Positive Early Childhood Experiences and School Readiness among US Preschoolers.

OBJECTIVES: To characterize the relationship between positive early childhood experiences (PECEs) and school readiness, and assess whether the PECEs-school readiness relationship was robust to and/or differed across levels of adverse childhood experiences (ACEs). METHODS: We analyzed national data on children ages 3-5 from 2016 to 2020 (n = 26 871) to examine associations between key PECE domains (nurturing relationships, home learning opportunities, safe and stable environments, and family routines) with being on track for school readiness, defined using a pilot, multidimensional measure called "healthy and ready to learn". Weighted univariate, bivariate, and multivariable analyses were conducted to generate nationally representative estimates. Multivariable models adjusted for sociodemographic factors and were assessed both with and without cumulative ACE exposure. RESULTS: Two-fifths of children were healthy and ready to learn. Exposure to PECEs was associated with higher school readiness, irrespective of relative ACE exposure. Compared with those with low PECEs, children with moderate (aOR, 2.19; 95% CI, 1.86-2.58) and high (aOR, 4.37; 95% CI, 3.58-5.34) PECEs had greater odds for being healthy and ready to learn, net of both sociodemographic factors and ACE exposure. Significant associations were robust across demographic groups (eg, race and ethnicity), ACE levels, and ACE types (eg, parental incarceration). CONCLUSIONS: Increasing PECEs correspond with greater likelihood of possessing capacities key for school functioning, even amidst ACEs. In concert with efforts to ameliorate early life trauma, caregivers, health care providers, educators, and systems can consider boosting PECEs to foster healthy development in childhood and beyond.

A review and synthesis of frameworks for engagement in health research to identify concepts of knowledge user engagement.

BACKGROUND: Engaging those who influence, administer and/or who are active users ("knowledge users") of health care systems, as co-producers of health research, can help to ensure that research products will better address real world needs. Our aim was to identify and review frameworks of knowledge user engagement in health research in a systematic manner, and to describe the concepts comprising these frameworks. METHODS: An international team sharing a common interest in knowledge user engagement in health research used a consensus-building process to: 1) agree upon criteria to identify articles, 2) screen articles to identify existing frameworks, 3) extract, analyze data, and 4) synthesize and report the concepts of knowledge user engagement described in health research frameworks. We utilized the Patient Centered Outcomes Research Institute Engagement in Health Research Literature Explorer (PCORI Explorer) as a source of articles related to engagement in health research. The search includes articles from May 1995 to December 2017. RESULTS: We identified 54 articles about frameworks for knowledge user engagement in health research and report on 15 concepts. The average number of concepts reported in the 54 articles is n = 7, and ranges from n = 1 to n = 13 concepts. The most commonly reported concepts are: knowledge user - prepare, support (n = 44), relational process (n = 39), research agenda (n = 38). The least commonly reported concepts are: methodology (n = 8), methods (n = 10) and analysis (n = 18). In a comparison of articles that report how research was done (n = 26) versus how research should be done (n = 28), articles about how research was done report concepts more often and have a higher average number of concepts (n = 8 of 15) in comparison to articles about how research should be done (n = 6 of 15). The exception is the concept "evaluate" and that is more often reported in articles that describe how research should be done. CONCLUSIONS: We propose that research teams 1) consider engagement with the 15 concepts as fluid, and 2) consider a form of partnered negotiation that takes place through all phases of research to identify and use concepts appropriate to their team needs. There is a need for further work to understand concepts for knowledge user engagement.

A descriptive study of sleep patterns and knowledge among department of juvenile services staff.

Study Objectives: Little is known about sleep health among staff in the US juvenile justice system. Poor sleep health is associated with negative mental and physical health, which may impact daily interactions and treatment of detained youth. The current study explored sleep-wake patterns and sleep health knowledge of Department of Juvenile Services (DJS) staff in Maryland (MD). Methods: DJS Staff (N = 218) were invited to complete a survey that queried staff on their own sleep-wake patterns, job role and schedule, and knowledge of youth sleep needs. Descriptive analyses and multivariate analyses of variance (MANCOVA) were conducted to summarize workers' sleep-wake patterns and examine differences by staff position and schedule. Results: Fifty-one percent of staff served as RAs who directly supervise the youth. Just over half (55%) worked in detention and 45% in treatment facilities. Staff reported sleeping 7.24 hours (SD = 4.10) on workdays and 8.59 hours (SD = 2.69) on non-workdays. RA staff working night/rotating versus day shifts reported the most sleep irregularity with larger weekend oversleep times. A little more than half of the staff (53.9%) were knowledgeable regarding youth sleep health with differences by position type. Conclusions: Findings show that DJS staff are meeting recommended sleep duration guidelines but are still experiencing sleep schedule and time in bed irregularity. Knowledge variability of youth sleep health across staff may necessitate focused educational programming. Overall, this study may inform future development and prioritization of sleep and circadian health interventions and educational campaigns for staff who work with detained juveniles. This paper is part of the Sleep and Circadian Health in the Justice System Collection.

Childhood Bereavement, Adverse and Positive Childhood Experiences, and Flourishing among Chinese Young Adults.

Childhood bereavement (CB) resulting from a parent or primary caregiver death is associated with a range of adverse outcomes. Little is known about the association between CB and adult flourishing in the context of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs). In a cross-sectional observational study, we examined how ACEs, PCEs, and adult flourishing differs by self-reported CB history among 9468 Chinese young adults (18-35 years), of which 4.3% experienced CB (n = 409). Data collection included convenience sampling among university students in Mainland China. Respondents voluntarily completed an online survey between August and November 2020. Descriptive statistics, chi-square tests, and logistic regressions examined frequencies and differences in ACEs, PCEs, and flourishing by the history of CB controlling for a few demographic covariates. Bereaved individuals reported significantly higher ACEs and lower PCEs. The odds of experiencing emotional, physical, and sexual abuse as well as household substance abuse, parental mental illness, and parental incarceration ranged from 2.0-5.2 times higher for bereaved individuals. Bereaved participants also reported significant negative relationships with Flourishing Index (ß = -0.35, t = -4.19, p < 0.001) and Secure Flourishing Index (ß = -0.40, t = -4.96, p < 0.001). Consistent with previous research, our findings demonstrate the lasting effects of CB on well-being. We discuss study implications for ACEs and PCEs screening and surveillance as well as grief counseling to promote flourishing among bereaved youth in China and beyond.

Adverse Childhood Experiences and Cardiovascular Risk among Young Adults: Findings from the 2019 Behavioral Risk Factor Surveillance System.

Background: Heart disease is the fourth leading cause of death for young adults aged 18-34 in the United States. Recent research suggests that adverse childhood experiences (ACEs) may shape cardiovascular health and its proximate antecedents. In the current study, we draw on a contemporary, national sample to examine the association between ACEs and cardiovascular health among young adults in the United States, as well as potential mediating pathways. Methods: The present study uses data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) to examine associations between ACEs and cardiovascular risk, as well as the role of cumulative disadvantage and poor mental health in these associations. Results: Findings indicate that young adults who have experienced a greater number of ACEs have a higher likelihood of having moderate to high cardiovascular risk compared to those who have zero or few reported ACEs. Moreover, both poor mental health and cumulative disadvantage explain a significant proportion of this association. Conclusions: The present findings suggest that young adulthood is an appropriate age for deploying prevention efforts related to cardiovascular risk, particularly for young adults reporting high levels of ACEs.