for psychopathology, including evidence suggesting that lower latent trait cortisol (LTC), a stable person-level indicator of the HPA axis, can pose risk for greater internalizing symptoms among youth (Stroud et al., 2018). However, scant research has examined psychosocial mechanisms of such biocontextual risk that perpetuate psychopa-thology among Latino youth. This is problematic because Latino youth are increasingly represented in higher education (de Brey et al., 2019), but report high rates of polyvictimization and mood disorders (Merikangas et al., 2010; López et al., 2016), both of which are linked with lower LTC (Gusman et al., 2023; Stroud et al., 2018). Using a biopsychosocial framework, the present study examined whether psychosocial factors (acculturative stress, coping efficacy) during college mediate effects of early-life polyvictimization and LTC on internalizing symptoms at the end-of-college. Methods: A longitudinal sample of self-identified Latino/Hispanic adolescents (N¼206; Mage¼18.1; 85% Mexican descent; 64% female) completed questionnaires during the summer/spring of their high school senior year (T1), second college semester (T3), and eighth college semester (T8). Salivary cortisol (T1) was collected over three consecutive weekdays at waking and 30 minutes after waking via passive drool (Stalder et al., 2015; 1,210 samples). Confirmatory factor analyses modeled LTC (Doane et al., 2015). Presence of poly-victimization (T1), defined as two or more types of abuse or domestic violence exposures, was measured using items from the Adverse Childhood Experiences survey (retrospective report of ages 0-16; Felitti et al., 1998; Finkelhor et al., 2007). The Depression Anxiety Stress Scale (T1a¼.96; T8a¼.98; Lovibond & Lovibond, 1995) measured internalizing symptoms. Questions assessed T3 coping efficacy (Sandler et al., 2000; a¼.92) and acculturative stress (stressor count 1-25; Rodriguez et al., 2002). Birth control, medication, de-mographics, and T1 covariates for each key variable were included in mediation analyses. Results: There were no significant direct or indirect effects of LTC or polyvictimization on T8 internalizing symptoms. Greater LTC was associated with lower acculturative stress (b¼-.197, SE¼.079, p¼.013). Greater coping efficacy in college predicted lower T8 inter-nalizing symptoms (b¼-.277, SE¼.080, p¼.001). Conclusions: We did not find that biocontextual risks prior to college precipitated greater internalizing symptoms at the end of college for Latino youth. However, lower LTC introduced risk for greater accul-turative stress during college. Further, cultivating greater coping efficacy (i.e., one's beliefs in their coping ability) may represent a key asset for reducing internalizing symptoms later in young adulthood. Interventions should leverage such psychological adaptations while supporting acculturative stress management for Latino youth. Purpose: Longstanding and robust evidence highlights poor mental health outcomes and suicide-related behaviors among U.S. adolescents in the years leading up to and through the COVID-19 pandemic. Current data primarily focus on health outcomes among high school-aged adolescents and point to gaps in understanding mental health, suicidal thoughts and behaviors among younger adolescents. In order to understand the impact of COVID-19 on the mental health of pre-adolescents, data on their mental health prior to the COVID-19 pandemic is essential. Methods: This study used pooled data from Centers for Disease Control and Prevention's Youth Risk Behavior Survey of middle school students (n¼127,912) between 2015-2019. Three dichoto-mized measures of lifetime suicide-related behaviors were assessed: suicidal thoughts, suicide planning, and suicide attempts. Weighted prevalence estimates with 95% confidence intervals were calculated to provide prevalence estimates for each survey year. Linear trends examined disparities in the prevalence of suicidal thoughts and behaviors , overall and by student demographic characteristics (i.e., sex, race/ethnicity, and grade). Main effects odds ratios compared estimates among racial and ethnic minority adolescents (Hispanic/ Latino; non-Hispanic Black or African American; Non-Hispanic Asian; Non-Hispanic Multiple races; Non-Hispanic American Indian/Alaska Native; Non-Hispanic Native Hawaiian/Other Pacific Islander) with non-Hispanic White students, controlling for sex and grade. Results: Overall, significant linear increases were observed between 2015-2019 for the percentage of middle school students who reported seriously thinking about suicide (18.2% to 22.3%), ever making a suicide plan (11.8% to 14.7%), and ever attempting suicide (6.9% to 9.3%). Racial and ethnic minority students, other than non-Hispanic Asian, showed overall higher odds of suicidal thoughts and behaviors compared with non-Hispanic White students. Conclusions: Findings highlight a concerning trajectory of trends in the years leading up to the pandemic's onset, offering a proximate context for understanding and evaluating middle school-aged ado-lescents' suicide thoughts and related behaviors during the pandemic. Needs for comprehensive and culturally responsive mental health and suicide prevention education and services remain for addressing health equity and disparities in adolescents' suicide-related behaviors during pandemic recovery.

