Marissa Raymond-Flesch

This study examines how social and family environments shape the future orientation and aspirations of adolescents (ages 13–15) in an agricultural, predominantly Latine community in California. We analyzed data from 80 in-depth interviews conducted with 40 participants over two years as part of the A Crecer study. We found that while youth recognized how financial hardship and anti-immigrant policies could hinder their goals, they also drew strength from their parents’ resilience in facing similar challenges. Programs aimed at supporting youth should address discrimination, anti-immigrant sentiment, and limited perceived opportunities, while also engaging parents and trusted adults as key sources of encouragement and guidance in future planning.

Purpose of Review: There is growing evidence that psychedelics and associated treatment modalities may offer therapeutic benefits across a range of psychiatric conditions. Anorexia nervosa (AN), a serious and often treatment-resistant illness associated with significant morbidity and mortality, is one such condition for which psilocybin-assisted therapy (PAT) may hold promise. Recent Findings: To date, research on PAT for AN has focused primarily on adults, despite the fact that AN frequently begins in adolescence, and early age of onset portends poorer prognosis, including more severe AN, more lifetime psychiatric comorbidity, and greater life difficulties. Summary: Given these risks, an exploration of the theoretical potential of PAT for adolescent populations is warranted. Important considerations include biological implications, developmental stage, and consent. Adaptations to the current models of psilocybin-assisted therapy in studies of adults are proposed, and emerging models that address the unique challenges of these patients are discussed.

Post-Roe v. Wade, 22 states now ban or heavily restrict abortion, decreasing safe and timely access for adolescents and young adults (AYAs) and limiting the number of abortion providers being trained. Further, no AYA-focused medication abortion (MAB) curriculum exists. To fill this gap, we developed an AYA-focused MAB curriculum for pediatric trainees. Using Kern's Six Steps, we designed a blended curriculum of online modules (30-40 minutes) and a workshop (120 minutes). Using pre/post surveys, we assessed differences in multiple-choice knowledge questions and Likert scales evaluating values and intentions; open-ended responses were analyzed using directed qualitative content analysis. Nine workshops were held over the 2023-2024 academic year, with a total of 52 learners completing the curriculum. Pre/post data are available from 29 learners, including 15 pediatric residents, 13 adolescent-focused nurse practitioner students, and one medical student. Learners demonstrated a significant increase in knowledge score after curriculum completion (60% vs. 90%; p < .01). Intentions to provide, refer, and advocate for MAB care did not change significantly (average of three questions on a 5-point Likert scale: 4.3 vs. 4.3; p = .92). Eighty-five percent of learners rated the overall curriculum as excellent or outstanding. Major themes included appreciating the opportunity to explore and anticipate challenging cases and finding case-based learning and role-play helpful. Our curriculum improved trainees’ knowledge of MAB provision for AYAs, instilled confidence, and helped learners anticipate challenging abortion cases. The generalizability of skills learned may vary by local political climate, legal restrictions, and/or institutional support.

Background: Alone time with health care providers is critical for adolescents, and several professional organizations recommend it. Alone time with providers promotes better utilization of health services, empowers adolescents to manage their health, and facilitates discussions on sensitive issues. However, only 40% of adolescents have private conversations with clinicians during visits. The advancement of mobile health technology provides an excellent opportunity to deliver effective interventions to promote adolescent-provider alone time with adolescents, parents, and providers. Objective: This pilot study aims to explore the preliminary efficacy of a technology-based intervention designed to increase alone time with providers during well-adolescent visits and its impact on trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support before and after the intervention. Methods: A pre- and postintervention design was used. Participants were recruited through local clinics. After obtaining consent, participants accessed a study website to complete a baseline survey, independently interact with 4 educational modules on a website or cellphone, and complete a post-test survey 1 month after their well-adolescent visits. The surveys assessed alone time with providers, trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support. Mixed model analysis and effect sizes were used to evaluate changes in these outcomes from pre- to postintervention. Results: Thirty-two dyads (38 adolescents and 32 mothers) participated in this pilot study. About 86% (n=33) of adolescents and 87% (n=28) of mothers completed the pre- and post-test assessments and the intervention. This study found a trend toward an increase in alone time from 81.6% to 84.4%, albeit not statistically significant. Adolescents initiating alone time with providers rose from 6.45% (n=2) to 18.5% (n=5). Over 90% (n=26) of adolescents reported feeling comfortable in one-on-one interactions with providers postintervention. Mixed model analysis revealed significant improvements among adolescents in parental monitoring (z=2.93, P<.001), sexual risk communication (z=3.11, P<.001), parent-adolescent communication (z=3.11, P<.001), open family communication (z=2.00, P=.04), and parental support (z=2.87, P<.001). For mothers, significant improvements were found in parental monitoring (z=2.45, P<.001) and problem family communication (z=2.24, P=.03). Conclusions: This pilot study demonstrates promising results regarding the preliminary efficacy of a technology-based intervention to increase alone time with providers during well-adolescent visits and to enhance communication and parenting practices. Improving access to alone time and strengthening communication between parents and adolescents facilitates discussions about sensitive topics, including parental monitoring, sexual and reproductive health, and may strengthen overall satisfaction with health care. Trial Registration: ClinicalTrials.gov NCT07064070; https://clinicaltrials.gov/study/NCT07064070

BACKGROUND Alone time with health care providers is critical for adolescents, and several professional organizations recommend it. Alone time with providers promotes better utilization of health services, empowers adolescents to manage their health, and facilitates discussions on sensitive issues. However, only 40% of adolescents have private conversations with clinicians during visits. The advancement of mobile health technology provides an excellent opportunity to deliver effective interventions to promote adolescent-provider alone time with adolescents, parents, and providers. OBJECTIVE This pilot study aims to explore the preliminary efficacy of a technology-based intervention designed to increase alone time with providers during well-adolescent visits and its impact on trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support before and after the intervention. METHODS A pre- and postintervention design was used. Participants were recruited through local clinics. After obtaining consent, participants accessed a study website to complete a baseline survey, independently interact with 4 educational modules on a website or cellphone, and complete a post-test survey 1 month after their well-adolescent visits. The surveys assessed alone time with providers, trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support. Mixed model analysis and effect sizes were used to evaluate changes in these outcomes from pre- to postintervention. RESULTS Thirty-two dyads (38 adolescents and 32 mothers) participated in this pilot study. About 86% (n=33) of adolescents and 87% (n=28) of mothers completed the pre- and post-test assessments and the intervention. This study found a trend toward an increase in alone time from 81.6% to 84.4%, albeit not statistically significant. Adolescents initiating alone time with providers rose from 6.45% (n=2) to 18.5% (n=5). Over 90% (n=26) of adolescents reported feeling comfortable in one-on-one interactions with providers postintervention. Mixed model analysis revealed significant improvements among adolescents in parental monitoring (z=2.93, P<.001), sexual risk communication (z=3.11, P<.001), parent-adolescent communication (z=3.11, P<.001), open family communication (z=2.00, P=.04), and parental support (z=2.87, P<.001). For mothers, significant improvements were found in parental monitoring (z=2.45, P<.001) and problem family communication (z=2.24, P=.03). CONCLUSIONS This pilot study demonstrates promising results regarding the preliminary efficacy of a technology-based intervention to increase alone time with providers during well-adolescent visits and to enhance communication and parenting practices. Improving access to alone time and strengthening communication between parents and adolescents facilitates discussions about sensitive topics, including parental monitoring, sexual and reproductive health, and may strengthen overall satisfaction with health care. CLINICALTRIAL ClinicalTrials.gov NCT07064070; https://clinicaltrials.gov/study/NCT07064070