Julia Raney

All Publications

• Sexual Identity Is Associated With Adverse Childhood Experiences in US Early Adolescents. Academic pediatrics Raney, J. H., Weinstein, S., Testa, A., Ganson, K. T., Memon, Z., Glidden, D. V., Baker, F. C., Brindis, C. D., Nagata, J. M. 2025; 25 (1): 102555

  Abstract

  To determine disparities in adverse childhood experiences (ACEs) by sexual identity in a national cohort of early adolescents.We analyzed cross-sectional data from year 2 of the Adolescent Brain Cognitive Development study (N = 10,934, 2018-20, ages 10-14 years). Disparities in ACE scores across lesbian, gay, or bisexual (LGB), not sure, and heterosexual adolescents were assessed using multinomial logistic regression analyses. Logistic regressions estimated the associations between sexual identity and each individual ACE. Analyses were adjusted for potential confounders.In adjusted models, LGB adolescents had a higher risk of experiencing 2, 3, or ≥4 ACEs (relative risk ratios [RRR] = 1.57, 95% Confidence Interval (CI) 1.01-2.42), 3 (RR = 1.78, 95% CI 1.100-2.88), or ≥4 ACEs (RRR = 3.20, 95% CI 1.92-5.32), and not sure adolescents had a higher risk of having ≥4 ACEs (RRR = 2.17, 95% CI 1.22-3.87), compared to heterosexual adolescents. LGB and not sure adolescents had higher risks of reporting emotional abuse ("yes" OR = 4.21, 95% CI 1.84-9.61; "maybe" OR = 6.20, 95% CI 2.91-13.19) and parent mental illness ("yes" OR = 1.95, 95% CI 1.48-2.57; "maybe" OR = 1.63, 95% CI 1.21-2.18) compared to heterosexual adolescents.LGB adolescents and those questioning their sexual identity were at greater risk of having higher ACE scores, with LGB adolescents experiencing the highest risk of experiencing ACEs. LGB adolescents also had higher odds of reporting emotional and parent mental illness. Recognizing this heightened risk of ACEs in early adolescence is critical for designing clinic and school-based interventions.

  View details for DOI 10.1016/j.acap.2024.07.022

  View details for PubMedID 39134208

  View details for PubMedCentralID PMC11805669

• Associations of adverse childhood experiences with blood pressure among early adolescents in the United States. American journal of preventive cardiology Al-Shoaibi, A. A., Lee, C. M., Raney, J. H., Ganson, K. T., Testa, A., Dooley, E. E., Gooding, H. C., Gabriel, K. P., Baker, F. C., Nagata, J. M. 2024; 20: 100883

  Abstract

  The associations of adverse childhood experiences (ACEs) with blood pressure in adulthood are inconclusive. Similarly, the association between ACEs and blood pressure earlier in the life course is understudied. This study aims to assess the associations of ACEs with blood pressure among early adolescents. We utilized data collected at baseline (age: 9-10 years) and Year 2 follow-up from 4077 participants in the Adolescent Brain Cognitive Development (ABCD) Study. We used adjusted multiple linear regression models to estimate the associations of ACEs (cumulative score and subtypes) at baseline with systolic blood pressure (SBP) and diastolic blood pressure (DBP) at year 2 of follow-up. Experiencing ≥4 ACEs (compared to 0) was significantly associated with higher SBP (B = 3.31, 95 % CI 0.03, 6.57, p = 0.048). Of the ACEs subtypes, household substance use (B = 2.28, 95 % CI 0.28, 4.28, p = 0.028) and divorce or separation (B = 2.08, 95 % CI 0.01, 4.15, p = 0.048) were both significantly associated with a higher SBP while household mental illness (B = 2.57, 95 % CI 1.32, 3.81, p < 0.001) was significantly associated with a higher DBP. Our findings suggest that exposure to multiple ACEs is associated with higher blood pressure in adolescence.

  View details for DOI 10.1016/j.ajpc.2024.100883

  View details for PubMedID 39507937

  View details for PubMedCentralID PMC11539657

• Sexual orientation discrimination and eating disorder symptoms in early adolescence: a prospective cohort study. Journal of eating disorders Nagata, J. M., Diep, T., Helmer, C. K., Domingue, S. K., Al-Shoaibi, A. A., Raney, J. H., Ganson, K. T., Testa, A., He, J., Brindis, C. D., Baker, F. C. 2024; 12 (1): 196