Purpose: Pediatric obesity disproportionately impacts Hispanic or Latino/a adolescents. Culturally appropriate family-based behavioral initiatives to improve weight status are warranted. The purpose of this research was to determine prevalence rates and identify protective factors associated with having overweight/obesity (body mass index ≥ 85th percentile) to inform Hispanic or Latino/a-targeted behavioral intervention development. Design: Secondary data analyses of a population-based statewide survey. Setting: Minnesota public high schools. Participants: Male (n = 2,644) and female (n = 2,798) Hispanic or Latino/a 9th and 11th graders (N = 5,442). Measures: Obesity-related behaviors (meeting fruit and vegetable [F&V] and physical activity [PA] recommendations), family caring, family country/region of origin, and weight status. Analysis: Stepwise logistic regression models (F&V, PA), stratified by biological sex, were used to identify protective factors of overweight/obesity. Results: The overall prevalence of meeting F&V and PA recommendations was 11.0% and 11.8%, respectively. Meeting F&V recommendations was not protective against overweight/obesity in either sex. Yet, males and females who met PA recommendations had significantly lower odds of having overweight/obesity (p <.05). In F&V and PA models, family caring was protective against overweight/obesity in females (p <.05), and family country/region of origin was protective against overweight/obesity in both sexes (p <.05). Conclusion: Findings illustrate a need for obesity prevention initiatives for Hispanic or Latino/a youth. More research is needed to understand the protective nature of family caring and country/region of origin.

SARS-CoV-2 is primarily transmitted through person-to-person contacts. It is important to collect information on age-specific contact patterns because SARS-CoV-2 susceptibility, transmission, and morbidity vary by age. To reduce the risk of infection, social distancing measures have been implemented. Social contact data, which identify who has contact with whom especially by age and place are needed to identify high-risk groups and serve to inform the design of non-pharmaceutical interventions. We estimated and used negative binomial regression to compare the number of daily contacts during the first round (April–May 2020) of the Minnesota Social Contact Study, based on respondent’s age, gender, race/ethnicity, region, and other demographic characteristics. We used information on the age and location of contacts to generate age-structured contact matrices. Finally, we compared the age-structured contact matrices during the stay-at-home order to pre-pandemic matrices. During the state-wide stay-home order, the mean daily number of contacts was 5.7. We found significant variation in contacts by age, gender, race, and region. Adults between 40 and 50 years had the highest number of contacts. The way race/ethnicity was coded influenced patterns between groups. Respondents living in Black households (which includes many White respondents living in inter-racial households with black family members) had 2.7 more contacts than respondents in White households; we did not find this same pattern when we focused on individual’s reported race/ethnicity. Asian or Pacific Islander respondents or in API households had approximately the same number of contacts as respondents in White households. Respondents in Hispanic households had approximately two fewer contacts compared to White households, likewise Hispanic respondents had three fewer contacts than White respondents. Most contacts were with other individuals in the same age group. Compared to the pre-pandemic period, the biggest declines occurred in contacts between children, and contacts between those over 60 with those below 60.

Objectives. To report insurance-based discrimination rates for nonelderly adults with private, public, or no insurance between 2011 and 2019, a period marked by passage and implementation of the Affordable Care Act (ACA) and threats to it. Methods. We used 2011-2019 data from the biennial Minnesota Health Access Survey. Each year, about 4000 adults aged 18 to 64 years report experiences with insurance-based discrimination. Using logistic regressions, we examined associations between insurance-based discrimination and (1) sociodemographic factors and (2) indicators of access. Results. Insurance-based discrimination was stable over time and consistently related to insurance type: approximately 4% for adults with private insurance compared with adults with public insurance (21%) and no insurance (27%). Insurance-based discrimination persistently interfered with confidence in getting needed care and forgoing care. Conclusions. Policy changes from 2011 to 2019 affected access to health insurance, but high rates of insurance-based discrimination among adults with public insurance or no insurance were impervious to such changes. Public Health Implications. Stable rates of insurance-based discrimination during a time of increased access to health insurance via the ACA suggest deeper structural roots of health care inequities. We recommend several policy and system solutions. (Am J Public Health. 2023;113(2):213-223. https://doi.org/10.2105/AJPH.2022.307126).

