This article reports findings from an assessment by the Office of Technology Assessment (OTA), an analytical arm of the U.S. Congress. In brief, OTA found the conventional wisdom that American adolescents as a group are so healthy that they do not require health and related services is not justified. Even more disturbing, U.S. adolescents often face formidable barriers in trying to obtain health care. OTA suggested that Congress could act to 1) increase adolescents' access to health care, most effectively by supporting school- or community-based comprehensive health services specifically for adolescents, 2) restructure and reinvigorate the federal role in adolescent health, most visibly by creating an office of adolescent health in the U.S. Executive branch, and 3) improve adolescents' social environments, by providing more support to the families of adolescents, limiting adolescents' access to firearms, supporting the expansion of recreational opportunities for adolescents, and further supporting opportunities for community service. Congressional actions taken since the release of OTA's report are summarized.
The current investigation examines the relation between perinatal complications and social anxiety incorporating the potential indirect effect of child temperament. Participants were 149 children aged 9 to 12 years (Mage = 9.97, SDage = 1.00) screened for behavioural inhibition (BI) and assessed for social anxiety symptoms using parent and child reports. Participating families also reported on the presence of perinatal complications. Results indicated that children who experienced perinatal complications were higher in BI and social anxiety than were children who did not experience complications. Furthermore, there was an indirect effect between perinatal complications and social anxiety via BI. These findings provide further support for the established relation between perinatal complications and anxiety and demonstrate, for the first time, that this relation may be mediated by temperament, setting the stage for longitudinal analyses. Highlights Perinatal complications were associated with increased social anxiety and fearful temperament (i.e., behavioral inhibition). The relation between perinatal complications and social anxiety may be mediated by children's fearful temperament. Results support the established relation between perinatal complications and anxiety and show that this relation may be mediated by temperament.
Background Community engagement represents a highly relevant way to integrate care across sectors and address social and structural determinants of health with populations. Yet, advancement of integrated care remains a challenge, particularly across health and social service organizations. Situating social cognition as a key element of integrated care, this paper explores the act community engagement within cross-sector integrated care. Methods An integrative review was conducted to determine what is known about the influence of community engagement on stakeholder perspectives in cross-sector integrated care, and to contribute to a more comprehensive evidence base for building and operationalizing equitable integrated care. In March 2022, four data bases were systematically searched, applying no date limits, for English language articles that described community engagement in relation to integrated care and resulting stakeholder perspectives. Using matrices, numerous variables were extracted and synthesized using thematic analysis derived from the Rainbow Model of Integrated Care and a continuum of community engagement. Results In total, 13 studies were included in this analysis. Two studies included the hospital as a partner, and the rest were a mix of public, private health and social service sectors. Positive stakeholder perspectives (N = 6) were found in studies that were consultative or collaborative, and led with social capital, shared reciprocity, and trust. Moderate and negative perspectives (N = 7) were found in studies that led with a utilitarian stance and lacked collective leadership, governance, longitudinal planning, and joint evaluations. Conclusions This review makes a singular contribution to cross-sector integrated care literature, utilizing perspectives from health and social service organizations to map what is known about the influence of community engagement on cross-sector integrative care. Perspectives from this review support calls for additional integrative care research exploring community-hospital relationships, and how power dynamics influence proximal and distal relationships, capabilities, motivations, and opportunities for collaboration.
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