  Abstract

  Sexual orientation discrimination increases the risks of negative health outcomes for sexual minorities. Previous studies have found increased rates of eating disorder symptoms in sexual minority individuals, which is attributable to minority stress and discrimination that they experience. Emerging research suggests relationships between sexual orientation discrimination and eating disorder symptoms. However, there is a lack of studies focusing on early adolescents. The objective of this study was to determine prospective associations between discrimination based on sexual orientation and eating disorder symptoms in a national sample of 10-13-year-old early adolescents in the U.S.We examined prospective data from Year 2 (2018-2020) and Year 3 (2019-2021) of the Adolescent Brain Cognitive Development (ABCD) Study (N = 8976). Multiple logistic regression analyses were used to estimate associations between self-reported experiences of sexual orientation discrimination in Year 2 and eating disorder symptoms in Year 3, adjusting for potential confounders, including eating disorder symptoms in Year 2. Sexual orientation discrimination was assessed based on the Perceived Discrimination Scale, which measures adolescents' perception of being treated unfairly based on various sociodemographic characteristics. Eating disorder symptoms were based on the parent-reported Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5).In this demographically diverse sample of early adolescents (N = 8976, age range 10-13 years at Year 2), 5.5% of adolescents reported sexual orientation discrimination in Year 2. The prevalence of parent-reported eating disorder symptoms in Year 3 varied from 1.0 to 8.3%. In the adjusted models, sexual orientation discrimination was prospectively associated with worry about weight gain (adjusted odds ratio [aOR] 2.33, 95% confidence interval [CI] 1.15-4.69) and self-worth tied to weight (aOR 1.60, 95% CI 1.01-2.53) one year later.Early adolescents who have experienced sexual orientation discrimination have higher odds of experiencing eating disorder symptoms, particularly worrying about weight gain and tying self-worth to weight. Clinicians may consider screening for sexual orientation discrimination and providing affirmative, trauma-informed care when evaluating and treating even younger sexual minority adolescents for eating disorder symptoms.

  View details for DOI 10.1186/s40337-024-01157-y

  View details for PubMedID 39614397

  View details for PubMedCentralID PMC11606175

• Transgender Identity and Attention Deficit Hyperactivity Disorder Symptoms: Findings From the Adolescent Brain Cognitive Development Study. The Journal of adolescent health : official publication of the Society for Adolescent Medicine Ignatova, E., Balasubramanian, P., Raney, J. H., Ganson, K. T., Testa, A., He, J., Baker, F. C., Nagata, J. M. 2024

  Abstract

  The purpose of this study was to examine associations between identifying as transgender and attention deficit hyperactivity disorder (ADHD) symptoms in US early adolescents.We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (Year 3, 2019-2021) to estimate associations between gender identity and ADHD symptoms using the Child Behavior Checklist Diagnostic and Statistical Manual of Mental Disorders-oriented attention problem scale scores, adjusting for age, sex, ethnicity, parent education, household income, and study site. Additional models adjusted for stress problems and depression symptoms. Multiple linear regression analyses estimated the association between gender identity and ADHD symptoms.In a sample of 10,277 adolescents, mostly 12-13-year-olds, 1.0% self-identified as transgender and 1.1% self-identified as gender-questioning. Self-reported transgender status (B = 3.41; 95% confidence interval = 0.79-6.04; p = .011) and gender-questioning status (B = 2.72; 95% confidence interval = 0.79-4.65; p = .006) were both associated with higher ADHD symptom scores when compared to cisgender peers after adjusting for sociodemographic variables. In models adjusting for stress problems and depression as well as sociodemographic variables, the associations between transgender and gender-questioning status and ADHD symptoms were attenuated and no longer statistically significant.Our results indicate that gender minority status may be linked to higher ADHD symptom scores, potentially due to higher minority stress.

  View details for DOI 10.1016/j.jadohealth.2024.10.015

  View details for PubMedID 39601720

• Associations Between Adverse Childhood Experiences and Early Adolescent Physical Activity in the United States. Academic pediatrics Al-Shoaibi, A. A., Iyra, P., Raney, J. H., Ganson, K. T., Dooley, E. E., Testa, A., Jackson, D. B., Gabriel, K. P., Baker, F. C., Nagata, J. M. 2024; 24 (4): 662-668

  Abstract

  To determine the associations between the number of adverse childhood experiences (ACEs) and objectively-measured physical activity (PA) in a population-based, demographically diverse cohort of 9-14-year-olds and to determine which subtypes of ACEs were associated with physical activity levels.We analyzed data (n = 7046) from the Adolescent Brain Cognitive Development (ABCD) Study 4.0 release at baseline and year 2 follow-up. ACE (cumulative score and subtypes) and physical activity (average Fitbit daily steps assessed at Year 2) were analyzed using linear regression analyses. Covariates included race and ethnicity, sex, household income, parent education, body mass index, study site, twins/siblings, and data collection period.Adjusted models suggest an inverse association between number of ACEs and Fitbit daily steps, with ≥4 (compared to 0) ACEs associated with 567 fewer daily steps (95% CI -902.2, -232.2). Of the ACEs subtypes, emotional abuse (B = -719.3, 95% CI -1430.8, -7.9), physical neglect (B = -423.7, 95% CI -752.8, -94.6), household mental illness (B = -317.1, 95% CI -488.3, -145.9), and household divorce or separation (B = -275.4, 95% CI -521.5, -29.2) were inversely and statistically significant associated with Fitbit daily steps after adjusting for confounders.Our results suggest that there is an inverse, dose-dependent relationship between cumulative number of ACEs and physical activity as measured by daily steps. This work highlights the importance of screening for ACEs among young people at an early age to help identify those who could benefit from interventions or community programs that support increased physical activity.