<p> Via a school-based survey, we used a developmental assets framework to investigate associations of internal and social characteristics and weight-based bullying with sport and physical activity (PA) among female adolescents with high weight status ( <italic>n</italic>  = 4,468; <italic>M</italic> _age  = 14.9 years, <italic>SD</italic> _age  = 1.3; body mass index ≥ 95th percentile). Participants reported ≥60 min of PA on approximately 3.0 days ( <italic>SD</italic>  = 2.1) in the previous week. Over one-third played organized team sports, averaging 3.5 days ( <italic>SD</italic>  = 1.5) per week. Weight-based bullying was common (46%) and unassociated with lower sport and PA. Results from <italic>t</italic> -tests and chi-squared tests demonstrated that adolescents who played sport (vs. those who did not) had higher internal developmental assets, better perceived health, and stronger perceptions of caring from parents, friends, and other community adults. Similarly, adolescents engaging in more PA reported higher developmental assets. In regression models adjusted for all variables and demographic characteristics, higher internal developmental assets, better perceived health, and stronger perceptions of caring from adults in the community were positively and significantly associated with increased odds of sport participation and higher PA. Findings suggest female adolescents with high weight status have internal and social assets related to their participation in PA and sport, despite experiencing weight-based bullying. Adults (e.g., coaches, parents, and healthcare professionals) should help female adolescents with high weight status participate in sport and PA and build developmental assets. Adults should also recognize the frequent weight-based bullying youth encounter and strive to mitigate it in sport and PA contexts. </p>

Background: We investigated the percentage of insufficiently active adolescents who became young adults meeting moderate to vigorous physical activity (MVPA) guidelines. We also explored adolescent psychosocial and environmental factors that predicted MVPA guideline adherence in young adulthood. Methods: Participants included N = 1001 adolescents (mean age = 14.1 y) reporting < 7 hours per week of MVPA and followed (8 y later) into young adulthood through Project EAT. We examined mean weekly hours of MVPA, MVPA change between adolescence and young adulthood, and the proportion of participants meeting MVPA guidelines in young adulthood. With sex-stratified logistic regression, we tested 11 adolescent psychosocial and environmental factors predicting meeting MVPA guidelines in young adulthood. Results: Overall, 55% of insufficiently active adolescents became young adults meeting MVPA guidelines. On average, participants reported 3.0 hours per week of MVPA, which improved to 3.8 hours per week in young adulthood. Among female participants, higher MVPA in adolescence and stronger feelings of exercise compulsion predicted greater odds of meeting adult MVPA guidelines (odds ratioMVPA = 1.18; odds ratiocompulsion = 1.13). Among female and male participants, perceived friend support for activity in adolescence predicted greater odds of meeting adult MVPA guidelines (odds ratiofemale = 1.12; odds ratiomale = 1.26). Conclusions: Insufficiently active adolescents can later meet adult guidelines. Interventions that increase perceived friend support for activity may benefit individuals across development.

Hispanic/Latina students face difficulties engaging in physical activity, but schools can help by integrating activity into accrue the school day and offering sport and activity-based extracurricul...

