Browsing by Subject "adolescents"
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Item 50 Years Ago in The Journal of Pediatrics: The Role of Marihuana in Patterns of Drug Abuse by Adolescents(Elsevier, 2019-02) Ferrin, Stephanie N.; Ott, Mary A.; Pediatrics, School of MedicineItem Adolescent Burmese Refugees Perspectives on Determinants of Health(Springer, 2018-04) Dixit, Avika; Miner, Emily M.; Wiehe, Sarah E.; McHenry, Megan S.; Pediatrics, School of MedicineOver 70,000 Burmese refugees have resettled in the United States in the past decade. While Burmese adolescents quickly acculturate into American society, their perspectives on health are not well-known. The purpose of this study was to identify adolescent Burmese refugee perspectives on determinants of health and health-related experiences after resettlement. In this qualitative study, Burmese adolescents took photographs depicting health-related experiences that were used as elicitation tools during focus groups. These discussions were recorded, transcribed, and analyzed for themes. Participants described positive determinants of health, including family and church. Rampant tobacco use was identified by the participants as a determinant of poor health within the Burmese community. Notably, the participants were proud to serve as liaisons within their community, despite the stressful nature of this role. Our results highlight the need to screen this population for anxiety, secondary to serving as a liaison for their community, as well as tobacco use.Item Adolescent Sexual Behavior Research: Perspectives of Investigators, IRB Members, and IRB Staff about Risk Categorization and IRB Approval(The Hastings Center, 2017) McGregor, Kyle A.; Hensel, Devon J.; Waltz, Amy C.; Molnar, Elizabeth; Ott, Mary A.; Pediatrics, School of MedicineItem Brief report: Using global positioning system (GPS) enabled cell phones to examine adolescent travel patterns and time in proximity to alcohol outlets(Elsevier, 2016-07) Byrnes, Hilary F.; Miller, Brenda A.; Morrison, Christopher N.; Wiebe, Douglas J.; Remer, Lillian G.; Wiehe, Sarah E.; Department of Pediatrics, IU School of MedicineAs adolescents gain freedom to explore new environments unsupervised, more time in proximity to alcohol outlets may increase risks for alcohol and marijuana use. This pilot study: 1) Describes variations in adolescents' proximity to outlets by time of day and day of the week, 2) Examines variations in outlet proximity by drinking and marijuana use status, and 3) Tests feasibility of obtaining real-time data to study adolescent proximity to outlets. U.S. adolescents (N = 18) aged 16–17 (50% female) carried GPS-enabled smartphones for one week with their locations tracked. The geographic areas where adolescents spend time, activity spaces, were created by connecting GPS points sequentially and adding spatial buffers around routes. Proximity to outlets was greater during after school and evening hours. Drinkers and marijuana users were in proximity to outlets 1½ to 2 times more than non-users. Findings provide information about where adolescents spend time and times of greatest risk, informing prevention efforts.Item Career Development and Exploration in Art Therapy(2022) Welker, Taylor; Misluk, Eileen; McCullough, ShannonThis research explains and implements creating a proposal with art therapy and career counseling for high school systems while working with adolescents. Within the literature review, existing research has demonstrated that career counseling yields benefits in professional planning and satisfaction. The adolescence stage has many expected developmental tasks, including choosing a career about individual traits and strengths. Research also addresses influences relating to adolescent needs that may help or hinder career choices. To manage educational settings and conditions, the research discusses benefits and limitations. While research has provided understanding for career counseling, limited research combines both art therapy and career development. Art therapy research has highlighted many goals about self-awareness and empowering individuals to understand themselves. Comparisons of research on art therapy and career counseling provide evidence and information to create a program proposal for individual students. Career theories such as Holland’s Theory of Vocational Choice and Social Cognitive Career Theory go in-depth on clients' needs in this process. These theories also tie in three themes explored from existing art therapy literature, including identity, self-efficacy, and self-esteem.Item Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya(Taylor & Francis, 2015) Vreeman, Rachel C.; Scanlon, Michael L.; Marete, Irene; Mwangi, Ann; Inui, Thomas S.; McAteer, Carole I.; Nyandiko, Winstone M.; Department