The Time to Act Is Now: Investing in LGBTQIA2S+ Student Mental Health in K-12 Schools With a Youth-Centered Approach.

Compared to youth a decade ago, today's youth experience increased rates of mental health concerns as well as greater severity of mental health issues. Prior to the COVID-19 pandemic in 2020, over a third of youth reported feeling sad and hopeless and one in five reported having seriously considered suicide. With this grim reality, schools and communities are no longer able to ignore how mental health affects the daily lives, social and emotional development, and identify formation of their youth. When schools implement mental health promotion programs and policies, they not only promote academic success but also increase protective factors that establish an environment supportive of help-seeking behaviors. Active Minds is committed to improving mental health outcomes for youth, specifically LGBTQIA2S+ students, enrolled in K-12 schools across the United States. These recommendations, grounded in evidence-based best practices, provide support for schools as they work to improve student mental health. These recommendations include the following:Implementing the Whole School, Whole Child, Whole Community (WSCC) model;Centering youth voices in mental health promotion;Participating in surveillance efforts;Ensuring mental health support for students with diverse identities and needs;Providing space to address individual biases and stigma;Developing and aligning policies and culture to support youth mental health.

A Mixed-Methods Assessment of a Peer-Enforced Tobacco- and Smoke-Free Policy at a Large Urban University.

The study aims to evaluate the enforcement, opinions, and effectiveness of the University of South Florida's tobacco free policy one year following implementation. By assessing readiness to change and using geographic information system (GIS) mapping this study sought to introduce a unique and effective way of evaluating college tobacco free policies. A cross-sectional survey was administered to students, faculty, and staff to assess knowledge of policy and resources, tobacco use observations, stage change regarding policy enforcement, self-efficacy to enforce, and policy impact on perceived campus tobacco use (n = 5242). Additionally, using ArcGIS Collector (in: ESRI, ArcGIS desktop: release 10, Environmental Systems Research Institute, Redlands, 2011) volunteers collected geospatial data on tobacco use continuing to occur on campus following policy implementation. Overall there was moderate knowledge of the current policy and low beliefs for policy enforcement. Majority of respondents were not approaching violators to remind them of the policy and did not plan to do so in the future. There were statistically significant differences between smokers and non-smokers as well as between students and faculty and staff. The mapping of observed violations revealed continued tobacco use on campus with 158 data points. From both the geospatial results as well as the survey findings, the current policy is ineffective in reducing tobacco use across campus. With rapidly increasing numbers of smoke and tobacco free universities, new and innovative evaluation tools are needed so institution leaders can efficiently evaluate their implementation.

A Pilot Evaluation of a University Health and Wellness Coaching Program for College Students.

Poor mental well-being has been associated with negative student success outcomes among college students. Health and wellness coaching programs have been implemented in college campuses to address gaps in well-being support services. This pilot study evaluated a health and wellness coaching program at a large, urban university. A total of 499 students expressed interest in the program with 120 responding to a retrospective survey about their experience. Findings revealed that most students attended coaching for issues related to time and stress management or factors that commonly influence stress. Overall, students who participated in coaching were successful at improving their self-efficacy toward behavior change, changing their behavior, and achieving their goals. Students reported attending an average of four sessions with number of sessions attended being associated with increased confidence and motivation. In addition, autonomy, competence, and relatedness felt within the relationship with the coach were correlated with increased motivation, confidence, and readiness for behavior change. There was some relapse in terms of goal attainment observed with 17.4% of students who met their goals being unable to maintain progress. The program participants appeared to have enjoyed the process with 96% of students saying they would recommend the program to a friend. Health and wellness coaching programs may alleviate the burden of stress and other subclinical mental health concerns as well as decrease the number of students requiring services from more intensive mental health resources on campus.

Mental healthcare on college campuses during COVID-19: Comparing telehealth, in-person, and hybrid modes of delivery.

Objective: During COVID-19, many colleges offered mental health services to their students through telehealth or through a combination of telehealth and in-person (hereby hybrid) services. This study examines the experiences and perceptions among students who received telehealth, hybrid, or in-person services. Participants: Data was collected from the Healthy Minds Survey, a national survey of college students, during Fall 2020 and Spring/Winter 2021 (n = 13,976). Methods: Chi-square and Kruskal-Wallis H tests were conducted to examine how students who received campus mental health services through different modes of delivery differed in reported barriers to care, satisfaction with care, and perceived support. Results: Students receiving in-person services differed from students receiving telehealth or hybrid services on multiple metrics. For example, they were less likely to be satisfied with the quality of therapists or the ability to schedule appointments without long delays. However, effect sizes were small. Conclusion: There may be unique strengths to telehealth and hybrid services.

