Navigating Both Roles: A Photovoice Exploration of the Young Adult Balancing Daughterhood and Caregiving for a Mother With Young-Onset Dementia.

Young adults thrust into the role of caregiving for parents with young-onset dementia (YOD) face unique challenges during their formative years. While existing research acknowledges the crucial role of young adult caregivers, a gap persists in understanding how this group experiences and redefines their identity amidst these circumstances, along with the psychological and societal challenges encountered. This knowledge deficit hinders the identification of suitable social support, adversely affecting the personal growth and well-being of these young adult caregivers. In this single-case study, we used a combination of a semi-structured interview and photovoice to explore the journey of a 19-year-old caregiver, Alice, whose mother had been diagnosed with dementia in the preceding 3 years. Through this unique perspective, we aimed to illuminate how caregiving for a mother with YOD may profoundly redefine familial roles and relationships. Over 3 months, Alice captured significant life moments through photography, selecting meaningful images for bi-weekly meetings. These images served as pivotal themes, triggering in-depth conversations during subsequent interviews to provide nuanced insights into her life experiences. Findings reveal four major themes faced by a young caregiver: (1) challenges adapting to an unexpected role, (2) navigating the complex emotional terrain of losing a loved one to YOD, (3) prioritizing the well-being of the healthy parent, and (4) expressing a profound desire for both informal and formal support. These results underscore the intricate identity and emotional challenges faced by young adult caregivers, emphasizing the urgency of addressing their unique needs through family-centered systemic support services.

Linking Adverse Childhood Experiences and Other Risk Factors to Subjective Cognitive Decline in an Aging Population.

Introduction: The Centers for Disease Control and Prevention's Healthy Brain Initiative (HBI) encourages an interdisciplinary approach to addressing the burden of subjective cognitive decline (SCD) among the aging US population as that population continues to increase. Our study is one of the first to evaluate associations between SCD and adverse childhood experiences (ACEs) and other modifiable risk factors to support implementation of the initiative. Methods: We used multivariate logistic regression to assess data from the 2020 Behavioral Risk Factor Surveillance System survey to evaluate associations between SCD and ACEs scores and sociodemographic, behavioral, and clinical risk factors. Models were weighted to account for the complex survey design. Results: Approximately 8.1% of survey respondents reported experiencing SCD within the past 12 months. Adjusted regression analysis showed that conditions such as depression (AOR, 2.85; 95% CI, 2.29-3.55), arthritis (AOR, 1.30; 95% CI, 1.05-1.60), and diabetes (AOR, 1.33; 95% CI, 1.05-1.68) were significantly associated with SCD. SCD was also associated with experiencing more than 3 falls per year (AOR, 2.95; 95% CI, 2.13-4.09), sleeping more than 9 hours per night (AOR, 2.06; 95% CI, 1.37-3.09), and physical inactivity (AOR, 1.32; 95% CI, 1.03-1.68). Two or more ACEs also significantly increased the odds of SCD (AOR, 1.69; 95% CI, 1.36-2.10). Conclusion: Findings from our study can be used to inform policy, environment, and systems change efforts aimed at addressing modifiable risk factors to support healthy aging. The role of ACEs as determinants of brain health across the life course should also be considered in the design of clinical and community-based interventions.

Community-Based Recreational Therapy for Veterans with Behavioral Health Disorders: Impacts on Quality of Life, Participation, and Happiness.

Identifying evidenced-based interventions that improve health outcomes for Veterans with behavioral health disorders is a national priority. Thus, this study examined the outcomes of a community-based recreational therapy (RT) program focused on health promotion for Veterans with behavioral health disorders. Fifty-five Veterans with disabilities completed pretest and posttest questionnaires that assessed Quality of Life (QOL), Participation, and Happiness. Significant improvements were found in Overall QOL, Environmental QOL, Psychological QOL, QOL Rated, Satisfaction with Health, Participation, and Happiness. Younger age and female gender were significantly associated with improved Overall QOL. Factors significantly associated with improved Environmental QOL included younger age and non-Caucasian race. Older age was significantly associated with improved Participation. Female gender was positively associated with improved Happiness, while being divorced/separated was negatively associated with Happiness. These results have important implications for the use and expansion of community-based RT health promotion programs for Veterans with behavioral health disorders.

