Adolescent Health Research Articles

Intersectionality, gender norms, and young adolescents in context: a review of longitudinal multicountry research programmes to shape future action.

Discriminatory gender norms can intersect and interact with other dimensions of discrimination-such as age, race, ethnicity, disability, education status, and sexual orientation-to shape individuals' experiences and impact their health and wellbeing. This interaction is referred to as intersectionality. Although the theory has been in circulation since the late 1980s, only recently has it gained traction in low-income and middle-income settings, and it has yet to fully penetrate global research on adolescence. The social and structural intersectional drivers of adolescent health and wellbeing, particularly during early adolescence (age 10-14 years), are poorly understood. The evidence base for designing effective interventions for this formative period of life is therefore relatively small. In this Review, we examine how gender intersects with other forms of disadvantage in the early stages of adolescence. Analysing data from hybrid observation-intervention longitudinal studies with young adolescents in 16 countries, our aim is to inform the health and wellbeing of girls and boys from a range of social contexts, including in conflict settings. Adolescents' perceptions about gender norms vary by context, depend on individual opinion, and are shaped by socioecological drivers of gender inequalities in health. Shifting those perceptions is therefore challenging. We argue for the importance of applying an intersectionality lens to improve health and wellbeing outcomes for young adolescents and conclude with five practical recommendations for programme design and research.

Back to Normal? Harnessing Long Short-term Memory Network to Examine the Associations Between Adolescent Social Interactions and Depressive Symptoms During Different Stages of COVID-19.

Adolescence is a developmental period in which social interactions are critical for mental health. While the onset of COVID-19 significantly disrupted adolescents' social environments and mental health, it remains unclear how adolescents have adapted to later stages of the pandemic. We harnessed a machine learning architecture of Long Short-Term Memory recurrent networks (LSTM) with gradient-based feature importance, to model the association among daily social interactions and depressive symptoms during three stages of the pandemic. A year before COVID-19, 148 adolescents reported social interactions and depressive symptoms, every day for 21days. One hundred sixteen of these youths completed a 28-day diary after schools closed due to COVID-19. Seventy-nine of these youths and additional 116 new participants completed a 28-day diary approximately a year into the pandemic. Our results show that LSTM successfully predicted depressive symptoms from at least a week of social interactions for all three waves (r2 > .70). Our study shows the utility of using an analytic approach that can identify temporal and nonlinear pathways through which social interactions may confer risk for depression. Our unique analysis of the importance of input features enabled us to interpret the association between social interactions and depressive symptoms. Collectively, we observed a return to pre-pandemic patterns a year into the pandemic, with reduced gender and age differences during the pandemic closures. This pattern suggests that the system of social influences in adolescence was affected by COVID-19, and that this effect was attenuated in more chronic stages of the pandemic.

The protective effect of physical activity on mental health of middle school students at different stages during the COVID-19 outbreak

This study aims to further understand the changes in physical activity level(PAL) and mental health among adolescents before and after the outbreak of COVID-19 and explore the protective role of physical activity (PA) on the mental health of adolescents during major disasters. A convenient sampling method was used to conduct a cross-sectional survey. The cross-sectional data from 2838 Chinese middle school students (mean age = 14.91 ± 1.71 years, 49.54% female) were used, of which 1,471 and 1,367 were in 2021 and 2022, respectively. The PAL was collected using the Physical Activity Questionnaire for Children (PAQ-CN), mental health status was collected using the Mental Health Inventory of Middle School Students (MMHI-60), sociodemographic information was collected using a self-reported questionnaire. Before and after the outbreak of COVID-19, the PAL of adolescents was 2.36 ± 0.74 and 2.50 ± 0.66, respectively, with a significant difference (p < 0.01, 95% CI: 0.09, 0.19). The mental health scores were 1.71 ± 0.60 and 1.86 ± 0.73, respectively, with a significant difference (p < 0.01, 95% CI: − 0.20, − 0.10). The detection rates of mental health problems were 27.50% and 35.50%, respectively. The rates of achieving PAL standards were 30.20% and 18.00% among adolescents, while the rates of not achieving PAL standards were 39.60% and 18.00%. PA is a protective factor for the mental health of adolescents during major disasters.

