Prevention Programs For Youth Research Articles

Evaluation of an integrated mental health and substance use video-based prevention program for Filipino youth

Evaluation of an integrated mental health and substance use video-based prevention program for Filipino youth

When Being Bad Feels Good: A Systematic Review of the Relationship Between Positive Emotion and Antisocial Behavior in Children and Adolescents.

Antisocial behavior in childhood and adolescence is associated with poor family and peer relationships, and a higher risk of mental and physical health problems in adulthood, as well as criminality. Emotions play a central role in children's moral development, but most research has focused on negative emotions (e.g., shame and guilt), in relation to childhood antisocial behavior. Research in adult populations indicates that positive emotions experienced in anticipation of, during, and after antisocial acts may play an important role in the development and maintenance of antisocial behavior. Consequently, this systematic review aimed to investigate the relationship between positive emotion and antisocial behavior in children and adolescents. A systematic search in five databases was conducted, yielding 52 studies that used different methodological approaches, samples, designs and methods to examine this association. Results provide support for a positive relationship between positive emotion and antisocial behavior across community, forensic and clinical samples. This link appeared to be stronger for younger children, boys, and for children high in social dominance, callous-unemotional or sensation-seeking traits. Results suggested that positive affect may act in concert with negative emotion, cognitive, personality and motivational processes, as well as peer influences to determine the initiation and maintenance of antisocial behavior. This review presents directions for future research and discusses the implications of findings for prevention and intervention programs for youth with antisocial behavior.

Equitable Prevention Science and Participatory Co-Design of the HEROES Strength-Based Programs

Latinx populations are disproportionately impacted by health disparities and are underserved in formal mental health and health systems. Participatory co-design of prevention and health promotion programs may better attend to cultural and systemic factors impacting access and effectiveness. Participatory methodologies offer an opportunity for prevention science researchers to empower and follow the expertise of communities to shape prevention and health promotion programs. Using community-based participatory research (CBPR) puts an emphasis on the local context and priorities related to health equity, whereas implementing human-centered design (HCD) processes provides strategies for the generation and co-design of innovative solutions. In the current study, Latinx youth, youth mentors, and promotores de salud (lay health workers) engaged in the process of co-designing two strength-based caregiver and youth prevention programs through a six-step CBPR + HCD approach. In the first phase, Latinx adolescents collaborated with researchers to co-design a six-module participatory photography program. In the second phase, youth mentors and promotores collaborated with researchers to co-design a four-module family resilience program, incorporating mindfulness, restorative communication, and child-directed interaction skills. Participatory co-design is a promising approach to developing and refining culturally congruent, community-embedded programs, while centering community priorities and meeting the preferences and needs of Latinx communities. Implications for participatory and design frameworks to better address prevention and health promotion and future research are discussed.

Flavored Tobacco Sales Restrictions and Youth E-cigarette Behavior: Impact by Tobacco Retailer Density in Diverse Communities in California.

Factors that impact flavored tobacco sales restriction (flavor restrictions) effectiveness on youth e-cigarette behavior are unclear. Tobacco retailer density (retailer density) is a health equity issue with greater retailer density in high-minority, low-income areas. We examined the association between flavor restrictions and youth e-cigarette behavior by retailer density across diverse communities in the California Bay Area. We analyzed data from the California Healthy Kids Survey using a difference-in-differences (DID) strategy. We compared pre- and post-policy changes in e-cigarette access and use one-year post-implementation among high school students in the Bay Area with a flavor restriction (n = 20 832) versus without (n = 66 126). Separate analyses were conducted for students in cities with low and high retailer density, with a median cutoff of 3.3 tobacco retailers/square mile. Students with high retailer density were more likely to identify as a minority and have parents with lower education. Among students with low retailer density, flavor restrictions were associated with 24% lower odds in the pre- to post-policy increase in ease of access relative to unexposed students (DID = 0.76, 95% CI: 0.58, 0.99). Among students with high retailer density, flavor restrictions were associated with 26% higher odds in ease of access (DID: 1.26, 95% CI: 1.02, 1.56) and 57% higher odds of current use (DID = 1.57, 95% CI: 1.31, 1.87). Flavor restrictions had positive impacts on youth e-cigarette access in low, but not high retailer density cities. From a health equity perspective, our results underscore how flavor restrictions may have uneven effects among vulnerable groups. In diverse communities in the California Bay Area, our results suggest a protective association between flavored tobacco sales restrictions and youth access to e-cigarettes in low, but not high tobacco retailer density cities one-year post-implementation. These results underscore how flavor restrictions may have uneven effects, and when implemented in high retailer density areas, may disproportionately place already vulnerable groups at heightened exposure to e-cigarette use and access. In high retailer density areas, additional tobacco control efforts may need to be included with flavor restriction implementation, such as increased education, youth prevention and cessation programs, policies to reduce tobacco retailer density, or stronger tobacco retailer enforcement or compliance monitoring.

