Adolescent Health Research Articles

Prevalence of symptomatic dry eye and influencing factors among Chinese adolescents: A cross-sectional study.

Comprehensive research on the impact of various types of refractive errors (RE) and anisometropia on dry eye disease is still lacking. This study aimed to estimate the prevalence rates and potential lifestyle factors related to symptomatic dry eye (SDE) among adolescents in eastern China. A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was used among adolescents in Nantong, China. Demographic information, including sex, age and BMI, were collected. All participants underwent optometric tests, while Ocular Surface Disease Index (OSDI) and self-designed questionnaires were administered. Both univariate and multivariate logistic regression analyses were used to assess associations between SDE and related parameters, and various types of RE and anisometropia were also included in the study. A total of 1,518 participants were enrolled in the study, and the overall prevalence of SDE was 20.3% among adolescents in Nantong, China. Multiple logistic regression analyses showed that high myopia (aOR = 3.42, 95% CI = 1.60-3.36, p = 0.025), frequent use of eye drops (aOR = 2.31, 95% CI = 1.60-3.36, p<0.001), a history of allergic conjunctivitis (aOR = 1.93, 95% CI = 1.09-3.34, p = 0.025), and frequent blinking (aOR = 3.23, 95% CI = 2.31-4.53, p<0.001) were identified as risk factors for SDE. Conversely, male gender (aOR: 0.76, 95% CI: 0.58-0.99, p = 0.043), increased sleep time (6-7 h: aOR = 0.64, 95% CI = 0.46-0.89, p = 0.009; 7-8 h: aOR = 0.64, 95% CI = 0.43-0.95, p = 0.026; >8 h: aOR = 0.43, 95% CI = 0.23-0.82, p = 0.010), and timely intervention when vision decline occurred were protective factors against SDE (aOR = 0.61, 95% CI = 0.43-0.85, p = 0.004). High myopia was found to be independently associated with an increased risk of SDE., while hyperopia, astigmatism, and anisometropia were not independent risk factors for SDE. The identified risk and protective factors may help provide valuable insights for future research and interventions aimed at improving ocular health in adolescents.

Effectiveness of The Culture-Based Anti-Stunting Education Package on Family Behavioral Changes in Stunting Prevention

Stunting remains a pressing global health concern, as evidenced by the prevalence of stunting in Indonesia. The Pasuruan Regency Government continues its efforts to reduce the stunting rate. Coastal areas are characterized by a relatively high incidence of stunting, which stands at 22.8%. The urgency of this research lies in the need for a change in family behavior toward stunting prevention through education optimalization in coastal areas. Stunting prevention education within the family can be summarized into the "Anti-Stunting Education Package", consisting of education on nutritious maternal food intake starting from 1000 days before childbirth, exclusive breastfeeding, adolescent health, and access to clean water. This research aims to demonstrate the effectiveness of anti-stunting education package in changing family behavior to prevent stunting in coastal areas. This was pre-experimental study with a pretest-posttest design approach. The research is conducted in coastal areas with a sample size of 30 stunting families selected through purposive sampling. The results of the research indicate that the Anti-Stunting Education Package is highly effective in improving knowledge, attitudes, and behavioral changes among mothers in supporting stunting prevention in coastal areas. This study falls under TKT 3, which demonstrates the analytical concept and experimental functions, providing stunting education through booklets with a focus on local culture to prevent stunting in coastal areas. The outcomes of this research serve as an innovation and technological development for maritime community well-being.

Study on the Emergence and Intervention of Mental Health Problems among Chinese Adolescents

The mental health of Chinese adolescents has received widespread attention due to the rising rate of adolescent suicide. Although previous studies have focused on the causal analysis of such problems, there is still room for further improvement. This study examines the impact of mental health problems from four distinct perspectives in Chinese society. Specifically, cognitive, psychological, behavioral, and physical effects. Then, this study analyzes the causality of mental health problems from three different aspects of adolescents’ daily lives: school-related causality, family-related causality, and peer-related causality. On this basis, the paper makes the following recommendations: Students can develop time management and self-control skills to reduce stress in a high-pressure educational system. Parents and peers can provide emotional support and counseling to help students experiencing emotional distress. Parents, in particular, can aim to create a harmonious family environment to ensure the mental well-being of adolescents Schools can create a harmonious school environment and build healthy peer relationships to prevent bullying behavior.

