Children In Community Research Articles

The gender gap in early language development among children from peri-urban China

In rural China, there exists a gender gap in academic achievement where girls outperform boys, suggesting similar differences in early language development. Moreover, recent research has revealed that children in peri-urban communities have worse language outcomes than children in rural communities. This study examines the impact of gender on early language development in low-SES, peri-urban Chinese communities. Data from 81 children (56.79% boys) aged 18-24 months (Mage = 21.16) living in peri-urban China were collected using two caregiver-reported tests for child language development and ability, and language environment analysis technology for measuring the home language environment. Results show that in peri-urban communities, girls were generally exposed to more adult-child conversations and showed higher counts of vocalizations than did boys; girls scored higher on language development measures than did boys. The implications of these findings on the gender gap and child development are discussed.

Low prevalence of soil transmitted helminth infection in Ugandan children hospitalized with severe malaria.

Co-infection by intestinal helminths and Plasmodium spp. may be common in endemic communities. Several studies have identified a relationship between helminth infection, Plasmodium spp. infection and malaria severity. However, the relationship is not well defined, and results are inconclusive. We analyzed 202 stool samples from a cohort of children with severe malaria enrolled in two hospitals in Uganda from 2014-2017 and asymptomatic community children from the same household or neighborhood and enrolled at the same time, all 6 months to 48 months of age. We investigated if intestinal helminth infection modified risk of severe malaria. We extracted nucleic acids from stool and tested them for six helminth species (Anyclostoma duodenale, Ascaris lumbricoides, Necator americanus, Strongyloides stercolaris, Trichuris trichiura, Shistosoma mansoni) using highly sensitive quantitative PCR. We found a low prevalence of infection by ≥1 intestinal helminth species in children with severe malaria (5.1%, n=9/177) and community control children (4.0%, n=1/25). Infection by ≥1 of the helminths assessed was not associated with severe malaria (aRR = 1.0, 95% Confidence Interval = 0.82, 1.3, p = 0.78). In 2003 Uganda instituted a national deworming program, with anti-helminth medication provided twice annually to children 6 months to 5 years of age. In these areas of Uganda, the national deworming campaign has been highly successful, as stool-based helminth infection was rare even when using highly sensitive methods of detection and was not a major contributor to risk of severe malaria.

Exploring the Path of Social Welfare Organizations' Participation in Community Children's Education --Taking Baoji's “Star Wish” Program as an Example

For a long time, children's education has been mainly focused on school education and family education, while the community, as an important place for children to live and grow up, is often neglected, resulting in the lack of community education function. Take the "Star Wish" program implemented by Baoji Sanlian Social Work Service Center (hereafter: Sanlian Social Work) as an example. We analyze and consider the effect of public welfare organizations' participation in community children's education from the implementation of the program. We need to improve the related facilities further, increase publicity, improve the relevant policy system to make it more reasonable, and increase cooperation among schools, families, and communities to form a joint effort in education.

Sustainable innovation for fermented cassava roasting: Examining the potential of parabolic dish solar collectors and thermal energy storage

Fermented cassava roasting is an energy-intensive process that is commonly used to produce gari, a popular food in Nigeria made from cassava. Traditional roasting methods use firewood as an energy source, which is inefficient and harmful to the health of those who inhale the smoke (mainly women and children in rural communities) and contributes to deforestation. This work aims to investigate a developed fermented cassava roasting system driven by a concentrated parabolic solar collector. Important data on the gari production food chain was obtained from a work-study in a rural community: temperatures and moisture content. The roasting temperatures range between 85oC - 100oC. The parabolic dish solar collector was designed and fabricated to achieve temperatures between 118oC-154oC at optimum tilt angles at Port Harcourt (4°54′ 22.86″N, 6°55′ 27.52″E) climatic conditions. The focal length ranges between 50 mm and 80 mm, and the fluctuation of the focal point position was considered for the thermal storage system design. Gravel was used as a thermal storage, and heat transfer was enhanced through small internally placed mild steel rods. The experimentally obtained average total fry/roast time per batch (40g) was 24 min, which is greater than the theoretically obtained value of 8.5 min. The fermented cassava roasting experiment was conducted for three days with favourable weather conditions, achieving a maximum temperature of 101oC. This innovation is important in addressing the health risks associated with traditional fermented cassava roasting methods and moving towards zero-emission and zero-poverty innovative systems.

Specific phobias in children with moderate to severe intellectual disabilities: SPIRIT, an adaptation and feasibility study.