Understanding farmers' conservation behavior over time: A longitudinal application of the transtheoretical model of behavior change.

Global waterbodies are experiencing increased risk of eutrophication and harmful algal blooms due to excess nutrients including phosphorus and nitrogen discharged from human activity on the landscape and as a result of climate change. Despite modeling that suggests the efficacy of best management practices in agricultural systems to be sufficient to address the problem, adoption by farmers remains far below the levels needed to achieve significant water quality improvements and new approaches to encourage and sustain adoption are urgently needed. In this work, we apply a modified transtheoretical model (TTM) of behavior change to a longitudinal dataset (N = 584) of farmers' adoption decisions and stated intentions to use cover crops, collected in the Maumee Basin of Lake Erie, USA in 2016 and 2018. The TTM posits that behavior changes over time and is influenced by different social-psychological processes at each stage of change. Our findings confirm past research into the importance of many of the factors investigated, while providing new insight into their role in specific stages of the change process with potential implications for the design of interventions for farmers in different stages. Several factors investigated (mean environmental concern, education, information from conservation groups and off-farm income) were uniquely important to a particular stage. Other factors (response efficacy at the field level, total farm size and risks of spring planting interference) were important at both an earlier and later stage, but less important in predicting middle stages of change. A third set of factors (self-efficacy, proportion rented, no-till adoption and uncertain long-term paybacks) were statistically important across each stage of the TTM model. In applying the TTM longitudinally, we found evidence that farmers in a more advanced stage of cover crop adoption, in the first wave of data collection (2016) were more likely to have adopted cover crops in the second wave (2018), a result not predicted by individual factors alone. We report findings for cover crops but see the potential for the transtheoretical model of behavior change to be applied to other best management practice adoption decisions and to diverse populations of farmers to generate similarly novel insight and utility for intervention design and targeting.

Social-ecological theory, substance misuse, adverse childhood experiences, and adolescent suicidal ideation: Applications for community-academic partnerships.

Suicide is the second leading cause of death among youth in the United States. Data from the 2015 Youth Risk Behavior Survey of 9th-12th grade students in New Hampshire (N = 14,837) were utilized. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models to evaluate associations between suicidal ideation, adverse childhood experiences (ACEs), and other risk factors including using opioids/drugs without a prescription and food insecurity. We also examined whether potentially protective behaviors may attenuate the relationship between ACEs and suicidal ideation. The prevalence of suicidal ideation was 15.4% (girls 20.15; boys 10.67). In unadjusted models, the crude odds ratio reflecting the relationship between suicidal ideation and higher ACE scores was 1.85 (95% CI 1.76-1.94). In adjusted models, suicidal ideation remained positively associated with higher ACE scores (aOR 1.61, 95% CI 1.52-1.70). Risk and protective behavioral factors identified in relation to suicidal ideation and ACEs are discussed within the context of community-academic partnerships and policy.

Associations between dietary fatty acid patterns and cognitive function in the Hispanic Community Health Study/Study of Latinos.

