University at Albany, State University of New York
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Teaching Information Literacy in the Emerging and Dynamic Fields of Preparedness and Security
Get PDFEmergency preparedness and security are comparatively new academic fields, but they have grown tremendously in the last ten years.1 Colleges and universities all over the United States and Canada are adding and expanding programs dedicated to various facets of these subjects. While the specific subtopics and focal areas can vary by program, they all explore threat assessment, risk management, and disaster mitigation in some capacity. Emergency preparedness or emergency management programs prepare students to pursue careers dealing with crisis mitigation and response, whether that crisis is a result of natural disaster, climate change, war, civil unrest, infrastructure failure, economic instability, cyberattack, or some other cause. Security programs similarly address risk and mitigation, although those programs and classes tend to focus more directly on human-caused threats such as terrorism, radicalization, and violence. Often, preparedness and/or security programs align with companion studies in environmental management, international relations, informatics and data analysis, public health, and so on. However, because preparedness and security have only recently been considered as independent fields of study, they lack the reservoir of resources available to better established academic areas
Advancing 4H-Silicon Carbide Power Device Technology through Improved Device Design, Performance and Reliability
Get PDFThe work presented in this document focuses on advancing the overall design, performance, and reliability of 4H-SiC power devices through various design architectures and processing strategies. Power devices serve as an efficient way to control the flow of power and thus are utilized throughout a vast number of different systems. These systems accommodate various current and voltage ratings to support applications such as personal electronics, electric vehicle components, fast chargers, renewable energy solutions, and energy storage systems. As the demand for these applications grows alongside global electrification and sustainability efforts, minimizing power losses becomes increasingly important. Therefore, developing efficient and cost-effective power devices is crucial for achieving global electrification and sustainability goals.
Similar to most of the semiconductor industry, Silicon-based power devices have dominated the market across a wide range of voltage applications due to the material\u27s well-established device design and fabrication process. However, the demand for more efficient power devices, particularly for voltage ratings exceeding 600V, has driven interest in wide bandgap materials such as 4H-SiC, which offer superior material properties compared to Silicon. These superior properties enable the design of thinner and more heavily doped epitaxial drift layer to support a given breakdown voltage, leading to a significant reduction in the on-resistance of 4H-SiC devices compared to Silicon-based ones at voltage ratings greater than 600V. However, the drift region is not the only critical component of these power devices. Other regions, such as the edge termination and active area, must also be optimized to ensure efficient and reliable performance while keeping manufacturing costs in mind. To achieve this, three main areas are being investigated: the implementation of full-scale Room Temperature (RT) ion implantation for 4H-SiC devices, the further development of the Junction Barrier Schottky Diode Integrated MOSFET (JBSFET), and the continued advancement of the Monolithically Integrated Bi-Directional Field Effect Transistor (BiDFET).
In 4H-SiC device fabrication, ion implantation was traditionally performed at elevated temperatures to mitigate lattice damage and prevent the generation of Basal Plane Dislocations (BPDs). However, these high-temperature ion implantation processes present several challenges for large-scale manufacturing, making the adoption of a RT ion implantation a more desirable process if significant BPD generation can be avoided. As a result, this dissertation presents a detailed investigation into the full-scale RT ion implantation process for 4H-SiC power devices. The study not only examines the implantation dose, which has been explored in previous research, but also considers the implantation profile and the overall architecture for 4H-SiC power devices.
4H-SiC MOSFETs have traditionally been paired with Junction Barrier Schottky (JBS) diodes to bypass the built-in body diode and enable unipolar current conduction during third-quadrant operation. However, this co-package solution adds additional complexities as more device components are needed, and thus it is crucial to address this to further the adoption of 4H-SiC power devices. As a result, the JBS diode was integrated into the MOSFET structure thereby creating a single device solution in the form of the JBS diode integrated MOSFET (JBSFET), greatly improving power device performance and area efficiency. This dissertation presents further development of the JBSFET, including advancements in second-generation designs and the exploration of various device architectures to support the development of third-generation JBSFETs.
