Preventing Pregnancy in High School Students: Observations From a 3-Year Longitudinal, Quasi-Experimental Study.

OBJECTIVES: To assess whether a sexual health education intervention reduces pregnancy rates in high school students. METHODS: We performed a secondary analysis of a 3-year quasi-experimental study performed in South Texas from 2011 to 2015 in which 1437 students without a history of pregnancy at baseline were surveyed each fall and spring. Potentially confounding risk factors considered included sexual behaviors, intentions, and demographics. The outcome measure was self-reported pregnancy status for male and female students. We performed analyses for male and female students using separate discrete time-to-event models. RESULTS: We found no difference in pregnancy rates between intervention and comparison students within the first 3 years of high school. Female and male students in the intervention groups had pregnancy hazard ratios of, respectively, 1.62 (95% CI = 0.9, 2.61; P = .1) and 0.78 (95% CI = 0.44, 1.48; P = .4) relative to the comparison groups. CONCLUSIONS: The educational intervention had no impact on the pregnancy rate. Social media tools in pregnancy prevention programs should be adaptive to new technologies and rapidly changing adolescent preferences for these services.

Social determinants of mental health and adolescent anxiety and depression: Findings from the 2018 to 2019 National Survey of Children's Health.

BACKGROUND: There is a current crisis in children's mental health. Defining social determinants of mental health (SDMH) facilitates investigations of social impact on mental health. AIMS: To examine associations between nine SDMH and adolescent depression and anxiety in a U.S. nationally representative sample. METHODS: Poor access to health care, caregiver underemployment, food insecurity, poorly built environment, housing insecurity, household dysfunction adverse childhood experiences (ACEs), racism, caregiver poor education, and poverty/income inequality were assessed from the 2018 to 2019 National Survey of Children's Health (NSCH) (N = 24,817). RESULTS: The likelihood of reporting adolescent depression and/or anxiety was assessed for each SDMH using multinomial logistic regressions. All SDMH, besides caregiver underemployment, were associated with increased odds of reporting adolescent anxiety, depression, or anxiety and depression. Only household dysfunction ACEs and racism had statistically significant associations for all three mental health outcomes. CONCLUSIONS: Interventions targeting ACEs and racism may be more impactful in mitigating mental health challenges associated with SDMH during adolescence. The NSCH may provide an important public health tool to investigate SDMH in children.

A Digital Single-Session Intervention Platform for Youth Mental Health: Cultural Adaptation, Evaluation, and Dissemination.

BACKGROUND: Despite the proliferation of evidence-based digital mental health programs for young people, their low uptake and inconsistent implementation preclude them from benefiting youths at scale. Identifying effective implementation strategies for evidence-based supports is especially critical in regions where treatment access is lowest owing to mental health provider shortages. OBJECTIVE: The goal of this academic-community partnership, funded by the City of San Antonio Metropolitan Health District, was to culturally adapt, disseminate, and gauge the acceptability and utility of an evidence-based digital mental health platform-Project Youth Empowerment and Support (YES)-among English- and Spanish-speaking youths living in south Texas. METHODS: Project YES is an open-access, anonymous platform containing 3 evidence-based, self-guided interventions for youth mental health. Project YES was culturally adapted via focus groups and co-design sessions with San Antonio youths with lived experience of depression and anxiety; translated into Spanish; and disseminated throughout San Antonio, Texas, via community and school partnerships. RESULTS: During the project period (April 2021 to December 2021), 1801 San Antonio youths began and 894 (49.64%) of them completed a 30-minute, single-session intervention within Project YES (aged 11-17 years; n=718, 39.87% male; n=961, 53.36% female; and n=3, 0.17% intersex; n=1477, 82.01% Hispanic; n=77, 4.28% non-Hispanic White; n=113, 6.27% Black; n=28, 1.55% Asian; and n=93, 5.16% other). This completion rate (49.64%) surpassed those previously observed for Project YES (eg, 34% when disseminated via social media). San Antonio youths rated Project YES as highly acceptable across all metrics, both in English and Spanish. In addition, the youths who completed Project YES-ENGLISH reported significant improvements in hopelessness (Cohen d=0.33; P<001), self-hate (Cohen d=0.27; P<001), and perceived agency (Cohen d=0.25; P<001) from before to after the intervention, and the youths who completed Project YES-SPANISH reported significant improvements in self-hate (Cohen d=0.37; P=.049) from before to after the intervention. CONCLUSIONS: The results indicate that Project YES-an open-access, free, and anonymous web-based single-session intervention platform-is an acceptable, accessible, and applicable mental health support for English- and Spanish-speaking San Antonio youths.

New forms of contraception.

Women have many options regarding contraception. A patient's desire for a long- or short-term method, for one that is reversible or permanent, and her belief that she can be compliant with the method all factor into the choice of contraceptive method. Practitioners must discuss coexisting conditions, contraindications, and whether the patient desires scheduled monthly bleeding or if she will tolerate unscheduled bleeding. Finally, cost and coverage by insurance tends to be one of the most important factors in choosing the method of contraception.

Stakeholder Education and Community Mobilization Garner Support for Sex Education.

PURPOSE: The University of Texas Health Science Center at San Antonio UT Teen Health (UTTH) implemented a community-wide teen pregnancy prevention (TPP) initiative in south San Antonio. This article describes how UTTH staff educated community stakeholders and mobilized community members to support implementation of evidence-based TPP interventions. METHODS: UTTH educated key stakeholders about the need for TPP efforts, strong local support for such efforts, and the value of evidence-based interventions (EBIs). The process of stakeholder education and partnership development leading to implementation of EBIs was lengthy with, for example, an average of 11 meetings and 13.5 months between the initial meeting and formal approval of EBI implementation among school partners. UTTH also mobilized the community by engaging community members on leadership teams that actively supported the initiative efforts. RESULTS: Partnerships to implement EBIs were developed with 16 middle and high schools across five local school districts, two divisions of the juvenile justice system, and five youth-serving organizations. From 2011 to 2015, more than 12,500 youth (51% female) aged 11 to 19 years received EBIs. Of the total served, 95% were served through partnerships with local schools, 4% by juvenile justice, and 1% by youth-serving organizations. CONCLUSIONS: Engaging and educating members of the community require notable time and resource investments up front; however, once strong partnerships are built, there is an ongoing opportunity to reach youth. In south San Antonio, schools provided the opportunity to reach the largest numbers of youth.