Journal of Adolescent Health最新文献

英文中文

Leaving No One Behind: Ensuring Adolescents Are Central in Efforts to Address Global Shocks 一个都不能少：确保青少年成为应对全球冲击的核心力量。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-18 DOI: 10.1016/j.jadohealth.2024.09.014

Jaameeta Kurji Ph.D., M.P.H., Luo Li M.P.H., Peter Azzopardi Ph.D., M.Epi., M.B.B.S.

引用次数: 0

Understanding Trajectories of Generalized Anxiety Disorder Among Adolescents During the COVID-19 Pandemic: Evidence From China and the Democratic Republic of the Congo 了解 COVID-19 大流行期间青少年广泛焦虑症的发展轨迹：来自中国和刚果民主共和国的证据。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-18 DOI: 10.1016/j.jadohealth.2024.09.012

Mengmeng Li M.D., M.S.P.H. , Sam Beckwith Ph.D. , Shoshanna L. Fine Ph.D., M.P.H. , Eric Mafuta M.D., Ph.D., M.P.H. , Qiguo Lian M.D. , Michelle Martinez-Baack M.S.P.H. , Caroline Moreau M.D., Ph.D., M.P.H.

Purpose

This study aims to assess anxiety trends over the COVID-19 pandemic and evaluate how pandemic-related adversities modify trajectories among underprivileged adolescents from two distinct settings.

Methods

Data came from the Shanghai, China and Kinshasa, Democratic Republic of the Congo sites of the Global Early Adolescent Study. Data were collected three times over approximately two years: prior to the pandemic (T1) and during the pandemic (T2, T3). Analyses included adolescents (aged 10–16) with complete information on generalized anxiety disorder (GAD) across all time points (Shanghai N = 548; Kinshasa N = 334). Weighted Generalized Estimating Equations assessed anxiety at T2 and T3 relative to T1. Effect modification analyses were used to investigate if COVID-19-related adversities modified anxiety trajectories.

Results

Six months into the pandemic, 15.3% (Shanghai) and 4.1% (Kinshasa) of adolescents reported having moderate-to-severe GAD. Adjusted Generalized Estimating Equation models did not suggest increases in GAD during the pandemic across both sites. However, female adolescents from Shanghai experienced increased anxiety (adjusted odds ratio [aOR]: 2.27, 95% confidence interval: 1.30–3.99) half a year into the pandemic. The trend was not sustained. COVID-related adversities did not modify anxiety trajectories in Kinshasa. In Shanghai, one year into the pandemic, we observed decreased odds of GAD among all (aOR: 0.31, 0.17–0.58) and female adolescents (aOR: 0.25, 0.08–0.75) without pandemic-associated negative household experiences.

Discussion

The COVID-19 pandemic differentially affected adolescent anxiety by time, place, and gender. Future research should examine the roles of social context and resilience to better understand adolescents' mental distress and to guide health-promoting programs and policies for young people.

目的：本研究旨在评估 COVID-19 大流行期间的焦虑趋势，并评估与大流行相关的逆境如何改变来自两种不同环境的贫困青少年的焦虑轨迹：数据来自全球青少年早期研究的中国上海和刚果民主共和国金沙萨研究点。在大约两年的时间里，共收集了三次数据：大流行之前（T1）和大流行期间（T2、T3）。分析对象包括在所有时间点上具有广泛性焦虑症（GAD）完整信息的青少年（10-16 岁）（上海：548 人；金沙萨：334 人）。加权广义估计方程评估了 T2 和 T3 阶段相对于 T1 阶段的焦虑程度。采用效应修正分析来研究与COVID-19相关的逆境是否会改变焦虑的轨迹：大流行发生六个月后，15.3%（上海）和4.1%（金沙萨）的青少年报告患有中度至重度焦虑症。调整后的广义估计方程模型表明，在大流行期间，两地的 GAD 均未增加。然而，上海的女性青少年在疫情发生半年后出现了焦虑增加（调整后的几率比 [aOR]：2.27，95% 置信区间：1.30-3.99）。这一趋势并未持续。在金沙萨，与 COVID 相关的逆境并没有改变焦虑的轨迹。在上海，大流行发生一年后，我们观察到所有青少年（aOR：0.31，0.17-0.58）和女性青少年（aOR：0.25，0.08-0.75）在没有与大流行相关的负面家庭经历的情况下，患 GAD 的几率有所下降：讨论：COVID-19大流行对青少年焦虑的影响因时间、地点和性别而异。未来的研究应探讨社会环境和复原力的作用，以便更好地了解青少年的精神痛苦，并为促进青少年健康的项目和政策提供指导。

