Family resilience mediates exposure to adverse childhood experiences on insufficient sleep among children: findings from a population-based study.

Background: Sleep plays a vital role in the well-being of children and adolescents. Researchers have identified adverse childhood experiences (ACEs) as an important factor associated with poor sleep among adolescents. The objective of this study was to examine the mediating role of family resilience on the association between ACEs and insufficient sleep among adolescents in the United States. Methods: Data for this study came from the 2018-2019 National Survey of Children's Health (N = 28,097). The outcome variable in this study was insufficient sleep, and the main explanatory variable was exposure to ACEs. The mediating variable was family resilience. Data were analyzed using binary logistic regression. Results: Based on parent reports, one in five (22.4%) adolescents did not meet the recommended sleep hours on an average night. About half of the adolescents had no ACEs, 24.2% had one ACE, and 14.6% had three or more ACEs. Controlling for the effect of other factors and family resilience, the odds of having insufficient sleep were 1.63 times higher for children exposed to three or more ACEs (AOR = 1.63, 95% CI = 1.30-2.05). Family resilience partially mediates the association between exposure to ACEs and insufficient sleep. Each additional increase in family resilience decreased the odds of having insufficient sleep by a factor of 12% (AOR = 0.88, 95% CI = 0.86-0.91). Conclusions: Family resilience partially mediated exposure to ACEs on insufficient sleep. There are modifiable factors that may improve sleep outcomes among adolescents who have been exposed to adversity. Future research can help elucidate findings and establish the directionality of this association.

Prevalence of youth experiencing homelessness and its association with suicidal thoughts and behaviors: Findings from a population-based study.

Although various studies have examined factors associated with suicidal behaviors among youth, few studies have investigated the association between youth experiencing homelessness (YEH) and suicidal thoughts and behaviors (STBs) using a large nationally representative sample. The objectives of this study were to investigate prevalence of YEH and its association with STBs. Data for this study came from the 2021 Youth Risk Behavior Survey. An analytic sample of 17,033 youth aged 14-18 (51.7 % male) was analyzed using binary logistic regression. Of the 17,033 youth examined, 3 % experienced homelessness during the past 30 days, 21.3 % experienced suicidal ideation, 17.3 % made a suicide plan, and 10.9 % attempted suicide during the past 12 months. Controlling for demographic characteristics and feeling sad or hopeless, YEH was associated with 2.48 times higher odds of experiencing suicidal ideation (AOR=2.48, p<.001), 2.46 times higher odds of making a suicide plan (AOR=2.46, p<.001), and 4.38 times higher odds of making a suicide attempt (AOR=4.38, p<.001). The findings of this study highlight the importance of identifying youth who are at risk of experiencing homelessness to ensure early interventions are put in place to prevent suicidal behaviors.

Association between Adverse Childhood Experiences and Unmet Health Care Needs among Children in the United States.

Although studies have investigated and found an association between adverse childhood experiences and poor health and mental health outcomes, there is a dearth of studies investigating the association between adverse childhood experiences and unmet health care needs among children. The objective of this study is to examine the association between adverse childhood experiences and unmet health care needs after adjusting for predisposing, enabling, and need factors of health care service utilization. Data for this study came from the 2016-2017 National Survey of Children's Health. An analytic sample of 46,081 children (51.3% males; average age 11.5 years) was analyzed using negative binomial regression. Based on parent reports, about 3.5% of children had unmet health care needs, and half (50%) of the sample had experienced at least one childhood adversity. Controlling for other factors, children who experienced three or more childhood adversities had 4.51 times higher odds of having unmet health care needs (AOR = 4.51, p < .001, 95% CI = 3.15-6.45) when compared to their counterparts with no childhood adversity. Children with parents who have someone to turn to for everyday emotional support were 31% less likely to have unmet health care needs (AOR = .69, p < .01, 95% CI = .54-.89). Adverse childhood experiences have a detrimental effect on unmet health care needs. The findings of this study offer an important opportunity for further research on how best to prevent adverse childhood experiences and mitigate their impact on families.

Exposure to Neighborhood Violence and Gun Carrying Among Adolescents in the United States: Findings From A Population-Based Study.

