Lessons Learned from Cross-Systems Approach to COVID-19 Pandemic Response in Juvenile Justice System, Colorado, USA.

The global COVID-19 pandemic illustrates the importance of a close partnership between public health and juvenile justice systems when responding to communicable diseases. Many setting-specific obstacles must be navigated to respond effectively to limit disease transmission and negative health outcomes while maintaining necessary services for youth in confinement facilities. The response requires multidisciplinary expertise and collaboration to address unique considerations. Public health mitigation strategies must balance the risk for disease against the negative effects of restrictions. Key aspects of the COVID-19 response in the juvenile justice system of Colorado, USA, involved establishing robust communication and data reporting infrastructures, building a multidisciplinary response team, adapting existing infection prevention guidelines, and focusing on a whole-person health approach to infection prevention. We examine lessons learned and offer recommendations on pandemic emergency response planning and managing a statewide public health emergency in youth confinement settings that ensure ongoing readiness.

Aperiodic EEG and 7T MRSI evidence for maturation of E/I balance supporting the development of working memory through adolescence.

Adolescence has been hypothesized to be a critical period for the development of human association cortex and higher-order cognition. A defining feature of critical period development is a shift in the excitation: inhibition (E/I) balance of neural circuitry, however how changes in E/I may enhance cortical circuit function to support maturational improvements in cognitive capacities is not known. Harnessing ultra-high field 7 T MR spectroscopy and EEG in a large, longitudinal cohort of youth (N = 164, ages 10-32 years old, 347 neuroimaging sessions), we delineate biologically specific associations between age-related changes in excitatory glutamate and inhibitory GABA neurotransmitters and EEG-derived measures of aperiodic neural activity reflective of E/I balance in prefrontal association cortex. Specifically, we find that developmental increases in E/I balance reflected in glutamate:GABA balance are linked to changes in E/I balance assessed by the suppression of prefrontal aperiodic activity, which in turn facilitates robust improvements in working memory. These findings indicate a role for E/I-engendered changes in prefrontal signaling mechanisms in the maturation of cognitive maintenance. More broadly, this multi-modal imaging study provides evidence that human association cortex undergoes physiological changes consistent with critical period plasticity during adolescence.

Behavior problems, social relationships, and adolescents' future orientation. Links from middle to late adolescence.

INTRODUCTION: As adolescents leave high school, plans for the future are of great importance. Future orientation reflects positive thoughts regarding further education, employment, and family life. While future orientation has been found to affect behavior problems, the influence of behavior problems on future orientation is mainly unknown. Positive parent-child and peer relations may boost positive outlooks, but the interplay of behavior problems and social relations for future orientation remains to be studied. METHODS: Participants were 485 adolescents, 54% girls, living in Mid-Sweden. At age 15, parents and adolescents rated ADHD- and internalizing symptoms, parents rated ODD-symptoms, and adolescents rated their relationship with parents and peers. At age 18, adolescents rated future orientation regarding education, employment, and family, and reported on delinquent acts. RESULTS: Low levels of inattention symptoms and of delinquency were important for all higher future orientation aspects. In contrast, higher levels of hyperactive-impulsive symptoms were associated with more positive outlooks on work and family life. Relationships with parents and peers were stronger predictors of future outlooks, compared with behavior problems. There were few interaction effects of behavioral symptoms and social relationship quality. CONCLUSIONS: Behavior problems in middle adolescence may negatively affect future outlooks. However, positive social relations, especially relations with peers, seem more important for optimistic views than behavior problems and thus may have a compensatory effect. The clinical implications should be to address the young person's social world, in the case of misgivings about the future, also in the presence of problematic behaviors.

Parental Burnout, Negative Parenting Style, and Adolescents' Development.

Research on parental burnout has focused more on its antecedents than on its consequences. Burned-out parents may experience a series of behavioral changes, negatively affecting their children's physical and mental development. This study examined the effects of primary caregivers' parental burnout on adolescents' development and the mediating role of negative parenting styles. This study used a time-lagged design, and data were collected at three different time points. Adolescents were asked to identify their primary caregivers, and parents were asked whether they were the primary caregivers of their children. Thereafter, paired data from the children and primary caregivers were collected. A total of 317 junior middle school students (178 boys, Mage = 14.20 ± 0.8 years) and primary caregivers (71 fathers, Mage = 42.20 ± 4.53 years) from Henan province participated. Primary caregivers' parental burnout was positively associated with negative parenting styles, and negative parenting styles mediated the relationship between parental burnout and adolescent development. From the perspective of prevention-focused interventions, it is necessary to focus on preventing the occurrence of parental burnout. Further, parents should try to avoid using abusive behaviors toward their children and neglecting them.

