Young People's Access Research Articles

Effects of the Hukou system on the geographies of young people in contemporary urban China

ABSTRACT The Chinese institution for population registration is called the hukou system. It divides residents into local and non-local hukou holders concerning geographical mobility. Within Chinese society, young people often move away from their birthplace and subsequently become non-local hukou holders in the destinations. The hukou system has become a barrier to the access of young people to urban rights, placing them in a peripheral position in society. To understand the often-overlooked geographies of young people in China, the article examines how the hukou system undermines young people’s right to the city. Subsequently, the invisible politics of young people in China is discussed, based on a scoping review that approaches the issue through three themes: young people’s tactics in their mobilities; housing inequality and residential segregation; and young people’s aspirations for the future. Combining authoritarianism and neoliberalism, the hukou system controls the distribution of city rights, and thus regulates the flows of young people. Such regulation constitutes a transitional regime that shapes the life trajectories of Chinese youths. Therefore, the article recommends hearing the voices of Chinese young people in the field of Children’s Geographies, and thus enabling their voices to influence future reforms of hukou policies.

Youth Services: Culture, Community, & Learning

The ALISE Youth Services Special Interest Group (SIG) presents a panel exploring the ways in which youth services in libraries empower youth and families and how youth programs address learning and incorporate culturally-relevant approaches. The session will begin with presentations of papers (15 minutes each) plus a themed question and answer portion to conclude. Attendees will be able to share their own experiences and work in progress on these topics in the discussion. Cahill, Joo, Minniear, LeFebvre, & Garcia will present “Math Talk in Public Library Virtual Storytime Programs.” This work presents an analysis of mathematics content integrated in public library virtual storytime programs. Cahill et al. characterize the mathematics environment of public library virtual storytime programs, discuss whether there are differences in the virtual storytime mathematics environment based on the population density of the community the library serves (i.e. urban, suburban, town, rural) and on library size. Preliminary findings suggest substantial differences in the amount of mathematics-related talk across virtual storytime programming for children. Kim, Choi, & Kang will present “Family Makers: A Culturally Relevant Online Engineering Programming for Youth Through Research-Practice Partnership with Public Library Professionals.” This work details research-practice partnership with seven rural libraries across the U.S using co-design and culturally-relevant pedagogy to develop the Family Makers program and strengthen library staff to deliver engineering learning opportunities. Kim et al. will discuss the importance of leveraging families’ cultural practices of making and forms of everyday sensemaking to design for family learning in engineering and highlight that rural library staff can support family learning in engineering by drawing on their personal experiences, relational knowledge, and non-engineering expertise as resources. Zalot will present “The kids are alright:” Understanding Youth Agency in Book Banning Discourse.” This presentation will discuss some of the factors influencing the absence of young people in book banning discourse and how social media operates as a means of access for young people in both book banning and political discourses. Youth services can nurture youth, community, and support learning and family connection. This presentation and the subsequent attendee discussion will explore the ways that the LIS field can work to address these and other community needs through excellent youth services.

PROMOTION AND PROTECTION OF HUMAN RIGHTS: INCLUSION OF PERSONS WITH DISABILITIES IN NORTH MACEDONIA

North Macedonia’s accession negotiations are conditioned by the country’s progress on fulfilling the Copenhagen criteria. Respect for human rights, defined as one of the founding values of European Union, it is associated with the fundamental political criteria for full membership for every candidate state. In the Progress Report for 2022, European Commission raised the concerns that North Macedonia had made “limited progress in improving the rights of persons with disabilities”. Considering that the country since its independence ratified several international treaties on human rights and assumed obligation not only to guarantee but also to protect the fundamental human rights, in this paper will be analyzed: the national legal framework on the protection of the fundamental rights of persons with disabilities, national strategies on the rights of persons with disabilities, and national policies on the integration of persons with disabilities. The purpose of this study it is to analyze the responsibilities and commitment of the state authorities in providing equal rights and opportunities for persons with disabilities, especially focusing on the access of women with disability to the labor market and access of children and young people with disability to education. The research it is in-depth analysis and guided by two research questions: What are the responsibilities of North Macedonia as a candidate country in promoting and enforcing the rights of persons with disabilities? What have done North Macedonia for social inclusion of persons with disabilities.