Form and functioning: contextualising the start of the global financing facility policy processes in Burkina Faso

ABSTRACT Background Burkina Faso joined the Global Financing Facility for Women, Children and Adolescents (GFF) in 2017 to address persistent gaps in funding for reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N). Few empirical papers deal with how global funding mechanisms, and specifically GFF, support resource mobilisation for health nationally. Objective This study describes the policy processes of developing the GFF planning documents (the Investment Case and Project Appraisal Document) in Burkina Faso. Methods We conducted an exploratory qualitative policy analysis. Data collection included document review (N = 74) and in-depth semi-structured interviews (N = 23). Data were analysed based on the components of the health policy triangle. Results There was strong national political support to RMNCAH-N interventions, and the process of drawing up the investment case (IC) and the project appraisal document was inclusive and multi-sectoral. Despite high-level policy commitments, subsequent implementation of the World Bank project, including the GFF contribution, was perceived by respondents as challenging, even after the project restructuring process occurred. These challenges were due to ongoing policy fragmentation for RMNCAH-N, navigation of differing procedures and perspectives between stakeholders in the setting up of the work, overcoming misunderstandings about the nature of the GFF, and weak institutional anchoring of the IC. Insecurity and political instability also contributed to observed delays and difficulties in implementing the commitments agreed upon. To tackle these issues, transformational and distributive leaderships should be promoted and made effective. Conclusions Few studies have examined national policy processes linked to the GFF or other global health initiatives. This kind of research is needed to better understand the range of challenges in aligning donor and national priorities encountered across diverse health systems contexts. This study may stimulate others to ensure that the GFF and other global health initiatives respond to local needs and policy environments for better implementation.

Using the universal design for learning framework to improve child and adolescent mental health

AbstractPoor mental health in childhood and adolescence has a significant impact on both physical and mental health throughout life. However, growing evidence suggests that current levels of child and adolescent mental health (CAMH) care are insufficient to meet the needs of many children and adolescents in the United States as evidenced by increasing rates of mental health problems, inequities in diagnosis, and inaccessibility of services. This article provides a discussion of current problems in CAMH and school mental health services and emphasizes a developmental perspective of CAMH, including the co‐occurrence of school difficulties and mental health concerns. A universal design for learning framework for school‐wide mental health programs is suggested as a means of addressing barriers to care and promoting prevention and early intervention in CAMH.

Manifold learning uncovers nonlinear interactions between the adolescent brain and environment that predict emotional and behavioral problems.

Background To progress adolescent mental health research beyond our present achievements - a complex account of brain and environmental risk factors without understanding neurobiological embedding in the environment - we need methods to unveil relationships between the developing brain and real-world environmental experiences. Methods We investigated associations among brain function, environments, and emotional and behavioral problems using participants from the Adolescent Brain and Cognitive Development Study (N=2,401 female). We applied manifold learning, a promising technique for uncovering latent structure from high-dimensional biomedical data like functional magnetic resonance imaging (fMRI). Specifically, we developed exogenous PHATE (E-PHATE) to model brain-environment interactions. We used E-PHATE embeddings of participants' brain activation during emotional and cognitive processing to predict individual differences in cognition and emotional and behavioral problems, both cross-sectionally and longitudinally. Results E-PHATE embeddings of participants' brain activation and environments at baseline show moderate-to-large associations with total, externalizing, and internalizing problems at baseline, across several subcortical regions and large-scale cortical networks, relative to the zero-to-small effects achieved by voxel or PHATE methods. E-PHATE embeddings of the brain and environment at baseline also relate to emotional and behavioral problems two years later. These longitudinal predictions show a consistent, moderate effect in the frontoparietal and attention networks. Conclusions Adolescent brain's embedding in the environment yields enriched insight into emotional and behavioral problems. Using E-PHATE, we demonstrate how the harmonization of cutting-edge computational methods with longstanding developmental theories advances detection and prediction of adolescent emotional and behavioral problems.

