Together, better youth adherence and higher QOL are two mechanisms by which more AP indirectly relates to better glycemic control during the early adolescent years.

Despite the growth of behavioral health services in the United States, reports show persistent disparities in racial and ethnic minority populations' access to them. Primary care practices are often where patients go first for their medical and mental healthcare, placing the burden for treatment of behavioral health problems on primary care physicians. Integrated behavioral healthcare (IBHC), which embeds behavioral health clinicians in medical settings, is growing rapidly and should become an important component of the healthcare system. This paper proposes IBHC as a solution to reduce disparities in access to behavioral health services for underserved populations, specifically Latinx and African American populations, as well as racial and ethnic minority youth. The authors surveyed the literature to describe the history and current use of IBHC and present the case for addressing the behavioral health needs of underserved populations with IBHC. Research suggests that patients treated in IBHC settings experience an improvement in their symptoms and functioning across behavioral health problems. Furthermore, IBHC patients in primary care clinics report satisfaction with care and strong therapeutic alliance with behavioral health clinicians. Preliminary research suggests that IBHC may also reduce stigma and cultural barriers in underserved racial and ethnic minority populations. IBHC provides a unique opportunity to fulfill a critical need by meeting patients where they are. Therefore, we need to focus on improving and expanding IBHC for underserved racial and ethnic minority communities. What is the significance of this article for the general public?This paper outlines current barriers to accessing behavioral healthcare for Latinx, African American, and racial and ethnic minority youth and how IBHC combats those barriers. Additionally, it highlights outcomes of brief behavioral interventions and patient and physician satisfaction with IBHC. IBHC is a viable option for providing behavioral healthcare to underserved patient populations.

Compared to their peers, Latina/o youth are at high risk of being overweight and obese and experiencing related health problems. Because of this, it is important to identify factors that may contribute to obesity among Latina/o youth. We explored the relationships among internal health locus of control (IHLOC), cultural factors (cultural orientation, ethnic identity), and Latina/o adolescents' body mass index (BMI; an index of obesity and overweight). One hundred twenty-eight Latina/o adolescents (ages 13-18 years) completed a series of questionnaires to assess ethnic identity (i.e., affirmation-belonging and participation), cultural orientation (i.e., Latina/o cultural orientation and Anglo cultural orientation), and IHLOC. We also obtained participants' reports of weight and height, which were used to calculate BMI. Results indicated that there was an inverse association between IHLOC and BMI; specifically, the greater internal control the adolescents perceived they had over their health, the lower their BMI. As expected, Latina/o cultural orientation moderated this relation, such that at moderate and high levels of Latina/o cultural orientation, IHLOC was associated with lower BMI. Contrary to expectations, ethnic identity affirmation-belonging moderated this relation in the opposite direction, such that at low and moderate levels of ethnic identity affirmation-belonging, IHLOC was associated with lower BMI. The importance of IHLOC, cultural factors, and context in obesity among Latina/o youth and the implications of these results for obesity intervention programming are discussed.

Sleep is a critical component of healthy development for youth, with cascading effects on youth’s biological growth, psychological well-being, and overall functioning. Increased sleep difficulties are one of many disruptions that adopted youth may face throughout the adoption process. Sleep difficulties have been frequently cited as a major concern by adoptive parents and hypothesized in the literature as a problem that may affect multiple areas of development and functioning in adopted youth. However, there is limited research exploring this relationship. Using a biopsychosocial framework, this paper reviews the extant literature to explore the development, maintenance, and impact of sleep difficulties in adopted youth. Finally, implications for future research and clinical interventions are outlined.

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