Care-experienced young people’s views and experiences of accessing general practice and dental services and attending health reviews in England: a qualitative study

BackgroundChildren in care and care leavers have worse health outcomes than their peers without care experience. This study addresses an evidence gap in exploring care-experienced young people’s views and experiences of accessing general practice and dental services and attending health reviews in England.MethodsWe conducted a qualitative study using podcasting as a creative medium. We recruited young people from two sites: one in South England (A) and one in greater London (B). We held two paired discussions in site A and two focus groups in site B, with 14 participants in total. Participants were aged between 13 and 22 years and were diverse in gender, ethnicity, and care experiences. Data were analysed thematically using candidacy theory as a theoretical framework.ResultsMental health was a prevailing concern for participants, but general practice was not considered a place to discuss it. Most participants reported distant relationships with primary healthcare professionals and considered opening-up to a professional to be risky, for example, it could result in an unknown/unwanted outcome. A lack of time and personal connection in appointments, and experiences of feeling judged, dismissed, or misunderstood, hindered young people’s ability to disclose mental health or relationship concerns. Participants reported variation in the timeliness and location of services, with salient examples of extensive waiting periods for braces. Participants perceived annual health reviews to be largely inconsequential.ConclusionsAny primary care presentation by a care-experienced young person should trigger additional professional curiosity. To build rapport and trust, professionals should not underestimate the power of active listening, being reliable and honest, and small acts of thoughtfulness, for example, ensuring medical letters are provided promptly. Carers and other trusted professionals should help care-experienced young people to understand the role of primary care and support them with access. Health reviews may not be of value to all young people in care. Further research is needed to examine primary healthcare access for care-experienced young people with significant safeguarding and healthcare needs.

Disinterest, normalisation of gender violence and fear of being cancelled: Mediatised learning on antifeminist and anti-LGBTIQ+ discourses among teenagers in Barcelona

This article examines the proliferation of antifeminist and anti-LGBTIQ+ discourses among teenagers in Barcelona (Catalonia) and the role of media and the manosphere – online communities and spaces where discussions about masculinity, anti-feminism, gender relations and men's issues take place – on the pollination of these discourses. Through short-term ethnography conducted in three education centres, involving the collaboration of 59 teenagers between 14 and 18 years old, the study researches the discourses that young people embrace, what mediatised environments are referring to when they speak about gender, feminism and LGBTIQ+ topics, and the meaning young people give to these media content. Findings reveal the manosphere facilitates young people's access to masculinist cultures and point to the urge of addressing the affective dimension of it. To conclude, it highlights the need to challenge these informal learning spaces within contemporary youth culture to promote gender equality and social justice.

The barriers to and facilitators of academic and social success for deafblind children and young people: A scoping review

AbstractDeafblind children and young people often perform poorly in education and social settings. The extent of this attainment gap is unknown. Following the Joanna Briggs protocol, a scoping review was conducted with the aim of establishing the barriers to and facilitators of academic and social success for this cohort. A database search was conducted seeking peer‐reviewed studies relating to deafblind children and young people, in academic and social settings, from any country, published in English, between 1989 and 2022. The review included 38 articles with a range of methodological approaches. The main barriers to success were limited opportunities and options to communicate, a lack of awareness of deafblindness within schools and the wider community, and limited opportunities and adaptations to the curriculum, resources and the environment. The facilitators included improving access to communication and resources, increased awareness, and collaboration between families and professionals. Additional research is needed in this field, particularly to investigate the impact of modern technology to aid access and communication for deafblind children and young people.

