Sexually Active Young People are Inadequately Screened for Sexually Transmitted InfectionUS Preventive Services Task Force guidelines recommend asymptomatic gonorrhea and chlamydia screening of sexually experienced adolescents and young adult women . The current US Preventive Services Task Force does not see sufficient evidence to support a recommendation for screening of men who have sex with women exclusively. However, the Centers for Disease Control and Prevention (CDC) recommends screening for men who have sex with men, transgender persons depending on their anatomy, and allows for routine screening of heterosexual young men “in high prevalence clinical settings such as adolescent clinics, correctional facilities, STI/sexual health clinic” .
Opportunities to Improve Adolescent Health and Wellbeing Through Medical Education and Delivery of Quality Preventive CareIn this issue of the journal, Al-Shimari et al. report on clinicians' time alone with adolescent patients during routine healthcare visits in 10 primary care clinics in Washington State . Their secondary analysis of adolescent well visits from two randomized controlled trials of electronic health risk behavior screening feedback found a wide variation in whether young people had private, one-on-one time with their clinicians during visits. The percent of adolescents who reported having had time alone during their visit varied from 51.6% to 97.8% across their study sites.
Filling in the Gaps: Building the Evidence Base for Screening, Brief Intervention, and Referral to Treatment in AdolescentsSubstance use disorders (SUDs) most commonly begin during adolescence and are the leading causes of premature death and health problems worldwide [1,2]. Overdose mortality among adolescents has risen dramatically in the wake of the COVID pandemic  and alcohol and drugs also contribute to motor vehicle crashes, suicides, and homicides—three of the leading causes of death in adolescents [1,4,5]. SUDs in adolescents are also associated with other adverse physical health outcomes, including transmission of human immunodeficiency virus, hepatitis C virus, and sexually transmitted infections [1,6,7]; mental health problems, such as depression [1,6,8]; and risk for addiction throughout the life course [9,10].
Intervening at the Fingertips: A Text-Based Approach to Mitigating Texting While DrivingDespite a demonstrable increase in legislation and public health interventions during the last few decades, motor vehicle crashes (MVCs) remain the second leading cause of death among adolescents and young adults (AYAs) in the United States . Recent data show that MVCs among this age group are despairingly on the rise after several years of progressive decline . Multiple risk factors contribute to these sobering statistics, but overwhelming evidence supports a strong association between distracted driving and an increased risk of MVC, particularly among young, inexperienced drivers [3–5].
The Evidence for SBIRT in AdolescentsWith this issue of the Journal of Adolescent Health, we bring you a supplement focused exclusively on building the evidence base for Screening, Brief Interventions and Referral for Treatment (SBIRT) for adolescents. The supplement opens with an editorial by Dr. Scott Hadland, the Guest Editor, providing a framework by highlighting that substance use disorders (SUDs) usually begin during adolescence and are the leading causes of premature mortality and health problems throughout the world . Given that the U.S.
An Urgent Need to Focus on Youth With Opioid Use DisorderYouth deaths are driven by the same patterns of thAs COVID-19 tore through communities, preliminary data suggest that overdose deaths climbed to greater than 100,000 during the 12-month period ending in September 2021 . Approximately 75% of those deaths were opioid-related, and most were fentanyl-involved . This overdose crisis has not spared youth. Prior to the emergence of COVID-19, synthetic opioid-related overdose deaths increased 2925% between 1999 and 2016 among young people . Between 2019 and 2020, overdose death rates increased 49% among 15- to 24-year-olds.
Digital Interventions to Improve College and University Student Mental HealthI am writing this editorial during a particular busy time in the collegiate calendar: the last 2 weeks of the spring semester. In a “typical” (e.g., pre COVID-19) academic year, my undergraduate students would be pulled in many directions while they finished projects and internships, took finals, and for some, prepared for graduation and postcollege life. As those of us who work with, advise, and clinically care for college-aged adolescents can attest, the past 2 years have been anything but “typical” for these young people.
The Prevention of Nonmedical Marijuana Use Must Extend Past AdolescenceConcerns about the normalization of marijuana use among youth are growing as liberalization of state drug laws becomes more prevalent. Although the available research on the effects of the legalization of nonmedical (“recreational” or “adult”) marijuana use on young people is still in its early stages, most published studies focus on changes in marijuana risk perceptions , initiation , use , and consequences [4,5] among adolescents. This focus is reasonable since adolescence is a stage of development when the human brain undergoes dramatic change and is highly vulnerable to the lures and consequences of any type of addictive substance, including marijuana [6–8].