Although studies have investigated and found an association between victimization and weapon carrying, few studies have examined the association between exposure to neighborhood violence (NV) and gun carrying among adolescents. The objective of this study was to examine the cross-sectional association between exposure to NV and gun carrying among adolescents. Data for this study came from the 2021 Youth Risk Behavior Survey. An analytic sample of 17,033 adolescents aged 14 to 18 years old (51.7% male) was analyzed using logistic regression with complementary log-log link function. The outcome variable investigated in this study is gun carrying and was measured as a binary variable, whereas the main explanatory variable examined in this study was exposure to NV, which was also measured as a binary variable. Of the 17,033 adolescents, 4.2% carried a weapon during the past year, and 18.7% were exposed to NV. Controlling for the effects of other factors, adolescents who were exposed to NV had more than double the odds of carrying a gun when compared to their counterparts not exposed to NV (adjusted odds ratio = 2.33, 95% Confidence Intervals [1.69, 3.23]). Other significant factors associated with gun carrying include being a male, non-Hispanic Black, being threatened or injured with a weapon, use of alcohol, cigarette smoking, and misuse of prescription opioids. High parental monitoring was protective against gun carrying. The findings of this study underscore the importance of developing age-appropriate intervention strategies to reduce gun carrying among adolescents. School counselors and other professionals working with adolescents in disadvantaged neighborhoods should actively engage parents in assessments and interventions.

The Relationship Between State Level Policy, Insurance and Health Care Engagement for LGBTQ+ Foster Alumni.

Minority stress theory posits that external environmental factors such as state level policies around equity and inclusion of LGBTQ+ people can have a significant impact on the health and wellness of those identifying as part of the larger LGBTQ+ community, as well as on their decisions to seek needed physical or mental health care. This secondary data analysis explored the relationship between state level policies related to LGBTQ+ equity and inclusion and physical and mental health care engagement for foster care alumni. Using data from the Jim Casey Opportunity Passport Survey (n = 2,420), the research team conducted a longitudinal analysis of youth's engagement with healthcare professional as needed physical and mental health care, using sociodemographic characteristics of the respondents and state level policies, such as Medicaid expansion and state level protections for LGBTQ+ citizens as predictors. Results indicate obtaining health insurance increased the likelihood that the youth would seek physical health care. LGBTQ+ young adults assigned female at birth had higher odds of not receiving physical health care relative to non-LGBTQ+ peers. Compared with non-LGBTQ+ youth, LGBTQ+ youth showed higher odds of not seeing mental health professionals when they needed to. Implications for practice, policy and advocacy are presented.

Investigating the co-occurrence of marijuana use and prescription opioid misuse with multiple suicide attempts among adolescents with a history of suicidal ideation.

This study investigated the co-occurrent association of marijuana use and prescription opioid misuse with multiple suicide attempts among adolescents with a history of suicidal ideation. Data came from the 2019 Youth Risk Behavior Survey. The sample was comprised of adolescents ages 14-18 who reported suicidal ideation during the past year (n = 2,562). Multinomial logistic regression was used to examine the co-occurring association of marijuana use and prescription opioid misuse with multiple suicide attempts. Of the 2,562 adolescents who experienced suicidal ideation, 19.2 % also attempted suicide multiple times during the past year and 19.0 % reported ever using marijuana and misusing prescription opioids, 8.8 % misused prescription opioids only, and 33.3 % used marijuana only. In the multivariate model, for adolescents who used marijuana and misused prescription opioid, the risk of attempting suicide once was 1.77 times higher (RRR = 1.77, 95 % CI = 1.22-2.59) and the risk of multiple suicide attempts was 3.23 times higher (RRR = 3.23, 95 % CI = 1.95-5.33) when compared to adolescents who had never used marijuana nor misused prescription opioid. The risk of multiple suicide attempts was greater for bisexual and racial/ethnic minority adolescents and adolescents who felt sad or hopeless. Interventions that prevent prescription opioid misuse among adolescents may be effective in mitigating suicide attempts.

State-level policies and reunification: A multi-level survival analysis.

