Cross-Country Comparison of School Neighborhood Food Environments in Houston, Texas and Guadalajara, Mexico Abstract Studies in the U.S. and Mexico have observed the clustering of food resources around schools, which may promote the use of these resources. Our study characterized and compared school neighborhood food environments in Guadalajara, Jalisco, and Houston, Texas, and examined socioeconomic disparities in food resource availability across school neighborhoods. We used the Goods and Services Inventory to document the frequency and type of resources within each school neighborhood. School neighborhoods in Guadalajara had significantly more food resources than those in Houston. We found that convenience stores and table service restaurants were the most prevalent food resources in school neighborhoods in both cities. Guadalajara school neighborhoods had a higher prevalence of supermarkets and grocery stores than Houston. Low-income school neighborhoods in Guadalajara with poorly educated residents had significantly more food carts than high-income neighborhoods with more educated residents. In Houston, we found significantly more fast food restaurants and convenience stores in school neighborhoods with more educated residents than school neighborhoods with less educated residents. The influence of food resources within school neighborhoods on the dietary habits of schoolchildren should be further explored in both the U.S. and Mexico. The characterization of school neighborhood food environments can inform policymakers, city planners, and school officials who seek to implement policies to create healthier food environments.

Stresses, Strengths and Resilience in Adolescents: A Qualitative Study Abstract Resilience, or positive adaptation in the face of adversity, mitigates the negative effects of stress and promotes lifelong physical and mental wellbeing. Identifying adolescents who are struggling with stress could provide opportunities for individual clinical preventive interventions. However, resilience assessments are rarely performed in clinical settings and no clear, evidence-based protocols or language for such exploration exist. The aim of this qualitative study was to identify both clinically feasible methods for assessment, and actual findings, regarding stress, supports, attributes, and strategies youth consider most useful for building resilience. We recruited 59 urban and rural dwelling 13–16 year olds from two Canadian primary care practices. Interviewers asked five open-ended questions about sources of stress and resilience and wrote summaries of answers provided. These were then coded. Researchers independently identified conceptual themes, then reached consensus on these. Stress arose from schoolwork and conflicts with friends or family, rather than from socioeconomic adversities. A majority of participants felt able to manage stresses well, finding strength through (1) social connection with family or friends; (2) self-reliant activities including exercise, music or drawing; and (3) personal attributes such as optimism, calmness and competence. They used a variety of approaches to work through stress, many of which align with key domains of resilience, as well as the novel technique of distraction. Ruminating on stress-provoking events made youth feel they were coping poorly. Most participants experienced stress and drew strength from psychosocial and emotional assets, as well as external resources that fostered resilience. Direct, open conversation was particularly effective for building rapport, augmenting strengths by discussing them, and identifying those who were struggling. Similar questions asked in clinical practice may open doors to deep and, perhaps, transformative conversations and evidence-based preventive interventions.

Mentor’s Self-Efficacy Trajectories During a Mentoring Program for At-Risk Adolescents Abstract The concept of self-efficacy is dynamic and may change over time. Mentors of youth exposed to risk factors are likely to experience shifts in the degree to which they feel confident in their ability to form a positive mentoring bond with their mentee, potentially affecting the quality of the relationship. Based on previous literature, mentors’ personality traits, their perceptions of positive mentee behaviors, and youth risk may influence changes in mentor self-efficacy over time. Our study includes 238 adolescents aged 11–18 years and their mentors who were recruited for a randomized controlled trial of a mentoring-based intervention for at-risk adolescents, known as Campus Connections. We used latent class growth analysis to identify mentor subgroups with different self-efficacy trajectories. Three subgroups emerged: mentors relatively high in self-efficacy throughout the mentoring relationship, the stable group; those high in self-efficacy at the beginning of the relationship and increasingly so, the increasing group; and those moderately high in self-efficacy and decreasingly so, the decreasing group. Greater mentor conscientiousness, extraversion, and agreeableness were associated with greater likelihood of belonging to the increasing group relative to the decreasing group. Greater mentor emotionality was associated with greater likelihood of belonging to the decreasing relative to the increasing group. Mentors and mentees were also more likely to report having a positive mentoring alliance in the increasing relative to the decreasing group. We found that mentor personality traits play an important role in how mentors perceive their ability to serve as a mentor, which may have implications for mentor recruitment and training in programs designed for at-risk youth.