Purpose: Girls on the Run is an after-school physical activity-based positive youth development program designed to enhance girls’ social, psychological, and physical development. We evaluated the effectiveness of the program by employing a longitudinal design and mixed methods. Methods: Girls (N = 203; aged 8–11 y) completed survey measures of positive youth development constructs (competence, confidence, connection, character, and caring), physical activity, and sedentary behavior prior to, at the end of, and 3 months after the season. Subsamples of girls, coaches, caregivers, and school personnel participated in focus groups. Coaches completed information about their team’s community impact project and number of girls who completed the season-ending 5k. Results: The full sample improved in confidence and connection, whereas girls who started below the preseason average showed the greatest gains from preseason to postseason on all measures, and scores were maintained or continued to improve at follow-up. All stakeholders in focus groups corroborated evidence of season-long improvement in social and emotional behaviors and health outcomes. Involvement in the community impact project contributed to girls’ growth in character and empathy skills. Conclusion: Findings provide empirical evidence that Girls on the Run is effective in promoting positive youth development, including season-long and lasting change in competence, confidence, connection, character, caring, and physical activity, especially among girls who exhibited lower preseason scores than their peers.

Federal regulations establish special enrollment periods--times outside of open enrollment periods--during which people may enroll in or change their health insurance plans offered through the federal and state-based exchanges, or Marketplaces. To be eligible, a person must experience a shift in income or another "qualifying life event," such as a change in marital status or the number of dependents, or the loss of minimum essential health coverage. We produced an upper-bound estimate that 3.7 million nonelderly adults with coverage through a federal or state Marketplace could have experienced a qualifying life event and become eligible for a special enrollment period because of income shifts. In addition, more than 8.4 million nonelderly adults who did not have Marketplace coverage--three-quarters of whom had no insurance--became eligible for a special enrollment period as a result of other qualifying life events. Many if not most of these people may be unaware of their eligibility. In states that did not expand Medicaid eligibility, we estimated that 1.9 million people experienced income shifts outside of the open enrollment period that would make them eligible for Marketplace subsidies. However, because they were uninsured or had nongroup coverage (instead of Medicaid) during the most recent open enrollment period, they had to wait until the next period to enroll in a Marketplace plan.

BACKGROUND Nicaragua was the first developing nation to implement routine immunization with the pentavalent rotavirus vaccine (RV5). In this RV5-immunized population, understanding infectious etiologies of childhood diarrhea is necessary to direct diarrhea treatment and prevention efforts. METHODS We followed a population-based sample of children <5 years in León, Nicaragua for diarrhea episodes through household visits. Information was obtained on RV5 history and sociodemographics. Stool samples collected during diarrhea episodes and among healthy children underwent laboratory analysis for viral, bacterial and parasitic enteropathogens. Detection frequency and incidence of each enteropathogen was calculated. RESULTS The 826 children in the cohort experienced 677 diarrhea episodes during 607.5 child-years of exposure time (1.1 episodes per child-year). At least 1 enteropathogen was detected among 61.1% of the 337 diarrheal stools collected. The most common enteropathogens among diarrheal stools were: norovirus (20.4%), sapovirus (16.6%), enteropathogenic Escherichia coli (11.3%), Entamoeba histolytica/dispar (8.3%), Giardia lamblia (8.0%) and enterotoxigenic E. coli (7.7%), with rotavirus detected among 5.3% of diarrheal stools. Enteropathogenic Escherichia coli and enterotoxigenic E. coli were frequently detected among stools from healthy children. Among children with diarrhea, norovirus was more commonly detected among younger children (< 2 years) and G. lamblia was more commonly detected among older children (2-4 years). The mean age of rotavirus detection was 34.6 months. CONCLUSIONS In this Central American community after RV5 introduction, rotavirus was not commonly detected among children with diarrhea. Prevention and appropriate management of norovirus and sapovirus should be considered to further reduce the burden of diarrheal disease.

Abstract. We estimated the incidence of watery diarrhea in the community before and after introduction of the pentavalent rotavirus vaccine in León, Nicaragua. A random sample of households was selected before and after rotavirus vaccine introduction. All children &lt; 5 years of age in selected households were eligible for inclusion. Children were followed every 2 weeks for watery diarrhea episodes. The incidence rate was estimated as numbers of episodes per 100 child-years of exposure time. A mixed effects Poisson regression model was fit to compare incidence rates in the pre-vaccine and vaccine periods. The pre-vaccine cohort (N = 726) experienced 36 episodes per 100 child-years, and the vaccine cohort (N = 826) experienced 25 episodes per 100 child-years. The adjusted incidence rate ratio was 0.60 (95% confidence interval [CI] 0.40, 0.91) during the vaccine period versus the pre-vaccine period, indicating a lower incidence of watery diarrhea in the community during the vaccine period.