The Association Between Relationships with Approachable Adults at School and Non-Suicidal Self-Harm in Vermont High School Youth Identifying as Transgender: A Cross-Sectional Study

Objectives. To explore the association between non-suicidal self-harm (also known as non-suicidal self-injury (NSSI)) in adolescents in Vermont identifying as transgender and relationships with approachable adults at school. Methods. Responses of self-reported self-harm in adolescents identifying as transgender and the ability to confide in an approachable adult or teacher at school were obtained from the 2019 Youth Risk Behavior Survey (YRBS) (n=18,613). Analysis was conducted using a binary logistic regression at a 95% confidence interval (CI) for the odds ratio (OR) and a best selection process. Results. Students who identify as transgender and had self-harmed in the past 12 months were 2.22 times more likely to engage in self-harm if they were unable to discuss a problem with an approachable adult or teacher at school (or were unsure), compared to transgender students who were able to discuss a problem with an adult or teacher at school. Conclusions. This research can be used at state and local levels to advocate for school policies and staff trainings to increase protective factors of adolescents identifying as transgender

A Peer-Based Strategy to Overcome HPV Vaccination Inequities in Rural Communities: A Physical Distancing-Compliant Approach.

The human papilloma virus (HPV) vaccine is the world\u27s first proven and effective vaccine to prevent cancers in males and females when administered pre-exposure. Like most of the US, barely half of Vermont teens are up-to-date with the vaccination, with comparable deficits in New Hampshire and Maine. The rates for HPV vaccine initiation and completion are as low as 33% in rural New England. Consequently, there is a compelling responsibility to communicate its importance to unvaccinated teenagers before their risk for infection increases. Messaging in rural areas promoting HPV vaccination is compromised by community-based characteristics that include access to appropriate medical care, poor media coverage, parental and peer influence, and skepticism of science and medicine. Current strategies are predominantly passive access to literature and Internet-based information. Evidence indicates that performance-based messaging can clarify the importance of HPV vaccination to teenagers and their parents in rural areas. Increased HPV vaccination will significantly contribute to the prevention of a broadening spectrum of cancers. Reducing rurality-based inequities is a public health priority. Development of a performance-based peer-communication intervention can capture a window of opportunity to provide increasingly effective and sustained HPV protection. An effective approach can be partnering rural schools and regional health teams with a program that is nimble and scalable to respond to public health policies and practices compliant with COVID-19 pandemic-related modifications on physical distancing and interacting in the foreseeable future