Emotional Health Problems Research Articles

Effectiveness of a community-based integrated service model for older adults living alone: A nonrandomized prospective study

ObjectiveOlder adults living alone face physical, emotional, and social health problems, and prefer to age in place (AIP) in their homes. A community-based integrated model for AIP is needed and few studies have identified its impact on older adults living alone. MethodsThis was a non-randomized prospective study. Participants were 877 community-dwelling older adults living alone, aged above 65 years, in S* city in South Korea. The intervention group (n = 331) received a community-based integrated service (CBIS) model based on AIP for six months from October 2019 to April 2020. ResultsScores on frailty (β = -0.377, p < .001), loneliness (β = -1.897, p = .018), and health-related quality of life (β = 4.299, p = .021) significantly improved in the intervention group. Among the intervention group, loneliness scores significantly improved among participants aged under 80 years than those aged over 80 years. ConclusionThe CBIS model improved frailty, loneliness, and quality of life in community-dwelling older adults living alone.

Storm Clouds and Silver Linings: Day-to-Day Life in COVID-19 Lockdown and Emotional Health in Adolescent Girls.

ObjectiveWe examined risk and protective factors for emotional health problems in adolescent girls during the COVID-19 pandemic. We investigated pre- to early-pandemic changes in symptoms of anxiety and depression, documented daily activities and perceived positive and negative impacts of the pandemic, and linked perceived positive and negative impacts of the pandemic to real-time changes in emotional health.MethodsThe study was a 10-day daily diary study with 93 U.S. adolescent girls (aged 12–17; 68% White non-Hispanic) at temperamental risk for anxiety and depression, conducted in April/May 2020 when all participants were under state-issued stay-at-home orders. Girls provided daily reports of positive and negative affect, depressive and anxious symptoms, activities, and positive and negative impacts resulting from the pandemic.ResultsGirls reported engaging in many activities that may contribute to well-being. Mixed effects analyses revealed positive impacts associated with improved same-day emotional health such as more time for family and relaxation and reduced pressure from school/activities. Negative impacts associated with poorer same-day emotional health included problems with online schooling, lack of space/privacy, lack of a regular schedule, and family conflict.ConclusionFindings highlight the importance of providing in-person or quality online schooling, resources and space for learning, promoting daily routines, and spending time with teens while reducing family conflict. The pandemic also appears to have offered many girls a respite from the chronic stress of modern teen life, with time to relax and engage in creative and healthy pursuits showing benefits for daily emotional health, which should be considered following the return to normal life.

The effects of adverse and advantageous childhood experiences on adult health in a low-income sample

BackgroundPrevious studies have indicated the advantageous childhood experiences (counter-ACEs) may improve health in adulthood regardless of adverse childhood experiences (ACEs) scores. However, these studies have primarily been conducted in low-risk communities, and little is known whether the results are similar in low-income settings. ObjectiveThe purpose of this study was to examine the effects of ACEs and counter-ACEs on mental and physical health in a low-income sample. A secondary objective was to assess the effects of repeated and prolonged exposure to ACEs on later health. Participants and settingThe sample included 206 low-income adults living in the western United States who completed a survey about their childhood experiences and adult health. MethodsA series of logistic regression analyses were performed to examine the effects of ACEs and counter-ACEs on adult health. ResultsIrrespective of ACEs, counter-ACEs were associated with lower odds of having two or more emotional and cognitive health problems and lower odds of suicidality in the past 12 months. When accounting for counter-ACEs, ACEs were associated with higher odds of having ever smoked and suicidality in the past 12 months, though these odds were attenuated compared to the unadjusted models. In the presence of repeated or prolonged ACEs exposure, counter-ACEs were associated with lower odds of having ever smoked and emotional and cognitive health problems. ConclusionsThe findings suggest that helping children develop healthy relationships within their family, community, and school may lead to improved health in adulthood even in the presence of poverty and childhood adversity.

UPSTREAM! Together evaluation results from community efforts to prevent mental, emotional, and behavioral health problems

Mental, emotional, and behavioral (MEB) health problems are prevalent globally. Despite effective programs that can prevent MEB problems and promote mental health, there has not been widespread adoption. UPSTREAM! Together was a planning project in three Colorado communities. Communities partnered with academic and policy entities to 1) translate evidence about MEB problem prevention into locally-relevant messages and materials and 2) develop long-term plans for broad implementation of interventions to prevent high-priority MEB problems. Community members recognized the need to talk about MEB problems to prevent them. The UPSTREAM! communities localized messages designed to start conversations and sustain attention on preventing MEB problems. The communities understood that prevention takes sustained community attention and advocacy, knowing that important outcomes may be years away. Long-term implementation plans aimed to strengthen families and enhance social connections among youth. Despite community readiness and capacity to implement evidence-based programs, there were few funding opportunities, delaying program implementation and revealing gaps between funding policies and community readiness. This community-engaged experience suggests an achievable approach, acceptable to communities, and worthy of further development and testing. Policies that cultivate and support local expertise may help to increase wider community adoption of evidence-based programs that promote mental health among youth.

