Improving Functioning of Children Birth to Five with Emotional and Behavioral Problems: The Role of Comprehensive Mental Health Services and Supports.

INTRODUCTION: Emotional and behavioral problems are growing among children ages birth to five, and racial/ethnic and socioeconomic disparities exist. Comprehensive, culturally responsive, family-driven systems of care, such as the one operated by California's diverse, urban Alameda County, offer one potential intervention. METHODS: We used client-level service data (n = 496 children) to calculate descriptive statistics and regression analyses (including multilevel models to account for observations for the same client at multiple points in time). We estimated the prevalence of mental health issues and assessed the association between the length of time using services and emotional and behavioral functioning. RESULTS: Comprehensive mental health services and supports were associated with improved emotional and behavioral functioning outcomes for children over time, even after controlling for other risk factors. DISCUSSION: Systems of care appear to support the multidimensional functioning of children and their families.

Opportunities to Reduce Young Adult College Students' COVID-19-Related Risk Behaviors: Insights From a National, Longitudinal Cohort.

PURPOSE: To study how young adult college students are managing their health behaviors and risks related to spreading COVID-19. METHODS: We created a national cohort of full-time college students in late April 2020 (n = 707), and conducted a follow-up survey with participants in July 2020 (n = 543). Participants reported COVID-19-related health risk behaviors and COVID-19 symptoms, and also responded to an open-ended prompt about how the COVID-19 pandemic has affected their lives. Quantitative data were analyzed in Stata and we conducted content analysis to identify themes in the qualitative data. RESULTS: For most health protective behaviors (e.g., frequent handwashing, social distancing), participants were less compliant in summer 2020 than spring 2020, with the exception of face mask use, which increased. In each month of the first half of 2020, only approximately half of participants with any symptoms that could indicate COVID-19 stayed home exclusively while symptomatic (there was no meaningful change from pre-pandemic or over the course of the pandemic). In qualitative data, the participants who had gone to bars or clubs at least twice within a 4-week period this summer reported being bored and/or isolated, stressed, and/or taking pandemic safety measures seriously. CONCLUSIONS: These findings suggest multiple areas for intervention, including harm reduction and risk management education approaches for the students who are going to bars and clubs, and creating policies and programs to better incentivize young people with symptoms to stay home exclusively while symptomatic.

Preventing maternal mortality in the United States: lessons from California and policy recommendations.

Maternal mortality remains a large concern in the United States (US), although other Western countries are making progress. In this scoping review, we identify four problems that may contribute to the maternal mortality burden in the US: inadequately investing in women's health, poor quality of care, increasing disparities, and poor data collection and monitoring of maternal health issues. Because maternal mortality is decreasing in California, we identify strategies implemented there that could improve maternal health outcomes nationwide: funding programs to address social determinants of maternal health; supporting health care strategies to improve maternal health (including national standards and goals for health care systems); and investing in maternal health monitoring and surveillance (including use of technology). We encourage researchers, practitioners, and policymakers to work together to develop evidence-based policies and practices to improve maternal health and reduce maternal. We conclude with recommendations for the United States and globally.

Association of Adult Depression With Educational Attainment, Aspirations, and Expectations.

INTRODUCTION: Social factors across one's lifespan may contribute to the relationship between low educational attainment and depression, but this relationship has been understudied. Previous studies assessing the association between educational attainment and depression did not fully account for prior common determinants across the life course and possible interactions by sex or race/ethnicity. It is also unclear whether the link between educational attainment and depression is independent of the role of aspired educational attainment or expected educational attainment. METHODS: We used generalized linear log link models to examine the association between educational attainment at age 25 and depression at age 40 in the National Longitudinal Survey of Youth 1979 cohort, adjusting for confounders and mediators from childhood, adolescence, and adulthood. RESULTS: Members of each educational attainment group were less likely to be depressed at age 40 than those with less education. After adjusting for educational aspirations and educational expectations, the risk ratios became closer to the null. Neither sex nor race/ethnicity interacted with educational attainment. Additionally, low educational expectations in adolescence, but not low educational aspirations, was associated with a higher risk of depression at age 40. CONCLUSION: Our study provides a nuanced understanding of the role of education, educational expectations, and educational aspirations as part of education's effect on risk of depression after controlling for a thorough set of confounders and mediators. Our findings may help advance the study of social determinants of depression.