Low-income Adolescents Research Articles

Does High Self-Control Accelerate Epigenetic Aging in Low-Income Adolescents?

PurposePersistent self-control in the context of upward mobility in low-income adolescents, especially those of color, may have physiological costs, such as greater risks of developing cardiometabolic diseases in young adulthood. One potential mechanism linking self-control to cardiometabolic health is epigenetic age acceleration (EAA). However, little is known regarding the association between high self-control and EAA, as well as what factors may play protective roles. Therefore, we evaluated (1) the association between self-control and EAA and if this association varies by race and ethnicity, and (2) whether neighborhood collective efficacy (NCE) and school connectedness moderate the association in low-income adolescents. MethodsThis study used data from the Future of Families and Child Wellbeing Study. Participants included 772 adolescents with a household income <300% of poverty level (mean age: 15.6 years). Self-control, NCE, and school connectedness were all self-reported. EAA was assessed in saliva and estimated using Horvath, Skin and Blood, and Pediatric-Buccal-Epigenetic clocks. Multiple linear regression and PROCESS analyses were employed. ResultsHigher self-control was positively associated with EAA estimated by the skin and blood clock in low-income adolescents of color. Further, the association of higher self-control with EAA was not significant among low-income adolescents of color with higher NCE. No significant association was found among low-income White adolescents. DiscussionThe results suggest that supportive resources like neighborhood collective efficacy could mitigate adverse associations of high self-control with health in low-income adolescents of color.

Street adolescents in low income setting exposed to hepatitis B and C, and disadvantaged by lifestyle: a Togolese cross-sectional study

BackgroundIn Togo, few data are available on viral hepatitis in street adolescents, a vulnerable population due to their lifestyle. The aim of this study was to describe the lifestyle of street adolescents (sexual practices and drug use), to estimate the prevalence of hepatitis B and C viruses, and to describe their HBV immunization profile in Togo.MethodsA cross-sectional study was conducted in Lomé (Togo) in July 2021. Street adolescents aged between 13 and 19 years were included. A questionnaire was used to document lifestyle. ELISA tests were performed for Hepatitis B surface antigen (HBsAg), Hepatitis B core and surface antibodies (anti-HBc, anti-HBs), and antibodies against hepatitis C virus (anti-HCV).ResultsA total of 299 adolescents (5.4% female) with a median age of 15 years (IQR: 14–17) were included. Of these, 70.6% (211/299) were sexually active and 70.6% (149/211) had not used a condom during their last sexual intercourse. Drug use was reported by 42.1% of the adolescents. The most used substances were cannabis (39.0%), cocaine (36.6%), glue solvents (19.5%), and tramadol (11.4%). However, cocaine use may have been overestimated due to information bias. Current HBV infection (HBsAg+) was detected in 3.7% (95%CI: 1.9–6.5) of the adolescents. Isolated anti-HBc + was present in 5.3%. All three HBV markers (HBsAg, anti-HBs, and anti-HBc) were negative in 71.6% of adolescents. Anti-HCV was detected in 4.7% of adolescents.ConclusionNearly one in 10 street adolescents has markers for HBV contact/current infection, and approximately 72% of street adolescents may still be infected with HBV, as they have no HBV markers. HCV is also circulating in this population. Given the reported high-risk sexual practices and high levels of drug use, there is an urgent need to develop integrated strategies to prevent infections, including HBV, and drug dependence in this population.

Riding for Focus as a Pathway to Improved Mental Health in Middle School Students

