Adolescent Health Research Articles

Quality Indicators for Transition from Pediatric to Adult Care for Youth With Chronic Conditions: Proposal for an Online Modified Delphi Study.

The transition from pediatric to adult care poses a significant health system-level challenge impeding the delivery of quality health services for youth with chronic health conditions. In Canada and globally, the transition to adult care is regarded as a top priority in adolescent health in need of readily applicable, adaptable, and relevant national metrics to evaluate and benchmark transition success across disease populations and clinical care settings. Unfortunately, existing literature fails to account for the lack of engagement from youth and caregivers in developing indicators, and its applicability across chronic conditions, primary care involvement, and health equity considerations. Our proposed study aims to establish a consensus-driven set of quality indicators for the transition to adult care that are universally applicable across physical, developmental, and mental health conditions, clinical care settings, and health jurisdictions. Using an integrated knowledge translation (iKT) approach, a panel comprising youth, caregivers, interdisciplinary health care providers, and health system leaders will be established to collaborate with our research team to ensure that the study methodology, materials, and knowledge dissemination are suitable and reflect the perspectives of youth and their families. We will then conduct an iterative 3-round Online Modified Delphi (OMD) study (n=160) to (1) compare and contrast the perspectives of youth, caregivers, health care providers, and health system leaders on quality indicators for transition; and (2) prioritize a key set of quality indicators for transition applicable across disease populations that are the most important, useful, and feasible in the Canadian context. Using the RAND/UCLA Appropriateness Method (RAM) multistage analytic approach, data from each panel and stakeholder group will be examined separately and compared to establish a key set of indicators endorsed by both panels. The study is funded by the Canadian Institutes of Health Research and Physicians Services Incorporated. This study will produce quality indicators to evaluate and inform action equitably to improve transition from pediatric to adult care for youth and their families in Canada. PRR1-10.2196/60860.

A cross-sectional study of the association between physical activity and depressive symptoms among adolescents in southwest China stratified by parental absence: the mediating role of insomnia and the moderating role of resilience

ObjectivesThis study explored the mechanisms by which physical activity was associated with depressive symptoms in multi-ethnic (Han, Yi and Tibetan) adolescents in southwest China. The mediating role of insomnia in...

The interplay of maternal and paternal postpartum depressive symptoms with children's internalizing and externalizing symptoms from childhood to adolescence: does socioeconomic status matter? Alongitudinal cohort study.

Maternal postpartum depression is an important risk factor for internalizing and externalizing problems in children. The role of concurrent paternal depression remains unclear, especially by socioeconomic status. This study examined independent and interactive associations of postpartum maternal and paternal depression with children's internalizing/externalizing symptoms throughout childhood and adolescence (ages 3.5-17 years). We used data from the Québec Longitudinal Study of Child Development, a representative birth cohort (1997-1998) in Canada. Data included self-reported maternal and paternal depressive symptoms at 5 months' postpartum using the Center for Epidemiologic Studies Depression Scale. Internalizing and externalizing symptoms in children were reported by parents, teachers and children/adolescents using the Social Behaviour Questionnaire (ages 3.5-13 years) and the Mental Health and Social Inadaptation Assessment for Adolescents (ages 15-17 years). We used three-level mixed effects modelling to test associations after adjusting for confounding factors. With 168 single-parent families excluded, our sample consisted of 1,700 families with useable data. Of these, 275 (16.2%) families reported maternal depression (clinically elevated symptoms), 135 (7.9%) paternal depression and 39 (2.3%) both. In families with high socioeconomic status, maternal depression was associated with greater child internalizing (β = .34; p < .001) and externalizing symptoms (β = .22; p = .002), regardless of the presence/absence of paternal depression. In families with low socioeconomic status, associations with symptoms were stronger with concurrent paternal depression (internalizing, β = .84, p < .001; externalizing, β = .71, p = .003) than without (internalizing, β = .30, p < .001; externalizing, β = .24, p = .002). Maternal depression increases the risk for children's internalizing/externalizing problems in all socioeconomic contexts. In families with low socioeconomic status, risks were exacerbated by concurrent paternal depression. Postpartum depression, especially in low socioeconomic environments, should be a primary focus to optimize mental health across generations.

