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Background: Sexting is common among adolescents and is associated with numerous health risk behaviors and negative psychosocial constructs. This study examined the relationships between high school students' experiences with sexual violence victimization, dating violence victimization, and engagement in risky sexual behaviors with experiences of receiving sexts. Methods: Cross-sectional data from the 2014 to 2016 data from Pennsylvania Youth Risk Behavior. Participants were selected using an independent 2-stage cluster sample design to produce a statewide population-based sample. The pencil and paper surveys were conducted in school. Participants included 6734 Pennsylvania high school students in grades 9-12. Results: Overall, 29.0% of Pennsylvania high school students had received a sext, which varied by sex, race/ethnicity, school grade, and sexual identity. Students who engaged in sexual risk behaviors, experienced dating violence, or experienced lifetime sexual violence outside of the dating context had a significantly higher prevalence of receiving a sext than students who did not engage in those behaviors or have those experiences. Conclusions: Early screening and prevention efforts that include discussions about sexting behaviors may help prevent other negative outcomes, such as risky sexual behaviors and interpersonal violence. Addressing sexting in the education and health sectors may help to prevent other related harmful health and violence experiences during adolescence.

Comprehensive sexual health education is critical for the prevention of STIs and unintended pregnancy among young people. Yet, increasing barriers to comprehensive sexual health education in classroom settings underscore the importance of youth-friendly technologies to address sexual health among young people. "It's OK to Ask Someone" (IOTAS) uses a customised technology to expand Planned Parenthood of Western Pennsylvania's sexual health programming with a confidential sexual health textline designed to answer sexual health questions in a timely, user-friendly manner. This paper describes results from a process evaluation focused on assessing who uses IOTAS, how they use IOTAS and in what ways IOTAS is perceived to be helpful to texters. Results illustrate that a textline-approach is an acceptable and appropriate way to engage with young people. Findings demonstrate that young people are using the confidential textline to seek information about sexual health and report it as a helpful resource. Findings are relevant for sexual health educators and practitioners working with young people, including those interested in using a technology approach to expand health education opportunities. Additional research should continue to explore the potential of youth-friendly, technology-based approaches to support sexual health information seeking.

Objectives: The objectives of this paper is to conduct a bibliometric analysis to examine the research status and development trend of anterior cruciate ligament injury and reconstruction in children and adolescents over the past 20 years. Design: Descriptive Research. Methods: This study obtained information regarding studies on Anterior Cruciate Ligament Reconstruction in Children and Adolescents from the Web of Science Core Collection database. Visual and bibliometric analysis were conducted using VOSviewer, Origin 2022, Pajek64 5.18and Excel 2019. These analytic tools facilitated the analysis of various aspects, including countries/regions, institutions, authors, journals and keywords related to the research. Results: From 2003 to 2023, a total of 1328 articles were retrieved in WOS, and 637 articles were selected by two authors. The most productive institutions are Childrens Hosp Philadelphia, Kocher, ms. Their articles have the highest number of publications and citations. The American journal of sports medicine is the most frequently cited journal for articles on anterior cruciate ligament reconstruction in children and adolescents. The most common keywords used in these articles were "anterior cruciate ligament reconstruction", "injury, children, adolescent", and "skeletally immature patients". Conclusions: This study provides valuable insights into the research focus of anterior cruciate ligament reconstruction in children and adolescents. In recent years, there has been significant attention paid to areas of "the return to sport, re-repture rate and functional recovery after anterior cruciate ligament reconstruction" in this specific population. These aspects have emerged as key directions for future research in this field. [ABSTRACT FROM AUTHOR]

As a Family and Consumer Science educator at Union City High School in Union City, Pennsylvania, I have heard and seen a great deal. I have been teaching for 24 years at this rural Pennsylvania Middle/High School where teen pregnancy has always been a problem. Teaching students abstinence as the only method of birth control has been a major challenge for me. Even before comprehensive sexuality education was in vogue, I decided that I had to teach more than abstinence only. I do not believe that simply telling a teen to just stay abstinent when they are feeling that they are in "love" for the first time is enough information to give them. I also knew that calling my curriculum Comprehensive Sexuality Education would not be acceptable to the School District. Using the word "sex" in a curriculum that should begin in kindergarten would be hard for a conservative community to accept, so I decided to name it a Comprehensive Family Life Education curriculum for grades K-12.

