Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood. However, basic information about how the prevalence of ADHD varies by race/ethnicity, sex, age, and socio-economic status remains poorly described. One reason is that difficulties in the diagnosis of ADHD have translated into difficulties developing an adequate case definition for epidemiologic studies. Diagnosis depends heavily on parent and teacher reports; no laboratory tests reliably predict ADHD. Prevalence estimates of ADHD are sensitive to who is asked what, and how information is combined. Consequently, recent systematic reviews report ADHD prevalence estimates as wide as 2%-18%. The diagnosis of ADHD is complicated by the frequent occurrence of comorbid conditions such as learning disability, conduct disorder, and anxiety disorder. Symptoms of these conditions may also mimic ADHD. Nevertheless, we suggest that developing an adequate epidemiologic case definition based on current diagnostic criteria is possible and is a prerequisite for further developing the epidemiology of ADHD. The etiology of ADHD is not known but recent studies suggest both a strong genetic link as well as environmental factors such as history of preterm delivery and perhaps, maternal smoking during pregnancy. Children and teenagers with ADHD use health and mental health services more often than their peers and engage in more health threatening behaviors such as smoking, and alcohol and substance abuse. Better methods are needed for monitoring the prevalence and understanding the public health implications of ADHD. Stimulant medication is the treatment of choice for treating ADHD but psychosocial interventions may also be warranted if comordid disorders are present. The treatment of ADHD is controversial because of the high prevalence of medication treatment. Epidemiologic studies could clarify whether the patterns of ADHD diagnosis and treatment in community settings is appropriate. Population-based epidemiologic studies may shed important new light on how we understand ADHD, its natural history, its treatment and its consequences.

The continuously growing demand for program results has produced an increased need for evaluation capacity building (ECB). The Integrative ECB Model was developed to integrate concepts from existing ECB theory literature and to structure a synthesis of the empirical ECB literature. The study used a broad-based research synthesis method with systematic decision rules and demonstrates the viability of the method for producing a reliable analysis of disparate data from a variety of designs. There was a high degree of consistency in what was reported in the empirical literature and the theoretical literature in terms of strategies and outcomes. Reported outcomes at the individual level included attitudes, knowledge, and behaviors and at the organizational level included practices, leadership, culture, mainstreaming, and resources. Collaborative processes and programmatic outcomes emerged as important issues for ECB models and practice. The consistency between the empirical and the theoretical literature indicates that the field is ready to develop common measures, use stronger designs, and report more systematically. This synthesis provides an overview of existing data and an empirical basis for refining strategies and common measures for enhancing the research and practice of ECB to achieve ECB and programmatic goals and outcomes.

BACKGROUND: Because little is known about long-term effects of adolescent protective factors across multiple health domains, we examined associations between adolescent connectedness and multiple health-related outcomes in adulthood. METHODS: We used weighted data from Waves I and IV of the National Longitudinal Study of Adolescent to Adult Health (n = 14 800). Linear and logistic models were used to examine associations between family and school connectedness in adolescence and self-reported health risk behaviors and experiences in adulthood, including emotional distress, suicidal thoughts and attempts, physical violence victimization and perpetration, intimate partner physical and sexual violence victimization, multiple sex partners, condom use, sexually transmitted infection (STI) diagnosis, prescription drug misuse, and other illicit drug use. RESULTS: In multivariable analyses, school connectedness in adolescence had independent protective associations in adulthood, reducing emotional distress and odds of suicidal ideation, physical violence victimization and perpetration, multiple sex partners, STI diagnosis, prescription drug misuse, and other illicit drug use. Similarly, family connectedness had protective effects for emotional distress, all violence indicators, including intimate partner violence, multiple sex partners, STI diagnosis, and both substance use indicators. Compared to individuals with low scores for each type of connectedness, having high levels of both school and family connectedness was associated with 48% to 66% lower odds of health risk behaviors and experiences in adulthood, depending on the outcome. CONCLUSIONS: Family and school connectedness may have long-lasting protective effects across multiple health outcomes related to mental health, violence, sexual behavior, and substance use. Increasing both family and school connectedness during adolescence has the potential to promote overall health in adulthood.