As global electrification efforts progress, the demand for efficient Bi-Directional switches capable of conducting current and blocking voltage in both the forward and reverse directions also grows. Due to the material properties and processing advancement in 4H-SiC, novel designs such as the monolithically integrated BiDFET have been developed. Although this approach simplifies the design of Bi-Directional switches, it has not yet been demonstrated at medium voltage ratings, which are crucial for renewable energy and grid-tied energy storage applications. As a result, this dissertation presents the further development of a medium-voltage monolithically integrated BiDFET, as well as a novel edge termination technique to reduce the required wafer area required for monolithic Bi-Directional switch integration
Student and Teacher Perceptions of Student Capabilities and Their Relationships to Learning Experiences in a High-Poverty Rural School
Get PDFBackground and Purpose. This study was designed to identify, delineate, and explain the significant factors contributing to high school students’ relatively better graduation outcomes in a high-poverty rural region in New York State. Emphasis was placed on identifying key characteristics of the relationships between students’ and teachers’ perceptions of student capabilities and the qualities of student learning experiences. This study drew upon secondary data from a two-phase study of positive outlier schools identified as having significantly better graduation rates than other schools with similar demographic profiles. Informed by Mindset Theory and Authentic Learning Theory, the study examined how personal, social, and organizational factors relating to perceptions of student capability influenced student learning experiences. A complementary social-ecological framework was used to identify the influences of social and environmental factors on student engagement.
Method. This qualitative study included 11 students (grades 11 and 12) and 12 teachers from one rural school who participated in interviews and focus groups relating to their learning and teaching experiences. This study employed a voice-centered analysis of the interview transcripts to identify themes across students and teachers in relation to the research questions.
Findings. This analysis revealed that student engagement emerged from 1) synergistic and supportive relationships between students and teachers, 2) focused attention to building on students’ individual capabilities, and 3) the provision of authentic and engaging learning experiences.
Conclusions and Implications. The research demonstrated how workforce stability and teachers’ self-reinforcing capability-enhancing teaching practices supported the sustainability of practices that enrich student learning experiences. Personal relationships proved crucial in building student self-efficacy and goal orientation, while distinctive rural advantages (e.g. smaller school size, strong social capital, and school-community connections) fostered authentic learning experiences. The study\u27s integrated framework provides policymakers and practitioners with a replicable model for leveraging rural contextual strengths to transform high-poverty schools
Paraconsistency in Legal Systems: Why Not to Evaluate the Law with Classical Logic
Get PDFThe following paper puts forth an argument for the analysis of legal systems via paraconsistent logics instead of classical logic due to the existence of legal dialetheia - true contradictions born from the law. Given that contradictions lead to absurdity in classical logic, a paraconsistent perspective becomes the clear choice once the existence of legal dialetheia is established. The first half of this argument, therefore, aims to support the work of Graham Priest in establishing legal dialetheia by explaining his view and combatting his opponent, J.C. Beall, who finds such dialetheia to fail beyond the limited scope of a legal system. Once the possibility of legal dialetheia is established, the consequence of failing to acknowledge their presence is explained and evidence for their importance in legal systems, due in part to the expressive power they provide, is presented. It is on the basis of all of this that paraconsistency is presented as the best foundation for our analysis of legal systems given that it can accommodate true contradictions without leading us to absurdity. By permitting us to continue on in the face of true contradictions, paraconsistency allows us to acknowledge the real life struggles that legal dialetheia may present, while maintaining the benefits of the complexity with which the social world operates
Understanding Spatiotemporal Heterogeneity, Sources, and Health Risks of Outdoor and Indoor Particles and Volatile Organic Compounds in Residential Neighborhoods
Get PDFIn the United States, community-level air quality observation networks often fall short in characterizing the wide array of air pollutants that influence human exposure from regional to neighborhood scales. While ambient air quality is routinely monitored in major urban centers, indoor air quality particularly within residential neighborhoods remains understudied, despite the fact that people spend the majority of their time indoors. This study presents a comprehensive assessment of outdoor and indoor air quality in the New York State (NYS) Capital Region and Hudson Valley communities of New York State, with a focus on fine particulate matter (PM2.5), volatile organic compounds (VOCs), black carbon (BC), and ultrafine particles (UFPs).
By examining ambient concentrations and sources of PM2.5 and VOCs in the NYS Capital, we investigated spatiotemporal variability of indoor and outdoor black carbon, PM2.5, UFPs, and indoor VOCs. We deployed relatively low-cost monitoring technologies including passive samplers and low-cost sensors in 4-5 homes per community, over one-week periods during the winter and spring seasons from November 2021 to May 2023. In total, air quality measurements were collected from over 60 homes. Data on meteorological parameters and questionnaire-based housing characteristics, and daily activities were also collected for each home. To determine the accuracy of the low-cost sensor data, low-cost sensors were co-located with reference monitors at the Albany County Health Department.
