To examine whether adverse parental legal system involvement (incarceration, arrest) was associated with suicide risk, accounting for other adverse childhood experiences, and whether there was a ...moderating relationship between positive childhood experiences (PCEs) and parental legal system involvement in suicide risk.
This cross-sectional study used 2-year follow-up data from the Adolescent Brain Cognitive Development Study when children were age 11 to 12 years. Outcomes were lifetime suicidal ideation, attempts, and nonsuicidal self-injury (NSSI). Exposures were parent incarceration or arrest. We used generalized linear models to estimate the relative risk of suicide outcomes from adverse parent legal involvement and whether there was an interaction between parent legal system involvement and PCE count, controlling for adverse childhood experiences and demographic factors.
Among our sample (n = 10 532;), 687 children (6.5%) reported parent incarceration and 1265 (12.0%) reported parent arrest. Suicidal ideation was the most frequent risk outcome (n = 490; 4.7%). Children whose parents had been incarcerated had a relative risk of suicidal ideation of 1.74 (95% CI: 1.32-2.31). Children whose parents had been arrested had a relative risk of suicidal ideation of 1.89 (95% CI: 1.53-2.37) and a relative risk of suicide attempt of 2.69 (95% CI: 1.7-4.25). Parental incarceration/arrest were not associated with NSSI. PCEs were associated with reduced relative risk of suicidal ideation and NSSI, though there was no significant interaction between PCEs and adverse parent legal system involvement exposures.
Parental legal system involvement may negatively affect child mental health. Strengthening PCEs in childhood may mitigate suicide-related risks.
Background: Latinx children in immigrant families have disproportionately high obesity rates; effective obesity treatment for this subset of Latinx children is critically needed. Objectives: To ...inform the development of weight management interventions we explored: 1) community facilitators and barriers to achieving childhood healthy weight through photovoice; and 2) participant reflections on the photovoice process. Methods: Photovoice was conducted using established methods in a local church. After photovoice, participants completed semi-structured interviews to reflect on their experience. Transcripts were analyzed using a general thematic analysis approach to arrive at preliminary themes, which were presented to participants for validation. Participant input was used to finalize the themes. Results: Six adults and two youth Latinx immigrants identified photograph themes over seven sessions. Four themes emerged regarding community barriers and facilitators to achieving childhood healthy weight: 1) family habits, 2) cultural influences on food, 3) built environment, and 4) food marketing. Participant reflections revealed they were motivated to participate in photovoice to learn more about health, recognized personal growth as a result of group sharing, valued representation as a community, and felt empowered to be role models. Conclusions: Findings from both photovoice and participant reflections reinforced the need for multi-level approaches to treating childhood obesity. Though participant reflections were gathered to inform continued engagement of Latinx families, they ultimately had a significant impact on our conclusions about priority intervention components.
U.S. immigration policies and enforcement can make immigrants fearful of accessing healthcare. Although current immigration policies restrict enforcement in "sensitive locations" including healthcare ...facilities, there are reports of enforcement actions in such settings.
Positive childhood experiences
PCEs) are supportive relationships and environments associated with improved health when aggregated into composite scores. Adverse childhood experiences (ACEs), a ...reciprocal measure to PCEs, are associated with worse health in aggregate scores
when disaggregated into measures of specific ACE types (hereafter domains). Understanding the associations between specific PCE domains and health, while accounting for ACEs, may direct investigations and intervention planning to foster PCE exposure.
We analyzed data from the nationally representative United States longitudinal Panel Study of Income Dynamics. Five PCE domains were examined: (i) peer support and healthy school climate, (ii) neighborhood safety, (iii) neighborhood support, and nurturing relationships with (iv) maternal and (v) paternal figures. Survey weighted logistic regression models tested associations between each PCE domain measure and adult general health rating, controlling for demographic covariates and nine ACE exposures: physical, emotional, or sexual abuse/assault; emotional neglect; witnessing intimate partner violence or household substance use; having a parent with mental illness; any parental separation or divorce; and/or having a deceased or estranged parent. Secondary outcomes included adult functional status and mental and physical health diagnoses. We also tested for statistical interactions between PCE domain and ACE score measures.
The sample included 7105 adults. Higher scores for the "peer support and healthy school climate" and "neighborhood safety" domain measures showed the most protective relationships with the adverse health conditions tested, most notably for mental illness. The relationship between PCE domain measures and health outcomes was attenuated, but not statistically moderated by ACE exposure.
Experiencing childhood peer support, a healthy school climate, and neighborhood safety were especially protective against multiple adult health conditions, including for ACE exposed individuals. Interventions that promote PCEs may yield population health gains.
OBJECTIVES/GOALS: Participating in out-of-school activities (i.e., sports) is associated with improved physical and mental health, but racial/ethnic and income disparities persist. Our goal was to ...describe parent perspectives to understand how to enhance family engagement in these activities, especially in low-income Black and Latinx communities. METHODS/STUDY POPULATION: We recruited parents through a large urban parks and recreation department located in Los Angeles County (LAC) and two community-based organizations who provide services primarily to low-income Black and Latinx residents in LAC. We conducted semi-structed English or Spanish interviews with parents of children ages 6-17 about the impact of activities on families, experiences making it difficult or easier for their child to be involved, and recommendations to meet their needs and facilitate family engagement. We coded the interviews using Dedoose and then performed thematic analysis. RESULTS/ANTICIPATED RESULTS: We completed 34 interviews (17 English, 17 Spanish). Parents shared these central ideas about out-of-school activities: (1) they support families and promote healthy child development; (2) they must create a safe environment and promote a sense of belonging for all families; and (3) service delivery changes reduced barriers, but activities often remained inaccessible. Barriers included lack of awareness about low-cost options, online enrollment, financial costs, waitlists, program timing, inaccessible parks/pools, safety, inconsistent quality, few opportunities for families to participate together, and a desire for more inclusive practices around race, culture, language, gender, children with special needs, and parent involvement. Parents offered recommendations to increase family engagement. DISCUSSION/SIGNIFICANCE: Involving parents in optimizing out-of-school activities may improve access, uptake, and quality of these health-promoting activities in low-income Black and Latinx communities.