THE PROBLEMS OF YOUTH IN PROFESSIONAL SELF-FULFILLMENT AS A SYSTEMIC PROBLEM: ANALYSIS OF SOCIAL FACTORS

The material of the article is devoted to the possibilities of professional self-realization of young people in the problem of employment, and the analysis of its social factors. It was shown that the generation of the problems of ensuring employment of young people is determined not only by the low level of their competitiveness in the labor market, the lack of necessary practical experience, work experience in the profession, but also by the access of young people to relevant public resources (economic, legal, social), the level of their economic, social and cultural capital. This is also the inadequate assessment of the objective conditions and opportunities of employment in accordance with their own profession and preferences. The article considers a number of social factors of generating the problem of professional certainty and its implementation, in particular: family factors, subjective (overestimated self-esteem, professional inflexibility), educational, stratification, and other situational factors. The educational factor of the problem is considered separately, where there is a mismatch of the content of professional education with modern market challenges, its inconsistency with the requirements and needs of the present. The problematic factor of the employer's pragmatism and its non-constructive role in the possibility of professional realization of a young employee is separately assessed (extreme pragmatism, inflexibility in personnel matters, additional unprofessional burden on a young employee). A number of socio-professional factors of youth competitiveness in the employment market have been determined, which are generative both by external social conditions and micro social components. Involving non-formal education with its revealed potential was positioned as one of the means of partially solving this problem. It is shown that non-formal education is indeed an important factor for self-realization and integration of students in education. And in view of modern realities - the challenges of war, the demand for non-formal education as an additional resource for formal education is growing even more.

Spatialities of shabaab: exploring the intersections of lifestage, space and mobility amongst refugee young people in urban Jordan

ABSTRACT Refugee young people in countries of first asylum navigate daily life through a set of deeply challenging, and often traumatic, structures, circumstances, and expectations. Attending to the complex interaction and relationship between identities, structures of legality, space and place facilitates an important critical lens to examine and understand refugee young people’s experiences, including their sense of belonging, hopes for the future and their conceptualisation of life stages of murahik (adolescence) and shabaab (youth) in shifting transnational spaces. Based upon participatory and exploratory research conducted in 2022 with Syrian & Iraqi refugee shabaab, this paper uses a socio-spatial justice framework which centres young people’s voices and explores the everyday places and spaces that these young people access, inhabit, frequent and avoid within the cities of Amman and Zarqa, the urban and economic heartland of Jordan.Using an approach which is sensitive to the role of identity, policy and structural constraint ensures plural insights into the spatial and mobile lives of young people and illustrates the diversity of their experiences, particularly highlighting the role of gendered identities and diverging refugee policies in impacting these diverse experiences, contributing to the growing research field on refugee youth and spatiality.

An Intersectional Analysis of Gender-Specific Barriers to Adolescent Health Literacy in South Africa

Various studies have shown that influencing factors such as gender, race, and socio-economic status could significantly impact adolescents’ health literacy in South Africa. The adolescent stage is crucial for acquiring and developing health-promoting knowledge and behaviors. Therefore, this study aimed to analyze the gender-specific determinants that prevent adolescents from accessing, understanding, and utilizing health-related information and services through an intersectionality theoretical lens. This study used content analysis of secondary data from 2010 until 2023 from electronic databases such as SciELO, Google Scholar, the Directory of Open Access Journals, Scopus, and governmental reports. From the initial 102 articles and documents obtained from the search process, a total of 26 papers were included in this study. The results indicated that gender roles, cultural norms, heteronormativity, gender-based violence, and associated stigmatization are gender-specific barriers to adolescents’ health literacy in South Africa. Based on the study findings, I argue that multi-stakeholder engagement is needed to address the identified barriers and collaboratively develop and implement a gender-responsive health literacy programme that promotes equitable and non-judgmental access for young people to health information and services in South Africa.

An early economic evaluation of Kooth, a web-based mental health platform for children and young people with emerging mental health needs

