Police Violence Exposure and Traumatic Stress Among Youth: A Systematic Review.

Youth exposure to violence increases the risk of poor mental and physical health outcomes lasting into adulthood. Traumatic stress is an outcome of particular concern as the physiological stress response impacts the developing brain. Recently, youth exposure to police violence has been conceptualized as an adverse childhood experience that may impact traumatic stress. To examine this possibility, we conducted a systematic review, drawing upon five databases to gather the existing quantitative and qualitative peer-reviewed research on exposure to police violence and traumatic stress in youth. Searches yielded 27 relevant articles utilizing various study designs: thirteen quantitative, thirteen qualitative, and one mixed method. Twenty-six of the 27 studies found evidence of a relationship between police violence exposure and traumatic stress in youth. Police violence was associated with youth traumatic stress across three types of exposures: direct, vicarious, and anticipated. Studies also explored differential impacts by race and gender. The review revealed current gaps in the literature, such as a lack of data on select sociodemographic groups (e.g., rural youth, LGBTQ+ youth) and potential protective factors (e.g., resilience and school connectedness). In line with the findings, we put forth a research agenda as well as policy and practice recommendations to improve police interactions with youth and mental health services for youth who have been exposed to police violence. Recommendations include improving systematic data collection to track all types of police violence exposure, creating spaces for positive police interactions with youth, and training mental health practitioners to support youth exposed to police violence.

Polysubstance Use among Maryland High School Students: Variations across County-Level School Districts.

BACKGROUND: Polysubstance use is a highly prevalent public health issue, particularly among adolescents, and decisions on prevention programming and policies are often made at the local level. While there is a growing literature examining patterns of polysubstance use among adolescents, little is known about differences in those patterns across geographic regions. METHODS: Using a large, representative sample of high school students from the state of Maryland (n = 41,091) from the 2018 Maryland Youth Risk Behavior Survey, we conducted a latent class analysis (LCA) of adolescent substance use along nine binary indicators, including past 30-day combustible tobacco, e-cigarette, alcohol, and cannabis use, as well as lifetime use of prescription opioids, cocaine, heroin, methamphetamine, and injection drug use. Measurement invariance across counties was examined using the Multiple Indicators and Multiple Causes (MIMIC) procedure. RESULTS: The results of the LCA show three classes of adolescent substance use for the total sample: (1) low substance use, (2) commonly used substances (i.e., e-cigarette, alcohol, and cannabis use), and (3) polysubstance use. The results from the MIMIC procedure demonstrated geographic differences in students' endorsement of specific indicators and their class membership. CONCLUSIONS: These differences demonstrate the need for an examination of local trends in adolescent polysubstance use to inform multi-tiered prevention programming and policy.

Long-term consequences of bullying involvement in first grade.

Few prospective studies have examined how early bullying experiences impact long-term adjustment and the differential impact of children's co-occurring bullying and peer victimization involvement on adjustment in adulthood. This study addressed these gaps by examining subgroups of first graders involved in bullying and associations with four outcomes in early adulthood, including (a) Major Depression diagnosis, (b) post-high school suicide attempt, (c) on-time high school graduation, and (d) criminal justice involvement. Additionally, middle school standardized reading test scores and suspensions were examined as potential mechanisms through which early bullying involvement is associated with adult outcomes. Participants were 594 children from nine urban elementary schools in the United States who participated in a randomized controlled trial of two school-based universal prevention interventions. Latent profile analyses using peer nominations identified three subgroups: (a) High involvement bully-victims, (b) Moderate involvement bully-victims, and (c) Low/No involvement youth. Compared to the No/Low involvement class, High involvement bully-victims were less likely to graduate high school on time (OR = 0.48, p = .002) and Moderate involvement bully-victims were more likely to be involved in the criminal justice system (OR = 1.37, p = .02). High bully-victims were at greater risk for both not graduating high school on-time and criminal justice system involvement, which were partially explained by 6th grade standardized reading test scores and suspensions. Moderate bully-victims were less likely to graduate high school on time, which was partially explained by 6th grade suspensions. Findings highlight how early bully-victim involvement increases risk for difficulties that affect adult quality of life.

School Climate and Bullying Bystander Responses in Middle and High School.

Bullying bystanders' reactions are important for either stopping or perpetuating bullying behaviors. Given school-based bullying programs' focus on bystanders, understanding the associations between school-level factors and individual bystander responses can improve intervention efficacy. Data from 64,670 adolescents were used to examine bullying bystander responses as a function of 13 school-climate dimensions within 3 main factors (Engagement, Environment, Safety) and individual-level factors (e.g., race/ethnicity, perceptions of student-teacher connectedness). Multi-level models showed schools with better Engagement and Safety had higher odds of defender behaviors, a better Environment was associated with lower odds of passive and assisting behaviors. Differences also varied by individual-level factors. For example, an aggressive climate was associated with passive behaviors more strongly in boys and high schoolers. Further, higher perceived parent-teacher and student-teacher connectedness were associated with positive bystander behaviors, and this was stronger for Black and Latinx youth, highlighting the importance of improving relationships as a crucial starting point.

