Introduction
Method
Results
Discussion
KEY WORDS
INTRODUCTION
- Foy J.M.
- Green C.M.
- Earls M.F.
Mental health competencies for pediatric practice.
- Weitzman C.
- Wegner L.
Promoting optimal development: Screening for behavioral and emotional problems.
Wissow, L. S., Van Ginneken, N., Chandna, J., & Rahman, A. (2016). Integrating children's mental health into primary care. Pediatric Clinics of North America, 63(1), 97–113. doi:10.1016%2Fj.pcl.2015.08.005
World Health Organization. (2020). Guidelines on mental health promotive and preventive interventions for adolescents: Helping adolescents thrive. https://www.who.int/publications/i/item/9789240011854
- Forkey H.
- Szilagyi M.
- Kelly E.T.
- Duffee J.
Trauma-informed care.
- Foy J.M.
- Green C.M.
- Earls M.F.
Mental health competencies for pediatric practice.
THEORETICAL FRAMEWORK: STRESS AND COPING
- Folkman S.

APPRAISALS, COPING AND WELL-BEING OUTCOMES
- Jiang X.
- Ji L.
- Chen Y.
- Zhou C.
- Ge C.
- Zhang X.
MEASUREMENT OF YOUTH COPING
- Wolcott M.D.
- Lobczowski N.G.
PURPOSE
METHODS
Design
Sample and Setting
Timelining Activity
Think about your life in general over the last year, all things considered. We want to know how you would rate your life now, a year ago, and the time in between. Draw a single line on the graph to show how things have been over the year.

Measures
Feasibility and acceptability
- Forkey H.
- Szilagyi M.
- Kelly E.T.
- Duffee J.
Trauma-informed care.
Coping appraisals
Coping strategies
Well-being outcomes
- Hamby S.
- Taylor E.
- Smith A.
- Blount Z.
- Cella D.
- Lai J.S.
- Nowinski C.J.
- Victorson D.
- Peterman A.
- Miller D.
- Bethoux F.
- Heinemann A.
- Rubin S.
- Cavazos J.E.
- Reder A.T.
- Sufit R.
- Simuni T.
- Holmes G.L.
- Siderowf A.
- Wojna V.
- Bode R.
- McKinney N.
- Podrabsky T.
- Moy C.
Analysis
Construct Validity
- Baron R.M.
- Kenny D.A.
MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614. doi:10.1146/annurev.psych.58.110405.085542
Qualitative Integration
RESULTS
Measures | Range (actual) | Mean ± SD |
---|---|---|
Coping appraisals | ||
Stressor severity | 0–4 | 2.4 ± 1.0 |
Problem-focused coping potential | −4 to 4 | 0.7 ± 2.3 |
Emotion-focused coping potential | −4 to 4 | 1.8 ± 2.0 |
Coping strategies | ||
Active coping | 0–4 | 2.1 ± 0.8 |
Passive coping | 0–4 | 1.6 ± 0.9 |
Accommodative coping | 0.75–4.00 | 2.4 ± 0.6 |
Outcomes | ||
Depression | 36.4–76.3 | 51.3 ± 7.8 |
Subjective well-being | 9.0–28.0 | 24.1 ± 3.9 |
Challenge category | Challenge descriptions in participant words (examples) | n (%) |
---|---|---|
School-related | Finals, hard classes, bullying, tests | 78 (33.8) |
Mental health-related | Anxiety, depression, body-insecurity | 36 (15.6) |
Friend-related | Challenges with friends, friend drama, lost a friend | 29 (12.6) |
Parent-related | Parents divorced, parent stressed, dad lost job | 22 (9.5) |
Physical health-related | Had COVID, broke ankle, torn muscle | 14 (6.1) |
Sibling-related | Fighting with sister, brother did not want to be with me | 12 (5.2) |
Sports-related | Coach was difficult, did not make nationals, soccer | 11 (4.8) |
Pet-related | Dog died, cat died, dog was sick | 7 (3.0) |
Something else | Grandma died, got in trouble, I got lost | 22 (9.5) |
Feasibility and Acceptability
Hypothesis Testing: Bivariate Associations
Variables | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
---|---|---|---|---|---|---|---|
1. Stressor severity | – | ||||||
2. PFCP | −0.21 | – | |||||
3. EFCP | −0.32 | 0.22 | – | ||||
4. Active coping | −0.03 | 0.28 | 0.11 | – | |||
5. Passive coping | 0.30 | −0.28 | −0.29 | −0.36 | – | ||
6. Accommodative coping | −0.02 | 0.04 | 0.17 | 0.25 | 0.25 | – | |
7. Depression | 0.29 | −0.29 | −0.26 | −0.29 | 0.51 | −0.13 | – |
8. Subjective well-being | −0.37 | 0.32 | 0.28 | 0.41 | −0.47 | 0.14 | −0.66 |