Youth mental health remains in a critical state even in a post-COVID pandemic world. Exercise is a well-regarded method to boost mental health and well-being in all age groups. The Riding 4 Focus (R4F) program is a cycling education program designed to equip students with basic cycling handling skills and introduce students to the lifetime physical activity of cycling. A secondary outcome of this program is to improve the behavioral health and well-being of adolescents in middle schools, primarily aged 10-14. The current study examined associations between participating in the R4F program and mental health and well-being in those with specific unmodifiable risk factors including gender, socioeconomic, and racial identity. Anonymous online surveys were collected from 3924 adolescent participants before the R4F program and 3289 students after the cycling program across 31 schools during the fall 2021 and spring 2022 semesters. Psychosocial well-being was quantified using the WHO-5 and PSC-17-Y metrics. Using non-parametric test statistics, the data shows a significant increase in the mental health and well-being of participants after the program. Further analysis revealed that participation in the R4F program was associated with improved psychological health and well-being of minority and low-income adolescents, as well as protective associations for both genders. Although these findings are encouraging, the effcacy of the program depends on a number of factors, and future studies are needed to assess causality. Outride, Loma Linda University School of Medicine, University of Redlands Summer Research Program, P20MD006988. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Food Insecurity, Low Household Income, and Low Education Level Increase the Risk of Having Metabolic Dysfunction-Associated Fatty Liver Disease Among Adolescents in the United States.

In the United States, 10.2% households (HH) report child food insecurity. We assessed associations between metabolic dysfunction-associated fatty liver disease (MASLD) and food insecurity among the adolescents in the United States. This cross-sectional study was performed using data from the National Health and Nutrition Examination Survey 2017-2018. Food insecurity was assessed by the US Department of Agriculture Child Food Security Survey Module. MASLD was defined by transient elastography. Among 771 adolescents (aged 12-18 years) (mean age 14.7 years; 52.5% male; 50.9% White, 12.7% Black, 24.4% Hispanic, and 12.1% other), 9.8% reported food insecurity; MASLD prevalence of 10.12% (95% confidence interval [CI] 7.13%-13.20%) affecting 4.27 million adolescents; and nonalcoholic fatty liver disease prevalence of 10.77% (95% CI 7.76-13.78) affecting 4.52 million adolescents. There was near-perfect concordance between MASLD and nonalcoholic fatty liver disease (Cohen's κ coefficient of 0.971, 95% CI 0.946-0.996). The prevalence of MASLD was greater among food-insecure adolescents vs food-secure ones (17.4% vs 9.4%) and adolescents living with a low HH income vs those with a higher HH income (15.0% vs 7.2%) and living with a head of HH with a lower education level vs one with a higher education level (18.0% vs 8.2%) ( P < 0.05). The fully adjusted model showed that compared with adolescents living in a higher HH income, food-insecure adolescents living in low income HH had a 3-fold greater risk (odds ratio [OR] 3.25, 1.31-8.08) of having MASLD, while food-secure adolescents living in low-income HH had no increased risk (OR 1.58, 0.85-2.93, P = 0.139). The fully adjusted odds of having MASLD was elevated by +163% with the presence of HTN (OR 2.63, 1.02-6.78), +241% with being Hispanic (OR 3.41, 1.36-8.56), and +138% with being male (OR 2.38, 1.20-4.75). In addition, a 1-unit increase in BMI was associated with 25% increase in the odds of having MASLD (OR 1.25, 1.17-1.33) among US adolescents. Food insecurity is associated with MASLD among US low-income adolescents especially Hispanic male individuals with obesity and hypertension. Policies addressing inequities are needed.

The influence of social support on low-income adolescents’ prosocial behavior: The mediating role of social goals

The current research aimed at deepening our understanding of how multiple sources of perceived social support (i.e., parent, teacher, friend, peer) predicted low-income adolescents’ multiple types of prosocial behavior (i.e., emotional, dire, compliant, anonymous, public, and altruistic) and if these relations were mediated by agentic and communal social goals across a 1-semester time span. Participants of the current research were adolescents in middle schools whose annul family income is less than 10,000 RMB (1,567.40 dollars) with ages ranging from 12 to 15 years old (Mean = 14.07, SD = 1.24, N = 689). The results showed that perceived social support from teachers, friends, and classmates positively predicted later prosocial behavior, and this relation was mediated by communal but not agentic social goal. Agentic social goal negatively predicted compliant prosocial behavior, anonymous prosocial behavior, and altruistic prosocial behavior. Perceived social support from parents, teachers, classmates, and friends did not significantly predict later agency. The present findings extended our understanding of the processes underlying the influence of social support on low-income adolescents’ prosocial development. Implications for practices to promote low-income adolescents’ prosocial development were discussed.