of Pediatrics, IU School of MedicineKnowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver-child dyads enrolled in the study, children's mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child's knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5-2.1), better WHO disease stage (OR 2.5, 95% CI 1.4-4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1-3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes.Item Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults: Suspected Myocarditis After COVID-19 Vaccination(AHA, 2022-02) Truong, Dongngan T.; Dionne, Audrey; Muniz, Juan Carlos; McHugh, Kimberly E.; Portman, Michael A.; Lambert, Linda M.; Thacker, Deepika; Elias, Matthew D.; Li, Jennifer S.; Toro-Salazar, Olga H.; Anderson, Brett R.; Atz, Andrew M.; Bohun, C. Monique; Campbell, M. Jay; Chrisant, Maryanne; D’Addese, Laura; Dummer, Kirsten B.; Forsha, Daniel; Frank, Lowell H.; Frosch, Olivia H.; Gelehrter, Sarah K.; Giglia, Therese M.; Hebson, Camden; Jain, Supriya S.; Johnston, Pace; Krishnan, Anita; Lombardi, Kristin C.; McCrindle, Brian W.; Mitchell, Elizabeth C.; Miyata, Koichi; Mizzi, Trent; Parker, Robert M.; Patel, Jyoti K.; Ronai, Christina; Sabati, Arash A.; Schauer, Jenna; Sexson Tejtel, S. Kristen; Shea, J. Ryan; Shekerdemian, Lara S.; Srivastava, Shubhika; Votava-Smith, Jodie K.; White, Sarah; Newburger, Jane W.; Pediatrics, School of MedicineBackground: Understanding the clinical course and short-term outcomes of suspected myocarditis after the coronavirus disease 2019 (COVID-19) vaccination has important public health implications in the decision to vaccinate youth. Methods: We retrospectively collected data on patients <21 years old presenting before July 4, 2021, with suspected myocarditis within 30 days of COVID-19 vaccination. Lake Louise criteria were used for cardiac MRI findings. Myocarditis cases were classified as confirmed or probable on the basis of the Centers for Disease Control and Prevention definitions. Results: We report on 139 adolescents and young adults with 140 episodes of suspected myocarditis (49 confirmed, 91 probable) at 26 centers. Most patients were male (n=126, 90.6%) and White (n=92, 66.2%); 29 (20.9%) were Hispanic; and the median age was 15.8 years (range, 12.1–20.3; interquartile range [IQR], 14.5–17.0). Suspected myocarditis occurred in 136 patients (97.8%) after the mRNA vaccine, with 131 (94.2%) after the Pfizer-BioNTech vaccine; 128 (91.4%) occurred after the second dose. Symptoms started at a median of 2 days (range, 0–22; IQR, 1–3) after vaccination. The most common symptom was chest pain (99.3%). Patients were treated with nonsteroidal anti-inflammatory drugs (81.3%), intravenous immunoglobulin (21.6%), glucocorticoids (21.6%), colchicine (7.9%), or no anti-inflammatory therapies (8.6%). Twenty-six patients (18.7%) were in the intensive care unit, 2 were treated with inotropic/vasoactive support, and none required extracorporeal membrane oxygenation or died. Median hospital stay was 2 days (range, 0–10; IQR, 2–3). All patients had elevated troponin I (n=111, 8.12 ng/mL; IQR, 3.50–15.90) or T (n=28, 0.61 ng/mL; IQR, 0.25–1.30); 69.8% had abnormal ECGs and arrhythmias (7 with nonsustained ventricular tachycardia); and 18.7% had left ventricular ejection fraction <55% on echocardiogram. Of 97 patients who underwent cardiac MRI at a median 5 days (range, 0–88; IQR, 3–17) from symptom onset, 75 (77.3%) had abnormal findings: 74 (76.3%) had late gadolinium enhancement, 54 (55.7%) had myocardial edema, and 49 (50.5%) met Lake Louise criteria. Among 26 patients with left ventricular ejection fraction <55% on echocardiogram, all with follow-up had normalized function (n=25). Conclusions: Most cases of suspected COVID-19 vaccine myocarditis occurring in persons <21 years have a mild clinical course with rapid resolution of symptoms. Abnormal findings on cardiac MRI were frequent. Future studies should evaluate risk factors, mechanisms, and long-term outcomes.Item Clinician Training, Then What? Randomized Clinical Trial of Child STEPs Psychotherapy Using Lower-Cost Implementation Supports with versus without Expert Consultation(APA, 2020-12) Weisz, John R.; Thomassin, Kristel; Hersh, Jacqueline; Santucci, Lauren C.; MacPherson, Heather A.; Rodriguez, Gabriela M.; Bearman, Sarah Kate; Lang, Jason M.; Vanderploeg, Jeffrey J.; Marshall, Timothy M.; Lu, Jack J.; Jensen-Doss, Amanda; Evans, Spencer C.; Psychiatry, School of MedicineObjective: Implementation of evidence-based treatments in funded trials is often supported by expert case consultation for clinicians; this may be financially and logistically difficult in clinical practice. Might less costly implementation support produce acceptable treatment fidelity and clinical outcomes? Method: To find out, we trained 42 community