Positive Behavioral Health Research Articles

Preconception and prenatal vitamin D associations with positive behavioral health in Black children.

Low levels of vitamin D during pregnancy are associated with offspring behavioral problems but little is known about pre-pregnancy influences. Additionally, Black American individuals are underrepresented in studies, limiting translational impact. We tested independent and interactive effects of preconception and prenatal vitamin D in Black women in relation to positive behavioral and emotional outcomes in early childhood. Black-identifying participants (N = 156) enrolled in the longitudinal Pittsburgh Girls Study (PGS) provided venous blood samples before and during pregnancy to measure 25-hydroxyvitamin D (25[OH]D) levels. Participants completed questionnaires assessing sociodemographic factors, depression severity and life stress, and later reported on child behavioral and emotional problems and prosocial behavior between 2 and 4 years. Mean serum 25(OH)D concentrations were 15.5 ng/ml (s.d. = 7.7) before pregnancy and 18.0 ng/ml (s.d. = 9.2) during pregnancy; below the sufficiency threshold according to commonly used dietary guidelines. After adjusting for covariates, prenatal 25(OH)D was negatively related to behavior problems and positively related to prosocial behavior in children, although the association attenuated for behavior problems after accounting for preconception 25(OH)D, which may reflect patterns of stability. Maternal 25(OH)D was unrelated to child emotional problems, and no synergistic effects of 25(OH)D timing were observed for any child outcome. Findings have relevance for Black women living in the northeast U.S. Results suggest specific associations between maternal vitamin D and positive behaviors in early childhood, regardless of sufficiency levels and suggest potential opportunities for early interventions to support healthy child development.

222 Prevalence of Gender Identity and Dysphoria in Adolescent Patients Presenting to a Pediatric Emergency Department With Positive Behavioral Health Screens

222 Prevalence of Gender Identity and Dysphoria in Adolescent Patients Presenting to a Pediatric Emergency Department With Positive Behavioral Health Screens

Assessing Strengths and Well-Being in Primary Care for Adolescents With Mental Health and Substance Use Concerns.

As the COVID-19 pandemic highlighted gaps in meeting adolescent behavioral health needs, primary care providers (PCPs) were a locus for interventions to address adolescent mental health and substance use concerns. Strength-based approaches may support PCP promotion of positive behavioral health in adolescents, but competing priorities or other factors may inhibit their use. We analyzed health record review data from 31 primary care practices to assess utilization of strength-based approaches during the health supervision visit (HSV) for adolescents with and without behavioral health concerns. We found that most had strengths identified (78%) or well-being topics addressed (83%). However, adolescents screening positive for depression were 40% less likely to have strengths identified, whereas those screening positive for anxiety or substance use were 89% and 163%, respectively, more likely to have well-being topics addressed. Primary care providers may need support for integrating strength-based approaches when managing adolescents screening positive for depression.

A brief report on the temporal relations between social functioning and behavioral health among veterans.

Using a four-wave longitudinal design, three competing hypotheses (i.e., social selection, social causation, and reciprocal causation) were tested pertaining to the relation between social functioning and several indices of behavioral health [i.e., post-traumatic stress symptoms (PTSS), distress, and alcohol-related problems] among military veterans exposed to trauma. Across two latent growth curve analyses, data largely supported longitudinal links between improved social functioning and positive behavioral health, often indicating that the improvements in social functioning frequently precede improvements in behavioral health. Overall, findings underscore the merit of directly targeting social functioning as part of mental health treatment among trauma-exposed individuals.

Cultural Dynamics, Substance Use, and Resilience Among American Indian/Alaska Native Emerging Adults in Urban Areas.

Identity development during emerging adulthood helps lay down the structure of values, social bonds, and decision-making patterns that help determine adult outcomes, including patterns of substance use. Managing cultural identity may pose unique challenges for American Indian/Alaska Native (AI/AN) emerging adults in “urban” areas (away from tribal lands or reservations), who are relatively isolated from social and cultural connections. This isolation is in turn a product of cultural genocide and oppression, both historically and in the present day. This paper uses qualitative data from 13 focus groups with urban AI/AN emerging adults, parents, and providers to explore how cultural dynamics are related to substance use outcomes for urban AI/AN emerging adults. We found that cultural isolation as well as ongoing discrimination presents challenges to negotiating cultural identity, and that the AI/AN social and cultural context sometimes presented risk exposures and pathways for substance use. However, we also found that culture provided a source of strength and resilience for urban AI/AN emerging adults, and that specific cultural values and traditions — such as mindfulness, connection to nature, and a deep historical and cosmological perspective — offer “binding pathways” for positive behavioral health. We conclude with two suggestions for substance use prevention and intervention for this population: (1) incorporate these “binding pathways” for health and resilience explicitly into intervention materials; (2) emphasize and celebrate emerging adulthood itself as a sacred cultural transition.Supplementary InformationThe online version contains supplementary material available at 10.1007/s42844-022-00058-w.

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

Feasibility of Social Media-Based Recruitment and Perceived Acceptability of Digital Health Interventions for Caregivers of Justice-Involved Youth: Mixed Methods Study.