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引用次数: 0

Understanding Whether Economic Instability and Food Insecurity During COVID-19 Moderate the Change in Emotional Abuse and Emotional Neglect Over Time: A Longitudinal Pre- and During COVID-19 Analysis From China, Democratic Republic of Congo, Indonesia, and Malawi 了解 COVID-19 期间的经济不稳定和粮食不安全是否会调节情感虐待和情感忽视随时间的变化：来自中国、刚果民主共和国、印度尼西亚和马拉维的 COVID-19 前后纵向分析。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-18 DOI: 10.1016/j.jadohealth.2024.09.002

Astha Ramaiya M.Sc., Dr.P.H. , Mengmeng Li M.D., M.S.P.H. , Eva Muluve M.P.H. , Xiayun Zuo Ph.D. , William Stones M.D. , Eric Mafuta M.D., M.P.H., Ph.D. , Caroline Moreau M.D., M.P.H., Ph.D. , Linnea Zimmerman M.P.H., Ph.D.

Purpose

This study explores whether economic instability or food insecurity moderates the changes in emotional abuse and neglect over time.

Methods

We used data from the Global Early Adolescent Study, a longitudinal study among adolescents ages 13–18 years (10–14 during pre–COVID-19 round) from poor urban communities in China (n = 387), the Democratic Republic of Congo (DRC) (n = 285), Indonesia (n = 400), and Malawi (n = 320). Data were collected before (2017 to March 2020) and during the pandemic (June to November 2020). Generalized estimating equations, using inverse probability weights evaluated changes in emotional abuse and neglect pre- and during COVID-19 and tested whether these changes varied by economic instability and food insecurity experiences during COVID-19.

Results

Pre–COVID-19, emotional abuse ranged from 37.2% in DRC to 65.3% in Indonesia, and emotional neglect from 10.9% in DRC to 50.3% in Indonesia. The odds of emotional neglect increased in all sites during COVID-19 except Indonesia (adjusted odds ratio (aOR) ranging from 1.7 in China to 4.1 in Malawi). In Indonesia, odds of abuse and neglect decreased significantly during COVID-19 (aOR ranging from 0.4 to 0.7); however, emotional abuse and/or neglect declines was less pronounced for those who experienced economic instability and/or food insecurity. In Malawi, adolescents who experienced food insecurity had a significant increase in odds of emotional neglect during COVID-19.

Discussion

The COVID-19 pandemic exacerbated emotional neglect and emotional abuse among adolescents living in low- and middle-income countries, although this effect varies by place and population. In Malawi and Indonesia, adolescents who experienced economic instability and/or food insecurity had more unfavorable outcomes during COVID-19, highlighting the importance of social programs correcting inequities during pandemics.

目的：本研究探讨了经济不稳定或粮食不安全是否会调节情感虐待和忽视随时间的变化：我们使用了全球青少年早期研究（Global Early Adolescent Study）的数据，该研究是一项纵向研究，研究对象是来自中国（n = 387）、刚果民主共和国（DRC）（n = 285）、印度尼西亚（n = 400）和马拉维（n = 320）贫困城市社区的 13-18 岁青少年（COVID-19 前一轮研究期间为 10-14 岁）。数据收集于疫情爆发前（2017 年至 2020 年 3 月）和疫情爆发期间（2020 年 6 月至 11 月）。使用反概率加权的广义估计方程评估了COVID-19之前和期间情感虐待和忽视的变化，并检验了这些变化是否因COVID-19期间的经济不稳定和粮食不安全经历而有所不同：结果：在 COVID-19 之前，情感虐待的比例从刚果民主共和国的 37.2% 到印度尼西亚的 65.3%，情感忽视的比例从刚果民主共和国的 10.9% 到印度尼西亚的 50.3%。在 COVID-19 期间，除印度尼西亚外，所有地区的情感忽视几率都有所上升（调整后的几率（aOR）从中国的 1.7 到马拉维的 4.1 不等）。在印度尼西亚，虐待和忽视的几率在COVID-19期间显著下降（aOR从0.4到0.7不等）；然而，对于那些经历过经济不稳定和/或粮食不安全的青少年来说，情感虐待和/或忽视的下降并不明显。在马拉维，经历过粮食不安全的青少年在 COVID-19 期间遭受情感忽视的几率显著增加：讨论：COVID-19大流行加剧了中低收入国家青少年的情感忽视和情感虐待，尽管这种影响因地点和人群而异。在马拉维和印度尼西亚，经历过经济不稳定和/或粮食不安全的青少年在COVID-19期间会有更多不利的结果，这凸显了社会项目在大流行期间纠正不公平现象的重要性。