Association between sedentary behavior and bone mass, microstructure and strength in children, adolescents and young adults: a systematic review

Sedentary behavior (SED) research is currently receiving increasing attention in the field of public health. While it has been shown to have negative effects on cardiovascular or metabolic health, there is limited knowledge regarding the relationship between SED and bone health in children, adolescents, and young adults. Thus, the purpose of this review is to investigate the associations between SED and bone health status, specifically bone mass, microstructure, and strength. A comprehensive literature search was conducted across five electronic databases, including EMBASE, PubMed, Medline, Cochrane, Web of Science and CNKI. The inclusion criteria were as follows: healthy participants aged 24 years or younger, with measured SED and measured bone outcomes. The quality of the included articles was assessed using the National Institute of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. After excluding, the final sample included 25 cross-sectional, 9 observational and 2 both cross-sectional and longitudinal studies. Among these, seven were rated as ‘high quality’, twenty-three were rated as ‘moderated quality’, and six were rated as ‘low quality’ according to the quality assessment criteria. After summarizing the evidence, we found no strong evidence to support an association between BMC or BMD and SED, even when considering gender or adjusting for moderate-to-vigorous physical activity (MVPA). However, a strong level of evidence was found indicating a negative relationship between objectively measured SED and cortical bone mineral density (Ct.BMD) in the tibia or stiffness index (SI) in the Calcaneus across all age groups. While the association between adverse bone health outcomes and SED still cannot be confirmed due to insufficient evidence, these findings suggest that bone microstructure and strength may be more sensitive to SED than bone mass. Thus, further evidence is needed to fully understand the connection between sedentary behavior and bone health, particularly regarding the relationship between SED and bone strength.

A personalised nutrition intervention for adolescent depression: a mixed-methods feasibility pilot study.

Randomised controlled trials have demonstrated the benefit of diet modification to improve diet quality in the treatment of adult major depressive disorder (MDD). However, research examining nutritional interventions for adolescents with MDD is sparse. This pilot study examined the feasibility of a personalised nutrition intervention for adolescents with MDD. Ten adolescents with MDD and their parents recruited from a tertiary care setting participated in an 8-week, single-arm mixed-methods study. Feasibility was assessed using five criteria (demand, acceptability, implementation, adaptation and limited efficacy testing) alongside qualitative interviews. The intervention involved four bi-weekly virtual nutrition counselling sessions with a stepped approach to dietary change, menu planning, grocery delivery and educational eHealth messages. Study participants sought positive changes in diet, health and lifestyle for adolescents and family-wide benefits. Recruitment challenges included concerns about managing mood fluctuations, anticipated dietary restrictions and the potential time and effort required for diet adherence. Feedback based on interviews emphasised moderate to high acceptability, satisfaction with menu planning and counselling and recognition of the benefits of trying new foods and sustaining positive dietary changes beyond the study. Improvements in depression symptoms (Cohen's d = 0·36, 95 % CI (-0·24, 3·36)), parent food modeling (Cohen's d = 0·24, 95 % CI (-0·43, 1·16) and the family food environment (Cohen's d = 0·61, 95 % CI (-0·04, 2·61)) were observed. This nutrition intervention was feasible for adolescents with MDD and was acceptable to both parents and depressed adolescents. These preliminary data suggest that further examination of the intervention and its potential benefits on depression symptoms and family food dynamics are warranted.

A participatory study of indoor environment quality in homes of children and youth in Kanehsatake First Nation

Indoor air quality is an important determinant for the health of children and youth, but the conditions within Indigenous communities are understudied. We collaborated with Kanehsatake First Nation in Quebec, Canada, to address this gap using a community-based participatory research approach. Levels of key indoor air indicators, including particulate matter (PM2.5), CO2, and relative humidity, were measured in 31 randomly selected households between June 2021 and January 2022. Questionnaires were administered remotely to collect information on housing conditions. Excessive humidity was common, with 52% of households having a relative humidity above 55%. The mean PM2.5 concentration was 21.0 (standard deviation 38.5) µg/m3, with higher mean levels observed in smoking compared to non-smoking households (36.1 µg/m3 and 10.1 µg/m3, respectively). The mean CO2 level in participating households was 881 ppm (standard deviation 256), with 30% (n = 9) of homes exceeding 1000 ppm. Flooding rates were high, with 55% of households reporting at least one past flood. One-third of houses were inadequately ventilated relative to occupancy, and over one-quarter reported needing major repairs. The results indicate the value and importance of characterizing the indoor environment in First Nations households and the viability of data collection through community-based participatory research in environmental health research.