There is a lack of interventions for specific phobia in children and adolescents with moderate to severe intellectual disabilities. The objectives were to: (a) develop an intervention for specific phobia, together with an intervention fidelity checklist and logic model, and evaluate candidate outcome measures, together with parents/carers and clinicians; (b) describe treatment as usual; (c) model the intervention to determine the acceptability and feasibility for all stakeholders, judge the appropriateness of outcome measures, explore recruitment pathways, and examine the feasibility and acceptability of consent and associated processes; and (d) describe factors that facilitate or challenge the intervention. Phase 1a: using consensus methods, an Intervention Development Group was established who met to develop the intervention, review candidate outcome measures and contribute to the development of the intervention fidelity checklists and logic model. Phase 1b: a national online survey was conducted with parents and professionals to describe treatment as usual. Phase 2: a single-group non-randomised feasibility study was designed to model the intervention and to test intervention feasibility and acceptability, outcome measures and aspects of the research process. Phase 2: participants were recruited from National Health Service community child learning disabilities teams and special schools in England. Treatment was delivered in the child learning disabilities teams. Children aged 5-15 years with moderate to severe learning disability and specific phobia, and their parents/carers. The SPIRIT intervention comprised two half-day workshops and eight support sessions plus treatment as usual. The feasibility and acceptability of the intervention and research processes, recruitment, outcome measure completion rates and acceptability, and intervention adherence. Parents completed all of the outcome measures, with very low rates of missing data. The recruitment of sites and participants was impacted by the COVID-19 pandemic. The intervention was successfully developed and modelled with 15 participants with moderate to severe learning disabilities and their parents. The intervention was judged to be feasible and acceptable by parents/carers and therapists. Parents/carers and therapists suggested minor intervention revisions. Randomisation was not modelled within this feasibility study, although the majority of parents and therapists indicated that this would be acceptable. The SPIRIT intervention and associated study processes were judged to be feasible and acceptable. The intervention requires minor revisions. The SPIRIT intervention should be tested further within a clinical trial. Current Controlled Trials ISRCTN34766613. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR130177) and is published in full in Health Technology Assessment; Vol. 28, No. 64. See the NIHR Funding and Awards website for further award information.

Gross hematuria and congestive heart failure – two sides of the same coin

Poststreptococcal glomerulonephritis (PSGN) is an immune-mediated disease following infection with nephritogenic strains of group A β-hemolytic Streptococcus (GAS), affecting children aged of 2 to 10. We report 2 different presentations of PSGN from “Grigore Alexandrescu” Hospital. Case 1: A 5 years old girl was admitted for gross hematuria. Investigations revealed: anemia, inflammatory syndrome, mild nitrogen retention syndrome, elevated ASO and low levels of serum C3, nephritic-range proteinuria and severe hematuria. she received antibiotic treatment with initial improvement. A relapse occurred in one week, a second course of antibiotic and corticosteroids was necessary. Case 2: A 15-year-old girl was admitted for acute cardiac failure, hypertension and oliguria. Investigations revealed anemia, nitrogen retention, dyslipidemia, inflammatory syndrome, high ASO titers, low serum C3, microscopic hematuria, nephrotic-range proteinuria. She had fluid build-up in both lungs and pericardium. The diagnosis was PSGN and congestive heart failure (volume overload). She received antibiotics, diuretics and ACE inhibitors. PSGN is re-emerging in pediatric practice due to the resurgence of streptococcal infections within children's communities. The clinical presentation might be highly variable, ranging from hematuria to heart failure. Clinicians should be aware and actively consider this diagnosis.

Improving Accessibility and Delivery of Healthcare Services to Underserved Children through Technology: A Comprehensive Approach of Literature Review