Associations of excessive internet use, sleep duration and physical activity with school absences: a cross-sectional, population-based study of adolescents in years 8 and 9

BackgroundInternet use has increased and sleep and physical activity (PA) have decreased in recent years among adolescents. Besides sleep and PA, another determinant of future health for adolescents is education....

Gender Matters: Exploring the Mental Health of Youth Experiencing Homelessness in Canada

The gender gap in adolescent mental health experiences is notable, with gender adding an additional layer to the already complex experience of being a young person who is experiencing homelessness. Yet, research in this area is limited. The purpose of this qualitative, interpretive description study was to understand how gender shapes the mental health of youth who are experiencing homelessness in the Niagara Region of Ontario, Canada. Eleven young people between the ages of 16 and 24 were recruited from a youth shelter and participated in individual semi-structured interviews. Thematic analysis and Gender-Based Analysis Plus was used to analyze the data, and findings revealed four contextual factors that appear to influence a young person’s mental health while homeless but that is experienced differently depending on one’s gender identity. These factors are: (1) housing acquisition is challenging, (2) physical presentation is meaningful, (3) cleanliness and hygiene are expected, and (4) utilizing mental health resources is complicated. Additionally, the many strengths that the youth identified and demonstrated in navigating their circumstances are highlighted in the results. These strengths involve (1) exhibiting resilience, (2) expressing the ability to survive, (3) imagining a world that is better, (4) articulating their needs, and (5) drawing on their social connections. The gendered lens that guides this study provides a challenge to the homogenous way that young people experiencing homelessness are often portrayed within the literature. Intersecting identities that include gender and age need to be considered within the mental health-related experiences of youth who live with homelessness. Ensuring that interventions are tailored to meet young people’s specific gendered needs is both a matter of human rights and health equity. Practical implications for service providers are discussed.

Psychometric adaptation of the Spanish version of the Brief Pittsburgh Sleep Quality Index in adolescents.

Good sleep quality is essential for adolescent health, yet sleep difficulties persist in this age group. The 6-item Brief Pittsburgh Sleep Quality Index (B-PSQI) was recently developed to improve sleep quality assessment, however, its validity in adolescents remains unexplored. This study examined the B-PSQI's psychometric properties in Spanish adolescents and adapted the scoring method to age-specific sleep recommendations. A cross-sectional study involving 1,065 adolescents (15-17 years; 56.8% female) was conducted in public high schools. Sleep quality was measured using the B-PSQI, the Insomnia Severity Index (ISI), the short Patient-Reported Outcomes Measurement Information System (PROMIS), and the Epworth Sleepiness Scale (ESS). Additionally, depression and anxiety were assessed using the Depression, Anxiety, and Stress Scales. Reliability, validity, and measurement invariance were analyzed. The B-PSQI global scores were 4.5 (SD = 1.9) for the original scoring method and 5.4 (SD = 2.8) for the age-adjusted. The age-adjusted B-PSQI showed satisfactory reliability (ω = 0.84) and concurrent, convergent, and discriminant validity (ISI rS = 0.67; PROMIS rS = 0.71; anxiety rS = 0.40; depression rS = 0.42; ESS rS = 0.29). Adequacy for one-factor structure (χ2(4) = 53.9; CFI = 0.97; TLI = 0.92; RMSEA = 0.108; SRMR = 0.05) and invariance across sexes were supported. Both B-PSQI scoring methods showed similar psychometric properties, but the original yielded a higher percentage of poor sleepers (43.1%; cutoff ≥5) than the age-adjusted version (41.9%; cutoff ≥6). Findings suggest that the B-PSQI is a valid and reliable measure to assess adolescent sleep quality. Its scoring can be adjusted to provide age-specific criteria for good sleep. The B-PSQI has potential utility for screening sleep problems and facilitating overall health promotion in adolescents.

Efficacy of Community-Delivered PEERS® for Adolescents: Increases in Social Skills and Decreases in Social Anxiety and Loneliness.