Hope &amp; despair: Implications for life outcomes &amp; policy

People’s ratings of life satisfaction, hope, and other dimensions of their well-being have become important metrics in disciplines such as economics and public health because they predict health, productivity, employment, and other social outcomes. Recent research suggests that hope, which can be measured with survey instruments, is the most important dimension of well-being for predicting future outcomes for individuals and society. Trends in hope have been tracked as a key factor in the rising numbers of U.S. deaths of despair—a term that encompasses suicide, overdoses, and alcohol-related mortality. Surveys of hope among low-income adolescents in Lima, Peru, and St. Louis, Missouri, have shown that those who have hope for the future—and who are often supported by a mentor—are more likely to invest effort in their education and avoid risky behaviors. By contrast, individuals in despair are unlikely to respond to incentives or opportunities and are vulnerable to misinformation and conspiracy theories. This article provides evidence that hope influences social and economic outcomes and examples of policies that can help restore hope in populations that have lost it. Preventing another generation from falling into despair is essential to a society’s health and security.

The effect of urban greenspace on adolescent sleep patterns

We investigated the effects of long-term greenspace deprivation on sleep during adolescence. Using data from a UK birth cohort, we studied deviations from age-recommended sleep duration through Time Use Diaries. Our sample (N = 1370; 53% female) of urban adolescents had been exposed to the same levels of neighbourhood greenspace from birth up to age 14 years when their time use was tracked. We factored in sex and ethnicity, family income, long-term illness, sharing of a bedroom, access to a garden, as well as air pollution and perceived area safety. Even after full adjustment, there was a significant interaction between greenspace availability and income when predicting sleep duration, such that low-income adolescents living in the greyest urban areas were found to sleep more than the 8–10 h recommended for their age group, while the inverse was true for their counterparts living in areas with more greenspace.

Factors Associated with Peer Victimization Among Brazilian Low-Income Adolescents

ABSTRACT Exposure to peer aggression and bullying victimization are both expressions of peer victimization but distinct constructs among adolescents. This study examined the potential associations between peer victimization and individual/family/peer factors and assessed whether the factors associated with peer aggression differed from those related to bullying victimization. This cross-sectional study, conducted in a low-income Brazilian city characterized by poverty, inequality, and violence, involved a three-stage probabilistic sampling plan that included a random selection of census units, eligible households, and the target child. Data collected from face-to-face confidential home interviews with 669 in-school adolescents (11 to 15 years, 51.7% girls) were analyzed. The level of exposure to peer aggression was determined by the sum of the presence of 15 events (within the categories of physical aggression, verbal harassment, and social manipulation) occurring at different frequencies in the previous six months. Bullying victimization occurring more than once a week or most days in the previous six months was investigated after presenting a bullying victimization definition to participants which required them to have felt harmed by their victimization experiences. Path analysis identified factors associated with peer aggression and bullying victimization. Suicide ideation or attempt was associated with bullying victimization, while being overweight, using alcohol (previous 12 months) and having no social support from a friend were associated with exposure to peer aggression. Community violence exposure was associated with both study outcomes. In conclusion, the fact that suicidality was associated with bullying victimization but not with peer aggression suggests that when adolescents recognize that peer victimization hurts their feelings, their mental health appears to be negatively affected.

Understanding and supporting the motivation of students from low-income families

Motivational development in low-income adolescents has been insufficiently studied, due to the difficulties involved in accessing the target population. Nevertheless, previous research suggests that some specific developmental patterns might be particular to this group. On the basis of Self-Determination Theory (SDT) and using latent growth modeling (LGM), we investigated the trajectories of intrinsic and extrinsic motivations in low-income students during adolescence, and we identified the role of parents, teachers, and classmates in determining these trajectories. The participants were 228 adolescents (Mage = 12.8; SDage = 1.74; 43.4% girls; 17.1% immigrants) officially certified by the Italian government as being below the poverty threshold. Data was collected by means of a four-wave research design over a period of two years.Our findings revealed a significant drop in levels of identified regulation over time, while all other forms of motivation, including intrinsic motivation, remained stable during the period considered. Low-income students therefore appear to experience a specific form of motivational decline during adolescence, so that they perceive studying as being less and less meaningful in relation to their goals, values and identities. This decline is even more pronounced for second-generation and male low-income adolescents.However, parents and teachers were significant predictors of identified regulation at each point in time, suggesting that their support for autonomy fosters identified regulation throughout adolescence. As regards the role of classmates, peer acceptance appears to support identified regulation, while having many friendships seems to have a negative impact on this kind of motivation.