Our objective was to quantify the cross-sectional associations between dietary fatty acid (DFA) patterns and cognitive function among Hispanic/Latino adults. This study included data from 8,942 participants of the Hispanic Community Health Study/Study of Latinos, a population-based cohort study (weighted age 56.2 y and proportion female 55.2%). The NCI (National Cancer Institute) method was used to estimate dietary intake from two 24-hr recalls. We derived DFA patterns using principal components analysis with 26 fatty acid and total plant and animal monounsaturated fatty acid (MUFA) input variables. Global cognitive function was calculated as the average z-score of 4 neurocognitive tests. Survey linear regression models included multiple potential confounders such as age, sex, education, depressive symptoms, physical activity, energy intake, and cardiovascular disease. DFA patterns were characterized by consumption of long-chain saturated fatty acids (SFA), animal-based MUFA, and trans fatty acids (Factor 1); short to medium-chain SFA (Factor 2); very-long-chain omega-3 polyunsaturated fatty acids (PUFA) (Factor 3); very-long-chain SFA and plant-based MUFA and PUFA (Factor 4). Factor 2 was associated with greater scores for global cognitive function (ß=0.037 ± 0.012) and the Digit Symbol Substitution (DSS) (ß=0.56±0.17), Brief Spanish English Verbal Learning-Sum (B-SEVLT) (ß=0.23 ± 0.11), and B-SEVLT-Recall (ß=0.11 ± 0.05) tests (P<0.05 for all). Factors 1 (ß=0.04 ± 0.01) and 4 (ß=0.70 ± 0.18) were associated with the DSS test (P<0.05 for all). Consumption of short to medium-chain SFA may be associated with higher cognitive function among U.S.-residing Hispanic/Latino adults. Prospective studies are necessary to confirm these findings.

Developing Core Capabilities for Local Health Departments to Engage in Land Use and Transportation Decision Making for Active Transportation.

OBJECTIVE: To develop a core set of capabilities and tasks for local health departments (LHDs) to engage in land use and transportation policy processes that promote active transportation. DESIGN: We conducted a 3-phase modified Delphi study from 2015 to 2017. SETTING: We recruited a multidisciplinary national expert panel for key informant interviews by telephone and completion of a 2-step online validation process. PARTICIPANTS: The panel consisted of 58 individuals with expertise in local transportation and policy processes, as well as experience in cross-sector collaboration with public health. Participants represented the disciplines of land use planning, transportation/public works, public health, municipal administration, and active transportation advocacy at the state and local levels. MAIN OUTCOME MEASURES: Key informant interviews elicited initial capabilities and tasks. An online survey solicited rankings of impact and feasibility for capabilities and ratings of importance for associated tasks. Feasibility rankings were used to categorize capabilities according to required resources. Results were presented via second online survey for final input. RESULTS: Ten capabilities were categorized according to required resources. Fewest resources were as follows: (1) collaborate with public officials; (2) serve on land use or transportation board; and (3) review plans, policies, and projects. Moderate resources were as follows: (4) outreach to the community; (5) educate policy makers; (6) participate in plan and policy development; and (7) participate in project development and design review. Most resources were as follows: (8) participate in data and assessment activities; (9) fund dedicated staffing; and (10) provide funding support. CONCLUSIONS: These actionable capabilities can guide planning efforts for LHDs of all resource levels.

Qualitative Exploration of Cross-Sector Perspectives on the Contributions of Local Health Departments in Land-Use and Transportation Policy.

INTRODUCTION: Transportation and land-use policies can affect the physical activity of populations. Local health departments (LHDs) are encouraged to participate in built-environment policy processes, which are outside their traditional expertise. Cross-sector collaborations are needed, yet stakeholders' perceptions of LHD involvement are not well understood. The objective of this study was to describe the perceived value of LHD participation in transportation and land-use decision making and potential contributions to these processes among stakeholders. METHODS: We analyzed qualitative data from 49 semistructured interviews in 2015. Participants were professionals in 13 US states and 4 disciplines: land-use planning (n = 13), transportation/public works (n = 11), public health (n = 19), and other (municipal administration and bike and pedestrian advocacy [n = 6]). Two analysts conducted directed content analysis. RESULTS: All respondents reported that LHDs offer valuable contributions to transportation and land-use policy processes. They identified 7 contributions (interrater agreement 91%): 1) physical activity and health perspective (n = 44), 2) data analysis and assessment (n = 41), 3) partnerships in the community and across sectors (n = 35), 4) public education (n = 27), 5) knowledge of the public health evidence base and best practices (n = 23), 6) resource support (eg, grant writing, technical assistance) (n = 20), and 7) health equity (n = 8). CONCLUSION: LHDs can leverage their strengths to foster cross-sector collaborations that promote physical activity opportunities in communities. Our results will inform development of sustainable capacity-building models for LHD involvement in built-environment decision making.