Early adolescent development in the face of violence: A systematic review running.

BACKGROUND: Exposure to violence has severe and lasting effects on development. Despite the body of research examining childhood exposures to violence and victimization, developmental outcomes during early adolescence are poorly understood. OBJECTIVE: To synthesize existing research on the effects of violence exposure on early adolescent development (youth 9-14 years old) and highlight areas for future research. METHOD: We conducted a systematic search of PubMed, CINAHL, Web of Science, Scopus, and EMBASE for articles published between 2012 and 2023. Included articles focused on violence exposure related to experiencing or observing community violence, witnessing domestic violence and/or being the victim of chronic physical abuse. RESULTS: Twenty-eight articles spanning four developmental domains were included: behavioral, biological, neurological, and social development. Behaviorally, violence exposure posed significant effects on both internalizing and externalizing symptoms. Biologically, violence exposure was strongly associated with advanced epigenetic age, accelerated puberty, and insomnia. Neurologically, violence exposure had significant associations with both structural and functional differences in the developing brain. Socially, violence exposure was related to poor school engagement, peer aggression, and low social support. CONCLUSION: This systematic review highlights varying effects of violence exposure on early adolescent development. The gaps presented should be addressed and implemented into clinical practice via evidence-based policies and procedures to ensure successful transition to adulthood.

Sex-Specific Depressive Symptom Trajectories Among Adolescents in Los Angeles County, 2013 to 2017.

Objective: After remaining stable for many years, the prevalence of depression among adolescents increased over the past decade, particularly among girls. In this study, we used longitudinal data from a cohort of high school students to characterize sex-specific trajectories of depressive symptoms during this period of increasing prevalence and widening gender gap in adolescent depression. Method: Using data from the Health and Happiness Cohort, a longitudinal 8-wave study of high school students residing in Los Angeles County from 2013 to 2017 (N = 3,393), we conducted a multiple-group, latent class growth analysis by sex to differentiate developmental trajectories in depressive symptoms scores measured by the Center for Epidemiological Studies- Depression (CES-D) scale (range, 0-60). Results: A 4-class solution provided the best model fit for both girls and boys. Trajectories among girls included low stable (35.1%), mild stable (42.8%), moderate decreasing (16.2%), and high arching (5.9%). Trajectories among boys included low stable (49.2%), mild increasing (34.7%), moderate decreasing (12.2%), and high increasing (3.9%). Average scores consistently exceeded or crossed the threshold for probable depression (≥16). Across comparable sex-specific trajectory groups, the average CES-D scores of girls were higher than those of boys, whose average scores increased over time. Conclusion: In a diverse cohort of students in Los Angeles County, depressive symptom trajectories were comparable to prior time periods but with a higher proportion of students in trajectories characterized by probable depression. Trajectories differed by sex, suggesting that future research should consider differential severity and onset of depression between boys and girls.

The role of parental maladaptive emotion socialization in the risk process for negative urgency and drinking behavior in adolescence.

INTRODUCTION: Negative urgency (the tendency to act rashly when experiencing negative emotions) is a robust risk factor for a number of problem behaviors, including early adolescent drinking. Little is known about the factors that precede the development of negative urgency, and hence the full etiology of this component of risk. The current study aimed to investigate the possibility that facets of childhood maladaptive emotion socialization (the tendency for children's expressions of emotions to be met with punishment, minimized, or invoke a reaction of distress from their parents/caretakers) increases risk for the development of negative urgency and drinking behavior. METHOD: Self-report measures of negative urgency, subfacets of maladaptive emotion socialization, and drinking behavior were collected during the 2021-2022 academic year from a sample of 428 high school students (mean age = 14.7, SD = 0.09, 44% female), assessed twice over the course of a semester, reflecting a 4-month longitudinal window. RESULTS: Distress emotion socialization predicted increases in negative urgency, minimizing predicted decreases in negative urgency, and punitive did not provide significant prediction. Additionally, results found that higher levels of both negative urgency and distress emotion socialization increased adolescents' likelihood of having tried alcohol. These processes were invariant across race and gender. CONCLUSIONS: The present study may inform the future creation of prevention and intervention efforts aimed at reducing maladaptive emotion socialization and increasing adaptive emotion socialization. Successful reductions in negative urgency as a consequence of increased adaptive emotion socialization may then lead to decreases in adolescent drinking and other impulsigenic behaviors.