This study investigates the use of technology to improve healthcare accessibility and delivery for children in underprivileged communities through article review comprehensively. A literature review with qualitative method that involved four distinct steps. In the initial stage, the search was conducted using Google Scholar (GS) and Scopus website. The second stage was filtering, which entails selecting the journals that will be examined. The last stage was analysis the articles, this analysis uses a 4-step PRISMA process to identify 123 articles published from 2019 to 2024 in Scopus journal. The review was evaluated the efficacy of telemedicine, mobile health applications, and wearable devices in monitoring and addressing children's health, while considering genetic predispositions and underlying medical issues that influence growth patterns. The research emphasizes the importance of a comprehensive strategy in evaluating child growth and development, utilizing health data to tailor interventions. Online systems, such as mobile phones and PDAs, can support healthcare workers in underserved rural areas. The integration of technology is essential for addressing unique challenges in underserved areas and ensuring access to high-quality healthcare services for all children. Current monitoring methods include regular check-ups, growth charts, and developmental screenings, with advancements in technology providing new tools like mobile health apps and wearable devices. Involving various stakeholders in the evaluation process is crucial, with participatory research focusing on community empowerment, ownership, and capacity building. Online systems offer efficient and accessible ways to track health data but may come with privacy concerns and data breach risks. The study focuses on the effectiveness of online systems for monitoring child health indicators, discussing data collection methods, sampling strategies, and ethical considerations. Findings reveal the need to address areas such as limited social interaction and incorporate interactive activities and group projects into online curriculum. Understanding the impact of online learning on students' health and well-being is crucial for tailoring approaches to ensure comprehensive support. The research findings have significant implications for child health policy and practice, emphasizing the importance of social connection and mental well-being in online learning environments.

The Impact of Smartphone Addiction on School Adjustment in Children at Community Child Centers: The Mediating Effect of Academic Enthusiasm

The Impact of Smartphone Addiction on School Adjustment in Children at Community Child Centers: The Mediating Effect of Academic Enthusiasm

Community Interaction, Influence, and Child Maltreatment: Variations by Rural and Urban Residence Status

Effects of community interventions on child maltreatment are interpreted via rational deterrence theory’s assumption of instrumental rationality. However, recent contrasting findings have raised questions about the social exchange currency that regulates human behaviour within the rational deterrence framework. This study contributes to this debate by examining the social currency of influence and its role in child maltreatment prevention. We hypothesized that both individual and community wealth of influence would predict physical abuse severity. Data was obtained from 1,100 nationally representative sample of female mothers in Ghana, and associations were examined using random effects regression models. We found a negative association between physical abuse severity and individual level influence as well as community wealth of influence. Results were only significant in the rural sample. The findings suggest that interventions aiming to increase community commitment to deter and prevent child maltreatment should focus on strengthening the currency of influence in communities.

Peripheral Perfusion Index in Ugandan Children With Plasmodium falciparum Severe Malaria: Secondary Analysis of Outcomes in a 2014-2017 Cohort Study.

Continuous, noninvasive tools to monitor peripheral perfusion, such as perfusion index (PI), can detect hemodynamic abnormalities and assist in the management of critically ill children hospitalized with severe malaria. In this study of hospitalized children with severe malaria, we aimed to assess whether PI correlates with clinical markers of perfusion and to determine whether combining PI with these clinical measures improves identification of children with greater odds of mortality. Post hoc analysis of a prospective, multicenter, cohort study conducted between 2014 and 2017. Two referral hospitals in Central and Eastern Uganda. Six hundred children younger than 5 years old with severe malaria and 120 asymptomatic community children. None. PI was measured at 6-hour intervals for the first 24 hours of hospitalization. We compared PI to standard clinical perfusion measures such as capillary refill time, presence of cold peripheral limbs, or temperature gradient. Admission PI was highly correlated with clinical measures of perfusion. Admission PI was lower in children with severe malaria compared with asymptomatic community children; and, among the children with severe malaria, PI was lower in those with clinical features of poor perfusion or complications of severe malaria, such as shock and hyperlactatemia (all p < 0.02). Among children with severe malaria, lower admission PI was associated with greater odds of mortality after adjustment for age, sex, and severe malaria criteria (adjusted odds ratio, 2.4 for each log decrease in PI [95% CI, 1.0-5.9]; p = 0.045). Diagnostically, the presence of two consecutive low PI measures (< 1%) predicted mortality, with a sensitivity of 50% and a specificity of 76%. In severe malaria, PI correlates with clinical complications (including shock and elevated serum lactate) and may be useful as an objective, continuous explanatory variable associated with greater odds of later in-hospital mortality.

Peran Bank Sampah Dalam Meningkatkan Pendapatan Masyarakat Belawan

Waste banks are blessed with processing. This processing has the aim of making waste into products that can be sold and gain economic value. Yayasan gugah nurani indonesia is a non-governmental humanitarian organization that works in accordance with the pillars of the SDGS (Sustainable Development Goals), especially in areas related to children's rights and community empowerment. Gugah nurani indonesia is a legal foundation under the decree of the minister of law and human rights number: ahu-594.ah.01.04. On February 24, 2009. Gugah nurani indonesia is an incorporated foundation under the decree of the minister of law and human rights number: ahu-594.ah.01.04. On February 24, 2009. The blessing waste bank has some waste management outside the waste bank. This management is the management of organic waste which is made into compost from the results of the compost is also sold by the waste bank to consumers who need it. Based on the results of the study, it shows that customers have a major contribution to improving the waste bank economy. In this study, the results of customer activeness from the blessing waste bank related to customer activeness in the waste bank are very good. Educating the community by providing knowledge related to waste and providing training. Providing guidance and support to customers by facilitating customers so that customers can become independent and able to create their own creativity.

