Socioecological factors influencing the risk of developing hypertensive disorders of pregnancy in India: a rapid review.

BACKGROUND: The prevalence of hypertensive disorders of pregnancy (HDPs) in India is 11%, which is one of the highest rates globally. Existing research on HDPs in India primarily focuses on biological risk factors, with minimal research on how socioecological factors combine to increase risk of HDPs. We conducted a rapid review using Bronfenbrenner's Ecological Model to understand the social and cultural factors associated with HDPs among Indian pregnant women to identify possible intervention targets that may uniquely improve health in this population. Bronfenbrenner's Ecological Model is a framework that can be used to understand the complex relationship between multiple influences on health. METHODS: We reviewed studies published between January 2010 and January 2024 using PubMed, Science Direct, and Scopus databases. Search terms included variants of hypertension, pregnancy, and India. Inclusion criteria were: (1) peer-reviewed journal article; (2) published between January 2010 to January 2024; (3) participants consisted of Indian women living in India; (4) studies evaluated socioecological risk factors associated with HDPs. One independent reviewer performed searches, screening, data extraction, and quality assessment. Each included study was then organized within Bronfenbrenner's Ecological Model. RESULTS: A total of 921 studies were generated from the initial search, with 157 exclusions due to duplicates. Following screening for inclusion and exclusion criteria at the title/abstract and full text levels, 17 studies remained in the final review. Socioecological risk factors of HDPs were identified at each level, with the most commonly identified influences including: low socioeconomic status (SES), lacking community education and knowledge on HDP management and prevention, and lacking prenatal HDP screening. CONCLUSION: This study determined that the high risk for HDPs in India is influenced by many intertwined socioecological factors. Women in rural and low SES areas need more health education on HDP management and prevention. There also needs to be more adequate prenatal HDP screening, with at least 4 and ideally 8 prenatal visits. Prenatal screenings should be accompanied with culturally appropriate patient education, especially for low SES women who have limited literacy, so that they can effectively make individual and microsystemic lifestyle decisions aimed at either managing or preventing HDPs.

Identified needs to enhance life for people with spinal cord injury: a part of the Swedish Needs Assessment Project.

PURPOSE: To identify factors that contribute to the enhanced life of people with spinal cord injury (SCI) in Sweden. MATERIALS AND METHODS: This cross-sectional study combined workshops (n = 38) and survey data (n = 243) from people living with SCI and their relatives, health professionals, and personal care assistants working with people living with SCI. The data were first categorized using Bronfenbrenner's bioecological model, followed by a conventional content analysis. RESULTS: The factors that contribute to an enhanced life for people living with SCI are similar to those of the general population, including relationships, leisure activities, and occupation within the mesosystem. However, the unique components of the exosystem and macrosystem are specifically associated with people living with SCI. The exosystem, particularly in healthcare, plays a major role for medical reasons but also tends to obtrude and minimize the mesosystem. The macrosystem is essential, as it sets the rules that govern the actors in the other layers, creating prerequisites for meeting the needs of the mesosystem and exosystem. CONCLUSIONS: The needs that contribute to an enhanced life are multifaceted and individualized. Therefore, these systems must be flexible throughout the lifespan of individuals with SCI.

This paper reports needs that contribute to an enhanced life for people living with spinal cord injury in Sweden.The factors that contribute to an enhanced life are multifaceted and individual, and these must be considered throughout the entire life span, including getting help if secondary complications arise, aging and other life events.Individuals' willingness to take ownership is strong but requires support from the surrounding systems that can accommodate individual's unique needs.The exosystem (ea health care) plays a major role but risk to obtrude and minimize the mesosystem (individual's immediate relations).Positive attitudes toward oneself, from family members and loved ones, from health care professionals and authorities are crucial for an enhanced life.

Using the ecological approach to explain risk factors of elder abuse in Iran (A qualitative study).