Private screen access in early adolescence predicts subsequent academic and social impairment at the end of high school for boys and girls. / Accès aux écrans dans les espaces privés au début de l'adolescence et difficultés scolaires et sociales à la fin des études secondaires chez les garçons et les filles.

INTRODUCTION: Youth media guidelines in Canada and the United States recommend that bedrooms should remain screen-free zones. This study aims to verify whether bedroom screens at age 12 years prospectively predict academic and social impairment by age 17 years. METHODS: Participants were from the Quebec Longitudinal Study of Child Development birth cohort (661 girls and 686 boys). Linear regression analyses estimated associations between having a bedroom screen (television or computer) at age 12 years and selfreported overall grades, dropout risk, prosocial behaviour and likelihood of having experienced a dating relationship in the past 12 months at age 17 years, while adjusting for potential individual and family confounding factors. RESULTS: For both girls and boys, bedroom screens at age 12 years predicted lower overall grades (B = -2.41, p ≤ 0.001 for boys; -1.61, p ≤ 0.05 for girls), higher dropout risk (B = 0.16, p ≤ 0.001 for boys; 0.17, p ≤ 0.001 for girls) and lower likelihood of having experienced a dating relationship (B = -0.13, p ≤ 0.001 for boys; -0.18, p ≤ 0.001 for girls) at age 17. Bedroom screens also predicted lower levels of prosocial behaviour (B = -0.52, p ≤ 0.001) at age 17 years for boys. CONCLUSION: The bedroom as an early adolescent screen-based zone does not predict long-term positive health and well-being. Pediatric recommendations to parents and youth should be more resolute about bedrooms being screen-free zones and about unlimited access in private exposures in childhood.

Social-ecological perspective on the suicidal behaviour factors of early adolescents in China: a network analysis.

Background: In early adolescence, youth are highly prone to suicidal behaviours. Identifying modifiable risk factors during this critical phase is a priority to inform effective suicide prevention strategies. Aims: To explore the risk and protective factors of suicidal behaviours (ie, suicidal ideation, plans and attempts) in early adolescence in China using a social-ecological perspective. Methods: Using data from the cross-sectional project 'Healthy and Risky Behaviours Among Middle School Students in Anhui Province, China', stratified random cluster sampling was used to select 5724 middle school students who had completed self-report questionnaires in November 2020. Network analysis was employed to examine the correlates of suicidal ideation, plans and attempts at four levels, namely individual (sex, academic performance, serious physical illness/disability, history of self-harm, depression, impulsivity, sleep problems, resilience), family (family economic status, relationship with mother, relationship with father, family violence, childhood abuse, parental mental illness), school (relationship with teachers, relationship with classmates, school-bullying victimisation and perpetration) and social (social support, satisfaction with society). Results: In total, 37.9%, 19.0% and 5.5% of the students reported suicidal ideation, plans and attempts in the past 6 months, respectively. The estimated network revealed that suicidal ideation, plans and attempts were collectively associated with a history of self-harm, sleep problems, childhood abuse, school bullying and victimisation. Centrality analysis indicated that the most influential nodes in the network were history of self-harm and childhood abuse. Notably, the network also showed unique correlates of suicidal ideation (sex, weight=0.60; impulsivity, weight=0.24; family violence, weight=0.17; relationship with teachers, weight=-0.03; school-bullying perpetration, weight=0.22), suicidal plans (social support, weight=-0.15) and suicidal attempts (relationship with mother, weight=-0.10; parental mental illness, weight=0.61). Conclusions: This study identified the correlates of suicidal ideation, plans and attempts, and provided practical implications for suicide prevention for young adolescents in China. Firstly, this study highlighted the importance of joint interventions across multiple departments. Secondly, the common risk factors of suicidal ideation, plans and attempts were elucidated. Thirdly, this study proposed target interventions to address the unique influencing factors of suicidal ideation, plans and attempts.