Mediation pathways for reduced substance use among parents in South Africa: a randomized controlled trial

BackgroundSubstance use is a major public health concern worldwide. Alcohol and drug use have increased during recent decades in many low- and middle-income countries, with South Africa, where this study was conducted, having among the highest rates in the world. Despite existing evidence on the effectiveness of family-based interventions in reducing substance use among parents and caregivers in low- and middle-income countries, little is known about the mechanism of change that contributes to the reduction. This study investigated mediators of change in a parenting programme (Parenting for Lifelong Health [PLH]) on reducing substance use among parents and caregivers of adolescents through three potential mediators: parental depression, parenting stress and family poverty.MethodsThe current study used a pragmatic cluster randomized controlled trial design. The total sample comprised 552 parent and caregiver of adolescents M = 49.37(SD = 14.69) who were recruited from 40 communities in South Africa’s Eastern Cape. Participants completed a structured confidential self-report questionnaire at baseline and a follow-up test 5 to 9 months after the intervention. Structural equation modeling was conducted to investigate direct and indirect effects.ResultsAnalyses indicated that the effect of the PLH intervention on reducing parental substance use was mediated in one indirect pathway: improvement in parental mental health (reduction in parental depression levels). No mediation pathways from the PLH intervention on parental substance use could be associated with parenting stress or family poverty.ConclusionsThe findings of the study suggest that intervention approaches targeting mental health among parents and caregivers have promise for reducing parental substance use. These findings emphasize the need to create supportive environments and systems for parents who suffer from emotional strain and mental health problems, particularly within families experiencing adversity.Trial registrationPan-African Clinical Trials Registry PACTR201507001119966. Registered on 27 April 2015. The trial can be found by searching for the key word ‘Sinovuyo’ on the Pan-African Clinical Trials Registry website or via the following link: http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?_nfpb=true&_windowLabel=BasicSearchUpdateController_1&BasicSearchUpdateController_1_actionOverride=%2Fpageflows%2Ftrial%2FbasicSearchUpdate%2FviewTrail&BasicSearchUpdateController_1id=1119

Innovative Cancer Survivorship Services for Rural and Underserved Communities.

In 2006, the Institute of Medicine recognized that cancer survivors faced complex physical and emotional health problems, often overlooked or inadequately managed. In Texas, access to programs specifically designed to address unique needs of cancer survivors is almost nonexistent for low-income uninsured or underinsured patients. In response to the unmet care needs of underserved cancer centers, Moncrief Cancer Institute, an affiliate of the National Cancer Institute-designated UT Southwestern Harold C. Simmons Comprehensive Cancer Center, established a community-based program using a survivorship care model similar to those offered in academic medical centers. Understanding that a one-size-fits-all approach could not successfully meet the needs across the service area, the cancer survivorship service line was mobilized to provide flexibility in delivery without sacrificing quality of care. The program continues to evolve, extending the foremost scientific information and resources into the communities it serves.

Long-term Follow-up Care for Childhood, Adolescent, and Young Adult Cancer Survivors.

Progress in therapy has made survival into adulthood a reality for most children, adolescents, and young adults with a cancer diagnosis today. Notably, this growing population remains vulnerable to a variety of long-term therapy-related sequelae. Systematic ongoing follow-up of these patients is, therefore, important to provide for early detection of and intervention for potentially serious late-onset complications. In addition, health counseling and promotion of healthy lifestyles are important aspects of long-term follow-up care to promote risk reduction for physical and emotional health problems that commonly present during adulthood. Both general and subspecialty health care providers are playing an increasingly important role in the ongoing care of childhood cancer survivors, beyond the routine preventive care, health supervision, and anticipatory guidance provided to all patients. This report is based on the guidelines that have been developed by the Children's Oncology Group to facilitate comprehensive long-term follow-up of childhood, adolescent, and young adult cancer survivors (www.survivorshipguidelines.org).