  View details for DOI 10.1016/j.acap.2023.10.004

  View details for PubMedID 37898383

  View details for PubMedCentralID PMC11045661

• Mental Well-Being Among Adversity-Exposed Adolescents During the COVID-19 Pandemic. JAMA network open Raney, J. H., Weinstein, S., Ganson, K. T., Testa, A., Jackson, D. B., Pantell, M., Glidden, D. V., Brindis, C. D., Nagata, J. M. 2024; 7 (3): e242076

  Abstract

  Further research is needed to understand factors associated with well-being during the COVID-19 pandemic among adolescents who have experienced adverse childhood experiences (ACEs).To explore factors associated with improved mental health during the COVID-19 pandemic among adolescents who have experienced ACEs.This cross-sectional study used data from the baseline (2016-2018) and sixth (March 2021) COVID Rapid Response Research (RRR) surveys of the Adolescent Brain Cognitive Development study, which includes 21 sites across the US. Adolescents aged 11 to 15 years who completed the COVID RRR mental health measures were included. Data analyses were conducted from June to August 2023.School-based factors (eg, in-person school) and 8 coping behaviors (eg, exercise).The primary outcomes were adolescent-reported positive affect (PA) and perceived stress (PS). Adolescents were stratified by no ACEs, low-to-intermediate ACEs (1-3), and high ACEs (≥4). Linear regressions estimated associations between factors and mental health, adjusting for potential confounders. Unstandardized beta coefficients (B) were compared with equality of coefficients tests.The 4515 adolescents in this study (mean [SD] age, 13.3 [0.88] years; 51% [95% CI, 50% to 53%] female) were racially and ethnically diverse (American Indian/Alaska Native, 2% [95% CI, 2% to 3%]; Asian, 8% [95% CI, 7% to 9%]; Black, 11% [95% CI, 10% to 12%]; Latino or Hispanic, 17% [95% CI, 15% to 18%]; White, 61% [95% CI, 60% to 63%]; other, 1% [95% CI, 0% to 2%]). For youths with high ACEs, caring for one's body (PA B = 4.02 [95% CI, 1.39 to 6.66]; PS B = -0.92 [95% CI, -1.84 to 0.00]), exercising (PA B = 3.19 [95% CI, 0.46 to 5.92]; PS B = -1.41 [95% CI, -2.40 to -0.43]), and engaging in healthy behaviors (PA B = 4.07 [95% CI, 1.28 to 6.84]; PS B = -1.01 [95% CI, -1.98 to -0.05]) were associated with higher PA and lower PS scores. In-person schooling had a greater impact on PA scores for youths with high ACEs (B = 5.55 [95% CI, 2.08 to 9.01]) than youths with low-to-intermediate ACEs (B = 1.27 [95% CI, 0.27 to 2.27]).These findings suggest that in-person schooling and several coping behaviors (caring for one's body, exercising, and engaging in healthy behaviors) were associated with significantly higher PA and lower PS during the COVID-19 pandemic among adolescents with high ACEs. Adolescents with high ACEs demonstrated especially greater mental health scores when they reported in-person schooling. Future studies should build on these findings to identify clinical and school-based mental health protective factors for adolescents with high ACE risk.

  View details for DOI 10.1001/jamanetworkopen.2024.2076

  View details for PubMedID 38477919

  View details for PubMedCentralID PMC10938185

• The Association Between Adverse Childhood Experiences (ACEs), Bullying Victimization, and Internalizing and Externalizing Problems Among Early Adolescents: Examining Cumulative and Interactive Associations. Journal of youth and adolescence Trompeter, N., Testa, A., Raney, J. H., Jackson, D. B., Al-Shoaibi, A. A., Ganson, K. T., Shao, I. Y., Nagata, J. M. 2024; 53 (3): 744-752

  Abstract

  Both adverse childhood experiences (ACEs) and bullying victimization are linked with mental health problems in adolescents. However, little is known about the overlap between the two factors and how this impacts adolescent mental health problems (i.e., internalizing and externalizing problems). The current study analyzed data from 8,085 participants (47.7% female; 44.1% racial/ethnic minority) in the Adolescent Brain Cognitive Development (ABCD) study, baseline (2016-2018, ages 9-10 years) to Year 2. Regression analyses were used to estimate associations between ACEs, bullying victimization and mental health problems, respectively, adjusting for sex, race/ethnicity, country of birth, household income, parental education, and study site. The findings showed that both ACEs and bullying victimization were independently associated with higher internalizing and higher externalizing problems. However, no significant interaction was found between ACEs and bullying victimization. Overall, the results align with the cumulative risk model of adversity, linking cumulative ACEs and bullying victimization to internalizing and externalizing problems in early adolescents.