Adolescents and sexual assault: A critical integrative review.

Adolescents are sexually assaulted at remarkably high rates. Adolescents are also unique given the specific dynamics of adolescent sexual assault, their current stage in human development, their limited legal standing and rights, and their experiences navigating postassault services and resources. While literature exists within each of these domains, it is somewhat disconnected and overlooks how adolescents are often relegated to the margins in research and practice. The purpose of this integrative review is to (1) provide a more complete understanding of adolescent sexual assault and survivors' nuanced needs; (2) frame adolescent survivors as a too-often-overlooked oppressed group that researchers and responders must consider and center in their work, lest contribute to their further marginalization; and (3) inspire and orient social justice-minded scholar activists to various action steps to take to center and prioritize adolescents in research and practice. Through our intersectional feminist approach, we offer specific action steps for social justice-minded scholar activists to recenter adolescents in their research and practice.

Lifestyle Factors Counteract the Neurodevelopmental Impact of Genetic Risk for Accelerated Brain Aging in Adolescence.

BACKGROUND: The transition from childhood to adolescence is characterized by enhanced neural plasticity and a consequent susceptibility to both beneficial and adverse aspects of one's milieu. METHODS: To understand the implications of the interplay between protective and risk-enhancing factors, we analyzed longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study (n = 834; 394 female). We probed the maturational correlates of positive lifestyle variables (friendships, parental warmth, school engagement, physical exercise, healthy nutrition) and genetic vulnerability to neuropsychiatric disorders (major depressive disorder, Alzheimer's disease, anxiety disorders, bipolar disorder, schizophrenia) and sought to further elucidate their implications for psychological well-being. RESULTS: Genetic risk factors and lifestyle buffers showed divergent relationships with later attentional and interpersonal problems. These effects were mediated by distinguishable functional neurodevelopmental deviations spanning the limbic, default mode, visual, and control systems. More specifically, greater genetic vulnerability was associated with alterations in the normative maturation of areas rich in dopamine (D2), glutamate, and serotonin receptors and of areas with stronger expression of astrocytic and microglial genes, a molecular signature implicated in the brain disorders discussed here. Greater availability of lifestyle buffers predicted deviations in the normative functional development of higher density GABAergic (gamma-aminobutyric acidergic) receptor regions. The two profiles of neurodevelopmental alterations showed complementary roles in protection against psychopathology, which varied with environmental stress levels. CONCLUSIONS: Our results underscore the importance of educational involvement and healthy nutrition in attenuating the neurodevelopmental sequelae of genetic risk factors. They also underscore the importance of characterizing early-life biomarkers associated with adult-onset pathologies.

Healthcare and support experiences of adolescents and young adults diagnosed with 47,XXY, 47,XXX, and 48,XXYY.

Sex chromosome aneuploidies (SCAs) are among the most common chromosomal conditions. There is little scholarship on how adolescents and young adults (AYAs) affected by SCA engage with and adapt to their diagnosis. In order to understand how AYAs adapt to a SCA diagnosis, we conducted a secondary analysis of qualitative interviews with AYAs. Eight in-depth semi-structured interviews with individuals with a diagnosis of 47,XXY, 47,XXX, and 48,XXYY were analyzed for iterative themes related to adaptation to a SCA diagnosis in accordance with standard qualitative methodology. Our findings suggest that the process of adaptation is highly variable and complex and is mediated by external factors including diagnosis delivery and community support. Factors associated with adaptation include feeling understood and supported by healthcare providers; researching the condition; receiving hormone replacement therapy; and receiving support from a community of peers. As access to prenatal and pediatric genetic testing continues to expand, non-genetic pediatric providers are increasingly likely to interact with individuals with SCAs as part of their initial diagnostic odyssey or ongoing medical management. Understanding the diversity of lived experiences of AYAs with SCAs is helpful for healthcare providers to facilitate holistic care and provide meaningful support to patients.

Psychological variables linked to hesitation toward vaccination against COVID-19 among late adolescents and young adults: The role of magical thinking and right-wing authoritarianism.

