Background: Teen dating violence (TDV) and exposure to intimate partner violence (eIPV) are associated with poorer mental health; however, few studies investigate verbal TDV or the independent contributions that TDV and eIPV have on mental health. Objective: Examine the prevalence of TDV (verbal, physical, sexual, multiple forms) among youth, associations between TDV and mental health, and how eIPV affects these associations. Participants and setting: A school-based sample of 71,635 9th and 11th grade students (51.5% assigned female, 71.9% White) completed the anonymous 2019 Minnesota Student Survey, providing data on mental/emotional/behavioral (MEB) problems and treatment, depression and anxiety symptoms, non-suicidal self-injury, suicidal ideation/attempts, TDV, and eIPV. Methods: Chi-square tests were used to compare the prevalence of mental health concerns by TDV form; logistic regression models controlled for demographic characteristics and eIPV. Interaction tests identified the multiplicative effects of eIPV and TDV on mental health. Results: TDV was reported by 36.4% of those with vs 13.6% of those without eIPV. Each type of TDV was significantly associated with adverse mental health (p's<0.001), even after adjusting for demographic variables and eIPV. The prevalence of each mental health outcome was significantly increased by eIPV for youth with no TDV (p's<0.001), verbal only (p's<0.001), sexual only (p's<0.05), and multiple forms of TDV (p's<0.001); findings for physical TDV varied. Conclusions: Education on healthy, consensual dating relationships is critical, alongside regular screening for eIPV and TDV, referring affected youth for treatment. Further research on factors that attenuate the association between TDV and mental health is warranted.

OBJECTIVES: To apply an intersectional lens to disparities in emotional distress among youth, including multiple social positions and experiences with bias-based bullying. METHODS: Data are from the 2019 Minnesota Student Survey (n 5 80 456). Social positions (race and ethnicity, sexual orientation, gender) and 2 forms of bias-based bullying (racist, ho-mophobic or transphobic) were entered into decision tree models for depression, anxiety, self-injury, suicidal ideation, and suicide attempts. Groups with the highest prevalence are described. Rates of emotional distress among youth with matching social positions but no bias-based bullying are described for comparison. RESULTS: LGBQ identities (90%) and transgender, gender diverse, and questioning identities (54%) were common among the highest-prevalence groups for emotional distress, often concurrently ; racial and ethnic identities rarely emerged. Bias-based bullying characterized 82% of the highest-prevalence groups. In comparable groups without bias-based bullying, emotional distress rates were 20% to 60% lower (average 38.8%). CONCLUSIONS: Findings highlight bias-based bullying as an important point for the intervention and mitigation of mental health disparities, particularly among lesbian, gay, bisexual, transgen-der, gender-diverse, queer, and questioning adolescents. Results point to the importance of addressing bias-based bullying in schools and supporting lesbian, gay, bisexual, transgender, gender-diverse, queer, and questioning students at the systemic level as a way of preventing emotional distress. WHAT'S KNOWN ON THIS SUBJECT: Several studies have identified disparities in emotional distress among youth across social positions, but are limited by inclusion of only 2 social positions (eg, sexual orientation and race), use of regression models, and sample sizes that necessitated combining groups. WHAT THIS STUDY ADDS: LGBQ identities (90%) and transgender/gender-diverse/questioning identities (54%) were common among the highest-prevalence groups for emotional distress, often concurrently; bias-based bullying characterized 82% of highest-prevalence groups. In comparable groups without bias-based bullying, emotional distress rates were 20%-60% lower.

Purpose: Latine transgender/gender diverse (TGD) adolescents may be at increased risk of emotional distress due to structural oppression affecting their intersecting nondominant identities. Multipl...

Purpose: The current study extends the limited body of intersectional research on adolescents' sexual health by examining experiences of bias-based bullying and multiple intersecting social positio...

Although research has examined disparities in HIV prevention behaviors, intersectional research is needed to understand who may be underserved. This study examines disparities in consistent condom use, HIV testing, and PrEP awareness and use across assigned sex, gender identity, sexual orientation, and racial/ethnic identity in a large sample of sexually active LGBTQ+ youth (mean age = 16.5) who completed the 2022 LGBTQ National Teen Survey. Four social identities were included as indicators in Chi-Square Automated Interaction Detection models to uncover disparate rates of HIV preventive behaviors. Generally, HIV testing and PrEP services were higher among gay/lesbian and queer youth assigned male, and lower among those assigned female. Certain LGBTQ+ youth may be systematically missed by these services, (e.g., those assigned female; those assigned male who also identify as bisexual, pansexual, asexual, questioning, or straight (and trans/gender diverse)). Providers should strive to serve populations who are not being reached by HIV prevention services.