The purpose of this paper was to demonstrate the cost-effectiveness of using the Instrumentalism in Occupational Therapy (IOT) conceptual practice model as a guide for intervention to assist teenagers with emotional and behavioral disorders (EBD) transition successfully into adulthood. The cost effectiveness analysis was based on a project involving 15 teenagers treated by the first author and a colleague in a Day Treatment Center in a small town in northeast Pennsylvania. The analysis revealed that the cost of intervention per positive effect realized per teenager was US$162.88. Further research is indicated to determine how this effect translates into monetary benefits. (Contains 1 table and 2 figures.)

Parent behavior management and child social skills training programs have demonstrated efficacy in clinical research settings and are highly efficient treatment modalities. Few studies have examined their effectiveness and efficiency within the typical clinical setting. The current paper examines the use of a concurrent parent behavior management and child social skills training program, evaluating the current sample, which consists of 22 children (ages 5-10) and their guardians, as well as two previous typical clinical samples. The Eyberg Checklist was utilized to assess pre and post treatment intensity scores for childhood externalizing symptoms, with an average treatment effectiveness of 0.89 standard deviations. This is consistent with previous findings (Tynan, et al., 1999; Tynan, et al., 2004) and further demonstrates the effectiveness of the concurrent parent and child training approach as utilized within the typical clinical setting. (Contains 3 tables.)

Adopting a constructivist perspective of adolescent development, we argue adolescents' perceptions of "being known" reflect teachers' authentic recognition of adolescents' multiple emerging identities. As such, adolescent perceptions of being known are a distinct factor associated with high school students' engagement in school. A mixed method approach (Phase 1 focus groups, N = 72, Phase 2 cross sectional survey, N = 890) guided the development and testing of an Adolescent Perception of Being Known Scale (A-PBKS). Here, we report on item development, item performance, convergent, divergent, and predictive validity as well as measurement invariance. We conclude the paper by outlining the promise research studying instructional moves through a developmental lens has for understanding teaching and learning in urban high schools. (Contains 8 tables and 1 footnote.)

The purpose of this paper was to examine the psychometric properties of a non-word repetition task (NRT), the Late-8 Non-word Repetition Task (L8NRT). This task was designed similarly to the NRT, but contains only Late-8 consonants to increase articulatory demands and avoid ceiling effects in studies with adolescents and adults. Thirty college students were administered the Woodcock Reading Mastery Tests-Revised/Normative Update WRMT-RNU, L8NRT and NRT. Results showed that inter- and intra-rater reliability of the L8NRT were high; split-half reliability was significant and comparable to that of the NRT. Average L8NRT scores were significantly lower than NRT scores overall and at all non-word lengths but the shortest (1 syllable). Both measures correlated significantly, at similar levels, with Total WRMT-RNU score. We conclude that the psychometric properties of the L8NRT were acceptable, but an error analysis suggested ways in which the task might be improved to better control perceptual demands and articulatory feature overlap. (Contains 2 tables.)

