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The Distinguished Dozen: 2020 Journal of Adolescent Health Articles Making Distinguished Contributions to Adolescent and Young Adult Health

      The Journal of Adolescent Health (JAH) is the official publication of the Society for Adolescent Health and Medicine. One of the Society's primary goals is the development, synthesis, and dissemination of scientific and scholarly knowledge unique to the health needs of young people. To amplify important contributions to the field, beginning in 2020, JAH asked all peer reviewers, “Does the manuscript merit special consideration in the Journal's monthly and/or annual collections of particularly important research?” Reviewers who responded affirmatively were provided with the opportunity to enter explanatory comments. Of the 228 scientific articles published in JAH during the 2020 calendar year, 66 were nominated by at least one peer reviewer to be considered for inclusion in a collection, highlighting particularly important research. The Journal's Editor-in-Chief and Associate Editors reviewed nominations and selected the articles to be highlighted this year. One dozen 2020 JAH articles that collectively make distinguished contributions to the field of adolescent and young adult health are summarized below.

      Adolescents' Motivations to Engage in Social Distancing During the COVID-19 Pandemic: Associations With Mental and Social Health. Oosterhoff, B., Palmer, C. A., Wilson, J., & Shook, N.

      Oosterhoff et al. conducted a national survey involving 683 adolescents aged 13–18 years on March 29 and 30, 2020, just 2 weeks after COVID-19 was declared a national emergency in the U.S. [
      • Oosterhoff B.
      • Palmer C.A.
      • Wilson J.
      • Shook N.
      Adolescents’ motivations to engage in social distancing during the COVID-19 pandemic: Associations with mental and social health.
      ]. The vast majority of adolescents reported social distancing and prosocial motivations, including social responsibility and not wanting others to get sick. In multivariate analyses, youth who reported engaging in social distancing because their state or city was on lockdown, their parents were making them distance, and it was socially responsible to distance were found to report engaging in more social distancing than those who did not endorse these reasons. Although this study relied on social media recruitment and is not a representative sample of youth in the U.S., the results suggest that the majority of adolescents were engaging in social distancing because of altruistic motivations. These early findings suggest that many adolescents are acting in accordance with public health recommendations, and such findings may help to inform strategies to promote ongoing social distancing among youth throughout the COVID-19 pandemic.

      Caring for Children and Adolescents With Eating Disorders in the Current COVID-19 Pandemic: A Singapore Perspective. Davis, C., Ng, K. C., Oh, J. Y., Baeg, A., Rajasegaran, K., & Chew, C. S. E.

      Editorial: Lessons learned in caring for adolescents with eating disorders: The Singapore experience. Gordon, C. M., & Katzman, D. K.

      Davis et al. provided detailed clinical observations based on their experience providing care for children and adolescents with eating disorders in Singapore very early in the COVID-19 pandemic [
      • Davis C.
      • Ng K.C.
      • Oh J.Y.
      • et al.
      Caring for children and adolescents with eating disorders in the current Coronavirus 19 pandemic: A Singapore perspective.
      ]. In March 2020, modifications to the Singapore model of care were described across multiple dimensions, including a sophisticated list of considerations for the use of telemedicine when caring for patients with eating disorders in the outpatient setting. An accompanying editorial by Gordon and Katzman amplified the importance of sharing clinical experiences and models early in the pandemic and placing these within local contexts [
      • Gordon C.M.
      • Katzman D.K.
      Lessons learned in caring for adolescents with eating disorders: The Singapore experience.
      ]. The results helped to inform colleagues who provide care to patients with eating disorders across the globe, as they were required to rapidly modify clinical program activities within the context of the pandemic.

      The COVID-19 Pandemic and Rapid Implementation of Adolescent and Young Adult Telemedicine: Challenges and Opportunities for Innovation. Barney, A., Buckelew, S., Mesheriakova, V., & Raymond-Flesch, M.

      Editorial: Telemedicine in the time of COVID and beyond. North S.

      Barney et al. provided a detailed description of their 1-month rapid pivot from in-person to telemedicine visits in an Adolescent and Young Adult Clinic in March 2020 in the U.S. [
      • Barney A.
      • Buckelew S.
      • Mesheriakova V.
      • Raymond-Flesch M.
      The COVID-19 pandemic and rapid implementation of adolescent and young adult telemedicine: Challenges and opportunities for Innovation.
      ]. The patient population served included young people receiving general adolescent and young adult health care, mental health services, care for eating disorders, reproductive health services, and addiction treatment. Lessons learned provided a useful roadmap for others working on similar transformations of clinical care early in the pandemic. An accompanying editorial by North placed the description of one clinic's COVID-related experience within a larger context, highlighting the potential opportunity that telemedicine provides to adolescent and young adult health services in the future beyond the current COVID-19 pandemic [
      • North S.
      Telemedicine in the time of COVID and beyond.
      ].