A case study characterizing animal fecal sources in surface water using a mitochondrial DNA marker.

Water quality impairment by fecal waste in coastal watersheds is a public health issue. The present study provided evidence for the use of a mitochondrial (mtDNA) marker to detect animal fecal sources in surface water. The accurate identification of fecal pollution is based on the notion that fecal microorganisms preferentially inhabit a host animal's gut environment. In contrast, mtDNA host-specific markers are inherent to eukaryotic host cells, which offers the advantage by detecting DNA from the host rather than its fecal bacteria. The present study focused on sampling water presumably from non-point sources (NPS), which can increase bacterial and nitrogen concentrations to receiving water bodies. Stream sampling sites located within the Piscataqua River Watershed (PRW), New Hampshire, USA, were sampled from a range of sites that experienced nitrogen inputs such as sewer and septic systems and suburban runoff. Three mitochondrial (mtDNA) gene marker assays (human, bovine, and canine) were tested from surface water. Nineteen sites were sampled during an 18-month period. Analyses of the combined single and multiplex assay results showed that the proportion of occurrence was highest for bovine (15.6%; n = 77) compared to canine (5.6%; n = 70) and human (5.7%; n = 107) mtDNA gene markers. For the human mtDNA marker, there was a statistically significant relationship between presence vs. absence and land use (Fisher's test p = 0.0031). This result was evident particularly for rural suburban septic, which showed the highest proportion of presence (19.2%) compared to the urban sewered (3.3%), suburban sewered (0%), and agricultural (0%) as well as forested septic (0%) sites. Although further testing across varied land use is needed, our study provides evidence for using the mtDNA marker in large watersheds.

Spatial and temporal patterns of North Carolina pedestrian and bicycle plans.

CONTEXT: Pedestrian and bicycle plans support community-level physical activity. In North Carolina, pedestrian/bicycle plans are becoming more prevalent. However, no studies have examined the spatial and temporal diffusion of pedestrian/bicycle plans. OBJECTIVES: This study assessed (a) temporal trends associated with municipal pedestrian/bicycle planning from 1974 to 2011 and (b) spatial patterns associated with municipal plans, specifically, whether the publication of a pedestrian/bicycle plan in a given year was associated with the number of neighboring municipalities with plans. SETTING: North Carolina from 1974 to 2011. MAIN OUTCOME MEASURES: The main outcome was date of publication of all North Carolina municipal pedestrian and bicycle plans (1974-2011). We calculated Euclidean distances from each municipality center to all other municipality centers to derive whether municipalities were within 20 and 50 miles of each other. Sociodemographic covariates (eg, education, grant funding status, poverty, urbanicity, racial composition, population size, population growth) were collected from the US Census of Population (1980-2010) and the American Community Survey (2006-2010). Time series models fitted by generalized estimating equations were used to assess relationships between plan presence and the temporal and spatial predictor variables. RESULTS: The number of pedestrian and bicycle plans significantly increased over time, especially after 2006 when a state grant funding program was initiated. Unadjusted models indicated that municipalities were significantly more likely to have a pedestrian plan if higher numbers of neighboring municipalities had pedestrian plans. After adjustment for sociodemographic covariates and funding source, this relationship was attenuated but remained statistically significant. For bicycle plans, no significant associations were observed between plan presence and the number of neighboring municipalities with bicycle plans in adjusted models. CONCLUSIONS: Findings from this study can be used to generate hypotheses to test theories about diffusion of innovation and social contagion processes in pedestrian/bicycle planning.

