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Topic: Early‐life experiences, the transmission of health and disease within families, and the influence of cumulative risks as well as protective factors throughout life shape the trajectory of health, including mental health. Long‐term health trajectories established early in life are influenced by biologic, social, and environmental factors. Negative trajectories may be more salient if exposures to adversity occur during critical developmental periods. Purpose: The purpose of this brief is to (a) review pediatric health disparities related to depression and the intergenerational transmission of pediatric depression using a Life Course Health Development (LCHD) model and (b) provide recommendations for pediatric mental health research. Sources: Peer‐reviewed papers available for PubMed, CINAL, and Medline. Other sources include published books, papers, and gray materials. Conclusions: The LCHD model is a perspective to guide and foster new scientific inquiry about the development of mental health outcomes over the life course. The model enables synthesis of mental health, nursing, and public health, linking mental health prevention, risk reduction, and treatment in children. [ABSTRACT FROM AUTHOR]

Appalachian youth are highconsumers of added dietary sugar and are very sedentary. Mentoring to be Active trains teens to deliver atheoretically based program to promote home-based physical activity (PA) and reduce dietary sugar among rural Appalachian youth. For this pre-test/post-test pilot study, 52 seventh graders from two Appalachian schools participated as mentees. Twenty-two 10th grade students served as peer mentors. The study estimated sedentary activity,and physical activity by accelerometers and dietary sugars (snacks, beverages) during 'out of school' time. Descriptive statistics and effect sizes (ES) were calculated. When the pre-post standard deviations differed, Hedge's g were reported. Sedentary activity decreased 36.7% (ES =.798). Moderate activity levels increased 16.5% (ES =.359). Vigorous activity increased 88% (ES =.359). Sugary- beverages declined over 4 ½ servings. Sugary snacks declined 2 ¼ servings. Peer mentoring is a strategy to promote social support for healthier behaviors among youth at risk for obesity and co-morbidities. Accelerometers rigorously assessed physical activity during 'out of school' time in rural youth. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Sugar-sweetened beverages ( SSBs) are the largest source of added sugar in the US diet. In adolescents aged 12-19, these drinks account for 13% to 28% of total daily calories. Compared with other adolescents, those residing in Appalachia have the highest consumption rates of SSBs. METHODS Using a Teen Advisory Council (TAC), a student-designed and student-led intervention was conducted at 2 high schools in a rural Appalachian county. Using repeated-measures models design with Bonferroni correction, data were collected on daily and weekly consumption of SSBs and of water at baseline, immediately post-intervention, and 30 days post-intervention. Vending machine surveys were completed. RESULTS The 186 participants reported purchasing SSBs from school vending machines (41.4%), cafeteria (36.5%), and school stores (7.7%). Daily SSB servings decreased from an average of 2.32 ( SD = 2.14) to 1.32 ( SD = 1.29) (p < .001). Weekly consumption decreased from an average of 4.30 ( SD = 2.40) days/week to 2.64 ( SD = 1.91) (p < .001). Water consumption increased 19% from baseline to immediately post-intervention. CONCLUSIONS Student-directed efforts to support behavioral change are feasible and effective at affecting individual lifestyle behaviors. Small and manageable changes may lead to net improvements in lifestyle behaviors. [ABSTRACT FROM AUTHOR]

Column Editor: Bonnie Gance-Cleveland Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building. [ABSTRACT FROM AUTHOR]

CONTEXT: It is unclear whether young adult men who have ever been forced to have sex are at increased risk for sexual risk-taking, and whether their risk differs according to the gender of the perpetrator. METHODS: Data from 1,400 males aged 18–24 who participated in the 2002 National Survey of Family Growth were used to determine the prevalence of a history of forced sex and the context of each respondent’s most recent experience with such assaults. Logistic regression analyses were conducted to examine the relationship between victimization and having a recent indicator of sexual risk (e.g., having had sex in the past year with five or more female partners, a female injection-drug user or an HIV-positive female). Separate analyses were performed for coercion by females and coercion by males. RESULTS: Six percent of men reported having been forced by a female perpetrator to have vaginal intercourse, while 1% said they had been forced by a male perpetrator to have oral or anal sex. Men had an elevated likelihood of having had one or more recent sexual risk indicators if they had ever been forced to have sex by a male (odds ratio, 6.9) or female (3.3). Verbal and physical forms of coercion and provision of alcohol and drugs were commonly used by perpetrators of both genders. CONCLUSIONS: A better understanding of the pathways linking sexual victimization to sexual risk-taking among men is needed. Clinicians working with young men should screen them for victimization and provide STD testing and referrals for counseling if abuse is suspected or disclosed. [ABSTRACT FROM AUTHOR]

