Structural Equality and Support Index in Early Childhood Education.

Importance: Whether early childhood education is associated with a wide range of adult outcomes above and beyond individual- and family-level outcomes is unknown. As a consequence of improving educational and career success, it is postulated that participation in high quality, comprehensive programs can promote residence in more supportive community contexts in adulthood. Objective: To investigate whether participation in high-quality early childhood programs (ECP) in high-poverty neighborhoods is associated with neighborhood-level social determinants of health (SDH) at midlife. Design, Setting, and Participants: This cohort study analyzed data from the Chicago Longitudinal Study, a prospective cohort investigation following-up 989 children aged 3 to 4 years attending the Child-Parent Center (CPC) preschool program between 1983 and 1985 and a comparison group of 550 children using a nonrandomized trial design. Participants from the original sample who completed a telephone interview on health and well-being between ages 32 and 37 years were included in this analysis. Data analysis was conducted from April to June 2024. Exposure: Participation in a CPC program, which includes preschool (ages 3 to 4 years) and school-age (kindergarten through third grade), vs usual early education programs. Main Outcomes and Measures: The study used a new SDH measure (Index of Structural Equality and Support [I-SES]) based on the Healthy People 2030 framework. This 9-item index score included neighborhood-level assessment, measurement of the quality of education and health services, and assessment of racial discrimination in social and community contexts. Years of education by age 34 years was assessed as the key mediator of influence. Results: A total of 1124 individuals (mean [SD] age at survey completion, 34.9 [1.4] years; 614 women [54.6%]; 1054 non-Hispanic Black [93.8%]; 69 Hispanic [6.2%]; 1 non-Hispanic White [<0.1%]) were included in the study, of whom 740 were in the CPC cohort and 384 were in the comparison cohort. After adjustment for baseline attributes and attrition, compared with no CPC preschool, CPC preschool was associated with significantly higher mean (SD) I-SES scores (5.93 vs 5.53; mean difference, 0.40; 95% CI, 0.16-0.65; standardized mean difference = 0.22). Compared with CPC participation for 0 to 3 years, CPC participation for 4 to 6 years showed a similar pattern of positive associations (adjusted mean I-SES score, 5.97 vs 5.69; mean difference, 0.28; 95% CI, 0.06-0.50; P = .01; SMD = 0.15). CPC participation had a larger-magnitude association with I-SES in married vs single-parent households. Years of education partially mediated the association of CPC with I-SES (up to 41%), especially among those growing up in the highest-poverty neighborhoods. Conclusions and Relevance: This cohort study found that early childhood programming is associated with SDH in adulthood. These findings reinforce the importance of early childhood education in addressing health disparities and contributing to healthier, more equitable communities and suggest that educational attainment is a key mechanism for health promotion.

Psychological and Academic Adaptation Through Universal Ethnic Studies Classes: Results of a Natural Experiment.

Schools in the United States are increasingly offering ethnic studies classes, which focus on exploring students' ethnic-racial identities (ERI) and critical analysis of systemic racism, to their diverse student bodies, yet scant research exists on their effectiveness for students of different ethnic-racial backgrounds in multiracial classrooms. A policy change to require all high school students in one school district to take an ethnic studies class facilitated a natural experiment for comparing the effects of quasi-random assignment to an ethnic studies class (treatment) relative to a traditional social studies class (control; e.g., U.S. Government, Human Geography). Student surveys and school administrative data were used to compare students' ERI development, well-being, and academic outcomes across ethnic studies and control classes. Participants (N = 535 9th graders; 66.1% ethnic studies) had diverse ethnic-racial (33.5% non-Latine White, 29.5% Black, 21.1% Latine, 10.7% biracial, 2.8% Asian, 2.2% Native American) and gender identities (44.7% female, 7.1% non-binary). Ethnic studies students reported marginally higher ERI exploration and resolution than controls, and sensitivity analyses showed a statistically significant effect on ERI among participants with complete midpoint surveys. Higher resolution was associated with better psychological well-being for all students and higher attendance for White students. Students with low middle school grades (GPA < 2.0) had better high school grades in core subjects when enrolled in ethnic studies than the control class. Overall, the results of this natural experiment provide preliminary support for ethnic studies classes as a method for promoting ERI development, well-being, attendance, and academic achievement for students from diverse ethnic-racial backgrounds.

Post-adoption experiences of discrimination moderated by sleep quality are associated with depressive symptoms in previously institutionalized youth over and above deprivation-induced depression risk.

The association of post-adoption experiences of discrimination with depressive symptoms was examined in 93 previously institutionalized (PI) youth (84% transracially adopted). Additionally, we explored whether sleep quality statistically moderated this association. Notably, we examined these associations after covarying a measure of autonomic balance (high/low frequency ratio in heart rate variability) affected by early institutional deprivation and a known risk factor for depression. PI youth exhibited more depressive symptoms and experiences of discrimination than 95 comparison youth (non-adopted, NA) raised in their biological families in the United States. In the final regression model, there was a significant interaction between sleep quality and discrimination, such that at higher levels of sleep quality, the association between discrimination and depression symptoms was non-significant. Despite being cross-sectional, the results suggest that the risk of depression in PI youth involves post-adoption experiences that appear unrelated to the impacts of early deprivation on neurobiological processes associated with depression risk. It may be crucial to examine methods of improving sleep quality and socializing PI youth to cope with discrimination as protection against discrimination and microaggressions.

Lift Every Voice: Engaging Black Adolescents in Social Justice Service-Learning to Promote Mental Health and Educational Equity.

This study reports on the feasibility and acceptability of a social justice infused service-learning (S-L) program to promote Black adolescent mental health and educational equity. We convened a community advisory board to help adapt and pilot test, via open trial mixed method design, an evidence-based service-learning program for Black middle school adolescents (n = 21) attending summer camp at a faith-based setting. We describe a S-L curriculum, with a focus on the achievement gap, and training for church staff and assess staff and youth reports of feasibility, acceptability, and promise to (a) improve/engage psychological engagement targets, and (b) improve academic motivation, and social-emotional and behavioral outcomes. Mixed method findings revealed high feasibility and acceptability of the S-L intervention as indicated by consistent attendance and enthusiastic engagement by staff and youth, high satisfaction, high completion rates of planned sessions, and emergent qualitative themes from staff interviews and adolescent focus groups highlighting that service-learning (1) facilitated skills (e.g., goal-setting, social-emotional and behavioral regulation, and problem-solving), (2) shaped perspectives and inspired openness, and (3) created a space for all to feel valued and included to address the inequities of education that directly impacted them. There was preliminary evidence for efficacy in that youth report of emotional symptoms, peer problems, and staff report of general internalizing symptoms decreased following the intervention, while youth report of prosocial behaviors increased. Implications suggest that S-L programming demonstrates promise to promote mental health outcomes, raise social awareness, and inspire critical consciousness and lift the voices of Black youth by providing tools for working toward systemic changes to reduce inequities in both education and mental health.