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.

This cross-sectional study analyzes data from 2 statewide school surveys to document the experiences of sexual and gender minoritized Asian American, Native Hawaiian, and Pacific Islander students in grades 9 through 12 who reported bullying related to their identity.

Interpersonal supports are protective against multiple negative health outcomes for youth, such as emotional distress and substance use. However, finding interpersonal support may be difficult for youth exposed to intersecting racism, heterosexism, and cisgenderism, who may feel they are “outsiders within” their multiple communities. This study explores disparities in interpersonal supports for youth at different sociodemographic intersections. The 2019 Minnesota Student Survey includes data from 80,456 high school students, including measures of four interpersonal supports: feeling cared about by parents, other adult relatives, friends, and community adults. Exhaustive Chi-square Automatic Interaction Detection analysis was used to examine all interactions among four social identities/positions (racialized/ethnic identity, sexual identity, gender identity, and sex assigned at birth) to identify groups who report different rates of caring from each source (Bonferroni adjusted p < .05). In the overall sample, 69.24 percent perceived the highest level of caring (“very much”) from parents, 50.09 percent from other adult relatives, 39.94 percent from friends, and 15.03 percent from community adults. Models identified considerable differences in each source of support. For example, more than 72 percent of straight, cisgender youth reported their parents cared about them very much, but youth who identified as LGBQ and transgender/gender diverse or gender-questioning were much less likely to report high parent caring (less than 36 percent) across multiple racialized/ethnic identities and regardless of sex assigned at birth. Findings highlight the importance of better understanding the ways interpersonal support might differ across groups and underscore a need for intersectionality-tailored interventions to develop protective interpersonal supports for LGBTQ+ youth, rather than one-size-fits-all approaches.

Purpose: Most extant scholarship that examines the health experiences of sexual and gender diverse youth (SGDY) is limited in the ability to apply an intersectional framework due to small sample si...

Given emerging adulthood is a period of increased independence, it is unclear how much contact emerging adults have with their parents, how this communication occurs, and how frequency of communication differs across sociodemographic characteristics. The main aim of this study was to examine communication patterns and modalities between emerging adults and their parents. Data are from an 8-year longitudinal, population-based study of socio-economically and racially/ethnically diverse adolescents followed into emerging adulthood (n = 1539; mean age = 22.1; 53.1% female). Latent profile analysis results supported a 5-class model, in which classes were characterized by patterns of frequency of communication with parents across different modalities. The most common communication modality included medium levels of engagement (i.e., few times/week), with both parents, and was in-person or via the phone (i.e., calls, text messages, email). Results differed by race/ethnicity. Findings from this exploratory study may be useful for supporting positive communication patterns between emerging adults and their parents and may inform what intervention delivery format (e.g., phone, social media-based, in-person) may be more effective for certain parent/emerging adult subgroups engaging in family-based interventions.

