Youth Participatory Approaches and Health Equity: Conceptualization and Integrative Review.

There is an array of youth participatory approaches relevant to health equity efforts in community psychology, adolescent health, youth development, and education. While they share some commonalities, they also reflect important distinctions regarding key processes and intended level of impact. Here, we consider the following: (a) youth-led participatory action research (YPAR), (b) youth organizing (YO), (c) youth-led planning, (d) human-centered design, (e) participatory arts, and (f) youth advisory boards. Informed by community psychology theories on empowerment and levels of change and social epidemiology frameworks that focus on the social determinants of health inequities, we aim to promote greater clarity in the conceptualization, implementation, and evaluation of youth participatory approaches; frame the "landscape" of youth participatory approaches and their similarities and differences; present an integrative review of the evidence regarding the impact of youth participatory approaches; and describe several illustrative cases so as to consider more deeply how some youth participatory approaches aim to influence the social determinants of health that lead to the physical embodiment of health inequities. We conclude by identifying areas of future policy- and practice-relevant research for advancing youth participation and health equity.

Use of Research Evidence Generated by Youth: Conceptualization and Applications in Diverse U.S. K-12 Educational Settings.

Youth-Led Participatory Action Research (YPAR) is a social justice-focused approach for promoting social change and positive youth development in which youth conduct systematic research and actions to improve their schools and communities. Although YPAR is oriented to generating research for action, with evidence-based recommendations often aimed at influencing adults with power over settings and systems that shape youths' lives, we have little understanding of how YPAR evidence influences the thinking and/or actions of adult policymakers or practitioners. In general, the participatory research field lacks a theoretically informed "use of research evidence" lens, while the use of evidence field lacks consideration of the special case and implications of participatory research. To start to address these gaps, this paper presents a conceptual linkage across these two fields and then provides six illustrative case examples across diverse geographic, policy, and programmatic contexts to demonstrate opportunities and challenges in the use of YPAR evidence for policy and practice. Our illustrative focus here is on U.S. K-12 educational contexts, the most-studied setting in the YPAR literature, but questions examined here are relevant to YPAR and other systems domestically and internationally, including health, educational, and legal systems. HIGHLIGHTS: The use of research evidence (URE) field identifies characteristics of research and conditions that strengthen URE. Youth-led Participatory Action Research is a special case for factors that influence research use. Six case examples across diverse K-12 contexts illustrate facilitators and barriers for YPAR use. We propose next steps for community psychology research and action to promote the study and use of YPAR evidence.

So Much to Do Before I Sleep: Investigating Adolescent-Perceived Barriers and Facilitators to Sleep.

Adolescent sleep deprivation is a pressing public health issue in the United States as well as other countries. The contexts of adolescents' lives are changing rapidly, but little is known about the factors that adolescents themselves believe affect their sleep. This study uses a social-ecological framework to investigate multiple levels of perceived influence on sleep patterns of urban adolescents. Data were drawn from interviews and surveys conducted in three California public high schools. Most participants identified homework as their primary barrier to sleep, particularly those engaged in procrastinating, multitasking, or those with extracurricular demands. Results indicate that the home context has important implications for adolescent sleep, including noise, household rules, and perceived parent values. These findings identify important areas for future research and intervention, particularly regarding the roles of parents.

Emotion Reactivity and Regulation in Maltreated Children: A Meta-Analysis.

The many adverse effects of child maltreatment make the scientific investigation of this phenomenon a matter of vital importance. Although the relationship between maltreatment and problematic emotion reactivity and regulation has been studied, the strength and specificity of these associations are not yet clear. We examine the magnitude of the maltreatment-child-emotion reactivity/regulation link. Studies with substantiated maltreatment involving children aged up to 18 were included, along with a smaller number of longitudinal studies (58 papers reviewed, encompassing more than 11,900 children). In comparison to nonmaltreated children, maltreated children experience more negative emotions, behave in a manner indicative of more negative emotion, and display emotion dysregulation. We outline several theoretical implications of our results.

"The hook-up": How youth-serving organizations facilitate network-based social capital for urban youth of color.