Active Engagement: The Impact of Group-Based Physical Activities on the Resilience of Israeli Adolescents with ADHD

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a pressing concern in pediatric public health, with its prevalence rising among children and teenagers. This study explored the relationship between group-based physical activity and the well-being, resilience, and distress levels of Israeli youth, with a specific focus on those with ADHD symptoms. Methods: This cross-sectional study surveyed 699 Israeli teenagers, assessing their participation in three types of physical activities: unorganized, structured, and the “Five Fingers” program. Data were collected through an online platform and analyzed using ANOVA, t-tests, and multivariable regression models to identify predictors of resilience. Results: Structured, group-based sport activities are associated with higher resilience (p &lt; 0.01) and lower distress (p &lt; 0.01) in adolescents. Adolescents with ADHD symptoms exhibited lower resilience (p &lt; 0.001) and well-being (p &lt; 0.001), and higher distress (p &lt; 0.001). However, those with ADHD symptoms who participated in group-based activities fared better in terms of distress (p &lt; 0.01) and well-being (p = 0.018) than those who did not. Participation in any sport activity, older age, male gender, and a higher socio-economic status predicted greater resilience in youth, generally. Conclusions: This study presents the potential of structured physical activities that involve psychosocial and group integration training to improve the mental health of adolescents, especially in the context of ADHD symptoms.

Perception, use of social media, and its impact on the mental health of Indian adolescents: A qualitative study

BACKGROUND Mental illness is a health challenge faced by adolescents that has grown worse after the Coronavirus disease 2019 pandemic. Research on social media and young people’s mental health has recently increased, and numerous studies have examined whether frequent use of social media is linked to issues such as anxiety, stress, depression, eating disorders, insomnia, frustration, feeling alone, and externalizing problems among adolescents. This influence of social media on adolescents’ lives is clear, with many platforms like Facebook, Instagram, and YouTube playing an important role in daily interactions and self-expression. Even though social media offers numerous benefits, such as connectivity and information sharing, excessive usage can have detrimental effects on mental health, particularly among adolescents. AIM To study the impact of social media on the mental wellbeing of adolescents, and the associated potential dangers in India. METHODS A total of 204 adolescents aged 14 years to 23 years were included in the study. This study explored the intricate relationship between social media usage and adolescent mental health in India. The study employs a cross-sectional survey design to capture a snapshot of adolescent mental health and social media usage patterns. Data collection involved administering structured questionnaires and the analysis utilized quantitative methods, including descriptive statistics. RESULTS Excessive use of social media is correlated with increased stress, anxiety, and depression. Adolescents engage in compulsive behaviors such as scrolling in the middle of the night, which negatively impacts their mental and physical health, and leads to significant sleep disruption. Findings from the study aim to provide insights into the current state of adolescent mental health and inform strategies to promote positive wellbeing in the Indian population. CONCLUSION The study underscores the need for further research to better understand the complex interplay between social media and adolescent mental health, and need for effective strategies to combat online harassment.

COVID-19 lockdown effects on adolescent brain structure suggest accelerated maturation that is more pronounced in females than in males

Adolescence is a period of substantial social-emotional development, accompanied by dramatic changes to brain structure and function. Social isolation due to lockdowns that were imposed because of the COVID-19 pandemic had a detrimental impact on adolescent mental health, with the mental health of females more affected than males. We assessed the impact of the COVID-19 pandemic lockdowns on adolescent brain structure with a focus on sex differences. We collected MRI structural data longitudinally from adolescents prior to and after the pandemic lockdowns. The pre-COVID data were used to create a normative model of cortical thickness change with age during typical adolescent development. Cortical thickness values in the post-COVID data were compared to this normative model. The analysis revealed accelerated cortical thinning in the post-COVID brain, which was more widespread throughout the brain and greater in magnitude in females than in males. When measured in terms of equivalent years of development, the mean acceleration was found to be 4.2 y in females and 1.4 y in males. Accelerated brain maturation as a result of chronic stress or adversity during development has been well documented. These findings suggest that the lifestyle disruptions associated with the COVID-19 pandemic lockdowns caused changes in brain biology and had a more severe impact on the female than the male brain.

Does maternal education moderate the relationship between adolescent cannabis use and mental health in early adulthood?

