Trends in youth risk behaviours and firearm injury in the USA over 20 years.

BACKGROUND: Firearm injuries are the leading cause of death in children and adolescents in the USA. We hypothesised that high rates of risky behaviour in high school students are associated with firearm injury and death in this population. METHODS: We obtained data from the Youth Behaviour Risk Survey of the Centers for Disease Control and Prevention (CDC) and combined it with data from the CDC Web-based Injury Statistics Query and Reporting System, CDC Wide-ranging Online Data for Epidemiologic Research and American Community Survey, 2001-2020. We examined trends over time using a non-parametric test for trends. RESULTS: The percentage of high school-aged youth carrying a weapon in the preceding 30 days ranged from 13.2% in 2019 to 18.5% in 2005, without a statistically significant trend over time (p=0.051). Those carrying a weapon to school peaked at 6.5% in 2005 and steadily downtrended to 2.8% in 2019 (p=0.004). Boys consistently reported higher rates of weapon carriage, with white boys reporting higher rates than black boys. Firearm homicides among adolescents 14-18 years showed no significant change, ranging from 4.0 per 100k in 2013 to 8.3 per 100k in 2020. This varied considerably by sex and race, with black boys suffering a rate of nearly 60 per 100 000 in 2020 and white girls rarely exceeding 1/100 000 during the study period. CONCLUSION: Self-reported weapon carriage among teens in the USA has steadily downtrended over time. However, shooting injuries and deaths have not. While the former suggests progress, the latter remains concerning. LEVEL OF EVIDENCE: Level III; retrospective cohort study.

Adolescent homelessness: Evaluating victimization risk based on LGBT identity and sleeping location.

BACKGROUND: Teen homelessness confers risk for victimization experiences, and teens that identify as lesbian, gay, bisexual, or transgender (LGBT) are at an even greater risk of experiencing victimization and homelessness. METHODS: Using the 2019 Youth Risk Behavior Surveillance System, we evaluated the association of experiencing homelessness with physical and sexual victimization and we examined whether LGBT identification moderated this relationship. We also evaluated if the odds of experiencing sexual and physical victimization differed depending on the reported sleeping location. RESULTS: Students who reported homelessness had increased odds of having experienced physical and sexual victimization. LGBT identity was related to increased risk for physical and sexual victimization; however, LGBT identity did not moderate the relationship between homelessness and victimization. Considering nighttime sleeping arrangement, students who reported having no usual place to stay had the highest odds of experiencing sexual or physical victimization, followed by car, park, campground, hotels/motels, emergency housing, and doubled-up with family or friends. Notably, all homeless sleeping locations were associated with increased odds of experiencing victimization relative to sleeping at a parent or guardian's home. CONCLUSIONS: Our findings confirm links between teen homelessness and sexual and physical victimization, as well as increased risk for victimization experienced by LGBT youth. Special considerations should be made when developing and implementing interventions for teens experiencing homelessness and teens who identify as LGBT.

Establishing a Valid, Reliable, and Efficient Chart Review Process for Research in Pediatric Integrated Primary Care Psychology.

Retrospective chart review is an accessible form of research that is commonly used across medical fields but is underutilized in behavioral health. As a relatively newer area of research, the field of pediatric integrated primary care (IPC) would particularly benefit from guidelines for conducting a methodologically sound chart review study. Here, we use our experiences building a chart review procedure for a pediatric IPC research project to offer strategies for optimizing reliability (consistency), validity (accuracy), and efficiency. We aim to provide guidance for conducting a chart review study in the specific setting of pediatric IPC so that researchers can apply this methodology toward generating research in this field.

Student Self-Reported Positive Purpose Over Two Years in Urban Middle Schools.

We used Developmental Systems Theory as a framework for understanding the role of contextual factors in the development of purpose in urban adolescents. The sample included primarily low-socioeconomic students of color attending urban middle schools (n = 2,629; 10-16 years of age). Longitudinal data were collected at four time points across two years. We used hierarchical linear modeling to model change in purpose. On average, purpose declined over time. We also identified several predictors of intercept and slope. For example, Black youth had a higher average purpose intercept, as well as a steeper average decline than other racial/ethnic groups. Females demonstrated a higher average purpose intercept than males, but this effect disappeared when academic achievement was added to the model.

Launching IDeA state early career clinician-scientists with mentored just-in-time grant-writing support.

Institutional Development Award (IDeA) programs build research infrastructure in regions with historically low access to NIH funds. The Mentored Research Development Award (MRDA), a professional development program embedded in our IDeA-funded center, provides junior investigators with mentorship and effort offset to write a grant. We evaluated outcomes from the first eight years (2013-2021; N = 55) using administrative records, publicly available data, and a self-report survey (n = 46, 84% response rate). Fifteen MRDA recipients (27%) went on to receive NIH funding. Providing just-in-time grant-writing support may launch early career clinician-scientists in an IDeA state context.

Mechanisms for change: A theoretical pathway for a school-wide social-emotional learning initiative in an urban middle school.

Introduction: Investment in academic instruction without complementary attention to the social-emotional environment of students may lead to a failure of both. The current study evaluates a proposed mechanism for change, whereby academic achievement occurs as a result of the social-emotional learning environment impacting behavioral (discipline) outcomes. Methods: We tested the hypothesized model during each year of a 3-year intervention to determine whether the relations among these constructs held potential as a pathway for targeted improvement. Results: Path analysis for each year demonstrated excellent fit [Year 1: χ2 (19) = 76.16, CFI = 0.99, RMSEA = 0.05,TLI = 0.98; Year 2: χ2 (19) = 70.68, CFI = 0.99, RMSEA = 0.048, TLI = 0.98; Year 3: χ2 (19) = 66.59, CFI = 0.99, RMSEA = 0.05, TLI = 0.98] supporting the theoretical model for change. For each year the effect of the SEL Environment construct on discipline was significant, as was the effect of discipline on Academic Performance. Further, the indirect effect of SEL Environment on Academic Performance was significant across all years. Discussion: The consistency of these relationships supports the proposed logic model as a potential mechanism for change and has the potential to guide interventions for whole school improvement.

Actions Against Racism:: Bringing Together Trauma-Informed Practices, Social-Emotional Learning, and Racial Socialization to Combat Racism in Schools.

Racism is a social determinant of health with dire consequences for the health, education, and mental health of students of color. Thus, there is an urgent need to develop and test evidence-based strategies to combat racism in schools. In response to this need, our team has developed a multi-tiered school-based intervention to build capacity for combatting racism in educators, students, and families. The "Actions Against Racism" intervention synthesizes three evidence-based practices: trauma-informed practices, social-emotional learning (SEL), and racial socialization. The multiple tiers of intervention aim to cultivate skills for combatting individual and structural racism in educators, families, and students across the school ecology. In this paper, we present the rationale for this intervention and provide an overview of the "Actions Against Racism" components.