Comprehensive sexual health education is critical for the prevention of STIs and unintended pregnancy among young people. Yet, increasing barriers to comprehensive sexual health education in classroom settings underscore the importance of youth-friendly technologies to address sexual health among young people. It's OK to Ask Someone (IOTAS) uses a customised technology to expand Planned Parenthood of Western Pennsylvania's sexual health programming with a confidential sexual health textline designed to answer sexual health questions in a timely, user-friendly manner. This paper describes results from a process evaluation focused on assessing who uses IOTAS, how they use IOTAS and in what ways IOTAS is perceived to be helpful to texters. Results illustrate that a textline-approach is an acceptable and appropriate way to engage with young people. Findings demonstrate that young people are using the confidential textline to seek information about sexual health and report it as a helpful resource. Findings are relevant for sexual health educators and practitioners working with young people, including those interested in using a technology approach to expand health education opportunities. Additional research should continue to explore the potential of youth-friendly, technology-based approaches to support sexual health information seeking. [ABSTRACT FROM AUTHOR]

This exploratory, qualitative study evaluated the impact of the Critical Ongoing Resource Family Education Teen Edition (CORE-Teen) post-licensure foster parent training curriculum designed to support foster/kinship caregivers caring for youth ages 12–20 years in the foster care system. A pilot study of the curriculum was implemented in three states (Florida, Pennsylvania, and Tennessee). Five semi-structured focus groups (three groups received CORE Teen training and the other two did not) were conducted with a total of 61 foster parents to explore the differences in parenting knowledge and practices among foster parents trained in CORE Teen versus those who were not. A thematic content analysis of the transcripts from the focus groups revealed three themes: (1) understanding what is considered normal teen behavior; (2) understanding and managing teen trauma and mental health; and (3) recommendations for building foster parents' skills to prepare for their role. Overall, CORE Teen-trained foster/kinship caregivers seemed to have deeper insight into normal teen behaviors, as well as how trauma and mental health challenges can underlie challenging behaviors. CORE Teen foster/kinship caregivers also seemed more satisfied with the training they had received to prepare them for caring for teens. The CORE Teen training curriculum offers promise for building the unique skills that foster/kinship caregivers need in order to effectively care for older youth in the foster care system. [ABSTRACT FROM AUTHOR]

In order to optimize environmental interventions, the current study aimed to investigate whether there are subgroups with different preferences regarding park characteristics for park visitation and park-based PA among adolescents (12–16 years). Furthermore, we examined whether the identified subgroups differed in socio-demographics, PA behavior, and park use characteristics (e.g. accompaniment to park, usual activities during park visitation, usual transportation to parks). Adolescents (12–16 years) were recruited via randomly selected secondary schools, located in Flanders (Belgium). Class visits were conducted between September and November 2016 and adolescents were asked to complete an online questionnaire. Latent class analyses using Sawtooth Software were used to identify possible subgroups. A final sample of 972 adolescents (mean age 13.3 ± 1.3 years) remained for analyses. Three subgroups of adolescents with similar preferences for park characteristics could be distinguished for both park visitation and park-based PA. Overall, current results indicate that park upkeep was the most important park characteristic for park visitation as well as park-based PA among at risk subgroups (i.e. adolescents with lower overall PA levels, girls, older adolescents,…) followed by the presence of a playground or outdoor fitness equipment. Among the more active adolescents, especially boys visiting the parks together with friends, the presence of a sport field (soccer and basketball) seems to be the best strategy to increase park visitation as well as park-based PA. Current results provide a starting point to advise policy makers and urban planners when designing or renovating parks that investing in good upkeep and maintenance of parks, and the provision of a playground or outdoor fitness equipment might be the best strategy to increase both park visitation and park-based PA among at risk adolescent subgroups. [ABSTRACT FROM AUTHOR]

This article describes a replicable model of health literacy that promotes positive youth development. Now in its fifth year of implementation and run by Advance African Development, Inc., it is an integrated year-long, in-class, student-centered, technology-driven, and service-learning youth empowerment program. Forty-minute sessions are offered once a week to create health literate K-12 public school students able to use the Internet to obtain and understand health information, and to practice informed decision-making about their health. Data collected were qualitative and included student service learning projects to solve community health issues. Community engagement exposed students to problem-solving, collaborative and transformational leadership, and advocacy skills. Prior to the program, less than half of the students had heard of MedlinePlus, and those who had heard of it rarely could describe its purpose. Approximately 500 students and 10 teachers participated, and over 40 sessions were provided from August 2015 to June 2016. [ABSTRACT FROM PUBLISHER]

