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This community-engaged, mixed-methods study aimed to understand stakeholders’ perceptions of strategies for promoting youth mental health using an innovation tournament. Stakeholders – including youth (aged 13 years and older), parents, and mental healthcare professionals – were first invited to nominate ideas for promoting youth mental health. Fifteen stakeholders nominated 46 ideas related to educating (46%), managing quality (26%), planning (17%), restructuring (15%), attending to the policy context (11%), and financing (9%). Stakeholders were then invited to rate the importance and feasibility of these ideas. Stakeholders rated all ideas to be very to extremely important and moderately to extremely feasible. Youth, parents, and mental healthcare professionals all rated ideas related to financing as the most important, albeit relatively less feasible. Mental healthcare professionals generally rated ideas to be less feasible than parents and other community stakeholders. Findings highlight the perceived importance of financing strategies in addressing the ongoing youth mental health crisis and suggest alignment of mental health priorities across stakeholders.

Data availability statement:The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy restrictions. Funding statement:The authors received no specific funding for this work. Conflict of interest disclosure:The authors declare that they have no conflict of interest.Ethics approval statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.Patient consent statement: Informed consent was obtained from all individual participants included in the study.

Background: AYA with T1D encounter many challenges in managing their diabetes, such as uncontrolled glycemic levels, higher probability of complications, and poor clinic attendance. AYA minorities often encounter health care disparities that could be addressed with culturally competent care, which considers the patient’s diverse background and sociocultural factors like communication, language, and beliefs that may influence health behaviors. Objective: To assess patient-reported provider cultural competence and health care utilization among diverse AYA population with T1D. Methods: Patients were recruited during routine diabetes outpatient care visits and asked to complete questionnaires on sociodemographic variables, health care utilization, and clinical experiences and cultural competence as assessed by the Consumer Assessment of Healthcare Providers and Systems (CAHPS). Results: One-hundred forty three AYA (58.7% Male; 45.5% Latinx, 22.4% non-Latinx white) participated, with an average HbA1c of 9.8% in Latinx and 8.6% in non-Latinx whites. Participants who reported some negative experience with provider cultural competence were marginally lower health care utilizers. Specifically, these AYA went to the ER for diabetes-related problems less frequently (p=0.07), had fewer urgent care visits (p=0.08), went to urgent care for hypoglycemia issues less frequently (p=0.08), and attended fewer diabetes care visits (p=0.07). They also went to urgent care for reasons unrelated to diabetes less frequently (p=0.11) and spent fewer days in the hospital when admitted (p=0.13), but these results were not significant. Conclusions: AYA who experience culturally discordant care may utilize health care less frequently. It is unclear if AYA receiving discordant care need less healthcare support, or if their experiences lead to avoidance of needed care. Our results are hypothesis-generating and further investigation is needed. Disclosure J.J. Flores Garcia: None. J. Raymond: Other Relationship; Self; Insulet Corporation. S. Agarwal: None. A. Torres Sanchez: None. M.W. Reid: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust