Explore the vast range of titles available.

Background Schools could play a vital role in mental health care, particularly in low-income countries such as Uganda. An understanding of the prevalence and associated factors of mental health symptoms among school-going adolescents is essential for designing effective school-based interventions in Uganda This is important given Uganda’s regional disparities, where adolescents in post-conflict areas may face higher exposure to trauma and limited access to mental health care compared to those in non-conflict regions. This study aimed to investigate the prevalence rates of depressive and anxiety symptoms among school-going adolescents aged 14 to 17 years in both post-conflict and non-conflict settings. It also examines factors associated with moderate depressive and anxiety symptoms in both settings. Methods In total, 2845 school-going adolescents (1,273 boys; 16.3 ± 1.0 years) were screened using the Patient Health Questionnaire-9 – adolescent version, Generalized Anxiety Disorder-7, and self-report items on food insecurity, health and wealth status, history of childhood abuse and neglect and level of physical activity. Logistic regression models were applied to examine predictors of moderate to severe levels of depression and anxiety symptoms. Results Findings indicate that 67.5% ( n  = 1905) reported at least mild, 34.1% ( n  = 962) at least moderate, 12.7% ( n  = 359) at least moderate-severe and 4.9% ( n  = 138) severe symptoms of depression, while 65.6% ( n  = 1860) at least mild, 27.5% ( n  = 777) at least moderate and 7.8% ( n  = 219) severe symptoms of anxiety. In the multivariable analyses, female sex, food insecurity, poor self-reported health, co-morbid anxiety symptoms, and a history of abuse and neglect were all significantly associated with a higher odds of moderate symptoms of depression, while female sex, living in a post-conflict setting, food insecurity, poor self-reported health, co-morbid depressive symptoms, and a history of abuse were all significantly associated with a higher odds of moderate anxiety symptoms. Conclusions A substantial proportion of school-going adolescents in Uganda report at least moderate symptoms of depression and anxiety. Government and public sector agencies should re-evaluate their strategies at both family and school levels, particularly in underserved settings. Schools can serve as platforms for screening-and-referral pathways and group-based psychosocial programs, while the health system should strengthen capacity for co-occurring conditions.

HIV prevalence among the general population in South Sudan, the world’s newest country, is estimated at 2.9% and in Nimule, a town at the border with Uganda, it is estimated at 7.5%. However, there is limited data describing the HIV epidemic among female sex workers and sexually exploited adolescents (FSW/SEA) in the country. This study was conducted using a respondent-driven sampling (RDS) among FSW/SEA aged ≥15 years in January-February 2017 who sold or exchanged sex in the last six months in Nimule. Consenting participants were administered a questionnaire and tested for HIV according to the national algorithm. Syphilis testing was conducted using SD BIOLINE Syphilis 3.0 and Rapid Plasma Reagin for confirmation. Data were analyzed in SAS and RDS-Analyst and weighted results are presented. The 409 FSW/SEA participants with a median age of 28 years (IQR 23–35) and a median age of 23 years (IQR 18–28) when they entered the world of sex work, were enrolled in the Eagle survey. Nearly all (99.2%) FSW/SEA lacked comprehensive knowledge of HIV though almost half (48.5%) talked to a peer educator or outreach worker about HIV in the last 30 days. More than half (55.3%) were previously tested for HIV. Only 46.4% used a condom during their last vaginal or anal sexual act with a client. One in five (19.8%) FSW/SEA experienced a condom breaking during vaginal or anal sex in the last six months HIV prevalence was 24.0% (95% CI: 19.4–28.5) and 9.2% (95% CI: 6.5–11.9) had active syphilis. The multivariable analysis revealed the association between HIV and active syphilis (aOR: 6.99, 95% CI: 2.23–21.89). HIV and syphilis prevalence were higher among FSW/SEA in Nimule than the general population in the country and Nimule. Specifically, the HIV prevalence was eight times higher than the general population. Our findings underscore the importance of providing HIV and syphilis testing for FSW/SEA in conjunction with comprehensive combination prevention, including comprehensive HIV information, promotion of condom use, and availing treatment services for both HIV and syphilis.

