Browsing by Author "Guerrero, Natalie"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Assessing the Gap in Adolescent Emergency Care Training for Emergency Medicine Residents: A Systematic Review
    (Springer Nature, 2023-06-22) Williams, Eileen S.; Guerrero, Natalie; Sisson, Amy; Fisher, Kathryn M.; Pediatrics, School of Medicine
    Over 1.5 million U.S. adolescents rely on emergency services for the majority of their healthcare, with increasing presentations (particularly for mental health complaints) during the coronavirus disease 2019 (COVID-19) pandemic. However, a majority of physicians practicing emergency medicine report feeling unprepared to care for adolescent patients. In turn, adolescent patients often report feeling uncomfortable or unsafe when attempting to access emergency care. Despite this deficiency, the extent to which adolescent medicine is addressed during emergency residency medical training remains unclear. Our objective in this systematic review was to identify any existing, publicly available curriculum targeted to teach adolescent emergency care during emergency medicine residency. We conducted a keyword search within the Medline Ovid, Embase, Web of Science, and Cochrane databases to identify relevant literature published between the years of 1968 and 2021; publications meeting inclusion criteria were then analyzed for content. Despite an extensive review of the existing literature, we identified no systematized curriculum and only seven individual papers describing educational efforts to promote competency in adolescent care among emergency medicine residents. Of the resources available, none provide instruction on the management of multiple adolescent presentations, nor common conditions that should be included in a more comprehensive general emergency residency curriculum. No standardized curricula exist for the instruction of relevant adolescent care in an emergency medicine residency. We conclude that the available education for emergency medicine residents is lacking in the area of adolescent care and future work is needed to identify specific competencies to target with further intervention.
  • Thumbnail Image
    Item
    Hopelessness as a Mediator of the Association Between Parenting Factors and Adolescent Suicidality and Substance Use Among Juvenile Justice‐Referred Youth
    (Wiley, 2025) Guerrero, Natalie; O'Reilly, Lauren; Dellucci, Trey V.; Pederson, Casey; Adams, Zachary W.; Hulvershorn, Leslie; Zapolski, Tamika C. B.; Aalsma, Matthew C.; Pediatrics, School of Medicine
    Youth involved in the juvenile justice system are more likely to have a substance use disorder and/or suicidality (e.g., suicidal thoughts and behavior) compared to other youth. Although parental support and monitoring may play an important role in youth substance use and suicidality outcomes, the potential mechanisms have not been elucidated. Our purpose was to evaluate the extent to which parental support and monitoring were associated with latent, continuous construct scores of suicidality and substance use and to determine whether youths' hopelessness may indirectly affect these relationships among a sample of youth referred to the juvenile justice system. The sample included juvenile justice-referred youth aged 14-17 (N = 77; 69% White, 58% male, 74% non-Hispanic). The primary predictors of interest were parental support and monitoring, measured by the Parent Support Scale and Parental Monitoring Scale. The primary potential mediator of interest was hopelessness. Linear regression was used to model continuous suicidality and substance use severity scores, measured via a computer adaptive test, on parental support and monitoring. We tested hopelessness as a potential mediator. All analyses controlled for age, sex assigned at birth, race, ethnicity, and family income. After adjustment, parental support was associated with decreased suicidality severity (β = -0.30, p = 0.002). Parent support and monitoring were associated with youth-reported hopelessness. The indirect mediation effects of hopelessness in the relationship between parental support (β = -0.18 [SE, 1.73]), as well as parental monitoring (β = -0.17 [SE, 0.20]), and suicidality severity were statistically significant. Parental support and youth hopelessness may be important intervention targets for improving and addressing disparities in substance use and suicidality among juvenile justice-referred youth. Hope-based interventions may be effectively integrated into existing juvenile justice programs, and their potential to improve both mental health and behavioral outcomes among justice-involved youth should be examined.