BACKGROUND: The use of patient-facing health technologies to manage long-term conditions (LTCs) is increasing; however, children and young people (CYP) may have preferences about health technologies which they interact or engage with, that influence their decision to use these technologies.
OBJECTIVE: To identify CYP\'s reported preferences about health technologies to self-manage LTCs.
METHODS: We undertook a scoping review, searching MEDLINE, PsycINFO and CINAHL in July 2021. Searches were limited to papers published between January 2015 and July 2021. We included any health technologies used to manage physical and mental LTCs. Qualitative content analysis of study data was undertaken to categorise data into themes and quantitative data were described and visually represented. We engaged CYP with LTCs to support the review design, interpretation of findings and development of recommendations.
RESULTS: 161 journal articles were included, describing preferences of CYP. Most included studies were undertaken in high-income countries. CYP\'s main preferences and needs were: design and functionality; privacy and sharing; customisation and personalisation of the technology; and interaction options within the technology.
CONCLUSIONS: This review highlights important preferences and needs that CYP may have before using technologies to self-manage their LTC. These should be considered when developing technology for this population. Future research should involve CYP throughout the development of the technologies, from identifying their unmet needs through to final design, development, evaluation and implementation of the intervention.

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BACKGROUND: Unhealthy diets pose a significant public health risk among European children, contributing to the increasing prevalence of overweight and non-communicable diseases. Children spend a substantial amount of time at school daily, including lunchtime, so the school setting becomes crucial for promoting healthy diets and lifestyle habits. While there is a large body of literature on the impact of school food policies on health and non-health outcomes, it is essential to identify which policies are effective and can be recommended for implementation to ensure the efficient use of resources. This article presents a protocol for a scoping review that aims to map the current published literature on the effects of school food policies on health outcomes, acceptance and affordability in secondary school children in Europe. Moreover, the scoping review will map the measurements used to assess health outcomes, acceptance and affordability.
METHODS: The scoping review protocol and review follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review. To identify eligible studies, we will search MEDLINE, PsycINFO, CINAHL and Web of Science. The reference lists of the included articles will be checked for additional studies. In addition, country-specific ministry reports from Member States of the European Union, the UK, Norway, Iceland and Switzerland will be identified. The WHO and European Commission websites will also be searched for relevant reports. The scoping review will include literature published until 20 September 2023. No restrictions to study design and language will be applied. Screening and data extraction will be carried out independently by three reviewers. Disagreements will be resolved by discussion. A pretested data charting table will be used to extract key information. Findings will be presented in tabular and visualised summaries and a narrative summary.
BACKGROUND: This scoping review does not require ethical approval. Our dissemination strategy comprises peer-reviewed publications, conference presentations and recommendations to policy-makers.

BACKGROUND: Suicidal ideation (SI) and suicide attempts (SA) are risk factors for suicide which peak during adolescence; however, evidence focused on differences in SI and SA risk among racial/ethnic minority youth is limited despite increasing suicide rates among several racial/ethnic minority groups.
METHODS: We analyzed a representative sample of adolescents aged 12-17 with prior depressive symptoms (n = 32,617) from the cross-sectional National Surveys on Drug Use and Health (2008-2019). Survey-weighted adjusted logistic regressions estimated the association of race/ethnicity with self-reported lifetime SI and SA, controlling for sociodemographics, lifetime substance use, lifetime major depressive episode, and self-rated health.
RESULTS: Compared to white adolescents, Black and Hispanic adolescents had a 2.5 % (p = 0.04) and 4.2 % (p < 0.001) lower likelihood of reporting SI. However, among participants reporting SI, Black and Hispanic adolescents had a 3.2 % (p = 0.03) and 3.1 % (p = 0.03) higher likelihood of reporting SA than white adolescents. Multiracial adolescents were 5.9 % (p = 0.03) more likely to report SA than white adolescents.
CONCLUSIONS: Although racial/ethnic minority groups are less likely to self-report mental health symptoms, we could only assess SI/SA among adolescents self-reporting prior depressive symptoms, and we could only assess SA among adolescents self-reporting SI due to survey methods.
CONCLUSIONS: Variation in the racial/ethnic distribution of suicidality supports theories conceptualizing separate pathways for SI and SA. This underscores the need for greater attention to racial/ethnic differences in suicide-related research, surveillance, and prevention efforts, including ensuring that mental health risk assessments directly evaluate SA in addition to SI in order to better identify high-risk racial/ethnic minority youth.

Research with siblings of children with congenital heart disease (CHD) is scarce, although more than one-third of them experience limitations on their quality of life. This interview study aims to explore the diagnosis-associated experience of German siblings of children with CHD, their interest in a potential intervention, and potential key topics and contextual conditions of such an intervention. Interviews with 10 siblings aged 10 to 21 and a respective parent were conducted from August to October 2021, resulting in 20 interviews. Negative experiences associated with CHD included concerns regarding hospitalization, health deterioration, and the death of the child with CHD, as well as burdens including reduced family activities, less parental attention and support, and extended family meals. Positive experiences included perceived positive consequences of CHD, such as strong family cohesion and empathy toward people with chronic illnesses. Furthermore, siblings experienced enhanced coping mechanisms, such as having conversations with friends and family about the high prevalence of CHD and successful treatment or using distractions such as entertainment or study. Siblings\' reported interest in a future intervention included empathy, peer support, and studying medical information on CHD. These findings should be used for counseling and developing tailored interventions to support these siblings.