Policy, systems, and environmental approaches for obesity prevention: a framework to inform local and state action.

The public health literature has not fully explored the complexities of the policy process as they relate to public health practice and obesity prevention. We conducted a review of the literature across the policy science and public health fields, distilled key theories of policy making, and developed a framework to inform policy, systems, and environmental change efforts on obesity prevention. Beginning with a conceptual description, we focus on understanding three domains of the policy process: the problem domain, the policy domain, and the political domain. We identify key activities in the policy process including the following: (a) assessing the social and political environment; (b) engaging, educating and collaborating with key individuals and groups; (c) identifying and framing the problem; (d) utilizing available evidence; (e) identifying policy solutions; and (f) building public support and political will. The article provides policy change resources and case studies to guide and support local and state efforts around obesity prevention.

Effects of Telehealth Parent Coaching in Supporting Family Participation, Cohesion, and Adaptability.

Families provide foundational contexts in which most children develop and grow. For families of children with special health care needs (CSHCN), interdisciplinary supports can build family participation capacities, beyond individualistic child supports. This single-group pretest-posttest quasi-experimental study sought to determine the preliminary effects of the Healthy Families Flourish Program (HFFP), a telehealth occupation-based parent coaching intervention to promote participation, cohesion, adaptability, and communication for families of CSHCN. Eleven families, including 17 parents and 27 children, completed the 10-session intervention consisting of parent education and individualized coaching. Participants completed the Canadian Occupational Performance Measure, Goal Attainment Scaling, and the Family Adaptability and Cohesion Evaluation Scales pre-/post-intervention. Within-group comparisons showed improvements in family participation, cohesion, adaptability, and communication with Cohen's d effect sizes ranging from 0.55-3.32. Researchers found positive relationships between family participation and cohesion as well as participation and adaptability. Findings provide considerations for supporting families within socioecological contexts.

The Institute of Medicine's call to action revisited: assuring access to public health education for U.S. college students.

The Educated Citizen and Public Health initiative promotes that an understanding of public health issues is a principal component of an educated population and is necessary to develop social responsibility and promote civic dialog. This initiative supports the Institute of Medicine's (now the National Academy of Medicine) recommendation that "all undergraduates should have access to education in public health." The purpose of our work is to examine the extent to which 2- and 4-year U.S. state colleges and universities offer and/or require a public health course. Select indicators identified include the presence and type of public health curriculum, public health course requirement, presence of public health graduate program offering, pathways to public health, Community Health Worker training, as well as demographic information for each institution. An analysis was also conducted for the historically Black colleges and universities (HBCUs), and the same select indicators were examined. The data suggest that there is an imperative need for a public health curriculum across the nation's collegiate institutions with 26% of 4-year state institutions lacking a full undergraduate public health curriculum; 54% of 2-year colleges not offering a pathway to public health education; and 74% of HBCUs not offering a public health course or degree. In the age of COVID-19, syndemics, and considering the post-pandemic phase, we argue that expanding public health literacy at the associate and baccalaureate level can help prepare an educated citizenry who is both public health literate and one that can demonstrate resilience in the face of public health challenges.

Parent Satisfaction With a Telehealth Parent Coaching Intervention to Support Family Participation.

COVID-19 catalyzed telehealth practice creating opportunities for clients and providers to discern best applications. Parent satisfaction with services supports partnership within therapy processes, potentially augmenting outcomes. We examined parent satisfaction levels and experiences with the telehealth approach of a parent coaching intervention for families of children with special health care needs (CSHCNs). We used a mixed-methods descriptive design. Fifteen parents completed the Telehealth Usability Questionnaire (TUQ) and a semistructured interview. We analyzed TUQ ratings using descriptive statistics, and we thematically analyzed participants' telehealth experiences. Parents found telehealth useful, easy to use, effective, reliable, and satisfactory. Parents described that telehealth addressed needs conveniently, enhanced parent-provider communication, and fostered shared parent involvement. Telehealth appears to be a satisfactory occupational therapy service delivery approach for parents of CSHCN. Findings build preliminary evidence for understanding for whom telehealth is well suited, supporting determination of relevant, fundable telehealth services.

