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.

We know little about why school administrators choose to adopt preventive mental health interventions within the context of school-based prevention trials. This study used a qualitative multiple-case study design to identify factors that influenced the adoption of a trauma-informed universal intervention by urban public school administrators during an efficacy trial. Semistructured interviews were conducted with 15 school administrators who adopted a traumainformed mindfulness intervention called RAP Club as part of their participation in a school-based trial with eighth graders. Findings indicated that administrators adopted RAP Club to provide support for students affected by trauma and prevent students from engaging in unhealthy coping behaviors. Examples of contextual factors that contributed to adoption included a lack of traumainformed mental health programs within schools, inadequate district funding for preventive school mental health services, and the perceived benefits of engaging in a university-community Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. http://www.springer.com/gb/openaccess/authors-rights/aam-terms-v1

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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