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引用次数: 0

Coping Strategies Among Adolescents During the COVID-19 Pandemic: A Cross-Cultural Exploration COVID-19 大流行期间青少年的应对策略：跨文化探索。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-18 DOI: 10.1016/j.jadohealth.2024.09.001

Kristin Mmari Dr.P.H., M.A. , Eric Mafuta Ph.D. , Chunyan Yu Ph.D. , Aang Pinandari M.P.H. , Ana Luiza Vilela Borges Ph.D. , Matilde Maddaleno M.D., M.P.H. , Michelle Martinez-Baack M.S.P.H.

Purpose

To identify the patterns of stressors associated with the COVID-19 pandemic among adolescents living in different cultural settings and to explore how adolescents cope with such stressors, particularly by type of stressor, site, and gender.

Methods

The study was based on focus group discussion data from 9 urban poor communities in Kinshasa (Democratic Republic of Congo), Blantyre (Malawi), Shanghai (China), Semarang and Denpasar (Indonesia), New Orleans (USA), Ghent (Belgium), São Paulo (Brazil), and Santiago (Chile). Translated transcripts from the focus group discussions were uploaded into ATLAS.ti (Version 9.1) and analyzed using an inductive thematic analytical approach to code and identify themes related to the primary objectives.

Results

Adolescents in Blantyre and Kinshasa reported stressors primarily related to economic constraints and hardships, whereas adolescents in other sites were more likely to report stressors related to school lockdowns. Patterns of coping strategies also loosely aligned with these differences, as adolescents in Blantyre and Kinshasa were also more likely to report using religious coping strategies compared to any other site. Still, the most common coping mechanism mentioned across sites was obtaining social support, with support from friends and family being the most dominant.

Discussion

A comprehensive understanding of adolescent stressors and coping mechanisms is valuable for promoting internal resources and positive outcomes for adolescents. Given that adolescents’ stressors and types of coping strategies varied primarily by socioeconomic factors, interventions that aim to bolster positive coping among adolescents need to consider the local context and available resources.

目的：确定生活在不同文化背景下的青少年与 COVID-19 大流行相关的压力模式，并探讨青少年如何应对这些压力，特别是压力类型、地点和性别方面的压力：本研究基于来自金沙萨（刚果民主共和国）、布兰太尔（马拉维）、上海（中国）、三宝垄和登巴萨（印度尼西亚）、新奥尔良（美国）、根特（比利时）、圣保罗（巴西）和圣地亚哥（智利）9 个城市贫困社区的焦点小组讨论数据。焦点小组讨论的翻译记录上传到 ATLAS.ti（9.1 版），并使用归纳式主题分析方法进行分析，以编码和确定与主要目标相关的主题：布兰太尔和金沙萨的青少年报告的压力主要与经济限制和困难有关，而其他地点的青少年更有可能报告与学校停课有关的压力。应对策略的模式也与这些差异大致吻合，因为与其他地方相比，布兰太尔和金沙萨的青少年更倾向于使用宗教应对策略。尽管如此，各地青少年最常提到的应对机制是获得社会支持，其中来自朋友和家人的支持最为主要：讨论：全面了解青少年的压力源和应对机制对于促进青少年的内部资源和积极成果非常重要。鉴于青少年的压力源和应对策略类型主要因社会经济因素而异，旨在促进青少年积极应对的干预措施需要考虑当地的环境和可用资源。

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引用次数: 0

Experiences of Pregnant and Parenting Adolescents and Young Women During COVID-19 Pandemic: A Mixed-Methods Study Among Girls and Women in Kenya 在 COVID-19 大流行期间怀孕和为人父母的青少年和年轻妇女的经历：肯尼亚女孩和妇女的混合方法研究。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-18 DOI: 10.1016/j.jadohealth.2024.09.011

Eva Muluve M.P.H. , Celia Karp Ph.D. , Daniel Osuka M.Sc. , Ruth Nanjekho Ph.D. , Daniel Mwanga M.Sc., M.A. , Caroline Moreau M.D., Ph.D., M.P.H. , Karen Austrian Ph.D., M.P.H.

