Accurately assessing dietary intake in children and adolescents is essential for understanding dietary patterns and informing public health strategies. In Latin America, rapid nutrition transitions and increasing childhood obesity highlight the need for culturally appropriate, validated dietary assessment tools (DATs). However, methodological challenges and limited regional data hinder effective dietary surveillance. This scoping review identified and characterised DATs used among children and adolescents (5–18 years) in Latin America, examining tool types, features, validation and regional coverage. Following Joanna Briggs Institute and PRISMA-ScR guidelines, comprehensive searches were conducted in EMBASE, Web of Science, PubMed, and LILACS (April 2024) in English, Spanish, and Portuguese. Eligible studies included original research developing, validating, or applying DATs in Latin American populations. Of 13,946 records screened, 105 reports met the inclusion criteria. Brazil and Mexico contributed the most studies, while six countries (Paraguay, El Salvador, Nicaragua, Panama, Honduras, and Belize) had none. Forty-three DATs were identified, 77% of which were food frequency questionnaires (FFQs). Half targeted adolescents, 39% children, and 11% both groups. Most were interviewer-administered (58%) and applied in person (49%), with only 19% conducted online, reflecting regional digital limitations. Validation was reported for 70% of tools, primarily against 24 HR. The DAT landscape in Latin America remains dominated by FFQs and traditional administration methods, with limited use of digital platforms. Developing age-appropriate, validated and culturally adapted digital DATs is essential to strengthen dietary surveillance and guide effective nutrition policies across the region.

This study examined trends in adolescent self-harm incidence rates and associated contextual factors among 77 low- and lower-middle-income countries. Annual sex-specific self-harm incidence rates for ages 10–19 years were obtained from the Global Burden of Disease 2021 database. Joinpoint regression assessed trends while country and year fixed-effects models examined their association with self-harm incidence rates. Median incidence rates declined from 35.9 to 35.3 per 100,000 among males and from 40.8 to 38.1 among females. Average annual percentage changes (AAPCs) among males were negative in 40 countries and positive in 37 (maximum 2.16%); among females, AAPCs were negative in 47 and positive in 30 (maximum 3.64%). Male self-harm incidence rates were positively associated with drug use exposure, adolescent fertility, new HIV infections, rule of law and unemployment, and negatively with control of corruption, alcohol use and urban population. Female incidence rates were positively associated with adolescent fertility rates, drug use, rule of law, mean years of schooling and labor force participation, and negatively with alcohol and tobacco use exposure, control of corruption, regulatory quality and sociodemographic index. These sex-specific differences in trends and contextual factors emphasize the need for integrated reproductive, mental and substance use targeted country-level prevention strategies.

There are few evidence-based suicide prevention interventions tailored for adolescents living with HIV (ALWH) in sub-Saharan Africa. The safety planning intervention targets acute suicidal behavior through co-creation of actionable coping strategies for use at the onset of suicide-related distress. We utilized the Assessment-Decision-Adaptation-Production-Topical Experts-Integration-Training–Testing framework to adapt and integrate safety planning into an existing Friendship Bench + peer support model for depressed ALWH in Malawi. We conducted interviews with ALWH who reported suicidal ideation or behaviors, their caregivers, healthcare facility leadership and police officers, and focus group discussions with healthcare facility staff, community and religious leaders and teachers in Lilongwe. The study team produced adapted manuals, sought and integrated expert topical feedback, trained interventionists using a training-of-trainers model and theater tested the protocol. Formative data yielded insights into acceptability, feasibility, delivery, content and implementation of safety planning. The final safety planning + Friendship Bench + peer support program consists of one safety planning session, five problem-solving sessions with suicide risk assessment and six peer support sessions. We revised the written Safety Plan to account for limited emergency services, modified the protocol for engaging guardians, integrated suicide assessment into the problem-solving sessions and incorporated suicide prevention activities into the peer support sessions.

Mental health promotion in schools has gained greater salience in high-income countries, especially since the COVID-19 pandemic. However, less is known about its conceptualisation and implementation in less developed countries such as Indonesia. This research aimed to describe what school communities in Surabaya, Indonesia, understand about their role and actions in promoting mental health. This exploratory study employed Focus Group Discussions with diverse members of junior high school communities, including students. Using the Health Policy Triangle as the theoretical framework, transcripts were thematically analysed using a deductive approach. Forty-six participants took part, from national to municipality levels. Three themes were found. First, participants considered that socialisation difficulties contributed to poor student mental health and engagement in learning. Second, while schools reported familiarity with a range of actions, from promotion to preventive and curative interventions, their primary focus was around ensuring access to services for students with mental health problems. Third, contextual barriers and enablers were identified impacting schools’ mental healthpromoting actions. The inter-related aspects of context, content, process, and actors were found to shape implementation. These findings highlight the multi-component expertise and resources of school communities, which, if better embraced, could enhance their capabilities to promote mental health in schools.

