Participation In Organized Activities Research Articles

Patterns of Participation in Organized Leisure Activities of Young People in Low and Middle Secondary Educational Tracks in Germany

Organized leisure activities are an important component of learning with a great potential for positive youth development. The available research has grown in the past decade but is still lacking differentiated analysis of specific activity determinants and longitudinal designs. Based on retrospectively collected quantitative data (n=1,547) at the end of low/ middle secondary schools in Germany (9th/10th grades), this study explores patterns of organized activity participation over the school years using LCA (Latent Class Analysis). Four latent classes could be identified on the basis of eight manifest activity determinants: None-Actives, Minor-Actives, Multiple-Actives, and Committed-Actives. Sociodemographic indicators as well as social, cultural, and economic capital predict the assignment to these classes.

Physical Literacy Levels in the Croatian Adult Population; Gender Differences and Associations with Participation in Organized Physical Activity

Physical literacy (PL) is the foundation for lifelong participation in physical activity. Most previous research concentrated on PL examinations in younger groups, while such research is scarce in the adult population. This study aimed to determine the PL levels of the Croatian adult population. Also, the aim was to investigate whether individuals with longer participation in organized physical activity have higher PL levels and do males and females differ in PL levels. The sample comprised 561 individuals (321 females, 240 males) aged 27.65±12.13 years. PL levels were assessed by the Croatian version of the Perceived Physical Activity Questionnaire (PPLQ-Cro). Demographic characteristics included age, gender, and years of involvement in organized physical activity. Gender differences were calculated using the Mann-Whitney U test and effect sizes. Spearman correlation coefficients were used to determine associations between study variables. Males had significantly higher PL levels compared to females (83.10±16.17 for males and 74.27±20.07 for females, Z=-6.88, p=0.001). Years of organized physical activity were associated with PL levels (R=0.48, p=0.001) in the total sample as well in males (R=0.55, p<0.001) and females (R=0.24, p<0.01) separately. The finding that years of organized physical activity are associated with total PL supports the theory that PL is the cornerstone for participating in lifetime physical activity. The results of this study emphasize the importance of introducing the concept of PL in numerous institutions and organizations connected with organized physical activity.

Examining associations between physical activity context and children meeting daily physical activity guidelines: the role of outdoor play, sports, and other organized activities.

Less than one-quarter of US children meet physical activity (PA) guidelines. Understanding the context in which PA occurs and how these contexts may play a role in meeting PA guidelines is an essential step toward developing effective behavioral interventions. The purpose of this study was to examine associations between PA context (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines in a representative sample of children living in Texas. We analyzed cross-sectional data from a statewide sample of fourth-grade children in Texas who completed the 2019-2020 Texas School Physical Activity and Nutrition (Texas SPAN) survey. The Texas SPAN survey was designed to monitor the statewide prevalence of overweight/obesity among school children and assess habitual self-reported obesity-related behaviors, including diet and PA. Weighted Poisson regression models were employed to examine the associations between PA contexts (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines, adjusting for sex, race/ethnicity, overweight/obesity, urban-rural status, and economic disadvantage. A total of 16.7% of fourth-grade children met physical activity guidelines every day during the week (mean age = 9.4 ± 0.6 years; female = 48.7, 51.8% Hispanic, mean days meeting PA guideline = 3.6 ± 2.3 days). One in ten (11.2%) children did not meet daily PA guidelines on any day of the week, and 72.1% met them between 1 and 6 days. Participating in sports (b = 0.22, 95%CI:0.14, 0.30), any other organized physical activities (b=0.13, 95%CI:0.017, 0.19), and playing outdoors 1-3 days (b = 0.25, 95%CI:0.04, 0.46) and 4-7 days in the past week (b = 0.77, 95%CI:0.57, 0.97) was significantly and positively associated with the number of days children met PA guidelines. Participating in sports, participating in other organized physical activities, and playing outdoors may beneficially influence the number of days children meet PA guidelines. PA programs should consider these contextual factors and investigate how to promote organized activities and outdoor play effectively and appropriately among children.

After-School Activities of Japanese Elementary School Children: Comparison of Children Who Attend Lessons and Cram Schools With Those Who Do Not.