Socioeconomic disadvantage has been associated with cannabis use and poor mental health. It is therefore hypothesised that lower maternal education, a proxy for socioeconomic disadvantage, may increase the risk of cannabis-related mental health and substance use consequences. A total of 5099 participants from the Avon Longitudinal Study of Parents and Children reported cannabis use via questionnaires at 16 or 18. Logistic regression was used to examine the relationship between any and regular (weekly or more) adolescent cannabis use with depression, anxiety, psychotic experiences, and problematic cannabis use at age 24. Maternal education was included as an effect modifier. Missing data were addressed through multiple imputation using chained equations. In total, 36.5% of participants reported adolescent cannabis use and, of these, 14% reported regular use. Adolescent cannabis use was associated with an increased likelihood of anxiety and problematic cannabis use; however, there was little evidence of moderation by maternal education. Regular cannabis use was associated with an increased likelihood of problematic cannabis use, with little evidence of moderation by maternal education. There was weak evidence that the association between regular cannabis use and depression (interaction p-value = 0.024) and anxiety (interaction p-value = 0.056) was stronger in people with high maternal education. Adolescent cannabis use is associated with increased risk of anxiety and cannabis use disorder, but there was insufficient evidence that childhood socioeconomic position (proxied by maternal education) modifies this relationship. Improved public health messages for all adolescents about these risks may be warranted.

Establishing Priorities for Improving Data Collection and Measurement of Mental Health and Well-Being of Adolescents With Special Educational Needs Within Nonmainstream Schools: Protocol for a Delphi Study.

There are more than 1.5 million children and young people in England with special educational needs (SEN), with over 160,000 young people in the United Kingdom attending a special school or alternative provision (AP) setting. Young people with SEN have been found to be at risk for poorer mental health and well-being than non-SEN peers. However, there is a range of both school-related and research challenges associated with identifying difficulties in a timely manner. This Delphi study aims to determine a list of stakeholder priorities for improving school-based measurement of mental health and well-being among young people with SEN, at an aggregated level, within secondary special school or AP settings. A secondary objective is to inform the implementation of school-based well-being surveys, improve engagement in special schools or AP settings, and improve survey response rates among children and young people with SEN. A mixed methods Delphi study will be conducted, including a scoping review and preliminary focus groups with school staff members and researchers to establish key issues. This will be followed by a 2-round Delphi survey to determine a list of stakeholder priorities for improving the measurement of mental health and well-being at an aggregate level within special schools and AP settings. A final stakeholder workshop will be held to discuss the findings. A list of recommendations will be drafted as a report for special schools and AP settings. The study has received ethical approval from the University College London Research Ethics Committee. The stage 1 scoping review has commenced. Recruitment for focus groups will begin in Autumn 2024. The first round of the Delphi survey will commence in early 2025, and the second round of the Delphi survey in the spring of 2025. The final workshop will commence in mid-2025 with final results expected in late 2025. There is a need for clear recommendations for special schools and AP settings on priorities for improving the measurement of mental health and well-being problems among young people with SEN. There is also a need for recommendations to researchers implementing school-based well-being surveys, including the #BeeWell program, to enable them to improve their engagement in special schools and AP settings and ensure surveys are accessible. PRR1-10.2196/58610.

Family meals on prescription as treatment for childhood obesity-a randomized controlled trial.