Diet Quality and Contextual Factors Influencing Food Choice among Adolescents with Food Security and Food Insecurity in Baltimore City.

This study evaluated differences in overall diet quality, diet quality components, and food-related contextual factors between adolescents with food security and those with food insecurity. Mixed methods analysis was conducted on data from three 24-h dietary recalls from 61 adolescents ages 14-19 years old living in Baltimore, Maryland, USA in 2020-2021. All adolescents were sampled from households eligible for the Supplemental Nutrition Assistance Program in 2020. There were no significant differences in overall diet quality or components between adolescents with food security and those with food insecurity in this sample, except for seafood and plant proteins, which was higher for adolescents with food insecurity. Qualitative analysis found that adolescents were largely influenced by their parents and the home food environment, and that workplace environments enabled adolescents to eat foods high in refined grains, sugar, and saturated fat. These findings provide insight about the experiences of low-income adolescents during times when they are home for prolonged periods (i.e., emergency school closures, summer, and winter breaks). Programs and policies that aim to improve healthy food access may positively impact adolescent food security and diet quality, and it is important to ensure that healthy foods are available and accessible to adolescents in the places where they spend the most time. Multilevel interventions in the home, school, and workplace may be most effective in encouraging healthy eating behaviors among adolescents.

How are Family Resources and School Resources Related to Low-Income Adolescents’ Psychological Adjustment? The Moderating Role of Belief in a Just World

How are Family Resources and School Resources Related to Low-Income Adolescents’ Psychological Adjustment? The Moderating Role of Belief in a Just World

Low-Income Adolescents’ Future Goals and Current Achievement: Parents as Sources of Resilience During the Transition to Middle School

Adolescents growing up in low-income communities experience decreases in school engagement during their transition to middle school due to multiple stressors. Holding goals for their futures increases their resilience, yet research on the types of goals that are most beneficial and on parents’ influence on the formation of future goals is limited. This study investigated relations between parental academic socialization, adolescent goals, and adolescent achievement. An ethnically diverse sample of 319 students reported on their intrinsic and extrinsic future goals, current mastery goals, and parents’ academic socialization messages. Results showed that adolescents’ intrinsic future goals and current mastery goals mediated relations between parents’ messages about the importance of working hard to succeed in school and adolescents’ grades. Parents influence adolescents’ motivation and achievement by conveying messages about the value of learning, and adolescents with higher intrinsic future goals may view mastery and hard work as means of achieving those goals.

Gender differences in the stress-buffering effects of mindfulness facets on substance use among low-income adolescents

Problematic substance use during adolescence predicts numerous adverse outcomes, including increased risk of substance use disorders in adulthood. Adolescents often use substances to cope with stress, particularly adolescents who have experienced environmental stress in childhood (e.g., low-income environments), but research indicates stress-related substance use disorders may develop differently across gender. This highlights a need to identify coping resources for stress-related substance use and understand whether these coping resources are differentially effective across gender. Mindfulness has garnered evidence as a coping resource for stress-related problematic substance use; however, there is limited research on how specific mindfulness facets (e.g., nonjudgment) may buffer against stress-related substance use among adolescents. This study examined whether overall mindfulness and specific facets buffered the association between stress and substance use differentially across gender in a predominantly low-income, racially-diverse (42 % Black, 24 % White, 15 % Hispanic/Latinx, 13 % Asian, 3 % American Indian/Alaskan Native, and 3 % multiracial) sample of adolescents (n = 212) using moderated moderation models. Girls with lower levels of two mindfulness facets (i.e., acceptance/nonjudgement, decentering/nonreactivity), relative to girls with higher levels, demonstrated a greater probability of substance use with increased stress. Conversely, boys with higher levels of acceptance/nonjudgement and decentering/nonreactivity, relative to boys with lower levels, reported a greater probability of substance use with increased stress. Results suggest that acceptance/nonjudgment and decentering/nonreactivity may be protective against stress-related substance use for girls and potentially contraindicated for boys, indicating that adolescent substance use prevention and intervention efforts may need to be tailored by gender.