PEERS® for Adolescents is an evidence-based social skills training program developed for individuals with autism spectrum disorder (ASD), which is now widely implemented by community providers in clinics and schools. However, majority of past efficacy studies on PEERS® were conducted in controlled research settings, with limited information about its effectiveness when delivered in the community. We sought to examine the effects of PEERS® on social functioning and mental health outcomes when delivered in an outpatient autism specialty clinic. Clinical data from 45 adolescents with social challenges (age range: 11-18 years old; 31.1% female assigned at birth) were extracted for secondary analyses. Paired t-tests were performed to examine the pre- to post-intervention changes in social and mental health outcomes. Correlations between pre- and post-change scores of outcome measures were examined. Self-reported social skills knowledge, caregiver-reported social skills (measured by the Social Skills Improvement Systems) and the number of get-togethers hosted, increased significantly from pre- to post-intervention. Additionally, caregiver-reported anxiety and self-reported loneliness significantly decreased from pre- to post-intervention. Exploratory analyses showed that increases in caregiver-reported social skills were associated with decreases in self-reported loneliness. Our findings provide evidence supporting the efficacy of PEERS® for improving social knowledge and skills of adolescents with social challenges when delivered in the community. The current study also showed the potential benefit of PEERS® for improving adolescent mental health.

Impact of high fat and low lean mass phenotype on bone mineral content: A cross-sectional study of Chinese adolescent population

Background and ObjectiveResearch on body composition phenotypes and bone health in adolescents is limited. Hence, this study aimed to analyze the relationship between different body composition phenotypes, bone mineral content, and bone metabolism markers in Chinese adolescents. MethodsIn this cross-sectional study, 1852 adolescents aged 12 to 18 years were selected from six schools in Yinchuan City between 2017 and 2020 using stratified cluster random sampling. The participant's body composition and bone mineral content (BMC) were measured using bioelectrical impedance analysis (BIA). Serum bone metabolic markers (OC, CTX, and Ca) were measured. Based on their FMI and LMI, individuals were categorized into four body composition phenotypes: low fat mass-low lean mass (LFMI-LLMI), low fat mass-high lean mass (LFMI-HLMI), high fat mass-high lean mass (HFMI-HLMI), high fat mass-low lean mass (HFMI-LLMI). ResultsThere was a statistically significant difference between the four different body composition phenotypes with BMC, CTX and Ca in boys (all P < 0.05), similar conclusions were found in girls, except the OC and CTX. After adjusting for age, gender, smoking, drinking, and others, compared with the LFMI-HLMI reference group, the two high FMI groups (HFMI-LLMI and HFMI-HLMI) had a greater negative correlation with BMC, while the low BMC risk of the HFMI-LLMI group was the highest (OR = 33.28; 95%CI: 11.12–99.63; P < 0.001). The correlation between BMC of different body composition phenotypes in boys was greater than that in girls. HFMI-HLMI is a risk phenotype negatively associated with Ca content (β = −0.12; 95%CI: −0.19 to −0.04; P < 0.05). Regardless of body composition level, BMC was always negatively correlated with fat mass (LLMI: β = −0.27; 95%CI: −0.32–0.21; HLMI: β = −0.52, 95%CI: −0.65–0.40) and positively correlated with lean mass (LFMI: β =0.24; 95%CI: 0.20–0.28; HFMI: β =0.23, 95%CI:0.13–0.33) (all P < 0.001). The fat mass showed different correlations with OC and CTX in girls and boys based on LLMI or HLMI (all P < 0.05). ConclusionHFMI-LLMI is a risk phenotype of low BMC in Chinese adolescents, and the relationship between fat mass and bone metabolism markers is affected by lean body mass and gender.

