un muestreo intencional estratificado, 27 hombres latinx, de 19 a 29 anos y que viven en una region fronteriza de EE. UU. y Mexico, completaron encuestas demograficas de autoinforme y participaron en entrevistas en profundidad, semiestructuradas, para evaluar las barreras y los facilitadores de PrEP. Se utilizo el analisis de contenido dirigido para identificar temas a priori y emergentes. La mayoria de los participantes informaron que otras personas, incluyendo companeros, amigos, parejas y proveedores de atencion medica, tanto apoyaban como desalentaban el uso de la PrEP. Las identidades interseccionales de los participantes como miembros de comunidades latinx y LGBTQ+ (lesbianas, gays, bisexuales, transgenero, queer) obstaculizaron y facilitaron el uso de PrEP.

In recent years, several publications and media outlets have highlighted how the skills and interests of autistic individuals may benefit organizations. However, there is scant empirical research on the topic. The present study's authors conducted a systematic review to find which potential employability skills, strengths, and interests of autistic individuals available research has highlighted. Data extraction methods identified 51 papers related to skills in this population. The skill sets autistic individuals may possess and the research behind these findings were organized, evaluated, and summarized. Based on these findings, investigators discuss implications for employment counseling and future research.

BACKGROUND: The employment rates of autistic young adults continue to be significantly lower than that of their neurotypical peers. OBJECTIVE: Researchers in this study sought to identify the barriers and facilitators associated with these individuals' transition into the workforce to better understand how educators and stakeholders can support students' post-secondary career plans. METHODS: Investigators used a classification tree analysis with a sample of 236 caregivers of autistic individuals, who completed an online survey. RESULTS: The analysis identified critical factors in predicting successful employment for respondents 21 years and under and those over 21 years old. These factors included: difficulties in the job search process, challenges with relationships at work, resources used, job maintenance, motivation to work, and the application process. CONCLUSION: These findings represent the first use of machine learning to identify pivotal points on the path to employment for autistic individuals. This information will better prepare school-based professionals and other stakeholders to support their students in attaining and maintaining employment, a critical aspect of achieving fulfillment and independence. Future research should consider the perspectives of other stakeholders, autistic individuals and employers, and apply the findings to the development of interventions.

The current case study examines the process and components of a multi-site school-wide restorative justice (SWRJ) implementation program. Using Participatory Action Research (PAR) methodology and the Outcome Logic Model (OLM), the authors describe results from a collaborative program evaluation conducted by university researchers and external specialists implementing SWRJ in five middle schools. OLM results include operational definitions and analyses of the program's implementation resources, activities, outputs, and outcomes, as well as findings surrounding gaps in practice and outcome monitoring. Key learnings from this case study included the importance of administrator buy-in, focused implementation teams, strong professional development systems, and the utility of systematic program mapping frameworks like OLMs. Identified challenges included leadership turnover in schools, overreliance on individual RJ specialists for implementation, and an imbalance of activities across the tiers. Implications and recommendations for organizational consultants, educational leaders, and school-based restorative justice scholars are discussed.

Student mental health was a growing concern globally prior to the onset of the COVID-19 pandemic. The aim of this study was to assess the impact of the pandemic and associated restrictions on the psychological wellbeing of college students. Baseline data were collected pre-pandemic in September 2019 among students attending a university in Northern Ireland and an Institute of Technology in the Republic of Ireland. Surveys were also conducted with this cohort during the pandemic, at the start of the academic years 2020 and 2021 (499 students fully completed all three waves). A follow-up survey was conducted at the end of their third year, in summer 2022 (n = 229). High levels of mental health problems were already present among students commencing college. The subsequent pandemic had a very negative impact on student’s academic experience and other aspects of life. Rates of depression (PHQ-9) increased significantly from the onset of the pandemic and remained high. Anxiety (GAD-7) initially decreased but then escalated at the end of college. The study highlights the importance of early intervention and makes recommendations for addressing the needs of students during times of stress. Additional supports may be required to deal with the long-lasting impact of the pandemic.