Background Despite growing advocacy for youth-led and inclusive physical activity provision, there remains limited evidence on how to effectively support underserved young women aged (16–25) and those from minoritised genders into Physical Activity leadership roles. Methods We used a two-phase sequential design. Phase 1 involved systematic mapping of 53 PA leadership programmes in England to describe programme focus, target populations, delivery models and stated outcomes. Phase 2 comprised seven online focus groups with 41 practitioners involved in designing, delivering or overseeing such programmes. Mapping data were summarised using descriptive statistics and narrative synthesis; focus group data were analysed using hybrid inductive–deductive framework analysis informed by Critical Positive Youth Development and feminist–intersectional lenses. Results Only a minority of mapped programmes were explicitly designed for girls and young women from underserved groups. Programmes most commonly operated through school- or club-based delivery, using modular learning, mentoring and cascaded models, with fewer incorporating financial support, digital delivery or clearly defined progression routes. Practitioners described how recruitment frequently relied on institutional gatekeepers and digital communication, raising concerns about who is reached and who is missed. They emphasised the importance of relational and culturally grounded recruitment and support, care-oriented infrastructures, and broader conceptualisations of leadership that include advocacy, representation and community influence. Conclusion Combining systematic mapping with practitioner insights provides an integrated descriptive and interpretive picture of current provision. The findings indicate uneven targeting of underserved girls and young women and variable support for their progression into leadership roles. Enhancing equity in PA leadership development will require attention to recruitment practices, relational support and progression pathways that recognise diverse forms of youth leadership.

This study explored the developmental trajectory and influencing factors of emotional symptoms in adolescents from economically disadvantaged families. We recruited 444 students from Hunan Province, China, from economically disadvantaged families classified as below the local income threshold, to participate in this study. The participants (165 boys and 279 girls) were ranged from 10 to 15 years, with the average age being 13.61 ± 1.62 year. Follow-up surveys were administered on the first and second year after the original survey in October 2017. Their developmental trajectories were analyzed from an individual-centered perspective using a latent class growth analysis. The 3-steps approach was used to analyze the effects of gender, age, and ecological risks on various classes. Latent class growth analysis favored a three classes solution: C1(resilient class), C2(stable class), and C3(disturbed class). There is population heterogeneity in the developmental trajectories of emotional symptoms among economically disadvantaged adolescents. Individuals with more ecological risk are more likely to belong to the stable class or the disturbed class.

Background Social isolation and loneliness are a growing public health concern. Inadequacies in neighbourhood social infrastructure can undermine social connectedness, particularly for youth, who are dependent on their local environments yet often marginalized from public spaces and city planning. Integrating citizen science with participatory action research, the Youth.hood study set out to explore how neighbourhood built environments help or hinder social connectedness from the understudied perspective of youth in under-resourced and racialized communities. Methods Youth ( n  = 42) from three neighbourhoods in Vancouver, Canada were recruited to: (1) Assess environmental assets and barriers to connectedness in their neighbourhoods using a digital photovoice app; (2) Analyze and prioritize their collective data into themes; and (3) Design and advocate for environmental improvements through a participatory workshop and forum with residents, city planners, and elected officials. Data on participant characteristics and neighbourhood perceptions were collected via an online survey and analyzed descriptively. Participatory analysis was conducted with youth using methods from thematic analysis, photovoice, and design thinking. Results Youth captured 227 environmental features impacting their connectedness. The most frequently reported assets were parks and nature ( n  = 39, 17%), including formal and informal green spaces, and food outlets ( n  = 25, 11%). Top barriers included poor neighbourhood aesthetics ( n  = 14, 6%) and inadequate streets and sidewalks ( n  = 14, 6%). Thematic analysis with youth underscored four themes: (1) Connecting through mobility: The fun and functionality of getting around without a car; (2) The power of aesthetics: Mediating connections to people and place; (3) Retreating to connect: Seeking out social and restorative spaces for all; and (4) Under-resourced, not under-valued: Uncovering assets for sociocultural connection. Youth described their local environments as affording (or denying) opportunities for physical, emotional, and cultural connection at both an individual and community level. Conclusion Our findings extend evidence on key environmental determinants of social connectedness for youth, while highlighting the potential of community design to support multiple dimensions of healthy social development. Additionally, this work demonstrates the resilience and agency of youth in under-resourced settings, and underscores the importance of honouring assets, co-production, and intergenerational planning when working to advance healthy, connected, and youthful cities.

