Journal of Adolescent Health最新文献

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Impact of Chest Binding on Respiratory Health: Clinical Considerations and Perspectives for Future Research 胸捆绑对呼吸系统健康的影响:临床考虑和未来研究的展望
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-24 DOI: 10.1016/j.jadohealth.2025.01.025
Nuray Kanbur M.D., Sinem Akgül M.D., Ph.D., Melis Pehlivantürk Kızılkan M.D., Ph.D., Koray Başar M.D., Zeynep Tüzün Ph.D.
{"title":"Impact of Chest Binding on Respiratory Health: Clinical Considerations and Perspectives for Future Research","authors":"Nuray Kanbur M.D., Sinem Akgül M.D., Ph.D., Melis Pehlivantürk Kızılkan M.D., Ph.D., Koray Başar M.D., Zeynep Tüzün Ph.D.","doi":"10.1016/j.jadohealth.2025.01.025","DOIUrl":"10.1016/j.jadohealth.2025.01.025","url":null,"abstract":"","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 5","pages":"Pages 939-940"},"PeriodicalIF":5.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Educating Teens and Parents on the Dangers of Fentanyl and Connecting Them to Naloxone Resources 教育青少年和家长芬太尼的危害,并将他们与纳洛酮资源联系起来
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-24 DOI: 10.1016/j.jadohealth.2024.12.023
Daisy Albarran Garcia M.P.H., Padmaja Padalkar M.D., Jenny Lee D. Peregrino M.B.A., Sabine Mendoza, Alex Tsang, Noelle Mendoza, Thomas Tsang, Wynnyee Tom M.D.
{"title":"Educating Teens and Parents on the Dangers of Fentanyl and Connecting Them to Naloxone Resources","authors":"Daisy Albarran Garcia M.P.H., Padmaja Padalkar M.D., Jenny Lee D. Peregrino M.B.A., Sabine Mendoza, Alex Tsang, Noelle Mendoza, Thomas Tsang, Wynnyee Tom M.D.","doi":"10.1016/j.jadohealth.2024.12.023","DOIUrl":"10.1016/j.jadohealth.2024.12.023","url":null,"abstract":"","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 5","pages":"Pages 940-941"},"PeriodicalIF":5.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concerning Caffeine: Are Highly Caffeinated Youth at Risk for Conduct Problems? 关于咖啡因:大量摄入咖啡因的青少年有行为问题的风险吗?
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-24 DOI: 10.1016/j.jadohealth.2025.02.005
Jack Peltz Ph.D., Assaf Oshri Ph.D.
{"title":"Concerning Caffeine: Are Highly Caffeinated Youth at Risk for Conduct Problems?","authors":"Jack Peltz Ph.D., Assaf Oshri Ph.D.","doi":"10.1016/j.jadohealth.2025.02.005","DOIUrl":"10.1016/j.jadohealth.2025.02.005","url":null,"abstract":"","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 5","pages":"Pages 749-751"},"PeriodicalIF":5.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Variability in Health Outcomes According to Pediatric to Adult Transfer-of-Care Status Among Young Adults With Sickle Cell Disease. 年轻镰状细胞病患者从儿童到成人的转诊状态对健康结果的影响
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-09 DOI: 10.1016/j.jadohealth.2025.01.023
Tarun Aurora, Emilia Nascimento, Patricia Moura, Heloisa Helena Miranda, Thais Oliveira, Nick Faris, Ana A Baumann, Jane S Hankins, Clarisse Lobo
{"title":"Variability in Health Outcomes According to Pediatric to Adult Transfer-of-Care Status Among Young Adults With Sickle Cell Disease.","authors":"Tarun Aurora, Emilia Nascimento, Patricia Moura, Heloisa Helena Miranda, Thais Oliveira, Nick Faris, Ana A Baumann, Jane S Hankins, Clarisse Lobo","doi":"10.1016/j.jadohealth.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.023","url":null,"abstract":"<p><strong>Purpose: </strong>Transitioning from pediatric to adult care is critical for young adults with sickle cell disease. While the transfer typically occurs at age 18, some pediatric providers continue care into adulthood. This study evaluates whether remaining in pediatric care versus transferring to adult care affects health outcomes. We hypothesized that those who remain in pediatric care after age 18 would experience fewer acute health-care events and better outcomes than those who transfer to adult care.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at HEMORIO, a blood center in Rio de Janeiro, Brazil. Health-care utilization (outpatient visits, emergency department visits, hospitalizations), hydroxyurea use, care abandonment, and mortality were compared among young adults with sickle cell disease aged 18-23 under pediatric or adult care. Wilcoxon rank sum tests and Fisher's exact tests were used for statistical analysis.