Housing mobility protects against alcohol use for children with socioemotional health vulnerabilities: An experimental design.

Neighborhood context may influence alcohol use, but effects may be heterogeneous, and prior evidence is threatened by confounding. We leveraged a housing voucher experiment to test whether housing vouchers' effects on alcohol use differed for families of children with and without socioemotional health or socioeconomic vulnerabilities. In the Moving to Opportunity (MTO) study, low-income families in public housing in five US cities were randomized in 1994 to 1998 to receive one of three treatments: (1) a housing voucher redeemable in a low-poverty neighborhood plus housing counseling, (2) a housing voucher without locational restriction, or (3) no voucher (control). Alcohol use was assessed 10 to 15 years later (2008 to 2010) in youth ages 13 to 20, N=4600, and their mothers, N=3200. Using intention-to-treat covariate-adjusted regression models, we interacted MTO treatment with baseline socioemotional health vulnerabilities, testing modifiers of treatment on alcohol use. We found treatment effect modification by socioemotional factors. For youth, MTO voucher treatment, compared with controls, reduced the odds of ever drinking alcohol if youth had behavior problems (OR=0.26, 95% CI [0.09, 0.72]) or problems at school (OR=0.46, [0.26, 0.82]). MTO low-poverty treatment (vs. controls) also reduced the number of drinks if their health required special medicine/equipment (OR=0.50 [0.32, 0.80]). Yet treatment effects were nonsignificant among youth without socioemotional vulnerabilities. Among mothers of children with learning problems, MTO voucher treatment (vs. controls) reduced past-month drinking (OR=0.69 [0.47, 0.99]), but was harmful otherwise (OR=1.22 [0.99, 1.45]). For low-income adolescents with special needs/socioemotional problems, housing vouchers protect against alcohol use.

The Impact of Coronavirus Lockdowns on Adolescents

This article examines the social, medical, and futuristic impacts of coronavirus lockdowns on adolescents. The effects of social isolation and school closures are the focus. The literature reveals that adolescents’ mental health declined due to social isolation during COVID, and that their social development was stunted. The brain development of adolescents could also have been negatively affected due to a lack of engagement in social decision making processes. The article examines the inequality exacerbated by the pandemic, namely the increased inequality by race and income in adolescents’ access to sports and the economic inequality in learning losses. Not only were learning losses during remote learning more prevalent among low-income adolescents, but these students are likely to experience a decrease in expected income over the course of their lifetimes. Based on existing research, an effective remedy to the negative impacts of COVID lockdowns on adolescents would be to increase funding to schools in order to decrease COVID cases among adolescents, provide individualized instruction to students who fell behind during remote learning, and to improve in-school counseling services.

Family satisfaction and self-efficacy among low-income adolescents during the COVID-19 pandemic: A comparative analysis of parents' educational attainment.

PurposesGiven that the period from middle to high school is important to develop and cultivate self-efficacy, reduced support in low-income families might negatively influence the development of self-efficacy among low-income students since COVID-19. This study aims to investigate the association between family satisfaction and self-efficacy among low-income students since COVID-19 and the moderating effect of parents' educational attainment on the relationship.Methods255 low-income students in South-Korea were selected for the final sample. The PROCESS macro 3.4 for Statistical Product and Service Solutions was used to analyze the data.ResultsFamily satisfaction was positively related to self-efficacy among low-income students. There was a significant moderating effect of parents' educational attainment on the relationship between family satisfaction and self-efficacy among low-income students during the COVID-19 pandemic.DiscussionFinancial support and COVID-19 benefits should be prioritized to low-income families with adolescents to improve family relationships, leading to increase self-efficacy among low-income students. Social welfare programs targeting family relationships in low-income households should be especially targeted toward low-income households without a parent who received higher education. Life-long education should be provided to parents in low-income families who did not gain higher education as their educational attainment influences the self-efficacy of their adolescent children.