The Impact of Posting and Viewing Selfies on Social Media on Self-Identity: A Case Study of xiaohongshu

The emergence of new social media platforms has significantly influenced adolescent mental health through their engagement in selfie-related behaviours. This paper uses xiaohongshu as a research platform to explore the impact of users’ selfie-related behaviour on their body satisfaction and self-identity on social media. This study employed a questionnaire-based survey to examine 60 xiaohongshu users, aged 19-59, utilizing the selfie-posting frequency scale, self-viewing scale, verbal commentary on physical appearance Scale, body Image states scale, and body surveillance subscale. The results show that selfie editing and posting, selfie viewing, and positive appearance-related commentary positively affect body satisfaction, while negative appearance-related commentary negatively affect body satisfaction. There is no statistically significant association identified between body satisfaction and self-objectification. Adolescents’ psychological issues are influenced, in part, by their selfie-related activities within social networking environments. However, a mindful and rational engagement with these platforms can foster self-identity and contribute to the positive development of youth mental health.

Digital Mental Health Interventions for Adolescents in Low- and Middle-Income Countries: Scoping Review.

Digital mental health interventions (DMHIs) are increasingly recognized as potential solutions for adolescent mental health, particularly in low- and middle-income countries (LMICs). The United Nations' Sustainable Development Goals and universal health coverage are instrumental tools for achieving mental health for all. Within this context, understanding the design, evaluation, as well as the barriers and facilitators impacting adolescent engagement with mental health care through DMHIs is essential. This scoping review aims to provide insights into the current landscape of DMHIs for adolescents in LMICs. The Joanna Briggs Institute scoping review methodology was used, following the recommendations of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Our search strategy incorporated 3 key concepts: population "adolescents," concept "digital mental health interventions," and context "LMICs." We adapted this strategy for various databases, including ACM Digital Library, APA PsycINFO, Cochrane Library, Google Scholar (including gray literature), IEEE Xplore, ProQuest, PubMed (NLM), ScienceDirect, Scopus, and Web of Science. The articles were screened against a specific eligibility criterion from January 2019 to March 2024. We analyzed 20 papers focusing on DMHIs for various mental health conditions among adolescents, such as depression, well-being, anxiety, stigma, self-harm, and suicide ideation. These interventions were delivered in diverse formats, including group delivery and self-guided interventions, with support from mental health professionals or involving lay professionals. The study designs and evaluation encompassed a range of methodologies, including randomized controlled trials, mixed methods studies, and feasibility studies. While there have been notable advancements in DMHIs for adolescents in LMICs, the research base remains limited. Significant knowledge gaps persist regarding the long-term clinical benefits, the maturity and readiness of LMIC digital infrastructure, cultural appropriateness, and cost-effectiveness across the heterogeneous LMIC settings. Addressing these gaps necessitates large-scale, co-designed, and culturally sensitive DMHI trials. Future work should address this.

Childhood emotional maltreatment affects depression of adolescents with mood disorders: the mediating role of functions of non-suicidal self-injury