Background Intersecting socioeconomic and demographic reasons for physical activity (PA) inequalities are not well understood for young people at risk of experiencing marginalisation and living with disadvantage. This study explored young people’s experiences of PA in their local area, and the associated impacts on opportunities for good physical and emotional health and wellbeing. Methods Seven local youth groups were purposefully sampled from disadvantaged areas across urban, rural and coastal areas of England, including two that were specifically for LGBTQ + young people. Each group engaged in three interlinked focus groups which explored young people’s perceptions and lived experience of PA inequalities. Data were analysed using an inductive, reflexive thematic approach to allow for flexibility in coding. Results Fifty five young people aged 12–21 years of different sexualities, gender and ethnicity took part. Analysis yielded four themes: PA experiences across spaces; resigned to a lack of inclusivity and ‘belonging’; safety first; complexities in access and accessibility. Young people felt more comfortable to be active in spaces that were simpler to navigate, particularly outdoor locations largely based in nature. In contrast, local gyms and sports clubs, and the school environment in general, were spoken about often in negative terms and as spaces where they experienced insecurity, unsafety or discomfort. It was common for these young people to feel excluded from PA, often linked to their gender and sexuality. Lived experiences or fears of being bullied and harassed in many activity spaces was a powerful message, but in contrast, young people perceived their local youth club as a safe space. Intersecting barriers related to deprivation, gender and sexuality, accessibility, disability, Covid-19, affordability, ethnicity, and proximity of social networks. A need emerged for safe spaces in which young people can come together, within the local community and choose to be active. Conclusions The overarching concept of ‘physical activity insecurity’ emerged as a significant concern for the young people in this study. We posit that PA insecurity in this context can be described as a limited or restricted ability to be active, reinforced by worries and lived experiences of feeling uncomfortable, insecure, or unsafe.

Background Evidence available on the determinants of vegetable intake in young populations is inconsistent. Vegetable intake is particularly low in adolescents from less-affluent backgrounds, yet no systematic review of qualitative studies investigating determinants for vegetable intake specifically has been conducted to date in this group. This systematic review aimed to identify determinants of vegetable intake in adolescents from socioeconomically disadvantaged urban areas located in very high-income countries reported in qualitative studies. Methods Five electronic databases (PubMed, Web of Science, CINAHL, PsycINFO and ERIC) were searched until August 2022. The search strategy used combinations of synonyms for vegetable intake, adolescents, and qualitative methodologies. Main inclusion criteria were studies exploring views and experiences of motivators and barriers to vegetable intake in a sample of adolescents aged 12–18 years from socioeconomically disadvantaged urban areas in very high income countries. Study quality assessment was conducted using criteria established in a previous review. Results Sixteen studies were included out of the 984 screened citations and 63 full texts. The synthesis of findings identified the following determinants of vegetable intake: sensory attributes of vegetables; psychosocial factors (nutrition knowledge, preferences/liking, self-efficacy, motivation); lifestyle factors (cost/price, time, convenience); fast food properties (taste, cost, satiety); home environment and parental influence; friends’ influence; school food environment, nutrition education and teachers’ support; and availability and accessibility of vegetables in the community and community nutrition practices. Studies attained between 18 and 49 out of 61 quality points, with eleven of 16 studies reaching ≥ 40 points. One main reason for lower scores was lack of data validation. Conclusion Multiple determinants of vegetable intake were identified complementing those investigated in quantitative studies. Future large scale quantitative studies should attempt to examine the relative importance of these determinants in order to guide the development of successful interventions in adolescents from socioeconomically disadvantaged backgrounds.