The Journal of Adolescent Health's Editor-in-Chief's Annual Reflection: A Year of Endurance and Looking Toward the FutureNow in its third year, the COVID pandemic continues to impact people of all ages in all countries of the world. Fortunately, COVID vaccines have provided hope and allowed us to look toward the future with optimism. The Journal of Adolescent Health (JAH) remains committed to publishing high-quality science that can be used to improve the health and well-being of adolescents and young adults aged 10–25 years. Recently, that commitment has led us to focus our efforts on better understanding the impact of the pandemic on young people and strategies to increase COVID vaccination rates in this population.
Toward a Deeper Understanding of the Spectrum of Parental Human Papillomavirus Vaccine HesitancyToo often, when evaluating vaccine uptake, we classify people into a simple dichotomy of “vaccinated” or “unvaccinated,” from which we infer low hesitance and high hesitance, respectively. This approach makes research simpler, but discards valuable nuances that can give us important insights into increasing vaccine uptake. In this issue of the Journal of Adolescent Health, Rositch et al.  take a more nuanced look into parental human papillomavirus (HPV) vaccine hesitance, using National Immunization Survey-Teen data on intention to vaccinate unvaccinated adolescents to classify parents by hesitance level.
COVID9TEEN Virtues: Help, Hope, and Holding SpaceFor the second year in a row, JAH Intersections issued a call for submissions for a themed contest open to young people and those who work with, parent, or serve young people in any way . This year's theme was COVID9TEEN, a solicitation for creative work exploring growth and change during the pandemic's extraordinary stressors and unprecedented circumstances. We received nearly 20 submissions from around the world, with 14 finalists and three winners. The winners' work was showcased in March at the Society for Adolescent Health and Medicine annual meeting.
Thanks to Our 2021 ReviewersWe take this opportunity each year to acknowledge the vital work of our peer reviewers. The Journal of Adolescent Health owes its place in the field to the following individuals, who kindly volunteered their invaluable time and expertise to fulfilling our mission:
Advancing Sexual and Reproductive Health Education—Pursuing the Long Arc of JusticeSince 1988, the Centers for Disease Control and Prevention's (CDC) Division of Adolescent and School Health has been instrumental in our country's efforts to promote “environments where youth can gain fundamental health knowledge and skills, establish healthy behaviors, and connect to health services to prevent HIV, sexually transmitted diseases (STDs), and unintended pregnancy.” Through its commitment to “translating science into innovative programs and tools,” CDC helps the country implement effective programs and practice standards that shape the field more broadly .
The Distinguished Dozen: 2021 Journal of Adolescent Health Articles Making Distinguished Contributions to Adolescent and Young Adult HealthThe 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. Last year, we initiated a strategy to amplify important contributions to the field culminating in the inaugural JAH Distinguished Dozen . The process of selection of articles is based on results of peer review. JAH now asks all peer reviewers, “Does this manuscript merit special consideration in the journal's monthly and/or annual collections of particularly important research?” Reviewers who responded affirmatively are provided with the opportunity to offer explanatory comments.
School-based Health Centers, Computer-delivered Health Care, and the Value of the Warm Handoff: Optimizing Behavioral Interventions for At-risk AdolescentsThe changing landscape of health care and the rapidly shifting circumstances during the COVID-19 pandemic have challenged the delivery of health services. In striving for access and autonomy for adolescents and young adults, providers have used some unique and promising means to deliver health care. In the past decade, there has been increased application of computer-facilitated or social media–assisted health care . Computerized care delivery may reduce logistical barriers, privacy concerns, cost, and time burdens to providers and patients.
Rising Rates of Adolescent Depression in the United States: Challenges and Opportunities in the 2020sMajor depressive disorder is a major public health concern. Many cases of depression have their onset during adolescence or even earlier . Critically, adolescent- (or earlier) onset depression tends to follow a recurrent course and is associated with more negative outcomes relative to adult-onset depression, including impairment in a range of important psychosocial domains that can persist into adulthood. Daly  examined the prevalence of adolescent depression using the National Survey on Drug Use and Health (NSDUH) in the United States.
Overlooked No More: Shining a Light on Asian American Pacific Islander Youth During the COVID-19 Pandemic and the Need for VisibilityThese last 2 years of the COVID-19 pandemic have drawn increased attention to Asian populations living in the United States and Canada . Frontline and essential workers are comprised of higher numbers of Asian American Pacific Islanders (AAPI), and they have higher risk of being exposed to COVID-19 than the general population . The AAPI community, already feeling vulnerable to xenophobia as a minority in North America, has experienced increasingly horrific anti-Asian acts of violence . The targeted racially motivated mass shooting of Asian individuals in a spa in Atlanta in May 2021 as well as the countless unprovoked random attacks, particularly of elderly Asian individuals, in New York City, San Francisco and throughout the United States, have left the AAPI community reeling [1,3].