Videoconferencing in mental health services for children and adolescents receiving child welfare services: a scoping review

BackgroundVideoconferencing is considered an alternative to face-to-face consultations and a possibility to help overcome access-to-care barriers in mental health care services. Barriers to child and adolescent mental health services are particularly apparent in the case of children and adolescents receiving child welfare services. This scoping review aims to provide an overview of research on videoconferencing in the mental health treatment of children and adolescents receiving support from child welfare services.MethodsThis scoping review follows the review framework outlined by the Joanna Briggs Institute. The following databases were searched from January 2012 to April 2024: Scopus, Web of Science, PubMed, PsycINFO (Ovid), CINAHL Plus, Social Services s (ProQuest), Sociological s (ProQuest), and Google Scholar.ResultsThe search yielded 4322 unique records and resulted in the inclusion of 22 articles that met the inclusion criteria. The studies originated from Denmark, England, Australia, Norway, Canada, Chile, and the USA, and were grouped into four areas: (1) videoconferencing to increase access to mental health treatment for vulnerable groups (2) young people’s perspectives (3) videoconferencing in interdisciplinary collaborative meetings, and (4) use, awareness, and acceptance of videoconferencing among health and social care providers.ConclusionsThis scoping review shows that if videoconferencing in mental health care is to become an established and trusted method aimed at children and adolescents receiving child welfare services, several unresolved and potentially negative issues need attention and more research. This particularly applies to whether videoconferencing decreases or exacerbates inequalities in access to mental health services. A further question is whether new barriers are raised by screen-based treatment to threaten good therapeutic relationships, and by extension treatment quality and clinical outcomes.

Technology at the Rescue? Online Games, Adolescent Mental Health and the COVID Pandemic.

The COVID pandemic has had a major impact on the mental health of the population, especially on female adolescents. Eating disorders and gender identity problems have increased markedly. Online activities have also grown enormously during this period occupying a large portion of adolescents' time. We explore the use of social networking and online gaming by adolescent girls and boys. We discuss their possible influence on different levels of psychological distress in boys and girls in the face of the pandemic. We propose that online games, mainly used by young boys, might offer them some emotional protection through mechanisms related to the body and its experience, to the group dynamics of competition, collaboration, and hierarchy, to the possibility of expressing aggression, and to the construction of a clearer and more stable identity. An unprejudiced look at new technologies is mandatory, if we are to avoid projecting our fears and expectations onto them.

Prediabetes Prevalence by Adverse Social Determinants of Health in Adolescents.

Several clinical practice guidelines advise race- and ethnicity-based screening for youth-onset type 2 diabetes (T2D) due to a higher prevalence among American Indian and Alaska Native, Asian, Black, and Hispanic youths compared with White youths. However, rather than a biological risk, this disparity likely reflects the inequitable distribution of adverse social determinants of health (SDOH), a product of interpersonal and structural racism. To evaluate prediabetes prevalence by presence or absence of adverse SDOH in adolescents eligible for T2D screening based on weight status. This cross-sectional study and analysis used data from the 2011 to 2018 cycles of the National Health and Nutrition Examination Survey. Data were analyzed from June 1, 2023, to April 5, 2024. Participants included youths aged 12 to 18 years with body mass index (BMI) at or above the 85th percentile without known diabetes. The main outcome consisted of an elevated hemoglobin A1c (HbA1c) level greater than or equal to 5.7% (prediabetes or undiagnosed presumed T2D). Independent variables included race, ethnicity, and adverse SDOH (food insecurity, nonprivate health insurance, and household income <130% of federal poverty level). Survey-weighted logistic regression was used to adjust for confounders of age, sex, and BMI z score and to determine adjusted marginal prediabetes prevalence by race, ethnicity, and adverse SDOH. The sample included 1563 individuals representing 10 178 400 US youths aged 12 to 18 years (mean age, 15.5 [95% CI, 15.3-15.6] years; 50.5% [95% CI, 47.1%-53.9%] female; Asian, 3.0% [95% CI, 2.2%-3.9%]; Black, 14.9% [95% CI, 11.6%-19.1%]; Mexican American, 18.8% [95% CI, 15.4%-22.9%]; Other Hispanic, 8.1% [95% CI, 6.5%-10.1%]; White, 49.1% [95% CI, 43.2%-55.0%]; and >1 or other race, 6.1% [95% CI, 4.6%-8.0%]). Food insecurity (4.1% [95% CI, 0.7%-7.5%]), public insurance (5.3% [95% CI, 1.6%-9.1%]), and low income (5.7% [95% CI, 3.0%-8.3%]) were each independently associated with higher prediabetes prevalence after adjustment for race, ethnicity, and BMI z score. While Asian, Black, and Hispanic youths had higher prediabetes prevalence overall, increasing number of adverse SDOH was associated with higher prevalence among White youths (8.3% [95% CI, 4.9%-11.8%] for 3 vs 0.6% [95% CI, -0.7% to 2.0%] for 0 adverse SDOH). Adverse SDOH were associated with higher prediabetes prevalence, across and within racial and ethnic categories. Consideration of adverse SDOH may offer a more actionable alternative to race- and ethnicity-based screening to evaluate T2D risk in youth.

