Low-income Youth Research Articles

Developmental Timing of Associations Among Parenting, Brain Architecture, and Mental Health

Parenting is associated with brain development and long-term health outcomes, although whether these associations depend on the developmental timing of exposure remains understudied. Identifying these sensitive periods can inform when and how parenting is associated with neurodevelopment and risk for mental illness. To characterize how harsh and warm parenting during early, middle, and late childhood are associated with brain architecture during adolescence and, in turn, psychiatric symptoms in early adulthood during the COVID-19 pandemic. This population-based, 21-year observational, longitudinal birth cohort study of low-income youths and families from Detroit, Michigan; Toledo, Ohio; and Chicago, Illinois, used data from the Future of Families and Child Well-being Study. Data were collected from February 1998 to June 2021. Analyses were conducted from May to October 2023. Parent-reported harsh parenting (psychological aggression or physical aggression) and observer-rated warm parenting (responsiveness) at ages 3, 5, and 9 years. The primary outcomes were brainwide (segregation, integration, and small-worldness), circuit (prefrontal cortex [PFC]-amygdala connectivity), and regional (betweenness centrality of amygdala and PFC) architecture at age 15 years, determined using functional magnetic resonance imaging, and youth-reported anxiety and depression symptoms at age 21 years. The structured life-course modeling approach was used to disentangle timing-dependent from cumulative associations between parenting and brain architecture. A total of 173 youths (mean [SD] age, 15.88 [0.53] years; 95 female [55%]) were included. Parental psychological aggression during early childhood was positively associated with brainwide segregation (β = 0.30; 95% CI, 0.14 to 0.45) and small-worldness (β = 0.17; 95% CI, 0.03 to 0.28), whereas parental psychological aggression during late childhood was negatively associated with PFC-amygdala connectivity (β = -0.37; 95% CI, -0.55 to -0.12). Warm parenting during middle childhood was positively associated with amygdala centrality (β = 0.23; 95% CI, 0.06 to 0.38) and negatively associated with PFC centrality (β = -0.18; 95% CI, -0.31 to -0.03). Warmer parenting during middle childhood was associated with reduced anxiety (β = -0.05; 95% CI -0.10 to -0.01) and depression (β = -0.05; 95% CI -0.10 to -0.003) during early adulthood via greater adolescent amygdala centrality. Neural associations with harsh parenting were widespread across the brain in early childhood but localized in late childhood. Neural associations with warm parenting were localized in middle childhood and, in turn, were associated with mental health during future stress. These developmentally contingent associations can inform the type and timing of interventions.

Factors Influencing the Use of Tobacco Among Youth in Low-Income, Lower-Middle-Income, and Upper-Middle-Income Countries: A Systematic Review.

The use of tobacco is a significant global public health issue. According to the World Health Organization, tobacco use is a considerable risk factor for many diseases and causes more than 8 million deaths per year, with a disproportionate impact on low- and middle-income countries. Therefore, this systematic review was conducted to identify the factors influencing tobacco use among youth in low-income, lower-middle-income, and upper-middle-income countries. Study Design: A system review. The review followed the PRISMA guidelines, and the protocol was registered on PROSPERO (CRD42023430552). Several data sources were utilized, including PubMed, Scopus, ScienceDirect, MEDLINE, CINAHL, and ProQuest, and cross-sectional data from participants aged 15‒24 underwent investigation. Original full-text articles have been published between 2015 and 2023. Out of the 2892 studies, 20 were included in this review after two reviewers confirmed the eligibility criteria. The average age of the participants was (mean±standard deviation: 19.45±1.686). Most studies were conducted in lower-middle and upper-middle-income countries. Frequently reported influences were at the individual and social levels, including demographic, economic, and psychological parameters, attitude and knowledge, individual behavioral factors, parental education, family member tobacco use, stressful life events, and social networks. At the environmental level, factors included secondhand smoke exposure, community context, media channels, and access to tobacco. The findings demonstrated a significant association between youth tobacco use and individual-, social-, and environmental-level factors. Consequently, specific interventions targeting these factors should be deployed to mitigate youth tobacco use in various socioeconomic settings.