      Boys Mentoring, Gender Norms, and Reproductive Health-Potential for Transformation. Plourde, K. F., Thomas, R., & Nanda, G.

      Plourde et al. conducted a systematic review to better understand the potential impact of mentoring interventions for adolescent boys and young men [
      • Plourde K.F.
      • Thomas R.
      • Nanda G.
      Boys mentoring, gender norms, reproductive health-potential transformation.
      ]. Evidence drawn from the evaluation of 27 mentoring interventions demonstrated promise for improving soft skills and social assets among adolescent boys and young men, two factors thought to contribute to positive youth development and reductions in violence perpetration. The impact of mentoring interventions to transform gender norms, reproductive health, and substance use was mixed. The results will help to inform research and strategies to increase successful investment in adolescent boys and young men, which has historically fallen short of investments in adolescent girls and young women.

      Racial Identity, Masculinities, and Violence Exposure: Perspectives From Male Adolescents in Marginalized Neighborhoods. Quam, S., VanHook, C., Szoko, N., Passarello, A., Miller, E., & Culyba, A. J.

      Editorial: Violence prevention and gender transformative programming. Bell, D. L.

      Quam et al. conducted a qualitative study involving interviews of 52 black male youth aged between 14 and 19 years living in neighborhoods with concentrated disadvantage in Pittsburgh, Pennsylvania, in the U.S. [
      • Quam S.
      • VanHook C.
      • Szoko N.
      • et al.
      Racial identity, masculinities, and violence exposure: Perspectives from male adolescents in marginalized neighborhoods.
      ]. Interviews explored youths' definitions of manhood, influences on manhood, and intersections with racial identity, racism, and violence, as well as other topics related to youths' lives. Thematic content analyses revealed in-depth perspectives within three overarching themes involving definitions of manhood, influences on manhood, and manhood in the context of violence prevention. An accompanying editorial by Bell amplifies that these young men aspire to manhood as a moral journey centered on positive and prosocial values in juxtaposition to their lived experiences of multiple layers of systemic racism and violence [
      • Bell D.L.
      Violence prevention and gender transformative programming.
      ]. Such encouraging findings will help to inform efforts to better address the needs of adolescent boys and young men of color who live in disadvantaged contexts.

      Active Shooter Drills in the United States: A National Study of Youth Experiences and Perceptions. Moore-Petinak, N., Waselewski, M., Patterson, B. A., & Chang, T.

      Editorial: Active shooter drills: A closer look at next steps. Zullig, K. J.

      Moore-Petinak et al. conducted a national open-ended text message poll asking young people aged between 14 and 24 years in the U.S. about active shooter drills in schools [
      • Moore-Petinak N.
      • Waselewski M.
      • Patterson B.A.
      • Chang T.
      Active shooter drills in the United States: A national study of youth experiences and perceptions.
      ]. The responses of 815 youths were analyzed using thematic analysis. Approximately 70% of respondents reported that their school had active shooter drills. Less than 10% of responders reported experiencing drills that follow national recommendations, and 60% of responders reported feeling unsafe, scared, helpless, or sad as a result of experiencing active shooter drills. An accompanying editorial by Zullig places this study within a larger social context, including the importance of multilevel approaches to reduce gun violence and limit gun access and the importance of following comprehensive evidence-based guidance in schools and districts that continue to conduct active shooter drills [
      • Zullig K.J.
      Active shooter drills: A Closer look at next steps.
      ].

      Association Between First Depressive Episode in the Same Year as Sexual Debut and Teenage Pregnancy. Vafai, Y., Thoma, M. E., & Steinberg, J. R.

      Using data from the U.S. National Comorbidity Survey–Adolescent Supplement, Vafai et al. conducted a study of 1,025 adolescent girls who reported having had sex [
      • Vafai Y.
      • Thoma M.E.
      • Steinberg J.R.
      Association between first depressive episode in the same year as sexual debut and teenage pregnancy.
      ]. Researchers tested whether depression that started before first sex, at the same age as first sex, or after first sex was associated with experiencing a first teenage pregnancy compared with no depression onset. Adolescents with depression onset at the same age as having initiated sex were at increased risk of experiencing teenage pregnancy. The results highlight the importance of timely diagnosis and treatment of depression, as well the importance of reproductive health services for adolescent girls with depression.