BACKGROUND: A growing body of research has focused on the relationships of policies and other macro factors and child welfare outcomes. However, to date, few studies have examined state child welfare policies and reunification, despite reunification being the priority case goal among children in foster care. OBJECTIVE: This study examined the relationship between state child welfare policies and other macro factors and reunification, while controlling for child factors. PARTICIPANTS AND SETTING: Data came from the 2016-2019 Adoption and Foster Care Analysis Reporting System (AFCARS), which contains case-level information on all children in foster care during each fiscal year. METHODS: We conducted a series of multi-level survival analyses to observe the fixed effects of state-level factors and child-level factors on time to reunification among children who entered foster care in 2016. RESULTS: In the unadjusted model, children in states with Title IV-E stipend programs for caseworkers had higher hazards of reunification (HR = 1.21, 95 % CI = 1.01-1.44) as did children in states with statewide in-home post-reunification services (HR = 1.63, 95 % CI = 1.16-2.28). Children in states that required a master's degree for caseworkers had lower hazards of reunification (HR = 0.72, 95 % CI = 0.59-0.95). CONCLUSIONS: Findings from this study highlight the importance of considering state policies and their impact on reunification. Implications for policy, practice, and research are explored.

Racial/ethnic differences in adolescents' non-response to suicide attempt: Findings from the Youth Risk Behavior Survey, 2015-2019.

Racial/ethnic minority adolescents are at greater risk of attempting suicide compared to their White counterparts. Yet, racial/ethnic minority adolescents are more likely to not respond to questions on suicidal behaviors. The objective of this study was to investigate the association between race/ethnicity and missing response to suicide attempt among adolescents in the United States. Data for this study were obtained the 2015-2019 national Youth Risk Behavior Survey (n = 40,360). The outcome variable investigated in this study was missing response to suicide attempt and the main explanatory variable was race/ethnicity. Two hierarchical binary logistic regression models were fitted to examine the association between race/ethnicity and missing response to suicide attempt. Of the 40,036 adolescents, 13.4% had missing response to suicide attempt. Controlling for the effects of demographic factors and symptoms of depression, adolescents who self-identified as non-Hispanic Black had more than threefold higher odds of having missing response to suicide attempt when compared to their non-Hispanic White counterparts (AOR = 3.62, p < .001, 95% CI = 2.45-5.34). Adolescent males and adolescents questioning their sexual identity had higher odds of having missing response to suicide attempt. Adolescents with depressive symptoms had lower odds of having missing response to suicide attempt. Missing response to suicide attempt among adolescents continues to differ by race/ethnicity and other demographic factors. The use of a single item in assessing suicide attempt history may be inadequate in capturing national estimates of adolescent suicide metrics.

State Policies on Child Maltreatment and Racial Disproportionality.

Over the past several decades researchers have documented disproportionality for Black families across multiple decision-making points within the child welfare system. Yet, few studies have examined how specific state policies may impact disproportionality across decision points. The racial disproportionality index (RDI) was calculated for Black children in each state and Washington DC (N = 51) based on the proportion of children who were received a referral to CPS, a substantiated investigation, or entered foster care. A series of bivariate analyses (one-way ANOVAs; independent sample t-tests) were used to explore the relationship between the RDI and these decision points. Further analyses were conducted between the RDI and state policies (e.g., child maltreatment definitions, mandated reporting, and alternative response). Our results suggest there is an overrepresentation of Black children in CPS across the three decision points. This overrepresentation continues with specific state policies such as a state using harsh punishment in their definition of child maltreatment. Recommendations are provided for policy and research, including a suggestion for further exploration of state policies and county-level disproportionality indexes.

Perceived racial discrimination and polysubstance use among racial/ethnic minority adolescents in the United States.

OBJECTIVE: Polysubstance use among adolescents is a significant public health concern, yet most studies on adolescent substance use focus on a singular substance. This study is one of the first to investigate the association between perceived racial discrimination (PRD) in school and polysubstance use among racial/ethnic minority adolescents using a nationally representative sample. METHODS: Data was from the 2021 Adolescent Behaviors and Experiences Survey. The sample included 4145 racial/ethnic minority adolescents (52.8% female). Hierarchical binary logistic regression was used to examine the association between PRD in school and polysubstance use among racial/ethnic minority adolescents. RESULTS: About 12% of racial/ethnic minority adolescents engaged in polysubstance use and 23.4% reported experiencing PRD in school sometimes/most of the time/always. Controlling for other factors, experiencing PRD in school sometimes/most of the time/always was associated with 1.52 times higher odds of polysubstance use when compared to adolescents who never experienced PRD in school (OR=1.52, p=.044, 95% CI=1.01-2.30). Cyberbullying victimization, symptoms of depression, and being emotionally abused by a parent during COVID-19 were also associated with polysubstance use. CONCLUSION: Controlling for demographic characteristics and psychosocial stressors, PRD in school was significantly associated with higher odds of polysubstance use among racial/ethnic minority adolescents. The findings of this study could inform clinicians and policymakers of the association between PRD in school and polysubstance use, which could contribute to early identification of polysubstance use among racial/ethnic minority adolescents.