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BACKGROUND: The COVID-19 pandemic strained India\'s healthcare system and health workers unprecedentedly.
OBJECTIVE: The extent of the contribution by peer educators (PEs) from India\'s National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK) to COVID-19 response activities remains uncertain necessitating an imperative investigation. Within the overarching objective of the \'i-Saathiya\' study (\'i\' signifies implementation science and Saathiya represents PEs in Madhya Pradesh), a key focus was to understand the role of PEs recruited under RKSK during COVID-19 in two Indian states, namely Madhya Pradesh and Maharashtra. The study states differ in sociodemographic characteristics and peer education implementation models.
METHODS: In-depth interviews (IDIs) were conducted with stakeholders (n=110, Maharashtra: 57; Madhya Pradesh: 53) engaged in the implementation of RKSK\'s peer education programme at state, district, block and village levels. Focus group discussions (FGDs) (n=16 adolescents, Maharashtra: 8; Madhya Pradesh: 8) were conducted with adolescents, part of the peer group of PEs (n=120 adolescents, Maharashtra: 66; Madhya Pradesh: 54). IDIs and FGDs were audio-recorded, translated, transcribed verbatim and analysed thematically. Adopting inductive and deductive approaches, a data-driven open coding framework was developed for thematic analysis.
RESULTS: The PE recruited under RKSK took a central role that extended beyond their predefined responsibilities within the RKSK. They provided crucial support to healthcare workers in curbing the spread of COVID-19. Their diverse contributions, including COVID-19 pandemic response support, addressing community and adolescent needs, role in COVID-19 vaccination efforts, navigating access to the health system and facilitating health workers in the implementation of various national health programmes and campaigns during COVID-19.
CONCLUSIONS: The findings underscore the potential of PEs in bolstering the health system. Despite their unpreparedness for the context (COVID-19), PEs demonstrated tenacity and adaptability, extending their roles beyond their predefined responsibilities. Recognising PEs through awards and incentives, skill courses and additional grades, can enhance their visibility, sustaining impactful work within RKSK and beyond.

OBJECTIVE: To determine disparities in adverse childhood experiences (ACEs) by sexual identity in a national cohort of early adolescents.
METHODS: We analyzed cross-sectional data from year 2 of the Adolescent Brain Cognitive Development Study (N=10,934, 2018-2020, ages 10-14 years). Disparities in ACE score across lesbian, gay, or bisexual (LGB), not sure, and heterosexual adolescents were assessed using multinomial logistic regression analyses. Logistic regressions estimated the associations between sexual identity and each individual ACE. Analyses were adjusted for potential confounders.
RESULTS: In adjusted models, LGB adolescents had higher risk of experiencing 2, 3, or ≥4 ACEs (Relative Risk Ratios [RRR] =1.57, 95% CI 1.01-2.42), 3 (RR=1.78, 95% CI 1.100-2.88), or ≥4 ACEs (RRR=3.20, 95% CI 1.92-5.32), and not sure adolescents had a higher risk of having ≥4 ACEs (RRR=2.17, 95% CI 1.22-3.87), compared to heterosexual adolescents. LGB and not sure adolescents had higher risks of reporting emotional abuse (\"yes\" OR =4.21, 95% CI 1.84-9.61; \"maybe\" OR=6.20, 95% CI 2.91-13.19) and parent mental illness (\"yes\" OR=1.95, 95% CI 1.48-2.57; \"maybe\" OR=1.63, 95% CI 1.21-2.18) compared to heterosexual adolescents.
CONCLUSIONS: LGB adolescents and those questioning their sexual identity were at greater risk of having higher ACE scores, with LGB adolescents experiencing the highest risk of experiencing ACEs. LGB adolescents also had higher odds of reporting emotional and parent mental illness. Recognizing this heightened risk of ACEs in early adolescence is critical for designing clinic and school-based interventions.

BACKGROUND: Adolescence is a key developmental period that affects lifelong health and is impacted by adolescents regularly engaging with digital health information. Adolescents need digital health literacy (DHL) to effectively evaluate the quality and credibility of such information, and to navigate an increasingly complex digital health environment. Few educational resources exist to improve DHL, and few have involved adolescents during design. The co-design approach may hold utility through developing interventions with participants as design partners.
OBJECTIVE: This project aimed to explore the co-design approach in developing an educational resource to improve adolescents\' DHL.
METHODS: Adolescents (12-17 years old) attended 4 interactive co-design workshops (June 2021-April 2022). Participant perspectives were gathered on DHL and the design of educational resources to improve it. Data generated were analyzed through content analysis to inform educational resource development.
RESULTS: In total, 27 participants from diverse backgrounds attended the workshops. Insight was gained into participants\' relationship with digital health information, including acceptance of its benefits and relevance, coupled with awareness of misinformation issues, revealing areas of DHL need. Participants provided suggestions for educational resource development that incorporated the most useful aspects of digital formats to develop skills across these domains. The following 4 themes were derived from participant perspectives: ease of access to digital health information, personal and social factors that impacted use, impacts of the plethora of digital information, and anonymity offered by digital sources. Initial participant evaluation of the developed educational resource was largely positive, including useful suggestions for improvement.
CONCLUSIONS: Co-design elicited and translated authentic adolescent perspectives and design ideas into a functional educational resource. Insight into adolescents\' DHL needs generated targeted educational resource content, with engaging formats, designs, and storylines. Co-design holds promise as an important and empowering tool for developing interventions to improve adolescents\' DHL.

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