Hypothesis Testing: Mediational Analyses
- Baron R.M.
- Kenny D.A.
Analysis 1: Predicting coping from appraisals | ||||
---|---|---|---|---|
Beta weights | ||||
Coping | Severity | EFCP | PFCP | r2 |
Active | 0.06 | 0.07 | 0.28 | 0.08 |
Passive | 0.20 | −0.19 | −0.20 | 0.17 |
Accommodative | 0.04 | 0.18 | 0.01 | 0.03 |
Analysis 2: Predicting outcomes from appraisals | ||||
Beta weights | ||||
Outcomes | Severity | EFCP | PFCP | r2 |
Subjective well-being | −0.27 | 0.14 | 0.11 | 0.22 |
Depression | 0.20 | −0.15 | −0.21 | 0.16 |
Analysis 3: Predicting outcomes from appraisals, controlling for coping | ||||
Step 1: Coping entered (beta weights) | ||||
Outcomes | Active | Passive | Accommodative | r2 |
Subjective well-being | 0.25 | −0.38 | 0.07 | 0.29 |
Depression | −0.09 | 0.48 | −0.10 | 0.28 |
Step 2: Appraisals entered (beta weights) | ||||
Outcomes | Severity | EFCP | PFCP | Δr2 |
Subjective well-being | −0.24 | 0.07 | 0.11 | 0.08 |
Depression | 0.13 | −0.06 | −0.11 | 0.04 |
Quantitative-Qualitative Integration
It started to get higher towards fall, which is when cross country season started, and that really improved my mental health because I met a lot of wonderful people and started to distract myself from the stressors in my life.
DISCUSSION
- Weitzman C.
- Wegner L.
Promoting optimal development: Screening for behavioral and emotional problems.
Wissow, L. S., Van Ginneken, N., Chandna, J., & Rahman, A. (2016). Integrating children's mental health into primary care. Pediatric Clinics of North America, 63(1), 97–113. doi:10.1016%2Fj.pcl.2015.08.005
World Health Organization. (2020). Guidelines on mental health promotive and preventive interventions for adolescents: Helping adolescents thrive. https://www.who.int/publications/i/item/9789240011854
- Wolcott M.D.
- Lobczowski N.G.
Limitations
IMPLICATIONS FOR RESEARCH AND PRACTICE
- Foy J.M.
- Green C.M.
- Earls M.F.
Mental health competencies for pediatric practice.
Wissow, L. S., Van Ginneken, N., Chandna, J., & Rahman, A. (2016). Integrating children's mental health into primary care. Pediatric Clinics of North America, 63(1), 97–113. doi:10.1016%2Fj.pcl.2015.08.005
- Mak W.W.S.
- Tsoi E.W.S.
- Wong H.C.Y.
- Zimmer-Gembeck M.J.
- Skinner E.A.
- Ungar M.
- Christmas C.M.
- Khanlou N.
Conclusions
Appendix. SUPPLEMENTARY MATERIALS
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Biography
Article info
Publication history
Publication stage
In Press Corrected ProofFootnotes
This work was supported by the University of Minnesota School of Nursing Foundation and the School of Nursing Office of Nursing Research and Scholarship. Lee was supported by a career development award funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health award number 1K23HD107179 (PI: Lee)
The University of Minnesota Institutional Review Board approved the protocol for this study.
Conflicts of interest: None to report.