P024 Adolescent Independent Eating Occasion Frequency and Dietary Intake by Personal and Household Characteristics

<h3>Background</h3> Independent eating occasions (iEOs) among adolescents were associated with poorer diet quality and overweight status in previous studies. Little is known about how iEOs (frequency and food groups/food types consumed) vary by personal (e.g., age, sex, race, ethnicity) and household (e.g., food security) characteristics and other factors (e.g., school learning format - online vs. remote). <h3>Objective</h3> To determine associations among iEOs (frequency and food groups/food types consumed) and key personal and household characteristics among low-income adolescents in the US. <h3>Study Design, Settings, Participants</h3> A US-based online cross-sectional survey was administered to a national sample of low-income adolescents who reported iEOs and their parents (n = 622 dyads) from Qualtrics survey panelists (November/December 2021). About half were 11-12 years (44%), boys (53%), non-Hispanic White (44%), and from food-insecure households (52%). About two-thirds (68%) reported attending school in person. An adapted 27-item FLASHE (Family Life, Activity, Sun, Health, Eating) Study food frequency questionnaire was used to quantify mean daily intake frequencies of food groups/types consumed overall and during iEOs. <h3>Measurable Outcome/Analysis</h3> Chi-square tests were used to compare iEO frequency by demographic characteristics. Linear regression analyses were used to determine associations among mean iEO and overall daily food group intake frequencies (dependent variables) and iEO frequency (independent variable) adjusting for demographic and household characteristics. <h3>Results</h3> Frequency of iEOs was ≤ 3-4 times/week (46%) and ≥ 5-6 times/week (54%), with no differences by age group, sex, or in-person school attendance. Frequency of IEOs was positively associated with intake frequencies for all food groups both during IEOs and overall. Higher daily iEO intake frequencies of sugar-sweetened beverages, fast food/convenience foods, and all detrimental foods were also associated with food insecurity and non-Hispanic White race. <h3>Conclusions</h3> More frequent iEOs were associated with greater daily intake frequency of less healthful and healthful foods during iEOs and overall. Nutrition education could focus on increasing intake of healthful foods during iEOs for food-insecure youth. <h3>Funding</h3> USDA

Academic Socialization From an “Informed Distance”: Low-Income Chinese American Adolescents’ Perceptions of Their Immigrant Parents’ Educational Messages

Background/Context: Despite research that has rebutted the tiger parent stereotype, the perception that Asian immigrant parents enact overly strict and controlling educational practices continues to be widespread and entrenched. This stereotype is problematic because it constrains the understanding of Asian Americans to a one-dimensional group and engenders a false narrative of Asian American educational success as expected. Purpose/Objective/Research Question/Focus of Study: Using an intersectional lens, this study interrogates the stereotype of Asian immigrant parents as tiger parents. We examine how one subgroup of Asian American youth—lower income Chinese American adolescents (children of Chinese immigrants) spoke about their parents’ involvement in their schooling and educational expectations. Our aim is to center young people’s explanations to explore how they perceive parental educational socialization and whether it conforms to notions of tiger parenting. We posed the following three specific research questions: (1) How do these students speak about and understand the ways in which their parents monitor their schoolwork? (2) How do these students describe and understand their parents’ messaging of educational expectations? and (3) In what ways do these students depict parent–child communication in their families? Research Design: Participants were 32 ninth-grade low-income Chinese American children of immigrants. We conducted individual interviews focused on educational socialization in the home. We used a combination of inductive and theoretically driven thematic analysis and explored the extent to which students’ perspectives of their parents converged or diverged with the tiger parent stereotype. We adopted a working definition of tiger parenting based on categories related to parenting, including close monitoring of schoolwork, perceptions of high parent expectations for school performance and educational/career attainment, and parent-initiated communications regarding children’s academic lives and decisions. Findings/Results: Our analysis revealed that participants did not experience their parents’ educational involvement as conforming to the tiger parent stereotype. Instead, students were largely self-directed and described their parents as exercising basic monitoring of schoolwork, conveying generic and pragmatic educational and career expectations, and trusting their children overall to manage schoolwork and share key school-related information as needed. We introduce a concept that we call “informed distance” as more salient for understanding our participants’ experiences. Conclusions/Recommendations: Educators must interrupt the tiger parent and model minority stereotypes to make room for a fuller and more complex understanding of Asian American students’ experiences and ensure their educational needs are equitably addressed. Teachers and counselors can play an affirmative role in educational guidance for Chinese American students.