Eco-anxiety is an emerging mental health concern among adolescents, particularly in regions affected by climate-related disasters. Following the 2023 wildfires in Canada’s Northwest Territories (NWT), this study examined associations between wildfire exposure severity, socio-ecological factors, and eco-anxiety among adolescents in the NWT. We conducted a cross-sectional survey with 290 adolescents aged 13–18 years across NWT secondary schools during the 2023–2024 school year. Structural equation modelling examined pathways linking social factors (gender, sexual orientation, Indigenous identity), living conditions (rural residence, caregiver status), structural conditions (food insecurity, wildfire exposure severity) and eco-anxiety. Self-esteem was examined as a moderator. Participants had a mean age of 13.7 years; most identifyied as Indigenous and lived in rural communities. Greater wildfire exposure severity and food insecurity were associated with higher eco-anxiety. Girls, LGBQ+ youth and rural youth reported higher eco-anxiety. Indigenous identity was indirectly associated with eco-anxiety through food insecurity and wildfire exposure severity. Higher self-esteem was associated with lower eco-anxiety and buffered the relationship between wildfire exposure and eco-anxiety. Findings suggest that eco-anxiety among NWT adolescents is shaped by climate-related disruption and social conditions. Interventions can address psychosocial resources and material conditions to support NWT youth mental health following climate-related disasters such as wildfires.

Firearm suicide among adolescents in the United States has increased in recent years, with Black and Latino youth experiencing disproportionately rising rates. Although firearm violence and mental health disparities have received growing attention, the structural conditions that shape racial inequities in firearm suicide risk remain insufficiently examined. This overview applies an intersectional and structural lens to analyze how systemic inequities including residential segregation, concentrated disadvantage, punitive school discipline practices, underinvestment in mental health infrastructure and commercial determinants of firearm availability contribute to differential suicide risk. Drawing on interdisciplinary literature and recent epidemiologic data, the manuscript maps the causal pathways through which structural racism and institutional inequities shape exposure to community violence, access to culturally responsive care, crisis response practices and household firearm environments. It further examines how these mechanisms interact with gender and lethal means availability to amplify disparities in suicide mortality. The analysis underscores the importance of multilevel, upstream interventions that address structural inequities, strengthen community-based supports and reduce access to lethal means. By reframing firearm suicide as a structurally patterned outcome rather than an individual-level phenomenon, this work advances a socio-ecological understanding of adolescent suicide prevention with implications for structural reform and suicide prevention policy.

School-based interventions offer a promising setting to promote healthier nutritional behaviours (NB) such as physical activity (PA), sedentary behaviour (SB) and eating behaviour, while addressing weight social inequalities. NB changes may occur before measurable effects on weight, which can take longer to emerge. This study evaluated the overall effectiveness of the school-based Promotion de l’ALIMentation et de l’Activité Physique – INEgalités de Santé (PRALIMAP-INÈS) trial on weight and NB social inequalities reduction among adolescents with overweight or obesity. Adolescents were divided into two intervention groups according to their socio-economic status (socially advantaged and socially less advantaged). NB were self-reported by adolescents. Outcomes were BMI z-score (BMIz), fruit and vegetables (FV) consumption, sweetened products and beverages (SPB) consumption, vigorous/moderate PA, walking and SB. Overall effectiveness was estimated using generalised pairwise comparisons, estimating net benefit for each outcome (δ) and overall net benefit (Δ). Of 985 adolescents (age = 15·3 (sd 0·7 years; 46·7 % boys), those in less advantaged group were 12·5 % more likely to have a favourable change in weight status and NB than those in advantaged group (Δ = 12·5 % (6·1, 19·1 %)). For each outcome, net benefits were as follows: BMIz (δ = 4·2 % (0·0, 8·6)), vigorous PA (δ = 4·2 % (0·4, 8·3)), FV (δ = 3·2 % (0·9, 5·5)), SB (δ = 0·8 % (–1·6, 3·2)), SPB (δ = −0·2 % (–1·1, 0·6)), moderate PA (δ = 0·2 %) (–0·7, 1·1) and walking (δ = 0·2 % (–0·2, 0·6)). Results showed an overall beneficial effect of the PRALIMAP-INÈS trial in reducing social inequalities in weight and NB among adolescents with overweight or obesity. Long-term effectiveness could be expected by reducing social inequalities in NB.

Mental health disorders are prevalent among adolescents and evidence suggests that stigma, poor mental health literacy (MHL) and access are key barriers to help-seeking for mental health difficulties in adolescence and throughout life. The study purpose is to assess existing mental health knowledge, stigma and help-seeking behaviour among adolescents in Uganda. A total of 889 secondary school students in Kampala completed standardised self-report questionnaires. The results reveal low-to-moderate levels of mental health knowledge (MAKS, range 12–60, M = 16.35, SD = 5.18, AMHLQ, range 33–138, M = 64.01, SD = 12.98), stigma (RIBS, range 4–20, M = 12.30, SD = 3.52) and prejudice towards people with mental illness (PPMI-TR, range 133–19, M = 73.85, SD = 13.38). Knowledge correlated with stigma (r = 0.166 and r = 0.135, p < 0.01), and with one’s capacity to assess own mental health (SELF-I range 5–25, M = 12.34, SD = 4.4). Adolescents are open to seek help from mental health professionals but reluctant to seek it from most accessible help sources like schoolteachers. The findings provide insights for future mental health-promoting and anti-stigma interventions for adolescents.