ABSTRACT BACKGROUND Project Connect is a national program to build partnerships among public health agencies and domestic violence services to improve the health care sector response to partner and sexual violence. Pennsylvania piloted the first school nurse-delivered adolescent relationship abuse intervention in the certified school nurses' office setting. The purpose of this study was to assess the feasibility of implementing this prevention intervention. METHODS In 5 schools in Pennsylvania, school nurses completed a survey before and 1 year after receiving training on implementing the intervention as well as a phone interview. Students seeking care at the nurses' offices completed a brief anonymous feedback survey after their nurse visit. RESULTS The school nurses adopted the intervention readily, finding ways to incorporate healthy relationship discussions into interactions with students. School nurses and students found the intervention to be acceptable. Students were positive in their feedback. Barriers included difficulty with school buy-in and finding time and private spaces to deliver the intervention. CONCLUSIONS A school nurse healthy relationships intervention was feasible to implement and acceptable to the students as well as the implementing nurses. While challenges arose with the initial uptake of the program, school nurses identified strategies to achieve school and student support for this intervention. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention models may not address psychological complexities among adolescents with mental illnesses. This study examined contextual factors related to HIV/STI risk among heterosexually active Black adolescents with mental illnesses to inform the development of targeted HIV/STI prevention strategies. Black adolescent males and females (aged 14-17) were recruited from outpatient mental health programs in Philadelphia, PA to complete a computer-assisted personalized interview on sociodemographics, sexual behaviors, and emotion regulation ( N = 53). Two sample t-tests, Wilcoxon Rank Sum tests and regression modeling were used to examine differences in the study measures by gender and relationship status. Reports of sexual partner concurrency were high-both while already in a sexual relationship (67.3%) and multiple sexual partners in the same day (42.3%). Boys reported significantly more risk behaviors than girls. Sadness dysregulation predicted currently being in a relationship, older age at first oral sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters. Coping difficulties predicted a greater number of vaginal and oral sexual partners, and a lower age at first vaginal sex. Increasing depression severity was related to older age at first vaginal sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters in the past 3 months. This formative work suggests that coping mechanisms should be addressed in HIV/STI prevention research through the inclusion of activities targeted toward emotion regulation and decreasing sexual risk behaviors. Psycho-education and skills building may mitigate the psychopathology that contributes to HIV/STI risk in the target demographic. [ABSTRACT FROM AUTHOR]

Background: An integrative multidisciplinary approach is required to elucidate the multiple factors that shape neurodevelopmental trajectories of mental disorders. The Philadelphia Neurodevelopmental Cohort (PNC), funded by the National Institute of Mental Health Grand Opportunity (GO) mechanism of the American Recovery and Reinvestment Act, was designed to characterize clinical and neurobehavioral phenotypes of genotyped youths. Data generated, which are recently available through the NIMH Database of Genotypes and Phenotypes (dbGaP), have garnered considerable interest. We provide an overview of PNC recruitment and clinical assessment methods to allow informed use and interpretation of the PNC resource by the scientific community. We also evaluate the structure of the assessment tools and their criterion validity. Methods: Participants were recruited from a large pool of youths (n = 13,958) previously identified and genotyped at The Children's Hospital of Philadelphia. A comprehensive computerized tool for structured evaluation of psychopathology domains (GOASSESS) was constructed. We administered GOASSESS to all participants and used factor analysis to evaluate its structure. Results: A total of 9,498 youths (aged 8-21; mean age = 14.2; European American = 55.8%; African American = 32.9%; Other = 11.4%) were enrolled. Factor analysis revealed a strong general psychopathology factor, and specific 'anxious-misery', 'fear', and 'behavior' factors. The 'behavior' factor had a small negative correlation (0.21) with overall accuracy of neurocognitive performance, particularly in tests of executive and complex reasoning. Being female had a high association with the 'anxious-misery' and low association with the 'behavior' factors. The psychosis spectrum was also best characterized by a general factor and three specific factors: ideas about 'special abilities/ persecution,' 'unusual thoughts/perceptions', and 'negative/disorganized' symptoms. Conclusions: The PNC assessment mechanism yielded psychopathology data with strong factorial validity in a large diverse community cohort of genotyped youths. Factor scores should be useful for dimensional integration with other modalities (neuroimaging, genomics). Thus, PNC public domain resources can advance understanding of complex interrelationships among genes, cognition, brain, and behavior involved in neurodevelopment of common mental disorders. Keywords: Community cohort, children, adolescents, young adults, psychopathology, mood, anxiety, behavior, psychosis, comorbidity, structure, genomics, neuroimaging, neurocognition, public domain. [ABSTRACT FROM AUTHOR]