BACKGROUND: World Health Organization suggests that different societies should investigate the causes of abuse in their culture. AIMS: This study was conducted to investigate the risk factors of elder abuse in Iran using an ecological approach. MATERIALS AND METHODS: This is a qualitative study, and the participants were older adults and caregivers. The data were collected using 66 interviews. Analysis of data was simultaneously performed with data collection, using MAXQDA 10, and results were reported based on Elo's recommendation. RESULTS: Five main categories of data analysis were obtained based on Bronfenbrenner's model: exo-system: conflict of care with caregivers' jobs, meso-system: failure to meet expectations of support systems, macro-system: social culture, socioeconomic structure, status of enactment, and implementation of legal and financial laws. CONCLUSIONS: This study showed risk factors of elder abuse in the sociocultural context of Iran, and its results can be used for health promotion interventions.

Stress in Chinese teachers who teach the mathematically gifted: a qualitative perspective.

Those who teach mathematically gifted high school students play a key role in both their identification and cultivation. Teachers who teach the Mathematical Olympiad in China work long hours and teach difficult content; they are under a significant amount of work-based pressure, and that is worthy of further study. This study analyzed the sources of stress for 33 Chinese teachers who teach the Mathematical Olympiad, collected data through semi-structured in-depth interviews, and adopted a subject analysis method based on Bronfenbrenner's ecological system that considers the influences that the complexity of socio-cultural and environment have on individual emotions. It is divided into five structural or environmental systems in which human beings develop, namely the macroscopic, external, meso, micro, and chrono systems. The research results show that the greatest influences on these teachers' stress come from the mesosystem and microsystem levels, and that the key players are students and school leaders. Educational policy and culture are found to be key factors from the macrosystem. Overall, long-term stress was seen to affect both teachers' moods and their physical health. Finally, the results offered implications for education policy and school management and suggestions for the cultivation and management of mathematics teachers who teach the gifted. Limitations of the study are discussed, and directions for future research are proposed.

Men's Suicide in Bangladesh: Impressions From the Socio-Ecological System Theory.

Suicide is a multilayered social behaviour containing overlapping components from individual to social spheres. This article discusses the findings of the context of male suicide in Bangladesh based on Bronfenbrenner's socio-ecological theory. The socio-ecological perspective allows to determine the risk factors of suicide at multiple levels. Fifteen male suicide cases were purposively selected from several rural areas of the Jhenaidah district which is known for high rates of suicide. Qualitative in-depth interviews (three for each case) with persons who are significant others to the deceased delineate the interactive context of suicide. While the analysis deductively hinges on four major themes (e.g., individual/micro, interpersonal/meso, community/exo, and societal/macro factors) in consonance with socio-ecological theory, ten sub-themes were inductively identified from the intriguing meanings of the interviews. Considering the integrative nature of suicide, the study underscores the necessity to introduce a multi-sectoral approach to effectively prevent suicide in Bangladesh.

The sociocultural influences in Lawrence Kohlberg's life: a psychobiography.

Lawrence Kohlberg (1927-1987) was a moral development specialist and moral teacher. He is considered an exceptional individual due to the success he obtained from developing his Theory of Moral Development. Throughout Kohlberg's life, there was a reciprocal influence between Kohlberg's development and the sociocultural influences of his time, guiding his life story. This psychobiography used a longitudinal, single-case research design from the qualitative paradigm, utilising the descriptive-interpretive approach to explore the influences which shaped major life events in Kohlberg's life. This research design enabled the illumination of how sociocultural circumstances shaped various spheres in Kohlberg's life, such as his identity, education, career path and vocational success. This was done through using Bronfenbrenner's Bioecological Theory of Human Development Framework, by including its enmeshed, most up-to-date scientific research design, the Proximal-Person-Context-Time Model.

A chronicle of the liberation struggle: the career development of Ahmed Kathrada.

Ahmed Kathrada (1929-2017), an anti-apartheid activist, political prisoner, and parliamentary politician had been at the centre of South Africa's liberation struggle for six decades and is remembered as a soft-spoken, strong-willed and incorruptible freedom fighter. This psychobiography uses the career development framework of Jeffrey Greenhaus and the ecological human development systems framework proposed by Urie Bronfenbrenner to investigate and illuminate Kathrada's life history. Kathrada was purposively selected as subject due to his extraordinary contributions to the liberation struggle. The study used primary and secondary documentary data. The findings indicate poor alignment between the age categories proposed by the Greenhaus framework and Kathrada's career development stages due to him joining the liberation movement at a very young age, his rapid career development during the early career stage and the impact of imprisonment on his career development. The findings relating to Bronfenbrenner's theoretical framework illustrate the interaction between individual and environmental factors that influenced Kathrada's life and career. Ultimately, employing two theoretical frameworks assisted in formulating a pragmatic, holistic and comprehensive psychobiography that illuminates Kathrada's life and career. The study contributes to the legacy of Kathrada and underscores the importance of longitudinal studies in the career development of extraordinary individuals.

