The impact of a growth mindset on high school students' learning subjective well-being: the serial mediation role of achievement motivation and grit.

Purpose: The learning subjective well-being of high school students has significant value for their academic achievement and future life development. A growth mindset is one of the key factors affecting the learning subjective well-being of high school students. However, research on the mechanism by which a growth mindset affects learning subjective well-being is still relatively limited. Therefore, the study aims to investigate the impact of a growth mindset on the learning subjective well-being of high school students, as well as the role that achievement motivation and grit play as serial mediators in this relationship. Methods: This study employed a convenience sampling method to select 708 high school students from Chinese public high schools as participants. The research utilized the Growth Mindset Scale, Achievement Motivation Scale, Grit Scale, and the Learning Subjective Well-being Questionnaire for High School Students to collect data. All data were analyzed using SPSS 26.0, employing Model 6 from Hayes' SPSS PROCESS macro to test the serial mediation model. Results: Our results found that (1) high school students' growth mindset positively predicted their learning subjective well-being. (2) Achievement motivation played a mediating role between a growth mindset and learning subjective well-being among high school students. (3) Grit acted as a mediator between learning subjective well-being and growth mindset among high school students. (4) Achievement motivation and grit served as serial mediators between a growth mindset and learning subjective well-being among high school students. Conclusion: A growth mindset can influence the learning subjective well-being of high school students through achievement motivation and grit. Educators can enhance the learning subjective well-being of high school students by implementing intervention strategies that foster a growth mindset, achievement motivation, and grit.

Differences in eating habits, physical activity, and sleep patterns among high school students and their parents before and during COVID-19 pandemic.

Introduction: The recent COVID-19 pandemic has profoundly disrupted the eating and lifestyle habits among populations, especially among younger populations who are more prone to unhealthy dietary behaviours. However, current knowledge related to eating and lifestyle patterns, especially physical activity and sleep among different generations is limited. Our study sought to understand the eating habits, physical activity, and sleep behaviours among high school students compared to their parents in Saudi Arabia, before and during the COVID-19 pandemic. Methods: This study was conducted in public high schools in Jeddah, Saudi Arabia (n = 8 schools), spanning from September 2021 to April 2022. Data were collected using an online questionnaire, distributed to all students and their parents (n = 516) in these schools. Results: During the pandemic, parents (46.4%) showed a heightened interest in health and nutrition compared to students (32.7%, p = 0.001). Food preferences changed for 58.1% of participants; 70.0% of parents and 36.7% of students opted for homemade food (p < 0.001). Unhealthy behaviours like eating out were more common in students. Weight varied by 74.0% during COVID-19, with more parents (41.4%) gaining weight than students (31.6%, p = 0.018). Physical activity dropped more for parents (42.1%) than students (23.9%), though 30.7 and 31.6% reported increases, respectively (p < 0.001). Regardless of the pandemic, students were more likely to sleep later compared to parents (58.0% vs. 41.4%; p < 0.001), while parents were more prone to waking up earlier compared to students (81.4% vs. 67.3%, p = 0.002). Discussion: The findings underscore the varied pandemic impact on eating habits and physical activity between students and parents. Tailored interventions are vital for promoting healthier choices during health crises.

Inspiring rural youth to consider healthcare careers through an interprofessional healthcare traveling roadshow.

There are well-documented shortages of healthcare providers in rural and remote communities worldwide, and these shortages correlate with inequitable health outcomes for rural peoples. Despite a wide array of efforts to remedy the issue, these shortages persist to this day. The Healthcare Traveling Roadshow (HCTRS) is a grassroots initiative that began in 2010 to help address the shortage of healthcare providers in rural communities throughout British Columbia. Since its inception, the HCTRS has been predicated on three evidence-based guiding principles which have been shown to markedly increase the rate at which healthcare students choose to practice rurally. These principles are: (1) to showcase healthcare careers as viable and realistic options for rural youth (high school students) using interactive stations and near-peer teaching; (2) to expose healthcare students to rural communities and showcase them as a potential opportunity for their future practice; and (3) to provide a unique interprofessional experience to healthcare students from diverse healthcare careers and backgrounds. Through the synergy of these three principles the HCTRS aims to increase the longitudinal recruitment and retention of healthcare workers in underserved rural communities. This paper will share our experience from 15 years of running this initiative, for those hoping to implement similar programs in other areas of the world.