Anticipation of Racially Motivated Police Brutality and Youth Mental Health.

Purpose: Exposure to police brutality is a significant risk to adolescent mental health. This study extends this literature by exploring connections between anticipation of racially motivated police brutality and multiple facets of adolescent mental health. Methods: Students ages 14 to 18 (n = 151) were recruited from a study administered in Baltimore City public schools. Between December 2020 and July 2021, participants completed a questionnaire assessing anticipatory stress regarding racially motivated police brutality and current mental health. Regression models examined associations between this anticipatory stress and mental health. Latent profile and regression analyses were used to examine whether anticipatory stress was more salient among adolescents with comorbid mental health symptoms, compared to those without comorbid symptoms. Results: Youth with anticipatory stress stemming from both personal and vicarious police brutality had more symptoms of anxiety, depression, and PTSD, as well as lower hope, compared to youth without anticipatory stress. The association between anticipatory stress and anxiety was stronger for girls than boys. Conclusions: Findings from this study highlight racialized police brutality as a common anticipated stressor among youth, particularly for girls. Findings have implications for policing interventions, including development of additional trainings for police officers and promoting positive police/youth interactions.

Confirming Profiles of Comorbid Psychological Symptoms in Urban Youth: Exploring Gender Differences and Trait Mindfulness.

Prior work has identified the need for replication of psychological research; however, validation efforts are rare. The purpose of the current study was to confirm latent profiles of comorbid psychological symptoms in an urban adolescent sample and examine differences in gender and trait mindfulness across these profiles. Cross-sectional data from 201 eighth grade students (63% female; Mage = 13.24; 86% Black) across nine Baltimore City public middle schools were analyzed. Confirmatory latent profile analyses showed that the previously-identified 3-profile solution with boundary constraints was the best fit for the data, and significant sex and trait mindfulness differences were identified. The current study supports the need for future replication studies using this methodology to improve theory and targeted interventions.

Multilevel Barriers and Facilitators to Sustainability of a Universal Trauma-Informed School-Based Mental Health Intervention Following an Efficacy Trial: A Qualitative Study.

Limited research exists about factors that influence the sustainability of preventive school mental health interventions when research support ends. This study assessed barriers and facilitators to sustaining RAP (Relax, be Aware, do a Personal rating) Club, a trauma-informed universal mental health intervention, in urban schools following efficacy trial implementation. Between 2016-2018, 13 Baltimore City schools implemented RAP Club. We evaluated RAP Club sustainability using semi-structured interviews with administrators (n=10) and school staff trained to deliver the intervention (n=11), as well as review of intervention fidelity logs (n=137) and notes from supervision calls (n=10) with school staff and research team members who implemented the program. Although most school staff described RAP Club as acceptable and beneficial, none of the 13 schools sustained the intervention. Barriers to sustainability included low self-efficacy among school staff trained to deliver the intervention, school staff turnover, logistical challenges with space and time in the regular school calendar to deliver the program, insufficient funding to sustain the program outside of the research context, and limited planning and ongoing communication between school personnel and researchers about sustainability. Recommendations for increasing post-trial program sustainability include developing sustainability plans with schools during the pre-implementation phase, enhancing ongoing support for school staff during the implementation phase, and using academic-community partnerships to facilitate sustainability and intervention scale-up during the post-implementation phase. Increasing sustainability of beneficial school-based mental health programs has the potential to reduce mental health disparities and promote health equity.

Electronic and School Bullying Victimization by Race/Ethnicity and Sexual Minority Status in a Nationally Representative Adolescent Sample.

PURPOSE: The purpose of the study was to examine the prevalence of electronic and school bullying victimization in sexual and racial/ethnic minorities in a nationally representative U.S. sample of high school students. METHODS: Cross-sectional data from the 2015 and 2017 National Youth Risk Behavior Survey (2015, n = 15,624; 2017, n = 14,765) were analyzed using logistic regression. RESULTS: Approximately 15% of the sample reported electronic bullying victimization and 20% reported school bullying victimization. Sexual minority youth were significantly more likely to report both types of bullying than their heterosexual peers, whereas black and Latinx students were significantly less likely to report both types. White students who identified as gay/lesbian or bisexual were more likely to report both types of bullying than white, heterosexual youth. Very few changes were observed in electronic or school bullying victimization from 2015 to 2017, although there was a statistically significant decrease in school bullying among white, heterosexual youth. CONCLUSIONS: A sizeable number of adolescents experience electronic and school bullying. Sexual minority and white adolescents report a higher prevalence of these phenomena. This may have implications for designing bullying prevention strategies that target sexual minority adolescents to reduce their risk for victimization both online and in school.

Research with youth of color in low-income communities: Strategies for recruiting and retaining participants.