The objectives of the present study were (a) to determine the effects of a 12-week intervention using wearables promoted through physical education classes on physical activity, body composition, physical fitness and psychological well-being of overweight or obese adolescents; and (b) to analyze the differences in outcomes based on gender and baseline physical activity. Seventy-three overweight and obese adolescents (mean age: 13.44 ± 1.12 years) were randomly assigned to an experimental group (EG) or control group (CG). The EG used a physical activity wearable for 12 weeks. Both groups were assessed before and after the intervention. Regarding primary outcomes, the EG showed an increase in physical activity (p = 0.048) and reductions in body mass index (p = 0.007), fat mass (p < 0.001), and sum of 3 skinfolds (p = 0.002), with moderate-to-large effect sizes (η2 > 0.09). According to the secondary outcomes, improvements in physical fitness were limited, with increases observed only in abdominal muscular endurance, and these changes were also present in the CG. Subgroup analyses showed that females and adolescents with low baseline physical activity experienced greater benefits, particularly in fat-related variables (p < 0.001–0.037), with large effect sizes (η2 > 0.14). Additionally, adolescents with greater exposure to the wearable-based intervention showed more consistent improvements in fat-related outcomes (p < 0.001–0.032), with large effect sizes (η2 > 0.25). In conclusion, a wearable-based intervention promoted through physical education classes may contribute to meaningful improvements in body composition, particularly among females and previously inactive adolescents who are overweight or obese. However, effects on physical fitness and psychological well-being were limited, highlighting the importance of intervention design, adherence, and complementary motivational strategies.

A limited intake of free and added sugars is recommended due to potential associations with adverse health effects and nutrient inadequacy. However, the impact of free and added sugars intakes on dietary intake is unknown in Swedish adolescents. This study investigated associations of free and added sugars intakes with nutrient and food consumption. Data were derived from the Riksmaten Adolescents 2016–2017 cross-sectional survey, including a nationally representative sample of 3099 adolescents, aged around 12, 15 and 18 years, which provided two 24-h recalls. Median nutrient and food group intakes were compared across sugars intake quintiles, with adjustments for sex, school year and energy misreporting. Inverse associations were observed for almost all micronutrients, dietary fibre, essential fats and food groups commonly included in a healthy diet (e.g. vegetables, fruit, dairy products, meat, fish). However, positive associations between free sugars and vitamin C intake were observed, with fruit juice influencing intake trends. Total energy intake was not positively associated with free or added sugars intakes. Higher intakes of free and added sugars (> 12·9 and > 11·3 % of total energy intake) significantly reduced the likelihood of meeting nutrient reference values. However, for critical nutrients within the adolescent diet (vitamin D, Se, dietary fibre and polyunsaturated fats), lower odds of meeting reference values were observed even at lower intakes of free and added sugars. To conclude, with increasing sugars intake, Swedish adolescents appear to displace nutrient-dense foods with sugars-rich foods, emphasising differences in dietary patterns between those with lower v. higher free and added sugars intake.

This study explores the association between school-based foreign language (FL) instruction and mathematical achievement among 15-year-old students, using data from the 2018 Programme for International Student Assessment (PISA). Two complementary analyses were conducted: a large-scale model (n = 300,656) examining the relationship between time spent in FL learning and maths performance across 73 countries and a machine learning (ML) approach (random forest (RF); n = 53,459) identifying specific programme features that most strongly influence this relationship. Results show that longer exposure to FL instruction was associated with a modest but statistically robust increase in maths scores (β = 0.08, p < .001), even after controlling for socioeconomic and contextual factors. Among programme characteristics, the integration of multicultural curricula emerged as a prominent predictor of higher maths performance. These findings indicate that sustained, culturally enriched FL learning is positively associated with numeracy outcomes, with implications for equity in academic achievement and cross-disciplinary performance.

Evidence on the association between self-esteem and suicide risk (SR) among adolescents in Latin America is limited. To address this gap, we examined this association in secondary school students from northern Peru. We performed an analytical cross-sectional study based on secondary data collected in 2022 from 1,314 adolescents attending 5 secondary schools. SR was assessed using the Plutchik Suicide Risk Scale, while self-esteem was measured with the Rosenberg Self-Esteem Scale. Prevalence ratios (PRs) and corresponding 95% confidence intervals (CIs) were calculated through Poisson regression with robust variance, both in crude and adjusted models. The study population comprised 54.2% males, with the majority (69%) in middle adolescence. Low self-esteem was identified in 44.7% of participants, while 29.4% presented average self-esteem. Overall, 33.3% of adolescents reported SR (95% CI: 30.8–36.0). In crude analyses, both average and low self-esteem were associated with a higher prevalence of SR compared with high self-esteem (PR = 2.30 and PR = 4.11, respectively). In adjusted models, average self-esteem was associated with a 42% higher prevalence (PR = 1.42) and low self-esteem with a 67% higher prevalence (PR = 1.67). One in three adolescents presented an SR, underscoring the need to integrate school- and community-based programs that promote self-esteem within suicide prevention.