INTRODUCTION: Several studies on the predisposition to be subjected to vaccination have shown that vaccine hesitation is a global phenomenon influenced by a lack of knowledge and awareness, as well as perceived risks and benefits. The purpose of this study was to investigate the mediating role of right-wing authoritarianism in the relationship between magical thinking and positive attitudes toward COVID-19 vaccines (i.e. trust of vaccine benefits, worries over unforeseen future effects, concerns about commercial profits, preference for natural immunity). METHOD: The sample consisted of 201 Italian young adults, 49 males (24.4%), and 152 females (75.6%), aged between 18 and 25. Data were collected during 2022. RESULTS: The results confirmed the role of right-wing authoritarianism as a mediator for magical thinking on positive vaccine attitudes. Findings indicated a positive association between right-wing authoritarianism and magical thinking and a negative relationship of both the aforementioned variables on positive vaccine attitudes. SEM analyses showed a direct positive association from magical thinking to right-wing authoritarianism and a direct negative association from right-wing authoritarianism to trust of vaccine benefits, to low worries over unforeseen future effects, to lack of concerns about commercial profits and to low preference for natural immunity. CONCLUSIONS: The findings highlight that common contribution of odd or magical beliefs and right-wing authoritarianism may slow the spread of vaccines among late adolescents and young adults. Our findings provide insight on what effective communication with vaccine-resistant individuals should look like in order to increase the chances of reaching vaccine-hesitant individuals.

Neural reward responsiveness and daily positive affect functioning in adolescent girls.

Deficits in reward processing have been implicated in the development of many forms of psychopathology, especially major depressive disorder (MDD). One facet of reward processing, known as reward responsivity, has been associated with the development and maintenance of depression across development. The reward positivity (RewP) is an event-related potential derived from electroencephalogram (EEG), which is thought to reflect reward responsivity. An attenuated RewP has been observed in both currently depressed individuals and youth at risk for depression, suggesting it may represent a biomarker of depression. Despite this, little is known about how the RewP translates to behavior and affect in the real world. In the current study, we examined how the RewP relates to real world emotional functioning, measured using ecological momentary assessment (EMA). Thirty-eight female adolescents (ages 11-16, Mage = 13.9 years) participated in the study; approximately half of the sample were considered high risk due to maternal lifetime history of MDD. Adolescents completed a monetary reward task while EEG was recorded, followed by a 10-day period of EMA assessing daily affect and emotion regulation strategy use following positive events. Results revealed that the RewP was positively associated with subjective reports of positive, but not negative, daily affect. Results also revealed that the RewP was positively associated with focusing on positive feelings following a positive event (e.g., savoring). Findings from this preliminary study highlight how neural responses to reward in the lab relate to daily life emotional functioning, supporting the RewP as an ecologically valid marker of positive affect functioning among youth.

Adolescents' mental health in the social-media era: The role of offline and online need-based experiences.

INTRODUCTION: Debate about the precise role of social media use (SMU) in the mental health of today's adolescents is still ongoing. The present study adds to the literature by focusing on adolescents' experiences during SMU and in their offline activities through the lens of basic psychological needs, which are central to self-determination theory. METHODS: To examine the joint and supplementary effects of need-experiences in the offline and SMU domain (i.e., SMU satisfaction, offline satisfaction, SMU frustration, offline frustration) on several indicators of adolescents' mental health (i.e., vitality, life satisfaction, sleep quality, anxiety, and depression), polynomial regression analyses were used. Three cross-sectional samples were collected in Belgium, including early to mid-adolescents during the COVID-pandemic (Sample 1; N = 447; Mage = 14.26; 54.4% female) as well as postpandemic (Sample 2; N = 179, Mage = 15.25; 54.2% female), and among college students in postpandemic times (Sample 3; N = 4977; Mage = 20.72; 69.1% female). RESULTS: The results showed that need-experiences common to both domains were a robust factor associated with mental health. This finding was obtained across all samples and outcomes, with need satisfaction playing a beneficial and need frustration a harmful role. We further found that offline need-experiences serve as a more crucial predictor of adolescents' mental health than need experiences on social media. CONCLUSIONS: Adolescents' experiences of need satisfaction and need frustration on social media and in offline activities are central to their mental health. However, only relying on SMU as a single source of need satisfaction may not be recommended, given that offline experiences seem to be more decisive.

