Codeveloping an Adolescent Health Program in India During the COVID-19 Pandemic: A Case Study of a Community-Partnered Responsive Feedback Approach.

We describe the responsive feedback (RF) approach experience of a nongovernmental organization, Girls Health Champions (now known as Adolescent Health Champions [AHC]), that undertakes peer education interventions in Mumbai, India, schools to improve gender equality and health outcomes for adolescents aged 13-19 years. AHC used the RF approach at the onset of the COVID-19 pandemic in light of uncertainties stemming from school closures and the negative impact of the lockdown on adolescents' physical and mental health. Using an RF approach, AHC was able to: (1) understand pandemic-specific challenges faced by adolescents; (2) overhaul its theory of change; (3) pilot new modes of intervention delivery; (4) design a curriculum for parents/guardians and a COVID-19 module; (5) design an AHC mobile app; (6) develop a new, more gender-inclusive name and visual identity; (7) change the overall structure, adolescent-friendly nature, and agility of the organization; (8) and help clarify future directions taken by the organization. Overall, use of the RF approach had significant positive impacts on AHC as an organization, such as changes in organizational culture, deeper stakeholder engagement, and innovation, and was instrumental in AHC's growth, development, and pandemic response. This article outlines the steps of the process, from initial informal stakeholder consultations to the eventual formalization of the RF approach into the everyday working of AHC through the creation of a youth advisory board. We discuss challenges, such as time and resource constraints encountered; strategies for dealing with such challenges; and general key findings and learnings from this experience that could be beneficial to other youth- and community-serving organizations.

Self-control and SAT outcomes: Evidence from two national field studies.

Self-control is often thought to be synonymous with willpower, defined as the direct modulation of impulses in order to do what is best in the long-run. However, research has also identified more strategic approaches to self-control that require less effort than willpower. To date, field research is lacking that compares the efficacy of willpower to strategic self-control for consequential and objectively measured real-world outcomes. In collaboration with the College Board, we surveyed two national samples of high school students about how they motivated themselves to study for the SAT college admission exam. In Study 1 (N = 5,563), compared to willpower, strategic self-control predicted more hours of SAT practice and higher SAT scores, even when controlling for prior PSAT scores. Additionally, the more self-control strategies students deployed, the higher their SAT scores. Consistent with dose-response curves in other domains, there were positive albeit diminishing marginal returns to additional strategies. Mediation analyses suggest that the benefits of self-control strategies to SAT scores was fully explained by increased practice time. These results were confirmed in Study 2, a preregistered replication with N = 14,259 high school students. Compared to willpower, strategic self-control may be especially beneficial in facilitating the pursuit of goals in high-stakes, real-world situations.

Evaluating the Impact of a School-Based Youth-Led Health Education Program for Adolescent Females in Mumbai, India.

Background: India's 120 million adolescent girls often have limited opportunities to receive health education, as health-related content in school curricula can be minimal, and the few existing external interventions for this demographic rarely cover multiple topics. Objectives: This study conducted a program evaluation of Girls Health Champions, a school-based peer education intervention in Mumbai, India that educates girls about leading causes of adolescent morbidity and mortality, including nutrition, mental health, and sexual & reproductive health. Methods: Female participants ages 12 to 16 in the eighth, ninth, and tenth standards were recruited at five participating schools in Mumbai, India to learn a multi-topic health curriculum from their peers, with a subset of ninth standard participants in each school trained as the peer educators. Using a quasi-experimental design, participant survey data was collected three times during the 2016-2017 academic year: at baseline, immediately following the peer-led education sessions, and five months following these sessions. Outcomes of interest included change in knowledge levels and health attitudes following the intervention, as well as retention at mid-year. An additional outcome was the change in self-reported leadership skills of peer educators before and after participating. Findings: Compared to baseline, participants demonstrated statistically significant increases in knowledge levels (+48%, p < 0.001) and positive shifts in health-related attitudes (+42%, p < 0.001). These changes were maintained at mid-year (+29% for knowledge levels, p < 0.001; +37% for attitudes, p < 0.001). Findings were consistent when data was stratified by standard and peer educator status (peer educators versus non-peer educators). Peer educators also demonstrated a statistically significant increase in their interest in health promotion. Conclusions: This study demonstrates the effectiveness of the peer education delivery model and finds school-based, peer-led programs covering a range of adolescent health topics can significantly increase knowledge and shift attitudes of program participants. Such benefits can accrue to both peer educators and non-peer educator program participants.

Association of Food Insecurity with Children's Behavioral, Emotional, and Academic Outcomes: A Systematic Review.

OBJECTIVE: Food Insecurity (FI) occurs in 21% of families with children and adolescents in the United States, but the potential developmental and behavioral implications of this prevalent social determinant of health have not been comprehensively elucidated. This systematic review aims to examine the association between FI and childhood developmental and behavioral outcomes in western industrialized countries. METHOD: This review provides a critical summary of 23 peer reviewed articles from developed countries on the associations between FI and adverse childhood developmental behavioral outcomes including early cognitive development, academic performance, inattention, externalizing behaviors, and depression in 4 groups-infants and toddlers, preschoolers, school age, and adolescents. Various approaches to measuring food insecurity are delineated. Potential confounding and mediating variables of this association are compared across studies. Alternate explanatory mechanisms of observed effects and need for further research are discussed. RESULTS: This review demonstrates that household FI, even at marginal levels, is associated with children's behavioral, academic, and emotional problems from infancy to adolescence across western industrialized countries - even after controlling for confounders. CONCLUSIONS: While the American Academy of Pediatrics already recommends routine screening for food insecurity during health maintenance visits, the evidence summarized here should encourage developmental behavioral health providers to screen for food insecurity in their practices and intervene when possible. Conversely, children whose families are identified as food insecure in primary care settings warrant enhanced developmental behavioral assessment and possible intervention.