BackgroundThis study examined how mental health clinic administrators decided whether or not to adopt evidence-based and other innovative practices by exploring their views of implementation barriers and facilitators and operation of these views in assessment of implementation costs and benefits.MethodsSemi-structured interviews were conducted with 75 agency chief executive officers and program directors of 34 New York State-licensed mental health clinics serving children and adolescents.ResultsThree interconnected themes relating to barriers and facilitators were identified, namely costs and benefits associated with adoption, capacity for adoption, and acceptability of new practices. The highest percentage of participants (86.7%) mentioned costs as a barrier, followed by limited capacity (55.9%) and lack of acceptability (52.9%). The highest percentage (82.3%) of participants identified available capacity as a facilitator, followed by acceptability (41.2%) and benefits or limited costs (24.0%). Assessment of costs and benefits exhibited several principles of behavioural economics, including loss aversion, temporal discounting use of heuristics, sensitivity to monetary incentives, decision fatigue, framing, and environmental influences.ConclusionsThe results point to opportunities for using agency leader models to develop strategies to facilitate implementation of evidence-based and innovative practices for children and adolescents.

Young maternal age at birth has been consistently recognized as a factor contributing to externalizing behavior. However, estimates of the magnitude of this association across existing studies are inconsistent. Such inconsistencies cloud the interpretation of the literature and highlight the need for a systematic synthesis of existing empirical evidence. Further, the roles of possible moderators in the association remain to be revealed. Moderation analyses will enhance the field’s capacity to evaluate needs and locate a subgroup of children born to teen mothers with particularly heightened vulnerabilities. To address these gaps, the present study had two primary aims. First, a meta-analysis was conducted to quantify the magnitude of the association between being born to young mothers and children’s externalizing behavior across existing studies. Second, moderation meta-analyses were conducted to evaluate whether the influence of being born to teen mothers on children’s externalizing behavior is stronger during specific developmental periods, for a specific gender, for a specific race, or across contexts with varying teen pregnancy rates at a societal level. The current study followed the PRISMA guidelines. The search utilized multiple electronic databases including Web of Science, ProQuest, PubMed, and Ovid MEDLINE through July 2019. Standardized mean difference, Cohen’s d , was used as a summary estimate of effect size. A random-effects model was conducted. Moderating effects were evaluated. Twenty-one effect sizes from 18 independent samples ( n = 133,585) were included in the meta-analysis. The main meta-analysis and sensitivity analysis suggested a small yet robust association between teenage motherhood and children’s externalizing behavior problems. The relevant moderation analyses detected no statistically significant moderating effect for a specific gender, for racial and ethnic minority groups, during a specific developmental period, or across varying contexts. The current meta-analysis findings suggest that the impact of young maternal age on children’s externalizing behavior is small, yet independent. Further, such impacts of young maternal age were similar for girls and boys, in different racial and ethnic groups, across developmental periods, and across different contexts with varying teen pregnancy rates. Prevention efforts seeking to curb the emergence of youth’s externalizing behavior should focus on parenting teens, regardless of their child’s gender, race, age, or contexts. Further, the current findings suggest that prevention strategies for this specific group may benefit from a hybrid approach that combines universal, selective, and indicated prevention strategies.

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Introduction: Adolescent birth is a known correlate of many challenging behavioral health consequences for offspring. This systematic review seeks to understanding the sex and substance use behaviors of children born to teen mothers extending the body of literature on the long-term outcomes of being born to a teen mother.Methods: A systematic approach, in accordance with PRISMA guidelines, was used to review and identify eligible studies in the following electronic databases: Web of Science, ProQuest, PubMed, and Ovid MEDLINE. Study inclusion: (a) maternal age (> 20) was the key predictor or group variable and (b) children's risky sexual or substance use behaviors were outcome variables. All articles meeting inclusion criteria were next screened using the quality assessment tool created by the Effective Public Health Practice Project.Results: Seventeen articles reporting on risky sexual behaviors and 12 articles on substance use behaviors met inclusion criteria. We found a consistent association between being born to a teen mother and risky sexual behaviors, including early sexual debut and transitioning into motherhood during adolescence/young adulthood. The link between being born to a teen mother and substance use behaviors was inconsistent and only found in large population-based studies. Conclusion:Teen mothers and their children have unique individual, family, and structural needs. Evidence highlights that while there is no clear need to adapt substance use prevention interventions for these children, investing in targeted adaptations of abstinence and safer sex interventions to meet the unique experiences of children of teen mothers and their children is warranted.

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