  View details for DOI 10.1007/s10964-023-01907-2

  View details for PubMedID 38066316

  View details for PubMedCentralID PMC10838217

• Adverse childhood experiences and unhealthy dietary behaviours in adulthood. Public health nutrition Testa, A., Zhang, L., Jackson, D. B., Ganson, K. T., Raney, J. H., Nagata, J. M. 2024; 27 (1): e40

  Abstract

  This study assesses the relationship between adverse childhood experiences (ACE) occurring before the age of 18 years and patterns of fast-food consumption and sugary beverage consumption in adulthood. The study also examines how perceived stress and socio-economic status (SES) (college educational attainment and income) in adulthood mediate this relationship.Using data from the National Longitudinal Study of Adolescent to Adulthood Health (N 8599), multinomial logistic regression analyses were carried out to assess the association between ACE and unhealthy dietary behaviours in adulthood. Karlson-Holm-Breen mediation analysis is used to determine the mediating effects of SES and perceived stress.Persons living in the USA in 2016-2018.Adults (n 8599) aged 33-44 years.The findings show an association between four or more ACE and high fast-food (relative risk ratio (RRR) = 1·436, 95 % CI = 1·040, 1·983) and high sugary beverage consumption (RRR = 1·435, 95 % CI = 1·002, 2·055). The association between ACE and high fast-food consumption is partially mediated by college educational attainment, and the association between ACE and high sugary beverage consumption is partially mediated by perceived stress and college educational attainment.ACE can have long-term consequences for unhealthy dietary behaviours in adulthood, and this relationship is partially due to a lower likelihood of higher perceived stress and college educational attainment among ACE-exposed persons. Future research is needed to understand further the influence of ACE on dietary patterns over the life course.

  View details for DOI 10.1017/S1368980024000144

  View details for PubMedID 38234114

  View details for PubMedCentralID PMC10882537

• Racial discrimination is associated with binge-eating disorder in early adolescents: a cross-sectional analysis. Journal of eating disorders Raney, J. H., Al-Shoaibi, A. A., Shao, I. Y., Ganson, K. T., Testa, A., Jackson, D. B., He, J., Glidden, D. V., Nagata, J. M. 2023; 11 (1): 139

  Abstract

  Racial and ethnic discrimination are known stressors and are associated with negative psychological and physical health outcomes. Previous studies have found relationships between racial/ethnic discrimination and binge-eating disorder (BED), though they have mainly focused on adult populations. The aim of this study was to determine associations between racial/ethnic discrimination and BED in a large, national cohort study of early adolescents. We further sought to explore associations between the racial/ethnic discrimination perpetrator (students, teachers, or other adults) and BED.We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (N = 11,075, 2018-2020). Logistic regression analyses examined associations between self-reported experiences of racial or ethnic discrimination and binge-eating behaviors and diagnosis, adjusting for potential confounders. Racial/ethnic discrimination measures were assessed based on the Perceived Discrimination Scale, which measures experiences of discrimination based on race/ethnicity and frequency of ethnic discrimination by teachers, adults outside of school, and students. Binge-eating behaviors and diagnosis were based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSAD-5).In this racially diverse sample of adolescents (N = 11,075, age range 9-12 years), 4.7% of adolescents reported racial or ethnic discrimination and 1.1% met the criteria for BED. In the adjusted models, racial/ethnic discrimination was associated with 3 times higher odds of having BED (OR 3.31, CI 1.66-7.74). Further, experiences of ethnic discrimination by students and adults outside school were associated with significantly increased odds of BED diagnosis (OR 1.36, CI 1.10-1.68 and OR 1.42 CI 1.06-1.90, respectively)., Increased odds of binge eating behaviors were only significantly associated with ethnic discrimination perpetuated by students (OR 1.12, CI 1.02-1.23).Children and adolescents who have experienced racial/ethnic discrimination, particularly when discrimination was perpetuated by other students, have higher odds of having binge-eating behaviors and diagnoses. Clinicians may consider screening for racial discrimination and providing anti-racist, trauma-informed care when evaluating and treating patients for BED.

  View details for DOI 10.1186/s40337-023-00866-0

  View details for PubMedID 37592364

  View details for PubMedCentralID PMC10433622

• Associations between adverse childhood experiences and early adolescent problematic screen use in the United States. BMC public health Raney, J. H., Al-Shoaibi, A. A., Ganson, K. T., Testa, A., Jackson, D. B., Singh, G., Sajjad, O. M., Nagata, J. M. 2023; 23 (1): 1213