Recommendations for Modernizing a Culturally Grounded Substance Use Prevention Program for American Indian and Alaska Native Youth.

American Indian and Alaska Native (AI/AN) youth use alcohol and drugs at a higher rate with earlier onset than the overall youth population in the United States. Youth interventions are needed to support the prevention and reduction of substance misuse-related issues. Connecting AI/AN children to their heritage through culturally grounded prevention programs has been shown to be more effective than programs designed for the general population. The objective of this formative evaluation was to provide community-informed updates for an existing culturally grounded substance use prevention program, The Beauty Way. This study was conducted in partnership with an AI/AN-serving community organization using key informant interviews and talking circles with community members and parents. Participants revealed the challenges and obstacles AI/AN youth face, the impact of cultural values, and activities which engage youth to prevent problematic substance use. Recommendations include the importance of 1) incorporating current challenges to behavioral health such as social media and vaping, 2) including cultural values and activities including land-based learning, and 3) creating a robust facilitator guide and hiring culturally sensitive program staff. These results generated recommendations to strengthen the cultural focus and application of The Beauty Way for AI/AN youth.

Coping Power-Rural: Iterative Adaptation of an Evidence-Based Preventive Intervention for Rural Upper Elementary and Middle Schools

Abstract Background Educators in rural schools are uniquely situated to address youth mental health disparities, yet often face challenges in delivering mental health supports. This paper describes the process of adapting the evidence-based Coping Power program, a small group prevention program for youth with aggressive behavior problems, to be a two-tiered (Tier 1 and Tier 2), transdiagnostic intervention to improve fit and feasibility for rural upper elementary and middle schools. Method Identified challenges with the Coping Power program for rural areas included program length, substantial staffing and resource requirements, lack of universal programming, low caregiver engagement, and co-occurring problems. Initial adaptations included a classroom and small group format implemented by school staff, teacher consultations integrated into coaching and co-facilitation, and a technology-supported caregiver component. Implementer feedback forms, coaching notes, and individual interviews informed the iterative development and feasibility testing process. Results Between 2019 and 2023, thirteen schools across six rural districts implemented the program. Student curriculum revisions included order and relative emphasis of content, classroom and small group overlap, necessary simplification of concepts, improved contextualization to the rural setting, and the addition of student workbooks. Supports for implementers included fully developed lesson plans and slides, a comprehensive implementation manual, video lesson overviews, action-focused training, and a 3-session coaching model to support implementer preparation and sustain motivation. Teacher and caregiver infographic text “nudges” were improved to promote generalization of concepts across settings. Discussion By partnering with school-based implementers, the adapted program holds promise to be more feasible and appealing for rural schools than the original model. This fully developed program is now ready for larger-scale testing in rural schools.

A Social Process Model of forms of aggression and victimization and internalizing problems

Using one-year longitudinal data, the present study examined the association between forms of aggression and internalizing problems and whether peer rejection and victimization mediated this association among Taiwanese children. Participants in the current study were 269 fourth and fifth graders (51% boys and 49% girls; M age = 10.02 for boys and 9.99 for girls, at the first time point) from four public elementary schools in northern Taiwan. Data was collected at three time points during one calendar year, six months apart (fall of grades 4 and 5, spring of grades 4 and 5, fall of grades 5 and 6). Serial mediation models were tested in which independent variables were forms of aggression (relational and physical), mediators were peer rejection and forms of peer victimization (relational and physical), and dependent variables were internalizing problems. Results indicated that peer rejection and relational victimization, in that order, mediated the association between relational aggression and internalizing problems, while controlling for gender (serial mediation: relational aggression → peer rejection → relational victimization → internalizing problems). In contrast, the results did not support the mediation or indirect effect of physical aggression on internalizing problems through peer rejection and physical victimization. However, physical aggression directly predicted internalizing problems during one school year. These differences in the pathways from each form of aggression to internalizing problems via peer rejection and forms of peer victimization suggest the need for differentiated intervention and prevention programs for at-risk youth with forms of aggression and victimization in Taiwanese schools.