Misuse of Prescription Opioids and Suicidal Behaviors Among Black Adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey.

PURPOSE: Although some studies have examined the association between prescription opioid misuse and mental health outcomes, few have investigated the effects of prescription opioid misuse on suicidal behaviors among Black adolescents. The objective of this study was to investigate the cross-sectional association between prescription opioid misuse and suicidal ideation, suicide plan, and suicide attempt among Black adolescents. METHODS: Data for this study came from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 4798 Black adolescents aged 14-18 years (51.2% female) was analyzed using binary logistic regression. The outcome variables investigated were suicidal ideation, suicide plan, and suicide attempt, and the main explanatory variable was prescription opioid misuse. RESULTS: Of the 4798 Black adolescents, 15% reported ever misusing prescription opioids; 16.2% experienced suicidal ideation; 14% made a suicide plan; and 11.3% attempted suicide during the past 12 months. In the multivariate logistic regression models, Black adolescents who misused prescription opioids had 1.39 times higher odds of making a suicide plan and 1.65 times higher odds of making a suicide attempt during the past 12 months when compared to their counterparts who did not misuse prescription opioids. Other significant factors associated with suicidal behaviors include female sex, school bullying, cyberbullying, depressive symptoms, and illicit drug use. In addition, physical activity had a protective effect on suicide attempt. CONCLUSION: The findings of the present study demonstrate the effects of prescription opioid misuse and its association with suicidal behaviors among Black adolescents.

Gender, romantic relationships and sexual health in Mexico: Parents' experiences of discussion with their children.

A focus on promoting sexual health and preventing sexual violence remains largely unaddressed in most evidence-based parenting prevention programmes, despite the promise of success in addressing these topics after foundational parenting practices have been strengthened. The primary objective of this study was to understand how Mexican family and gender values shape the way families in Mexico City approach discussion of sexual health and violence with their adolescent children. The goal was to inform the development of a culturally relevant sexual health promotion and violence prevention module to add to an existing parenting intervention. During focus groups with 17 mothers and 3 fathers who had recently completed a parenting intervention, five major themes were identified: mediating messages from the outside world; the view that dads are not part of sex education; the belief that romantic relationships spell trouble; gender differences in responsibility and fear; and comfort talking about condoms. Findings indicate that caregivers adopt different approaches to education about sexual health and the prevention of sexual violence according to whether their adolescent is a boy or a girl. These differential approaches were primarily informed by cultural and contextual influences. Strategies for more overtly addressing gender relations in parenting interventions for sexual health promotion and violence prevention are discussed.

State Child Maltreatment Policies and Disparities in Substantiation: A Study of State-Administered Child Welfare Systems in the U.S.

Although several studies have examined child and family factors associated with substantiation, less research has explored the role of state child maltreatment policies in substantiating cases of alleged maltreatment. In parallel, there is growing pressure to reduce racial/ethnic disproportionality and disparities across the span of a child welfare case. We examined the relationship between state child maltreatment policies and substantiation, with child race/ethnicity as a moderator of this relationship. Data came from the 2019 National Child Abuse and Neglect Data System (NCANDS) and the State Child Abuse and Neglect (SCAN) Policy Database. Using a series of multi-level binary logistic models, we calculated the odds of substantiation based on child characteristics (e.g., child age, number of types of alleged maltreatment) and state policies (e.g., state definitions of maltreatment that include exposure to domestic violence, harsh punishment). Approximately 17% of the variance in substantiation occurs between states. Although we did not find a direct effect of state policy on substantiation, there were significant interaction terms, in that inclusion of exposure to domestic violence, harsh punishment, or educational neglect in state policy was more strongly associated with substantiation for children of color than white children. Implications for policy and research are explored.

Exploring the lived experiences of women with children during COVID-19: Maternal stress and coping mechanisms.