A youth-driven, social media-based campaign aimed at improving knowledge about and increasing testing for sexually transmitted infections (STIs)/HIV among youth 13-17 years old was assessed by: tracking website/social media use throughout the campaign; online survey of knowledge of and attitudes towards STI testing 9 months after campaign launch; and comparing rates of STI testing at affiliated family planning clinics during the 1 year period immediately prior versus 1 year immediately after campaign launch. Over 1,500 youth were reached via social media. Survey results showed 46 % of youth had never been tested, but 70 % intended to test in the next 6 months. While the total number of GC/CT tests conducted and positive results were not significantly different pre- and post-campaign, there was a large increase in the proportion of visits at which Syphilis (5.4 vs. 18.8 %; p < 0.01) and HIV (5.4 vs. 19.0 %; p < 0.01) testing was conducted post-campaign launch. Future campaigns should incorporate lessons learned about engaging younger adolescents, social media strategies, and specific barriers to testing in this age group. [ABSTRACT FROM AUTHOR]

Aims This study examined the personality traits of negative emotionality and constraint and the ability to resist drinking during negative affective states as correlates of solitary drinking in adolescence. We hypothesized that higher levels of negative emotionality and lower levels of constraint would predict solitary drinking and that these relationships would be mediated by the ability to resist drinking in response to negative emotions. Design Structural equation modeling was used to fit a path model from the personality traits of negative emotionality and constraint to solitary drinking status through intermediate effects on the ability to resist drinking during negative emotions using cross-sectional data. Setting Clinical and community settings in Pennsylvania, USA. Participants The sample included 761 adolescent drinkers (mean age = 17.1). Measurements Adolescents completed the Lifetime Drinking History, the Multidimensional Personality Questionnaire, the Constructive Thinking Inventory and the Situational Confidence Questionnaire. Findings The path model provided a good fit to the data. The association between trait negative emotionality and solitary drinking was fully mediated by adolescents' ability to resist drinking during negative affective states ( b = 0.05, P = 0.01). In contrast, constraint had a direct effect on solitary drinking (odds ratio (OR) = 0.79, b = -0.23, P<0.01), as well as an indirect effect through the ability to resist drinking during negative affective states ( b = -0.03, P = 0.02). Conclusions The ability to resist drinking while experiencing negative feelings or emotions may be an important underlying mechanism linking trait negative emotionality (a tendency toward depression, anxiety and poor reaction to stress) and constraint (lack of impulsiveness) to adolescent solitary drinking. [ABSTRACT FROM AUTHOR]

We assessed anxiety consistent (i.e., 'traditional') and inconsistent (i.e., 'atypical') with diagnostic and statistical manual (DSM) definitions in autism spectrum disorder (ASD). Differential relationships between traditional anxiety, atypical anxiety, child characteristics, anxiety predictors and ASD-symptomology were explored. Fifty-nine participants (7-17 years, M = 10.48 years; IQ > 60) with ASD and parents completed semi-structured interviews, self- and parent-reports. Seventeen percent of youth presented with traditional anxiety, 15 % with atypical anxiety, and 31 % with both. Language ability, anxious cognitions and hypersensitivity predicted traditional anxiety, whereas traditional anxiety and ASD symptoms predicted atypical anxiety. Findings suggest youth with ASD express anxiety in ways similar and dissimilar to DSM definitions. Similarities support the presence of comorbid anxiety disorders in ASD. Whether dissimilarities are unique to ASD requires further examination. [ABSTRACT FROM AUTHOR]