Food insecurity risk and alcohol use disorder in US young adults: Findings from the National Longitudinal Study of Adolescent to Adult Health.

The relationship between food insecurity and alcohol use disorder remains unknown. The aim of this study was to determine the association between food insecurity risk and alcohol use disorder in a nationally representative sample of young adults. Cross-sectional nationally representative data of 14,786 US young adults aged 24-32 years old from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health were analyzed to assess a single-item measure of food insecurity risk and Diagnostic and Statistical Manual, 5th Edition (DSM-5) alcohol use disorder. Among young adults, 12% were found to be at risk for food insecurity. Young adults with food insecurity risk had greater odds of moderate (adjusted odds ratio [AOR]: 1.34, 95% confidence interval [CI]: 1.13-1.58) and severe (AOR: 1.67, 95% CI: 1.34-2.07) threshold alcohol use disorder than food-secure young adults, adjusting for age, sex, race/ethnicity, education, income, receipt of public assistance, household size, and smoking. Food insecurity risk was also associated with a 23% higher (95% CI: 11%-37%) number of problematic alcohol use behaviors (e.g., risky behaviors, continued alcohol use despite emotional or physical health problems). Food insecurity risk is associated with problematic patterns of alcohol use. Health care providers should screen for food insecurity and problematic alcohol use in young adults and provide referrals for further resources and treatment when appropriate. This nationally representative study of US young adults is the first to find an association between food insecurity risk and alcohol use disorder using DSM-5 criteria.

Health Related Quality of Life among Tuberculosis Patients

Aims: To find out health related quality of life among patients being treated for tuberculosis in the hospital of Lahore, Pakistan.&#x0D; Study Design: Cross sectional survey is used as research design in this study.&#x0D; Place and Duration of Study: Farooq Hospital west wood branch Lahore, Gulab Davi Hospital Lahore, Social Security Hospital Lahore between June 2020 and July 2021.&#x0D; Methodology: Sample (N=150) was drawn through purposive sampling technique from various hospitals of Lahore with age range of 18 – 65 years of 56.7% male and 43.3% female patients of Tuberculosis.Standardized questionnaire (SF-36) was used to determine the health related quality of Life. This questionnaire determines the effect of TB on physical activities, social activities, emotional activities and limitation in routinely work. Data was analyzed through SPSS with descriptive statistic of frequency and percentages.&#x0D; Results: On the basis of total scores of general health category 53.3% patients considers their health as good when taking antituberculosis medicine. Total scores of Limitations of activities 70.7% patients considers their social activities limited a lot. On the basis of total score of physical health problem category 81.3% considered their physical health were not affected. On the basis of total score of social activities 70.0% patients considered their emotional health problems interfered with normal social activities affected.&#x0D; Conclusion: It was concluded that limitations of physical activity and compromised psychological status impacted the HRQOL in patient with pulmonary TB. Tuberculosis effect on patient’s physical, psychological and social activities of daily routine. Patient become bed bound due dyspnea and unable complete their task to fulfill the needs of life.

Quality of Life in Behçet’s Disease in Three Centers Experience

Background: Behcet’s syndrome (BS) is a systemic inflammatory vasculitis of unknown etiology, characinoid by recurrent oral, genital ulcers and uveitis. Its symptoms may affect patients’ quality of life. Objective: This study aimed to evaluate the quality of life (QoL) in patients with Behcet’s disease (BD) in three centers experience (Menoufia University Hospital, Mansoura University Hospital, and Banha Teaching Hospital) Patients and methods: A cross sectional study that was carried out on 70 BD patients selected from Rheumatology and Immunology Unit from Menoufia University Hospital, Benha Teaching Hospital, and Mansoura University Hospital from January 2019 till December 2020 on patients who were diagnosed by trained well qualified dermatologists and rheumatologist. All participants were assessed by the SF-36 QoL Scale to evaluate the QoL. Results: The mean general health score was 12.0 ± 2.09 . The mean limitations of activities score was 10.57± 2.44 . The mean physical health problems score was 2.04 ± 0.97 . The mean emotional health problems score was 1.53 ± 0.90. The mean social activities was 3.94 ± 1.15 . The mean pain was 4.03 ± 1.19 . The mean energy and emotions was 17.63 ± 2.27 , and the mean overall QoL was 51.74 ± 5.03 . Conclusion: QoL scores do not correlated with demographic characteristics such as age, gender, BMI and weight. We also found that disease characteristics such as presence of oral ulcer, genital ulcer, and arthritis and skin lesion do not affect QoL scores.

