Objective: Adverse childhood experiences, including abuse, neglect and household instability, affect lifelong health and economic potential. The present study investigates how adverse childhood experiences are associated with food insecurity by exploring caregivers' perceptions of the impact of their childhood adversity on educational attainment, employment and mental health. Design: Semi-structured audio-recorded in-person interviews that included (i) quantitative measures of maternal and child health, adverse childhood experiences (range: 0-10) and food security using the US Household Food Security Survey Module; and (ii) qualitative audio-recorded investigations of experiences with abuse, neglect, violence and hunger over participants' lifetimes.

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Despite evidence that school mental health can enhance access to care for students from marginalized racial/ethnic groups, disparities remain in the appropriateness, quality, effectiveness, and outcomes of school mental health services. Implementation strategies hold some promise for addressing the disparities that emerge as result of inequitable implementation of mental health services. However, without explicitly examining implementation strategies through an equity lens, it is unclear the extent to which they will promote equitable implementation or student outcomes. Thus, the goal of the current paper is to describe the Adapting Strategies to Promote Implementation Reach and Equity framework, a generalizable process for adapting implementation strategies to explicitly center the goal of reducing disparities in implementation and service recipient outcomes. We outline a three‐step process for incorporating an equity lens into implementation strategies and provide examples of how this framework can be applied to implementation strategies in school mental health. We also discuss examples of projects where implementation strategies were intentionally paired with school mental health programs to enhance racial equity. Implications and recommendations for school mental health and implementation research and practice are discussed.

Television advertising has been a primary method for marketing new health plans available under the Affordable Care Act (ACA) to consumers. Kantar Media/CMAG data were used to analyze advertising content during three ACA open enrollment periods (2013-2016). Few advertisement airings featured people who were elderly, disabled, or receiving care in a medical setting, and airings increasingly featured children, young adults and people exercising overtime. The most common informational messages focused on plan choice and availability of low-cost plans, but messages shifted over open enrollment cycles to emphasize avoidance of tax penalties and availability of financial assistance. Over the three open enrollment periods, there was a sharp decline in explicit mentions of the ACA or Obamacare in advertisements. Overall, television advertisements have increasingly targeted young, healthy consumers and informational appeals have shifted toward a focus on financial factors in persuading individuals to enroll in Marketplace plans. These advertising approaches make sense in the context of pressures to market plans to appeal to a sufficiently large, diverse group. Importantly, dramatic declines over time in explicit mention of the law mean that citizens may fail to understand the connection between the actions of government and the benefits they are receiving.

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Background: As the costs associated with obesity increase, it is vital to evaluate the effectiveness of chronic disease prevention among underserved groups, particularly in urban settings. This research study evaluated Philadelphia area Keystone First members and church participants enrolled in a group health education program to determine the impact of the Daniel Fast on physical health and the adoption of healthy behaviors. Methods: Participants attended six-weekly health education sessions in two participating churches, and were provided with a digital healthy eating platform. Results: There was a statistically significant decrease from baseline to post assessment for weight, waist circumference and cholesterol. Participants reported a significant improvement in their overall well-being, social and physical functioning, vitality and mental health. Conclusion: Results of this study demonstrate that dietary recommendations and comprehensive group health education delivered in churches and reinforced on a digital platform can improve physical health, knowledge and psychosocial outcomes.

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Objective: Mental health services are often implemented in settings in which mental health is not the primary mission. Schools, primary care clinics, criminal justice and child welfare institutions, and senior centers have been increasingly adding mental health care to their compendium of services owing to the high rates of mental health needs in these settings. Despite numerous challenges to implementing mental health practices in settings where mental health care has not traditionally been a part of the service model, the demand for mental health services in these settings is growing. Implementation science offers a lens through which to understand unique challenges and potential solutions to implementing mental health services in these settings, with the ultimate goal of ensuring the implementation of evidence-based services. Method and Results: In this conceptual article, we discuss common overarching barriers to implementing evidence-based mental health interventions in nonspecialty mental health settings, such as workforce challenges, competing priorities, and financial considerations. Then, using examples from schools and primary care, we elucidate unique contextual considerations and implementation challenges in these settings. Finally, we articulate a research agenda for advancing implementation of evidence-based practices in nonspecialty mental health including highlighting promising implementation strategies (e.g., task shifting, adaptation) and the most relevant implementation outcomes to assess in these contexts (e.g., appropriateness, feasibility). Conclusions: Given that nonspecialty mental health settings deliver a large proportion of mental health care to traditionally underserved populations, there are important public health implications to advancing research in this area and ensuring implemented services are evidence-based.