The aim with the present study was to evaluate the effects and tolerability of Family Meals on Prescription, a 3-month intensive dietary intervention with a participatory approach on body mass index (BMI) and metabolic health in children living with obesity. In this prospective randomized controlled trial, children aged 5-15years were included from the Pediatric Obesity outpatient Clinics in Halland, Sweden. Participants were randomly assigned to receive lifestyle treatment with or without Family Meals on Prescription (FMP) consisting of a subsidized prepacked grocery bag including recipes and provisions for five Family Meals per week for 3months. The primary endpoint was changed in BMIz after 3, 12 and 18-24months and secondary endpoints included to assess tolerability of FMP and effects on metabolic biomarker and frequency of shared meals. Eighty-nine children (51.7% female) entered the study, 54 patients in the intervention group and 35 in the control group. There were no significant differences between the groups concerning gender, age or level of obesity at baseline. The Family Meal on Prescription intervention combined with lifestyle treatment led to a significantly greater reduction in BMIz than lifestyle treatment alone after the 3-month long intervention (- 0.17 vs + 0.01, p < 0.01); however, this difference was not sustained throughout the study period, and in fact, the control group had a greater reduction in BMIz after 18-24months.A subsidized prepacked grocery bag may be a novel, well-tolerated and effective tool in the treatment of childhood obesity. The fact that the BMIz reduction shown at the end of the intervention did not persist over time emphasized the need of long-term treatment. Registered at clinicaltrals.gov 27 Nov 2020, retrospectively registered: clinicaltrials.gov number 19002468. https://clinicaltrials.gov/study/NCT05225350 What is Known: • Swedish data shows that lifestyle treatment alone is not sufficient for many families undergoing treatment for childhood obesity. • Regular family meals and mealtime routines have been shown to be important for nutritional health and dietary patterns in children and adolescents. What is New: • This intervention with a participatory approach involving prepacked family meals was well tolerated and led to a significant reduction in BMIz during the intervention. • That fact that these results were not sustained over time indicates a need to evaluate longer interventions, and that childhood obesity is a chronic and complex disease which requires long-time treatments.

Enhancing school safety through psychological support: Key findings and strategies

A crucial aspect of creating a safe and supportive learning environment is the integration of psychological support to reduce school violence. Research highlights that school violence impacts not only students' physical safety but also their mental health and emotional development. Effective psychological support can play a pivotal role in preventing and mitigating violent behaviors by addressing underlying emotional difficulties and unresolved trauma. Key strategies include implementing early interventions through school psychologists and counselors, who offer individual and group counseling to help students manage conflicts and intense emotions constructively. Additionally, psychological support programs can improve the school climate through workshops on emotional intelligence, stress management, and social skills, fostering empathy and reducing conflicts. Integrating psychological services with other school resources, such as emotional education programs and violence prevention strategies, is essential. Collaboration among school psychologists, teachers, parents, and administrators ensures a holistic approach to violence prevention, considering all aspects of students' school lives. The research demonstrates that peer social support significantly mediates the relationship between school victimization and psychological health. Social support acts as a buffer, mitigating the negative effects of violence, and is crucial for students of all genders and ethnicities. Furthermore, family support is identified as a vital moderator, enhancing adolescent mental health despite exposure to violence. Psychological intervention strategies, such as establishing psychological warning systems and prevention mechanisms, are essential in proactively addressing violence. Schools should focus on creating a protective environment and integrating psychological strategies into broader prevention efforts. Continuous mental health education and a safe space for students to express concerns can significantly reduce violent behaviors and support a positive educational atmosphere.

Vaccination of Adolescents as an Important Way to Preserve Demographic Nation's Potential

Relevance. Currently, adolescents are protected against 8 infections within the framework of the National Vaccination Schedule: tuberculosis, viral hepatitis B, diphtheria, tetanus, measles, rubella, mumps and influenza (annually). Post-vaccination immunity to whooping cough, acquired in the first years of life, begins to decline since 4–7 years. In recent decades, there has been an increase in the incidence, including among adolescents, of such pathogens as Neisseria meningitidis, Streptococcus pneumoniae, Bordetella pertussis, strains of the human papillomavirus (HPV) of high oncogenicity, the herpes zoster virus and etc., that affect the creation of the foundation of future health nation. Aim. To substantiate the vaccination strategy for adolescents as one of the most important factors for creating the demographic security of the nation. Results. The burden of infectious pathologies of meningococcal, pneumococcal etiology, pertussis, HPV and herpes Zoster, its impact on the development of the health of adolescents in Russia and the intended tactics for implementing vaccination of young people with the help of modern immunobiological drugs are shown. Conclusion. Vaccination of adolescents against infections such as meningococcal and pneumococcal infections, whooping cough, chicken pox, and HPV is a strategic task, since reducing the risk of contracting infectious diseases in this age group directly affects the preservation of the demographic potential of the nation

The effects of heavy screen viewing on the health of secondary school-aged children in Duhok city