  Abstract

  Problematic screen use, defined as an inability to control use despite private, social, and professional life consequences, is increasingly common among adolescents and can have significant mental and physical health consequences. Adverse Childhood Experiences (ACEs) are important risk factors in the development of addictive behaviors and may play an important role in the development of problematic screen use.Prospective data from the Adolescent Brain Cognitive Development Study (Baseline and Year 2; 2018-2020; N = 9,673, participants who did not use screens were excluded) were analyzed in 2023. Generalized logistic mixed effects models were used to determine associations with ACEs and the presence of problematic use among adolescents who used screens based on cutoff scores. Secondary analyses used generalized linear mixed effects models to determine associations between ACEs and adolescent-reported problematic use scores of video games (Video Game Addiction Questionnaire), social media (Social Media Addiction Questionnaire), and mobile phones (Mobile Phone Involvement Questionnaire). Analyses were adjusted for potential confounders including age, sex, race/ethnicity, highest parent education, household income, adolescent anxiety, depression, and attention-deficit symptoms, study site, and participants who were twins.The 9,673 screen-using adolescents ages 11-12 years old (mean age 12.0) were racially and ethnically diverse (52.9% White, 17.4% Latino/Hispanic, 19.4% Black, 5.8% Asian, 3.7% Native American, 0.9% Other). Problematic screen use rates among adolescents were identified to be 7.0% (video game), 3.5% (social media), and 21.8% (mobile phone). ACEs were associated with higher problematic video game and mobile phone use in both unadjusted and adjusted models, though problematic social media use was associated with mobile screen use in the unadjusted model only. Adolescents exposed to 4 or more ACEs experienced 3.1 times higher odds of reported problematic video game use and 1.6 times higher odds of problematic mobile phone use compared to peers with no ACEs.Given the significant associations between adolescent ACE exposure and rates of problematic video and mobile phone screen use among adolescents who use screens, public health programming for trauma-exposed youth should explore video game, social media, and mobile phone use among this population and implement interventions focused on supporting healthy digital habits.

  View details for DOI 10.1186/s12889-023-16111-x

  View details for PubMedID 37349707

  View details for PubMedCentralID PMC10286460

• Adverse childhood experiences and early adolescent cyberbullying in the United States. Journal of adolescence Nagata, J. M., Trompeter, N., Singh, G., Raney, J., Ganson, K. T., Testa, A., Jackson, D. B., Murray, S. B., Baker, F. C. 2023; 95 (3): 609-616

  Abstract

  With the increasing use of social media and online platforms among adolescents, the relationship between traumatic life events and cyberbullying remains unclear. This study aimed to determine the associations between adverse childhood experiences (ACEs) and cyberbullying victimization among a racially/ethnically and socioeconomically diverse sample of early adolescents.We analyzed longitudinal data from 10,317 participants in the Adolescent Brain Cognitive Development (ABCD) study, baseline (2016-2018, ages 9-10 years) to Year 2. Logistic regression analyses were used to estimate associations between ACEs and cyberbullying victimization, adjusting for sex, race/ethnicity, country of birth, household income, parental education, and study site.In the sample (48.7% female, 46.0% racial/ethnic minority), 81.3% of early adolescents reported at least one ACE, and 9.6% reported cyberbullying victimization. In general, there was a dose-response relationship between the number of ACEs and cyberbullying victimization, as two (adjusted odds ratio [AOR]: 1.45, 95% confidence interval [CI]: 1.13-1.85), three (AOR: 2.08, 95% CI: 1.57-2.74), and four or more (AOR: 2.37, 95% CI: 1.61-3.49) ACEs were associated with cyberbullying victimization in adjusted models. In models examining the specific type of ACE, sexual abuse (AOR: 2.27, 95% CI: 1.26-4.11), physical neglect (AOR: 1.61, 95% CI: 1.24-2.09), and household mental health problems (AOR: 1.39, 95% CI: 1.18-1.65) had the strongest associations with cyberbullying victimization.Adolescents who have experienced ACEs are at greater risk for experiencing cyberbullying. Interventions to prevent cyberbullying could use a trauma-informed framework, including inter-peer interventions to break this cycle of trauma.

  View details for DOI 10.1002/jad.12124

  View details for PubMedID 36443937

  View details for PubMedCentralID PMC10079567

• Adverse childhood experiences and sipping alcohol in U.S. Children: Findings from the Adolescent Brain Cognitive Development study. Preventive medicine reports Nagata, J. M., Smith, N., Sajjad, O. M., Zamora, G., Raney, J. H., Ganson, K. T., Testa, A., Vittinghoff, E., Jackson, D. B. 2023; 32: 102153

  Abstract

  The objective of this study was to explore the relationship between accumulating adverse childhood experiences (ACEs) and sipping alcohol in a large, nationwide sample of 9-to-10-year-old U.S. children. We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study (2016-2018). Of 10,853 children (49.1 % female), 23.4 % reported ever sipping alcohol. A greater ACE score was associated with a higher risk of sipping alcohol. Having 4 or more ACEs placed children at 1.27 times the risk (95 % CI 1.11-1.45) of sipping alcohol compared to children with no ACEs. Among the nine distinct ACEs examined, household violence (Risk Ratio [RR] = 1.13, 95 % CI 1.04-1.22) and household alcohol abuse (RR = 1.14, 95 % CI 1.05-1.22) were associated with sipping alcohol during childhood. Our findings indicate a need for increased clinical attention to alcohol sipping among ACE-exposed children.