Coping and empowerment preventive intervention buffers early adolescent neuroendocrine-related risk for internalizing problems

There is an absence of mechanism-driven interventions equipped to reduce the large mental health disparities that exist for preadolescent youth living in poverty. Building a Strong Identity and Coping Skills (BaSICS) is a preventive intervention designed to target multiple aspects of poverty-related stress adaptation, including altered neuroendocrine function. The purpose of the current study was to examine whether pre-post shifts in preadolescent hypothalamic-pituitary-adrenal (HPA) activation could longitudinally predict internalizing outcomes and to determine whether BaSICS could buffer such HPA-related risk for psychopathology. Low-income youth (n = 112) ages 11–12 years were randomized to the 16-session intervention or assessment-only control (53% intervention; 54% female; 40% Hispanic, 63% Black, 20% White). Youth completed questionnaires and the Trier Social Stress Test, and provided cortisol via saliva at six timepoints during the 90-minute assessment. Adjusting for pre-intervention Cortisol Area Under the Curve–Ground (CAUCg) scores and internalizing problems, post-intervention CAUCg and intervention main and interactive effects were modeled as predictors of internalizing outcomes across post-intervention, 6-month, and 12-month follow-up assessments using multilevel regression methods. A significant post-intervention CAUCg by intervention interaction emerged (B=1.198, SE=0.433, p = .006). For control youth, baseline-adjusted decreases in cortisol output were associated with increases in internalizing problems that remained stably elevated across follow-up assessments. For BaSICS youth, however, internalizing problems decreased and remained stably low following program delivery, irrespective of post-intervention increases or decreases in cortisol output. Findings illustrate how BaSICS may buffer against HPA-related risk for internalizing psychopathology and provide support for interventions targeting biological mechanisms of risk for low-income preadolescents.

Association Between Park Use and Moderate-to-Vigorous Activity During COVID-19 Years among a Cohort of Low-Income Youth.

Neighborhood parks are important venues to support moderate-to-vigorous (MVPA) activity. There has been a noticeable increase promoting physical activity among youth in neighborhood parks. This paper aims to assess the association between park use and MVPA among low-income youth in a large urban area. We recruited a cohort of 434 youth participants during the COVID pandemic years (2020-2022) from low-income households in Washington, D.C. We collected multiple data components: accelerometry, survey, and electronic health record data. We explored the bivariate relationship between the accelerometer-measured daily MVPA time outcome and survey-based park use measures. A mixed-effect model was fitted to adjust the effect estimate for participant-level and time-varying confounders. The overall average daily MVPA time is 16.0min (SD = 12.7). The unadjusted bivariate relation between daily MVPA time and frequency of park visit is 1.3min of daily MVPA time per one day with park visits (p < 0.0001). The model-adjusted estimate is 0.7 daily MVPA minutes for 1day with park visit (p = 0.04). The duration of a typical park visit is not a significant predictor to daily MVPA time with or without adjustments. The initial COVID outbreak in 2020 resulted in a significant decline in daily MVPA time (- 4.7min for 2020 versus 2022, p < 0.0001). Park visit frequency is a significant predictor to low-income youth's daily MVPA time with considerable absolute effect sizes compared with other barriers and facilitators. Promoting more frequent park use may be a useful means to improve low-income youth's MVPA outcome.

The Impact of Debt on Job-Search Behavior Among South-Korean Low-Income Youths: Focusing on the Mediating Effect of Self-Esteem

The Impact of Debt on Job-Search Behavior Among South-Korean Low-Income Youths: Focusing on the Mediating Effect of Self-Esteem

Impact of Youth Empowerment Programmes in Low-Income Settings: A Systematic Review of the Qualitative Evidence

The impact and sustainability of youth empowerment programmes is highly contentious in a context marked by significant levels of poverty, unemployment and inequality. Youth empowerment programmes play a role in supporting low-income youth. This article presents a systematic review of six studies that were conducted between 2008 and 2013 in poor, urban, semi-rural and rural communities in South Africa. The main goal of the article is to describe how young people have been impacted by participating in youth empowerment programmes in their communities. Themes on key development indicators, results-based transformation, and sustainable youth empowerment programmes, summarise the main factors that influence how youth empowerment programmes are perceived. The systematic review of the literature results provides a basis for further research into youth empowerment programmes.

Living, learning, working, and playing during COVID-19: tackling existing and exacerbated problems of low-income Singaporean youth

ABSTRACT COVID-19’s adverse, disproportionate impact on low-income youth — prompting youth-serving professionals to adapt and adjust — is well-documented. However, research gaps exist, including explanatory processes underlying COVID-19’s deleterious impact, systematic documentation of existing and exacerbated problems, and short- and long-term responses of youth-serving professionals. Using a multi-informant mixed methods design guided by a live-learn-work-play theoretical framework, exploratory findings indicated that COVID-19 worsened existing problems across all domains. In the short-term, Singaporean professionals prioritised, moved online, and evaluated programmes. Progressively, they sought to build youth communities, empower families, collaborate, and experiment. Findings have implications for understanding and resolving structural problems perpetuating pre-disaster vulnerabilities.