We examine adolescents’ interpretations of instructional interactions to understand the academic and developmental implications of pedagogy for urban youth of color. In doing so, we seek to advance existing knowledge regarding student engagement in two ways—enhancing the ecological validity of such theories and making the links to teacher practice explicit. Urban youth of color (N= 28) were recruited from two urban high schools in Pittsburgh, Pennsylvania, and two youth development programs in Saint Paul and Minneapolis, Minnesota. The following three emergent findings summarize engagement-relevant interpretations of instructional interactions made by the adolescents in our study: (a) feeling heard in class, (b) going all in, and (c) taking students seriously. [ABSTRACT FROM PUBLISHER]

Background Sleep disturbances are both common and well-characterized in adults with alcohol use disorders ( AUDs), but have received little study in adolescents with AUDs. Furthermore, a handful of studies suggest that sleep complaints are a risk factor for AUDs. However, no published studies have yet examined the longitudinal course of sleep complaints in adolescents with AUDs; in particular, it remains unclear how persistent AUD-associated sleep complaints are in this age group, and what types of sleep complaints are most relevant to alcohol-use symptoms. We investigated these questions in a 5-year longitudinal study of adolescents with and without AUDs at baseline. Methods Participants were 696 adolescents (age 12 to 19) from a longitudinal study at the Pittsburgh Adolescent Alcohol Research Center. At baseline, 347 participants had a current AUD ( AUD+), while 349 had no current or past AUD ( AUD−). We examined sleep and alcohol involvement at baseline as well as 1-, 3-, and 5-year follow-up visits. Sleep variables included self-reported insomnia and hypersomnia, as well as variability in weekday-weekend sleep duration, all at baseline. Covariates included sex, age, current alcohol symptoms, and depression severity. Results The AUD+ group reported more overall sleep disturbance at baseline, including greater insomnia and hypersomnia complaints, and greater variability in weekday-weekend sleep duration. Group differences in insomnia and hypersomnia complaints persisted to the 5- and 3-year follow-ups, respectively. In the AUD− group, greater insomnia complaints at baseline predicted an increase in alcohol symptoms at the 1-year follow-up, while greater variability in sleep duration at baseline predicted an increase in alcohol symptoms at the 3- and 5-year follow-ups. Conclusions These results complement previous findings in other samples, indicating that insomnia and other sleep problems are a chronic predicament for adolescents with AUDs. The findings also suggest that sleep disturbances may place adolescents without AUDs at an elevated risk of developing alcohol problems. [ABSTRACT FROM AUTHOR]