BackgroundChildhood emotional maltreatment, non-suicidal self-injury and depression are prevalent among adolescents with mood disorders. While existing model indicated that childhood emotional maltreatment, functions of non-suicidal self-injury and depression are interrelated, not much is understood about the interplay of functions of non-suicidal self-injury in the relationship between childhood emotional maltreatment and depression. Thus, the goal of this research was to ascertain how functions of non-suicidal self-injury relate to childhood emotional maltreatment and depression.MethodsThe participants were adolescents with mood disorders from three hospitals in Sichuan Province, data was collected using self-administered questionnaires, including the Childhood Trauma Questionnaire, Ottawa Self-injury Inventory-Functions, and Childhood Depression Inventory. SPSS26.0 software and PROCESS v3.3 model 4 were used for analysis.ResultsIn all, 235 adolescents (Mage=14.8, SD = 1.62) participated in the research. The functions of non-suicidal self-injury (r = 0.289, P < 0.01) and depression (r = 0.475, P < 0.01) were considerably positively connected with childhood emotional maltreatment, and the functions of non-suicidal self-injury were strongly positively correlated with depression (r = 0.364, P < 0.01). The direct impact of childhood emotional maltreatment on depression in adolescents was found to be significant (95% CI 0.434, 0.828) in the mediated effects model. Additionally, the indirect effect of childhood emotional maltreatment on depression through functions of non-suicidal self-injury was found to be significant (95% CI 0.055, 0.236), with a mediating effect value of 17.58%.ConclusionChildhood emotional maltreatment has a direct impact on depression, but it also has an indirect influence through mediation roles of functions of non-suicidal self-injury. Medical staff should take care of the mental health of adolescents hospitalized for mood disorders so that they can clarify the role of functions of NSSI in lowering depressive symptoms and improving quality of life and create more targeted and effective intervention plans.

A REALIZAÇÃO DO PROGRAMA SAÚDE NA ESCOLA COMO FERRAMENTA PARA PROMOÇÃO DE EDUCAÇÃO EM SAÚDE DURANTE A FORMAÇÃO EM MEDICINA DE FAMÍLIA E COMUNIDADE: UM RELATO DE EXPERIÊNCIA

Introduction: The School Health Program (PSE), announced by the Ministry of Health in 2007, aims to promote health in partnership with educational institutions to improve the quality of life of the population, specifically school-aged children. This involves collaboration between health and education professionals, providing appropriate knowledge to reduce vulnerabilities that may compromise the development and the future of children and adolescents. Objective: To report the experience of a family medicine resident, part of a family health team (eSF) in the Federal District (DF), primarily promoting sexual education for children and adolescents in two public schools within the team's area of coverage. Methodology: This is a descriptive and qualitative study, of the experience report type, conducted during the two years of residency in Family and Community Medicine, from 2023 to 2024, in the satellite city of Sobradinho, Federal District. Results: The students involved, aged between 9 and 12 years, showed great interest in the topics addressed regarding sexuality and hygiene habits, adopting a participatory attitude, engaging in the exchange of experiences, raising questions, and discussing the subjects covered in the meeting and topics detailed in the adolescent health booklet. Conclusion: The necessity of partnership between health teams and education professionals was evident to provide health promotion, especially focused on sexual education, aiming to reduce negative outcomes and minimize future social and health damages in the vulnerable population of the DF.

Dose-response associations between physical activity and mental health among USA adolescents

Abstract Background Adolescent mental health is a critical public health concern. Physical activity has been shown to reduce risk of negative mental health outcomes. However, in adolescents little is known about the dose-response nature of this relationship. This study aims to fill this gap by examining the association between varying levels of self-reported physical activity and the odds of reporting depressive symptoms and poor mental health, among US high school students. Methods This is a cross-sectional study using data from the 2021 Youth Risk Behavior Survey. Physical activity exposure was assessed as students’ self-reported weekly frequency of ≥ 60min moderate-to-vigorous physical activity (MVPA), as well as frequency of participation in muscle-strengthening activities, sports teams, and physical education (PE) classes. For the dose-response analysis three categories were created for each item. Depressive symptoms and poor mental health were measured using established survey items. Multivariate logistic regression risk models were used. Results A total of 8,015 high-school students were included. Depressive symptoms were reported by 43% of students, and 28% reported poor mental health. Moderate doses (1-4 days) of muscle-strengthening activities reduced the odds of depressive symptoms by 23% and the odds of poor mental health by 38% compared to low doses (0 days). Higher reductions were observed for higher doses (5-7 days). Similar results were observed for sports teams (1 vs 0 teams). Moderate doses (1-4 days) of MVPA ≥60min showed a significant reduction in the odds for poor mental health (38%) but not depressive symptoms compared to low doses (0 days). No effect was observed for any dose of PE attendance. Conclusions The findings suggest a dose-response pattern in the association between physical activity and mental health in adolescents. Any increase in physical activity levels among young adults would be valuable in preventing poor mental health. Key messages • A dose-response pattern was observed between self-reported mental health and physical activity exposure in adolescents. • Moderate levels of physical activity significantly reduced the risk of self-reported poor mental health among adolescents.

