Some public health practices, especially those focused on weight loss, have been found to increase weight stigma, which is harmful to physical and mental health. We used the Delphi method to establish expert consensus on how to address weight stigma in public health. Our participants were recruited from a convenience sample of individuals attending a single-day symposium on public health prevention of eating disorders, though they reported having high levels of formal (education, employment) and informal (advocacy, lived experience in eating disorders) expertise, all of which was relevant to weight stigma. Three online surveys were completed by 88 experts. Of the 177 ideas presented, 68 were endorsed and 109 were rejected. Experts reached consensus on an array of topics: cross-disciplinary collaboration, the need for inclusivity and diversity, defining how weight stigma arises in research and practice, and advocating for change in popular culture and industry. Experts also agreed on the need to shift focus away from body weight toward health behaviors; however, they did not reach consensus on how to make that shift. Although this study requires replication with a larger and more diverse sample of experts, these initial outcomes provide clear recommendations for changes in public health research, practice, and policy, and highlight areas for further research.

IMPORTANCE Annual preventive health visits provide an opportunity to screen youths for unhealthy substance use and intervene before serious harm results. OBJECTIVES To assess the feasibility and acceptability and estimate the efficacy of a primary care computer-facilitated screening and practitioner-delivered brief intervention (CSBI) system compared with usual care (UC) for youth substance use and associated risk of riding with an impaired driver. DESIGN, SETTING, AND PARTICIPANTS An intent-to-treat pilot randomized clinical trial compared CSBI with UC among 965 youths aged 12 to 18 years at 5 pediatric primary care offices and 54 practitioners. Patients were randomized to CSBI (n = 628) or usual care (n = 243) groups within practitioner with 12 months of follow-up.

Few studies have examined the impact of resilience training on youth in lower/middle income countries (LMICs). This study assessed feasibility, acceptability, and efficacy of GROW, a 24-week character-based resilience curriculum rooted in positive psychology and spirituality and taught via storytelling. Our pilot design -a mixed method, cluster-randomized controlled trial -was conducted with 28 classes of 643 Zambian youth ages 10-13 (M = 11.39, SD = 0.95, 55.4% female). Classes were divided into initial-start and delayed-start intervention phases. In 17 focus groups, parents, teachers, GROW leaders, and children affirmed the program's excellent cultural fit. Adult stakeholders observed positive impacts on school attendance, academic performance, and students' character and behavior. Initial-start students showed a pre-post increase in psychological resilience (p < .05). Together, these findings suggest GROW has promise for improving early adolescents' positive development. This strengthens the evidence base for the potential impact of culturally appropriate, spiritually-oriented programs delivered by lay providers for LMIC youth.

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