Exploring the world of food with families: perspectives of low-income families on factors influencing their food choices.

OBJECTIVE: The aim of this study was to investigate the social and environmental factors involved in the food decision-making processes of families living on lower incomes on the Island of Ireland. DESIGN: A qualitative design was employed for this study, using photovoice and creative mapping methods. Parents were requested to take photos and draw maps of their food environments. Interviews were then conducted with parents, using the materials produced by parents as a cue to discuss their food environments, influences and decision-making processes around food choices. SETTING: The participants were interviewed online via Microsoft Teams. PARTICIPANTS: The participants were parents or guardians of children between the ages of 2 and 18 who self-defined as 'living on a tight budget'. RESULTS: Twenty-eight participants were recruited and interviewed for this study, including twelve parents in Northern Ireland and sixteen in the Republic of Ireland. The findings were mapped on to Bronfenbrenner's Ecological Systems Theory and showed that multiple, overlapping and intersecting factors at the individual, micro-, meso-, exo-, macro- and chrono-system were implicated in family food choices. Upstream factors in particular, including structural, policy and commercial determinants, appear to be significant drivers of behaviour. CONCLUSIONS: While the findings suggest that a complex range of factors are involved in family food choices, it is clear that policy measures and regulations are needed to stave off the impacts of rising social inequality and food poverty. Health promoters should strive to find non-stigmatising interventions to bridge the nutritional divide experienced by lower-income families.

"Finding happiness in daily work": an ecological study on the emotions of novice EFL teachers in rural primary schools in China.

While research on teacher emotions has grown in the past decades, little is known about rural teachers' and novice teachers' emotions. Based on ecological theory, this study selected two novice EFL teachers as the research objects. The goal was to explore their emotional experiences and the factors that influenced them over 3 years while teaching in rural primary schools. The research data was collected primarily through semi-structured interviews, teaching diaries, and narrative frameworks. Three-step coding and topic analysis were used to analyze the collected data. The data analysis revealed that the two novice teachers generated 62 emotions while interacting with various ecosystems. In Microsystems, teacher-student interaction has a strong influence on participants' emotions. Two participants experienced 19 positive emotions and 9 negative emotions during their interactions with the students. In addition, novice teachers may experience negative emotions if they are burdened with too many non-teaching tasks. In this study, two participants were able to effectively manage their negative emotions. The general emotional trend was positive, which motivated them to stay and continue teaching in the rural area. The results of this study have implications for the professional development of rural teachers and novice teachers.

Enablers and barriers for hearing parents with deaf children: Experiences of parents and workers in Wales, UK.

BACKGROUND: More than 90% of deaf children are born to hearing families who know little about deafness. Benefits from hearing screening at birth are often lost, as families find little information about pathways for deaf children but are key to ensuring deaf children receive relevant language and communication support. Systems surrounding deaf children and family members are crucial for children's health and social development. Experiences of hearing parents raising deaf children and understanding factors that influence families' experience of navigating pathways for deaf children through health and education services are currently underreported. METHODS: An exploratory study was conducted in Wales, UK. Twenty participants were interviewed, including 10 hearing parents of deaf children and 10 people who work with deaf children using semistructured interviews. Bronfenbrenner's ecological systems theory was used as a lens to explore the micro-, meso-, exo-, macro- and chronosystems that surround children and families. This study explores potential supports and barriers in those systems. FINDINGS: Findings are reported under two broad headings: enablers and barriers. Under enablers, it was found that provision of resources, supporting people and knowledge were key factors. Under barriers, a lack of knowledge, lack of provision and battling services and attitudes were key issues that need addressing. CONCLUSION: Hearing parents of deaf children in Wales, UK reported experiencing a range of enablers and barriers that impact upon their experiences of raising a deaf child. Further provision is needed by policymakers and governments to recognise support needs to improve the outcomes for deaf children. PATIENT OR PUBLIC CONTRIBUTION: This project was developed from initial discussions with the stakeholder reference group and progressed with the group's deaf panel and hearing parents with deaf children. The project's steering group was involved in study design, recruitment and continuous feedback on all stages of the research process.