BackgroundCaregiver involvement is critical for supporting positive behavioral health and legal outcomes for justice-involved youth; however, recruiting this population into clinical research studies and engaging them in treatment remain challenging. Technology-based approaches are a promising, yet understudied avenue for recruiting and intervening with caregivers of justice-involved youth.ObjectiveThis mixed methods study aimed to assess the feasibility of recruiting caregivers of justice-involved youth using social media into clinical research and to understand caregivers’ perceptions of the acceptability of digital health interventions.MethodsCaregivers of justice-involved youth were recruited through paid Facebook advertisements to participate in a Web-based survey. Advertisement design was determined using Facebook A/B split testing, and the advertisement with the lowest cost per link click was used for the primary advertisement campaign. Survey participants were offered the option to participate in a follow-up qualitative phone interview focused on the perceived feasibility and acceptability of digital health interventions.ResultsFacebook advertisements were successful in quickly recruiting a diverse set of caregivers (80/153, 52.3% female; mean age 43 years, SD 7; 76/168, 45.2% black, 34/168, 20.2% white, and 28/168, 16.7% Latinx; and 97/156, 62.2% biological parents); cost per click was US $0.53, and conversion rate was 11.5%. Survey participants used multiple social media platforms; 60.1% (101/168) of the participants indicated they would participate in a digital health intervention for caregivers of justice-involved youth. Survey respondents’ most preferred intervention was supportive and motivational parenting messages via SMS text message. Of the survey respondents, 18 completed a phone interview (12/18, 67% female; mean age 45 years, SD 10; 10/18, 56% black, 7/18, 39% white, and 1/18, 6% Latinx; and 16/18, 89% biological parents). Interview participant responses suggested digital health interventions are acceptable, but they expressed both likes (eg, alleviates barriers to treatment access) and concerns (eg, privacy); their most preferred intervention was video-based family therapy.ConclusionsRecruiting and intervening with caregivers of justice-involved youth through social media and other digital health approaches may be a feasible and acceptable approach to overcoming barriers to accessing traditional in-person behavioral health care.

Standardization of Care Following a Positive Behavioral Health Screen in Pregnancy [32F

INTRODUCTION: Provider bias plagues behavioral health screening in pregnancy. One in three pregnant women will utilize illicit substances, experience depression/anxiety, or be a victim of violence. Following our Phase I results presented in 2019, we aimed to develop a standardized algorithm for providers to guide response to positive behavioral health screens. METHODS: Through an IRB approved protocol, we screened 260 patients at three intervals during pregnancy between January and June 2019. Patients in a Maternal Fetal Medicine clinic voluntarily completed the Integrated Screening Tool at three separate encounters. A novel, evidence-based algorithm was developed and utilized to guide provider response to a positive screen. RESULTS: During the study period, 479 eligible screening visits occurred among 260 patients. Compared to Phase I, indicated urine drug screen (UDS) completion increased from 13% to 80% (P<.001), of which 11% were positive. Across the screening intervals, 65% of patients with an initial positive screen, subsequently answered negative. Of the patients who initially screened negative, 25% had a positive screen later in pregnancy, of which 33% UDS were positive. Referral to mental health services for patients with a positive emotional health screen increased by 100% following implementation of the algorithm (P<.002). CONCLUSION: Utilizing a standardized algorithm guiding provider response to behavioral health screening in pregnancy significantly increased provider action yet did not identify a significant increase in detecting patients using illicit substances. Longitudinal screening is important as patients are likely to change their response. Additional study is indicated to further establish validity of this novel algorithm.

Building behavioral health systems from the ground up

Building behavioral health systems from the ground up

Promoting Positive Behavioral Health: A Non-pharmacologic Toolkit for Senior Living Communities

Promoting Positive Behavioral Health: A Non-pharmacologic Toolkit for Senior Living Communities

Promoting Positive Behavioral Health: A Nonpharmacological Toolkit for Senior Living Communities

Promoting Positive Behavioral Health: A Nonpharmacological Toolkit for Senior Living Communities

Peers and Obesity during Childhood and Adolescence: A Review of the Empirical Research on Peers, Eating, and Physical Activity.

Obesity during childhood and adolescence is a growing problem in the United States, Canada, and around the world that leads to significant physical, psychological, and social impairment. In recent years, empirical research on factors that contribute to the development and maintenance of obesity has begun to consider peer experiences, such as peer rejection, peer victimization, and friendship. Peer experiences have been theoretically and empirically related to the “Big Two” contributors to the obesity epidemic, eating and physical activity, but there has not been a comprehensive review of the extant empirical literature. In this article, we review and synthesize the emerging theoretical and empirical literatures on peer experiences in relation to: (a) eating (food consumption and food selection); and (b) physical activity, during childhood and adolescence. A number of limitations and issues in the theoretical and empirical literatures are also discussed, along with future research directions. In conclusion, we argue that the involvement of children and adolescents’ peer networks in prevention and intervention efforts may be critical for promoting and maintaining positive behavioral health trajectories.

Community-Based Collaboration: A Philanthropic Model for Positive Social Change

· A highly publicized incident served as a catalyst for the Austin, Texas, community, convened by the Hogg Foundation for Mental Health, to address gaps in the behavioral health system. · The foundation worked with the local behavioral health authority, the mayor’s office, police and sheriff’s departments, and the city health department to design the Austin Mayor’s Mental Health Task Force. The task force was succeeded by a monitoring committee that identified six focus areas in which to develop action plans and monitor community progress. · This collaborative process aimed to strengthen public commitment to behavioral health services and create a cross-agency planning structure to make concrete improvements in the existing service delivery systems. · Fourteen indicators were compiled into a Mentally Healthy Community Score Card, including indicators related to positive behavioral health, such as fitness, housing, and employment. Of the 14 scored indicators, 78 percent showed improvement between 2005 and 2006. · System change outcomes included improved quality and access to data, greater public awareness of mental health issues, and the development of new programs, including funding for pilot programs.