Resilience and mental and physical health of higher and lower educated youth during COVID-19

Abstract Background COVID-19 had a considerable impact on the mental and physical health of youth. To limit the impact of this crisis on their health, resilience was required. This study aims to discover how resilient, in terms of mastery, emotional reactivity and social support, groups of youth with different SES were during COVID-19, and what risk and protective factors they experienced. Methods Two qualitative datasets were analyzed. One dataset included 10 interviews of university students during April-May 2020, and the other dataset included 8 interviews with pre-vocational secondary education adolescents during October 2021 to March 2022. Interviews were held in person or online. Data were analyzed with thematic analysis in Atlas.ti. Results In general, university students displayed resilience despite the tumultuous beginning of the pandemic, and their mental and physical health was positive. Protective factors that helped them during COVID-19 were spending time with friends and family, being healthy and having a healthy lifestyle, and being able to avoid stressful situations. Risk factors that impacted their resilience were loneliness, COVID-19 anxiety, and missing stability and routine. Adolescents receiving pre-vocational secondary education showed mixed resilience later in the COVID-19 period, and they made negative observations about their health. Protective factors that helped them were achieving good results in school, hobbies, and avoiding stressful situations. Risk factors they experienced were lack of motivation and having difficulties at school. They experienced worry about school progress during COVID-19. Conclusions University students and lower educated adolescents seemed to have differing resilience during the impactful stages of COVID-19, possibly due to differences in their psychological development. To protect their well-being, it is important that policy makers consider the protective and risk factors that impact the health of youth during crises. Key messages • Resilience differs among the two different age groups and education levels. • Policy makers should consider the protective and risk factors that impact the health of youth during crises.

Promoting Equity: Child &amp; Adolescent Health Service

Abstract The health and well-being of children and adolescents face significant challenges, particularly in times of social instability. In response to these challenges, the Norwegian government allocated funding in 2021 to establish a national center for Child and Adolescent Health Promotion Services. Situated within the Norwegian Institute of Public Health, this center focuses on enhancing expertise, professional development, and research within municipal maternity and child health clinics, school health services, and youth health clinics. This presentation delves into the crucial role of Universal Health Promoting Services (UHPS) in mitigating the adverse effects of social inequality on child and adolescent health. By leveraging evidence-based practices and identifying knowledge gaps in health promotion and disease prevention in primary care settings, UHPS serve as catalysts for reducing health disparities and enhancing outcomes among expecting parents, children, and adolescents. Moreover, UHPS plays a vital role in addressing the underlying determinants of health inequality, including social network, lifestyle factors, promotion of health literacy and ensuring accessible health care services for all. UHPS empowers individuals and communities to actively participate in health promotion efforts, fostering a culture of health equity and resilience. Through targeted health education programs, early intervention strategies, and community empowerment initiatives the UHPS work both at a systems and individual level to address social inequality in health. This presentation contextualizes UHPS within a broader picture aimed at promoting child and adolescent health while addressing social inequality in health. By highlighting effective approaches and areas requiring further research, it aims to contribute to the ongoing discourse on optimizing health outcomes for young populations.

How does family support mitigate the impact of childhood adversity on adolescent mental health?