A systems approach to the perceptions of the integration of public health into pharmacy practice: A qualitative study.

Background: Pharmacists, as health professionals, are ideally positioned to support the health and wellbeing of populations, in addition to their role of providing individualised health care. Objective: The aim of this study was to explore current opinion on the contribution of pharmacists to public health and how this may be enhanced to positively impact public health indicators. Methods: A total of 24 pharmacists from Australia, United Kingdom, Canada and the United States of America, and Australian public health professionals and consumers participated in semi-structured interviews between January and October 2021. Interpretive thematic analysis was applied with coding of transcripts using the constant comparison method. Themes were developed and named in accordance with Bronfenbrenner's ecological theory of development. Results: Pharmacists contribute to public health and have important roles in health education and illness prevention services. Strong enablers in community pharmacy include trust by consumers and ease of accessibility to pharmacists. Pharmacists are viewed as leaders in communities and contribute to the health system broadly in areas such as medication policy and public health organisations.Participants suggested that pharmacist contributions to public health are often unrecognized by the pharmacy profession, health professionals and consumers, and could be developed to allow effective contributions. Strategies to improve pharmacist contributions included clarifying public health-related terminology, increased development of pharmacy roles and reform for community pharmacies to participate in health prevention and promotion services. Integration of public health in pharmacy education, professional development, and recognition of pharmacy roles across all system levels were also identified as important. Conclusions: The study indicated that pharmacists currently contribute to the improvement of public health. However, development strategies are required for this to be more effective in integrating public health approaches into their professional practice to be recognized for their public health-related roles.

The role of digital technologies in supporting quality improvement in Australian early childhood education and care settings.

This national study explored the role of digital technologies in early childhood education and care settings and whether they could contribute to quality improvement as reported by educators and assessors of quality in Australia. In this paper, data from Stage 2 of the Quality Improvement Research Project were used, which comprised 60 Quality Improvement Plans from educators linked with 60 Assessment and Rating reports from the assessors who visited early childhood centres as part of the administration of the National Quality Standards by each of Australia's State and Territory jurisdictions. Bronfenbrenner's ecological systems theory ( Bronfenbrenner, U. (1995). Developmental ecology through space and time: A future perspective. In P. Moen, G. H. Elder, Jr., & K. Lüscher (Eds.), Examining lives in context: Perspectives on the ecology of human development (pp. 619-647). American Psychological Association. 10.1037/10176-018; Bronfenbrenner & Ceci, Bronfenbrenner and Ceci, Psychological Review 101:568-586, 1994) was adopted to facilitate a systemic and dynamic view on the use of digital technologies in these 60 ECEC settings. References (e.g. comments/ suggestions/ examples) made by the educators about the implementation of digital technologies were counted and thematically analysed. Results revealed the strong role new technologies (e.g. documentation and management platforms, tablets, apps, etc.) play in the majority of ECEC settings and especially in relation to three of the seven Quality Areas: Educational programme and practice (Quality Area 1); Collaborative partnerships with families and communities (Quality Area 6) and Governance and leadership (Quality Area 7). Future directions for research are suggested and implications for embracing a more holistic, integrated and broad view on the use of digital technologies are discussed.

Swedish schoolchildren's voices of health-promoting factors: a focus group study.

Children have the right to express their views on all issues related to their health and development. The aim was to explore health-promoting factors voiced by 8- to 12-year-old children, to determine how the children prioritize those factors and inform school personnel how to develop health-promoting approach based on those findings. Focus groups, with the use of photographs, were conducted with 15 children. A deductive content analysis was used, with overall results showing that health-promoting factors are meaningful relationships and recreational activities. The results add new perspectives to the earlier model of health-promoting factors. By highlighting children's experience of what promotes health, measures at the individual, group and community level can be adapted to children's priorities, based on their own needs.

Ecosystems Determinants of Nutritional Adequacy Among the Indian Preschool Children.