</p><p><strong>Results: </strong>Among 472 eligible patients (50% female, 71% Hb SS or Hb Sβ0 thalassemia), 81 (17%) remained in pediatric care, while 391 (83%) transferred to adult care. After age 18, patients in pediatric care had fewer emergency visits and hospitalizations compared to those in adult care. Transferred patients showed increased emergency visits and hospitalizations relative to their adolescent period, whereas those remaining in pediatric care experienced reduced rates of these events.</p><p><strong>Discussion: </strong>Transitioning to adult care is associated with increased adverse outcomes despite more frequent ambulatory visits. Enhancing transition programs to improve adult care integration and engagement is essential to address these disparities.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Guidelines on the Inclusion and Protection of Adolescent Minors and Young Adults in Health Research: A Position Statement of the Society for Adolescent Health and Medicine 关于将未成年青少年和青年纳入和保护健康研究的准则:青少年健康和医学学会的立场声明。
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-09 DOI: 10.1016/j.jadohealth.2025.02.007
The Society for Adolescent Health and Medicine
{"title":"Guidelines on the Inclusion and Protection of Adolescent Minors and Young Adults in Health Research: A Position Statement of the Society for Adolescent Health and Medicine","authors":"The Society for Adolescent Health and Medicine","doi":"10.1016/j.jadohealth.2025.02.007","DOIUrl":"10.1016/j.jadohealth.2025.02.007","url":null,"abstract":"<div><div>These guidelines aim to assist researchers and research ethics committees/institutional review boards in the ethical conduct of health research with adolescents and young adults (AYA), particularly research with adolescent minors. Inclusion of AYA in research and protection from research harms are essential if, as individuals and as a group, they are to receive the benefits of research. The ethical principles of respect for persons, beneficence, and justice, the human rights concepts of best interests and emerging capacity, and the concept of appropriate inclusion collectively provide an ethical framework for evaluating the circumstances within which adolescent minors can and should be involved as research participants. Likewise, legal concepts guiding informed consent in health-care practice—age of majority, emancipation, mature minor, and minor consent—provide an important conceptual basis for informed consent with adolescents in health research. Consent processes in adolescent health research should be based on scientific understandings of AYA cognitive, psychological, and social development; the weight of current scientific evidence suggests that capacity to provide informed consent for research is present by the age of 14 years. When adolescent minors consent for themselves (i.e., autonomously or independent of parents/guardians), procedures should be in place to assess and support their desire for advice from parents and other trusted adults. Researchers should involve AYA in the codesign of research and should involve community members, parents, and AYA in the development of research priorities and questions, to ensure that research is relevant to AYA, to protect privacy and confidentiality, to facilitate the dissemination of research findings, and to promote translation of research into practice. Research with AYA should never reinforce stigma and discrimination of AYA or the groups to which they belong.</div></div>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":"76 5","pages":"Pages 944-953"},"PeriodicalIF":5.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Physical Activity is Related to Lower Levels of Neurofilament Light and Plasma Tau Protein: A 22-Year Follow-Up Study From Adolescence to Adulthood. 体育活动与较低水平的神经丝光和血浆Tau蛋白有关:一项从青春期到成年期22年的随访研究
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-04 DOI: 10.1016/j.jadohealth.2025.02.003