Perceptions of “Decent Life” Among Low-Income Youth

Perceptions of “Decent Life” Among Low-Income Youth

Exploring the challenges and benefits of online youth-led nutrition programs

Nutrition educators at the University of California Cooperative Extension (UCCE) have been engaging low-income youth in youth-led participatory action research (YPAR) for several years. During COVID-19, these educators transitioned from in-person to online YPAR programming. Delivering the YPAR program online presented challenges but also fostered new strategies and provided benefits. This study assesses the challenges, strategies and benefits of online YPAR programming, and it examines future program implications from the perspectives of both nutrition educators and youth. Qualitative interviews were conducted via Zoom with eight nutrition educators who attempted to implement YPAR programming during the 2020–2021 school year. We used a retrospective Qualtrics survey to gain information from 54 youth participants. We found that online facilitation encouraged the innovative use of technology, which was especially important because it allowed teams to connect with each other during tumultuous times. This online format made meetings easier in terms of planning, documentation and logistics. However, the online format presented particular challenges, such as coping with internet and technology difficulties and trying to sustain authentic engagement among participants without in-person interactions. Consequently, 50% of nutrition educators and 45% of youth respondents said they preferred a mix of in-person and online meetings for future YPAR programming.

The Impact of Short-Term Employment for Low-Income Youth: Experimental Evidence from the Philippines

Abstract We use a randomized field experiment to test the causal impact of short-term work experience on employment and school enrollment among disadvantaged, in-school youth in the Philippines. This experience leads to a 4.4 percentage point (79%) increase in employment eight to twelve months later. Although we find no aggregate increase in enrollment, we also do not find that the employment gains push youth out of school. Our results are most consistent with work experience serving as a signal of unobservable applicant quality, and these findings highlight the role of temporary work as a stepping stone to employment for low-income youth.

Family income as a moderator of relations between sleep and physical health during adolescence

ObjectivesSleep duration, quality, and consistency are associated with overall physical health in adolescence, yet the effects of sleep on development may be not uniform because both sleep and physical health vary systematically along gradients of family income. To understand “for whom” sleep may be particularly beneficial, the present study tested family income as a moderator of relations between youth sleep and physical health. MethodsThree hundred twenty-three youth (M age=17.39years; 53% female; 41% Black, 59% White) wore wrist actigraphs for 1week at home. Four well-recognized sleep parameters were derived: minutes, efficiency, long wake episodes, and variability in minutes across the week. Parents reported family income, and mothers rated adolescents’ physical health. In independent path models, physical health was regressed onto each indicator of sleep, family income, and Sleep × Family Income interactions to test potential moderation effects. ResultsAssociations between sleep and physical health were moderated by family income. Lower sleep efficiency, more long wake episodes, and more variability in sleep minutes were associated with poorer physical health among adolescents from lower-income families. At optimal levels of all sleep variables, income-based differences in physical health were mitigated. Youth from higher-income families tended to have better physical health regardless of their sleep. ConclusionsFindings build evidence that sleep has relations with physical health for low-income youth in particular. Clinicians and other service providers working with youth might benefit from considering the role of sleep in prevention and interventions programs geared toward improving health.

Relationship of mindset, religiosity and subjective well-being of low-income youth in Malaysia

Relationship of mindset, religiosity and subjective well-being of low-income youth in Malaysia

Stakeholder perspectives on the advantages and challenges of expanded school mental health services for publically-insured youth.

Although partnerships between community-based mental health (MH) organizations and school systems to deliver MH services on school grounds (i.e., expanded school mental health, ESMH services) are growing, qualitative research is needed about stakeholders' perspectives on ESMH services. This study collected qualitative data from caregivers, MH providers, and MH administrators recruited from three MH organizations to understand their perspectives regarding potential advantages and challenges associated with ESMH services. The three MH organizations were located in three regions of Georgia and the majority of youth served by the organizations were enrolled in Medicaid. We conducted four focus groups with 33 caregivers and 13 semistructured interviews with MH administrators and providers, and we implemented a thematic content analysis. Caregivers, providers, and MH administrators described how ESMH services could improve MH services by (a) facilitating appointment attendance through the reduction of logistical barriers to care (including geographic barriers, missed class time, and missed work time) and (b) enhancing communication between providers and teachers. However, some participants also described logistical issues with ESMH services including school space constraints and challenges scheduling appointments. In addition, some caregivers expressed concerns about peer stigma if MH services are delivered at school (vs. the clinic). Providers and MH administrators discussed problems with low caregiver engagement and challenges collaborating with school personnel that stem from lack of understanding of MH problems and treatment. Although ESMH services can improve MH treatment among low-income youth, MH providers and MH administrators may consider collaborating with school personnel to proactively develop strategies to address challenges to its success. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining the Effect of a Parent-to-Parent Intervention for Low-Income Youth with Serious Emotional and Behavioral Challenges.