Background“Kooth” is a web-based mental health platform commissioned by the National Health Service (NHS), local authorities, charities, and businesses in the UK. The platform gives children and young people (CYP) access to an online community of peers and a team of counsellors. This study reports an early economic evaluation of the potential benefits of Kooth in the UK. MethodsAn early evidence cost calculator was built to estimate the potential costs and savings of implementing Kooth from a UK NHS and crime sector perspective. A decision tree structure was used to track the progress of CYP with emerging mental health needs (EMHN), comparing CYP with access to Kooth to CYP without access to Kooth. The model implemented a 12-month time horizon and followed a typical Kooth contract in relation to costing, engagement, and CYP demographics. ResultsThe base case results followed a cohort of 2160 CYP. The results of the cost calculator estimated that engagement with Kooth is associated with a cost saving of £469,237 to the NHS across a 12-month time horizon, or £236.15 per CYP with an EMHN. From a combined NHS and UK crime sector perspective, the cost savings increased to £489,897, or £246.54 per CYP with an EMHN. The largest cost savings were provided by an estimated reduction of 5346 GP appointments and 298 antidepressant prescriptions. For this cohort, the model predicted that engagement with Kooth averted 6 hospitalisations due to suicidal ideation and 13 hospitalisations due to self-harm. Furthermore, the number of smokers and binge drinkers was reduced by 20 and 24, respectively. When a crime sector perspective was taken, 3 crimes were averted. DiscussionThis early model demonstrates that Kooth has the potential to be a cost-saving intervention from both an NHS and a combined NHS and UK crime sector perspective. Cost savings were provided through aversion in clinical and social outcomes. The model used a conservative approach to balance the uncertainty around assumptions of the intermediate outcomes (GP and medication use). However, it is limited by a paucity of costing data and published evidence relating to the impact of digital mental health platforms.

A mixed-method systematic review of the perspectives of young people, carers and professionals on psychiatric diagnosis in childhood and adolescence.

The significance and complexities of a psychiatric diagnosis have been well-documented in existing literature. Despite the reliability and accuracy of such diagnoses, the impact and use of diagnostic labelling on young people remains unclear. A systematic review was conducted using six databases, identifying 13 studies that explored psychiatric diagnosis experiences in professionals, caregivers, and young people. This review focuses on three main themes related to psychiatric diagnosis in young people. The first theme is diagnostic subjectivity, which explores the accuracy, usefulness, potential harm and alternatives (e.g. psychological formulation) to psychiatric diagnosis in this population. The second theme is the utility of psychiatric diagnosis, which considers whether it helps young people access appropriate support and gain a better understanding of themselves and their presenting issues. The third theme is stigma, which examines the negative experiences and discrimination that young people may face due to their psychiatric diagnosis. There is relatively limited literature which discusses the experience of psychiatric diagnosis in young people, caregivers and professionals. The available literature is difficult to compare due to discrepancies between methodologies and services, and there are several gaps i.e. a limited focus on the experience of young people themselves. Different views and experiences of psychiatric diagnosis among professionals, caregivers, and young people could impact young people's quality of life, access to healthcare, and identity development. The current literature needs to be more comprehensive to draw firm conclusions about young people's experiences with psychiatric diagnosis.

Mental Health Distress and Delayed Contraception Among Older Adolescents and Young Adults.

Background: Symptoms of mental distress increased sharply during the COVID-19 pandemic, especially among older adolescents and young adults. Mental health distress may make it more challenging for young people to seek other needed health care, including contraception. This study explored the association of symptoms of depression, anxiety, and stress with delays in getting a contraceptive method or prescription. Materials and Methods: Data from a supplementary study (May 15, 2020-March 20, 2023) to a cluster randomized trial in 29 sites in Texas and California were used. The diverse study sample included community college students assigned female at birth of ages 18-29 years (n = 1,665 with 7,023 observations over time). We measured the association of depression (CES-D [Center for Epidemiologic Studies Depression Scale]) or anxiety and stress (DASS-21 [Depression Anxiety Stress Scales]) symptoms with delayed contraceptive care-seeking with mixed-effects multivariable regression with random effects for individual and site. We controlled for age and sociodemographic factors important for access to care. Results: Over one-third of participants (35%) reported they delayed getting the contraceptive method they needed. Multivariable regression results showed increased odds of delayed contraceptive care among participants with symptoms of depression (adjusted odds ratio [aOR] 1.58, 95% confidence interval [CI] 1.27-1.96). Likewise, delays were associated with anxiety and stress symptoms (aOR 1.46, 95% CI 1.17-1.82). Adolescents were more likely to delay seeking contraception than young adults (aOR 1.32, 95% CI 1.07-1.63). Conclusions: Results showed a strong association between mental distress and delayed contraception. Interventions are needed to increase contraceptive access for young people delaying care, along with supportive mental health care services, including for adolescents who face elevated odds of delay. ClinicalTrials.gov Identifier: NCT03519685.