Current status and influencing factors of test anxiety of senior one students in Yanji, China: a cross-sectional study.

Objective: Examining the current situation of test anxiety among first year senior high school students in Yanji City and investigating the factors that contribute to exam anxiety. Methods: Using cluster sampling, a survey was conducted on 1,550 first-year high school students from three high schools in Yanji City in April-May 2023. The survey utilized general information questionnaires, the Minnesota Multiphasic Personality Inventory (MMPI), and the Self-Rating Anxiety Scale (SAS). Logistic regression analysis was used to determine the influencing factors of test anxiety. Results: A total of 1,550 first-year high school students were included in the analysis, with a test anxiety occurrence rate of 79.8%. Test anxiety exhibited statistical differences among different genders, ethnicities, family economic levels, frequency of communication with parents, and relationships with parents (with results of 53.44, 10.42, 17.31, 20.42, 31.95, all p < 0.05). Scores of hypochondriasis (Hs), depression (D), psychasthenia (Pt), paranoia (Pa), psychopathic deviate (Pd), schizophrenia (Sc), and hypomania (Ma) in the 10 clinical personality scales were significantly positively correlated. Logistic regression analysis revealed that gender, ethnicity, frequency of communication with parents, and scores of hypochondriasis (Hs), depression (D), psychasthenia (Pt), paranoia (Pa), and hypomania (Ma) in the 10 clinical personality scales were the main influencing factors for test anxiety in first-year high school students (all p < 0.05). Conclusion: The test anxiety level of high school students in Yanji City is relatively high, with variations in test anxiety levels among students of different genders, ethnicities, parental communication styles, and deviant personality traits. It is recommended that schools and teachers should give more consideration to test anxiety among high school students, particularly targeting those with potential risk factors. Parents should also be more attentive to their children's development and advancement, and improve their family education principles.

The impact of teacher autonomy support on students' assessment literacy: The chain mediating effects of self-efficacy and critical reflection.

In the realm of classroom assessment, the shift towards "assessment as learning" underscores the pivotal role of students in developing assessment literacy. This study aims to bridge the gap in the literature by examining the understudied area of students' assessment literacy. The author introduces a novel chain mediation effect structure model to investigate the interactions between teacher autonomy support, self-efficacy, critical reflection, and students' assessment literacy. The sample comprises 704 high school students from central China, with an even gender distribution (321 boys and 383 girls), which provides a robust dataset for analysis. By utilizing the Student Evaluative Scale, Critical Reflection Scale, and Self-Efficacy Scale, the study reveals a significant and positive correlation between teacher autonomy support and the level of assessment literacy among students. Furthermore, the findings indicate that self-efficacy and critical reflection act as mediators in the relationship between teacher autonomy support and students' assessment literacy. This suggests that educators who foster an environment of autonomy, empowering students to take ownership of their learning, can significantly enhance students' belief in their own abilities (self-efficacy) and their capacity for reflective thinking, thereby improving students' assessment literacy. The study concludes with concrete suggestions for classroom practice and identifies avenues for future research to further refine our understanding of the complex interplay between teacher support, student self-efficacy, critical reflection, and assessment literacy.

Estimation of Prevalence of Hyperacusis in High School Students of Mysore District.

Objective: Hyperacusis, characterized by an abnormal sensitivity to everyday sounds, is a condition associated with subjective distress and physiological changes in the auditory system. Prevalence rates have varied significantly worldwide, emphasizing the need for standardized criteria. This study aimed to determine the prevalence of hyperacusis among high school students in Mysore district and explore gender differences. Methods: A diverse cohort of 597 high school students participated in this cross-sectional study. The Modified Khalfa Hyperacusis Questionnaire assessed hyperacusis symptoms. Demographic data included age, gender, and educational status. A cut-off score of 28 on the questionnaire identified hyperacusis cases. Data were analyzed descriptively. Results: The study revealed a substantial hyperacusis prevalence of 17.25% among high school students in the Mysore district. Out of 103 identified cases, 43.69% were females, and 56.31% were males. These results suggest a potential gender disparity in hyperacusis prevalence. The study's findings highlight the high prevalence of hyperacusis among Indian high school students, emphasizing the need for attention to this issue in adolescent health. Gender differences observed in this study align with previous research, indicating a higher prevalence among males. Conclusions: Hyperacusis is a prevalent condition among Indian high school students, warranting further research on its causes and co-occurrence across different age groups. These findings underscore the significance of addressing hyperacusis as a critical health concern among adolescents and emphasize the need for tailored interventions and increased awareness.

