Individual and family-based approaches to increase physical activity in adolescents with intellectual and developmental disabilities: Rationale and design for an 18 month randomized trial.

Adolescents with intellectual and developmental disabilities (IDD) are less physically active and have lower cardiovascular fitness compared with their typically developing peers. This population faces additional barriers to participation in moderate-to-vigorous physical activity (MVPA) such as reliance on parents, lack of peer-support, and lack of inclusive physical activity opportunities. Previous interventions to increase MVPA in adolescents with IDD have met with limited success, at least in part due to requiring parents to transport their adolescent to an exercise facility. We recently developed a remote system to deliver MVPA to groups of adolescents with IDD in their homes via video conferencing on a tablet computer. This approach eliminates the need for transportation and provides social interaction and support from both a health coach and other participants. We will conduct a 18-mo. trial (6 mos. active, 6 mos. maintenance, 6 mos. no-contact follow-up) to compare changes in objectively assessed MVPA in 114 adolescents with IDD randomized to a single level intervention delivered only to the adolescent (AO) or a multi-level intervention delivered to both the adolescent and a parent (A + P). Our primary aim is to compare increases in MVPA (min/d) between the AO and A + P groups from 0 to 6 mos. Secondarily we will compare changes in MVPA, sedentary time, cardiovascular fitness, muscular strength, motor ability, quality of life, and the percentage of adolescents achieving the US recommendation of 60 min. MVPA/d across 18 mos. We will also explore the influence of process variables/participant characteristics on changes in MVPA across 18 mos. NCT registration: NCT03684512.

The role of life stress and social support in the adjustment of sexually victimized pregnant and parenting minority adolescents.

Associations among sexual victimization and the psychosocial functioning of African American and Latina pregnant and parenting adolescents were examined. Forty-seven (17.7%) of the 265 participants reported histories of sexual victimization, most of which was unwanted sexual intercourse. The victimized adolescents reported higher levels of depression, anxiety, and life stress and, although the two groups reported no differences in their levels of social support, support was found to be differentially related to depression and anxiety in the two groups. In particular, victims derived benefits from social support at low levels of stress, but social support provided no protection against depression and anxiety at average or high levels of stress. For nonvictims, social support provided no benefits at low levels of stress, but protected against depression and anxiety at moderate levels of stress and against depression at high levels of stress. Implications of these findings for research, theory, and intervention are discussed.

Mom and dad are at it again: adolescent perceptions of marital conflict and adolescent psychological distress.

In these two studies, the authors used children's perceptions of family relationships to examine simultaneously direct and indirect links between marital conflict and child adjustment. With data pertaining to 146 sixth and seventh graders, Study 1 supported direct and indirect effects of perceptions of marital conflict on internalizing behaviors, and indirect effects for externalizing behaviors. In Study 2, data analyzed from 451 families showed indirect effects of marital conflict and parent-to-child hostility, through adolescent perceptions of such behavior, on both current distress and distress 12 months later in 3 of 4 models estimated. Direct and indirect effects were found for boys' concurrent internalizing behavior. Implications and limitations of both studies are discussed to address the need for a more sophisticated theoretical approach to examine why an association exists between marital conflict and child adjustment.