Purpose

This study examines the experiences of pregnant/parenting adolescents and young women during the first two years of the coronavirus disease 2019 (COVID-19) pandemic.

Methods

This explanatory sequential mixed-methods study leverages quantitative data collected among a cohort of adolescents and young people aged 15–22 years in three Kenyan counties; Nairobi, Kisumu, and Kilifi at three time points (2020, 2021, 2022), and two rounds of qualitative interviews in the same settings conducted in 2020 and 2022.

Results

Among 2337 (2020), 1438 (2021), and 1669 (2022) respondents, pregnant/parenting adolescents and youth comprised 140 (6%), 101 (7%), and 83 (5%) individuals, respectively. Across the three time points, the experience of depressive symptoms was similar between pregnant/parenting adolescents and those not pregnant/parenting. Pregnancy and parenting was associated with twice the odds of skipping health services (adjusted odds ratio [aOR] 2.18, 95% confidence interval [CI] 1.43–3.35), in 2020, and 85% higher odds (aOR 1.85, 95% CI 1.14–3.02) in 2021, and 90% higher odds of skipping meals (aOR 1.90, 95% CI 1.19–3.03) in 2022. Qualitative findings indicated experiences of psychological distress, food insecurity, and inadequate access to health care services among pregnant/parenting young people during the pandemic.

Discussion

The pandemic increased pre-existing challenges associated with adolescent and young people's health, predisposing young pregnant/parenting women to greater adversity than their nonpregnant/parenting counterparts. Targeted and responsive approaches during emergencies and crises such as social protection, food security, and mental health programs for this group of vulnerable people are required and need to be integrated into disaster response plans.

目的：本研究探讨了在冠状病毒病 2019 年（COVID-19）大流行的头两年中怀孕/育儿的青少年和年轻女性的经历：这项解释性顺序混合方法研究利用了在三个时间点（2020 年、2021 年和 2022 年）从肯尼亚三个县（内罗毕、基苏木和基利菲）的 15-22 岁青少年群体中收集的定量数据，以及 2020 年和 2022 年在相同环境中进行的两轮定性访谈：在 2337 名（2020 年）、1438 名（2021 年）和 1669 名（2022 年）受访者中，怀孕/育儿的青少年分别占 140 人（6%）、101 人（7%）和 83 人（5%）。在这三个时间点上，怀孕/育儿青少年与未怀孕/育儿青少年的抑郁症状经历相似。2020 年，怀孕和养育子女的青少年不接受医疗服务的几率是未怀孕和养育子女青少年的两倍（调整后的几率比 [aOR] 2.18，95% 置信区间 [CI] 1.43-3.35），2021 年的几率比未怀孕和养育子女青少年高 85%（aOR 1.85，95% 置信区间 [CI] 1.14-3.02），2022 年的几率比未怀孕和养育子女青少年高 90%（aOR 1.90，95% 置信区间 [CI] 1.19-3.03）。定性研究结果表明，在大流行期间，怀孕/为人父母的年轻人经历了心理困扰、食物无保障以及无法获得足够的医疗保健服务：大流行加剧了与青少年健康相关的原有挑战，使年轻孕妇/父母比非孕妇/父母面临更大的逆境。在紧急情况和危机期间，需要采取有针对性的应对措施，如针对这一弱势群体的社会保护、食品安全和心理健康计划，并将其纳入灾害应对计划。

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引用次数: 0

Psychosocial Interventions for Preventing Mental Health Conditions in Adolescents With Emotional Problems: A Meta-Analysis. 预防有情绪问题青少年心理健康问题的社会心理干预：元分析。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-16 DOI: 10.1016/j.jadohealth.2024.09.030