Adaptation of a trauma-informed intervention to prevent opioid use among youth in the legal system

IntroductionYouth in the legal system are at high risk for opioid and other substance use problems and exhibit high rates of trauma exposure. Trauma-focused therapeutic approaches to prevent substance use show promise, but few evidence-based interventions are designed with justice-involved youth in mind. Consequently, implementing trauma-informed, evidence-based interventions within juvenile justice systems is challenging. The current paper describes the systematic adaptation of Trust-Based Relational Intervention (TBRI) as a family-centered substance use prevention program for youth transitioning from secure residential facilities. MethodsThe study utilized the ADAPT-ITT methodological framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention designed to help caregivers support children and youth with histories of trauma. Phases of adaptation included (1) Assessment, (2) Decision, (3) Prototype Development, and (4) Testing and Integration. The adaptation process explored contextual factors (e.g., systems, facilities, and staff) and the needs of the new target population (i.e., youth in the legal system and their caregivers). Adaptations were made to both content (e.g., terminology and activities) and structure (e.g., session duration and delivery setting) with input from participants from the target population, key stakeholders, and content experts. ResultsThe systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the TBRI Caregiver Curriculum, TBRI Youth & Young Adult Curriculum, and TBRI Nurture Groups. The secondary intervention, delivered after youth transition home, includes the TBRI Family Coaching Curriculum. ConclusionsUtilizing a systematic methodological framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually appropriate interventions. Accounting for contextual factors and population needs can improve the fit of evidence-based interventions for youth in the legal system, facilitating uptake and ultimately improving outcomes for youth at risk for substance use problems. Trial registrationClinicalTrials.gov Identifier: NCT04678960.

Youth Aggression and Peer Victimization as Predictors of Adolescent Alcohol and Marijuana Use: A Longitudinal Analysis of Youth with Aggressive Behavior Problems.

Youth who are behaviorally aggressive and victimized by their peers comprise a significant population with specific risks and vulnerabilities relative to substance use. The goals of the current study were to examine the roles that youth aggression and peer victimization play in determining the timing of alcohol and marijuana use initiation and the frequency of use 5-years later in a sample of at-risk, aggressive youth. 360 youth (Mage= 10.17 years; 65% boys, 35% girls; 78.1% African American, 20.3% Caucasian, 1.4% Hispanic, and 0.3% other) recruited for a prevention program for at-risk youth were followed for 5 years (4th - 9th grade). Cox PH regressions were conducted to predict timing of alcohol and marijuana use initiation. Zero-inflated negative binomial regressions were used to predict frequency of alcohol and marijuana use 5 years later. Results showed that peer victimization inferred decreased risk of alcohol use initiation. However, this effect was only observed for youth with relatively moderate, and low levels of aggression. Findings suggest that differences in youth aggression and victimization interact to predict distinct outcomes, suggesting the need for a more comprehensive approach when working with aggressive youth who have experienced peer victimization.

Do Self-Processes and Parenting Mediate the Effects of Anxious Parents' Psychopathology on Youth Depression and Suicidality?

To understand how anxious parents' global psychopathology increases children's risks for depression and suicidality, we tested mediational pathways through which parent global psychopathology was associated with youth depression and suicidality over a six-year period. Parents (n = 136) who had an anxiety disorder at baseline reported global psychopathology and youth internalizing problems. Youth did not have any psychiatric disorder at baseline and they reported self-esteem, perceived control, and perceived parental warmth and rejection at baseline and 1-year follow-up. At 6-year follow-up, youth depression and suicidality were assessed via multiple reporters including the self, parent, and/or an independent evaluator. Results showed that parental psychopathology had an indirect but not direct effect on youth depression and suicidality via perceived control. No associations were found for the other hypothesized mediators. Perceived control might be a transdiagnostic intervention target in depression and suicide prevention programs for youth exposed to parental anxiety.