Purpose This paper describes a case study of a developmental program evaluation on the Autism Community Toolkit, a collaborative skills training program for parents and school professionals. The purpose of this study was to examine the influence of the training on participants’ knowledge, competence and perceived collaboration; and potential improvements to the training program. Design/methodology/approach The program included multiple training sessions for families and school professionals, designed to educate participants on autism, evidence-based interventions and to increase home-school communication and collaboration. Data collection methods included pre- and post-measures and feedback forms. Findings Results indicated that the training program was beneficial for participants overall. Pre- and posttest measures indicated growth in knowledge and competency in autism interventions. While there were no statistically significant differences in the quantitative measure of collaboration, qualitative results suggest that participants reported increased collaboration posttraining. Practical implications Overall, the training program was effective, and the ongoing implementation assessment was conducive to continuous improvement. The authors also discuss difficulties with implementation and recommendations for future intervention implementation. Originality/value This case study provides practical information about creating, evaluating and improving a unique intervention designed to support school–home collaboration.

Abstract Background Compared with peers, young sexual and gender minorities (SGM) are at a four to seven-fold increased risk of attempting suicide. Prior epidemiological studies, mainly focusing on monomorbid inequalities and without conducting diagnostic clinical interviews, have been unable to report robust data on psychiatric comorbidities among those who attempted suicide. The purpose of this presentation is to describe the presence of current psychiatric comorbidities among SGM youth and young adults at elevated risk for repeat suicide attempts. Methods A diverse convenience sample of SGM youth and young adults with a lifetime history of suicide attempts and current suicidal ideation was recruited for an open-phase suicide prevention trial in San Diego, CA. At baseline, participants underwent a 15-module DIAMOND interview for adults or computerized K-SADS for minors, and a battery of self-report questionnaires. Results Among the 31 participants (Mage = 22 years [Range: 16, 29]; 100% sexual, 52% gender, and 61% racial/ethnic minority), 27 (87%) participants met criteria for any mood disorder, 24 (77%) for any anxiety disorder, 16 (52%) for any trauma or stress disorder, and 2 (6%) for any psychotic disorder. One (3%) participant did not meet criteria for any psychiatric diagnoses, while five (16%) met criteria for a single and 25 (81%) for multiple diagnoses. The average number of diagnoses was 3.2 (Range: 0, 7). Additionally, 20 (65%) participants met the cut-off for likely ADHD, 20 (65%) for possible borderline personality disorder, and 21 (68%) for likely body dysmorphic disorder, with 11 (35%) within the 90th percentile for reference eating disorder severity. Conclusions The degree of psychiatric comorbidities in the sample of SGM youth and young adults at elevated risk for suicide was high. Beside direct suicide risk mitigation efforts, suicide prevention programs that target young SGM with a history of attempts should screen for untreated psychiatric disorders. Key messages • LGBTQ+ youth and young adults at elevated risk for repeat suicide attempts experience a high degree of psychiatric comorbity. • Beyond suicide risk mitigation, LGBTQ+ youth suicide prevention programs should focus on untreated psychiatric comorbidities.

Body image is a critical component of an individual's sexual experiences. This makes it critical to identify demographic and sociocultural correlates of sexuality-related body image: the subjective feelings, cognitions, and evaluations related to one's body in the context of sexual experience. We examined how sexuality-related body image differed by gender, sexual orientation, race, age, and BMI. Four items assessing sexuality-related body image were completed by 11,620 U.S. adults: self-perceived sex appeal of their body, nude appearance satisfaction, and the extent to which they believed that body image positively or negatively affected their sexual enjoyment and feelings of sexual acceptability as a partner. Men reported slightly less nude appearance dissatisfaction and fewer negative effects of body image on sexual enjoyment and sexual acceptability than women, but did not differ in reported sex appeal. Poorer sexuality-related body image was reported by people with higher BMIs, not in relationships, who had sex less frequently, among White compared to Black women and men, and among gay compared to heterosexual men. Data also revealed a subgroup of respondents who reported that their body image had a positive impact on their sex lives. The findings highlight a need for interventions addressing sexuality-related body image.