Abstract Background Childhood adversity is associated with increased risk of developing mental health problems over the life course. We investigated how family emotional support in adolescence may mitigate the impact of childhood adversity on adolescent mental health. Methods We used longitudinal data from the UK Millennium Cohort Study on 9,269 children followed to age 17 years. Individuals were assigned to exposure trajectories characterised using group-based trajectory models that included measures of poverty and family adversities (parental mental ill health, parental alcohol misuse and domestic violence) up to age 14 years. Using counterfactual causal mediation analysis and four-way decomposition modelling approach, we evaluated how perceived family emotional support at age 14 (measured using the three-item Short Social Provisions Scale) influences the association of childhood adversity trajectories on mental health at ages 14 and 17, assessing the relative contributions of mediation and interaction simultaneously. Results Compared with children experiencing low adversity and poverty, those exposed to childhood adversity were almost three times more likely to experience poor mental health (RR 2·99, 95% CI 2 ·41 to 3·57) at age 14 and age 17 (RR 2·58, 95% CI 2·09 to 3·06). Perceived emotional support mitigates up to 18% (95% CI: 9% to 26%) of this effect at age 14, and 13% (95% CI: 5% to 22%) at age 17, mainly due to interactive mechanisms. Conclusions Childhood adversity has a strong effect on mental health, which is partially mitigated by perceived family support in adolescence. Policies that support positive family functioning may be particularly beneficial for children who have experienced adversity. Key messages • Socio-economic – associated mental health problems in adolescence differed based on levels of family support. • Approximately 20% of the social inequality in mental health outcomes in adolescence may be mitigated or reduced by improving levels of family support.

The changing association between pandemic-related stressors and child and adolescent mental health during the waning phase of the COVID-19 pandemic

This study examined the relation between pandemic-related stressors and mental health among young people (YP) in India during two time points in the waning phase of the pandemic. We use data from two cross-sectional waves of over 20,000 YP aged 5–19 in February 2022, during the peak of the Omicron wave, and October 2022, during a reduction in infections and easing of restrictions. COVID illness/death in the family’s social network, current lockdown stringency, and significant change in household income were examined in relation to adult respondents’ reports of YP internalizing symptoms. Internalizing symptoms declined slightly from February to October 2022. COVID-19 illness/death in the family’s network was generally associated with more internalizing symptoms. Higher lockdown stringency was associated with lower levels of internalizing symptoms. YP in households with increases in income tended to have more internalizing symptoms. Many associations were driven by older adolescents and were stronger during the earlier (Feb-2022) than later (Oct-2022) data collection time-points. The findings illustrate the importance of anchoring results within a study’s specific geographic context, including concurrent events during the study period. Importantly, findings that may initially seem counterintuitive ultimately illuminate the dynamic and complex processes underlying child and adolescent mental health.

The association between screen use, psychological distress and sleep among adolescents in Norway

Abstract Background Today’s adolescents dedicate a significant portion of their time to screens. Concerns have arisen regarding the lasting impact of screen use on adolescent health, making it a crucial public health topic. Previous studies have presented both positive and negative outcomes associated with screen use. Further insight is required into various forms of screen use and the influence on adolescent health. The objective of this study is to examine the relationship between gaming, social media use, psychological distress, and sleep among adolescents. Methods This study is based on cross-sectional data from the Ung-HUNT4-study, a health study conducted among adolescents 13-19 years old in Trøndelag municipality in Norway from 2017-2019 (n = 8066). Binomial logistic regression was used to analyse the association between gaming, social media, psychological distress and sleep. Analysis was controlled for gender, age, family economy and having friends. Results Preliminary results showed that the odds for having psychological distress were higher for those who spent more than 3 hours on social media after school (OR: 1.31, 95% CI: 1.10-1.57), and on weekends (OR: 1.45, 95% Cl: 1.22 - 1.73), and on gaming in weekends (OR:1.30 Cl: 1.08-1.55) compared to those who spent 3 hours and less. The odds for sleeping &amp;lt; 8 hours per day on weekdays were higher for those who spent more than 3 hours on gaming after school (OR: 1.27 Cl:1.07-1.52), and more than 3 hours on social media after school, (OR:1.41 Cl:1.20-1.67) or on weekends (OR:1.39 Cl: 1.19-1.62), compared to those who spent 3 hours or less. Conclusions More than 3 hours spent on social media after school and on weekends was associated with significantly higher odds for psychological distress and less sleep on weekdays. More knowledge about the impact of different types of screen use on adolescents’ health is needed, and new public health strategies to secure safe screen use should be developed. Key messages • Screen use is associated with psychological distress and less sleep. • Awareness on various types of screen use and its influence on health in adolescence, is important in public health policy and practice.

