Effect of a Randomized Controlled Trial of Housing Vouchers on Adolescent Risky Sexual Behavior Over a 15-Year Period.

We examined whether a housing voucher intervention influenced adolescent risky sexual behavior (RSB) across 15 years in the Moving to Opportunity Study. Low-income families in public housing that resided in 5 cities were randomized to one of three treatment groups: a housing voucher to move to low-poverty neighborhoods (i.e., < 10% poverty rate), a Sect. 8 voucher but no housing relocation counseling, or a control group that could remain in public housing. Youth and their caregivers completed baseline surveys, as well as two uniform follow-ups: interim (2001-2002; 4-7 years after baseline) and final (2008-2010; 10-15 years after baseline). Approximately 4,600 adolescents (50.5% female) aged 13-20 years participated at the final timepoint. Adolescents reported on their RSB, including condom use, other contraceptive use, early sexual initiation (< 15 years old), and 2+ sexual partners in the past year. We modeled each indicator separately and as part of a composite index. We tested baseline health vulnerabilities as potential effect modifiers. The low-poverty voucher group and the Sect. 8 voucher group were combined due to homogeneity of their effects. Applying intent-to-treat (ITT) regression analyses, we found no significant main effects of voucher receipt (vs. control) on any RSB. However, we found protective effects of voucher receipt on RSB among youth with health problems that limited activity, and youth < 7 at baseline but adverse effects among females, youth > 7 at baseline, and youth who were suspended/expelled from school. Results highlight the importance of understanding how housing interventions differentially influence adolescent health and behaviors.

Is fair representation good for children? effects of electoral partisan bias in state legislatures on policies affecting children's health and well-being.

Increasing evidence suggests that state policies impact constituents' health, but political determinants of health and health inequities remain understudied. Using state and year fixed-effects models, we determined the extent to which changes in electoral partisan bias in lower chambers of U.S. state legislatures (i.e., discrepancy between statewide vote share and seat share) were followed by changes in five state policies affecting children and families (1980-2019) and a composite of safety net programs (1999-2018). We examined effects on each policy and whether the effect was modified when bias was accompanied by unified party control. Next, we determined whether the effect differed depending on which party it favored. Less bias resulted only in higher AFDC/TANF benefits. Both pro-Democratic and pro-Republican bias was followed by decreased AFDC/TANF benefits and increased Medicaid benefits. AFDC/TANF recipients, unemployment benefits, minimum wage, and pre-K-12 education spending increased following pro-Democratic bias and decreased following pro-Republican bias. Estimated effects on the composite measure of safety net policies were all close to null. Some effects were modulated by unified party control. Results demonstrate that increasing fairness in elections is not a panacea by itself for increasing generosity of programs affecting children's well-being. Indeed, bias can be somewhat beneficial for the expansiveness of some policies. Furthermore, with the exception of unemployment benefits and AFDC/TANF recipients, Democrats have not been using the additional power that comes with electoral bias to spend more on major programs that benefit children. Finally, after decades in which electoral bias was in Democrats' favor, bias has started to shift toward Republicans in the last decade. This trend forecasts more cuts in almost all the policies in this study, especially education and AFDC/TANF recipients. There is a need for more research and advocacy emphasis on the political determinants of social determinants of health, especially at the state level.

The role of adverse childhood experiences (ACEs) in predicting academic problems among college students.

BACKGROUND AND OBJECTIVE: The complex associations between adverse childhood experiences (ACEs) and academic performance among college students are not well understood. The following aims were examined in this longitudinal study: the direct association of ACEs on academic problems after 4 years without (1) and with accounting for other academic risk factors (2a), the possible mechanisms linking ACEs and academic problems (2b). PARTICIPANTS AND SETTING: First-semester freshmen (N = 268; 71.3% female; Mage = 18.30; 76.9% White, 14.6% Asian, 3.7% Black, 2.6% multiracial, 1.1% Native American, and 1.1% other) were recruited from a Midwestern U.S. university. METHODS: Participants reported their ACEs, intrinsic motivation, psychological distress, and financial status as first-semester freshmen. Administrative records (i.e., SAT/ACT scores, GPA, courses taken not counted toward degree progress, and graduation) were collected prospectively over 4 years. Structural equation modeling was used to test the research aims. Post-hoc analyses without SAT/ACT scores were conducted. RESULTS: ACEs were associated with academic problems assessed 4 years later, when studied in isolation (ß = 0.36, p < .001) but not after adjusting for other risk factors (ß = 0.08, p = .278). Psychological distress and SAT/ACT scores during the first semester predicted academic problems 4 years later (ß = 0.33 and - 0.38, p < .001). There was an indirect effect of ACEs on academic problems through psychological distress (ß = 0.13, p < .001). CONCLUSIONS: There is a need to expand mental health services and address barriers to utilization on college campuses.

Interactive Effects of Neighborhood Safety and Screen Time on Adolescent Internalizing Symptoms.