BACKGROUND: Youth of color from low-income urban communities are crucial participants in research, as their involvement can shape effective, culturally responsive interventions and policy to promote youth health and well-being. These young people, however, are an often-neglected research population, due in part to perceived challenges associated with their inclusion as well as marginalized communities' justifiable mistrust of research. OBJECTIVES: Based on our experience conducting a school-based randomized intervention trial in Baltimore, Maryland, we present strategies for conducting research with low-income, urban youth of color. We discuss strategies in three domains: university-community partnership development, participant recruitment, and participant retention. METHODS: We reviewed partnership building and recruitment strategies employed by our team across four years of trial implementation and evaluated success of participant retention at our final survey timepoint. RESULTS: Partnership building was facilitated by selection of a study design that maximized benefits for all participants, promotion of capacity building at partner institutions, and attention to research staff hiring and training practices. Effective study recruitment strategies included personal contact with parents and close cooperation between school personnel and study staff. Providing incentives and collecting multiple types of participant contact information contributed to increased retention rates. On average, those who participated in the final survey timepoint were less likely to be male and Latinx and exhibited more favorable baseline mental health than those who did not, suggesting differential attrition based on youth characteristics. CONCLUSIONS: Lessons learned from this school-based trial can be applied more broadly to research with low-income urban youth of color. Researchers should strive to maximize scientific rigor, minimize harm to vulnerable adolescents and their communities, promote positive research experiences for young people, and provide concrete benefits to those who participate.

Factors that Influenced Adoption of a School-Based Trauma-Informed Universal Mental Health Intervention.

We know little about why school administrators choose to adopt preventive mental health interventions within the context of school-based prevention trials. This study used a qualitative multiple-case study design to identify factors that influenced the adoption of a trauma-informed universal intervention by urban public school administrators during an efficacy trial. Semi-structured interviews were conducted with 15 school administrators who adopted a trauma-informed mindfulness intervention called RAP (Relax, be Aware, and do a Personal Rating) Club as part of their participation in a school-based trial with eighth graders. Findings indicated that administrators adopted RAP Club to provide support for students affected by trauma and prevent students from engaging in unhealthy coping behaviors. Examples of contextual factors that contributed to adoption included a lack of trauma-informed mental health programs within schools, inadequate district funding for preventive school mental health services, and the perceived benefits of engaging in a university-community partnership. The study's findings suggest strategies to increase school program adoption in the context of research and, more broadly, for implementation science.

A randomized controlled trial of a trauma-informed school prevention program for urban youth: Rationale, design, and methods.

INTRODUCTION: Youth in disadvantaged urban areas are frequently exposed to chronic stress and trauma, including housing instability, neighborhood violence, and other poverty-related adversities. These exposures increase risk for emotional, behavioral, and academic problems and ultimately, school dropout. Schools are a promising setting in which to address these issues; however, there are few universal, trauma-informed school-based interventions for urban youth. METHODS/DESIGN: Project POWER (Promoting Options for Wellness and Emotion Regulation) is a randomized controlled trial testing the impact of RAP Club, a trauma-informed intervention for eighth graders that includes mindfulness as a core component. Students in 32 urban public schools (n = 800) are randomly assigned to either RAP Club or a health education active control group. We assess student emotional, behavioral, and academic outcomes using self-report surveys and teacher ratings at baseline, post-intervention, and 4-month follow up. Focus groups and interviews with students, teachers, and principals address program feasibility, acceptability, and fidelity, as well as perceived program impacts. Students complete an additional self-report survey in ninth grade. Schools provide students' academic and disciplinary data for their seventh, eighth, and ninth grade years. In addition, data on program costs are collected to conduct an economic analysis of the intervention and active control programs. DISCUSSION: Notable study features include program co-leadership by young adults from the community and building capacity of school personnel for continued program delivery. In addition to testing program impact, we will identify factors related to successful program implementation to inform future program use and dissemination.

Preschool children with gender normative and gender non-normative peer preferences: psychosocial and environmental correlates.

We addressed several issues concerning children who show gender non-normative (GNN) patterns of peer play. First, do young children with GNN peer preferences differ from children with gender normative (GN) peer preferences in problem behaviors? Second, do GNN and GN children differ in sociability and isolation and do they have differential socialization opportunities with externalizing, internalizing, and socially competent peers? We employed a Bayesian approach for classifying children as GNN based on their peer preferences as compared to their peers using a sample of Head Start preschool children from a large Southwestern city (N = 257; 53 % boys; M age = 51 months; 66 % Mexican American). To calculate socialization opportunities, we assessed affiliation to each child in the class and weighted that by each peer's characteristics to determine the exposure that each child had to different kinds of peers. GN children of both sexes interacted more with same-sex peers, which may limit learning of different styles of interaction. As compared to GN children, GNN children exhibited more engagement in other-sex activities and with other-sex play partners and GNN children experienced somewhat fewer peer interactions, but did not differ on problem behaviors or social competence. Boys with GNN peer preferences had increased exposure to peers with problem behaviors. GNN girls experienced little exposure to peers with problem behaviors, but they also had little exposure to socially competent peers, which may reduce learning social skills from peers. Implications of these findings for future socialization and development will be discussed.