BACKGROUND AND OBJECTIVES: Despite the widespread epidemic of mass incarceration in the US, relatively little literature exists examining the longitudinal relationship between youth incarceration and adult health outcomes. We sought to quantify the association of youth incarceration with subsequent adult health outcomes.

IMPORTANCE Adverse childhood experiences (ACEs) are associated with long-term poor mental health. Less is known about factors that improve long-term mental health among those with ACEs. OBJECTIVE To evaluate, among those exposed to ACEs, whether team sports participation during adolescence is associated with better mental health in adulthood and whether the association between team sports participation and mental health varies by sex. DESIGN, SETTING, AND PARTICIPANTS This study used data from 9668 individuals who participated in waves 1 (1994-1995) and 4 (2008) of the National Longitudinal Study of Adolescent to Adult Health. Individuals were included if they had complete data on exposure to ACEs (physical and sexual abuse, emotional neglect, parental alcohol misuse, parental incarceration, and living with a single parent) and a valid sample weight. Statistical analysis was performed from November 6, 2017, to January 4, 2019. MAIN OUTCOMES AND MEASURES The association between team sports participation in grades 7 to 12 (wave 1) and diagnosis of depression and/or anxiety and current depressive symptoms (determined by Center for Epidemiologic Studies Depression scale-10 scores) at ages 24 to 32 years (wave 4) among individuals exposed to ACEs. Multivariable logistic regression models were weighted based on propensity scores for factors associated with team sports participation and controlled for individual, family, and school characteristics. Interaction terms tested whether associations between team sports participation and mental health varied by sex. RESULTS Of 9668 individuals included in the study (4470 male [50.0%]; mean [SD] age, 15.2 [1.75] years), 4888 (49.3%) reported 1 or more ACE and 2084 (21.3%) reported 2 or more ACEs. Among those with ACEs, team sports participation during adolescence was significantly associated with lower odds of receiving a diagnosis of depression (unadjusted rate, 16.8% vs 22.0%; propensity score-weighted [PSW] adjusted odds ratio [aOR], 0.76; 95% CI, 0.59-0.97) or anxiety (11.8% vs 16.8%; PSW aOR, 0.70; 95% CI, 0.56-0.89) and having current depressive symptoms (21.9% vs 27.5%; PSW aOR, 0.85; 95% CI, 0.71-1.01). There were no significant differences in associations between team sports participation and mental health by sex. Stratified analyses showed significant associations for all outcomes among males (depression: PSW aOR, 0.67 [95% CI, 0.46-0.99]; anxiety: PSW aOR, 0.66 [95% CI, 0.45-0.96]; depressive symptoms: PSW aOR, 0.75 [95% CI 0.56-0.99]) but only 1 outcome among females (anxiety: PSW aOR, 0.73; 95% CI, 0.54-0.98). CONCLUSIONS AND RELEVANCE Among individuals affected by ACEs, team sports participation in adolescence was associated with better adult mental health. Team sports may be an important and scalable resilience builder.

OBJECTIVES Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by challenges in social communication and interaction and restricted or repetitive behavior, interests, or activities. Although ASD symptoms generally manifest in early childhood, many individuals experience delays accessing an autism diagnosis and related services. In this study, we identify the individual, social, and structural factors that influence parents’ experiences of children’s ASD diagnosis. METHODS Parents of 25 children with autism participated in 60- to 90-minute semistructured in-person interviews. Interviews were recorded and transcribed verbatim. Transcripts were analyzed using the method of grounded theory. This inductive method allowed analysts to identify key themes related to participants’ experiences of children’s ASD diagnosis. RESULTS The process of ASD diagnosis reflects an odyssey that includes 3 key phases: the prediagnosis phase, in which “Making Sense of Child Difference” is a primary characteristic of participants’ experiences; the during-diagnosis phase, when “Navigating Diagnosis” suggests systematic barriers that influence the timing of ASD diagnosis; and the postdiagnosis phase, when participants’ experiences of “Connecting to Services” point to the important role that personal efforts play in gaining access to care. CONCLUSIONS In this study, we highlight individual, social, and structural factors that influence parent experiences before, during, and after their child’s autism diagnosis. Our findings indicate the need for more consistent and continuous support for autistic individuals and their families during the diagnostic odyssey, as well as resources that better represent the diversity of experiences and symptoms associated with autism across the life course.