This study examined the after-school activities of Japanese elementary school children in which little information is available for understanding the process by which participation in organized activities leads to the decrease in children's independent mobility. One thousand eight hundred and twenty-four mothers of elementary school children participated in an online survey. The mothers responded to the questions on the number of lessons (or cram schools) their children attended weekdays, as well as their children's behavior after classes, and parents providing transportation when their children go out to play. The proportion of children attending lessons and/or cram schools increased as their grades progressed. A significant interaction existed between the degree of parental transportation and grade in terms of whether or not the children attended lessons and/or cram schools. Parental involvement included pick up or drop-off for a large percentage of younger children without lessons, whereas the degree of parental involvement was greater for older children attending lessons. In other words, parents of children without attending lessons or cram schools tended to allow children to engage in independent activities when they reached the higher grades, whereas parents of children who frequently attended lessons and cram schools tended to remain involved in transporting their children, even when they reached the higher grades. The results suggested that the participation of children in organized activities leads to a routine of parental pickup and/or drop-off, which renders difficult the facilitation of opportunities for children to independently participate in play activities.

It doesn't matter if I feel obliged as long as I enjoy it: The associations between organized leisure-time activities and adolescents' mental health and wellbeing.

There is a consensus that adolescents' participation in organized leisure-time activities (OLTAs) is pro-developmental and beneficial for youth mental health. While enjoyment in OLTA is commonly regarded as positive, the role of obligation in the context of adolescents' OLTA has been scarcely researched. The present study investigated how these theoretically contradictory experiences (enjoyment and/or obligation) in OLTA participation relate to adolescents' wellbeing and incidence of psychological complaints accounting for their possible co-occurrence. A nationally representative sample of 14,128 eleven-fifteen-year-old adolescents (49.7% girls) drawn from the Czech 2021/2022 Health Behaviour in School-aged Children cross-sectional study was used. A series of multivariate regression analyses assessed how perceptions of obligation and enjoyment in OLTA related to wellbeing and occurrence of psychological complaints. A person-centered approach derived groups of respondents on the basis of their perceptions of obligation and enjoyment. Regression analyses, controlled for sociodemographic and family environment factors, and dimensions of OLTA participation, indicated that adolescents enjoying their OLTA displayed more favourable mental wellbeing reports. In contrast, perceptions of obligation were only weakly associated with more frequent psychological complaints and not at all with wellbeing, unless adolescents also reported the lack of enjoyment. Enjoyment in OLTA plays a pivotal role in the association between OLTA participation and mental health, whereas the role of obligation is far less pronounced. In fact, if adolescents do not enjoy their participation, but feel obliged to participate, their self-assessed mental wellbeing is comparable to their peers not participating in OLTA at all.

Participation in organized physical activity and discomfort with locker rooms among youth across sexual, gender, and racial identities.

Participation in organized physical activity and discomfort with locker rooms among youth across sexual, gender, and racial identities.

Financial Incentives for Physical Activity and Sports Participation in Young People.

Physical inactivity is a global health problem. Childhood is an opportune time to establish healthy physical activity behaviors, including the participation in organized physical activity, such as sports. We hypothesize that financial incentives can improve young people's participation in physical activity and sports. The design of the incentive and the context in which it operates are crucial to its success.

Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort

IntroductionSelf-rated health (SRH) offers insights into the evolving health demographics of an ageing population. AimTo assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival. MethodsAll participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests. FindingsMost participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05). ConclusionThis study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.

Adherence to the WHO recommendation of three weekly days of vigorous intensity activities in children: an accelerometry study of vigorous physical activity bouts.