Intergenerational cycles of adversity likely increase one's risk of criminal legal system involvement, yet associations with potential contributors, such as parents' adverse childhood experiences ...(ACEs) and positive childhood experiences (PCEs), have not been explored.
To investigate the association of parents' ACEs and PCEs with their adult children's involvement in US legal systems, from arrest to conviction.
The study team analyzed data from the Panel Study of Income Dynamics (PSID), a nationally representative cohort study of families in the US. PSID-2013 survey data were merged with the 2014 PSID Childhood Retrospective Circumstances Study (CRCS), collected May 2014 to January 2015, which asked adults aged 18 to 97 years to retrospectively report on their childhood experiences. Parents and their adult children were linked in the data set. Data were analyzed from October 2022 to September 2023.
The child arrest outcome was regressed on parents' ACE and PCE scores using logistic regression models. In addition, multinomial logistic regression models were used to assess the associations of parents' ACE and PCE scores with the number of times their child was arrested and convicted.
Of 12 985 eligible individuals, 8072 completed the CRCS. Among CRCS participants, there were 1854 eligible parent-child dyads (ie, parents and their adult children) that formed the analytic sample. The mean (SD) age of offspring at the time of CRCS completion was 38.5 (10.9) years, and 1076 offspring (51.3%) were female. Having 4 or more parental ACEs was associated with 1.91-fold (95% CI, 1.14-3.22) higher adjusted odds of arrest before age 26 and 3.22-fold (95% CI, 1.62-6.40) higher adjusted odds of conviction before age 26 years, compared with children of parents without ACEs. These associations persisted after controlling for parental PCEs.
In this nationally representative study, children of parents with higher ACEs were at greater risk of arrest during adolescence and young adulthood, even after controlling for parents' PCEs. Addressing and preventing childhood adversity through multigenerational life course approaches may help disrupt intergenerational pathways to the criminal legal system.
Little is known of pediatric clinicians’ experiences with and approaches to taking care of immigrant children who have been in US custody. The objectives of this article are to (1) recognize the ...challenges facing pediatric clinicians in caring for immigrant children previously in custody, and (2) propose ways that healthcare and legal professionals can collaborate to optimize the wellbeing of formerly detained immigrant children. We identify themes by assessing answers to multiple choice and short responses from a national survey. These findings can help to identify current issues faced by both detained immigrant children and pediatric clinicians, and suggest approaches to addressing these issues.
Adverse childhood experiences (ACEs) and trauma are common and can negatively impact children's health. Standardized patient (SP) learning may provide trainees with knowledge and skills to screen for ...and manage ACEs, apply trauma-informed care approaches, and teach resilience strategies.
With content experts, we developed three SP cases based on common clinical encounters, as well as didactic and debriefing materials. Case 1 focused on somatic symptoms in an adolescent with ACEs, case 2 focused on an ACE disclosure by a parent, and case 3 focused on de-escalation. The workshop required facilitators, SPs, simulation exam room and meeting space, and audiovisual equipment. It lasted 4 hours and included an orientation (1 hour), the three SP cases (totaling 2 hours), and group debriefing (1 hour).
We conducted five identical workshops with 22 pediatric residents. Participants responded favorably to case fidelity and applicability to their clinical work. Resident mean self-assessment scores improved significantly from baseline. Specifically, we assessed comfort with inquiring about and discussing ACEs, explaining the health impacts of trauma, identifying protective factors, resilience counseling, and de-escalation. Over 90% of responses indicated that residents were likely to apply what they had learned to their clinical practice.
These findings demonstrate that our SP cases were well received and suggest that such curricula can help pediatric residents feel more prepared to address trauma and promote resilience. Future work will assess these outcomes, as well as behavior change, in a larger sample to further substantiate these promising findings.
Expanding access to extracurricular activities (EA) may help address the growing mental health needs of children and caregivers. Evidence supports that EA may benefit child mental health, but few ...studies explore whether this association is influenced by child and EA factors. Further, the impact of EA on caregivers remains unknown.
We conducted a secondary analysis of the 2019 National Survey of Children's Health (NSCH), a nationally representative sample of children and their caregivers. We used responses from caregivers of children aged 6 to 17. Weighted logistic regressions tested associations between EA and 1) child anxiety and/or depression diagnosis, 2) caregiver mental health, and 3) parental aggravation, controlling for child, family, and neighborhood-level covariates. Interaction terms tested whether associations were moderated by child age, sex, and presence of physical, developmental, or behavioral condition. Subanalyses explored whether results varied by EA number and type.
Weighted sample included 21,259 children. There were disparities in which children were engaged in EA. EA participation was associated with lower odds of a 1) child being diagnosed with anxiety and/or depression; 2) caregiver reporting “fair/poor” mental health, and 3) caregiver reporting “usually/always” experiencing parental aggravation. Child age, sex, EA number and type, but not health condition, influenced the relationship between EA and child anxiety and/or depression diagnosis.
Access to EA is associated with child mental health and family functioning. Further studies should assess causality and specific mechanisms of action.
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