Young people of color residing in distressed urban contexts face challenges in accessing social capital that supports positive development and the transition to educational and employment opportunities. Youth-serving organizations play potentially important roles for youth participants to access and leverage networks. This ethnographic study draws on qualitative interviews, conducted with adolescents at a youth-serving organization based in East Oakland, California, to examine how network-based social capital is activated and sustained for and by urban Black and Latinx youth. We found that relationships with supportive adult staff at the organization put youth in contact with caring, trusted adults of color outside of their families who serve as role models for them. These adults provide loving accountability to young people, serving as critical forces in distressed and stigmatized communities. We also found that adult staff activate social leverage to garner various current and future educational and professional opportunities for the youth there. These unique opportunities serve to boost young people's current self-esteem and also to prime them to envision positive futures for themselves. Overall, these findings point to the importance of interpersonal pathways embedded within neighborhood institutions in the activation of network-based social capital.

Dream Teens: Adolescents-Led Participatory Project in Portugal in the Context of the Economic Recession.

This article describes the implementation process of a nationwide project to enhance young people's participation and active citizenship in the context of Portugal's economic recession. This project used an innovative Positive Youth Development approach that engaged Portuguese youth (aged 11-18 years) through social media tools to facilitate their civic engagement and development. Participants from all over the country were empowered (1) to design and conduct research activities on topics of their choice and about their life contexts and (2) to create ways to improve youth civic participation in their communities, while developing supportive interactions with adults and peers. Overall, youth were engaged in their activities, felt their voices were heard, and felt that they were viewed as experts of their own well-being and living contexts. Youth research actions and preliminary findings were then compiled in a set of recommendations that was formally received by a high commissioner of the Ministry of Health. The article concludes with a discussion of the next steps for the project and its limitations so far.

Adolescent Sleep Barriers: Profiles within a Diverse Sample of Urban Youth.

Most adolescents face numerous obstacles to good sleep, which may undermine healthy development. In this study, we used latent class analysis and identified four categories of sleep barriers in a diverse sample of 553 urban youth (57% female). The majority profile, School/Screens Barriers, reported the most homework and extracurricular barriers, along with high screen time. The Home/Screens Barriers class (i.e., high environmental noise, light, screen use) and the High/Social Barriers class (i.e., high barriers across domains, particularly social) reported the poorest sleep quality and highest depressive/anxiety symptoms. The Minimal Barriers class-predominately male, with low depressive/anxiety symptoms-reported more sleep per night. We discuss implications of our findings for targeting interventions to address poor adolescent sleep among specific clusters of students.

Obstacles to preventing obesity in children aged 2 to 5 years: Latino mothers' and fathers' experiences and perceptions of their urban environments.

BACKGROUND: The prevalence of obesity among Latino children is alarmingly high, when compared to non-Latino White children. Low-income Latino parents living in urban areas, even if they are well-educated, face obstacles that shape familial health behaviors. This study used qualitative methods to explore parents' experiences in providing meals and opportunities to play to their children aged 2 to 5 years. In contrast to most prior studies, this study examined perceptions of familial behaviors among both mothers and fathers. METHODS: An ecological framework for exploring the associations of parental feeding behaviors and children's weight informed this study. An interview guide was developed to explore parents' experiences and perceptions about children's eating and physical activity and administered to six focus groups in a community-based organization in the Mission District of San Francisco. Transcripts were coded and analyzed. Twenty seven mothers and 22 fathers of Latino children ages 2 to 5 participated. RESULTS: Mothers, fathers, and couples reported that employment, day care, neighborhood environments and community relationships were experienced, and perceived as obstacles to promoting health behavior among their children, including drinking water instead of soda and participating in organized playtime with other preschool-age children. CONCLUSIONS: Results from this study suggest that the parents' demographic, social and community characteristics influence what and how they feed their children, as well as how often and the types of opportunities they provide for physical activity, providing further evidence that an ecological framework is useful for guiding research with both mothers and fathers. Mothers and fathers identified numerous community and society-level constraints in their urban environments. The results point to the importance of standardized work hours, resources for day care providers, clean and safe streets and parks, strong community relationships, and reduced access to sugar-sweetened beverages in preventing the development of obesity in preschool-age Latino children.