Yasmin Ezzatvar, José Francisco López-Gil, Rodrigo Yáñez-Sepúlveda, Jorge Olivares-Arancibia, Jacqueline Páez-Herrera, Antonio García-Hermoso
{"title":"Physical Activity is Related to Lower Levels of Neurofilament Light and Plasma Tau Protein: A 22-Year Follow-Up Study From Adolescence to Adulthood.","authors":"Yasmin Ezzatvar, José Francisco López-Gil, Rodrigo Yáñez-Sepúlveda, Jorge Olivares-Arancibia, Jacqueline Páez-Herrera, Antonio García-Hermoso","doi":"10.1016/j.jadohealth.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.003","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between physical activity (PA) and neurodegeneration biomarkers from adolescence to adulthood by examining tau protein and neurofilament light chain (NfL) levels in blood samples.</p><p><strong>Methods: </strong>The study analyzed data from adolescents aged 12-19 years who participated in Waves I (1994-1996) and V (2016-2018) of the Add Health study over a span of 22 years. It assessed PA through self-reported questionnaires. Neurodegeneration measures at Wave V used venous blood collected via phlebotomy. Samples were analyzed using single-molecule array (Simoa) technology on a Quanterix HD-1 analyzer, using digital enzyme-linked immunosorbent assay to quantify NfL and tau proteins from serum and plasma samples.</p><p><strong>Results: </strong>In the present study, 3,182 individuals participated, with females comprising 61% of the sample. Participants adhering to the PA guidelines in both waves reported lower levels of NfL (-0.583 pg/mL, 95% bias-corrected and accelerated (BCa) confidence interval (CI): -1.235 to -0.068) and tau protein levels (-0.244 pg/mL, 95% BCa CI: -0.405 to -0.078). Adjusted analyses confirmed significant lower levels of tau protein (-0.210 pg/mL, 95% BCa CI: -0.350 to -0.072) for Wave I adherents and even lower levels in NfL (-0.421 pg/mL, 95% BCa CI: -0.929 to -0.007) and tau protein levels (-0.229 pg/mL, 95% BCa CI: -0.412 to -0.053) for active participants in both waves.</p><p><strong>Discussion: </strong>Our findings suggest that consistent engagement in PA may reduce certain neurodegenerative biomarkers, potentially influencing neurological health outcomes.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterisation and Management of Children and Young People Referred to a Paediatric Tertiary Post-COVID Service. 转诊到儿科三级COVID后服务机构的儿童和青少年的特征和管理。
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-03 DOI: 10.1016/j.jadohealth.2025.01.026
Anne-Lise Goddings, Rebecca Johnston, Elizabeth Wortley, Ria Patel, Holly Boyd, Fiona Newlands, Roz Shafran, Benjamin Baig, Elizabeth Whittaker, Terry Y Segal
{"title":"Characterisation and Management of Children and Young People Referred to a Paediatric Tertiary Post-COVID Service.","authors":"Anne-Lise Goddings, Rebecca Johnston, Elizabeth Wortley, Ria Patel, Holly Boyd, Fiona Newlands, Roz Shafran, Benjamin Baig, Elizabeth Whittaker, Terry Y Segal","doi":"10.1016/j.jadohealth.2025.01.026","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.026","url":null,"abstract":"<p><strong>Purpose: </strong>Post-COVID condition (PCC) emerged following the 2020 coronavirus pandemic and required rapid service development to manage affected patients. This evaluation describes the demographics, medical background, management and six-month outcomes of children and young people with PCC-related symptoms referred to one specialist tertiary service between June 2020 and August 2022.</p><p><strong>Methods: </strong>Data were retrospectively collected from referral information and medical notes.</p><p><strong>Results: </strong>176 patients (61% female) aged 6-18 years were referred, with a mean 8.2 PCC-related symptoms impacting on functioning (97%) and school attendance (86%). 10% patients had an autistic spectrum disorder diagnosis, above the ∼2% national prevalence, while rates of atopy and mental health were similar to national prevalence. 