PURPOSE. This study explored the relationships between internal and external assets, risk behaviors, health behaviors, and thriving behaviors in diverse children. DESIGN AND METHODS. The strength of relationships existing between measures, differences between group means based on gender, grades earned, and school, and confidence interval (p ≤  .05) were tested in a sample of 61 urban sixth graders. RESULTS. Few assets were related to substance use. Assets were related to delinquency acts, health behaviors, and thriving indicators. Group differences between schools and gender and the total number of assets were noted. PRACTICE IMPLICATIONS. Supporting assets are important to consider when nurses perform assessments and design interventions to support youths in their maturation processes. [ABSTRACT FROM AUTHOR]

This study tested a model of adolescent male sexuality and evaluated its usefulness for predicting sexual behaviors among a diverse sample. Secondary analysis using a national sample was conducted. Sexuality was conceptualized as depending on family, peers, and school. Neighborhood was hypothesized to influence sexuality indirectly. Sexuality was hypothesized to influence sexual behaviors and age at first sex. Structural equation modeling techniques were used with ethnic comparisons. Family was the strongest predictor of sexuality. Males who were closer to their family were sexually conservative; males closer to peers were sexually permissive. Neighborhood's influence was moderated through family and school. Ethnic differences were not found. Sexuality assessments and strengthening family relationships are essential. [ABSTRACT FROM AUTHOR]

Aims: To explore how emerging adult‐aged women self‐manage their sexual and reproductive health and to generate a grounded theory of these self‐management processes. Design: Grounded theory methods using a constructivist approach. Methods: Between September 2019 and September 2020, 18‑ to 25‐years‐old women (n = 13) were recruited from a 4‐year university, a 2‐year community college, and neighbourhoods surrounding the institutions of higher education. Individual interviews were transcribed verbatim and qualitatively analysed using a constant comparative method and inductive coding. Results: The theory purports that core processes of sexual and reproductive health self‐management used by the women in this study included both passive and (re)active processes. These processes expanded upon and/or maintained the women's accessible sexual and reproductive health knowledge, behaviour and beliefs, defined as the sexual and reproductive health repertoire. The processes appeared to be cyclical and were often initiated by a catalysing event or catalyst and resulted in conversations with confidantes, or trusted individuals. A catalyst was either resolved or normalized by expanding or maintaining the sexual and reproductive health repertoire. Conclusion: The resulting theory, EMeRGE Theory, offers insight into the complex and cyclical processes emerging adult‐aged women use to simultaneously develop and adapt their foundational sexual and reproductive health knowledge, behaviours and beliefs. Implications for the Profession and/or Patient Care: This explication of emerging adult‐aged women's sexual and reproductive health self‐management processes can be used by nurses and nurse researchers to better address this population's unique health needs. Impact: The EMeRGE Theory provides valuable guidance for future exploratory and intervention research aimed at improving the health and well‐being of emerging adult‐aged women. Reporting Method: The authors adhered to the Consolidated Criteria for Reporting Qualitative studies (COREQ) in preparation of this publication. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction: This study describes sugar‐sweetened beverage (SSB) behaviors of children and compares child‐reported SSB behaviors to parent‐reported SSB behaviors during school days and nonschool days. Method: Six elementary schools from Tennessee participated with 444 students and 287 parents. Descriptive statistics included means, standard deviation (SD), ranges of values, and measures of central tendency. To explore the relationship between parent and child report, intraclass correlation coefficients (ICC) were analyzed. The mean (SD) differences and limits of agreement were calculated using paired t tests with Bonferroni corrections for multiple outcomes of interest. A p < 0.05 was significant. Results: Reporting differed with SSB type of school day. Children reported higher quantities of sweet tea and "coke/soda." Both agreed on SSB abstention, except for juice. ICCs ranged from 0.383 to 0.513 (p = 0.000). The lowest and highest ICCs were for sweet tea, based on school days or nonschool days. Discussion: To determine the best estimate of SSBs, information should be obtained from children and parents to improve accuracy and enhance education about health behaviors. [ABSTRACT FROM AUTHOR]