Predictors of academic engagement of high school students: academic socialization and motivational beliefs.

The potential of academic engagement to enhance academic outcomes and well-being has been empirically supported, yet studies addressing its predictors are too limited. Hence, the current study collected self-report cross-sectional data from randomly selected 614 (male = 323) high school students in Ethiopia and examined the relations of academic socialization (parental and peer), self-efficacy, and outcome expectations in explaining variance in academic engagement, guided by an integrative model of engagement. Structural equation modeling with the maximum likelihood method indicated that (a) the hypothesized model fit the data well, (b) direct paths from parental and peer academic socialization to self-efficacy, outcome expectations, and academic engagement were positive and significant, (c) the relationships of the constructs in the model explained a significant portion of the variance in academic engagement, and (d) self-efficacy and outcome expectations significantly and positively but partially mediated the pathway from academic socialization to academic engagement. The findings' implications for boosting student academic engagement were forwarded.

Parenting style and the non-cognitive development of high school student: evidence from rural China.

Introduction: Understanding the relationship between parenting style and the non-cognitive development of high school students is crucial, particularly in rural China. Non-cognitive abilities, including traits such as emotional regulation, resilience, and interpersonal skills, play a significant role in students' overall development and future success. This study aims to investigate how different parenting styles impact non-cognitive abilities among high school students in rural China. Methods: This study surveyed 6,549 high school students and their primary caregivers in rural China. The students had an average age of 17.61 years, with 48% being male, and 62% of Han ethnicity. Primary caregivers self-reported their parenting styles, while the students' non-cognitive abilities were assessed using the Big Five Inventory-Short (BFI-S). The relationship between parenting style and non-cognitive development was analyzed using two distinct methods: two dimensions (authoritative and authoritarian) and four categories of parenting styles. Results: The study revealed that an authoritative parenting style had a positive impact on the non-cognitive abilities of students. Conversely, a negative association was observed between the authoritarian parenting style and the students' non-cognitive development. This association was more pronounced in the non-cognitive developmental scores of girls compared to boys. Additionally, parents from wealthier families or those with higher levels of education were more likely to adopt an authoritative parenting style rather than an authoritarian one. Discussion: The results of this study highlight the significant influence of parenting styles on the non-cognitive development of high school students in rural China. Authoritative parenting, characterized by warmth and structure, appears to foster better non-cognitive outcomes, while authoritarian parenting, marked by strictness and less warmth, is associated with poorer non-cognitive development. The gender differences observed suggest that girls may be more sensitive to variations in parenting style. Furthermore, the socioeconomic and educational background of parents plays a crucial role in determining the parenting style adopted. These findings underscore the importance of developing and implementing parenting training interventions in rural China, aimed at promoting authoritative parenting practices to enhance the non-cognitive development of students.

Interindividual differences in physical function and their impact on regular player selection among junior high school soccer athletes.

[Purpose] Unlike professional teams that use comprehensive evaluations, player selection in local and school-level soccer teams relies on the coaches' practical experience. This study investigated the differences in physical function between regular and non-regular male junior high school soccer players to provide valuable insights into player selection. [Participants and Methods] We assessed grip strength, rebound jumps, muscle strength, agility, short-distance running, anaerobic power, and countermovement jumps in 55 Japanese junior high school boys, who were divided into regular (R) and non-regular (NR) groups. Moreover, the age, height, and weight of the groups were compared. [Results] The analysis revealed significant differences in countermovement jumps and anaerobic power, while accounting for age and physique. [Conclusion] These results suggest that countermovement jumps and anaerobic power may constitute determining factors for regular and non-regular players, even when age and physical characteristics are considered.