The Association Between Peripartum Depression and Childhood Resilience: A Systematic Review

Pregnancy can be a colossal change for some women, with the commencement of motherhood possibly generating emotional health problems, including peripartum depression (PPD). PPD significantly affects the parent-child relationship, which is the foundation for the socioemotional development of the child. In this article, we reviewed the association between PPD and resilience, and identified their mediators and moderators. Eight studies were included after a rigorous screening process. There was a significant relationship between PPD and childhood resiliency, resulting in an increased risk of psychiatric disorders in children and adolescents. Maternal sensitivity and emotional availability were possible mediators. Maternal education, income level, maternal trauma, life adversities, marital conflicts, and perceived social support were reported moderators. This article highlights the need for timely recognition and treatment of PPD with targeted interventions to improve the parent-child relationship. [ Psychiatr Ann . 2021;51(7):322–330.]

Associations between Socioeconomic Status and Health-Related Quality of Life in Patients with AL Amyloidosis

Introduction: Socioeconomic status (SES) can affect health-related quality of life (HRQoL) through a variety of mechanisms, including poor access to healthcare, physical and mental health comorbidities, low levels of health literacy or health activation, and consequent negative health behaviors. The impact of low SES on HRQoL of patients with AL amyloidosis, however, has not been well described. AL amyloidosis is a rare, complex disease associated with significant organ dysfunction, disability, and death. Although patients with AL amyloidosis report significant HRQoL impairments, it is likely that patients in lower SES groups report even greater deficits. The aim of this study was to assess the impact of SES on HRQoL in AL amyloidosis patients.Methods: This was a cross-sectional, observational study. A total of 1,289 patients with AL amyloidosis were evaluated at the Amyloidosis Center at Boston University between 1994 and 2014 and completed the SF-36v1 Health Survey within seven days of their initial evaluation. The SF-36v1 assessed HRQoL across eight domains and two component summary measures: physical functioning (PF); role limitations due to physical health problems (RP); bodily pain (BP); general health (GH); vitality (VT); social functioning (SF); role limitations due to emotional health problems (RE); mental health (MH); and physical (PCS) and mental (MCS) component summaries. SES was based on patients' occupation type (ie, professional/managerial positions vs. other occupations, including administrative/clerical, service, blue-collar, and farming positions vs. retired vs. disability) and educational attainment (≤ high school diploma versus > a high school diploma). Regression models using each SF-36v1 domain or summary score as a dependent variable were fit to examine whether there was an association between SES and HRQoL, independent of other demographic and clinical characteristics including type of organ involvement, multi-organ involvement, eligibility for stem cell transplantation, and time since diagnosis. Adjusted least-square means for each SF-36v1 domain and summary were obtained from two sets of models using educational or occupational group as the measure of SES. Established minimally important differences (MIDs) were used to determine whether differences in adjusted mean scores across groups were also clinically meaningful.Results: The mean age of the population was 61.6 years and the average time since diagnosis was 7.3 months. Based on multivariable models, patients with fewer years of education reported worse HRQoL impairment (i.e., significantly worse scores for all SF-36v1 domain and summary scores) compared to patients with more education (p < 0.05 for all) [Figure 1]. With the exception of GH, MH, and MCS, differences by educational attainment all exceeded the threshold of 1 MID.In multivariable models using occupation as the independent variable for SES, SF-36v1 scores also differed significantly by occupation (Figure 2). Relative to scores among patients with professional/managerial occupations: •Patients in other occupations reported statistically (p < 0.05 for all) and clinically (i.e. exceeding 1 MID) significant deficits on all SF-36v1 scores.•Patients on disability also exhibited significantly worse SF-36v1 scores (p < 0.05 for all). Deficits exceeded 1 MID for all scores. For PF, VT, and PCS, these differences exceeded 2 MIDs.•Retired patients reported only significant deficits for PF and RP (p < 0.05 for both); however these differences did not meet the threshold for an MID.Conclusions: Patients from lower SES groups, defined in terms of education or employment, had poorer HRQoL as compared to those with more years of education or professional/managerial positions. These relationships were independent of other clinical variables that served as proxies for disease severity. Outreach efforts designed to increase the understanding of the disease among community-based clinicians should highlight the additional HRQoL burden and potential need for more comprehensive care among patients in lower SES groups. As treatments of AL amyloidosis and healthcare resource utilization can be costly, future research should examine whether SES is associated with costs associated with treatment, type of health care received, and consequently HRQoL.Supported by Amyloid Research Fund at BUMC and a grant from Prothena Biosciences Inc. [Display omitted] DisclosuresMcCausland:Optum: Employment; Prothena Biosciences: Research Funding. White:Prothena Biosciences: Research Funding; Optum: Employment. Yokota:Optum: Employment; Prothena Biosciences: Research Funding. Quock:Prothena Biosciences Inc: Employment, Other: Stockholder. Bayliss:Optum: Employment; Prothena Biosciences: Research Funding.