The purpose of this explanatory sequential mixed methods study was to examine parenting outcomes and experiences over time among marginalized adolescent mothers enrolled in randomized clinical trials (RCT) between 2002 and 2016 testing Minding the Baby® (MTB), an early home visiting program. The quantitative phase examined associations between measures of maternal experiences and parenting outcomes from 71 participants 2–8 years since RCT completion. MTB mothers reported less hostile parenting and fewer child behavior problems. The sequential qualitative phase involved interviews with a subsample ( n = 31) and revealed six themes about their personal and parenting maturation. Through integration of quantitative and qualitative data, we generated metainferences, revealing a nuanced understanding of participants’ experiences. Integrated findings revealed the complex personal and parenting experiences among former adolescent mothers during their developmental phases of emerging and early adulthood. Findings inform clinical and research approaches to promote personal growth and positive parenting outcomes over time among women who began childbearing in adolescence.

The aim of this systematic review is to identify cognitive interventional studies which have used randomized controlled trials (RCT) and whose purpose was to improve the cognitive development of vulnerable children and adolescents (< 18 years old). We conducted a systematic literature search in the following databases: Web of Science (core collection), PsycInfo, Cochrane Central Register of Controlled Trial, ERIC, PubMed and Opengrey Register. All reviewing processes were conducted independently by two reviewers. Relevant data were extracted, including sample traits, outcomes, specifics of the intervention, as well as follow-up measures. This review followed both PICOS and SWiM guidelines. A qualitative and quantitative synthesis of results was undertaken following the Synthesis Without Metanalysis (SWiM) guidelines. Of the 31 studies selected for inclusion, the majority were focused on attention, language, and executive functions processes. Analysis of the quantitative data using the combination of p values method revealed that in each of the following areas there is at least one published study which has been beneficial for children that live at social risk: attention, executive functioning, math skills, motor/praxis and composite cognition. Although the target processes in most of the studies were attention, language, and executive functions, it would be also beneficial to conduct interventions in other processes such as memory. Understanding the characteristics of successful and unsuccessful interventions could help to support and create effective programs that may help to improve the lives of those children and adolescents that live in disadvantaged situations by enhancing their cognitive development. CDR42020150238.

Background Adolescence represents a crucial phase of life where health behaviours, attitudes and social determinants can have lasting impacts on health quality across the life course. Unhealthy behaviour in young people is generally more common in low socioeconomic groups. Nevertheless, all adolescents should have a fair opportunity to attain their full health potential. Health literacy is positioned as a potential mediating factor to improve health, but research regarding health literacy in adolescents and socially disadvantaged populations is limited. As part of Phase one of the Ophelia (OPtimising HEalth LIterAcy) framework, The purpose of this study was to explore the perceptions of socially disadvantaged Irish adolescents in relation to health literacy and related behaviours, and utilise this data to develop relevant vignettes. Methods A convergent mixed method design was used to co-create the vignettes. Questionnaires were completed by 962 adolescents (males n  = 553, females n  = 409, Mean age = 13.97 ± 0.96 years) from five participating disadvantaged schools in Leinster, Ireland. Focus groups were also conducted in each school ( n  = 31). Results were synthesised using cluster and thematic analysis, to develop nine vignettes that represented typical male and female subgroups across the schools with varying health literacy profiles. These vignettes were then validated through triangular consensus with students, teachers, and researchers. Discussion The co-creation process was a participatory methodology which promoted the engagement and autonomy of the young people involved in the project. The vignettes themselves provide an authentic and tangible description of the health issues and health literacy profiles of adolescents in this context. Application of these vignettes in workshops involving students and teachers, will enable meaningful engagement in the discussion of health literacy and health-related behaviours in Irish young people, and the potential co-designing of strategies to address health literacy in youth. Conclusion As guided by the Ophelia framework, the use of authentic, interactive and participatory research methods, such as the co-creation of vignettes, is particularly important in groups that are underserved by traditional research methods. The approach used in this study could be adapted to other contexts to represent and understand stakeholders’ perceptions of health, with a view to explore, and ultimately improve, health literacy.