You-Me-Us: Results of a Cluster Randomized Trial of a Healthy Relationships Approach to Sexual Risk Reduction Abstract By middle adolescence, most young people have been involved in at least one romantic relationship, a context in which many sexual interactions occur. Indeed, researchers have suggested the importance of attending to relationships in programs focused on sexual risk, yet few evidence-based programs have a strong relationships focus. Our study examined the impact of a healthy relationship program called You-Me-Us that included a classroom curriculum and a school-wide peer norms approach. We evaluated the intervention using a small group randomized trial that included nine participating urban middle schools (defined as schools that include grades 6–8) in three urban school districts. We invited all 7th grade students within the study schools to enroll. Students completed three surveys during 7th and 8th grades (baseline plus two follow up surveys at 6 and 18 months following baseline). A total of 911 youth with positive consent and assent were enrolled in the study. Follow up survey response rates among those taking the baseline were 92% at 6 months and 80% at 18 months. Multilevel regression models were used to adjust for the correlation among students within the same school, and the correlation of repeated measurements taken on the same student over time. The intervention reduced vaginal sexual initiation by about half at the 6-month follow-up, and this approached significance. Further, youth in the intervention condition were less likely to believe it is okay for people their age to have vaginal sex without using condoms if the girl is on birth control. None of the remaining variables differed significantly by intervention condition. This study provides insights on using a healthy relationship approach for younger urban adolescents. This approach produced a programmatically significant reduction in sexual initiation that did not reach standard levels of statistical significance, and warrants further exploration.

Prevalence and Correlates of Homelessness Among American Indian and Alaska Native Youth Abstract Youth homelessness is a serious national challenge affecting millions of young people every year. However, due to their relatively small population size, together with limitations related to data and research efforts on homelessness to date, prevalence estimates and evidence of homelessness experiences among American Indian and Alaska Native (AIAN) youth have been scarce. This is particularly the case at the national level. We report findings on the prevalence, characteristics, and correlates of AIAN youth experiencing homelessness that are based on a nationally representative survey on homelessness among adolescents and young adults, age 13 to 25. The overall national survey sample included 25,492 respondents. During a 12-month period, approximately 10.2% of AIAN households with 13–17 year olds reported youth homelessness or runaway experiences that lasted at least one night. For AIAN 18–25 year olds, the 12-month population prevalence of homelessness experiences was 12.2%. AIAN young adults had three times the prevalence rate of homelessness as their White non-Hispanic peers. Furthermore, most AIAN youth experiencing homelessness, like most AIAN people overall, reside in predominantly urban counties. Controlling for other variables, lower educational attainment, and parenting (especially if unmarried) were associated with higher likelihood of homelessness. There is a clear and urgent need for tailored, culturally-responsive homelessness prevention and intervention strategies, along with focused housing and support investments, for AIAN young people and the communities in which they live. The federal government and local jurisdictions need to take policy actions to address high rates of AIAN youth homelessness in urban and suburban communities, in addition to policies centered on AIAN reservations and rural communities.

Students’ Perceptions of School Connectedness and Being Part of a Team: A Brief Report Evaluating Project TEAM™ Abstract School connectedness constitutes a protective factor for students, diminishing negative outcomes and increasing positive ones. Enhancing school connectedness positively affects students’ stress levels, social confidence, victimization, health risks behaviors, and school performance, including attendance and grades. Interventions for promoting school connectedness are preventive, goal-oriented, and target the wellbeing of all students. We investigated a pilot implementation of a team-oriented whole school prevention program (Project TEAM™) developed to enhance school connectedness by increasing students’ sense of being cared about by adults and peers in their school, as a way to diminish social isolation and marginalization. We examined the relationship of students’ perceptions of their school connectedness and their sense of being a part of a team culture within this program. Findings reflected increases, across a 2-year period, in students’ sense of value in being a part of a team and connectedness to their school. Younger students and girls demonstrated greater increases in school connectedness than older students and boys. Findings suggested that creating a sense of a whole school team-oriented culture may hold promise for enhancing school connectedness.