Association of Ideal Cardiovascular Health in Youth with Cancer Risk in Adulthood: Cardiovascular Risk in Young Finns Study.

Lifestyle factors may affect cancer risk. This study aimed to identify whether American Heart Association (AHA) Ideal Cardiovascular Health (ICH) score and its individual variables in youth associate with subsequent cancer incidence. Study comprised of participants of the Cardiovascular Risk in Young Finns Study free of cancer at analysis baseline in 1986 (n=1873). Baseline age was 12-24 years and the follow-up occurred between 1986-2018. Among 1873 participants (mean age 17.3±4.1 years; 53.4% females at baseline), 72 incident cancer cases occurred during the follow-up (mean follow-up time 31.4±3.4 years). Baseline ICH score was not associated with future cancer risk (HR 0.96, 95% CI 0.78-1.12 per 1-point increment). Of individual ICH score variables, ideal physical activity (PA) was inversely associated with cancer incidence (age- and sex-adjusted HR 0.45 (0.23-0.88) per 1-category change [nonideal/ideal]), and remained significant in multivariable-adjusted model including also BMI, smoking, diet and socioeconomic status. A continuous physical activity index at ages 9-24 years and moderate to vigorous physical activity in youth were also related to decreased cancer incidence (p<0.05). BMI, smoking, diet, total cholesterol, glucose and blood pressure were not related to cancer risk. Of the dietary components, meat consumption was associated with cancer incidence (p=0.023). These findings indicate that higher PA levels in youth associate with a reduced subsequent cancer incidence whereas AHA´s ICH score in youth does not. This finding supports the efforts in promoting healthy lifestyle and encourages in physical activity during childhood yielding in subsequent healthier life.

Patient actor training improves PrEP delivery for adolescent girls and young women in Kenya: a cluster randomized trial.

To evaluate effectiveness of a standardized patient actor (SP) training intervention to improve quality of PrEP services for adolescent girls and young women (AGYW) in Kenya. Cluster randomized trial and mystery shopper evaluation. Twelve of 24 maternal child health and family planning facilities were randomized to SP training. Providers at intervention facilities participated in 2-day training in adolescent health, PrEP guidelines, values clarification, and communication skills, followed by role-playing and de-briefing with trained actors. Control facilities received standard national training. The primary outcome was quality of care, assessed by unannounced SPs (USPs) or "mystery shoppers" blinded to intervention arm. Quality was measured in two domains: guideline adherence and communication skills. Intent to treat analysis compared post-intervention quality scores by randomization arm, clustering on facility, and adjusting for baseline scores and USP. Overall, 232 providers consented to USP visits, and 94 providers completed the training. Following training, USPs posed as AGYW seeking PrEP in 142 encounters (5-6 encounters per site). The mean quality score was 73.6% at intervention sites and 58.4% at control sites [adjusted mean difference=15.3, 95% Confidence interval (CI): 9.4-21.1, p < 0.001]. Mean guideline adherence scores were 57.2% at intervention sites and 36.2% at control sites (adjusted mean difference=21.0, 95% CI: 12.5-29.4, p < 0.001). Mean communication scores were 90.0% at intervention sites and 80.5% at control sites (adjusted mean difference=9.5, 95% CI: 5.5-13.6, p < 0.001). SP training significantly improved quality of PrEP care for AGYW in Kenya. Incorporating SP training and unannounced SP evaluation could improve PrEP uptake among AGYW.