Predicting the occurrence of in-season groin pain in male high school soccer players: a cohort study.

[Purpose] This study investigated whether pre-season HAGOS (Japanese Copenhagen Hip and Groin Outcome Scores) and eccentric muscle strength of the hip muscles predict in-season groin pain incidences in high school soccer players. [Participants and Methods] This study had a cohort design. The participants were male high school players under 18 years playing in the Japan Soccer League, which is an elite-level soccer league of that age category in Japan. The HAGOS and the strength of hip abductor and adductor muscles in eccentric contraction were measured before the season, and hip and groin pain incidences were recorded during the season. Multiple logistic regression analysis was performed to investigate the factors derived from the pre-season HAGOS and hip muscle strength tests, presumably pertaining to the development of in-season groin pain. [Results] The eccentric adductor muscle strength of the dominant leg and the HAGOS were selected as factors associated with groin pain during the season. [Conclusion] Low pre-season HAGOS and weak dominant-leg eccentric adductor muscle strength were suggested as factors to predict in-season groin pain occurrence in male high school soccer players.

Changes in high school students attitudes toward health sciences following a hands-on outreach STEM program.

Despite attempts to diversify healthcare workplaces and education, racial and ethnic minorities (REM) remain underrepresented in these fields. This study investigated changes in high school students' health science interest following a single exposure, hands-on anatomy laboratory visit. One hundred and eighty-eight high school students participated in a single day, one-hour visit to a human anatomy laboratory on a university campus. Participants engaged in hands-on activities centered around both human and animal specimens led by university mentors. Using a modified Science Technology Engineering and Mathematics-Career Interest Survey (STEM-CIS) questionnaire, health science STEM interest was calculated before and after the visits and compared using a paired t-test (α = 0.05). A 2 × 2 ANOVA (α = 0.05) was run on pre-to-post-visit interest score differences with factors of Race (White/REM) and Gender (Male/Female) to determine if race/ethnicity and/or gender moderated the gains observed. Overall, health science STEM interest increased significantly from pre- to post-visit (p < 0.001), and these gains were greater in REM students (p < 0.05) but did not differ as a function of gender. These findings indicate that a single visit to an anatomy laboratory with hands-on activities can be used as a tool to engage high school aged students in STEM and may be particularly beneficial for racial/ethnic minority students, potentially influencing health science STEM interest.

Prevalence of depressive symptoms among urban school adolescents in Vietnam: The role of youth, family, and school relationships.

BACKGROUND: Adolescents frequently encounter a spectrum of psychiatric conditions, predominantly depressive and anxiety disorders, along with various behavioral disturbances. OBJECTIVE: This investigation aims to delineate the prevalence of depressive disorders among adolescents in urban Vietnam and to elucidate the interrelationships between familial and school-related dynamics and adolescent depression. MATERIALS AND METHODS: A cross-sectional survey was conducted in 2022, involving 507 students aged 15 to 17 from high schools in Hanoi, Vietnam. Reynolds Adolescent Depression Scale - Second Edition (RADS-2) was used to assess the presence of depressive symptoms. Social-demographic characteristics, adolescent-family and adolescent-school relationships, and academic environment characteristics of high school students were interviewed. Multivariate Tobit regression models were employed to discern contributory factors across four domains of RADS-2. RESULTS: Among the 507 adolescents, the mean scores on the RADS scale were 15.1 ± 4.2 for the dysphoric mood domain, 16.4 ± 4.0 for the anhedonia-negative domain, 13.1 ± 4.4 for the negative self-evaluation domain, and 12.4 ± 3.7 for the somatic complaints domain. The analysis indicated that adolescents with suboptimal parental relationships, absence of confidants, frequent parental conflicts, exposure to parental arguments, substantial exam-related stress, or overwhelming academic demands were more likely to exhibit elevated depressive symptoms. Conversely, adolescents who were satisfied with their friendships at school and received care, support from teachers or friends, and involved in school's extracurricular activities lower exhibited levels of depression. CONCLUSIONS: Findings reveal the significant impact of family and peer relationships, as well as academic stress, on the development of depressive symptoms. These significant results inform the design and development of future interventions aimed at mitigating depression risks among high school students, emphasizing the crucial roles of both educational institutions and family dynamics.