The World Health Organization (WHO) recommends that children and adolescents incorporate vigorous intensity activities (VIAs) at least three days a week. This recommendation has not been sufficiently studied using objective methods, such as accelerometry. Physical education classes and extracurricular sports activities are optimal opportunities for compliance with this recommendation. To identify VIAs through bouts of vigorous physical activity (VPA-Bouts) evaluated with accelerometry and, with this, to know the compliance with the recommendation on VIAs. A cross-sectional study of the habitual physical activity of 353 children (8-9 years old) was carried out using accelerometry and participation in organized extracurricular sports activities was asked through a questionnaire. School days with and without physical education class, weekends, and the average weekly day were identified, as well as school time and out-of-school time. A VPA-Bout was defined as an interval of at least 60 minutes with a proportion of VPA of at least 16.7% in boys and 12.5% in girls (10.0 and 7.5 minutes/hour of VPA, respectively). The average daily time in organized extracurricular sports activities declared by questionnaire and the average daily duration of the VPA-Bouts evaluated with accelerometers in the extracurricular period was 21.3 (SD 19.8) and 23.9 (SD 31.2) minutes, respectively, in boys, whereas, in girls it was 20.2 (SD 17.4) and 11.0 (SD 16.9) minutes, respectively. In school time including a physical education class, there was a higher proportion of VPA-Bouts than without these classes (with: 28.6%, without: 2.1%, p < 0.001). Children who reported at least three weekly hours of organized extracurricular sports activities accumulated a higher proportion of school afternoons with VPA-Bouts than those with fewer weekly hours of this type of activities (≥3 hours/week: 27.5%, <3 hours/week: 9.3%, p < 0.001). On the weekend, boys who reported at least three weekly hours of organized extracurricular sports activities performed more VPA-Bouts than those participating in less weekly hours, while in girls no significant differences were observed (weekend; boys, ≥3 hours/week: 26.0%, <3 hours/week: 9.0%, p < 0.001; girls: 8.3%, 8.0%, p = 0.917). Compliance with the recommendation to incorporate VIAs at least three days a week was 23.8%. Children who reported at least three weekly hours of extracurricular sports activities achieved higher compliance than those who reported fewer extracurricular activities (≥3 hours/week: 35.1%, <3 hours/week: 12.7%, p < 0.001). Additionally, boys showed higher compliance rates than girls (boys: 32.9%, girls: 15.3%, p < 0.001). One in every four children met the WHO recommendation to incorporate VIAs at least three days a week, as evaluated by accelerometry. Physical education classes and extracurricular organized sports activities contributed to compliance with this recommendation.

PENINGKARAN KARAKTER DENGAN ORGANISASI LUAR SEKOLAH

Abstract&#x0D; The Ngreco branch of the IPNU-IPPNU organization plays a crucial role in shaping individual character through a series of activities held by its management, including khataman, carnival and management meetings. Active support from the surrounding community, both in the form of direct participation and provision of facilities, is an important factor in the success of organizational activities. Continuous interaction between organizational members and the community is a strategy to maintain this support. When facing obstacles, the management and members of the organization carry out deliberations and evaluations to improve the implementation of activities in the future. Organization members, as resource persons, demonstrated the positive impact of their participation in organizational activities, including increasing self-confidence and building good character. Despite admitting a lack of experience in carrying out leadership roles, members still try to overcome obstacles, showing the development of the character of independence and cohesion within the organization. Collaboration with other organizations is also part of the strategy to strengthen friendship and collaboration in organizational activities. Overall, the roles and interactions within the Ngreco branch of the IPNU-IPPNU organization strengthen the formation of quality youth character.&#x0D; Keywords: Ngreco branch of the IPNU-IPPNU organization; Formation of adolescent character.

Pre-analysis protocol for an observational study on the effects of adolescent sports participation on health in early adulthood

Abstract: We will study the impact of adolescent sports participation on early-adulthood health using longitudinal data from the National Study of Youth and Religion. We focus on two primary outcomes measured at ages 23–28 — self-rated health and total score on the PHQ9 Patient Depression Questionnaire — and control for several potential confounders related to demographics and family socioeconomic status. Comparing outcomes between sports participants and matched non-sports participants with similar confounders is straightforward. Unfortunately, an analysis based on such a broad exposure cannot probe the possibility that participation in certain types of sports (e.g., collision sports like football or soccer) may have larger effects on health than others. In this study, we introduce a hierarchy of exposure definitions, ranging from broad (participation in any after-school organized activity) to narrow (e.g., participation in limited-contact sports). We will perform separate matched observational studies, one for each definition, to estimate the health effects of several levels of sports participation. In order to conduct these studies while maintaining a fixed family-wise error rate, we deployed an ordered testing approach that exploits the logical relationships between exposure definitions. Our study will also consider several secondary outcomes including body mass index, life satisfaction, and problematic drinking behavior.