Access to land and youth involvement in agricultural value chains in Kenya

The study investigated the relationship between land accessibility and youth participation in the agricultural value chain in Kakamega County, Kenya. Utilizing a stratified questionnaire for data collection from 240 respondents, chosen through stratified and simple random sampling, the research analyzed data to generate frequencies, percentages, and correlations. Results showed that limited access to land is a significant barrier for youth involvement in agriculture, impacting all stages of the value chain except consumption. This study is novel in its comprehensive analysis of the entire agricultural value chain, from production to consumption, and its focuses on the youth, a crucial demographic in Kenya. The findings highlight the importance of land accessibility for the youth's active participation and the potential economic benefits thereof. The insights are valuable for policymakers and donor organizations in crafting strategies to improve land access for young people, thus enhancing their livelihoods and fostering entrepreneurial growth in the most promising segments of the agricultural value chain.

Access to Dental Care for Children and Young People in Care and Care Leavers: A Global Scoping Review.

This scoping review aimed to explore three research questions: 1. What is the dental care access for children and young people (CYP) in care and care leavers? 2. What factors influence CYP in care and care leavers' access to dental care? 3. What pathways have been developed to improve access to oral health care for CYP in care and care leavers? Five databases (Ovid MEDLINE, Ovid Embase, CINAHL, SocINDEX and Dentistry and Oral Sciences Source) and grey literature sources were systematically searched. Articles relating to CYP in care or care leavers aged 0-25 years old, published up to January 2023 were included. Abstracts, posters and publications not in the English language were excluded. The data relating to dental care access were analysed using thematic analysis. The search identified 942 articles, of which 247 were excluded as duplicates. A review of the titles and abstracts yielded 149 studies. Thirty-eight were eligible for inclusion in the review: thirty-three peer-reviewed articles, one PhD thesis and four grey literature sources. All papers were published from very high or medium Human Development Index countries. The studies indicate that despite having higher treatment needs, CYP in care and care leavers experience greater difficulty in accessing dental services than those not care-experienced. Organisational, psycho-social and logistical factors influence their access to dental care. Their experience of dental care may be impacted by adverse childhood events. Pathways to dental care have been developed, but little is known of their impact on access. There are very few studies that include care leavers. The voices of care-experienced CYP are missing from dental access research. care-experienced CYP are disadvantaged in their access to dental care, and there are significant barriers to their treatment needs being met.

Socio-economic factors associated with post-traumatic stress symptoms among adolescents and young people during the first wave of the COVID-19 pandemic

This study assessed the association between sociodemographic factors and post-traumatic stress symptoms (PTSS) among 18–24-year-olds during the first wave of the COVID-19 pandemic. This was a secondary analysis of data from 4508 individuals collected through an online survey conducted between June and January 2021. PTSS was measured as a dependent variable using the checklist for post-traumatic stress disorder in civilians. Age, birth sex, sexual, level of education, access to emotional and social support, and emotional distress were the independent variables. A multivariate logistic regression analysis was conducted to determine the associations between the dependent and independent variables while controlling for the country related confounding variables. Females (AOR:2.023), sexual minority individuals (AOR:1.868), those who did not disclose their sexual identify (AOR:1.476), those with poor access to emotional and social support (AOR:4.699) and individuals with no formal education (AOR:13.908), and only primary level education (AOR:4.521) had higher odds of PTSS. The study highlights the multifaceted nature of PTSS during the pandemic and suggests the importance of promoting access of young people, especially females, sexual minority individuals and those with low educational status, to emotional/social support to mitigate the probability of PTSS, especially among sexual minority individuals.