Protective Factors for Youth Exposed to Violence in Their Communities: A Review of Family, School, and Community Moderators.

This review provides a comprehensive investigation of the pattern and strength of findings in the literature regarding the environmental moderators of the relationship between exposure to community violence and mental health among children and adolescents. Twenty-nine studies met criteria for inclusion in our analysis of family, school, and community variables as moderators. Dependent variables included internalizing (e.g., anxiety, depression, posttraumatic stress disorder) and externalizing symptoms (e.g., aggression, substance use). Effect sizes for the interactions of exposure to violence and potential moderators were summarized by their patterns of protective processes. The majority of studies in the literature examined family characteristics as moderators of the exposure to violence-symptom relationship, rather than school- or community-level factors. Our results indicated more consistent patterns for (a) close family relationships and social support for internalizing symptoms and (b) close family relationships for externalizing symptoms. Overall, the most common type of protective pattern was protective-stabilizing, in which youth with higher levels of the environmental attribute demonstrate relative stability in mental health despite exposure to violence. We found no consistent evidence that parental monitoring-a dimension inversely associated with exposure to violence in prior studies-moderated the relationship between exposure to violence and symptoms. The study emphasizes the importance of strengthening family support for young people's exposure to community violence; more research is needed to provide a solid evidence base for the role of school and community-level protective factors for youth exposed to violence.

Scaling-Up Youth-Led Social Justice Efforts through an Online School-Based Social Network.

The exploration of social networking sites (SNS) in promoting social change efforts offers great potential within the field of community psychology. Online communities on SNS provide opportunities for bridging across groups, thus fostering the exchange of novel ideas and practices. Currently, there have only been limited efforts to examine SNS within the context of youth-led efforts. To explore the potential of SNS to facilitate the diffusion of social justice efforts between distinct youth groups, we linked three school-based youth-led participatory action research projects involving 54 high school students through a SNS. This study offers an innovative methodological approach and framework, utilizing social network analysis and strategic sampling of key student informants to investigate what individual behaviors and online network features predict student adoption of social change efforts. Findings highlight prospective facilitators and barriers to diffusion processes within a youth-led online network, as well as key constructs that may inform future research. We conclude by providing suggestions for scholars and practitioners interested in examining how SNS can be used to enhance the diffusion of social justice strategies, youth-led engagement efforts, and large-scale civic organizing.

A case study of middle school food policy and persisting barriers to healthful eating.

Decreasing access to competitive foods in schools has produced only modest effects on adolescents' eating patterns. This qualitative case study investigated persistent barriers to healthful eating among students attending an ethnically diverse middle school in a working-class urban neighborhood that had banned on campus competitive food sales. Participant observations, semi-structured interviews and document reviews were conducted. Unappealing school lunches and easily accessible unhealthful foods, combined with peer and family influences, increased the appeal of unhealthy foods. Areas for further inquiry into strategies to improve urban middle school students' school and neighborhood food environments are discussed.

The impact of participatory research on urban teens: an experimental evaluation.

Although there is much practice of community-based participatory research in economically-developing countries and increasingly in North America, there has been little systematic assessment of empowerment effects. Youth-led participatory research holds particular promise for fostering positive development and civic participation among economically disadvantaged urban youth. The present investigation uses a clustered-randomized, within-school experimental design to test the effects of youth-led participatory research on the psychological empowerment of 401 students attending urban public schools. We find that attending a participatory research elective class during the school day was associated with increases in sociopolitical skills, motivation to influence their schools and communities, and participatory behavior. We found no significant effects for perceived control at school. The implications for participatory research and related youth development interventions are discussed.

"Bounded" empowerment: analyzing tensions in the practice of youth-led participatory research in urban public schools.