      Understanding the Mental Health of Transgender and Nonbinary Youth. Price. Feeney, M., Green, A. E., & Dorison, S.

      Editorial: Commemorating pride: Reflecting on progress and continuing to advocate for gender diverse and sexual minority youth. Vance, S. R.

      Price-Feeney et al. conducted a national survey of more than 25,000 lesbian, gay, bisexual, transgender, queer, and questioning youth aged between 13 and 24 years in the U.S. [
      • Price-Feeney M.
      • Green A.E.
      • Dorison S.
      Understanding the mental health of transgender and nonbinary youth.
      ]. Researchers found that transgender and nonbinary youth were at increased risk of experiencing depressed mood, seriously considering suicide, and attempting suicide compared with cisgender lesbian, gay, bisexual, queer, and questioning youth. Within-group analyses highlighted particularly increased risk for negative mental health outcomes among transgender males and nonbinary youth assigned female at birth. This study emphasizes the importance of researchers and clinicians avoiding the assumption that gender diverse and sexual minority youth represent a homogenous group. In an accompanying editorial, Vance stresses the importance of ongoing research on health and psychosocial issues facing sexual minority and gender diverse youth and places this within the context of measurement challenges and larger policy issues [
      • Vance S.R.
      Commemorating pride: Reflecting on progress and continuing to advocate for gender diverse and sexual minority youth.
      ].

      Adverse Experience Reports of Seizures in Youth and Young Adult Electronic Nicotine Delivery Systems Users. Faulcon, L. M., Rudy, S., Limpert, J., Wang, B., & Murphy, I.

      Editorial: Seizures after vaping nicotine in youth: A canary or a red herring? Benowitz, N. L.

      Faulcon et al. describe 122 voluntary reports of seizures and neurologic symptoms among users of electronic nicotine delivery systems received by the Food and Drug Administration between December 1, 2010, and June 30, 2019 [
      • Faulcon L.M.
      • Rudy S.
      • Limpert J.
      • et al.
      Adverse experience reports of seizures in youth and young adult electronic nicotine delivery systems users.
      ]. The results suggest a potential association between electronic nicotine delivery systems use and seizures. An accompanying editorial by Benowitz noted that a formal causation analysis has not yet been done [
      • Benowitz N.L.
      Seizures after vaping nicotine in youth: A canary or a red herring?.
      ]. However, providers should be aware of the possible link between nicotine vaping and neurologic events and should carefully evaluate the medical causes of such events. Evaluation should include collecting vaping devices and liquids for later analyses, if possible, and reporting such cases to the Food and Drug Administration and state health departments.

      Frequent Alcohol Intoxication and High Alcohol Tolerance During Adolescence as Predictors of Mortality: A Birth Cohort Study. Levola, J., Sarala, M., Mustonen, a., Rose, R. J., Miettunen, J., Niemelä, A.-E., & Niemelä, S.

      Editorial: Can asking adolescents about being drunk and their subjective experience of intoxication help in screening for risky drinking? Wellman, R. J., & Morgenstern, M.

      Levola et al. conducted a study to examine the predictive associations between self-reported alcohol tolerance and frequent intoxication at age 15–16 years and the risk of death by age 33 years [
      • Levola J.
      • Sarala M.
      • Mustonen A.
      • et al.
      Frequent alcohol intoxication and high alcohol tolerance during adolescence as predictors of mortality: A Birth cohort study.
      ]. Using data collected from 6,156 members of the Northern Finland Birth Cohort Study born in 1986, researchers found that by the age of 33 years, 53 participants (.8%) were deceased. During adolescence, participants were asked how many drinks they needed to feel intoxicated and how many times in the previous 30 days they had been intoxicated. Alcohol intoxication was defined according to self-reported subjective experience of intoxication. In multivariate analyses, subjectively experienced tolerance and frequency of intoxication in the month preceding the adolescent survey were significantly associated in both males and females with both all-cause mortality and mortality attributable to accident or suicide by age 33 years. An accompanying editorial by Wellman and Morgenstern highlighted the novel approach of relying on subjective reporting of experienced inebriation, rather than the number of standard drinks consumed within a specific time frame [
      • Wellman R.J.
      • Morgenstern M.
      Can asking adolescents about being drunk and their subjective experience of intoxication help in screening for risky drinking?.
      ]. This approach may identify adolescents who can become intoxicated with relatively few drinks and may not meet typical definitions of binge drinking, which has the potential to advance research on sequelae of underage drinking.