Numerous barriers to mental health utilization exist for families of children who present with serious emotional and behavioral challenges. Evidence-based practices that facilitate equitable outcomes across diverse populations are essential to identify. This study examined possible differential service outcomes in a Medicaid-funded, parent-to-parent intervention called Parent Support Partner (PSP). Data from four hundred and sixty-four parents who received PSP services were evaluated for possible demographic differences in service completion. Within-group analyses were utilized for an analysis of outcomes (parent change, child functioning; treatment acceptability) within a subset (N = 153) of those who completed services. No racial disparities were found in those who completed PSP (43%) when compared to those who did not (57%). Regression analyses uncovered significant improvements in parent competence and confidence, as well as overall child functioning (global functioning across domains such as school, home, behaviors). Consistent with identifying evidence-based practices, findings were seen consistently across the diverse sample of those who completed PSP services. Improvements in parents' sense of competence and confidence were correlated with perceptions of treatment acceptability. PSP is an innovative and promising intervention with demonstrated high levels of acceptability found to increase parent confidence and self-competence to advocate for treatments that can improve the mental health functioning of their child. Future investigations of factors associated with increasing PSP service completion and outcomes in larger and more diverse populations are necessary. Implications for considering and possibly adopting this evidence-informed practice within the nursing profession are provided.

Disparities in museum attendance among youth over two decades: an empirical analysis of who attends and how often

In prior research, museum attendance has been shown to positively impact educational outcomes for children, teens, and adults, yet little has been documented about who is attending and how often. This paper is the first to provide comprehensive descriptive and regression analyses to explore museum attendance among youth (5 to 18 year-olds) in the U.S. using data from five nationally representative datasets spanning two decades. Furthermore, though anecdotal evidence indicates disparities across demographic groups, there has yet to be a comprehensive analysis documenting the magnitudes of these differences. Our analyses identify characteristics that are highly correlated with museum attendance generally, and art and science museums, specifically. Our findings show that attendance rates among youth typically range from 50-70%, but that there are significant differences by socioeconomic status, race/ethnicity, gender, and location. These findings indicate that policies to improve access to museums for students, particularly low income youth and those in rural areas, may be beneficial for promoting wider cultural, artistic, and hands-on STEAM opportunities.

46. Needs Assessment of Implementing a Mental Health Intervention for Low Income Youth in Job Readiness Programs

46. Needs Assessment of Implementing a Mental Health Intervention for Low Income Youth in Job Readiness Programs

Formative evaluation of a STEAM and nutrition education summer program for low-income youth

In-depth formative evaluations are vital for curriculum development and program planning but are often not conducted before a program pilots. A formative evaluation of Project stRIde was conducted to gain insight from experts and identify revisions to the curriculum. Project stRIde is a science, technology, engineering, arts, and mathematics (STEAM) and nutrition-based curriculum developed for 4th and 5th grade students from low-income and diverse families. Nine experts spanning the fields of nutrition education, cultural competency, elementary education, summer programs, and STEAM outreach were recruited to participate in an expert content review (ECR) survey and virtual interviews. Seven core themes were identified: effectively promoting student engagement, increased guidance or support needed, activity too difficult for age, time, confidence in teaching lessons, cultural appropriateness, and strengths of curriculum in promoting STEAM education and innovation. Across the lessons, all reviewers agreed that the lessons were accurate, incorporated STEAM concepts, and were culturally appropriate for this population. Future major edits to the curriculum include creating supplemental videos, modifying some activities for age level, and incorporating more opportunities for participant engagement. Overall, an ECR is an effective way to examine a program’s strengths and limitations and should be included in the beginning stages of program planning.