59% patients were managed in specialist tertiary clinics by clinicians with input from allied health professionals. At 6 month review, 40/73 patients reported improvement in their daily functioning, with 30/73 reporting no change and 3/73 reporting functional deterioration. School attendance increased over 6 months for 43/67 patients, with 12/67 reporting no change and 4/67 reporting reduced school attendance.</p><p><strong>Discussion: </strong>Patients referred for PCC-related specialist input have significant functional impairment and challenges accessing education. More than half of those seen in specialist clinics showed functional improvement and increased school attendance over 6 months, while a subgroup had persistent symptoms. This suggests that the service model is beneficial for this complex patient group overall, although needs to be resourced for longer input for some. Further work is needed to understand the variability in presentation and symptom course.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transgender Youth's Perspectives on the Relationships Between Pregnancy, Contraceptives, and Dysphoria. 跨性别青年对怀孕、避孕和焦虑之间关系的看法。
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-03 DOI: 10.1016/j.jadohealth.2025.01.024
A J Lowik, Shams M F Al-Anzi, Ace Chan, Michele Ybarra, Elizabeth Saewyc
{"title":"Transgender Youth's Perspectives on the Relationships Between Pregnancy, Contraceptives, and Dysphoria.","authors":"A J Lowik, Shams M F Al-Anzi, Ace Chan, Michele Ybarra, Elizabeth Saewyc","doi":"10.1016/j.jadohealth.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.01.024","url":null,"abstract":"<p><strong>Purpose: </strong>To explore how trans youth with pregnancy capacity think through and understand the associations between pregnancy, contraception methods, and dysphoria.</p><p><strong>Methods: </strong>We conducted 8 asynchronous online focus groups (n = 152) between 2020 and 2021 with trans youth assigned female at birth, and thus presumed capable of pregnancy, aged 14-18, who were living in the United States. Data were analyzed using a qualitative thematic approach informed by interpretive description.</p><p><strong>Results: </strong>Some youth participants were unequivocal in their belief that both pregnancy and contraception would give rise to gender-related distress, which affected how they framed the acceptability of pregnancy and various methods for its prevention. Others had more dynamic understandings of dysphoria, recognizing that it is not inevitable or uniformly experienced. Still others posited that dysphoria that does occur can be managed considering the individual's priority goal or desire - whether to become a gestational parent or to prevent pregnancy. Participants discussed the importance of accessing sexual and reproductive healthcare, even if doing so requires them to navigate terrains of potential dysphoria, including dysphoria that is provoked by having to access gendered spaces and services and due to the use of gendered language.</p><p><strong>Discussion: </strong>Youth participants had varied, nuanced understandings of dysphoria and its potential impact on their conception, pregnancy, and contraception experiences. Many did not hold prescriptive views that dysphoria is a defining aspect of their lives as trans people. Findings suggest strategies for the delivery of gender-affirming, youth-friendly sexual and reproductive healthcare that attends to dysphoria-as-distress when it occurs.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adverse Childhood Experiences are Associated With the Timing of Puberty in Girls but Not in Boys. 不良童年经历与女孩的青春期时间有关,而与男孩无关。
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-03 DOI: 10.1016/j.jadohealth.2025.02.009
Ai Kubo, Sara Aghaee, Julia Acker, Julianna Deardorff