Resistance to peer influence, smoking friends, cigarette and betel nut use, and gender among Pacific Islander youth

The present study examined the relationships between resistance to peer influence and cigarette and betel nut use, as well as the potential mediating role of friends who use cigarettes and betel nut, among boys and girls in Guam. This study included 673 ethnically diverse students (49% female; M age = 12.7, SD = 0.89) from eight public middle schools. The mediation analysis demonstrated that higher resistance to peer influence for both cigarette and betel nut use was associated with lower cigarette and betel nut use directly and that this association was mediated by friends who used cigarette and betel nut products. That is, low resistance to peer influence for both cigarette and betel nut use was associated with a greater number of friends who smoke and use betel nut, which was linked with more cigarette and betel nut use. The moderated mediation analysis revealed no gender difference in the indirect effect (i.e., the mediation of friends who used cigarettes and betel nut). These findings can be used to inform the design and implementation of intervention and prevention programs for at-risk youth, regardless of gender, who are vulnerable to substance use in the Pacific.

Reciprocal Links Between Friendship Quality and Peer Victimization Among Middle Adolescents.

There is a robust association between friendship quality and victimization in adolescence; yet, it remains unclear whether friendship quality may be linked causally with different forms of victimization in middle adolescence. To fill this gap, this study examines the bidirectional associations of friendship quality and relational/verbal victimization with data collected at two time points, 6 months apart, in a sample of 671 middle Chinese adolescents (Mage = 15.63, SDage = 0.73, 49% males). Cross-lagged panel analyses revealed a two-way relationship between friendship quality and victimization, which existed in both verbal and relational victimization. Multi-group panel analyses observed that the cross-lagged associations between friendship quality and relational/verbal victimization were only found for males, but not for females. This result suggests that adolescent males' victimization is both affected by and a predictor of friendship quality, with implications for youth prevention programs.

Web-Based Delivery of a Family-Based Dating Abuse Prevention Program for Adolescents Exposed to Interparental Violence: Feasibility and Acceptability Study.

Numerous studies have demonstrated that exposure to caregiver intimate partner violence (IPV) can have cascading negative impacts on children that elevate the risk of involvement in dating abuse. This cascade may be prevented by programs that support the development of healthy relationships in children exposed to IPV. This paper describes the results of a study of the web-based adaptation of an evidence-based dating abuse prevention program for IPV-exposed youth and their maternal caregivers. Core information and activities from an evidence-based program, Moms and Teens for Safe Dates, were adapted to create the web-based program (e-MTSD), which comprises 1 module for mothers only and 5 modules for mother-adolescent dyads to complete together. The primary objective of this study was to evaluate the feasibility and acceptability of the e-MTSD program and the associated research processes. We also examined the practicability of randomizing mothers to receive SMS text message reminders and an action planning worksheet, which were intended to support engagement in the program. Mothers were recruited through community organizations and social media advertising and were eligible to participate if they had at least one adolescent aged 12 to 16 years of any gender identity who was willing to participate in the program with them, had experienced IPV after their adolescent was born, and were not currently living with an abusive partner. All mothers were asked to complete the program with their adolescent over a 6- to 8-week period. Participants were randomized to receive SMS text message reminders, action planning, or both using a 2×2 factorial design. Research feasibility was assessed by tracking recruitment, randomization, enrollment, and attrition rates. Program feasibility was assessed by tracking program uptake, completion, duration, and technical problems, and acceptability was assessed using web-based surveys. Over a 6-month recruitment period, 101 eligible mother-adolescent dyads were enrolled in the study and were eligible for follow-up. The median age of the adolescent participants was 14 years; 57.4% (58/101) identified as female, 32.7% (33/101) identified as male, and 9.9% (10/101) identified as gender diverse. All but one mother accessed the program website at least once; 87.1% (88/101) completed at least one mother-adolescent program module, and 74.3% (75/101) completed all 6 program modules. Both mothers and adolescents found the program to be highly acceptable; across all program modules, over 90% of mothers and over 80% of adolescents reported that the modules kept their attention, were enjoyable, were easy to do, and provided useful information. Findings suggest the feasibility of web-based delivery and evaluation of the e-MTSD program. Furthermore, average ratings of program acceptability were high. Future research is needed to assess program efficacy and identify the predictors and outcomes of program engagement.