Background: The transtheoretical model is an influential theoretical model in health psychology, particularly in its application to smoking cessation research. Decisional Balance (DB) and Temptations are key constructs within this framework. Purpose: This study examines the psychometric properties of the DB and Temptations scales for smoking in a predominantly African-American sample of urban adolescent girls. Methods: We used confirmatory factor analysis to compare the fit of previously published factor structures in smokers ( n = 233) and nonsmokers ( n = 598). External validity was tested by examining stages of change differences in the retained subscales. Results: Results supported the internal and external validity of the DB scale for smokers and nonsmokers. Notably, previously published three-factor (Social Pros, Coping Pros, Cons) and four-factor (Cons split into 'Aesthetic Cons' and 'Health Cons') models fit equally well, with Cons subscales correlating highly. For Temptations, a previously published three-factor (Negative Affect, Social, Weight Control) hierarchical model fit well in nonsmokers. In smokers, previously published subscales were reliably measured, but their structural relationship remained unclear. Stage difference tests showed medium to large effect sizes of DB and Temptation subscales in smokers and nonsmokers. Conclusions: The use of DB was validated for both smokers and nonsmokers in this sample of primarily African-American adolescent females, where Cons can be combined or separated into 'Aesthetic Cons' and 'Health Cons' based on practical utility and preference. For Temptations, more research is needed but large stage differences in Temptations subscales underscore the importance of this concept in smoking acquisition and cessation. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted between December 2007 and March 2008 that involved 19 gender-stratified focus groups with African American parents and adolescents from Allegheny County, Pennsylvania, to explore the process and content of parent—adolescent communication about sex. Discussions about intimate partner violence (IPV) and healthy relationships emerge inductively as critical topics in these conversations. The authors use a grounded theory approach to content analysis to identify and organize themes related to discussions on these topics. A total of 125 participants from 52 families are recruited for the study. Family history of child sexual abuse often motivates discussions. Mothers are described as the primary parent discussing sexual issues with children. Fathers primarily role model ideal male partnership behavior for sons and daughters. Parents seek to prevent daughters from experiencing sexual abuse or emotional manipulation by partners and focus on instilling a sense of responsibility to and respect for romantic partners in sons. Parents prioritize and express the need for tools to influence their adolescent’s socialization as romantic partners. Mothers and fathers approach this process differently. Family-focused interventions to prevent unhealthy relationships can build on parent’s efforts. [ABSTRACT FROM AUTHOR]

We examined rural primary care providers' (PCPs) self-reported practices of screening, brief interventions, and referral to treatment (SBIRT) on adolescent alcohol use and examined PCPs', adolescents', and parents' attitudes regarding SBIRT on adolescent alcohol use in rural clinic settings. In 2007, we mailed surveys that inquired about alcohol-related knowledge, attitudes, and treatment practices of adolescent alcohol use to all PCPs in 8 counties in rural Pennsylvania who may have treated adolescents. We then conducted 7 focus groups of PCPs and their staffs (n = 3), adolescents (n = 2), and parents (n = 2) and analyzed the narratives using structured grounded theory, evaluating for consistent or discordant themes. Twenty-seven PCPs from 7 counties returned the survey. While 92% of PCPs felt that routine screening for alcohol use should begin by age 14, 84% reportedly screened for alcohol use occasionally, and reportedly 32% screened all adolescent patients. The provider focus groups (n = 20 PCPs/staff) related that SBIRT for alcohol use for adolescents was not currently effective. Poor provider training, lack of alcohol screening tools, and lack of referral treatment options were identified barriers. Adolescents (n = 12) worried that physicians would not maintain confidentiality. Parents (n = 12) acknowledged a parental contribution to adolescent alcohol use. All groups indicated computer-based methods to screen for alcohol use among adolescents may facilitate PCP engagement. Despite awareness that rural adolescent alcohol use is a significant problem, PCPs, adolescents, and parents recognize that SBIRT for adolescent alcohol use in rural PCP settings is ineffective, but it may improve with computer-based screening and intervention techniques. [ABSTRACT FROM AUTHOR]

Aim: To identify and describe gender-related differences in the self-esteem and optimism levels of rural adolescents. Background: Self-esteem and optimism have been broadly examined and are associated with health-practices, social interaction, attachment, resiliency, and personal identity. Information describing the relationship of self-esteem and optimism as it relates to gender is limited. Methods: Using a cross-sectional survey design, students (N = 193) from three high-schools in rural Pennsylvania, USA completed the Rosenberg Self-Esteem Scale and the Optimism Scale-Life Orientation Test-Revised as part of a National Institute of Health, National Institute of Nursing Research funded study. Results: Both instruments' mean scores were in the range of average for this population, with females scoring lower than males in both self-esteem (p < 0.0001) and optimism (p < 0.0001). The results of this study have nursing implications for evidenced based interventions that target self-esteem and optimism. Attention to self-esteem and optimism in female youth is recommended. [ABSTRACT FROM AUTHOR]