Factors related to health literacy among Brazilian adolescents: cross-sectional study / Factores relacionados con la alfabetización en salud de adolescentes brasileños: estudio transversal / Fatores relacionados ao letramento em saúde de adolescentes brasileiros: estudo transversal

ABSTRACT Objective: To analyze the relationship between sociodemographic and clinical factors with health literacy in Brazilian adolescents. Method: This is a cross-sectional study with 526 adolescents aged 14 to 19. Data were collected virtually between July and September 2021 using a sociodemographic characterization questionnaire, clinical profile and the Health Literacy Assessment Tool - Portuguese version. The variables were evaluated by multiple linear regression with normal response, with significance p < 0.05. Results: The average age was 16.9 years (±1.6), the average health literacy score was 25.3 (±5.4). Female gender (p = 0.014), university educational level (p = 0.002) and use of medication (p = 0.020) were related to higher levels of health literacy. Adolescents with chronic illnesses had a higher total literacy score, on average 1.51 points, compared to those without chronic illnesses. Conclusion: Male adolescents and those with less education performed worse in health literacy and, therefore, deserve special attention in health promotion actions.

RESUMEN Objetivo: Analizar la relación entre factores sociodemográficos y clínicos con la alfabetización en salud de adolescentes brasileños. Método: Se trata de un estudio transversal llevado con 526 adolescentes entre 14 y 19 años. Los datos se recogieron virtualmente entre julio y septiembre de 2021 mediante un cuestionario de caracterización sociodemográfica, de perfil clínico y de la Health Literacy Assessment Tool - versión en portugués. Las variables se sopesaron por regresión linear múltiple con respuesta normal y significación p < 0,05. Resultados: La edad promedio era de 16,9 años (±1,6) y la puntuación media en alfabetización en salud de 25,3 (±5,4). El sexo femenino (p = 0,014), la mayor escolaridad (p = 0,002) y el uso de medicación (p = 0,020) estaban relacionados con niveles más altos de alfabetización en salud. Los adolescentes con enfermedades crónicas obtuvieron una puntuación total de alfabetización más alta, en media, 1,51 puntos, en comparación con los que no padecían dichas enfermedades. Conclusión: Adolescentes del sexo masculino y aquellos con menos escolaridad presentaron un desempeño pobre en la alfabetización en salud y, por esa razón, necesitan atención especial durante las acciones de promoción de la salud.

RESUMO Objetivo: Analisar a relação entre fatores sociodemográficos e clínicos com o letramento em saúde de adolescentes brasileiros. Método: Trata-se de um estudo transversal com 526 adolescentes de 14 a 19 anos. Os dados foram coletados virtualmente entre julho e setembro de 2021 por meio de questionário de caracterização sociodemográfica, do perfil clínico e do Health Literacy Assessment Tool - versão em português. As variáveis foram avaliadas por regressão linear múltipla com resposta normal, com significância p < 0,05. Resultados: A média de idade foi de 16,9 anos (±1,6), a pontuação média do letramento em saúde foi de 25,3 (±5,4). Sexo feminino (p = 0,014), maior escolaridade (p = 0,002) e uso de medicamentos (p = 0,020) foram relacionados a maiores níveis de letramento em saúde. Adolescentes com doenças crônicas apresentaram pontuação total do letramento superior, em média 1,51 pontos, comparados aos sem doença crônica. Conclusão: Adolescentes do sexo masculino e os com menor escolaridade apresentaram pior desempenho no letramento em saúde e, por isso, merecem especial atenção nas ações de promoção da saúde.

The parental involvement process regarding childhood cancer survivors becoming independent: Focus on balancing health management and social lives from adolescence to adulthood.