Prevalence and associated factors of premenstrual dysphoric disorder among high school students in Finote Selam town, northwest Ethiopia.

Background: Premenstrual dysphoric disorder (PMDD) is the most prevalent but neglected psychiatric disorder, with somatic symptoms that are severe enough to markedly affect usual daily activities and have a negative impact on mental health and quality of life by affecting female patients' behavior and cognition. Studies regarding premenstrual dysphoric disorder and associated factors among high school students in low- and middle-income countries are limited. Therefore, the aim of this study was to assess the prevalence and associated factors of PMDD among high school students, and this is pivotal in further investigation. Methods: A school-based cross-sectional study was conducted from March 25 to April 17, 2023 using a simple random-sampling technique to select a sample of 564 participants. Premenstrual dysphoric disorder was assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Self-administered standardized questionnaires were used to collect data. Result: A total of 548 study participants participated, with a 97.2% response rate. The prevalence of premenstrual dysphoric disorder among high school students was found to be 33.03% (95%CI: 29.20-37.09). In a multivariable analysis, irregular menstruation cycle (AOR = 4.242, 95%CI = 2.182-8.246), depression (AOR = 5.272, 95%CI = 2.779-10.002), having greater than 4 days of menstruation bleeding duration (AOR = 2.138, 95%CI = 1.105-4.138), and high perceived stress (AOR = 3.468, 95%CL = 1.217-9.880) were the factors significantly associated with premenstrual dysphoric disorder. Conclusion: The overall prevalence of PMDD which was one-third among high school students was high. Moreover, long duration of menstruation bleeding, depressive symptoms, irregular menstruation cycle, and high perceived stress were significant factors in PMDD. Therefore, it needs early screening and intervention in primary healthcare settings, especially for those who have high perceived stress, having depression, having a long duration of menstruation bleeding, and having an irregular menstruation cycle, so as to have good academic achievement and psychological wellbeing.

Gambling Habits and Attitudes among Athlete and Non-Athlete High School Students in Skåne Region, Sweden.

Previous literature has reported increased rates of gambling problems in athletes compared to non-athletes. More liberal gambling-related attitudes have been suggested as a reason, although this rarely has been researched. The present study aimed to examine gambling experience, gambling problems, and gambling-related attitudes and parental gambling experience in high school students, comparing student-athletes to students at conventional schools. This is a cross-sectional web survey study in high school students (N = 473, 53% at sports high schools, 57% male) at eleven schools in the Skåne region, Sweden, who answered a web survey addressed gambling experiences, parental gambling and gambling-related attitudes, and included validated screening instruments for gambling problems and psychological distress. A history of any gambling was common and increased with age. Problem gambling was detected in 10% (13% of males and 5% of females, p < .001), and was associated with paternal and maternal gambling but not with psychological distress. Sports high school students were not more likely (9%) than other students (10%) to endorse gambling problems and history of each gambling type. However, paternal (but not maternal) gambling was more commonly reported in athletes, who also had more positive attitudes to gambling's effects on society and gambling availability. In contrast to other studies, this study did not demonstrate higher prevalence of gambling or gambling problems among young athletes than among other students, but liberal attitudes towards gambling, and experience of parental gambling on the father's side, were more common among athletes than among non-athletes. Gambling attitudes in adolescents may need to be targeted in future preventive efforts in young athletes and others.

Being able to think when caught in the maelstrom - how adolescents used mindfulness when facing exams.