A cross-sectional National Health and Nutrition Examination survey-based study of the association between systemic immune-inflammation index and blood urea nitrogen levels in United States adolescents

Blood urea nitrogen (BUN) level is one of the commonly used indicators to assess renal function and systemic immune-inflammatory status. In the adolescent population, changes in BUN levels may be associated with a variety of factors, including physiologic dehydration, lifestyle influences such as nutritional intake, physical activity, and possible endocrine or metabolic disorders. In recent years, more and more studies have shown that BUN levels are not only a reflection of kidney function, but it may also be related to the inflammatory state of the body. The Systemic Immune Inflammatory Index (SII) is a comprehensive index that takes into account platelet counts, neutrophil and lymphocyte counts, and is thought to be effective in reflecting the body's immune status and inflammatory response. However, research on the relationship between the two, SII and BUN, remains understudied in the adolescent population. The purpose of this study was to examine the relationship between SII and BUN levels in a population of American adolescents and to further analyze the factors that influence it. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) database. Using descriptive statistics, correlation analysis, and regression analysis, we explored the relationship between SII and BUN levels. We found a significant negative correlation between SII and BUN levels, with BUN levels decreasing when SII levels increased (BUN as the dependent variable and SII as the outcome variable). We performed a multiple regression analysis of this relationship, controlling for possible confounders such as gender, age, race, and BMI, and found that this negative correlation remained significant. Our findings reveal an important relationship between SII and BUN levels and provide new perspectives for understanding adolescent health.

Sexual health in adolescents with inflammatory bowel disease – The paediatric gastroenterologists' point of view

Sexual health in adolescents with inflammatory bowel disease – The paediatric gastroenterologists' point of view

Use of physical activity as a coping strategy mediates the association between adolescent team sports participation and emerging adult mental health

PurposeWe explored how team sport participation during adolescence may have prepared emerging adults to use physical activity (PA) as a coping strategy during the COVID-19 pandemic and therefore protect their mental health. MethodsMATCH study participants reported their involvement in team sports from age 11 to 18. At age 20, in the context of the COVID-19 pandemic, they reported their level of positive mental health, strategies to cope with stress, and perception of how helpful these are. Mediation analyses were used to estimate the natural direct effect of number of years of team sport participation during adolescence on emerging adults’ mental health, and the natural indirect effect through using PA as a coping strategy. ResultsData from 454 participants were available. PA was the most prevalent coping strategy reported (51.5%) and 74% of those using this strategy reported it helped a lot. More years of team sport participation during adolescence was associated with higher odds of reporting PA as a coping strategy (OR [95% CI] = 1.012 [1.007; 1.017]) and with higher level of mental health during emerging adulthood (β [95% CI] = 0.059 [0.024; 0.095]). The natural indirect effect suggests that the use of PA as a coping strategy partially explained the association between team sport participation in adolescence and mental health in emerging adulthood (NIE [95% CI] = 0.038 [0.002;0.074]). DiscussionMore team sports participation during adolescence is associated with better mental health during emerging adulthood. This association may operate through using PA to cope with stress.

Characterizing models of adolescent and youth-friendly health services in sub-Saharan Africa: a scoping review.

This scoping review provides an up-to-date overview of the evidence on adolescent and youth-friendly health services (AYFHS) in sub-Saharan African countries. We conducted a search of four databases and grey literature sources to identify English language publications from January 1, 2005, to December 14th, 2022. The review synthesized evidence on the models and characteristics of AYFHS, the application of World Health Organization (WHO) standards, and whether AYFHS have improved young people's health outcomes. In total, 77 sources were included in the review, representing 47 AYFHS initiatives spanning 19 countries, and three multi-country reports. Most commonly, AYFHS were delivered in public health facilities and focused on sexual and reproductive health, with limited application of WHO standards. Some evidence suggested that AYFHS increased young people's health service utilization and contraceptives uptake. There is a clear need to strengthen and develop innovative and multi-pronged approaches to delivering and evaluating AYFHS in this region.