In Reply In response to our article, 1 Apana et al emphasized the importance of data analysis that disaggregates Asian Ameri-can and Native Hawaiian and Pacific Islander populations. Our study used public health data sets from Minnesota and Cali-fornia and included racial and ethnic identities, along with other social identities and experiences, which are often collapsed , disguising differences between and among subgroups. Apana et al rightly noted that our approach still resulted in invisibilizing Native Hawaiian and Pacific Islander adolescents, who were effectively combined with Asian Ameri-can youth in prevalence estimates. We have therefore reexamined variables from our study comparing Native Hawaiian and Pacific Islander vs non-Native Hawaiian and Pacific Islander Asian American students. In Minnesota, 540 of 6954 students (7.8%) self-identified as Native Hawaiian and Pacific Islander, and the additional 92.2% selected Asian (potentially in combination with other racial or ethnic groups except for Native Hawaiian and Pacific Islander). In California, 8111 of 67 338 (12.0%) self-identified as Native Hawaiian and Pacific Islander. In Minne-sota, 2.5% of Native Hawaiian and Pacific Islander students identified as transgender, genderqueer, or genderfluid vs 1.5% of non-Native Hawaiian and Pacific Islander Asian American students. Native Hawaiian and Pacific Islander students self-reported a bisexual identity (9.9%) or a sexual orientation not listed (4.2%) at higher rates than non-Native Hawaiian and Pacific Islander Asian American students (6.7% and 2.3%, respectively). In California, Native Hawaiian and Pacific Islander students reported identifying as gay or lesbian (2.1%) and bisexual (6.3%) at higher rates than non-Native Hawai-ian and Pacific Islander Asian American peers (1.7% and 5.2%, respectively). Native Hawaiian and Pacific Islander adolescents also reported approximately 1.5 to 2 times the rates of gender-(11.5% vs 6.3% in Minnesota and 8.1% vs 5.7% in Cali-fornia) and sexual orientation-based bullying (11% vs 5.9% in Minnesota and 8.8% vs 5.8% in California) than non-Native Hawaiian and Pacific Islander Asian American adolescents and had higher rates of elevated depressive symptoms (31.0% vs 24.7% in Minnesota and 38.4% vs 31.8% in California). We concur with Apana et al's place-based research advo-cacy. History and context are important. Native Hawaiian and Pacific Islander individuals do not share the same cultural heritage as Asian American individuals, 2 and Native Hawaiian and Pacific Islander communities have histories with militariza-tion of the land and violent attempts of colonization and assimilation affecting long-term health outcomes. 3 As Apana et al noted, Indigenous Native Hawaiian and Pacific Islander cultures also uphold expansive conceptualizations of gender and sexuality, which may account for the higher self-reported sexual and gender identities above. 4 Further, this long-standing cultural stance likely contributed to Hawaii's legislative protections. For example, Hawaii has policies prohibiting bullying due to gender identity and expression and sexual orientation in educational settings. 5 The importance of this context and assessing how such policies are associated with health outcomes cannot be understated. We also think valuable information can come from assessing health outcomes of Native Hawaiian and Pacific Islander adolescents with multiple marginalized social identities in additional locations where such protections may or may not be in place, and with the reality that migration has increased for various reasons. Future research may benefit from examining results from Hawaii, the US Affiliated Pacific Islands, and other locations, which could support expansion and scaffolding of policies such as those in Hawaii. We appreciate and value Apana et al's advocacy and agree with the importance of inclusion with regard to data equity and research partnerships. Our team has secured funding to extend this work, include more Native Hawaiian and Pacific Islander people on our research team and youth advisory board, and strengthen and expand community partnerships with transparency and intention.

Helicopter parenting, a parenting style defined by over-involvement, may lead to poor health outcomes. However, research has primarily focused on children and adolescents from White, high socio-eco...

Objective: Limited research incorporates an intersectional approach when evaluating disordered eating behaviors among those holding minoritized social positions, such as lesbian, gay, bisexual, queer, questioning, and/or transgender/gender diverse (LGBTQ) adolescents. The current study assessed stigma experiences from peers at school, self-esteem, LGBTQ pride, and overlapping social positions as they relate to disordered eating behaviors among LGBTQ adolescents. Method: Participants included 11,083 adolescents (Mage = 15.6, SD = 1.3; 34.8% transgender/gender diverse) from a large national survey study of LGBTQ adolescents from 2017. Exhaustive Chi-square Automatic Interaction Detection analysis was used to identify bias-based bullying experiences (i.e., weight-based, identity-based), self-esteem, LGBTQ pride, and overlapping social positions (i.e., gender identity, sexual identity, race/ethnicity, body mass index (BMI) percentile) associated with the highest prevalence of unhealthy weight control behaviors, extreme unhealthy weight control behaviors, and past year binge eating. Results: Adolescents in the 28 identified groups with a high prevalence of disordered eating behavior held at least one structurally marginalized social position (e.g., high BMI), bias-based bullying experience, low self-esteem, or low LGBTQ pride in addition to being LGBTQ. Weight-based bullying was a salient risk-factor for disordered eating across social positions. Among adolescents with the same social positions, levels of self-esteem, LGBTQ pride, but no bias-based bullying experience, prevalence estimates of disordered eating were, on average, 23% lower. Discussion: LGBTQ adolescents with multiple marginalized social positions and related factors engage in disproportionately high prevalence disordered eating. Findings underscore the importance of addressing intersecting experiences of stigma to reduce disordered eating and promote health equity among adolescents. Public significance: Multiply marginalized LGBTQ adolescents, most of whom also reported experiencing bias-based bullying from peers at school, reported disproportionately high prevalence disordered eating. In comparison groups of adolescents with no bias-based bullying experience, prevalence of disordered eating was, on average, 24% lower. Findings underscore the importance of addressing intersecting experiences of stigma to reduce disordered eating and promote health equity among adolescents.

<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>