Sexual minority men (SMM) remain disproportionately burdened by sexually transmitted infections. Although gay community involvement has been theorized to be protective against many negative health outcomes, research examining the association between community involvement and condomless anal sex (CAS) has yielded conflicting results. The current study, conducted between 2018–2020, examined whether the importance one places on various aspects of community involvement was associated with CAS among a sample of young adult SMM aged 18–34 years with body image concerns (N = 180). Gay community involvement was measured using the Importance of Gay Community Scale, and the results of an exploratory factor analysis indicated the presence of two factors: “social activism” and “going out/nightlife.” A zero-inflated Poisson regression was conducted to examine the association between gay “social activism,” “going out/nightlife,” and their interaction with the number of CAS partners. Upon examining a significant interaction, “social activism” had a protective effect against CAS at low levels of “going out/nightlife,” but this effect was non-significant at higher levels. These results suggest that encouraging gay community involvement through activism could be effective at reducing CAS and addressing the health disparity that exists within this population.

OBJECTIVE:To evaluate the prevalence of suicidal ideation (SI), plans and attempts, and non-suicidal self-injury (NSSI) among students with attention deficit hyperactivity disorder (ADHD). Furthermore, we explored the mediating effects of depression, anxiety, alcohol and substance use on the association between ADHD and suicidal behaviors and NSSI. METHOD:Participants were first-year undergraduate students (n = 1,829) recruited as part of the World Mental Health International College Student Initiative. Participants completed validated clinical measures online. RESULTS:The prevalence of suicide behaviors and NSSI were significantly higher among students with ADHD than those without. Mediation analyses indicated that ADHD directly and indirectly increased suicidal behaviors and NSSI. While ADHD increased suicidal behaviors and NSSI through depression, ADHD and the co-variates age and gender also had indirect effects on suicidal behaviors via substance use. CONCLUSIONS:Specific predictors of risk were identified for students with ADHD which may inform the development of more targeted mental health and suicide prevention strategies across campuses.

Objective: We examined sadness/hopelessness and suicide among racial/ethnic and sexual minority youth (SMY).Methods: 2017 Youth Risk Behavior Survey (YRBS) data on sadness/hopelessness and suicide were analyzed among White, Black, and Hispanic/Latino youth.Results: A main effect of sexual minority (SM) identity emerged for sadness/hopelessness, suicidal ideation, suicide plan, suicide attempts, and injurious attempts; SMY reported increased risk compared to their heterosexual peers. An interaction between Black race and SM identity emerged for sadness/hopelessness, suicidal ideation, and suicide plan; White SMY were at greater risk than Black SMY. A main effect of Black race on suicide attempts was found; Black youth reported increased risk of suicide attempts compared to White youth.Conclusions: Black SMY exhibited lower risk of sadness/hopelessness, suicide ideation, and suicide plans than their White SMY peers, whereas Black youth overall were more likely to report suicide attempts than their White peers.HIGHLIGHTSThere was an interaction of sexual minority identity and race (Black or White) for three outcomes.SM and Black identities were associated with higher risk for suicide attempts.Only SM identity was associated with increased risk of injurious suicide attempts.