Stefani Du Toit, Mark Tomlinson, Christina A Laurenzi, Sarah Gordon, Laura Hartmann, Nina Abrahams, Melissa Bradshaw, Amanda Brand, G J Melendez-Torres, Chiara Servili, Tarun Dua, David A Ross, Joanna Lai, Sarah Skeen

Mental health conditions constitute a major burden of disease for adolescents globally and can lead to significant adverse consequences. This systematic review aimed to identify if psychosocial interventions are effective in preventing mental health conditions in adolescents already experiencing emotional problems. We searched for randomized controlled trials comparing psychosocial interventions for preventing mental health conditions with care as usual in adolescents aged 10-19 who are experiencing symptoms of emotional problems. We searched PubMed/Medline, PsycINFO, ERIC, EMBASE, and ASSIA databases to identify studies. We found 82 eligible studies (n = 13,562 participants). Findings show that interventions can reduce mental health conditions and increase positive mental health. Across all reported time points, psychosocial interventions showed significant, small-to moderate-sized beneficial effects on preventing mental health conditions (SMD: -0.26, 95% CI [-0.42, -0.19] and small positive effects on positive mental health (SMD: 0.17, 95% CI [0.097, 0.29]. There were no statistically significant pooled findings suggesting that psychosocial interventions had either a positive or negative effect on self-harm or suicide; aggressive, disruptive and oppositional behavior; substance use; or school attendance. Despite the positive findings, a critical gap exists in the design of effective psychosocial interventions to reduce self-harm and suicide, and other risk behaviors in adolescents with symptoms of emotional problems.

心理健康问题是全球青少年的主要疾病负担，可导致严重的不良后果。本系统性综述旨在确定社会心理干预是否能有效预防已出现情绪问题的青少年出现心理健康问题。我们搜索了一些随机对照试验，这些试验比较了针对 10-19 岁有情绪问题症状的青少年预防精神健康状况的社会心理干预与常规护理。我们检索了 PubMed/Medline、PsycINFO、ERIC、EMBASE 和 ASSIA 数据库，以确定相关研究。我们发现了 82 项符合条件的研究（n = 13,562 名参与者）。研究结果表明，干预措施可以减轻心理健康状况，提高积极的心理健康水平。在所有报告的时间点上，社会心理干预对预防精神健康状况有显著的小到中等规模的有益影响（SMD：-0.26，95% CI [-0.42，-0.19]），对积极心理健康有小幅的积极影响（SMD：0.17，95% CI [0.097，0.29]）。没有具有统计学意义的汇总结果表明，心理干预对自残或自杀、攻击性、破坏性和对抗性行为、药物使用或入学率有积极或消极影响。尽管研究结果具有积极意义，但在设计有效的社会心理干预措施以减少有情绪问题症状的青少年的自残、自杀和其他危险行为方面，仍存在严重的差距。

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引用次数: 0

Invited Reflections After Reading the Letter by Rick Yang 杨瑞克的《应邀读信后的思考》。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-14 DOI: 10.1016/j.jadohealth.2024.09.013

Daniel Tan-Lei Shek Ph.D.

引用次数: 0

An Unexpected Opportunity: How the COVID-19 Pandemic Can Help Us Better Support Adolescents in the Future 意外的机遇：COVID-19 大流行如何帮助我们在未来更好地支持青少年。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-14 DOI: 10.1016/j.jadohealth.2024.09.016

Tor D. Berg, Carol A. Ford M.D.

引用次数: 0

Trapped in Violence 受困于暴力

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-14 DOI: 10.1016/j.jadohealth.2024.09.007

Joseph B. Richardson Jr. Ph.D., William Wical Ph.D.

引用次数: 0

Guidance and Counseling Programs as a Response to Food Insecurity and Adolescent Suicide Risks: A Multisectoral Approach 以指导和咨询计划应对粮食不安全和青少年自杀风险：多部门方法。

IF 5.5 2区医学 Q1 PEDIATRICS

Journal of Adolescent Health

Pub Date : 2024-11-14 DOI: 10.1016/j.jadohealth.2024.08.014

Riza Amalia S.Psi, M.Sc, Henny Indreswari M.Pd., Rudi Haryadi M.Pd.

引用次数: 0

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