9.N. Practice session: From Data to Action – Joining forces to close the inequity gap in adolescent health

Abstract Persistent adolescent health inequalities exist in Europe, necessitating interventions that address both individual and societal factors, especially those pertinent to youths in unfavourable contexts. Collaborative efforts involving cross-sectoral partnerships and adolescent engagement are crucial in identifying and mitigating these disparities. Three case studies exemplify this approach. Case study 1: Effective intervention development hinges upon the translation of epidemiological insights into tangible actions. Heiko Schmengler will discuss how individual and contextual-level data is made actionable for the development of ePro-schools, an e-health intervention to promote healthy dietary habits and physical activity amongst adolescents in socially disadvantaged settings. ePro-schools brings together stakeholders from academia, the health sector, the education system, and local communities. This collaborative approach ensures that the intervention is not only grounded in solid scientific evidence but also fits the specific cultural, social, and economic contexts of the adolescents it aims to serve. Case study 2: Adolescents are not passive consumers of interventions, but active agents who frequently understand best what they need to improve regarding their health. Lourdes Cantarero Arevalo will share innovative methodologies and best practices for involving adolescents in data collection, intervention design, and policy development processes with the final aim to empower the voices of adolescents in vulnerable situations while addressing problems that are relevant for them. Case study 3: Filipa Alves da Costa will draw attention to the health concerns of adolescents resulting from incarceration. This talk will outline the development of a policy brief derived from UN global study data, which highlights the importance of cross-sectoral collaboration in developing actions to safeguard access to high quality healthcare for adolescents within the criminal justice system. A cross-sectoral approach is critical given that criminal justice systems typically fall outside the direct oversight of health ministries. The goal is to encourage policymakers, practitioners, and advocates to consider inter-sectoral strategies to address the complex health challenges these adolescents face. Following the presentations, we will facilitate a dynamic discussion with the audience, encouraging an exchange of ideas on strategies to address adolescent health inequalities from a multilevel perspective. This discussion aims to draw on the collective expertise of participants from diverse backgrounds, including practitioners, researchers, and policymakers. This dialogue aims to identify common barriers and opportunities, fostering a collaborative approach to tackling inequalities. The goal is to emerge from the workshop with a richer understanding of effective strategies that can be leveraged to close the gap in adolescent health across Europe. Key messages • Health inequalities among adolescents must be tackled collaboratively across different sectors and with participation of adolescents. • Participants will gain valuable insights on innovative solutions and effective methodologies from the case studies to inform their own efforts in addressing adolescent health inequalities.

Empowering youths through citizen science to address health inequalities in adolescence

Abstract Citizen Science (CS) stands as a beacon of hope in the fight against inequalities in adolescent health, revolutionizing scientific research by involving individuals from diverse backgrounds. Unlike traditional methods, CS transcends academic boundaries, fostering inclusivity and collaboration irrespective of age, nationality, or social status. This approach has gained momentum in adolescent health research, empowering young people as co-researchers from project inception, thereby reducing disparities in health knowledge and access. Studies demonstrate its efficacy in enhancing empowerment and health literacy among participants. YouthChronic is an example of how CS can mitigate health inequalities among adolescents. The project ensures active participation in every research stage by engaging adolescents with chronic conditions as citizen scientists. Open-ended questions facilitate detailed responses, while participation in analysis and dissemination enhances their research involvement and sense of ownership. Through initiatives like YouthChronic, CS is reshaping the research landscape, making it more relevant and impactful to bridge the inequality gap. Young Citizen Scientists’ views on their participation: “As part of YouthChronic, we felt like our experiences with chronic conditions were finally being heard. The researchers were cool-they listened to us, let us be flexible with our participation, and even taught us some research skills. Learning from other peers’ experiences made us feel less alone and gave us new insights. But it’s frustrating that we’re limited by resources. We have big ideas, like running an advocacy campaign, but we need funding to make them happen”. In conclusion, by actively involving adolescents in the scientific process through CS initiatives like YouthChronic, we can reduce inequalities in adolescent health, empower marginalized voices, and pave the way for a brighter, more inclusive future in scientific exploration and discovery.