Organized physical activity participation among autistic Australians: Barriers, enablers and implications for inclusion

Engagement in organized physical activities offers numerous benefits for autistic people, yet persistent barriers hinder participation, especially as individuals age. This Australian study employed a mixed methods approach to investigate the experiences of organized physical activities among 103 autistic adults and 169 parents of autistic children. Although most autistic children were involved in such activities, participation significantly declined among autistic adults, with both groups expressing a desire for increased involvement. This research identified barriers spanning intrapersonal (anxiety, physical challenges), interpersonal (social communication difficulties), and societal (limited inclusive opportunities, insufficient autism awareness) domains. Key facilitators to enhanced participation included sensory accommodations, inclusive policies, improved accessibility, personalized coaching, and enhanced autism education for staff. These findings are consistent with international research and hold particular relevance within the Australian cultural context. This study represents a significant empirical contribution, shedding light on the intricate barriers and potential support mechanisms necessary to bridge the gap between the aspirations for organized physical activity and actual participation among autistic individuals throughout their lives. Realizing progress demands comprehensive changes across various levels, encompassing policies, programs, attitudes, and accessibility. Such transformations are essential to cultivate inclusive sporting cultures and counteract the disengagement observed from childhood through adulthood. Lay abstract Sports and physical activities can be really beneficial for autistic people, but they often encounter challenges, especially as they get older. In our Australian study, we surveyed 103 autistic adults and 169 parents of autistic children to better understand these challenges. We discovered that many autistic children take part in sports and activities, but as they become adults, it becomes harder for them to stay involved. Both the adults and parents expressed a desire for more opportunities for autistic individuals to participate. We also identified some common problems that make it difficult for autistic people to engage in these activities. These challenges include personal issues like anxiety and physical difficulties, difficulties with social communication, and broader societal issues such as a lack of inclusive opportunities and insufficient awareness about autism. On a positive note, we found effective strategies to make participation easier for autistic individuals. These include creating sensory-friendly environments, implementing inclusive rules, ensuring that places are easy to access, offering personalized support, and educating staff about autism. Importantly, our findings are not unique to Australia; they align with research from other countries. This study sheds light on the obstacles autistic people face in sports and activities and provides solutions to improve their experiences. To bring about meaningful change, we must adjust policies, programs, attitudes, and overall accessibility. This will foster inclusive sports and activities for autistic individuals from childhood through adulthood.

Benefits and Challenges of Adolescents’ Participation in Organized Activities for Mexican-origin Families

In our study, we aimed to qualitatively understand Mexican-origin parents’ perceptions of how adolescents’ participation in organized activities can contribute to benefits and challenges for families and examine whether these benefits and challenges varied depending on the parents’ level of enculturation to Mexican culture. Semi-structured qualitative interviews were conducted with 34 Mexican-origin parents (mean age = 39.45; 47% 1st generation immigrants, 26% 1.5 generation, and 26% 2nd generation). Inductive and deductive approaches were used in multiple iterative stages of coding to determine the final themes. A cross-case analysis was conducted to compare parents’ responses based on their enculturation to Mexican culture. Parents perceived that the benefits of adolescents’ participation in organized activities were protection, family bonding, transfer of skills, and reinforcement of family ethnic culture. The challenges parents reported were exposure to unsafe situations, constraints on family resources, and family conflict. Parents with a higher enculturation to Mexican culture, more frequently reported family bonding and reinforcement of family ethnic culture as a benefit and family conflict as a challenge of activities compared to parents with a lower enculturation. Findings from our study have implications to help organized activities be culturally responsive to the Mexican-origin families and adolescents they serve.