Background and objectives: Although there has been a remarkable increase in screen time among children over recent years, the literature includes contradictory reports on its effects of the individuals' health. In this regard, the present study was an attempt to figure out the effects of heavy screen time on the health of secondary school-aged children in Duhok city, Kurdistan-Iraq. Methods: A cross-sectional study was conducted on 850 secondary school students aged 14- 18 years, from September 2022 to September 2023 in Duhok secondary schools. Data about screen viewing were gathered through a questionnaire. then data were analyzed via SPSS (version 25.0). Chi-square were used and 0.05 was set a level of significant. Results: The students aged 14-18 years, with the largest group being 18 years of age (38.4%). Most of the students (59.4%) were females. Grade 12 students were the largest group (57.3%). Most of them (76.2%) were from middle-income families and (65.4%) had healthy body mass index. Significant associations were found between the students' screen time and their age (P-value&lt;0.001), gender (p-value&lt;0.001), parents' education (P-value&lt;0.001), parents' occupation (P-value&lt;0.05), and socioeconomic status (p-value=0.014). Moreover, significant associations were found between their screen time duration and their medical problems (P-value&lt;0.001), previous surgical operation (p-value=0.008), mood during the day (P-value&lt;0.001), relationship with parents (p-value=0.003), sleep difficulties (p-value=0.002), and eating during screen viewing (p-value&lt;0.001). Conclusions: Most adolescence in Duhok city have excessive screen time (more than two hours) in which affects their health and quality of life adversely. Health practitioners and families should consider these factors while designing and implementing adolescent health promoting programs.

Teenage pregnancy and its associated factors in Kenya: a multilevel logistic regression analysis based on the recent 2022 Kenyan demographic and health survey

ABSTRACT Teenage pregnancy remains a critical public health issue in developing countries, significantly impacting maternal health. In Kenya, despite an expected decrease in teenage pregnancy rates from 18% in 2014 to 15% in 2022, evidence on its prevalence and associated factors is still limited. This study utilized data from the latest Kenya Demographic and Health Survey, analysing 6,390 participants through multilevel binary logistic regression. The findings revealed a 15.3% prevalence (95%CI: 14.4, 16.2%) and identified key factors linked to teenage pregnancy, including being aged 18–19, higher education, contraceptive use, unemployment, wealth status, media exposure, and a higher proportion of uneducated individuals. The study underscores the urgent need for strategic investment in policy development and evaluation to enhance adolescent sexual and reproductive health. Targeted interventions should prioritize economically disadvantaged households, focusing on maternal education and empowerment to reduce teenage pregnancies by 2030.

Strengthening the mental health literacy and self-efficacy of school counsellors using “MDAS” module: A pilot project in Malaysia

Mental health difficulties affect children and adolescents pervasively. School counsellors serve as frontliners to support the students in need, but often face challenges from the complexity of their cases. This study aims to develop a training module named MDAS (Mental Health disorder, Developmental disorders, Attachment and Self-compassionate) program to improve the school counsellors’ mental health knowledge and counselling self-efficacy. The Module was adapted from Child and Adolescent Mental Health Training Module for Specialist 2009 (Second Edition). The study adopted a one group pre-test/post-test design to assess 28 school counsellors at 0-month and 4-month after the training. The scales used were Counselling Self-Efficacy scale (COSE), Mental Health Literacy Scale (MHLS) and Self-Compassionate Scale – Short Form (SCS-SF). Post-training, there were significant increment of COSE and MHLS scores ( p &lt; .001 and p &lt; .046) with Cohen’s d of 1.01 and 0.58. Four of the COSE subscales (micro skills, counselling process, cultural competence and dealing with difficult clients’ behaviour) significantly increased after MDAS training ( p &lt; .001, p = .006, p = .001 and p = .01). In addition to increasing the counselling capacity of school counsellors, our training module can serve as a promising platform for mental health professionals and counsellors.