  View details for DOI 10.1016/j.pmedr.2023.102153

  View details for PubMedID 36875509

  View details for PubMedCentralID PMC9978032

• Adverse childhood experiences and binge-eating disorder in early adolescents. Journal of eating disorders Chu, J., Raney, J. H., Ganson, K. T., Wu, K., Rupanagunta, A., Testa, A., Jackson, D. B., Murray, S. B., Nagata, J. M. 2022; 10 (1): 168

  Abstract

  Adverse childhood experiences (ACEs) are common and linked to negative health outcomes. Previous studies have found associations between ACEs and binge-eating disorder (BED), though they have mainly focused on adults and use cross-sectional data. The objective of this study was to examine the associations between ACEs and BED in a large, national cohort of 9-14-year-old early adolescents in the US.We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,145, 2016-2020). Logistic regression analyses were used to determine the associations between self-reported ACEs and BED based on the Kiddie Schedule for Affective Disorders and Schizophrenia at two-year follow-up, adjusting for sex, race/ethnicity, baseline household income, parental education, site, and baseline binge-eating disorder.In the sample, (49% female, 46% racial/ethnic minority), 82.8% of adolescents reported at least one ACE and 1.2% had a diagnosis of BED at two-year follow-up. The mean number of ACEs was higher in those with a diagnosis of BED compared to those without (2.6 ± 0.14 vs 1.7 ± 0.02). The association between number of ACEs and BED in general had a dose-response relationship. One ACE (adjusted odds ratio [aOR] 3.48, 95% confidence interval [CI] 1.11-10.89), two ACEs (aOR 3.88, 95% CI 1.28-11.74), and three or more ACEs (aOR 8.94, 95% CI 3.01-26.54) were all associated with higher odds of BED at two-year follow-up. When stratified by types of ACEs, history of household mental illness (aOR 2.18, 95% 1.31-3.63), household violence (aOR 2.43, 95% CI 1.42-4.15), and criminal household member (aOR 2.14, 95% CI 1.23-3.73) were most associated with BED at two-year follow-up.Children and adolescents who have experienced ACEs, particularly household challenges, have higher odds of developing BED. Clinicians may consider screening for ACEs and providing trauma-focused care when evaluating patients for BED.

  View details for DOI 10.1186/s40337-022-00682-y

  View details for PubMedID 36384578

  View details for PubMedCentralID PMC9670461

• Associations Between Adverse Childhood Experiences, Adolescent Screen Time and Physical Activity During the COVID-19 Pandemic. Academic pediatrics Raney, J. H., Testa, A., Jackson, D. B., Ganson, K. T., Nagata, J. M. 2022; 22 (8): 1294-1299

  Abstract

  To determine the associations between Adverse Childhood Experiences (ACEs), adolescent screen time, and physical activity during the early COVID-19 pandemic.Data (2016-2020) from the Adolescent Brain Cognitive Development (ABCD) study were analyzed. Linear regression analyses estimated associations between ACE score and screen time and physical activity in May 2020, adjusting for potential confounders.Of the 6749 adolescent respondents primarily aged 12-13, 81.6% reported a history of one ACE or more. In adjusted models, a higher ACE score was significantly associated with greater hours per day of screen time, with youth with ≥4 ACEs associated with 2.3 more hours of screen time per day compared to youth with 0 ACEs. In addition, the adjusted models found that a higher ACE score was associated with lower physical activity; youth with ≥4 ACEs averaged 0.8 fewer hours per week of physical activity and 0.5 fewer days per week of 60 minutes of physical activity compared to youth with 0 ACEs. Gender and race were also significantly associated with changes in screen time and physical activity.ACEs are associated with higher adolescent sedentary behaviors, particularly greater screen time, during the early COVID-19 pandemic (May 2020). Clinicians caring for youth exposed to trauma in the postpandemic environment should explore screen time and physical activity behaviors.

  View details for DOI 10.1016/j.acap.2022.07.007

  View details for PubMedID 35853601

  View details for PubMedCentralID PMC9288265

• Ineffective penicillin treatment and absence of partner treatment may drive the congenital syphilis epidemic in Brazil. AJOG global reports Swayze, E. J., Cambou, M. C., Melo, M., Segura, E. R., Raney, J., Santos, B. R., Lira, R., Pinto, R. B., Dos Santos Varella, I. R., Nielsen-Saines, K. 2022; 2 (2)