Attrition in Psychological mHealth Interventions for Young People: A Meta-Analysis

AbstractPsychological interventions provided via mobile, wireless technological communication devices (mHealth) are a promising method of healthcare delivery for young people. However, high attrition is increasingly recognised as a challenge to accurately interpreting and implementing the findings of mHealth trials. The present meta-analysis consolidates this research and investigates potential methodological, sociodemographic, and intervention moderators of attrition. A systematic search of MEDLINE, PsycInfo, and Embase was conducted. Study reporting quality was evaluated (QualSyst tool), and attrition rates (proportions) were calculated and pooled, using both random- and mixed-effects models. The pooled attrition rate, sourced from 15 independent samples (Nparticipants = 1766), was 17% (CI [9.14, 30.13]). This increased to 26% (CI [15.20, 41.03]) when adjusting for publication bias. Attrition was significantly higher among application-based interventions (26%, CI [14.56, 41.86]) compared to those delivered via text or multimedia message (6%, CI [1.88, 16.98]). These data were, however, characterised by significant between-study variance. Attrition in mHealth trials with young people is common but may be mitigated by using message-based interventions. Taken together, the results can provide guidance in accounting for attrition across future mHealth research, clinical practice, public policy, and intervention design. However, sustained research focus on the effectiveness of different engagement strategies is needed to realise mHealth’s promise of equitable and efficient healthcare access for young people globally.

Proximity of alcohol outlets and presentation to hospital by young people after self-harm: A retrospective geospatial study using the integrated data infrastructure.

There is a well-established association between alcohol use, misuse, intoxication and self-harm, the latter of which is associated with suicide. This study aimed to better understand the association between proximity to alcohol outlets and the likelihood of young people presenting to hospital following self-harm. This was a nationwide retrospective geospatial study using data from the New Zealand Integrated Data Infrastructure using population-level data for 10-29-year-olds for the 2018 and 2017 calendar years. Presentations to hospital following self-harm were identified using the national minimum data set. Proximity to alcohol outlets was defined in road network distance (in kilometres) and ascertained using Integrated Data Infrastructure geospatial data. Alternative measures of proximity were employed in sensitivity analyses. Complete-case two-level random intercept logistic regression models were used to estimate the relationship between alcohol outlet proximity and hospital presentation for self-harm. Adjusted models included sex, age, ethnicity, area-level deprivation, urbanicity and distance to nearest medical facility. Analyses were also stratified by urbanicity. Of the 1,285,368 individuals (mean [standard deviation] age 20.0 [5.9] years), 7944 (0.6%) were admitted to hospital for self-harm. Overall, the odds of presenting to hospital for self-harm significantly decreased as the distance from the nearest alcohol outlet increased, including in adjusted models (adjusted odds ratio 0.980; 95% confidence interval = [0.969-0.992]); the association was robust to changes in the measure of alcohol proximity. The effect direction was consistent across all categorisations of urbanicity, but only statistically significant in large urban areas and rural areas. The findings of this study show a clear association between young people's access to alcohol outlets and presentation to hospital for self-harm and may provide a mandate for government policies and universal interventions to reduce young people's access to alcohol outlets. Further research regarding causative mechanisms is needed.

Pandemic experiences and mental health among young people in Ireland: lessons from Teenpath COVID

Abstract Teenpath COVID is a mixed-methods, participatory study exploring the experiences of young people in Ireland since the COVID-19 pandemic and its impacts on existing health inequalities. As part of an exploratory sequential research design, we conducted a stakeholder analysis, online survey, and participatory arts programme evaluation to identify cross-cutting issues impacting the health and well-being of young people in Dublin and across Ireland. Interviews conducted with stakeholders spanning youth service, public health, and education sectors, and young people aged 16-25 explored individuals’ experiences of the pandemic; adaptations to working and maintaining engagement online; key concerns about young people's health and wellbeing; and priorities for future research and policy. Thematic analysis identified impacts of the pandemic on health inequalities with potential policy implications. This informed a subsequent online survey exploring young people's mental health since the pandemic, and an ethnographic case study of a participatory arts programme exploring key issues important to young people in Dublin. Our findings suggest the pandemic has impacted predominantly on young people's mental health and access to youth mental health services; disruption to work, education and social and peer support networks; and health behaviours. Protective measures, from accessing and maintaining social support networks, to developing coping strategies were important for young people's mental health. However the extent to which these were possible was shaped significantly by individuals’ personal circumstances at the time. These findings show the importance of social participation and support for young people in navigating the uncertainties and difficulties of growing up in a pandemic. Participatory approaches can be a pathway for aligning healthy priorities and policy that contributes unique and rich insights into community health, and places young people at the centre of change. Key messages • Young people in Ireland have experienced significant impacts to their mental health since the COVID-19 pandemic began, particularly regarding disruptions to education and social support networks. • Participatory approaches to research and youth engagement with young people is important for gathering high quality and diverse data on complex topics such as mental health and health inequalities.