This multi-method study examines tensions in the practice of youth-led participatory research (YPAR) in urban high schools among 15 semester-cohorts. Student participants in the present study were 77 ethnically diverse youth from four high schools in a major metropolitan school district. Data were gathered using systematic classroom observations, interviews with teachers and students involved in the projects, and participant observation. The two most commonly-constrained phases of the YPAR project were issue selection and action steps. A central tension in the issue selection phase for projects enacted across multiple semester cohorts was the tension between original inquiry and "traction:" Sticking with the same topic enabled sustained building of strategic alliances and expertise for making change, but limited the incoming cohort's power to define the problem to be addressed. In further analyses, we identified processes that promoted student power despite continuity-related constraints-teachers' framing and buy-in strategies, "micro-power" compensation, and alignment of students' interests with the prior cohort-as well as constraints in other phases of the projects. This study's findings regarding the promotion of youth power in the face of constraints advance the integration of theory and practice in youth-led research and have implications for participatory research more broadly.

Toward Integration of Life Course Intervention and Youth Participatory Action Research.

We provide an overview of diverse forms of youth participation, with a focus on youth participatory action research (YPAR) and its synergies with life course intervention research to promote healthier development for young people and across the life span. We analyze why YPAR matters for research, practice, and policies related to the systems and settings in which young people develop. We also illustrate how young people perform YPAR work to improve the developmental responsiveness and equity of school and health systems, including descriptions of an innovative youth-led health center in Rwanda and a long-standing and evolving integration of YPAR into public high schools in the United States. We then briefly consider the adult capacities needed to do this work well, given that YPAR challenges typical youth-adult power relationships and broader assumptions about who can generate expert knowledge. We consider the alignment and potential challenges for integration of life course intervention research as well as YPAR and next steps for research and practice at this intersection.

Adolescent Technology-use Rules and Sleep in a Large Representative Sample.

PURPOSE: This study investigated the prevalence of technology-use rules, typical sleep habits, and associations between rules and sleep using the representative 2017-2018 California Health Interview Survey adolescent sample. METHODS: Adolescents aged 12-17 years completed the California Health Interview Survey, including queries of (1) rules at home regarding times to turn off or put away electronics and (2) school-night bedtime and rise time. Rates of rules and associations between rules and sleep were investigated using descriptive statistics and bivariate and multivariable analyses. RESULTS: Seventy-two percent reported technology-use rules. Rates were comparable across subgroups. Rules and sleep were not significantly associated after adjusting for covariates. Reported time in bed fell below National Sleep Foundation guidelines for 38% of participants. CONCLUSIONS: Most adolescents reported technology-use rules at home. Associations between rules and bedtime were mixed, suggesting that further exploration of contextual and developmental factors is needed. Many reported inadequate sleep duration, supporting sleep as a key topic in adolescent health.

The role of parental emotion reactivity and regulation in child maltreatment and maltreatment risk: A meta-analytic review.

The prevalence and impact of child maltreatment make the scientific investigation of this phenomenon a matter of vital importance. Prior research has examined associations between problematic patterns of parents' emotion reactivity and regulation and child maltreatment and maltreatment risk. However, the strength and specificity of these relationships is not yet clear. To address this, we conducted a systematic literature search of four databases from inception through February 2021 to identify studies that reported these relationships. Our resulting meta-analysis of maltreatment involved parents of children who are up to 18 years of age (k = 46, encompassing 6669 parents). Our focus was the magnitude of the difference in levels of emotion reactivity and regulation between parents who maltreat or are at risk of maltreating and parents who do not maltreat their children or are not at risk of maltreating their children. As expected, results from meta-analyses using robust variance estimation indicated significantly higher problems with reactivity and regulation in maltreating parents / parents at risk (r = 0.40, k = 140; 95% CI [0.34, 0.45]), indicating that maltreating / at risk parents were more likely to have overall worse measures of reactivity and regulation. In comparison to non-maltreating parents, maltreating / at risk parents experience more negative emotions, display more negative emotion behavior, and are more dysregulated. These effects were fairly stable with little to no remaining heterogeneity. The current review concludes with a theoretical framework outlining the role of emotion reactivity and regulation in multiple risk factors of maltreatment, aiming to guide future study in this area.

Promoting institutional change to support public psychology: Innovations and challenges at the University of California.