Educating adolescents on preventing substance use: The role of 24-h movement behaviors ─ data from 2021 Youth Risk Behavior Surveillance

BackgroundLittle is known about how adhering to the health guidelines for physical activity (PA), screen time (ST), and sleep duration (SD) relates to substance use in adolescents. Thus, this study aims to explore the potential association between adherence to the 24-h movement behavior (24-h MB) guidelines and substance use among adolescents. MethodsData from the 2019 Youth Risk Behavior Surveillance was analyzed. Participants reported their weekly PA, ST, SD, and substance use (alcohol and smoking) over the past 30 days. The mean age in the total participants was 15.56, and 48.03 % of the participants were females. Logistic regression was used in this study to explore the potential association between 24-h MB and substance use. Odds ratios (ORs) were reported alongside a 95 % confidence interval to enhance understanding of the observed association. ResultsOnly 2.22 % participants adhered to all three 24-h MB guidelines, while 47.99 % did not follow any guidelines. Notably, there was no significant difference in the odds of cigarette smoking between participants who followed none of the guidelines and those who followed some or all of them. Nevertheless, adherence to one or more guidelines was found to be associated with higher odds of abstaining from alcohol consumption compared to non-adherence (one guidelines: OR = 1.17 [1.08, 1.28], two guidelines: OR = 1.28 [1.13, 1.44]). ConclusionsAdhering to 24-h MB guidelines may reduce adolescents’ alcohol consumption, but the adherence was not significantly associated with smoking. Longitudinal studies are needed to confirm these findings. These results can inform adolescent health policies and interventions aimed at reducing substance use from the perspective of healthy time-use behaviors, which can be used for researchers and educator.

Childhood Adversity and Adolescent Epigenetic Age Acceleration: The Role of Adolescent Sleep Health.

We investigated how a dimension of early life adversity (ELA) capturing threat in the home relates to later epigenetic age acceleration in adolescence through sleep (duration, efficiency, and timing), to empirically test theoretical models suggesting the importance of sleep as a key mechanism linking ELA with poor health outcomes, and to expand the limited literature on sleep and epigenetic aging among youth. We utilized data from 861 participants from the Future of Families and Child Wellbeing Study (FFCWS) who participated in the actigraphy sub study at age 15. Sleep variables used were average total sleep time (TST), sleep efficiency (SE), and sleep onset timing. Home threat was determined at ages 3, 5, and 9 from parent reports on the Child Conflict Tactics Scale (CTS-PC), and epigenetic aging was measured through DNA methylation analyses of saliva samples collected at age 15. Higher levels of childhood home threat exposure were associated with less adolescent TST, lower SE, and later sleep onset timing. Adolescent SE and timing were associated with a faster pace of aging and epigenetic age acceleration. Sleep efficiency and timing mediated the link between childhood home threat exposure and adolescent epigenetic aging. Epigenetic embedding of childhood threat exposure in the home may occur through adversity-related sleep disturbances in adolescence. Findings warrant greater attention to pediatric sleep health in theoretical models of biological embedding of adversity and point to the examination of improving sleep health as a potential way to prevent adversity-related epigenetic age acceleration.

The effects of folk-dance in schools on physical and mental health for at-risk adolescents: a pilot intervention study.

We present the findings from a pilot study to evaluate the effects of a six-week adapted folk-dance intervention on physical and mental health for at-risk adolescents conducted in schools. At-risk adolescents are at particular risk for sedentary behavior, poor mental health, and lower quality of life, and are likely to benefit from motivating and health-promoting activities such as dance. However, it can be challenging to conduct and evaluate evidence-based interventions with this population. We conducted a convergent parallel mixed-method design using pre-post measures of mental well-being, as well as pre-post measures using inertial measurement units to assess physical activity during a 6-week adapted folk-dance intervention. At the completion of the study, we conducted semi-structured interviews with all stakeholder groups. We observed significant improvements in mental well-being, as indicated by increased WEMWBS and MHC-SF scores, while the UCLA score showed no significant change, with these outcomes independent of age and gender. Furthermore, at-risk adolescents reduced the time spent in stationary/resting position, while their heart rates were also reduced by ∼15% in such conditions. Our results suggest that at-risk youth who participated in adapted folk-dance became more enthusiastic and showed more willingness to move over the course of the intervention. Quantitative results were supported by interviews, which found that participants responded positively to the adapted folk-dance classes, and reported both elevated physical exertion and high levels of enjoyment. The mixed-method research design also provided insights into the suitability of data collection methods for this hard-to-reach population. We report on these outcomes, including best practices for working within schools on health-promoting physical activities.