Effectiveness, Acceptability, and Feasibility of a Telehealth HIV Pre-Exposure Prophylaxis Care Intervention Among Young Cisgender Men and Transgender Women Who Have Sex With Men: Protocol for a Randomized Controlled Trial.

Despite its promise for HIV prevention, the uptake of pre-exposure prophylaxis (PrEP) has been slow, and there have been substantial inequities in PrEP access. Young men who have sex with men and transgender women of color are most in need of PrEP and least likely to have that need fulfilled. PrEP telehealth care, which provides remote PrEP care via electronic communication, seems well suited to address several of the challenges of PrEP provision, including discomfort with stigmatizing and difficult-to-access health care systems, transportation challenges, and privacy concerns, and address disparities in PrEP access. Research suggests that PrEP telehealth care has promise and is a favored option for many prospective recipients of PrEP. However, despite growing attention to telehealth approaches as an avenue for increasing access to PrEP amidst the COVID-19 pandemic, there have been no published randomized controlled trials (RCTs) on PrEP telehealth care to date, making it difficult to draw strong conclusions about the advantages or disadvantages of telehealth compared with usual PrEP care. We developed PrEPTECH, a telehealth intervention that focuses specifically on alleviating issues of stigma, access, cost, and confidentiality for young people with risk factors for HIV infection who are seeking PrEP care. Leveraging data from the 2017 observational pilot study, we redesigned and enhanced PrEPTECH. This study aims to assess the effectiveness, acceptability, and feasibility of a telehealth HIV PrEP care intervention, PrEPTECH, in increasing PrEP uptake. This is the protocol for an RCT of young cisgender men and transgender women who have sex with men in 4 regions within the United States: the San Francisco Bay Area, California; Los Angeles County, California; Miami-Dade County, Florida; and Broward County, Florida. Participants in the intervention arm received access to a web-based telehealth program, PrEPTECH, which offers a fully web-based pathway to PrEP, whereas those in the control arm received access to a dynamic web page containing publicly available informational resources about PrEP. Follow-up data collection occurred at 3 and 6 months. An analysis will be conducted on outcomes, including PrEP initiation, persistence, adherence, coverage, and medication prescription, as well as PrEPTECH acceptability and feasibility. The study was funded in 2019 and received institutional review board approval in 2020. The PrEPTECH intervention was developed over the next 1.5 years. Study recruitment was launched in February 2022 and completed in September 2022, with 229 participants recruited in total. Data collection was completed in April 2023. The results of this RCT will offer valuable evidence regarding the effectiveness, acceptability, and feasibility of telehealth HIV PrEP care interventions among young cisgender men and transgender women who have sex with men. ClinicalTrials.gov NCT04902820; https://clinicaltrials.gov/ct2/show/NCT04902820. PRR1-10.2196/47932.

Support for young farmers in the European Union: How much discretion for Member States?

AbstractGenerational renewal is at the heart of the European Union's (EU) agricultural priorities embedded in the Green Deal and Farm to Fark Strategy, since young farmers not only play a vital role in ensuring the competitiveness of European agriculture but also have significant potential in transitioning towards a sustainable agri‐food system. However, the number of young farmers across the EU has been rapidly decreasing over time. To address this issue and enable better access of young people to the farming profession, the EU's Common Agricultural Policy (CAP) lays down various mechanisms to support young farmers. In case C‐119/20, the Court of Justice of the EU took important steps to clarify the exact degree of discretion for Member States in terms of these support schemes, specifically on the definition of a ‘young farmer’, as well as the possibility to accumulate different types of financial support under the CAP. This case note presents the reasoning behind the Court's judgement, before discussing the judgements' impact on young (female) farmers in light of the goal of fostering generational renewal in rural areas and a transformation towards a sustainable agri‐food system. We conclude that the Court's decision might threaten to meet the goal of generational renewal, along with associated sustainability goals.