JAMA Network Open最新文献

Importance: As generative artificial intelligence (GenAI) tools become increasingly integrated into the daily lives of youth, it is critical to study their usage patterns and potential implications for mental health. While there is evidence of a rapid pace of adoption among adults, rates of GenAI use among youth remains largely undocumented.

Objective: To characterize GenAI application (app) usage among US youth, including adoption rates and time spent.

Design, setting, and participants: This cross-sectional study documented digital behavior of US youth extracted from a parental monitoring app. Participants were ages 4 to 17 years and were in families using a commercially available Aura app in the US. No identifying information was collected about the child except year of birth. Data were collected using passive sensing methods from naturalistic smart device use between September 2024 and April 2025. Data were analyzed in May and June 2025.

Main outcome and measures: Adoption rates (ie, number of youth ever accessing GenAI apps on their device) and time spent using GenAI (ie, average minutes accessing GenAI apps), measured by age and time period.

Results: In a cohort of 6488 participants, nearly 2072 youths (31.9%) used GenAI apps on their device. GenAI use was highest among teens (age 13 to 14 years, 899 of 2139 [42.0%]; age 15 to 17 years, 628 of 1246 [50.4%]), although adoption among preteens (age 10 to 12 years, 484 of 2366 [20.5%]) and school-aged children (age 8 to 9 years, 49 of 522 [9.4%]) was not trivial. GenAI usage was higher after school than at nighttime or during school. Overall, users spent a mean (SD) 2.37 (10.55) and a median (IQR) 0.18 (0.04-0.84) minutes a day using GenAI, yet large variances and skewed distributions suggest that a small subset of youth use GenAI extensively, with the heaviest users accessing GenAI for over 40 minutes a day.

Conclusions and relevance: In this cross-sectional study, Gen AI app use varied widely among participants, with up to half of adolescents having some use and a small subset engaging in heavy use. Future research must address individual differences in GenAI use to determine impacts on development.

Importance: National monitoring surveys indicate that developmental disabilities among US children constitute a substantial public health issue. While scientific literature documents the benefits of targeted, developmental interventions, there has been less study of formal early intervention (EI) services provided through Part C of the Individuals With Disabilities Education Act.

Objective: To assess the population-level utilization of the New York City EI program and estimate the association between receipt of EI services before 3 years of age and academic achievement later in childhood.

Design, setting, and participants: This retrospective cohort study was performed within an administrative data linkage of public health and educational data systems in New York City, with records from January 1, 1994, to December 31, 2007. Participants included children born in New York City between January 1, 1994, and December 31, 1998, who attended public elementary school for third grade. Analyses were conducted from January 1, 2023, to December 31, 2024.

Exposure: Any use of EI services from birth through 3 years of age.

Main outcomes and measures: The primary outcomes were standardized test scores in math and English language arts (ELA) in third grade. After propensity score matching, linear and log-binomial regression were used to estimate differences in standardized test scores and incidence ratios of meeting test-based standards, comparing individuals who did and did not receive EI services.

Results: The study population consisted of 214 370 children with records through third grade. Of the 13 022 children who had received EI services (6.1%) before 3 years of age, 8516 (65.4%) were male (mean [SD] gestational age, 37.5 [3.8] weeks). When examining third grade standardized test scores, higher absolute test scores were observed among children who received EI in ELA (estimate, 0.045; 95% CI, 0.021-0.069) and greater incidence of meeting test-based standards in both math (incidence ratio, 1.08; 95% CI, 1.06-1.10) and ELA (incidence ratio, 1.09; 95% CI, 1.07-1.12) when comparing propensity score-matched samples. Evidence of heterogeneity was observed, as individuals who required special education, those from households with lower socioeconomic status, and those born to immigrant mothers had greater test score benefits associated with EI.

Conclusions and relevance: The findings of this cohort study suggest that EI services for children younger than 3 years with moderate to severe developmental delays or disabilities had tangible academic benefits later in childhood. Future research should investigate the implementation of EI services among individuals with different diagnoses and developmental delays to determine the most beneficial service plans for children with differing needs.

Importance: Black adults may derive long-term cognitive benefits from attendance at a historically Black college or university (HBCU) compared with a predominantly White institution (PWI). This association has not been evaluated in a nationwide sample.

Objective: To estimate the association between HBCU vs PWI attendance and cognitive health among later-life Black adults.

Design, setting, and participants: This cohort study used data from the Reasons for Geographic and Racial Differences in Stroke study, a prospective cohort study that recruited Black and White US adults aged 45 years and older during 2003 to 2007. The national cohort oversampled Black individuals and residents from the Stroke Belt (56%), a group of 8 Southern states defined by excess stroke mortality. The analytic sample included Black participants who attended high school in a state with an HBCU and attended college. Analysis was conducted from February to September 2025.

Exposure: Participants self-reported each college ever attended, classified as a PWI (reference) or HBCU.

Main outcomes and measures: Assessments of memory, language, and global cognition were conducted during follow-up every 6 months (2006-2021). Cognitive measures were standardized (ie, z-transformed). Linear regression was used to estimate the average treatment effect (ATE) using inverse of probability of treatment weighting. Additional analyses evaluated potential modification by being college-aged before 1955 (during legal racial segregation), 1955 to 1964 (during sanctioned racial discrimination), or after 1964.

Results: Among 1978 Black college-goers (mean [SD] age at first assessment, 61.8 [8.2] years; 1333 [67.4%] female), 699 (35.3%) attended an HBCU, 1952 (98.7%) completed a memory assessment, 1970 (99.6%) completed a language assessment, and 530 (26.8%) completed both assessments during the same follow-up visit. Compared with PWI attendance, HBCU attendance was associated with better z-scored memory (ATE, 0.13; 95% CI, 0.05-0.21), language (ATE, 0.19; 95% CI, 0.08-0.29), and global cognition (ATE, 0.22; 95% CI, 0.09-0.34). Estimates were consistent for individuals who were college-aged after 1955 but were not statistically significant among respondents who were college-aged prior to 1955.

Conclusions and relevance: In this cohort study using a national dataset, HBCU attendance was associated with better cognition compared with PWI attendance for aging Black adults, which held for those attending college before and after legal racial segregation and sanctioned racial discrimination in education.