Given the specified importance of dietary diversity in reducing the burden of malnutrition, our study explores the reasons for the high rate of malnutrition in India through assessment of a comprehensive range of ecosystem factors leading to poor nutrients intake. The study uses the Dietary Diversity Score (DDS) to investigate preschoolers, through differences in wealth, gender, and health. Demographic and Health Survey (2015-16) data of 1,40,470 preschool children between the ages of 2-5 years, is investigated using the Bronfenbrenner's Ecological Systems Theory. Multiple linear regression models developed to investigate the association between variables, depict the importance of vaccination (p-value < 0.01, 95% CI 0.02-0.06) as positively impacting the outcome measures. Interestingly, overall wealth index does not impact the dietary diversity of the child. The lower wealth index, however, significantly impacts the DDS of the female child as compared to the male child (p-value < 0.1, 95% CI - 0.03 to 0.02), indicating that the lower wealth index plays a role in developing the non-egalitarian gender attitudes for female children. Policy implications involve adapting biofortified foods with higher density of nutrients with major focus on female children to minimize the gender gap and leveraging the digital technology such as telemedicine, and advanced techniques such as artificial intelligence, machine learning, and big data to offer real-time surveillance to address the healthcare needs in the ongoing immunization programs. Supplementary Information: The online version contains supplementary material available at 10.1007/s41745-022-00339-4.

Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment.

Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.

Medium-term outcomes of a program to upgrade the nursing faculty in Cambodia: A qualitative study.

Continuous professional development is important for improving professional competencies, such as cognitive knowledge, technical skills, behaviors, and attitudes. Trainees who complete training programs can have a positive influence on their workplaces. However, it is challenging to establish a process that can facilitate individual learning and help achieve training outcomes in educational and clinical workplaces. In Cambodia, a tumultuous history has played a part in the deficit of adequately prepared nursing faculty. Since the faculty development is vital to ensuring the quality of education, the application of upgraded nursing programs has started in 2011. After the completion of upgraded program, an immediate post-training study was conducted in 2014. Results showed that some faculty members did not accept trainees because they lacked an understanding about nursing concepts. The current study aimed to evaluate the medium-term outcomes of an established program that can improve nursing education and to identify relevant factors in light of the institutional development of educational and clinical facilities in Cambodia. A qualitative study incorporating focus group discussions, key-informant interviews, and teaching document reviews was performed with a thematic analysis using the four-level training evaluation model of Kirkpatrick. Finally, factors influencing outcomes were assessed based on the Bronfenbrenner's ecological system theory. Five themes for behavior and three themes for results were identified as medium-term outcomes from an institutional development aspect. The major enabling factors for the above-mentioned themes were the support of institutional managers, continuous networking among trainees, and supportive national policy. Compared with the immediate post-training study findings, the perceived medium-term outcomes became more strategically focused. Then, the impact of training at a considerably broader scale within the workplace was discussed. The findings highlighted the importance of medium-term program delivery and monitoring if one understands the role played in stimulating outcomes. Moreover, the importance of contextual factors including the influence of managers and policy environment were emphasized.

Reinvigorating an Academy of Medical Educators Using Ecological Systems Theory.

The educational framework of communities of practice postulates that early learners join medical communities as social networks that provide a common identity, role modeling and mentorship, and experiential learning. While being elected into a medical society is an honor, member engagement in these groups can falter if the society membership is seen as an honorific rather than one requiring continuing participation. As an example, Academies of Medical Educators have been established by many academic medical centers to encourage collaboration, skill development, professional identity formation, and scholarship. The University of North Carolina established the Academy of Educators in 2006 to create a diverse community of educators to promote the scholarship, teaching skills, and professional identity of educators. Despite rapid growth to over 500 members, we had less than 30 participants at events over the 2017-2018 academic year. To increase member engagement and participation, our academy leadership team used Bronfenbrenner's Ecological Systems Theory to design interventions at each layer of environmental influence, specifically at the microsystem, mesosystem, exosystem, macrosystem, and chronosystem levels. In this paper, we describe the multipronged approach used to increase the University of North Carolina Academy of Medical Educators event attendance from 30 to 1,000 faculty participants over the course of one academic year (2018-2019). This paper provides a model as to how medical societies can use ecological systems theory as a natural and comprehensive approach to plan and improve their member engagement and experience.

Difficulties in teaching Grade 3 learners with reading problems in full-service schools in South Africa.