Risk of Atherosclerotic Cardiovascular Disease Among US Adults: Use of 1999–2014 NHANES Data Abstract One in four deaths in the US is caused by cardiovascular disease (CVD), and early detection may be a key aspect of prevention. We assessed the probability of a first hard atherosclerotic cardiovascular disease (ASCVD) event within 10 years in US Non-Hispanic White and African American population aged 40–79 years. With data from 16 years of the National Health and Nutrition Examination Survey (NHANES), we utilized the 2013 Pooled Cohort Equations developed by the American College of Cardiology and the American Heart Association to calculate risk scores for a representative sample. NHANES is a repeated, cross-sectional survey aimed at assessing the health and nutritional status of the country. Out of 17,087 eligible participants, a sample of 1876 (11%) remained for the analysis after excluding participants missing data required to compute the scores. Our results showed that 25.2% of the sample had a greater than 10% risk of contracting ASCVD within 10 years, and we also found sex-, race-, and age-based disparities. The ASCVD risk scores can thus be used to evaluate the general cardiac health of the population. Results showed that a quarter of the US adult population was at risk to contract ASCVD in the next 10 years, indicating the need for targeted preventative measures. With the aging population and rise in obesity rates, these results may also indicate trend continuation of high CVD-related morbidity and mortality.

Parenting Practices and Emerging Adult Sexual Health: The Role of Residential Fathers Abstract Emerging adulthood is a developmental period with high rates of sexual risk behavior. Effective parenting practices can reduce the likelihood of this behavior, but most research on the protective effects of parenting focuses on mothers. Research is needed to assess the role of paternal parenting in regards to their children’s sexual risk behavior, particularly for children of teen mothers, who show a greater likelihood of risky sexual behaviors than those with older mothers. We investigated associations between residential fathers’ parenting processes—communication, disapproval of teen sexual behavior, parental presence, and closeness—during adolescence and sexual risk behaviors reported by their children in emerging adulthood. Using multiple group structural equation modeling with data from 7399 participants at Wave I and Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined whether and how residential fathers’ parenting relates to their children’s sexual risk behavior independent of mothers’ parenting processes, and whether these associations differ across children’s sex and for children of teen and older mothers. We found that adolescents’ perceptions of higher father disapproval of teen sexual behavior predicted lower levels of sexual risk behavior during emerging adulthood with no significant differences across emerging adults’ sex or for children of teen relative to older mothers. Our findings suggest that teens’ relationships with their fathers during adolescence are important for their future sexual health, despite a general understanding of emerging adulthood as a period characterized by independence and separation from parents. Additionally, our results suggest that even though children of teen mothers show greater likelihood of risky sexual behaviors than those of older parents, the processes through which fathers can support teens’ sexual health may be similar.

Mindful Awareness: Can a Neuro-Developmentally Timed Approach Prevent Youth Substance Misuse Abstract Youth substance use remains a significant public health issue. Although there are numerous evidence-based substance use preventive interventions, room for program improvement remains. Mindfulness practice, due to its feasibility of implementation, capacity to promote neuro-networks associated with delayed substance use initiation and progression to substance use disorders, and efficacy in promoting protective and reducing risk factors associated with substance use, may constitute one strategy for increasing the effectiveness of substance use preventive interventions. However, mindfulness-based approaches to substance use prevention have yet to be systematically tested with youth. In this conceptual paper, we first define mindfulness and its potential, through practice, to strengthen neuro-circuitry associated with substance use disorders. We then review evidence supporting the effectiveness of mindfulness-based preventive interventions to promote protective factors and reduce risk factors known to predict youth substance use. Thus, a case is made for neuro-developmentally timed, mindfulness-based substance use preventive interventions, with the ultimate goal of preventing future substance misuse and associated health consequences.

Exchange and Survival Sex, Dating Apps, Gender Identity, and Sexual Orientation Among Homeless Youth in Los Angeles Abstract We estimated the association between gender and sexual identities, and engagement in exchange and survival sex and seeking these partners via dating apps or websites, within a sample of homeless youth. In 2017, 253 homeless youth were interviewed from three different drop-in centers in Los Angeles. Multivariable regression analyses assessed associations between gender/sexual identity, and exchange and survival sex, adjusting for demographic characteristics. Sexual minority (43.6%) and gender minority (12.1%) youth reported elevated rates of exchange sex compared to cisgender heterosexual youth. Twenty-three percent of youth who engaged in survival or exchange sex used dating apps or websites to find partners. Exchange sex was associated with having recent HIV positive sex partners. Reporting an HIV positive partner and a relatively high number of sexual partners were significant predictors of engaging in survival sex. Programs and interventions for homeless youth should address engagement with technology and exchange and survival sex, and should respond to the unique needs of sexual and gender minority homeless youth.