This paper presents the results of a qualitative study of mothers' lived experiences during the COVID-19 lockdown in the United States. An analysis of open-ended interviews with 44 mothers who had children ages zero-to-five identified two main themes: (1) increased stress among mothers; and (2) resilience through the use of coping mechanisms. The findings indicate that the COVID-19 pandemic has led to higher stress among mothers due to issues of work-family life balance, family and children's needs, decision-making about getting sick, concerns for children's development, and lack of clarity from government officials. Mothers described using a variety of problem-focused and emotion-focused methods to cope with this stress. The lived experiences of mothers during the pandemic highlights the need for innovations in childcare modalities, paid leave policies to relieve stress, and strengthening whole family processes and resilience through the use of coping mechanisms.

Association between use of electronic vaping products and insufficient sleep among adolescents: Findings from the 2017 and 2019 YRBS.

BACKGROUND AND OBJECTIVE: Although studies have investigated the association between cigarette smoking and sleep outcomes among adolescents in the United States, few studies have examined the association between electronic vaping products (EVPs) use and insufficient sleep among adolescents. The objective of this study was to investigate the cross-sectional association between the use of EVPs and insufficient sleep among adolescents. METHODS: Data were pooled from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 28,135 adolescents (51.2% female) was analyzed using binary logistic regression. The dependent variable investigated was insufficient sleep, and the main independent variable was the use of EVPs. RESULTS: Of the 28,135 adolescents, 22.6%, 19.2%, and 58.2% were current, former, and never users of EVPs, respectively. More than three in four adolescents (76.5%) did not obtain the recommended 8 h of sleep on an average school night. Controlling for demographic factors and other covariates, adolescents who currently used EVPs had 1.33 times higher odds of having insufficient sleep (AOR = 1.33, p < .001, 95% CI = 1.16-1.52), and adolescents who previously used EVPs had 1.29 times higher odds of having insufficient sleep (AOR = 1.29, p < .001, 95% CI = 1.15-1.44) when compared to adolescents who had never used EVPs. Adolescents were more likely to get insufficient sleep if they were older, non-Hispanic Black, had symptoms of depression, experienced suicidal ideation, engaged in excessive screen-time behaviors, or currently used alcohol. Physical activity had a protective effect on insufficient sleep. CONCLUSION: This study found that EVPs use was associated with insufficient sleep among adolescents over and above demographic and other covariates. As EVP use increases among adolescents, it is important to consider the potential impact on multiple domains, including sleep. Future studies that employ longitudinal designs may offer additional insight into the mechanisms underlying the association between EVPs use and insufficient sleep.

Perceived racial discrimination and suicidal behaviors among racial and ethnic minority adolescents in the United States: Findings from the 2021 adolescent behaviors and experiences survey.

The objectives of this study were to investigate: (1) the prevalence of perceived racial discrimination (PRD) in school, among racial/ethnic minority adolescents, and (2) the association between PRD and suicidal behaviors among racial/ethnic minority adolescents in the United States. Data from a sample of 3241 racial/ethnic minority adolescents (53.7% female) from the 2021 Adolescent Behaviors and Experiences Survey were analyzed using binary logistic regression. Controlling for other factors, racial/ethnic minority adolescents who experienced PRD had 1.57 times higher odds of experiencing suicidal ideation (adjusted odds ratio (AOR) = 1.57, 95% Confidence Intervals (CI) = 1.09-2.25), 1.64 times higher odds of making a suicide plan (AOR = 1.64, 95% CI = 1.09-2.49), and 1.67 times higher odds of attempting suicide (AOR = 1.67, 95% CI = 1.04-2.68) during the past year. Other factors associated with suicidal behaviors included self-identifying as lesbian/gay, bisexual, or other/questioning; experiencing cyberbullying; feeling sad or hopeless; and poor mental health during the pandemic. The findings of this study extend past research and demonstrate that racial/ethnic minority adolescents who experienced PRD were more likely to report suicidal behaviors over and above other well-established risk factors for suicidal behaviors. Future studies that employ longitudinal designs are needed to elucidate mechanisms underlying these associations.

The impacts of COVID-19 on LGBTQ+ foster youth alumni.