Background Elevated levels of suicidality, ADHD, mental ill-health and substance disorders are reported among college students globally, yet few receive treatment. Some faculties and courses appear to have more at-risk students than others. The current study aimed to determine if students commencing college in different academic disciplines were at a heightened risk for psychopathology, substance use disorders and suicidal behaviour, and examined variations in help-seeking behaviour. Materials and methods The study utilised data collected from 1,829 first-year undergraduate students as part of the Student Psychological Intervention Trial (SPIT) which commenced in September 2019 across four Ulster University campuses in Northern Ireland and an Institute of Technology, in the North-West of Ireland. The SPIT study is part of the World Mental Health International College Student Initiative (WMH-ICS) which uses the WMH-CIDI to identify 12-month and lifetime disorders. Results Students from Life and Health Sciences reported the lowest rates of a range of psychological problems in the year prior to commencing college, while participants studying Arts and Humanities displayed the highest levels (e.g. depression 20.6%; social anxiety 38.8%). However, within faculty variations were found. For example, psychology students reported high rates, while nursing students reported low rates. Variations in help seeking behaviour were also revealed, with male students less likely to seek help. Conclusions Detecting specific cohorts at risk of psychological disorders and suicidality is challenging. This study revealed that some academic disciplines have more vulnerable students than others, with many reluctant to seek help for their problems. It is important for educators to be aware of such issues and for colleges to provide information and support to students at risk. Tailored interventions and prevention strategies may be beneficial to address the needs of students from different disciplines.

Some students with autism spectrum disorder and other learning differences may have superior visual acuity, increased attentional focus, and logical thinking abilities, lending to an affinity for science, technology, engineering, and mathematics (STEM) fields. At the same time, economists report that, the United States will experience a 28.2% increase in STEM-related jobs between 2014 and 2024. Although students with disabilities (SWD) can help to fill those positions, 85% of SWD graduates are either underemployed or unemployed as they enter young adulthood. Thus, there is a need to develop, evaluate, and report outcomes of STEM preparation programs specifically tailored to SWD. This mixed-methods study was designed to develop an evaluation procedure to measure a STEM school’s program for SWD and to analyze the first two years of data to help shape the evaluation process. A comprehensive evaluation model of STEM education for children with learning differences was developed and tested. Implications for practice and future research are discussed.

Effective collaboration is associated with positive outcomes for students and is a key component of equitable educational opportunities. There are challenges to effective collaboration, however, as our understanding of it differs based on the various definitions in the literature. The purpose of this systematic review is to identify the common constructs across definitions of collaboration as a means to develop a universal model that can be used in the schools. Through the development of a “building blocks” framework, we provide a common definition and identify the steps that must be taken before true collaboration can occur. This model highlights the iterative nature of the collaborative process and the importance of revisiting the foundational aspects of collaborative development. The systematic review focuses on using a common definition for research and the practice of collaboration.

Introduction Men who have sex with men (MSM) are one of the most at-risk group for contracting HIV in the USA. However, the HIV epidemic impacts some groups of MSM disproportionately. Latino MSM comprise 25.1% of new HIV infections among MSM between the ages of 13 and 29 years. The daily medication tenofovir/emtricitabine was approved by the Food and Drug Administration for pre-exposure prophylaxis (PrEP) in 2012 and has demonstrated strong efficacy in reducing HIV acquisition. Methods and analysis Through extensive formative research, this study uses a pilot randomised controlled trial design and will examine the feasibility and acceptability of a patient navigation intervention designed to address multiple barriers to improve engagement in the PrEP continuum among 60 Latino MSM between the ages of 18 and 29 years. The patient navigation intervention will be compared with usual care plus written information to evaluate the feasibility and acceptability of the intervention and study methods and the intervention’s potential in improving PrEP continuum behaviours. The results will be reviewed for preparation for a future full-scale efficacy trial. Ethics and dissemination This study was approved by the institutional review board at San Diego State University and is registered at ClinicalTrials.gov. The intervention development process, plan and the results of this study will be shared through peer-reviewed journal publications, conference presentations and healthcare system and community presentations. Registration details Registered under the National Institutes of Health’s ClinicalTrials.gov (NCT04048382) on 7 August 2019 and approved by the San Diego State University (HS-2017–0187) institutional review board. This study began on 5 August 2019 and is estimated to continue through 31 March 2021. The clinical trial is in the pre-results stage.