AIM: This study aimed to elucidate the parental involvement process regarding childhood cancer survivors' (CCSs') independence while balancing their health management and social lives from adolescence to adulthood to obtain suggestions for long-term support for CCSs and their parents. METHODS: Semi-structured interviews were conducted with 19 parents of Japanese CCSs aged 16-25 years. The data were then qualitatively analyzed using the modified grounded theory approach. RESULTS: Three "categories" and 20 "concepts" were generated. The connections among these categories and concepts revealed the parental involvement process regarding CCSs' independence while balancing their health management and social lives. The first phase in this process is to "support careful behaviors," mainly during CCSs' treatment in the outpatient clinic or shortly after discharge. As CCSs recover after cancer treatment, parents "watch over, but feel conflicted," with "conflicts between protecting their sons/daughters and giving them independence." Then, parents reach a phase in which they "acknowledge and entrust," which includes "acknowledgment of development and efforts" of their sons/daughters, and develop an "attitude to entrust medical checkups to their sons/daughters, along with their preparation." The influencing factors of the three phases include "ongoing anxieties about the late effects of therapy and recurrence" and an "expectation for their sons/daughters to acquire abilities for living independently." CONCLUSIONS: These findings suggest that nurses need to accept parents' feelings and thoughts regarding conflicts with CCSs, recognition of CCSs' development, and values. These processes may help nurses and health-care professionals support parents from a comprehensive perspective.

REDESIGNING JUVENILE PROBATION TO ALIGN WITH BEHAVIORAL HEALTH AND POSITIVE DEVELOPMENT PRINCIPLEs: A Quasi-Experimental study.

Science advisory boards and policy organizations have called for adolescent brain science to be incorporated into juvenile probation operations. To achieve this, Opportunity-Based Probation (OBP), a probation model that integrates knowledge of adolescent development and behavior change principles, was developed in collaboration with a local juvenile probation department. The current study compares outcomes (recidivism and probation violations) for youth in the OBP condition versus probation as usual. Inverse probability weighting (IPW) and coarsened exact matching (CEM) were used to estimate causal effects of OBP's average treatment effect (ATE). Results indicated clear effects of OBP on reducing criminal legal referrals, but no significant effects were observed for probation violations. Overall, results provide promising recidivism-reduction effects in support of developmentally grounded redesigns of juvenile probation.

Addressing challenges to carrying out intervention programs with youth populations: Successes and strategies.

We identify five challenges notoriously faced by researchers conducting youth intervention studies: access to the target population, successful recruitment, ensuring continued attendance, promoting engaged, enthused, and task-focused participation, and efficient data collection. To ensure research quality, we have devised strategies to address these obstacles. Successes and lessons are included from The Compass Project (TCP), a 9-week morality strengthening program designed to facilitate positive attitudinal and behavioral outcomes in young people. Despite four of the five identified challenges being overcome in TCP, the fifth challenge of data collection was insurmountable as many participants failed to complete questionnaire scales. We propose that researchers build on our success by building rapport and trust with participants and youth organizations and building a participant sense of community, and improve upon our design by scrutinizing the format, accessibility, and length of data measures. Ultimately, tests of whether intervention programs can result in positive outcomes in the lives of young people hinge on adequately overcoming the identified challenges. Implementation of the proposed strategies will be instrumental to allow for meaningful and powerful statistical analyses to more accurately gauge the positive impact of intervention programs on young people's lives.

Integrity over fidelity: transformational lessons from youth participatory action research to nurture SEL with adolescents.

Much has been written about social and emotional learning (SEL) and its positive impact on young people's academic and life outcomes, yet most of this research is based in early childhood and elementary settings. SEL programming for adolescents has shown mixed results, with many programs proving to be largely ineffective or even showing slightly negative impacts for some youth. Adherence to scripted SEL curricula, or "fidelity" to the program components, is often seen by young people to be "lame", inauthentic, and condescending, failing to connect to the topics and issues that feel most critical to them in this stage of their development. For all students, and especially for those whose identities have been systematically marginalized or oppressed by the dominant culture, SEL programming that fails to explicitly address these experiences of injustice often feels inauthentic and out of touch for youth. Therefore, effective implementation of SEL for adolescents is likely to require skillful adaptation and responsiveness to the identities, interests, and motivations of students by educators. In this case, effective SEL may look less like fidelity to a specific set of scripts, sessions, or activities, but rather a commitment to the wholeness of a set of core principles, relationships, and opportunities for adolescent exploration and leadership/empowerment, or what we will call integrity of implementation. In this paper, we present one promising approach to adolescent social and emotional development - youth participatory action research (YPAR) - and the ways in which studying the YPAR process (in addition to the research topics selected by youth) can provide key insights into the social and emotional learning and development of youth.