Green List Prevention - An Evidence Registry for Prevention and Health Promotion in Germany

Abstract Introduction Evidence-based prevention and health promotion will be supported by practice-relevant evidence registries. The Green List Prevention provides an overview of evidence-based prevention programs for children and youth in Germany. It was modeled after the U.S. Blueprints for Healthy Youth Development in the context of the Communities That Care community prevention system. Programs are reviewed for conceptual, implementation, and evaluation quality and are categorized into three levels of evidence: (1) effectiveness theoretically well established, (2) ∼ likely, (3) ∼ proven. The Green List Prevention is used in communities, at state and national levels, and research. This paper provides insight into its content, keywording and enhancements. Methods To characterize the evidence-based programs, an inductive-deductive procedure was used to form 14 super- and 33 subcategories with 226 characteristic attributes. Based on these, all registry entries were categorized and summarized descriptively. Results The 100 programs listed (4/2023) address not only the primary target group of children and adolescents, but also secondary target groups (mainly teachers n = 53, guardians n = 46, educators n = 19) and are located in different environments (mainly school n = 61, family n = 28, kindergarten n = 23). Behavioral prevention on violence including bullying n = 64, addiction n = 47 and mental health n = 34 are in the foreground; topics such as nutrition (n = 3) and physical activity (n = 2) are little represented. Social and life skills programs (n = 61) and training for guardians (n = 25) are listed particularly often. Conclusions The Green List Prevention provides an overview of effective prevention and health promotion interventions for different contexts. Its current expansion to rate environmental and behavioral prevention measures on nutrition and physical Key messages • The Green List Prevention enables stakeholders to make a targeted selection of evidence-based programs and offers practice-relevant information e.g. main focus, program formats, implementation. • The evidence register Green List Prevention supports evidence-based prevention and health promotion in Germany.

HIV/AIDS Risky Behavior Model for LGBT Youth in the Gorontalo Province

Context: The behavior model for preventing HIV/AIDS transmission in lesbian, gay, bisexual, and transgender (LGBT) youth can contain HIV/AIDS information in this population. Objective: According to Planned Behavior Theory (PBT), human growth within different social environments may gain further information on various issues. This information can be the basis of their behavioral beliefs, social demands of essential others (normative beliefs), and obstacles that can prevent them from showing certain behaviors (control beliefs). These factors can influence intention and behavior. This study aims to develop a model for HIV/AIDS risk-related behavior among LGBT youth based on PBT. Methods: This was an observational study using a cross-sectional approach. The modeling used the Structural Equation Model (SEM) pathway through the AMOS 8.50 software application. The variables in this study are internal factors, such as religious obedience, knowledge, beliefs, intention, and risky behavior. Participants: This study occurred in Gorontalo Province with 200 LGBT youths with risky behaviors. Results: Risk behavior modeling results of LGBT youths in Gorontalo; Religious adherence affects risk behavior through intention. Overall, research results from the study using the PBT approach emphasize that religious obedience does not directly affect the behavioral variables but rather beliefs and intentions. Conclusion: HIV/AIDS prevention programs for LGBT youth should focus on religious activities.

Preliminary findings from Mapping Q: An arts-based suicide prevention program for sexual and gender minority youth.

Preliminary findings from Mapping Q: An arts-based suicide prevention program for sexual and gender minority youth.

Establishing Core Content for Culturally Grounded Harm Reduction Intervention for Urban Indigenous After-School Youth in the Pacific Northwest

Indigenous adults (18 years or older) including parents, staff, and volunteers of an urban Indigenous youth after-school program participated in individual interviews (n = 10) as part of a community-based participatory research (CBPR) Indigenous harm reduction study to identify alcohol and other drug (AOD) content to include in prevention programming for youth participants. Adult findings were organized using a risk environment framework to identify culturally relevant social, physical, policy, and economic AOD risk factors for youth. We report where adult findings intersect with previously described youth results to establish a list of core content (i.e., culturally relevant AOD prevention activities and discussion topics) to guide program implementation. Core content includes intergenerational Indigenous perspectives (i.e., youth, adult, and elder) to reflect Indigenous cultural lifeways and values of protecting future generations. Findings may be highly relevant to other Indigenous after-school groups or others who wish to develop harm reduction prevention programming for urban Indigenous youth in the Pacific Northwest or beyond.