Adolescent Psychosocial Adjustment during COVID-19: An Intensive Longitudinal Study

ABSTRACT Objective COVID-19 has presented threats to adolescents’ psychosocial well-being, especially for those from economically disadvantaged backgrounds. This longitudinal study aimed to identify which social (i.e., family conflict, parental social support, peer social support), emotional (i.e., COVID-19 health-related stress), and physical (i.e., sleep quality, food security) factors influence adolescents’ same- and next-day affect and misconduct and whether these factors functioned differently by adolescents’ economic status. Method Daily-diary approaches were used to collect 12,033 assessments over 29 days from a nationwide sample of American adolescents (n =546; M age = 15.0; 40% male; 43% Black, 37% White, 10% Latinx, 8% Asian American, and 3% Native American; 61% low-income) at the onset of the COVID-19 pandemic. Results Peer support, parent support, and sleep quality operated as promotive factors, whereas parent-child conflict and COVID-19 health-related stress operated as risk factors. Although these links were consistent for adolescents irrespective of economic status, low-income adolescents experienced more conflict with parents, more COVID-19 health-related stress, less peer support, and lower sleep quality than higher-income adolescents. Food insecurity was connected to decreased same- and next-day negative affect for low-income adolescents only. Low-income adolescents also displayed greater negative affect in response to increased daily health-related stress relative to higher-income adolescents. Conclusion These results highlight the role of proximal processes in shaping adolescent adjustment and delineate key factors influencing youth psychosocial well-being in the context of COVID-19. By understanding adolescents’ responses to stressors at the onset of the pandemic, practitioners and healthcare providers can make evidence-based decisions regarding clinical treatment and intervention planning for youth most at risk for developmental maladjustment.

Economic cost of pregnancy care attributable to the failure of Mexico's teenage pregnancy prevention policy

The objective was to estimate the direct medical cost of pregnancy care attributable to the failure of Mexico's teenage pregnancy prevention policy. From the provider's perspective, this economic study estimated the mean cost of prenatal care, childbirth, puerperium, abortion and complications. To quantify the costs attributable to policy failure, three scenarios were constructed: (a) total number of pregnancies; (b) number of pregnancies above the target; (c) number of unwanted pregnancies. The cost of providing contraceptive methods was also estimated and the characteristics of pregnant adolescents were described. Of the adolescents (n = 5,477,027), 30.2% were sexually active; 46.8% used contraception; 44.1% had become pregnant and 9.1% had an abortion. Most pregnant women (65%) attended secondary school or under; 30% dropped out of school; 72.5% lived with a partner; 72.3% had complications. The mean cost of pregnancy care was estimated at USD 2,210.55 and the mean cost of providing contraceptives at USD 64.95. The total cost of policy failure was estimated for each scenario (in millions): (a) USD 1,614.39, (b) USD 876.61 and (c) USD 171.50, respectively; whereas the annual cost of providing contraceptives in each scenario was estimated in: (a) USD 47.43, (b) USD 25.76 and (c) USD 5.04. The failure of the policy is expressed in the high frequency of pregnancy in low-income adolescents and in high costs for the health system. The provision of contraceptives is 34 times cheaper than pregnancy care and could, together with improved living conditions, contribute to reduce the frequency of adolescent pregnancies.