{"title":"Adverse Childhood Experiences are Associated With the Timing of Puberty in Girls but Not in Boys.","authors":"Ai Kubo, Sara Aghaee, Julia Acker, Julianna Deardorff","doi":"10.1016/j.jadohealth.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.009","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the associations between adverse childhood experiences (ACEs) scores from routine screenings in pediatric checkups and timing of puberty in a diverse cohort of adolescents.</p><p><strong>Methods: </strong>A retrospective cohort study of 52,573 pediatric members of Kaiser Permanente Northern California, an integrated healthcare delivery system. Exposure was the total ACEs score, determined using caregiver- and self-reported scores across all well-child visits, and categorized into 0, 1-3, 4-6, or 7-10 ACEs. Outcomes were age at menarche and pubertal onset, using physician-assessed Sexual Maturity Ratings.</p><p><strong>Results: </strong>Girls with ACEs had a substantially higher risk of earlier menarche and pubertal onset compared to those without ACEs. There were no associations between ACEs and boys' pubertal timing.</p><p><strong>Discussion: </strong>These results highlight the importance of screening for ACEs in a clinical setting to address adolescents' psychological well-being and healthy lifestyle habits, which in turn may prevent adverse health outcomes associated with early puberty.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adverse Childhood Experiences and Unmet Health Care Needs due to Cost and the COVID-19 Pandemic: A Nationally Representative Analysis of U.S. Adolescents. 由于成本和COVID-19大流行导致的不良童年经历和未满足的医疗保健需求:对美国青少年的全国代表性分析
IF 5.5 2区 医学
Journal of Adolescent Health Pub Date : 2025-04-03 DOI: 10.1016/j.jadohealth.2025.02.001
Rohan Khazanchi, Ryan C L Brewster, Destiny G Tolliver, Nia J Heard-Garris, Aditi Vasan, Tyler N A Winkelman, Scott E Hadland
{"title":"Adverse Childhood Experiences and Unmet Health Care Needs due to Cost and the COVID-19 Pandemic: A Nationally Representative Analysis of U.S. Adolescents.","authors":"Rohan Khazanchi, Ryan C L Brewster, Destiny G Tolliver, Nia J Heard-Garris, Aditi Vasan, Tyler N A Winkelman, Scott E Hadland","doi":"10.1016/j.jadohealth.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jadohealth.2025.02.001","url":null,"abstract":"<p><strong>Purpose: </strong>Adverse childhood experience (ACE) exposure and poor mental health are closely intertwined. In 2020, the prevalence of both began precipitously increasing among adolescents. We explored associations of individual and cumulative ACE exposure with cost and COVID-19 pandemic-related unmet health needs to assess ACEs as risk markers for broader structural adversity.</p><p><strong>Methods: </strong>We conducted a nationally representative analysis of 5,536 adolescents (weighted N = 20,294,070) aged 13-17 years using the 2019 and 2021 National Health Interview Survey. Outcomes included mental health symptoms, preventive care access, cost and COVID-19-related unmet needs, and health care use. We estimated associations with lifetime exposure to 4 ACEs using marginal effects from multivariable logistic regressions.</p><p><strong>Results: </strong>Millions of adolescents were exposed to parental incarceration (7.8%, N = 1,407,670), neighborhood violence (6.9%, N = 1,567,483), a guardian with serious mental illness (10.3%, N = 2,088,957), and/or a guardian with alcohol or drug problems (11.4%, N = 2,304,953). Overall, 77.7% (N = 15,758,023), 13.2% (N = 2,671,342), and 9.2% (N = 1,864,704) were exposed to 0, 1, and 2+ of these ACEs. In adjusted models, compared with exposure to 0 ACEs, exposure to 1 or 2+ ACEs was positively associated with anxiety and depression symptom frequency, urgent care and emergency department use, trouble paying medical bills, delayed and forgone mental health care due to cost, and delayed and forgone care due to the COVID-19 pandemic.</p><p><strong>Discussion: </strong>Adolescents exposed to ACEs experienced mutually reinforcing disadvantages: a worse mental health symptom burden, yet greater barriers to accessing needed medical and mental health care. ACEs must be reconceptualized as markers of structural-rather than individual-adversity and addressed through structural and policy interventions.</p>","PeriodicalId":56278,"journal":{"name":"Journal of Adolescent Health","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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