OBJECTIVE: Perceptions of less neighborhood safety and higher levels of screen time are independently linked to adolescent anxiety and depression. Furthermore, residing in a neighborhood perceived as less safe is associated with engaging in higher levels of screen time. Screen time may act as a potential mechanism by which the effects of neighborhood safety on internalizing symptoms differ. Yet, research has not investigated whether the relationship between neighborhood safety and psychosocial adjustment varies at high and low levels of screen time. Therefore, this study examined the interaction between perceived neighborhood safety and screen time on adolescent internalizing symptoms (i.e., anxiety and depressive symptoms). METHOD: A total of 184 adolescents (53% female; mean age = 17.09, SD = 1.07) were recruited from an ongoing longitudinal study of adolescent drivers. Participants reported their perceptions of neighborhood safety, screen use, anxiety and depressive symptoms, and demographic characteristics. The independent and interactive contributions of neighborhood safety and screen time predicting anxiety and depressive symptoms in adolescents were tested with hierarchical linear regressions. RESULTS: Perceptions of less neighborhood safety and higher levels of screen time each uniquely predicted adolescent anxiety and depressive symptoms. The relationship between living in a neighborhood perceived as less safe and anxiety symptoms was stronger for youth with high levels of screen time. CONCLUSION: The findings suggest that youth residing in less safe neighborhoods may have higher levels of anxiety symptoms, and this anxiety symptomology is higher at high levels of screen time.

Validation of the attention-related driving errors scale in novice adolescent drivers.

INTRODUCTION: Motor vehicle collisions (MVCs) are a leading cause of death among adolescents. Identifying factors that contribute to adolescent MVCs is a pressing public health need. Exogenous (cell phones, passengers, music) and endogenous (stress, worry, mind-wandering) forms of driver inattention account for approximately 78% of all MVCs in the United States. Though both exogenous and endogenous distraction contribute to crash risk, prior work investigating adolescent crash risk has largely focused on exogenous distractors. The Attention-Related Driving Errors Scale (ARDES) is a promising measure assessing individual differences in endogenous driver inattention that has been validated in adult drivers. Its validation in an adolescent sample may prove useful in tailoring future interventions to decrease MVC risk in young drivers. METHODS: This study sought to validate the ARDES in novice adolescent drivers by investigating its underlying factor structure and its relations with self-reported measures of daily inattention, performance-based attention assessments, and a self-report measure of driving behavior. RESULTS: Replicating earlier work in adults, results suggested ARDES items can be classified according to their operational level of the driving. The ARDES had good internal reliability and construct validity, suggesting it is a valid self-report measure of the propensity for adolescents' attentional errors while driving. DISCUSSION: The ARDES provides a useful tool for researchers to identify adolescents at greater risk of attentional errors while driving. Future research should use the ARDES to better understand the role of driver inattention in adolescent crash risk.

Religious coping and psychosocial adjustment in patients with cystic fibrosis.

The role of religious coping (RC) in psychosocial outcomes and health-related quality of life (HRQoL) in adults with cystic fibrosis has not been addressed. Multivariate regressions evaluated the effects of baseline RC on depressive and anxiety symptoms and HRQoL at 3-month follow-up in 123 adult cystic fibrosis patients. Higher positive RC attenuated the effects of perceived stress on greater depressive and anxiety symptoms. Negative RC predicted less vitality and social HRQoL, as well as more digestion symptoms. Positive RC may buffer the impact of stress on patients' psychological distress, whereas negative RC may contribute to lower health-related quality of life.

Adolescent driving behavior before and during restrictions related to COVID-19.

INTRODUCTION: Understanding who heeds the driving-related COVID-19 restrictions is critical for assisting public health professionals improve response to this and future pandemic events. The purpose of the current study was to characterize driving behavior changes among adolescents as a function of COVID-19 restrictions. It was hypothesized that adolescent driving would be reduced by COVID-19 restrictions, especially for younger teens, non-minorities, females, non-working teens, and those with higher prosocial tendencies. METHODS: Participants were licensed drivers in "REACT," a longitudinal study of adolescent driving attention. Upon enrollment in REACT, drivers were required to be age 16 or 18, have been issued a driver's license within the last two weeks, and be fluent in written/spoken English. The current observational cohort study was of drivers reporting driving exposure between February 8 and April 22, 2020. Linear mixed-effects models estimated differences in driving changes between COVID-19 periods. RESULTS: Results indicated a decrease across pre-COVID-19 period (February 8 - March 13, 2020) in days driven per week and vehicle miles driven (VMD) was explained by the change of slope post-COVID-19 restrictions (March 14 - April 22, 2020). Post-COVID-19, driving days per week decreased by 37 % and VMD decreased by 35 %. This decrease was lower in ethnic minorities, older adolescents, and employed adolescents. Those with greater dire prosocial tendencies showed greater post-COVID-19 driving decline. DISCUSSION: Findings provide early evidence of COVID-19 restriction-related adolescent driving changes suggesting older, employed, minority teens and teens with lower prosocial tendencies are less likely to reduce driving behavior. These observations provide a foundation for more extensive studies of adolescent drivers during various driving and contact restrictions and inform future public health campaigns for social distancing.