MySSOF: Gamification Reward System for Enhancing Employee Participation and Activeness in Organizational Activities

This research introduces MySSOF, a gamification-based reward system that aims to increase employee participation and activeness in organizational activities. This system combines elements such as points, experience levels, activities, and leaderboards to encourage employee involvement. The evaluation was carried out using quantitative research by distributing questionnaires to 60 respondents according to the Slovin formula. It was concluded that in End-User Computing Satisfaction (EUCS), respondents perceived the content of the instrument with an average score of 4.18, the accuracy of the instrument with an average score of 4.28, the format of the instrument with an average score of 4.46, the ease of use of the instrument with an average score of 4.46, and punctuality. Instrument with an average score of 4.72, so the overall average score is above 4, which indicates a high level of respondent satisfaction with the MySSOF system in the very satisfied category.

Pengaruh keikutsertaan dalam organisasi dan Pengalaman PKL terhadap penguasaan soft skill siswa SMKN 3 Surakarta

&lt;p&gt;&lt;em&gt;The aims of this study were: 1) to find out whether there was an effect of participation in organizational activities on the soft skill mastery of students at SMKN 3 Surakarta; 2) to find out whether there is an influence of internship programs on the soft skill mastery of students at SMKN 3 Surakarta; and 3) to find out whether there is an effect of participation in organizational activities and street vendors together on the soft skill mastery of students at SMKN 3 Surakarta. This study uses quantitative techniques and correlational methods. The population is all OTKP grade 12 students, totaling 106 students. The results show that: 1) there is a positive influence between student participation in organizational activities and the mastery of soft skills, as evidenced by t count (2.107) &amp;gt; t table (1.983) and a significance value of 0.038 &amp;lt;0.050, 2) there is a positive influence between the internship program and the mastery of soft skills, as evidenced by t count (3.774) &amp;gt; t table (1.983), and 3) there is simultaneously a positive influence of student participation in organizational activities and internship programs on the mastery of soft skills, as evidenced by the value of Fcount (11.661) &amp;gt; Ftable (3.08).&lt;/em&gt;&lt;/p&gt;

Behavioral regulation and approaches to learning: Moderators of the association between extracurricular involvement and academic readiness

Participation in organized extracurricular activities (EAs) has become increasingly common among preschool-aged children. Prior studies have shown inconsistent findings on the association between young children's involvement in EAs and their subsequent developmental outcomes. Moving beyond examining the main effects of EA participation, this study focused on whether children's behavioral regulation and approaches to learning—two important domain-general skills closely linked to learning—would moderate the association between EA participation and academic readiness. Participants included 317 Chinese preschoolers residing in Shanghai. The breadth of EA participation positively predicted children's early math skills, but only for those demonstrating relatively lower behavioral regulation or less positive approaches to learning. The findings provide support for the compensatory hypothesis that participation in EAs is more beneficial for children at greater developmental risk. Unexpectedly, the intensity of EA participation negatively predicted receptive vocabulary beyond certain thresholds among children with relatively poor behavioral regulation or approaches to learning (B = −2.272, p = .032, effect size (ES) = 0.423), but this relationship was not significant for children with better learning behaviors (B = 0.111, p = .712, ES = 0.021). According to the findings, children with worse behavioral regulation and approaches to learning were actually more vulnerable to the negative effects of intensive participation in EAs (B = −15.698, p = .022, ES = 1.797). EA participation did not predict children's Chinese word reading (ps > 0.05). The findings revealed a complex pattern of relationships between preschoolers' EA participation and academic readiness and have highlighted the importance of considering child characteristics when examining the developmental effects of EA involvement.

Neighborhood Condition Effects on Latina/O Student Attendance and Participation in Afterschool Activities

ABSTRACT This study examined how parents’ perception of neighborhood conditions are associated with school absenteeism and participation in afterschool activities, and how social support networks moderate those linkages among two-parent and single-parent families. Data from the second and third Waves of the Making Connections Survey were analyzed. A subsample of 1,053 Latina/o parents with 10–17-year-old children was examined. Longitudinal path analyses suggest an indirect positive association between neighborhood control and participation in organized afterschool activities via instrumental social support, but only among two-parent families. Neighborhood cohesion was associated with school days missed and participation in organized afterschool activities among single-parent families. Implications for practice and policy are discussed.