  Abstract

  BACKGROUND: Reducing congenital syphilis has been the focus of Brazilian health programs for decades, yet the cases continue to increase. Although health interventions have targeted HIV screening and treatment, syphilis management continues to be challenging. Syphilis during pregnancy may enhance the HIV maternal seroconversion risk. The potential factors fueling the syphilis epidemic were evaluated in south Brazil, an area of high HIV or syphilis endemicity.OBJECTIVE: We hypothesized that ineffective treatment because of a lack of partner treatment, late presentation to care, and reinfection of previously treated mothers were potential drivers of syphilis mother-to-child transmission.STUDY DESIGN: Data on women diagnosed with syphilis during pregnancy between January 1, 2008 and December 31, 2018 were obtained from a large urban hospital in Porto Alegre, Brazil. The patients were stratified into effective vs ineffective treatment groups according to the World Health Organization guidelines. Crude and adjusted risk ratios for the prediction of congenital syphilis and adverse fetal or neonatal outcomes were computed using Poisson regression.RESULTS: Nearly 56,000 pregnant women delivered over the 11-year period; 1541 (2.8%) had confirmed syphilis during pregnancy, with 934 (61%) receiving ineffective syphilis treatment because of late presentation and diagnosis, delayed treatment initiation, and loss to follow-up with no treatment recorded. Ineffective treatment was associated with maternal education, prenatal care, timing of syphilis diagnosis, venereal diseases research laboratory titers, and maternal HIV coinfection. On multivariate regression analysis, ineffective treatment (adjusted risk ratio, 4.52; 95% confidence interval, 2.35-8.69), absence of prenatal care (adjusted risk ratio, 9.31; 95% confidence interval, 3.77-23.0), syphilis diagnosis at delivery (adjusted risk ratio, 3.08; 95% confidence interval, 2.07-4.58), and maternal nontreponemal titers ≥1:64 (1.09-1.93) were associated with an increased risk of fetal loss. Ineffective treatment (adjusted risk ratio, 1.71; 95% confidence interval, 1.59-1.84), year of diagnosis 2014 to 2016 (adjusted risk ratio, 1.07; 95% confidence interval, 1.02-1.13), absence of prenatal care (adjusted risk ratio, 1.44; 95% confidence interval, 1.17-1.76), and maternal nontreponemal titers >1:4 were associated with an increased risk of congenital syphilis. Although partner treatment reduced the congenital syphilis risk (adjusted risk ratio, 0.60; 95% confidence interval, 0.55-0.66), only 31.8% of partners received treatment. Maternal HIV coinfection was not associated with an increased risk of fetal loss, low birthweight, preterm birth, congenital syphilis, or symptomatic neonatal infection.CONCLUSION: Public health initiatives promoting effective syphilis treatment in pregnancy, increased access to high-quality prenatal care, and partner treatment should be considered to reduce congenital syphilis.

  View details for DOI 10.1016/j.xagr.2022.100050

  View details for PubMedID 36081843

• Words Matter: An Antibias Workshop for Health Care Professionals to Reduce Stigmatizing Language. MedEdPORTAL : the journal of teaching and learning resources Raney, J., Pal, R., Lee, T., Saenz, S. R., Bhushan, D., Leahy, P., Johnson, C., Kapphahn, C., Gisondi, M. A., Hoang, K. 2021; 17: 11115

  Abstract

  Introduction: Biased language influences health care providers' perceptions of patients, impacts their clinical care, and prevents vulnerable populations from seeking treatment. Training clinicians to systematically replace biased verbal and written language is an essential step to providing equitable care.Methods: We designed and implemented an interactive workshop to teach health care professionals a framework to identify and replace stigmatizing language in clinical practice. The workshop included a reflective exercise, role-play, brief didactic session, and case-based discussion. We developed the program for a broad target audience of providers and initially delivered it at three academic conferences. We used descriptive statistics to analyze Likert-style items on course evaluations and identified themes in open-text responses.Results: A total of 66 participants completed course evaluations; most believed the workshop met its objectives (4.8 out of 5.0) and strongly agreed that they would apply skills learned (4.8). Participants planned to incorporate reflection into their verbal and written language. Potential barriers to applying course content included perceived difficulty in changing entrenched practice habits, burnout, and fatigue. Suggestions for improvement included more time for group discussions and strategies to teach skills to colleagues.Discussion: Participants found the course material highly engaging and relevant to their clinical practice. Learners left the workshop feeling motivated to engage in more mindful word choice and to share key concepts with their colleagues.

  View details for DOI 10.15766/mep_2374-8265.11115

  View details for PubMedID 33768147

• Training and evaluating simulation debriefers in low-resource settings: lessons learned from Bihar, India. BMC medical education Raney, J. H., Medvedev, M. M., Cohen, S. R., Spindler, H., Ghosh, R., Christmas, A., Das, A., Gore, A., Mahapatra, T., Walker, D. 2020; 20 (1): 9

  Abstract

  BACKGROUND: To develop effective and sustainable simulation training programs in low-resource settings, it is critical that facilitators are thoroughly trained in debriefing, a critical component of simulation learning. However, large knowledge gaps exist regarding the best way to train and evaluate debrief facilitators in low-resource settings.METHODS: Using a mixed methods approach, this study explored the feasibility of evaluating the debriefing skills of nurse mentors in Bihar, India. Videos of obstetric and neonatal post-simulation debriefs were assessed using two known tools: the Center for Advanced Pediatric and Perinatal Education (CAPE) tool and Debriefing Assessment for Simulation in Healthcare (DASH). Video data was used to evaluate interrater reliability and changes in debriefing performance over time. Additionally, twenty semi-structured interviews with nurse mentors explored perceived barriers and enablers of debriefing in Bihar.RESULTS: A total of 73 debriefing videos, averaging 18min each, were analyzed by two raters. The CAPE tool demonstrated higher interrater reliability than the DASH; 13 of 16 CAPE indicators and two of six DASH indicators were judged reliable (ICC >0.6 or kappa >0.40). All indicators remained stable or improved over time. The number of 'instructors questions,' the amount of 'trainee responses,' and the ability to 'organize the debrief' improved significantly over time (p<0.01, p<0.01, p=0.04). Barriers included fear of making mistakes, time constraints, and technical challenges. Enablers included creating a safe learning environment, using contextually appropriate debriefing strategies, and team building. Overall, nurse mentors believed that debriefing was a vital aspect of simulation-based training.CONCLUSION: Simulation debriefing and evaluation was feasible among nurse mentors in Bihar. Results demonstrated that the CAPE demonstrated higher interrater reliability than the DASH and that nurse mentors were able to maintain or improve their debriefing skills overtime. Further, debriefing was considered to be critical to the success of the simulation training. However, fear of making mistakes and logistical challenges must be addressed to maximize learning. Teamwork, adaptability, and building a safe learning environment enhanced the quality enhanced the quality of simulation-based training, which could ultimately help to improve maternal and neonatal health outcomes in Bihar.