Scoping Conceptions of Equity: Reviewing a Decade of Physical Activity Research.

Lee and Cubbin's (2009) call for a "socially just" Ecological Model of Physical Activity (EMPA) prompted an inquiry into physical activity (PA), active living (AL) research that advances social justice framed as a set of equity-centered principles for research. In response to the call, we conducted a scoping review to explore how PAAL research has operationalized equity to advance a socially-just EMPA. We searched for original research, published between 2010 and 2020, using key terms for 'physical activity' and 'equity' that produced 5,152 non-duplicated records. Title-abstract screening for exclusion/inclusion criteria disqualified 4,392 records. A review protocol and coding guide was developed, piloted, and revised by team members. The remaining 760 abstracts were reviewed and consensus coded for PA Variable (dependent or independent) and Factor (individual outcome or contextual exposure), Equity (population demographic or social-environmental determinant), and Social Ecological Milieu (SEM) (PAAL-specific or SEM-general policy, system, or environment (PSE) operations. Of the 463 studies selected, PA codified as an individual outcome (67%) more often than as a contextual-exposure (33%) factor. Equity codified more frequently as a population demographic (69%) rather than as a social-environmental determinant (31%). The SEM codified as PAAL-specific (44%) or as SEM-general (56%) PSE factors. Based on multistep study abstract reviews, the selected studies more often missed the opportunity to center equity in PAAL research by examining social, environmental, political, and systemic factors as institutionalized inequities at the root of PAAL disparities. We will not achieve a socially-just EMPA without shared conceptualizations of equity followed by intentional action.

Reimagining the Role of Health Departments and Their Partners in Addressing Climate Change: Revising the Building Resilience against Climate Effects (BRACE) Framework.

Public health departments have important roles to play in addressing the local health impacts of climate change, yet are often not well prepared to do so. The Climate and Health Program (CHP) at the Centers for Disease Control and Prevention (CDC) created the Building Resilience Against Climate Effects (BRACE) framework in 2012 as a five-step planning framework to support public health departments and their partners to respond to the health impacts of climate change. CHP has initiated a process to revise the framework to address learnings from a decade of experience with BRACE and advances in the science and practice of addressing climate and health. The aim of this manuscript is to describe the methodology for revising the BRACE framework and the expected outputs of this process. Development of the revised framework and associated guidance and tools will be guided by a multi-sector expert panel, and finalization will be informed by usability testing. Planned revisions to BRACE will (1) be consistent with the vision of Public Health 3.0 and position health departments as "chief health strategists" in their communities, who are responsible for facilitating the establishment and maintenance of cross-sector collaborations with community organizations, other partners, and other government agencies to address local climate impacts and prevent further harm to historically underserved communities; (2) place health equity as a central, guiding tenet; (3) incorporate greenhouse gas mitigation strategies, in addition to its previous focus on climate adaptation; and (4) feature a new set of tools to support BRACE implementation among a diverse set of users. The revised BRACE framework and the associated tools will support public health departments and their partners as they strive to prevent and reduce the negative health impacts of climate change for everyone, while focusing on improving health equity.

Complexity in built environment, health, and destination walking: a neighborhood-scale analysis.

This study investigates the relationships between the built environment, the physical attributes of the neighborhood, and the residents' perceptions of those attributes. It focuses on destination walking and self-reported health, and does so at the neighborhood scale. The built environment, in particular sidewalks, road connectivity, and proximity of local destinations, correlates with destination walking, and similarly destination walking correlates with physical health. It was found, however, that the built environment and health metrics may not be simply, directly correlated but rather may be correlated through a series of feedback loops that may regulate risk in different ways in different contexts. In particular, evidence for a feedback loop between physical health and destination walking is observed, as well as separate feedback loops between destination walking and objective metrics of the built environment, and destination walking and perception of the built environment. These feedback loops affect the ability to observe how the built environment correlates with residents' physical health. Previous studies have investigated pieces of these associations, but are potentially missing the more complex relationships present. This study proposes a conceptual model describing complex feedback relationships between destination walking and public health, with the built environment expected to increase or decrease the strength of the feedback loop. Evidence supporting these feedback relationships is presented.