Knowledge of and satisfaction with a behavioral intervention team at a large urban southeastern university.

Background: Campus behavioral intervention teams (BITs) provide early identification of students and/or situations that may be a risk to the community, as well as determine and implement intervention plans for a safe resolution. Methods: An evaluation of 529 faculty and staff was conducted at a large urban, southeastern research university to assess BIT knowledge, triggers for referral, referral self-efficacy, referrals, and satisfaction regarding said university's BIT (Students of Concern Assistance Team, otherwise known as SOCAT). Results: Findings revealed low levels of knowledge, self-efficacy, and referrals among faculty and staff. Utilization of SOCAT resulted in high levels of satisfaction among the process and follow-up outcomes. Discussion: Findings from this study will guide future implementation by highlighting strategies to enhance the referrals to and utility of BITs on college campuses and identifying best practices in improving faculty and staff satisfaction with the referral system process for BITs.

A qualitative assessment of mental health literacy and help-seeking behaviors among male college students.

Although the number of students receiving care from college counseling centers has increased, engaging male college students to seek help presents a unique challenge. This qualitative study explored mental health literacy and help-seeking behaviors among undergraduate college men. Semi-structured interviews (n = 26) based on three vignettes (anxiety, depression, stress) were employed to assess mental health literacy. Analysis revealed three general themes and associated sub-themes: (a) knowledge of signs and symptoms (physiological, behavioral, and emotional); (b) recommended help-seeking behaviors (do nothing, self-care, seek help); and (c) barriers to help-seeking (social stigma, self-stigma, masculinity). Findings present a triadic interplay between the person, help-seeking behavior, and environment. Future research should explore this dynamic relationship to inform interventions aimed at improving college male mental health help-seeking behavior.

Indicators of transition success for youth living with HIV: perspectives of pediatric and adult infectious disease care providers.

Rates of HIV infection among adolescents in the US continues to rise, resulting in more individuals who must eventually transition from pediatric to adult care. It is critical that this process go smoothly to ensure continuity of care and to maximize patient outcomes. While research has examined youths' experiences with the transition process, disease-specific indicators of successful transition from pediatric to adult care remain undefined. Identifying indicators will facilitate the evaluation of transition processes, and, ultimately, the empirical determination of best practices. Interviews were conducted with 19 professionals who provide care for children and adults with HIV in southeastern state in the US. Approximately half of the providers self-identified as pediatric care providers. Nine of those interviewed were nurses and physicians and 10 were social workers. Providers had been working in the field of HIV for an average of 11.2 years. Interviews were taped, transcribed, and coded for emergent themes. Providers who care for HIV-infected youth identified both behavior and seriologic indicators of succesful transitions. Behavioral indicators identified were keeping appointments, medication adherence, and demonstrating ownership of medical care. Providers also identified serological markers of a succesful transition, specifically,viral load and CD4 count. Findings provided valuable insight into the perspectives of infectious disease care providers on indicators of successful transition from pediatric to adult care for adolescents with HIV. This is an important first step in developing empirical evaluation measures for transition practices and models. Similar research should be conducted with other groups of providers to assess the generalizability of these findings. Additionally, future research should seek to operationalize the identified behavioral indicators and determine appropriate values to indicate success for all indicators.

Best practices in transitioning youth with HIV: perspectives of pediatric and adult infectious disease care providers.

Recently, national attention has been drawn to the increasing number of adolescents infected with HIV in the US, particularly in the South. According to the Center for Disease Control and Prevention (2007), at least 50% of new HIV infections occur in persons 15-25 years of age, and the majority of these persons are likely infected in their teens. Adolescents with HIV present new challenges to health and social-service providers. Infected teens are typically identified and initially followed by pediatricians and pediatric staff upon diagnosis. The transition to adult infectious disease care can be difficult due to the increased responsibility for self-care and monitoring placed on the young adult. Interviews were conducted with 19 professionals who provide care for children and adults with HIV in North Carolina in order to identify the best practices for transition to adult care. Approximately half of the providers self-identified as pediatric care providers. Nine of those interviewed were nurses and physicians and 10 were social workers. Interviews were transcribed and emergent themes were identified. Findings indicate that promoting medical independence among adolescents, close communication between pediatric and adult providers, and addressing system level concerns, including helping patients' families navigate health insurance and other social services, as well as having a separate clinic for adolescents with HIV, constitute best practices for transitioning youth with HIV from pediatric to adult care.