BACKGROUND: LGBTQ+ youth frequently experience disparities in outcomes related to permanency and overall well-being while in out-of-home care. These negative outcomes often persist after youth have transitioned out of care, particularly in the domains of housing, education, employment, and mental health. Initial research has found that the ongoing COVID-19 pandemic has exacerbated negative physical and mental health outcomes, as well as decreased economic stability among transition age youth. OBJECTIVE: This study seeks to determine if COVID-19 has resulted in unique impacts on foster care alumni, and if these impacts are the same for LGBTQ+ and non-LGBTQ+ transition age youth. PARTICIPANTS AND SETTING: This study used data from the 2020 Jim Casey Youth Opportunities Initiative Opportunity Passport Survey to explore these questions. METHODS: This survey was administered electronically to a national sample of 1223 youth ages 18-26 with lived experience in foster care. RESULTS: Results indicate that relative to non-LGBTQ+ foster care alumni, LGBTQ+ foster care alumni experienced more negative outcomes in housing stability, employment, and mental health/trauma due to COVID-19. No significant differences were found for education-related impacts. Outcomes varied by sex assigned at birth, ethnicity, and sexual orientation, gender identity and expression (SOGIE) of respondents, with female respondents, black, indigenous and other people of color (BIPOC) youth and LGBTQ+ youth being most frequently impacted. CONCLUSIONS: Results indicate that relative to non-LGBTQ+ foster care alumni, LGBTQ+ foster care alumni experienced more negative outcomes in housing stability, employment, and mental health/trauma due to COVID-19. No significant differences were found for education-related impacts. Outcomes varied by sex assigned at birth, ethnicity, and sexual orientation, gender identity and expression (SOGIE) of respondents, with female respondents, BIPOC youth and LGBTQ+ youth being most frequently impacted. Implications for practice and policy are explored.

Predicting children's differential trajectories of emotion dysregulation: A study on the intergenerational transmission of child and caregiver maltreatment.

BACKGROUND: Child maltreatment and caregiver history of abuse is negatively associated with the development of emotion regulation, and maltreatment in early childhood may be particularly disruptive. OBJECTIVE: We examined patterns of emotion dysregulation and the contribution of caregiver victimization and early maltreatment history on the development of distinct emotion dysregulation trajectories. PARTICIPANTS: The current study sample (n = 1354) came from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a longitudinal study of the antecedents and consequences of child maltreatment. Children had a varied risk of maltreatment from high risk but not referred to child protective services to children who were removed from parental care. METHOD: We employed a growth mixture modeling approach to model differential trajectories of children's emotion dysregulation from age four to age ten and assessed whether children's experiences of maltreatment prior to age four and caregiver histories of abuse were associated with children's probable class membership in the identified trajectories. RESULTS: We identified three classes of emotion dysregulation trajectories: Well-Regulated, Increasingly Dysregulated, and Highly Dysregulated. Early experiences of multiple maltreatment types and caregiver history of abuse were associated with higher odds that children would be in the Increasingly Dysregulated and Highly Dysregulated classes compared to the Well-Regulated class. CONCLUSION: The current study extends the literature on the negative associations of caregiver histories of abuse and child experiences of multiple maltreatment types to children's emotion dysregulation, which may be long-lasting. Furthermore, our findings highlight the need for intervening early as a crucial component of breaking the intergenerational impact of maltreatment.

'I'm not perfect': Navigating screen time among parents of young children during COVID-19.

BACKGROUND: The use of screen time for young children has been hotly debated among experts. This study explored the utilization of screen time among mothers with young children during the COVID-19 pandemic. The objective of this study was to understand maternal motivation for utilizing screen time and how mothers have engaged in screen time since the beginning of the pandemic. METHOD: This paper uses a sample of n = 25 mothers who participated in an in-depth interview about parenting during the COVID-19 pandemic. The team utilized a thematic analysis approach to qualitatively code the transcripts. All analyses were conducted in Dedoose 8.3, and all transcripts were coded by three independent researchers to enhance rigour. RESULTS: Five main themes emerged from the interviews: (1) harbouring screen guilt versus letting it go, (2) managing full-time work and full-time parenting, (3) prioritizing mental sanity, (4) socially distant supports demand screen time and (5) screens can have positive uses, too. CONCLUSION: During the COVID-19 pandemic, mothers have resorted to screen time use to cope with increased stress and challenges. However, mothers have also found positive uses for screen time, such as connection with extended family members, peer interaction and educational activities. Findings highlight the need to differentiate screen time use by quality and to update formal screen time guidelines considering changing roles of technology.