A Coproduced Family Reporting Intervention to Improve Safety Surveillance and Reduce Disparities.

Objectives: Examine family safety-reporting after implementing a parent-nurse-physician-leader coproduced, health literacy-informed, family safety-reporting intervention for hospitalized families of children with medical complexity.

Methods: We implemented an English and Spanish mobile family-safety-reporting tool, staff and family education, and process for sharing comments with unit leaders on a dedicated inpatient complex care service at a pediatric hospital. Families shared safety concerns via predischarge surveys (baseline and intervention) and mobile tool (intervention).

Sexual Debut in Early Adolescence and Individual, School, and Neighborhood Social Capital.

Purpose: Sexual debut in early adolescence is associated with poor health outcomes in adulthood. We examined the associations of social capital within families, schools, and neighborhoods with early sexual debut.

Methods: Using data from the Healthy Passages cohort, a longitudinal multilevel study of adolescents, we performed a series of cross-classified multilevel logistic regression models to examine (1) the relative contribution of schools and neighborhoods to the variance and (2) the association of markers of social cohesion/social capital in families, schools, and neighborhoods with sexual debut by 10th grade.

Hippocampal gray matter volume in young adulthood varies with adolescent alcohol use.

Adolescent substance use is linked with negative future outcomes (e.g., depression, anxiety, substance use disorder).

Impairment Types and Combinations Among Adolescents and Young Adults with Disabilities: Colorado 2014-2018.

Objective: Understanding the types of functional challenges faced by adolescents and young adults with disabilities (AYA-WD) can help payers, clinicians, community-based service providers, and policymakers recognize and meet needs. This paper describes state-level prevalence rates for 1) AYA-WD overall and for 2) impairment types singly and in combinations; and 3) examines how rates may differ between those insured by Medicaid versus commercial insurance.

Methods: This descriptive study uses Colorado's All Payer Claims Dataset 2014-2018 to identify insured 10- to 26-year-olds (Medicaid only: 333,931; commercially only: 392,444).

Stress-induced Changes in Autonomic Reactivity Vary with Adolescent Violence Exposure and Resting-state Functional Connectivity.

Exposure to violence during childhood can lead to functional changes in brain regions that are important for emotion expression and regulation, which may increase susceptibility to internalizing disorders in adulthood. Specifically, childhood violence exposure can disrupt the functional connectivity among brain regions that include the prefrontal cortex (PFC), hippocampus, and amygdala. Together, these regions are important for modulating autonomic responses to stress.

Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.

Objective: To evaluate the measurement properties of a set of six items designed to elicit narrative accounts of pediatric inpatient experience.

Data Sources: Data came from 163 participants recruited from a probability-based online panel of U.S.

Improving HPV Vaccination Rates in a Racially and Ethnically Diverse Pediatric Population.

Background And Objectives: Nationally, 54.2% of youth are fully vaccinated for human papilloma virus (HPV) with persistent gender and racial/ethnic disparities. We used a quality improvement approach to improve completion of the HPV vaccine series by age 13 years.

Sex-related differences in violence exposure, neural reactivity to threat, and mental health.

The prefrontal cortex (PFC), hippocampus, and amygdala play an important role in emotional health. However, adverse life events (e.g.

Family Safety Reporting in Medically Complex Children: Parent, Staff, and Leader Perspectives.

Background And Objectives: Despite compelling evidence that patients and families report valid and unique safety information, particularly for children with medical complexity (CMC), hospitals typically do not proactively solicit patient or family concerns about patient safety. We sought to understand parent, staff, and hospital leader perspectives about family safety reporting in CMC to inform future interventions.

Methods: This qualitative study was conducted at 2 tertiary care children's hospitals with dedicated inpatient complex care services.

Analysis of Reported Health Care Use by Sexual Orientation Among Youth.

Importance: In the United States, adolescents who are lesbian, gay, or bisexual (LGB) face disparities across physical and mental health outcomes compared with non-LGB youth, yet few studies have looked at patterns of health care utilization by sexual orientation.