Exploring a public health perspective on pedestrian planning.

A pedestrian plan is a public document that explains a community's vision and goals for future pedestrian activity. This study explored whether involvement by public health professionals in the development of pedestrian plans was associated with certain characteristics of the plan (vision, goals, identified programs, and evaluation). This study identified, collected, and analyzed content of all pedestrian plans in North Carolina through 2008. Among the 46 plans, 39% reported involvement by public health professionals in their development. Overall, 72% of pedestrian plans included a vision statement; health was mentioned four times and quality of life was mentioned five times. Slightly more than half (52%) of the plans included goals to improve public health. Plans that involved public health professionals more often included the type of physical activity, safety, or education program. Only 22% of all pedestrian plans included a proposal to evaluate their implementation. Plans that included public health professionals were less likely to include an evaluation proposal (11%) compared with those that did not involve public health professionals (21%). Public health professionals are encouraged to seek involvement in the pedestrian planning process, particularly in the areas of health program development, implementation, and evaluation.

Assuring Healthy Populations During the COVID-19 Pandemic: Recognizing Women's Contributions in Addressing Syndemic Interactions.

A syndemic framework examines disease interactions and the contributions of structural, social, economic, and environmental factors that synergistically interact to contribute to adverse health outcomes. Populations residing in environments with structural susceptibilities experience health disparities and syndemics to a greater extent than their less vulnerable counterparts. The interactions among the social determinants of health (SDoH) and the COVID-19 pandemic have had different results for marginalized populations and have worsened health outcomes for many in this synergistic pandemic. Also, the exposome, the exposure measures for an individual over their lifetime and how those exposures relate to the individual's health, may help to explain why some populations experience more serious cases of COVID-19 compared to other groups. The purpose of this perspective is to: (1) examine the relationship between the syndemic model and the SDoH-exposome; (2) highlight, via specific examples, the contributions of female health professionals to SDoH and the COVID-19 syndemic in response to the Women in Science Research Topic, and (3) propose health policy to address syndemic-exposome interactions to help mitigate or prevent public health challenges. By investing in policies that assure health for all populations, the investments could pay dividends in the form of a less severe syndemic next time since we are starting from a place of health and not disease. Lastly, due to the magnification of underlying societal inequities laid bare during the COVID-19 syndemic, we support the expansion of the disease-focused syndemic model to include societal syndemics, such as systemic racism.

Aligning Physical Literacy With Critical Positive Youth Development and Student-Centered Pedagogy: Implications for Today's Youth.

The purpose of this article is three-fold: (1) revisit the concept of life skills to position physical literacy as a social justice life skill; (2) make the argument that physical literacy is particularly relevant within a critical positive youth development perspective; and (3) propose a novel critical praxis for developing physical literacy amongst youth. When considering emergent social issues, youth programming has the potential to integrate concepts from a range of theoretical frameworks, which may help youth transform into social change activists and competent movers. Such critical perspectives may guide sport and physical education programming as contemporary society poses numerous challenges concerning youths' diverse emotional, mental, physical, and social needs. In order to advance knowledge and practice, we urge researchers and practitioners to rethink the way sport and physical education has been traditionally conceptualized. Ultimately, we propose that educating individuals to recognize and then confront neoliberal values within a post-pandemic landscape is critical. These notions may help researchers (re)frame their positionality and readiness to tackle physical literacy through broader theoretical lenses which-as alluded to in this article-may equip practitioners and researchers to meaningfully advance social justice.