The Opportunity to End Child Marriage Throughout the WorldWith this issue of the Journal, we bring readers our second supplement on child marriage. As was so clearly stated in our December 2021 supplement, “The Diversity and Complexity of Child Marriage,” child marriage is a global problem with a prevalence that is highly variable by region and country [1,2]. The supplement opens with an editorial from Das, Guedes, Molestane, and Svanemyr—the supplement’s guest editors—which brings additional clarity to our dialogue by defining the issue as Child, Early, and Forced Marriage and Unions (CEFMU) .
Ultra-Processed Food Intake in U.S. Adolescents: National Public Health ImplicationsBeginning in youth, weight status and dietary intake are important predictors of lifelong health habits related to chronic disease [1,2]. While consuming foods rich in micronutrients enhances health and prevents chronic disease , intake of “ultra-processed” foods (UPFs) is related to increased cardiometabolic risk and cancer . UPFs are defined as “multi-ingredient, industrially formulated mixtures containing little intact foods” (e.g., frozen meals, processed deli meats) . The negative health influence of UPF consumption is documented in adults [4,6]; however, there is a paucity of data in youth.
Complex Primary Care Interventions Focused on Reducing Adolescent Risk BehaviorRisk behaviors, defined as intentional participation in some form of behavior that involves potential negative consequences or losses as well as perceived positive consequences or gains , are the primary drivers of early mortality among adolescents in the U.S.. Recent data from the Centers for Disease Control and Prevention show that overdoses, motor vehicle crashes, and other unintentional injuries are, with suicide, among the leading causes of death for adolescents aged 12–17 . It is important to identify youth who are engaging in risk-associated behaviors so that we can guide them to appropriate interventions and mitigate undesired negative consequences.
Contextualizing Cannabis Legalization OutcomesCannabis (“marijuana”) has a long history of legality and prohibition in the United States. However, it has been federally illegal since the 1970s Controlled Substances Act. The Controlled Substances Act currently categorizes cannabis as a schedule I substance, the most restrictive schedule, quantifying cannabis on par with heroin and indicating a high potential for abuse, no currently accepted medicinal use, and lack of safety for use under medical supervision .
Recovery Efforts: Understanding Adolescent Substance Use Through a Longitudinal COVID LensAs I write this editorial in mid-August 2021, my adolescent is entering her second school year impacted by the COVID-19 pandemic. Like nearly all young people, she has spent the last 18 months balancing remote and in-person learning, canceled and/or constrained sports and extracurricular activities, and ever changing access to peer interaction and has rotated between heightened stress, anxiety, and boredom. And she is one of the more fortunate ones—some of her peers have also grappled with food insecurity, worries about housing stability, and parental job loss.
A Clear Message: Child Marriage Is a Significant Global Problem Requiring a Collaborative, Contextual, and Evidence-Based ResponseWith this issue comes a first for the Journal of Adolescent Health: a comprehensive review of child marriage throughout the world. The supplement begins with an editorial from the supplement's guest editors Muthengi, Olum, and Chandra-Mouli highlighting the magnitude of this public health and social challenge—globally, approximately 12 million girls are married before the age of 18 each year . The editorial also clarifies that all of our data on child marriage are from pre-COVID-19 pandemic estimates where there was optimism about declining rates of child marriage globally.
The Cardiovascular Effects of Testosterone as Gender Affirming Treatment for Adolescents: Areas for Future InvestigationThe health care of gender-diverse adolescents remains an ever-growing and evolving field composed of professionals and researchers working to improve the quality and delivery of care to patients. The article by Kean et al. featured in this issue of JAH was created by an interdisciplinary team of pediatric cardiologists, adolescent medicine specialists, and endocrinologists with a common goal. They have written a narrative highlighting the limitations of the existing literature and clinical guidelines on the care of gender-diverse youth using testosterone for gender affirming hormone therapy (GAHT) in regard to the cardiovascular effects of the medication .
Comprehensive Adolescent Health Screening in AfricaAfrica is the land of the young. Across the 46 countries in sub-Saharan Africa, the average median age is 20, exemplified by Nigeria, Zimbabwe, and Ghana with median ages of 18.6, 20.5, and 21.4, respectively . Such relative youth embodies the important potential of the ‘demographic transition’ to drive national wealth—but only if countries can educate and employ their large numbers of young people, protect them from war and civil unrest, promote gender equality, and maintain their health. The disproportionately high health burden experienced by adolescents in Africa reinforces the importance of their access to comprehensive, affordable health services [2,3].