“Awe, Masekinders!”: Kullid Identities from Eden Park, Johannesburg in the Work of Bougaard

ABSTRACT Bougaard, an emerging South African creative practitioner, examines games from her “Coloured” childhood community in Eden Park, Johannesburg, and how these games may offer a window into a reframed Kullid identity. She considers the rhymes used in these games and the role of language—specifically Afrikaaps—in identity formation, and explores through papermaking and art installations the social contexts and meanings embedded in these games. In this article, the authors analyse Bougaard’s use of sculpture, papermaking and printmaking techniques both to mediate and to subvert conventionalised tropes and stereotypes of “Coloured” communities as well as to empower a sense of her familial and community-based identity through an emergent Kullidness. The authors focus on selected paper works and on three mixed media installations (2021–2022). The authors complicate any reading of these works as uncritically affirmative of a declamatory and essentialist identity position by proposing Bougaard’s visual strategies as premised upon mediation, ambivalence, indexicality, and refuting iconicity. The authors identify Bougaard as deploying elements of strategic essentialism in her desire for community visibility and visual sovereignty, and the authors therefore critique the benefits and the limitations of this approach, concluding that Bougaard’s choice of mediating strategies avoids a simplistic narrative of community life.

Upaya Pencegahan Stunting Melalui Program Pemberian Makan Tambahan (PMT) di Desa Sukamulya

Stunting, a significant global health concern, is a condition where children suffer from impaired growth and development due to poor nutrition. This study evaluates the "Pemberian Makan Tambahan" (PMT) program implemented in Sukamulya Village, Indonesia, aimed at reducing stunting. The research involves collaboration between Universitas Muhammadiyah Bandung, BKKBN, and community stakeholders, focusing on providing supplementary food to children under five. The study utilized preparation implementation, monitoring, recording, and reporting. The results indicated an increase community awareness and child nutrition outcomes, emphasizing the effectiveness of targeted nutritional interventions in preventing stunting.

Children’s exposure to chemical contaminants: Demographic disparities and associations with the developing basal ganglia

Children are regularly exposed to chemical contaminants that may influence brain development. However, relatively little is known about how these contaminants impact the developing human brain. Here, we combined silicone wristband exposure assessments with neuroimaging for the first time to examine how chemical contaminant mixtures are associated with the developing basal ganglia—a brain region key for the healthy development of emotion, reward, and motor processing, and which may be particularly susceptible to contaminant harm. Further, we examined demographic disparities in exposures to clarify which children were at highest risk for any contaminant-associated neurobiological changes. Participants included 62 community children (average age 7.00 years, 53% female, 66% White) who underwent structural neuroimaging to provide data on their basal ganglia structure and wore a silicone wristband for seven days to track their chemical contaminant exposure. 45 chemical contaminants—including phthalates and their alternatives, brominated flame retardants, organophosphate esters, pesticides, polycyclic aromatic hydrocarbons, and polychlorinated biphenyls—were detected in over 75% of wristbands. Notable demographic disparities in exposure were present, such that Non-White and lower-income children were more exposed to several contaminants. Exposure to chemical contaminant mixtures was not associated with overall basal ganglia volume; however, two organophosphate esters (2IPPDPP and 4IPPDPP) were both associated with a larger globus pallidus, a basal ganglia sub-region. Results highlight demographic disparities in exposure and suggest possible risks to a brain region key for healthy emotional development.

Pelatihan Pembuatan Kerajinan dari Manik-manik untuk Meningkatkan Kreativitas Anak-anak di Rumah Yoel

This research aims to: Provide assistance to the children of the Rumah Yoel Community to build entrepreneurial skills using the main materials of beads and string which are cheap and easy to obtain. Building children's mindset to become independent, creative and highly competitive individuals in society. This research uses descriptive qualitative methods. The research subjects were the children of the Rumah Yoel Community. The training participants were 16 children in the Rumah Yoel Community. The meeting took place over three meetings with stages, 1) observation and interviews with the Rumah Yoel Community administrators, 2) observation and interviews with the children with the assistance of Rumah Yoel Community teachers, 3) skills training for the Rumah Yoel Community children. Training is evaluated using the results of service video comments, pretest and posttest. Results of the service: 1) researchers were able to train children's skills in making crafts through creativity using the main materials of beads and rope so that children were able to make key chains, bracelets, headbands and rings. Second; 2) researchers invite children to use packaging for their work so that it has economic value. 3) Researchers are able to invite children to take part in activities according to the procedures directed in making works using practical methods. 4) researchers provide skills for the children of the Rumah Yoel community because by training them to be creative with beads it can motivate them to become entrepreneurs from an early age to help their parents.