The Effects of Stigma on Determinants of Mental Health Help-Seeking Behaviors Among Male College Students: An Application of the Information-Motivation-Behavioral Skills Model.

Considered a public health issue, the prevalence and severity of poor mental well-being on college campuses has continued to rise. While many college campuses offer mental health counseling services, and utilization rates are increasing, their proportional usage is low especially among males, who often deal with poor mental well-being by adopting unhealthy coping strategies. The purpose of this study was to use the Information-Motivation-Behavioral Skills (IMB) model to assess the relationship between the determinants as factors that may impact help-seeking behaviors in a large sample ( n = 1,242) of male college students. Employing a cross-sectional study design, a 71-item online survey assessed information via total mental health literacy (MHL), motivation via attitudes toward mental health and subjective norms regarding mental health, and behavioral skills via intentions regarding help-seeking behaviors, and stigma. Results revealed correlations between information and motivation ( r = .363, p < .01), information and behavioral skills ( r = .166, p < .01), and motivation and behavioral skills ( r = .399, p < .01). Multiple regression was used to determine stigma is a mediator for all relationships. These findings represent an opportunity to take a public health approach to male mental health through developing multilayered interventions that address information, motivation, behavioral skills, and stigma.

Mental health literacy, stigma, and help-seeking behaviors among male college students.

OBJECTIVE: Mental health literacy (MHL) is low in college-aged men potentially resulting in impaired mental wellbeing. This study assessed MHL, psychosocial determinants, and help-seeking behaviors among male university students. PARTICIPANTS: Male undergraduate and graduate students were surveyed in Spring 2017 (n = 1,242) at a large southeastern university in the United States. METHODS: Preexisting validated scales for MHL, psychosocial determinants, and help-seeking intention were used in measurement and demographic variables were collected. T-tests and one-way ANOVA were performed to measure differences between groups. RESULTS: Participants showed low scores for all constructs with statistically significant differences between undergraduate and graduate students, as well as between races and major classifications. Undergraduate men had moderate MHL and low intentions to seek professional care. CONCLUSIONS: Interventions focusing on increasing mental health knowledge and improving beliefs can improve MHL among male college students. Further, interventions should be tailored for racial groups and major classifications.

Hormonal Contraception, depression, and Academic Performance among females attending college in the United States.

Associations between Hormonal Contraception (HC) and Depression have been previously reported, and indicate increased risk to younger women. These relationships need be explored and expanded to include measures of impact on Academic Performance (AP). Data was acquired from the National College Health Assessment (NCHA), administered from Fall 2008 to Spring 2015 across 370 schools nationwide. The most popular HC method was oral, followed by an IUD, and vaginal ring. HC use increased across all ages groups 18-29, and then decreased in the 30-34 age group. HC use significantly increased the odds of ever being diagnosed with depression in all age groups. HC use was found to have significantly increased odds of reporting AP issues in the 18-19 age group and to have significantly decreased odds of reporting AP issues in the 25-29 age group. Adding depression as a moderator, HC use continued to significantly increase the odds of AP issues. Women and their providers should balance the risks and benefits of initiating HC. Specifically, younger women, and be advised of the risks that HC presents in terms of a potential association with depression. Efforts to develop standardized protocols for discussing the risk-benefits for HC therapy should be pursued.

Design Considerations for Patient Portal Adoption by Low-Income, Older Adults.

This paper describes the results of an interview study investigating facilitators and barriers to adoption of patient portals among low-income, older adults in rural and urban populations in the southeastern United States. We describe attitudes of this population of older adults and their current level of technology use and patient portal use. From qualitative analysis of 36 patient interviews and 16 caregiver interviews within these communities, we derive themes related to benefits of portals, barriers to use, concerns and desired features. Based on our initial findings, we present a set of considerations for designing the patient portal user experience, aimed at helping healthcare clinics to meet U.S. federally-mandated 'meaningful use' requirements.