PURPOSE: Research indicates that exam anxiety may decline with mindfulness-based interventions but there is a lack of research on adolescents' accounts of the processes involved. We explored high-school students' descriptions of how they perceived and applied mindfulness in managing anxiety-inducing thoughts related to academic performance following an 8-week Mindfulness-Based Stress Reduction (MBSR) course. METHOD: Post-course individual semi-structured interviews with 22 high school students (2 males, mean age 17.8 years) were transcribed verbatim and analysed using reflexive thematic analysis. RESULTS: The analyses identified six themes: (1) Noticing and attending to the attention-binding "maelstrom" of anxious thoughts and feelings (2) Attending to the breath to cope with the maelstrom, (3) "removing" and "getting rid of" anxious thoughts (4) Being able to "think" (5) awareness of more helpful thoughts, and (6) Agency and control. The findings are discussed in light of the Buddhist notion of "unwholesome thoughts" and the distinction between thought suppression and the use of breathing as a benign distraction. We propose that mindfulness encompasses both a receptive, nonjudgmental awareness and an active, intentional redirection of attention. CONCLUSION: Mindfulness training aided participants by enhancing their capacity to disengage from fear-engaging thoughts, thereby maintaining them within their window of tolerance and facilitating cognitive processing.

Disposable e-cigarette use: Factors, frequency and cigarette smoking among United States high school students.

BACKGROUND AND AIMS: Disposable e-cigarette use has increased among United States (US) high school students in recent years. However, there is limited research on the profile of these users, how often they use these products, and whether they displace cigarette smoking. This study aimed to measure how disposable e-cigarette use among US youth varies according to demographic characteristics and whether there is any association between e-cigarette use and reduced use of traditional cigarettes. DESIGN: We used cross-sectional data from the 2022 National Youth Tobacco Survey and conducted a multinomial logistic regression to examine factors associated with the types of e-cigarette devices used in the prior 30 days, adjusting for sex, sexual identity, grade level and race/ethnicity. We also used a finite mixture model to account for unobserved differences among users and identify e-cigarette use patterns in different subgroups of users. SETTING: United States. PARTICIPANTS: High school students in grades 9-12 (n = 14 389). MEASUREMENTS: Survey participants self-reported the type of e-cigarette device used, the frequency of e-cigarettes used and cigarettes smoked over the past 30 days. FINDINGS: Disposable e-cigarettes were the most popular e-cigarette type. Sex, sexual orientation, grade level and race/ethnicity were associated with disposable e-cigarette use. The odds of disposable e-cigarette use were lower in male students than in female students (odds ratio [OR] = 0.78, 95% confidence interval [CI] = [0.64-0.96]), and higher in students who identified as gay or lesbian (OR = 1.70, 95% CI = [1.11-2.61]) or bisexual (OR = 1.52, 95% CI = [1.16-1.99]) than in heterosexual students. The odds of disposable use were higher among students in higher grades (10th, 11th and 12th) than in 9th graders (OR = 1.71, 2.24 and 2.52, respectively). Disposable e-cigarette users had a lower frequency of traditional cigarette use than other e-cigarette users, both in the low-frequency class (incidence rate ratio [IRR] = 0.33, 95% CI = [0.12-0.92]) and the high-frequency class (IRR = 0.27, 95% CI = [0.08-0.92]). CONCLUSIONS: Disposable e-cigarette use appears to be higher among United States high school students who are female, older and/or identify as gay, lesbian or bisexual. Disposable e-cigarettes appear to be associated with reduced traditional cigarette use.

A Novel Scoring System and Correlative Analysis of the Strength and Effectiveness of Nationwide High School Cardiopulmonary Resuscitation Mandates: Insights from a High School CPR Study.

BACKGROUND: Numerous states have introduced cardiopulmonary resuscitation (CPR) training mandates for high school students and staff to prevent sudden cardiac death (SCD). However, the content and implementation of these mandates vary substantially. Furthermore, a comprehensive and objective assessment of these mandates and their impact is lacking. OBJECTIVE: To conduct a thorough evaluation of CPR training mandates across the United States. METHODS: We developed a novel scoring system based on proposed CPR standards, training and certification requirements, and legislative action to assess current mandates. This was used to rate the CPR mandates across all 50 states and the District of Columbia. Mandate scores were then compared to available real-world registry data as a surrogate for efficacy from 2018 to 2021. RESULTS: State CPR mandate scores ranged from 0 to 47, with a higher score indicating more robust mandates. The median and mean scores were 24 [IQR 19.5-27] and 21.52±8.61, respectively, with 35 being the highest score. Intra-observer variability was 0.986 (95% CI 0.944-1.028; p<0.001). The year of implementation did not influence the strength of the score (R2=-0.173; 95% CI -0.447-0.131, p=0.262), Correlation between SCD rate (R2=-0.76; 95% CI -0.492-0.367, p=0.742), bystander-initiated CPR (R2= -0.006; 95% CI -0.437-0.427, p=0.978), automatic external defibrillator use (R2= -0.125; 95% CI -0.528-0.324, p=0.590), or cardiovascular death rate (R2=-0.13; 95% CI -0.379-0.21, p=0.355) failed to reach statistical significance. CONCLUSION: Modest scoring consistency highlights the need for robust, standardized CPR requirements to potentially mitigate SCD. This study lays the groundwork for evidence-informed policy development in this area.