Adult characteristics, skills, and approaches that facilitate supportive relationships with youth: A qualitative investigation of Sources of Strength

IntroductionSources of Strength is a universal prevention program for youth that provides tools and educational opportunities to promote wellness and reduce risk. A major aim of Sources is to build youth-adult relationships to support youth in times of distress. However, no study to date has investigated how adults effectively build relationships with youth despite this being critical to successful implementation of Sources. The present study explores both student and staff perspectives of what characteristics, skills, and approaches encourage the development of supportive student-adult relationships to inform efforts for successful intervention implementation. MethodsThis qualitative supplement to a Randomized Controlled Trial (RCT) of Sources, recruited 23 students in grades 9 to 12 for individual interviews and 11 staff members for focus groups from 2 high schools implementing the intervention. Semi-structured interview guides were used, and emergent themes were identified through process and pattern coding. ResultsKey facilitators of supportive and effective adult-youth relationships included perceptions of adults as approachable, caring, encouraging, and understanding. Successful adult advisors used humor and were perceived as invested and engaged in the lives of youth. Maintaining accountability for youth, balanced with intervention and provision of resources additionally emerged as a critical factor supporting positive relationships with youth. Sources itself emerged as a catalyst for the growth of these positive and supportive youth-adult relationships. ConclusionsTrusted adults are instrumental as both operators within prevention programs targeting young people and as facilitators in adult-youth relationships through leveraging key skills and approaches. These findings can inform quality implementation of interventions, like Sources, that embed adult-youth connections as a central feature of the program model.

Implementation Fidelity and Theory-Informed Dose Effects of a Teen Pregnancy Prevention Program for Native American Youth

In 2019, Native youth had the highest rate of teen pregnancy of all racial/ethnic groups. “Respecting the Circle of Life” (RCL) is one of the first evidence-based teen pregnancy prevention programs for Native teens and there is interest in replicating the program across tribal communities. To inform replication, it is important to consider process data including quality, fidelity, and dosage as these may all moderate impact of the program. Participants were Native youth aged 11–19 and a trusted adult. This study includes participants randomized to the RCL program only (N = 266). Data sources include independent observations, facilitator self-assessments, attendance logs, and self-report assessments completed by enrolled youth at baseline and 3 months post assessment. Data was compiled and summed by cohort. Dosage was number of minutes participating in activities separated by theoretical constructs. Linear regression models were utilized to assess moderation of the effects of the intervention dosage on outcomes of interest. Eighteen facilitators delivered RCL. One hundred eighteen independent observations and 320 facilitator self-assessments were collected and entered. Findings indicate RCL was implemented with high fidelity and quality (4.40 to 4.82 out of a 5-point Likert scale; 96.6% of planned activities completed). Dosage was high with an average completion of 7 out of 9 lessons. There was no association between theoretical construct dosage and outcomes of interest. Overall, this study indicates RCL was delivered with high fidelity, quality, and dosage in this trial. This paper informs future replication of RCL and provides support for hiring paraprofessionals from the local community as facilitators, delivering the RCL to peer groups of the same age and sex, delivering the RCL with short duration and high frequency, and encouraging youth to attend all RCL lessons, but continue to serve youth who have missed one or more lessons.

Bystanders' Victim Blaming and Minimizing Consequences of Weight-Based Cyberhate Attacks: The Roles of anti-Fat Attitudes, Body-Positive Online Content, and Gender.

Physical appearance and, specifically, weight are common reasons for cyberhate attacks among adolescents. Using a between-subject experimental design, this study focuses on the bystanders of such attacks on Instagram. We investigate bystanders' assessments in the form of two moral disengagement (MD) mechanisms-victim blaming and minimizing consequences-and we compare the assessments of attacks that are diversified by the victim's weight (i.e., a victim who is plus-size and a victim who is thinner). We also examine the moderating roles of bystanders' prejudice against people who are plus-size in the form of the so-called anti-fat attitudes, their frequency of viewing body-positive online content, and gender. The study's data come from an online survey conducted in 2020 with a representative sample of 658 Czech adolescents, aged 13-18. We tested our hypotheses with structural equation modeling. The results show that the two MD mechanisms work differently. The victim's displayed weight affected the bystanders' tendency to victim blame: adolescents blamed the victim who is plus-size more than the victim who is thinner, but the victim's weight made no difference in minimizing the consequences of the incident. A moderating effect for anti-fat attitudes and gender was found for victim blaming. Bystanders with higher anti-fat attitudes and boys blamed the victim who is plus-size more than the victim who is thinner. On the other hand, there was no effect for the frequency of viewing body-positive online content for either of the MD mechanisms. The results are discussed with regard to the differences between the two mechanisms and the practical implications for educational and prevention programs for youth.