The impact of absenteeism and the relationship with emotional absence based on individual stories

The relationship between the concepts of stress, mental illness and burnout syndrome seems to be indistinguishable when it comes to work leave by individuals who present specific and common symptoms. Recent research has shown an increase in absenteeism as a pandemic in society, one of the main problems faced by organizations, the consequences of illness generated by lack of emotional health, and the emergence of such symptoms arising from these relationships. This study analyzes the discourse of individuals diagnosed with burnout syndrome, seeking to identify the multiple relationships between the underlying symptoms and emotional health problems, a new concept discussed by theorists in recent years. For research purposes, elements of qualitative methodology were used. The narratives were analyzed considering psychoanalysis, and supported by the social interpretation of the reports. The results showed a significant trend towards a relationship between the concepts, the subject studied and the stories told in the interviews, leading us to reflect on the emotional impact of these relationships on work environments, individuals and society.

Psychological Problems resulted from COVID-19 and its relation to E-Learning and E-Assessment Stress in a sample of College of Education Students, Sultan Qaboos University

The present study aimed at identifying the psychological problems resulted from the COVID-19 outbreak. Additionally, it explored the frequency, and gender differences in those problems. The paper also investigated the correlation relationship between COVID-19 associated psychological problems and e-learning and e-assessment stress. To achieve the objectives of the study, a COVID-19 psychological problems scale (CPPS) and an E-learning and E-assessment stress questionnaire were developed and validated. Data were collected through Google form from 125 students enrolled in the College of Education, Sultan Qaboos University. Results indicated that COVID-19 associated psychological problems (Emotional problems, behavioral and health problems, fear of infection, social isolation, and lack of motivation) occupied a moderate rank. A significant positive correlation relationship was detected between COVID-19 associated psychological problems and e-learning stress r= 0.492, P &gt; 0.01 and e-assessment stress r= 0.331, P &gt; 0.01. No significant differences were found between both genders in COVID-19 associated psychological problems, e-learning stress, and e-assessment stress.

Parental Emotional Support and Health Problems: The Role of Social Support and Social Strain

Parental Emotional Support and Health Problems: The Role of Social Support and Social Strain

Physical health and emotional and behavioral problems in maltreated children according to family economic status: Health problems of maltreated children in Korea.

Low family income is a risk factor for child maltreatment. However, there has been no comparative study on the association between child maltreatment and family income. The objective of this study was to investigate the physical health and emotional and behavioral problems of maltreated children according to the economic status of their family.Cross-sectional nationwide studyData from 2012 to 2014 was extracted from the Korean National Child Abuse Registry (age <18 years) operated by the National Child Protection Agency (NCPA). Demographic characteristics and 34 physical health and emotional/behavioral problems of maltreated children were compared by family economic status. Family economic status was classified into 2 groups: families receiving the National Basic Livelihood Guarantee (NBLG) and those not receiving the guarantee (non-NBLG group).A total of 17,128 children were registered in the system. Mean age was 9.3 years (SD 4.8 years), 44.4% were females, and 29.2% were in the NBLG group. Poor hygiene, anxiety, and attention deficit were frequently reported physical and emotional health problems. Common behavioral problems included running away, rebelliousness/impulsivity/aggressiveness, maladjustment in school, learning problems at school, and frequent unauthorized absenteeism and truancy. Physical health problems (7 of 8 items) occurred more often in the NBLG group, and behavioral problems (6 of 17 items) occurred more often in the non-NBLG group.Children in Korea who are maltreated have different physical health, emotional, and behavioral problems depending on their family income level. These results can be useful in approaching the recognition of and interventions for child maltreatment.