BACKGROUND:Many students struggle with psychological problems during their college years. These problems may be even more apparent during the COVID-19 pandemic with the accompanying restrictions and transition to an online learning environment, but few longitudinal studies have been conducted to date. The aim of this study was to compare symptoms of depression, anxiety and suicidality prior to and during the pandemic, and identify stressors. METHODS:This study was conducted among students attending Ulster University, Northern Ireland (NI) and LYIT, Republic of Ireland (ROI), as part of the World Mental Health International College Student Initiative (WMH-ICS). Data was collected from first year students in September 2019. The completed response rate was 25.22% (NI) and 41.9% (ROI) in relation to the number of first-year students registered. A follow up study was conducted in Autumn 2020, with 884 students fully completing the online survey in both years, equating to just under half of those who completed initially. RESULTS:High levels of mental health problems were found in year 1, especially in the ROI. Levels of depression increased significantly in year 2, particularly among students in NI, however, levels of anxiety decreased. No significant variations were found for suicidal behaviour. Several stressors were revealed, including increased social isolation, and worrying about loved ones. LIMITATIONS:The findings may not be generalised to other student populations. CONCLUSIONS:This study reveals variation in symptoms of depression and anxiety since the onset of the pandemic. In particular, the large increase in students with depression is of concern.

Collaboration between school staff, families, and community partners is vital for ensuring all students’ success, particularly those with disabilities. In this case study, we will discuss a community-university partnership involving a university school psychology graduate program, several local school districts, and a specialized medical facility for children with autism and related neurodevelopmental disorders. These partners came together to create the Families and Schools Partnership Program (FSPP). Facilitated by School Psychology faculty and graduate students, FSPP offers support to families and schools through a cohesive multidisciplinary approach to intervention. In this study, we examined the experiences of 700 families referred to the FSPP consultation team and evaluated the reasons for referral, levels of intervention required by each family, and case outcomes. As a result, we offer a series of steps and tips for developing collaborative interagency relationships, an outline of the consultation framework and processes developed, and lessons learned throughout implementation.

Intimate partner violence (IPV) has been associated with increased prevalence of eating disorders. In men, disordered eating is often related to the muscularized ideal. Sexual minority men (SMM; e.g., gay, bisexual, etc.) are at higher risk for eating disorders and Latino SMM may be at particularly high risk; however, IPV and eating pathology has yet to be examined in this population. Therefore, the aim of this study is to elucidate the association between IPV and muscularity-related dissatisfaction and muscularity-oriented behavior in Latino SMM. Participants were 81 Latino SMM. Thirty participants (37% of the sample) met the cutoff score for experiencing IPV in the past month. In bivariate analyses, IPV was associated with muscularity-oriented behavior, but not muscularity-related dissatisfaction. In multivariable analyses, IPV was negatively associated with muscularity-related dissatisfaction with a small effect size and positively associated with muscularity-oriented behavior with a large effect size. It may be that SMM engage in muscle building behavior to increase self-esteem, regulate affect, or better physically protect themselves from their abusive partner. Future research should investigate motivation for muscle building behavior in individuals experiencing IPV.

The increase in psychological disorders and suicidal behaviour in students is a reason for growing concern. Some may start university with pre-existing problems, while others develop problems during this time. It is important to evaluate mental health and wellbeing early, identifying those at risk. The aim of this study was to compare mental health problems and help-seeking behaviour between students in Northern Ireland (NI) and the Republic of Ireland (ROI). Whilst geographically proximate, the institutions span a cross-border region with distinct education and healthcare systems. First-year undergraduate students (n = 1828) were recruited in September 2019 as part of the World Mental Health International College Student Initiative. Suicidal behaviour, mental health and substance disorders were investigated using the World Mental Health- Composite International Diagnostic Interview. Prevalence of disorders was high, with more ROI students experiencing problems than NI students. Students were significantly more likely to experience mental health problems if they were female (p<0.001), non-heterosexual (p<0.0001), and over the age of 21 (p<0.0001). These findings show that many students are starting university with high levels of psychopathology and suicidal behaviour, highlighting the importance of early intervention which may need to be tailored to different student populations.