Evaluating the Food Allergy Passport: A Novel Food Allergy Clinical Support Tool

The prevalence of pediatric food allergy (FA) has increased in the past 2 decades. The previous literature suggests that FA presents burdens, both economically and psychosocially, to children and their caregivers, especially families in lower-income strata. Using data from a previously published needs assessment, the Food Allergy Management in Low-Income Youth study, the FA Passport and Workbook tools were developed to address identified needs. This study evaluated the utility of the FA Passport in helping families insured by Medicaid to manage FA better and improve quality of life. Families insured through Illinois Medicaid were recruited from two Chicago-based allergy clinics. Caregivers of children with FA completed a pretest evaluating knowledge, attitudes, beliefs, and practices regarding FA management. A clinician guided caregivers through the FA Passport. The caregivers then completed a posttest immediately afterward and again 3 months later. Changes were evaluated from baseline responses and direct feedback was elicited about the tool. The FA Passport successfully improved caregiver-reported confidence with epinephrine autoinjector use (from 69% to 93%), caregiver anaphylaxis recognition (from 66% to 73%), and reported quality of life, and it nearly doubled caregiver comfort regarding leaving the child in the care of others (from 40% to 75.7%). Caregivers rated the FA Passport tool as extremely helpful overall (9.4 out of 10). The FA Passport is a novel FA clinical support tool that addresses barriers to proper FA management described in previous studies. It proved effective at improving caregiver comfort with regarding leaving the food-allergic children with other caregivers, increasing FA knowledge, and improving the quality of life in families affected by FA.

Patterns of Trauma Among Youth Seeking Mental Health Services at a Community-Based Clinic: A Latent Class Analysis Approach.

We examine the association between trauma patterns, gender identity, ethnicity, foster care involvement, and mental health needs in a sample of low-income youth. Our community sample included 2,175 clients aged 6 or older (Mage = 11.9), has a closely-even gender ratio (55% female and 45% male and others) and is ethnically diverse (37% Black, 31% Multiracial, 14% Latinx, 9% White, 10% Others). 61% of youth in this sample have involvement with the foster care system. Latent class analysis was used to identify trauma patterns, explore predictors of latent class membership, and estimate the cumulative mental health needs for each trauma class. Results revealed four trauma patterns (Low Trauma, Caregiving Disruption, Community Violence, and Multiple Trauma). Girls were more likely than boys to be in the high-trauma groups. Compared to Black youth, Latinx youth were more likely to be in the Multiple Trauma class, whereas White youth were less likely to be in the high trauma classes. Youth with past or current involvement with the foster care system were more likely than those without to be in the high-trauma classes. Mental health needs for youth in Low Trauma and Caregiving Disruption were comparable, but were highest for those in Community Violence. Contrary to expectation, the Multiple Trauma group did not have the highest-level mental health needs. Interventions for low-income youth can benefit from knowing which trauma patterns are associated with various levels of mental health needs. Newer models of care focusing on building healthy communities may be the way forward.

Improving Continuous Glucose Monitoring Uptake in Underserved Youth with Type 1 Diabetes: The IMPACT Study.

Background: Continuous glucose monitoring (CGM) improves glycemic control. Less than half of youth with type 1 diabetes (T1D) use CGM, with disparities among minority and low-income youth. The aim of this study was to determine if trial CGM use increases uptake of personal CGM. Methods: T1D youth were provided sample CGM placement at the point of care, with CGM education and app setup. Follow-up calls at 5 and 10 days assessed CGM data, and desire to continue using CGM. Follow-up at 3-6 months recorded CGM use, CGM data, and A1c. Participants completed surveys at enrollment, 10 days, and 3 months. Differences were assessed between baseline and follow-up. Results: Of the 26 enrolled participants with T1D, 15 were CGM naive, and 11 were prior CGM users. The mean age was 14.1 ± 2.9 years, 65% male, 42% were Black, 12% were Hispanic, 65% were on public insurance, and 43% had household income of <$50,000. The median duration of diabetes was 4.6 years (interquartile range 2.4-7.7), mean baseline A1c was 10.7% ± 2.4%. After trial CGM use, 85% of participants reported wanting personal CGM, and at 3-6 months follow-up 76% had obtained one and 43% were using a personal CGM. There were no improvements in A1C or time in range, but participants reported an increase in the perceived benefits of CGM usage (4.0 vs. 4.3, p = 0.03). Conclusions: Placing a sample CGM at the point of care can improve uptake of personal CGM and may help mitigate disparities in CGM use in minority and underserved youth. Long-term studies are needed to determine how similar interventions impact glycemic control and patient outcomes. ClinicalTrials.gov: NCT04721145.