Background: Rural Appalachian populations have poorer health and fewer positive health-related behaviors compared to other United States populations. Appalachians are the most sedentary U.S. population and teens are particularly sedentary. Obesity prevention through improving physical activity is a top priority in Rural Healthy People 2020. Obesity prevalence among Appalachian teens exceeds the national rates of 13.9% and has consistently been greater than 26%. Organized sports has not been effective at improving daily physical activity or health outcomes for Appalachian teens. The purpose of this study is to test the efficacy of a 10-week school-based intervention in promoting self-regulation of physical activity among adolescents not participating in organized sports. By using accelerometers, our study will measure both sedentary time and planned exercise during waking hours.Methods: The design for this four-year study is a group-randomized controlled trial (G-RCT). We will recruit high schools in 3 waves, with 4 in Wave 1, 8 in Wave 2, and 8 in Wave 3, for a total of 20 schools. For each wave of schools, we will randomly assign half of the schools to each condition--intervention (peer-to-peer mentoring [MBA]) and comparison (teacher-led [PBA])--for a total of 10 schools in each of the two conditions by study's end. We will collect data at baseline (T1), 3 months post intervention (T2), and 6 months post intervention (T3). Linear Mixed Models (LMMs) and Generalized Linear Mixed Models (GLMMs) will be used to test the main hypotheses. Power for this study was based the primary analysis comparing BMI outcomes at T2 between the groups, adjusting for baseline BMI values.Discussion: This study provides age-appropriate lifestyle education and skill building. Peer-to-peer mentoring by local high school students and school-based tailored support strengthens sustainable behavioral change. Focusing on unique healthy-lifestyle challenges prevalent in low-resource areas such as Appalachia such as overcoming environmental, social, and psychological barriers may improve adherence to physical activity. Serving as role models, peer mentors may improve their own lifestyle behaviors, providing a dual intervention.Trial Registration: NCT02329262 . [ABSTRACT FROM AUTHOR]

Aim: The aim of this article is to provide practical strategies for maintaining methodological rigour in executing a virtual qualitative study. Strategies are based on evidence from existing research about virtual qualitative methods and on the strategies used by the authors to convert a planned in‐person qualitative, grounded theory study to an entirely virtual grounded theory study during the COVID‐19 pandemic. The study began in‐person in September 2019 and was converted to virtual in March 2020. Virtual data collection was completed in September 2020. Design: This article provides a case exemplar of virtual adaptations made to a study underway when the pandemic rendered all in‐person research impractical and potentially dangerous. Data sources: The strategies discussed are based on our own experiences and the supporting theoretical assumptions of qualitative research, specifically grounded theory methods. Implications for nursing: Nursing scholars conducting qualitative inquiry may find these strategies helpful in continuing research activities during periods of limited access to the phenomena or persons of interest. Furthermore, these strategies allow nursing scholars to conduct rigorous, in‐depth research without geographical limitations, providing greater possibilities for international collaborations and cross‐institution research. Conclusion: Despite novel challenges, methodological adaptations that are carefully planned and purposeful allow qualitative and non‐qualitative scholars to continue research activities in a fully virtual manner. Impact: This case exemplar and discussion provide practical strategies for qualitative scholars to consider while planning new studies or converting an in‐person study to a virtual one. Despite the in‐person nature of in‐depth qualitative inquiry, a historic pandemic and a changing research environment require qualitative researchers to adapt to virtual methods while still conducting high quality, methodologically rigorous research. Qualitative scholars can use the strategies presented here to continue rigorous qualitative inquiry despite limited access to phenomena or persons. [ABSTRACT FROM AUTHOR]