Sport Participation, Extracurricular Activity Involvement, and Psychological Distress: A Latent Class Analysis of Canadian High School Student-Athletes

Although psychological distress has been shown to increase during adolescence, participation in organized activities may have protective effects. The present study aimed to identify whether there is a relationship between high school student-athletes’ breadth of participation in organized activities and psychological distress, using a latent class analysis. Canadian adolescent-athletes (n = 930) in Grades 11 and 12 completed an online survey that measured: (a) high school sport participation, (b) community sport participation, (c) nonsport extracurricular activities participation, and (d) psychological distress. The latent class analysis indicated that a two-class model (i.e., Class 1 = narrower breadth, low distress; Class 2 = wider breadth, moderate distress) was most appropriate. Results indicated that despite the divergent probability of organized activity participation, participants in both classes had a low to moderate probability of presenting elevated levels of psychological distress. However, levels of psychological distress were still higher than other Canadian adolescent populations, suggesting that overscheduling could be of concern. Gender and time (i.e., prior/during COVID-19 pandemic) were significant covariates in the model.

Crisis response during the COVID-19 pandemic: Changes in social contact and social participation of older Americans.

This study aimed to assess changes in social contact with family, friends and healthcare providers, as well as social participation in working, volunteering, religious services and other organized activities, among older adults during the COVID-19 pandemic while examining the role of pre-COVID sociodemographic characteristics or cognitive and physical limitations in changes in social contact and participation. We conducted secondary data analyses in the National Health and Aging Trends Study (NHATS) COVID-19 questionnaire, collected in 2020 during a period of workplace closures and social distancing guidelines. We linked data to pre-COVID sociodemographic and medical information collected in 2019 before COVID interrupted social life. The frequency of participants' social contact and social participation prior to and during the COVID-19 pandemic, were compared using paired t-tests for summed scores. Multivariate linear regression was used to relate participants' socio-demographic, prior physical and cognitive performance with levels of social contact and participation and with changes reported during the COVID-19 pandemic. In total, results from 2,486 eligible participants revealed that COVID-19 was associated with decreased social contact among family and friends (change: -0.62; SE: 0.06; p<0.0001), and social participation among older adults (change: -0.58; SE: 0.02; p<0.0001). Pre-COVID characteristics including older age, lower educational attainment, poorer physical performance, and more chronic conditions were associated with lower social contact and social participation and with how older adults adapted their social lives during the COVID-19 pandemic. These results emphasize the importance of increasing digital inclusion for older adults in a major crisis.

Association between resilience promotion factors during childhood and risk of drug use disorder during adulthood.

Few studies have been conducted on the relationship between "outside-residing" resilience characteristics and the risk of developing drug use disorder later in life. These characteristics include responsive and caring parenting, household routines involving regular family meals and bedtime routines, social support from peers, participation in organized activities, and religious service attendance. We quantified the association between these resilience promotion factors during childhood and the risk of developing criteria for drug use disorder during adulthood using data from a retrospective cohort study of 618 adults born in Massachusetts during 1969-1983, including those with adverse childhood experiences (ACEs). Self-administered questionnaires gathered information on criteria for drug use disorder, ACEs, and family and community resilience promotion factors. Compared to individuals with "low" numbers of resilience promotion factors, 30% (95% CI: 0.5-0.9) and 50% reductions (95% CI: 0.4-0.8) in the risk of developing one or more criteria for drug use disorder were observed among those with "moderate" and "high" numbers of resilience factors, respectively (p value for trend=0.003). Overall, family factors were associated with greater risk reductions than comparable numbers of community factors. Among individuals with ACEs, a "high" number of family factors but not community factors were associated with a reduction in risk (RR:0.6, 95% CI:0.4-1.0 for family factors, RR:1.0, 95% CI:0.5-1.8 for community factors). These results suggest that the risk of developing criteria for drug use disorder decreases in a dose-response fashion according to the number of "outside-residing" resilience promotion factors during childhood, and that family factors are associated with greater risk reductions than community factors, particularly among individuals with ACEs. Coordinated prevention efforts at the family and community level are recommended to reduce the risk of this important societal problem.