Background: Many primary school learners in South Africa, including those in so-called full-service schools (FSSs), are reading below their grade level. Objectives: The authors of this article embarked on a study to find out what difficulties a group of Grade 3 teachers in full-service school faced to support their young custodians with reading problems. Methods: The research followed a qualitative approach using semi-structured interviews and classroom observation. Results: The data showed that the reading problems experienced by some Grade 3 learners can be attributed to the multiple levels of the education system. On the macro system as set out by Bronfenbrenner's ecological systems theory where the government and provincial departments operate, the first issue was the national department's progression policy which allows Grade 2 learners to progress to Grade 3 without the required reading competency. The second issue was a lack of enough readers and overcrowding in classrooms. Problems on the microsystem included aspects such as the language of learning and teaching; learners' reading skills and attitudes towards reading; teachers' lack of knowledge about diverse learning needs and parental support. Conclusion: It is envisaged that the study will contribute to an understanding of the teachers' difficulties in teaching reading so that the Grade 3 learners' reading problems especially those in FSSs could be dealt with through combined efforts of all the stakeholders in the education system.

Understanding STEM academics' responses and resilience to educational reform of academic roles in higher education.

BACKGROUND: Across the globe, there have been significant reforms to improve STEM education at all levels. A significant part of this has been teacher reform. While the responses and resilience of STEM teachers to educational reforms in secondary education have received significant attention, the responses and resilience of STEM teachers in higher education remains understudied. In higher education, educational reforms of academic roles have seen increasing numbers of STEM academics focussed on education. Responses of STEM academics to education reform of the academic role have some parallels with teacher resilience, but there are also potential misalignments within a culture which values and prioritises science disciplinary research. This study examined the responses of STEM academics in higher education to educational reform of the academic role using the theoretical construct of resilience and Bronfenbrenner's socio-ecological model. This was a 2-year case study of 32 academics and senior educational leaders in higher education in STEM. Data collection included semi-structured interviews which were theme coded and inductively analysed. RESULTS: The responses and resilience of STEM academics focussed on education appeared to be dependent on interactions between individual disposition in the microsystem and influences of the exosystem and the external macrosystem. Five major themes emerged about the value and quality, scholarship and expertise, progress and mobility, status and identity and community and culture of STEM academics focussed on education. The exosystem was a significant unidirectional influence on STEM academics where judgements were made concerning academic performance, awards, and promotion. Responses of senior leaders in the exosystem were influenced by the macrosystem and culture of science. Academics focussed on research, rather than education were more valued and more likely to be both financially rewarded and promoted. CONCLUSION: During this pressured decade, where COVID-19 has intensified stress, more attention on the direction and reciprocal relationships in the socio-ecological model of higher education is needed in order for educational reform in higher education STEM to be effective. Resilience of STEM academics to educational reform in higher education is a dynamic quality, and the capacity to "bounce back", learn from challenges, and realise expectations of educational reform will depend on an understanding of resilience and support of Bronfenbrenner's spheres of influence.

Technologizing Bronfenbrenner: Neo-ecological Theory.

We propose an adaptation of Urie Bronfenbrenner's bioecological theory, neo-ecological theory. As bioecological theory was developed in the 20th century, it requires significant modifications to reflect some of the most ubiquitous contexts in which adolescents learn, play, and grow-the technological and virtual ones. Although several scholars have developed laudable theories related to youth development in virtual contexts, the field lacks an overarching theory to address the intersection of development and technology. In developing neo-ecological theory, we hold true to the tenets of bioecological theory, but suggest key modifications to reflect our technologized world. We delineate a key alteration to the microsystem, namely the existence of two types of microsystems-physical and virtual. In addition, we emphasize the importance of macrosystemic influences (i.e., the influences of culture and within-society subcultural variation) in understanding development in the digital age. The implications of these modifications cascade across the Process-Person-Context-Time (PPCT) model; proximal processes, person characteristics, context, and time are all reexamined. In the digital age, virtual microsystems are central contexts in which youth engage in proximal processes. As such, we believe that all scholars of development, regardless of their specific research interests, should consider the ways digital contexts influence their outcomes of interest. Without it, practitioners, policy makers, parents, and technologists will be in the dark about how best to support adolescents.