OBJECTIVE. In this study we identified child and family-level characteristics that were associated with medication treatment for attention-deficit/hyperactivity disorder using nationally representative survey data.METHODS. National Survey of Children's Health data from 79 264 youth 4 to 17 years of age were used. Data were weighted to adjust for the complex survey design of the National Survey of Children's Health. Gender-specific logistic regression models were generated to identify child and family-level characteristics that were collectively associated with current medication status among youth with a reported diagnosis of attention-deficit/hyperactivity disorder.RESULTS. Nationally, 7.8% of youth aged 4 to 17 years had a reported attentiondeficit/hyperactivity disorder diagnosis, and 4.3% had both a disorder diagnosis and were currently taking medication for the disorder. Current medication treatment among youth with attention-deficit/hyperactivity disorder was associated with white race, younger age, English spoken in the home, health care coverage, a health care contact within the last year, and reported psychological difficulties. Gender-specific logistic regression models revealed that, together, younger age, higher income, health care coverage, having psychological difficulties, and a health care contact in the past year were associated with medication use among boys with attention-deficit/hyperactivity disorder. Among girls with the disorder, younger age, psychological difficulties, fair-to-poor paternal mental health status, and a health care contact within the last year were collectively associated with current medication use.CONCLUSIONS. Regardless of gender, younger age, the presence of psychological difficulties, and a recent health care contact were significantly associated with medication treatment for attention-deficit/hyperactivity disorder. However, additional health care access and income variables among boys and paternal mental health status among girls represented gender-specific factors that were also associated with medication treatment for the disorder. Future studies should characterize how and when the burden associated with attention-deficit/hyperactivity disorder leads to treatment, support, or services for this prevalent and impairing neurobehavioral disorder. suggest that many people with mental disorders experience significant delays or never receive mental health care. Clearly, there is a gap between the recognition of mental health problems and the initiation of treatment, such that simply meeting the diagnostic criteria for a disorder does not entirely explain diagnosis, help-seeking, and treatment patterns. [2][3][4][5][6] For youth, factors leading to mental health treatment are further complicated because parents and guardians often act as gatekeepers to identification and treatment. 7 Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric conditions of childhood, 8 with recent population-based studies reporting rates of diagnosed ADHD...

The present study examined the relationship among acculturation, familismo, and HIV-related adolescent sexual risk behavior. Data were collected from Latino mother-adolescent dyads to permit parent and adolescent analyses of familismo for predicting oral, vaginal, and anal sexual behaviors. A random sample of 702 Latino eighth-grade students and their mothers was recruited from New York City. The sample included Mexicans (n = 203), Puerto Ricans (n = 239), and Dominicans (n = 260). Acculturation was unrelated to sexual behavior, but adolescent familismo was related to girls' but not boys' sexual behavior. The most important facet of familismo was subjugation to the family, which was negatively associated with girls' sexual behavior. The implications for HIV prevention programs for Latino youth are discussed.

In the field of teen pregnancy prevention many efficacious prevention programs are available but adoption of these programs is slow at the community level. In this article, we present a multi-site, capacity-building effort called the Promoting Science-based Approaches to Teen Pregnancy Prevention project (PSBA) as a case example of a proactive application of the Interactive System Framework (ISF) for dissemination and implementation. The ISF is a multi-system model leading to dissemination and implementation of science-based prevention programming through the work of three interactive systems: The "Prevention Delivery," "Prevention Support," and "Prevention Synthesis & Translation" Systems. This article describes the proactive use of the ISF to conceptualize and bolster the PSBA program's goal of assisting local prevention partners in the use of science-based approaches (SBA) to prevent teen pregnancy. PSBA uses all three systems of the ISF to facilitate practice improvements and offers valuable research opportunities to investigate factors related to dissemination and implementation processes across these systems. Describing our application of this framework highlights the feasibility of actively using the ISF to build prevention infrastructure and to guide large-scale prevention promotion strategies in the area of teen pregnancy prevention. The program's ongoing evaluation is presented as an example of early efforts to develop an evidence base around the ISF. Research implications are discussed.

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Black and Latino young men who have sex with men (YMSM) are at disproportionate risk for sexually transmitted diseases (STDs), including HIV. This study informs school-centered strategies for connecting YMSM to health services by describing their willingness, perceived safety, and experiences in talking to school staff about sexual health. Cross-sectional data were collected from black and Latino YMSM ages 13–19 through Web-based questionnaires (n=415) and interviews (n=32). School nurses were the staff members youth most often reported willingness to talk to about HIV testing (37.8%), STD testing (37.1%), or condoms (37.3%), but least often reported as safe to talk to about attraction to other guys (11.4%). Interviews revealed youth reluctance to talk with school staff including nurses when uncertain of staff members’ perceptions of LGBTQ people or perceiving staff to lack knowledge of LGBTQ issues, communities, or resources. Nurses may need additional training to effectively reach black and Latino YMSM.