Independent mobility and outdoor play time: Insights from urban informal settlements in India

This study assesses differences in children's independent mobility and outdoor play time between two urban informal housing settlements within India's in-situ slum redevelopment policy. This redevelopment policy involves replacement of existing slum housing with new apartment-style structures at the original site. One of the settlements under study has undergone redevelopment, while the other remains on the waitlist for redevelopment. Additionally, the study explores potential gender-based variations in independent mobility and outdoor play time, shedding light on the distinct effects of redevelopment on boys and girls. Questionnaires were administered to mothers, addressing aspects such as independent mobility licenses, the range of independent mobility, the age at which mobility licenses are granted, and the duration of outdoor play of children. Findings show that children in slum settlement were reported to have more mobility licenses, broader independent mobility range, and earlier licenses than children in redeveloped settlement. Gender differences are evident, with girls in redeveloped settlement receiving mobility licenses later than both boys and girls in slum settlement, but boys' age at which they received independent mobility licenses remained consistent regardless of their place of residence. Boys in the redeveloped settlement engage in more outdoor play time than boys and girls in slum settlement. Conversely, girls in slum settlement participate in more outdoor play time than those in redeveloped settlement. These findings have important implications for slum redevelopment policies, highlighting the need to consider morphological aspects of residential environments that support girls' outdoor play time and independent mobility. It is crucial that these considerations be integrated into the design of redeveloped settlements to ensure equitable development of children in such communities.

Impact of the Welsh Government Flying Start programme on children’s BMI and immunisation uptake

Flying Start (FS) is the Welsh Government’s targeted Early Years programme for families with children under 4 years of age who live in some of the most disadvantaged areas of Wales. The programme aims to mitigate the impact of poverty which is linked to poor life outcomes in early childhood. In particular, this study aims to investigate the impact of FS programme on FS children’s health outcomes in the form of Body Mass Index (BMI) and immunisation uptake, using linking analysis. The datasets linked to the FS cohort are respectively the Child Measurement Programme (CMP) and the National Community Child Health (NCCH). CMP consists of routinely taking height and weight measures of children in reception year to monitor BMI, whereas the NCCH is used to monitor health surveillance programmes, including immunisation. This project will use linked data to investigate the prevalence of fully immunised children across different levels of engagement with FS programme (normal and under-engagement). It will also look at prevalence of different BMI thresholds (underweight, overweight, and normal weight) and differences in mean BMI scores by FS programme engagement levels. In particular, chi-square will be used to explore differences in the proportion of fully immunised children and BMI thresholds, and t-test will be used to identify between-group differences in mean BMI scores. Results from this programme will inform of long-term health outcomes in relation to Early Years programmes. It will also help policy target resources and inform relevant interventions to support the healthy growth of children.

Micronutrient intake inadequacies in Northwest Ethiopian children aged 6–23 months