Objective: To compare health care utilization indicators for LGB and non-LGB youth.

Design, Setting, And Participants: This cohort study analyzed wave 3 data from Healthy Passages, a longitudinal observational study of diverse public school students in Birmingham, Alabama; Houston, Texas; and Los Angeles County, California.

White Matter Microstructure in the Young Adult Brain Varies with Neighborhood Disadvantage in Adolescence.

Neighborhood disadvantage and community violence are common in poor, urban communities and are risk factors for emotional dysfunction. Emotional processes are supported by neural circuitry that includes the prefrontal cortex (PFC), hippocampus, amygdala, and hypothalamus. These brain regions are connected by white matter pathways that include the cingulum bundle, uncinate fasciculus, stria terminalis, and fornix.

Culturally Competent Clinical Care for Older Sexual Minority Adults: A Scoping Review of the Literature.

Study Objective: As recent efforts to improve culturally competent clinical care (CCCC) have largely overlooked older LGB adults, we conducted a scoping review of position statements, empirical, and non-empirical research and suggest action steps.

Methods: We followed PRISMA Extension for Scoping Reviews Guidelines and searched for articles 1/1/11-3/14/19 (n = 1210) and other resources (n = 52), deduplicating, dually screening abstracts (n = 1,156), reviewing full-text (n = 107), and conducted a content analysis to identify distinct and cross-cutting domains (n = 44).

Main Findings: Most research was based on simple pre/post-training differences in provider knowledge.

Stress-elicited neural activity in young adults varies with childhood sexual abuse.

Objective: Childhood physical and sexual abuse are stressful experiences that may alter the emotional response to future stressors. Stress-related emotional function is supported by brain regions that include the prefrontal cortex (PFC), hippocampus, and amygdala. The present study investigated whether childhood physical and sexual abuse are associated with stress-elicited brain activity in young adulthood.

Examining Sex and Racial/Ethnic Differences in Co-use of Alcohol, Cannabis, and Cigarettes in a Community Sample of Adolescents.

Although adolescents often co-use alcohol, cigarettes, and cannabis, little is known about sex and racial/ethnic differences in the co-use of these substances. Therefore, this investigation examined sex and racial/ethnic differences in alcohol, cigarette, and cannabis co-use in a large and ethnically diverse group. : Participants were drawn from a large, multi-site study of adolescents from three regions in the United States ( = 4,129; M=16.

Building Equity, Inclusion, and Diversity Into the Fabric of a New Medical School: Early Experiences of the Kaiser Permanente Bernard J. Tyson School of Medicine.

In July 2020, the Kaiser Permanente Bernard J. Tyson School of Medicine opened in Pasadena, California, with an inaugural class of 50 students. The school endeavors to address systemic barriers that have contributed to health care and educational disparities in the United States.

Racial/Ethnic Differences in the Relationship Between Stressful Life Events and Quality of Life in Adolescents.

Purpose: Stressful life events (SLEs) increase allostatic load and require adaptation. Experiencing SLEs has been associated with decreased health-related quality of life (HRQOL) among adolescents. This study examined racial/ethnic and developmental differences in the relationship between SLEs and HRQOL from preadolescence to midadolescence.

Soft Drink Consumption and Mental Health in Adolescents: A Longitudinal Examination.

Purpose: Previous studies showed associations between soft drink consumption and mental health problems in adolescents, but the direction of these effects is unknown. This study examines the hypotheses that soft drink consumption predicts aggression and depressive symptoms over time and that these mental health problems predict soft drink consumption.

Methods: Interviews were conducted with 5,147 children and their caregivers from three sites at child ages 11, 13, and 16.

Trends in 30-Day Readmission for Medicaid and Privately Insured Pediatric Patients: 2010-2017.

Background: Children insured by Medicaid have higher readmission rates than privately insured children. However, little is known about whether this disparity has changed over time.

Methods: Data from the 2010 to 2017 Healthcare Cost and Utilization Project Nationwide Readmissions Database were used to compare trends in 30-day readmission rates for children insured by Medicaid and private insurers.