      Early Affordable Care Act Medicaid: Coverage Effects for Low- and Moderate-Income Young Adults. Cha, P., & Brindis, C. D.

      Cha and Brindis conducted a study to evaluate the impact among young adults of Medicaid expansion programs used in three early adopter states (California, Connecticut, and Minnesota) in the U.S. using an approach that is relatively new in public health research [
      • Cha P.
      • Brindis C.D.
      Early Affordable Care Act Medicaid: Coverage effects for low- and moderate-income young adults.
      ]. To examine the effects of the programs, they created “synthetic control states” using data collected in the same early adopter Medicaid states before policy changes. Researchers estimated that Medicaid expansion increased insurance coverage among young adults, primarily among young men. Favorable impact on insurance coverage was noted among both low- and moderate-income young adult populations. The results can help to inform ongoing strategies to improve health insurance coverage in the U.S., a primary goal of the Affordable Care Act.

      Artificial Intelligence for Personalized Preventive Adolescent Healthcare, 67(2S), S52–S58. Rowe, J. P., & Lester, J. C.

      Included in the JAH August 2020 Supplement entitled Innovative Digital Technologies to Improve Adolescent and Young Adult Health, Rowe and Lester review from a computer science perspective how emerging artificial intelligence (AI) technologies can be used to model adolescent learning and engagement and to deliver personalized support and adaptive health technologies [
      • Rowe J.P.
      • Lester J.C.
      Artificial intelligence for personalized preventive adolescent healthcare.
      ]. The authors provide examples and discussion of how AI applications emerging in the fields of education, training, and entertainment may provide new opportunities in the fields of health and health care. Examples are presented of empirical findings about the effectiveness of AI technologies for user modeling and adaptive coaching. This review underlines the value of innovation and cross-disciplinary collaboration when discussing future strategies to improve adolescent and young adult health.
      In conclusion, we are delighted to highlight these 12 JAH publications and accompanying editorials that collectively make distinguished contributions to the field of adolescent and young adult health. We express sincere appreciation to our peer reviewers who contributed to the selection process. Congratulations to all contributing authors. JAH presents this collection in the spirit of our mission to synthesize and disseminate important scientific and scholarly knowledge unique to the health needs of young people.

      References

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        • Wilson J.
        • Shook N.
        Adolescents’ motivations to engage in social distancing during the COVID-19 pandemic: Associations with mental and social health.
        J Adolesc Health. 2020; 67: 179-185
        • Davis C.
        • Ng K.C.
        • Oh J.Y.
        • et al.
        Caring for children and adolescents with eating disorders in the current Coronavirus 19 pandemic: A Singapore perspective.
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        • Gordon C.M.
        • Katzman D.K.
        Lessons learned in caring for adolescents with eating disorders: The Singapore experience.
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        • Barney A.
        • Buckelew S.
        • Mesheriakova V.
        • Raymond-Flesch M.
        The COVID-19 pandemic and rapid implementation of adolescent and young adult telemedicine: Challenges and opportunities for Innovation.
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        • North S.
        Telemedicine in the time of COVID and beyond.
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        • Plourde K.F.
        • Thomas R.
        • Nanda G.
        Boys mentoring, gender norms, reproductive health-potential transformation.
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        • Quam S.
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        • et al.
        Racial identity, masculinities, and violence exposure: Perspectives from male adolescents in marginalized neighborhoods.
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        Association between first depressive episode in the same year as sexual debut and teenage pregnancy.
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        Understanding the mental health of transgender and nonbinary youth.
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        Adverse experience reports of seizures in youth and young adult electronic nicotine delivery systems users.
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        Frequent alcohol intoxication and high alcohol tolerance during adolescence as predictors of mortality: A Birth cohort study.
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        • Wellman R.J.
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        Can asking adolescents about being drunk and their subjective experience of intoxication help in screening for risky drinking?.
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        Early Affordable Care Act Medicaid: Coverage effects for low- and moderate-income young adults.
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        • Lester J.C.
        Artificial intelligence for personalized preventive adolescent healthcare.
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