The early stages of childhood are a crucial period of life for health, with inadequate nutrition impacting physical growth, cognitive development, and the immune system. A considerable proportion of children are affected by micronutrient intake inadequacy and deficiency across the globe. Evidence on micronutrient intake among children aged 6–23 months is limited in Northwest Ethiopia, where there is a divergence between production and dietary consumption practices compared to other regions of the country. This study aimed to determine micronutrient inadequacy and associated factors among children aged 6–23 months. From February 1 to February 18, 2023, 435 children aged 6–23 months participated in a community-based cross-sectional study in the North Mecha District of the Amhara Region, Northwest Ethiopia. The study participants were selected using a multistage sampling technique. A multiphasic interactive 24-h dietary recall was used to collect dietary intake data via an interviewer-administered questionnaire. The interviews were conducted with the mothers of the selected children. Nutrient values for the selected 12 micronutrients were calculated using the NutriSurvey 2007 software and food composition tables from Ethiopia, Tanzania, and Kenya. SPSS version 25 was used for the remaining parts of the analysis. The Nutrient Adequacy Ratio and Mean Adequacy Ratio were calculated to evaluate the nutrient intakes. To identify the factors associated with overall micronutrient intake inadequacy, a binary logistic regression analysis was performed, with statistical significance determined at a p-value < 0.05. The overall prevalence of micronutrient intake inadequacy was 64.7% (95% CI 59.9, 69.2). The odds of inadequacy of micronutrient intake were 2.8 times higher among children aged 6–8 months than children aged 9–23 months (AOR = 2.80, 95% CI 1.71, 4.59). Children with paternal education unable to read and write and primary school incomplete were 3.1 (AOR = 3.12, 95% CI 1.26, 7.70) and 2.4 (AOR = 2.40, 95% CI 1.01, 5.73) times more likely to have micronutrient intake inadequacy, respectively, compared to children with paternal education of primary school completed and above. The likelihood of micronutrient intake inadequacy was 1.8 times higher among children from mothers who had an unfavorable nutrition-related attitude than those from mothers who had a favorable attitude (AOR = 1.76, 95% CI 1.02, 3.05). Inadequate intake of micronutrients was shown to be highly prevalent among children aged 6–23 months. Child age, paternal education, and maternal nutrition-related attitude were significantly associated with micronutrient intake inadequacy. Integrating community-guided nutrition interventions targeting nutrition-related knowledge and attitudes of parents is critical in addressing the inadequate micronutrient intake of children in the study community, where production is not a major problem.

Developing community-based physical activity interventions and recreational programming for children in rural and smaller urban centres: a qualitative exploration of service provider and parent experiences

BackgroundChildren’s physical inactivity is a persisting international public health concern. While there is a large body of literature examining physical activity interventions for children, the unique physical activity context of low-density communities in rural areas and smaller urban centres remains largely underexplored. With an influx of families migrating to rural communities and small towns, evaluations of health promotion efforts that support physical activity are needed to ensure they are meeting the needs of the growing populations in these settings. The aim of this community-based research was to explore service providers’ and parents’ perspectives on physical activity opportunities available in their community and recommendations toward the development and implementation of efficacious physical activity programming for children in rural communities and smaller urban centres.MethodsThree in-person community forums with recreation service providers (n = 37 participants) and 1 online community forum with the parents of school-aged children (n = 9 participants) were hosted. An online survey and Mentimeter activity were conducted prior to the community forums to gather participants’ views on the barriers and facilitators to physical activities and suggestions for activity-promoting programs. The service provider and parent discussions were audio-recorded, transcribed verbatim, and analyzed following a deductive approach guided by Hseih and Shannon’s (2005) procedure for direct content analysis. A code list developed from the responses to the pre-forum survey and Mentimeter activity was used to guide the analysis and category development.ResultsSeven distinct categories related to the existing physical activity opportunities and recommendations for programs in rural communities and smaller urban centres were identified during the analysis: (1) Recovery from Pandemic-Related Measures, (2) Knowledge and Access to Programs, (3) Availability, (4) Personnel Support, (5) Quality of Programs and Facilities, (6) Expenses and Subsidies, and (7) Inclusivity and Preferences.ConclusionTo improve the health and well-being of children who reside in low-density areas, the results of this study highlight service provider and parent recommendations when developing and implementing community-based physical activity programs and interventions in rural and smaller urban settings, including skill development programs, non-competitive activity options, maximizing existing spaces for activities, and financial support.

Mental Health Aftercare Availability for Juvenile Justice-Involved Youth in New York City.

The goal of our study was to describe the availability of community child and adolescent mental health services, trauma-informed care, and the geographic accessibility of these services for juvenile justice-involved (JJ) youth who received mental health services while in secure detention. Data collection occurred through direct contact with the child and adolescent outpatient clinics listed on the New York State Office of Mental Health website. Zip codes were collected from the juvenile secure detention census. Of the clinics contacted, 88.5 percent accepted JJ youth; however, 43.5 percent accepted them on a conditional basis. Only 62.1 percent offered trauma-informed care, including evidence-based interventions and unspecified care. Although 84.5 percent of the clinics that would accept this population reported currently accepting new patients, reported wait times were as high as six or more months. When JJ residents' home zip codes and those of the clinics were geographically mapped, there were few clinics in the zip codes where most residents lived. The clinics that accepted youth on a conditional basis often refused high-risk patients, essentially ruling out a large majority of this population. The geographical inaccessibility of these clinics limits their ability to provide care for this vulnerable population.