Online Human-Centered Design Methods are Acceptable, Appropriate, and Feasible for Generating Adolescent Relationship Abuse Intervention Ideas With Sexual and Gender Diverse Youth.

PURPOSE: Sexual and gender diverse youth (SGDY) are at greater risk for adolescent relationship abuse (ARA) than cisgender heterosexual youth, but there are not enough evidence-based interventions for reducing ARA among SGDY. We piloted online human-centered design (HCD) methodology to engage SGDY in generating ARA intervention ideas. This study evaluated the acceptability, appropriateness, and feasibility of the online methods and identified SGDY-derived intervention ideas for reducing ARA. METHODS: From August 2020 through March 2021, we conducted a longitudinal online HCD study with 46 SGDY (aged 14-18 years) recruited via social media from across the United States. SGDY completed HCD activities using MURAL (collaborative digital whiteboard) in four group-based sessions (1.5 hours each) and a follow-up survey with validated measures of acceptability, appropriateness, and feasibility (a priori success benchmarks: means > 3.75 on each five-point scale). RESULTS: SGDY in the sample were 41% racial/ethnic minorities. SGDY rated the online HCD methods as highly acceptable, appropriate, and feasible (means ≥ 4.29). SGDY co-created a breadth of ARA intervention concepts across all social-ecological levels, including commonplace ideas (e.g., curriculum for schools) and novel ideas, such as social media-based interventions to foster healthy relationships, incentivization interventions for performing social justice work, and school plays with SGDY storylines. DISCUSSION: Online HCD methods are acceptable, appropriate, and feasible for designing ARA intervention ideas. The intervention ideas generated in this study can help catalyze ARA intervention research for SGDY. Our method can be transported to other populations and health topics to help advance adolescent health and equity.

Generational Immigration Status Modifies the Association Between Psychosocial Distress and Substance Use Among Alternative High School Students.

PURPOSE: Alternative high schools (AHS) are designed to provide individualized education, more flexible scheduling, and smaller class sizes for students referred out of traditional high school. AHS students report higher levels of substance use (SU) and face disproportionately higher levels of trauma and toxic stress than their traditional high school peers. We sought to examine whether generational immigration (GenIm) status modifies the association of mental health and SU among AHS students using a longitudinal study of 1,060 Southern California AHS students. METHODS: Subscales from the 21-item Depression Anxiety Stress Scale were administered. Effect modification was examined by GenIm status defined as first generation (born outside of the United States), second generation (born in the United States with a parent born outside the United States), or third generation (born in the United States with US-born parent(s)). Main outcomes included the number of times different substances were used in the past year over a 3-year period. RESULTS: Multilevel, negative binomial, covariate-adjusted latent growth curve models generated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) of the time-varying association between depression, anxiety, or stress and the use of cigarettes, e-cigarettes, cigars, alcohol, or marijuana. Multiple-group models examined effect modification by GenIm status. DISCUSSION: The link between mental health and SU was stronger among first- and second-generation students than third-generation students. For example, a one-unit increase in stress relative to the average stress of students from the same school was associated with an increase in the rate of e-cigarette use among first-generation (IRR = 2.03, 95% CI = 1.07-3.85), second-generation (IRR = 2.25, 95% CI = 1.86-2.72), and third-generation (IRR = 1.68, 95% CI = 1.31-2.16) students. Effective strategies tailored to subgroups of AHS students are needed to counter disparities between traditional and alternative school systems that may contribute to long-term trajectories of SU.