Family-based sexual health intervention for adolescents; A systematic review and meta-analysis

Abstract Background Family-based interventions are important in promoting adolescent sexual health outcomes. However, the effectiveness of these interventions in promoting adolescent sexual and reproductive health (ASRH) in Lower and middle-income countries (LMIC) has not been empirically evaluated. This review aimed to summarise the effectiveness of family-based sexual and reproductive health interventions in promoting ASRH in LMIC. Methods We conducted a systematic search for studies published in English from 2000 to October 2023 using MEDLINE, PsyINFO, CINAHL, Web of Science, and EMBASE databases. Studies were included if they involved adolescents aged 10-19 years, included family members in a key intervention component, evaluated the effectiveness of the interventions using an experimental or quasi-experimental design, assessed ASRH outcomes reported by adolescents and were conducted in LMIC setting. Standardized mean difference (SMD) and 95% confidence intervals were computed and meta-analyses were conducted using random effect models. Results Ten articles involving 2,246 participants were included in the review. The studies were nostly conducted in Africa. Across studies, there was no significant impact of family-based interventions in improving adolescent sexual health knowledge (SMD=0.5, 95%CI: -1.98 to 2.98), attitudes (SMD= -0.05, 95%CI: -1.92 to 1.82), practices (SMD=0.53, 95%CI: -0.69 to 1.75), or sexual communication with their family (SMD= 0.14, 95%CI: -0.42 to 0.7). Although individual studies reported a mixed effect of family-based interventions in improving sexual health outcomes, the pooled results from the meta-analysis showed no significant impact of family-based interventions. Conclusions Our review did not find any significant impact of family-based interventions in improving ASRH in LMIC. We recommend interventions using innovative approaches and novel strategies to align with the socio-cultural and economic background of the study setting. Key messages • This study found no significant impact of family-based interventions in improving ASRH in LMIC. • Additional studies, particularly from Asia, using culturally relevant interventions is required in this area.

Exploring the association between low birthweight and adolescent mental health in the United Kingdom

Abstract Low birthweight (LBW) is associated with a range of medical conditions including behavioural and emotional problems over the life course. This study aimed to explore the association between LBW and internalising and externalising mental health problems (MHP) in adolescents born in the United Kingdom between 2000 and 2002. Data were analysed for 10,485, 9,228, and 8,402 Millennium Cohort Study participants at ages 11, 14 and 17, respectively. Internalising and externalising MHP were measured using the Strengths and Difficulties Questionnaire (SDQ). LBW was subcategorised by size for gestational age and prematurity. Crude and adjusted associations between LBW subgroup and internalising and externalising MHP were estimated using binary logistic regression. Internalising MHP were more prevalent in LBW than NBW participants at ages 11 (14.2% vs 10.3%, p &amp;lt; 0.001), 14 (19.4% vs 13.7%, p &amp;lt; 0.001), and 17 (parent-report: 20.3% vs 14.8%, p &amp;lt; 0.001; self-report: 25.7% vs 20.1%, p &amp;lt; 0.001), respectively. Externalising MHP were more common amongst LBW participants at ages 11 (9.4% vs 7.3%, p = 0.02) and 14 (9.0% vs 6.6%, p = 0.01). Compared with NBW peers, the odds of internalising (males: aOR 2.18, 95% CI 1.21-3.73, p = 0.007; females: aOR 2.17, 95% CI 1.22-3.66, p = 0.005) and externalising MHP (males: aOR 2.01, 95% CI 1.05-3.60, p = 0.014; females: aOR 2.58, 95% CI 1.14-5.24, p = 0.016) were significantly increased in male and female premature small for gestational age (SGA) participants at age 11. Externalising MHP were significantly increased amongst premature SGA females aged 14 (aOR: 2.53, 95% CI 1.01-5.66, p = 0.016). Internalising MHP were significantly increased in premature SGA females at age 17 based on parent (aOR: 2.41, 95% CI 1.38-4.22, p = 0.005) and self-report (aOR: 1.95, 95% CI 1.14-3.31, p = 0.014). Amongst LBW individuals, premature SGA females have the greatest risk of internalising and externalising MHP during adolescence, thus identifying an important target group for intervention. Key messages • This study provides evidence for the longitudinal association between low birth weight and mental health in adolescents born in the United Kingdom in the 21st century. • Stratification of low birth weight individuals by size for gestational age and prematurity enabled the identification of a subgroup of adolescents for mental health promotion.