Quality of life in euthymic patients with bipolar disorder

IntroductionPatients with bipolar disorder (BD) frequently experience residual symptoms, problems in psychosocial functioning, cognitive impairment, and poor quality of life (QOL).Objectives* To evaluate the QOL of euthymic patients with BD compared to healthy controls (HC). * To identify factors associated with its deterioration.MethodsThis is a comparative and analytical study, conducted over 3 months, involving 30 euthymic patients with BD, followed up in the outpatient psychiatry department of Hedi Chaker University Hospital in Sfax (Tunisia). They were compared to 34 HC. General, clinical and therapeutic data were collected using a pre-established questionnaire. QOL was assessed with the «36 item Short-Form Health Survey» (SF-36).ResultsThe mean ages of BD patients and HC were 44.17 years and 40.1 years, respectively. Compared with HC, patients with BD had decreased overall SF-36 scores (53.73 vs 73.78; p=0.000) and decreased physical and psychological subdomain scores (p=0.001; p=0.000). The study of the relationship between the dimensional average scores and different variables revealed correlations between; physical health problems and somatic disease (p=0.021) and unemployment (p=0.001), impaired general health and somatic disease (p=0.02) and psychotropic association (p=0.021), emotional health problems and psychiatric family history (p=0.023), pain and psychotropic association (p=0.031), and impaired global QOL and psychiatric family history (p=0.05).ConclusionsOur results confirm the impairment of the QOL of patients with BD even in euthymic periods. Many factors have been associated, including demographic and clinical variables. The improvement of QOL is to consider these factors in the management of these patients.

Hypothalamic-Pituitary-Adrenal Axis Activity in Childhood Predicts Emotional Memory Effects and Related Neural Circuitry in Adolescent Girls.

Negative emotional experiences can be more difficult to forget than neutral ones, a phenomenon termed the "emotional memory effect." Individual differences in the strength of the emotional memory effect are associated with emotional health. Thus, understanding the neurobiological underpinnings of the emotional memory effect has important implications, especially for individuals at risk for emotional health problems. Although the neural basis of emotional memory effects has been relatively well defined, less is known about how hormonal factors that can modulate emotional memory, such as glucocorticoids, relate to that neural basis. Importantly, probing the role of glucocorticoids in the stress- and emotion-sensitive period of late childhood to adolescence could provide actionable points of intervention. We addressed this gap by testing whether hypothalamic-pituitary-adrenal (HPA) axis activity during a parent-child conflict task at 11 years of age predicted emotional memory and its primary neural circuitry (i.e., amygdala-hippocampus functional connectivity) at 16 years of age in a longitudinal study of 147 girls (104 with complete data). Results showed that lower HPA axis activity predicted stronger emotional memory effects, r(124) = -.236, p < .01, and higher emotional memory-related functional connectivity between the right hippocampus and the right amygdala, β = -.385, p < .001. These findings suggest that late childhood HPA axis activity may modulate the neural circuitry of emotional memory effects in adolescence, which may confer a potential risk trajectory for emotional health among girls.

Girls suffer: the prevalence and predicting factors of emotional problems among adolescents during upper secondary school in Norway

This longitudinal, quantitative survey examined factors predicting 1077 Norwegian adolescents` emotional problems during Upper Secondary School (grades I–III, approximately 16–19 years old) considering the following research question: “To what extent do students in Upper Secondary School experience emotional problems, and how are these problems predicted by gender, academic/social self-concept, coping beliefs, appearance pressure and school stress?”. The mentioned variables were scrutinized through analysis of frequencies, zero order correlations and structural equation modeling. Results verified previous findings that there was an increase in emotional problems for adolescents, especially among girls. Furthermore, the study results indicate that coping beliefs is a crucial factor when it comes to the perception of pressure and stress, and the subsequent development of emotional health problems.

Promoting Children's Mental, Emotional, and Behavioral (MEB) Health in All Public Systems, Post-COVID-19.

The COVID-19 pandemic exacerbates the mental, emotional, and behavioral (MEB) health problems of children and adolescents in the United States (U.S.). A collective and coordinated national economic and social reconstruction effort aimed at shoring up services to promote children's MEB, like the Marshall Plan that helped rebuild Europe post-World War II, has been proposed to buttress against the expected retrenchment. The plan prioritizes children's well-being as a social objective. We propose strategically reconstructing the public safety-net systems serving youth, including early education, maternal and child health, child welfare, corrections, and mental health. That plan called for a concentrated focus on coalition-building and contracting by state mental health systems to establish a foundation for an improved health system. This paper offers a complementary set of suggestions for the four non-mental health systems mentioned above by recommending actionable steps based on scientific evidence to support improved services for children at risk for MEB problems. For each system we describe examples of evidence-informed services, policies or programs that (1) prevent disabilities and promote health, (2) protect and preserve families and neighborhoods, and (3) provide quality care. Prioritizing the promotion of children's MEB health by all state systems can shape U.S. children's health and well-being for generations to come.