  View details for DOI 10.1186/s12909-019-1906-2

  View details for PubMedID 31914989

• Simulation-enhanced nurse mentoring to improve preeclampsia and eclampsia care: an education intervention study in Bihar, India. BMC pregnancy and childbirth Raney, J. H., Morgan, M. C., Christmas, A., Sterling, M., Spindler, H., Ghosh, R., Gore, A., Mahapatra, T., Walker, D. M. 2019; 19 (1): 41

  Abstract

  Inadequately treated, preeclampsia and eclampsia (PE/E) may rapidly lead to severe complications in both mothers and neonates, and are estimated to cause 60,000 global maternal deaths annually. Simulation-based training on obstetric and neonatal emergency management has demonstrated promising results in low- and middle-income countries. However, the impact of simulation training on use of evidence-based practices for PE/E diagnosis and management in low-resource settings remains unknown.This study was based on a statewide, high fidelity in-situ simulation training program developed by PRONTO International and implemented in collaboration with CARE India on PE/E management in Bihar, India. Using a mixed methods approach, we evaluated changes over time in nurse mentees' use of evidence-based practices during simulated births at primary health clinics. We compared the proportion and efficiency of evidence-based practices completed during nurse mentees' first and last participation in simulated PE/E cases. Twelve semi-structured interviews with nurse mentors explored barriers and enablers to high quality PE/E care in Bihar.A total of 39 matched first and last simulation videos, paired by facility, were analyzed. Videos occurred a median of 62 days apart and included 94 nurses from 33 primary health centers. Results showed significant increases in the median number of 'key history questions asked,' (1.0 to 2.0, p = 0.03) and 'key management steps completed,' (2.0 to 3.0, p = 0.03). The time from BP measured to magnesium sulfate given trended downwards by 3.2 min, though not significantly (p = 0.06). Key barriers to high quality PE/E care included knowledge gaps, resource shortages, staff hierarchy between physicians and nurses, and poor relationships with patients. Enablers included case-based and simulation learning, promotion of teamwork and communication, and effective leadership.Simulation training improved the use of evidence-based practices in PE/E simulated cases and has the potential to increase nurse competency in diagnosing and managing complex maternal complications such as PE/E. However, knowledge gaps, resource limitations, and interpersonal barriers must be addressed in order to improve care. Teamwork, communication, and leadership are key mechanisms to facilitate high quality PE/E care in Bihar.

  View details for DOI 10.1186/s12884-019-2186-x

  View details for PubMedID 30674286

  View details for PubMedCentralID PMC6344989

• Frequency and Importance of Incomplete Screening Fetal Anatomic Sonography in Pregnancy. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Silvestri, M. T., Pettker, C. M., Raney, J. H., Xu, X., Ross, J. S. 2016; 35 (12): 2665-2673

  Abstract

  To determine (1) how often routine screening fetal anatomic sonography fails to completely visualize fetal anatomy; (2) the proportion of women with incomplete ultrasound examinations who are recommended for repeat screening and then undergo repeat sonography; and (3) how often abnormal fetal anatomy is detected on repeat sonography.We conducted a retrospective cohort study at a high-volume academic obstetric ultrasound center. Participants were 16,300 women at 17 through 21 weeks' gestation with a singleton pregnancy presenting for screening anatomic sonography between January 2009 and December 2013. Main outcome measures were (1) incomplete visualization of anatomy at initial screening sonography; (2) among women with incomplete but otherwise normal initial screening ultrasound examinations, recommendation for and performance of repeat sonography; and (3) among women undergoing repeat sonography, discovery of abnormal fetal anatomy within anatomic components that were previously incompletely visualized.The mean maternal age ± SD was 30.8 ± 6.3 years, and the mean gestational age was 18.8 ± 1.0 weeks. Among 16,300 initial screening ultrasound examinations, 2157 (13.2%) had incomplete visualization of fetal anatomy. Of those women eligible for follow-up, 91.5% were recommended for repeat screening, of whom 92.8% had a subsequent examination. Of 1560 repeat screening ultrasound examinations, 8 (0.5%) showed an abnormality in the components of anatomy that were previously visualized incompletely.In this large single-center study, incomplete visualization was common in screening fetal anatomic ultrasound examinations. Recommendations for repeat imaging were nearly universal, but abnormal fetal anatomy was infrequently discovered on repeat screening.

  View details for DOI 10.7863/ultra.16.01084

  View details for PubMedID 27821652