Community partnerships are vital for the co-production, implementation, and dissemination of practice- and policy-relevant research to advance public psychology. Particularly in "Research 1" universities, the institutional infrastructure, culture, and criteria for faculty advancement are often a mismatch for impactful community-partnered research. Past and current efforts by psychologists and others at the University of California (UC) seek to promote partnerships, infrastructure, and practices for faculty development and advancement that align excellence and impact in scholarship with advancing the public mission of the UC and its campuses. Here, we delineate "partnered" public scholarship and provide an overview of mismatch between this scholarship and university structures. We then describe unique features of the UC and three cases of interdisciplinary partnerships to advance educational equity that illustrate how distinctive campuses and units engaged resources, deployed diverse strategies, and succeeded as well as failed to address challenges related to (a) how partnered scholarship is enacted, (b) supports to sustain the initiatives, and (c) faculty evaluation. We then consider lessons learned, implications, and ethical issues related to public psychology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

High School Composition and Health Outcomes in Adulthood: A Cohort Study.

BACKGROUND: A multitude of empirical evidence documents links between education and health, but this focuses primarily on educational attainment and not on characteristics of the school setting. Little is known about the extent to which aggregate characteristics of the school setting, such as student body demographics, are associated with adult health outcomes. METHODS: We use the U.S. nationally representative National Longitudinal Survey of Youth 1979 cohort to statistically assess the association between two different measures of high school student composition (socioeconomic composition, racial/ethnic composition) and two different health outcomes at age 40 (self-rated health and obesity). RESULTS: After adjusting for confounders, high school socioeconomic composition, but not racial/ethnic composition, was weakly associated with both obesity and worse self-rated health at age 40. However, after adding adult educational attainment to the model, only the association between high school socioeconomic composition and obesity remained statistically significant. CONCLUSIONS: Future research should explore possible mechanisms and also if findings are similar across other populations and in other school contexts. These results suggest that education policies that seek to break the link between socioeconomic composition and negative outcomes remain important but may have few spillover effects onto health.

Diffusion of school-based prevention programs in two urban districts: adaptations, rationales, and suggestions for change.

The diffusion of school-based preventive interventions involves the balancing of high-fidelity implementation of empirically-supported programs with flexibility to permit local stakeholders to target the specific needs of their youth. There has been little systematic research that directly seeks to integrate research- and community-driven approaches to diffusion. The present study provides a primarily qualitative investigation of the initial roll-out of two empirically-supported substance and violence prevention programs in two urban school districts that serve a high proportion of low-income, ethnic minority youth. The predominant ethnic group in most of our study schools was Asian American, followed by smaller numbers of Latinos, African Americans, and European Americans. We examined the adaptations made by experienced health teachers as they implemented the programs, the elicitation of suggested adaptations to the curricula from student and teacher stakeholders, and the evaluation of the consistency of these suggested adaptations with the core components of the programs. Data sources include extensive classroom observations of curricula delivery and interviews with students, teachers, and program developers. All health teachers made adaptations, primarily with respect to instructional format, integration of real-life experiences into the curriculum, and supplementation with additional resources; pedagogical and class management issues were cited as the rationale for these changes. Students and teachers were equally likely to propose adaptations that met with the program developers' approval with respect to program theory and implementation logistics. Tensions between teaching practice and prevention science-as well as implications for future research and practice in school-based prevention-are considered.

Participatory action research (PAR) in middle school: opportunities, constraints, and key processes.

Late childhood and early adolescence represent a critical transition in the developmental and academic trajectory of youth, a time in which there is an upsurge in academic disengagement and psychopathology. PAR projects that can promote youth's sense of meaningful engagement in school and a sense of efficacy and mattering can be particularly powerful given the challenges of this developmental stage. In the present study, we draw on data from our own collaborative implementation of PAR projects in secondary schools to consider two central questions: (1) How do features of middle school settings and the developmental characteristics of the youth promote or inhibit the processes, outcomes, and sustainability of the PAR endeavor? and (2) How can the broad principles and concepts of PAR be effectively translated into specific intervention activities in schools, both within and outside of the classroom? In particular, we discuss a participatory research project conducted with 6th and 7th graders at an urban middle school as a means of highlighting the opportunities, constraints, and lessons learned in our efforts to contribute to the high-quality implementation and evaluation of PAR in diverse urban public schools.