Parental involvement and adolescent athletes' mental health: The mediating role of psychological resilience

The stigmatization of mental health among adolescent athletes is influenced by external factors. We explored the impact of parental involvement on mental health stigma, examining the mediating roles of psychological resilience and subjective well-being. Utilizing a nonprobability convenience sampling technique, we recruited 250 Chinese university student athletes who completed paper questionnaires on site at a single time point. The results revealed negative associations between mental health stigma and parental involvement, psychological resilience, and subjective well-being. Psychological resilience and subjective well-being independently and sequentially mediated this relationship. Our findings highlight the tangible benefits of positive parental involvement in mitigating mental health stigma, as well as offering a theoretical foundation for interventions addressing mental health stigma in Chinese adolescent athletes.

Study protocol of a proposed Neurofeedback-Assisted Mindfulness Training Program on symptoms of anxiety and psychological distress associated with smartphone use in young adults: a randomized controlled trial.

Nomophobia is a specific phobia characterized by the appearance of anxiety, nervousness, discomfort and distress when the mobile phone is not used and is considered an emerging public health problem because of the negative consequences on the physical and mental health of young people and adolescents, especially women. Neurofeedback-Assisted Mindfulness Training Programs may prove beneficials for improving self-control abilities, a key ability in addressing addictive behaviors. The main objective of this study is to evaluate the impact, in a young population aged 18-35 years, of an intervention based on Neurofeedback-Assisted Mindfulness Training Program (NAMTP) on disorders associated with problematic use of mobile phones. The effect of the intervention on the total score in the nomophobia test and habits of internet and social network use, as well as on signs of depression, anxiety and stress will be analyzed. As a secondary objective, the effect of the intervention on signs of insomnia will be analyzed. Randomized, controlled clinical-trial with two-parallel groups. 40 young adults (18-35 years) will be included and randomly assigned to Intervention Group-NAMTP or Control Group (CG). The NAMTP will include a total of 25 sessions (2-3/week) during 3-months. Each session will have a duration of 10/15 min. The instrument to be used for the neurofeedback sessions is MUSE® (InteraXon Inc.). Study variables will be collected at the baseline visit and at the final visit (3-months after randomization). During these visits, questionnaires will be administered to evaluate the main and secondary variables that will include the Smartphone Addiction Scale-Short Version, Nomophobia Questionnaire, Depression, Anxiety and Stress Scale 21-item (DASS-21) and Athens Insomnia Scale. This trial will make an important contribution to the need for evidence of effective education programs and other primary care interventions through new non-invasive interventions in reducing the risk of developing addictions to new technologies and alleviating the symptoms of discomfort associated with this problem. The project was approved by the Clinical Research Ethics Committee of the Salamanca Health Area (CEIm Code: PI 2023 071340). ClinicalTrials.gov, http://www.Clinicaltrials.gov/ct2/show/NCT06188910.

Affective-Sexual Behaviors in Youth: Analysis of a Public Health Survey in the School Setting.

Adolescence is a critical period for the development of affectivity and sexuality. Adolescents begin to explore their sexual identities, form intimate relationships, and learn to manage their emotions in new and complex contexts. This study aims to analyze the prevalence of habits and behaviors related to the affective-sexual health of adolescents in the fourth year of ESO, identifying risk factors, comparing their behaviors and risks, monitoring these behaviors, analyzing their pornography consumption, and evaluating the use of the internet as a source of sexual information. Descriptive cross-sectional study using questionnaires. Participants are fourth-year ESO students from a school in the Baix Llobregat province (Catalonia), aged between 14 and 18 years. Descriptive and bivariate statistical analyses are conducted using the chi-square test and p-value calculations with the R Project software. Frequency and percentage analyses are also used to describe the health behaviors of the participants. The study reveals that girls have better knowledge of the contraceptive pill and male condom than boys. Sexual initiation and condom use management vary between the genders, with girls being more capable of persuading their partners to use them. Pornography consumption also shows significant differences in terms of the age of initiation and frequency between boys and girls. This study on adolescent affectivity and sexuality reveals knowledge about contraceptives, early sexual initiation, and high pornography consumption, highlighting the need for early and diverse affective-sexual education, youth empowerment, and media misinformation management to promote safer and healthier behaviors within municipal public health.