clinicians from four community clinics in Modular Approach to Therapy for Children (MATCH), then randomly assigned them to receive multiple lower-cost implementation supports (LC) or expert MATCH consultation plus lower-cost supports (CLC). Clinically referred youths (N = 200; ages 7–15 years, M = 10.73; 53.5% male; 32.5% White, 27.5% Black, 24.0% Latinx, 1.0% Asian, 13.5% multiracial, 1.5% other) were randomly assigned to LC (n = 101) or CLC (n = 99) clinicians, and groups were compared on MATCH adherence and competence, as well as on multiple clinical outcomes using standardized measures (e.g., Child Behavior Checklist, Youth Self-Report) and idiographic problem ratings (Top Problems Assessment). Results: Coding of therapy sessions revealed substantial therapist adherence to MATCH in both conditions, with significantly stronger adherence in CLC; however, LC and CLC did not differ significantly in MATCH competence. Trajectories of change on all outcome measures were steep, positive, and highly similar for LC and CLC youths, with no significant differences; a supplemental analysis of posttreatment outcomes also showed similar LC and CLC posttreatment scores, with most LC–CLC differences nonsignificant. Conclusions: The findings suggest that effective implementation of a complex intervention in clinical practice may be supported by procedures that are less costly and logistically challenging than expert consultation.Item A Community Focus in Grief Groups: Children and Adolescents Experiencing Cancer Related Parental Loss(2021-05) Gore, Emile; Misluk, EileenApproximately 2.85 million children under 18 live with a parent affected by cancer in the United States and cancer is the second leading cause of death worldwide. These children are at risk for developmental and mental health related distress. The purpose of this study was to gain a deeper understanding of the ways group art therapy can be used to work through grief processes and build a sense of community in the group for children. It was hypothesized that a community focus and building community in a group art therapy setting would be an effective and beneficial way in teaching coping strategies for dealing with grief and loss for children that have lost one or more parents to cancer. A traditional literature review was conducted to review the impact community-based art therapy can have on children and adolescents who have lost one or more parents to cancer. Group art therapy was found to be an effective and beneficial treatment for working with children that are experiencing grief, though more research is needed to clearly define the influence and definitions of a focus on community. Finding ways to improve treatment for children’s grief processing can work to reduce present and future developmental and mental health risks.Item Community-Based Referential Music Making with Limited-Resource Adolescents: A Pilot Study(Oxford, 2020) Thomas, Natasha; Music and Arts Technology, School of Engineering and TechnologyBlack/African American adolescents from limited-resource communities face challenges and circumstances that are unique to their racialization and socioeconomic status; this merits community-engaged resources, such as community music therapy, that are equally unique in creating culturally responsive opportunities for limited-resource adolescents to engage socially with peers and experience meaningful success in a safe, supportive environment. The purpose of this study was to pilot and explore the feasibility of and behavioral processes in a community-based referential music-making intervention for limited-resource adolescents labeled as “at-risk.” The methods consisted of a concurrent nested (embedded) mixed methods design based on the principles of participatory actions research (PAR), during which qualitative data were collected during 8 focus group style music-making sessions. Quantitative data assessing self-efficacy were collected prior to first and following the 8th music-making session. The validity of quantitative results was challenged by the lowered reading level of participants and a high amount of mis-labeled (and thus unusable) data. Qualitative data suggest 3 themes, including creating community, artistic prioritization, and pride. All results were impacted by issues, such as inconsistent attendance and malfunctioning recording equipment. Nevertheless, participants expressed a collective desire to share their work with their community group. Discussion points are raised including how participants in this community music therapy-based approach were able to create and direct their own stories. The implementation of community music therapy approaches seems a valuable way to bring authentic representations of limited-resource adolescent participants into clinical practice.