Results from source apportionment analysis for the period 2015–2019 revealed the background and secondary organic aerosol (SOA)-related sources as dominant contributors to both ambient VOCs and PM2.5 at Albany. Other notable sources included petroleum-related emissions, secondary inorganic aerosol and traffic Our results indicated significantly elevated pollutant concentrations outdoors (backyards) compared to indoors (living rooms), suggesting strong influence from local, community-specific sources such as nearby traffic or industrial operations. Moreover, indoor pollutant levels varied markedly across neighborhoods, influenced by home location and housing conditions.
We also delved into potential sources of air pollutants generated within indoors and outdoors.
Source apportionment of VOCs revealed that petroleum-related emissions and OP-EC2-aldehydes-rich sources contributed substantially to ozone and secondary organic aerosol formation, with several compounds posing elevated cancer risks based on U.S. EPA benchmarks.
This study provides one of the first integrated assessments of indoor and outdoor air pollution at the neighborhood level in the NYS Capital Region and Hudson Valley. Findings highlight the disproportionate burden of pollution faced by certain communities and underscore the need for tailored interventions. The results offer vital insights to inform air quality management strategies, promote environmental justice, and support public health initiatives across New York State\u27s residential neighborhoods. The findings of this study can provide an improved understanding of community-specific air quality problems, raise public awareness and empower communities to take actions and/or inform stakeholder and policy makers to develop appropriate management initiatives to improve air quality and public health across residential neighborhoods in NYS
A Systematic Review and Meta-Analysis Examining the Impact of the First Step to Success/First Step Next Intervention: A PBIS Tier 2 Intervention for Pre-K - 3rd Grade Students
Get PDFStudents with or at risk for emotional and behavioral disorders often experience significant challenges that adversely affect their academic performance and overall well-being. Although the First Step to Success/First Step Next (FSS/FSN) intervention has been widely implemented as a PBIS Tier 2 intervention to support Pre-K to 3rd-grade students with challenging behaviors, research findings have been inconsistent. This systematic review and meta-analysis synthesizes the literature on the intervention’s effectiveness across studies, focusing on both social-emotional behavioral outcomes and academic performance.
Using a comprehensive search strategy, studies meeting rigorous inclusion criteria were identified, and effect sizes (Hedges’s g) were calculated to capture pre- to post-intervention changes between intervention and control groups. Given the dependency of multiple effect sizes within studies, a subgroup-correlated hierarchical effects (SCHE) model was employed, with robust variance estimation (RVE) and small-sample corrections to account for within-study correlations. Sensitivity analyses were conducted by varying assumed within-study correlations. Publication bias was assessed via funnel plots and an adjusted Egger’s regression test, and effect size adjustments to address publication bias were conducted using Precision-Effect Test (PET) and Precision Effect Estimate with Standard Error (PEESE) models. Additionally, exploratory moderator analyses examined study-level factors, including baseline behavior severity and implementation fidelity, as potential sources of heterogeneity.
Overall, the results indicate that the FSS/FSN intervention yields a medium to large positive effect on improving adaptive behaviors of (g = 0.59, SE = 0.08, 95% CI [0.40, 0.77], p \u3c .001), while significantly reducing maladaptive behaviors (g = -0.53, SE = 0.08, 95% CI [-0.71, -0.35], p \u3c .001). The results also indicate that the FSS/FSN intervention has a small positive iii
impact on students’ academic functioning (g = 0.22, SE = 0.05, 95% CI [0.06, 0.37], p = \u3c .05). Exploratory moderator analysis tested 10 study-level variables (baseline behavior severity, rater type, socioeconomic status, grade level, gender composition, study design, special-education status, intervention version, risk-of-bias, and race/ethnicity), but no coefficient met both the Satterthwaite degrees of freedom criterion and practical significance. Implications for practice, limitations of the current synthesis, and directions for future research are discussed
Poética Transatlántica Vanguardista de Winétt de Rokha, Magda Portal, Norah Lange y Ernestina de Champourcín
No full textEn el auge de la vanguardia histórica, desde Europa hasta Hispanoamérica, intelectuales de ambos lados del atlántico coincidieron en renovar los géneros literarios. El objetivo de la vanguardia consistía en promover diferentes formas de expresión escrita para manifestar su inconformidad sobre los acontecimientos sociales, estos provocaron cambios a la estética del momento. Es decir que se buscaba deconstruir a través de diferentes Ismos como el futurismo, el ultraísmo, el creacionismo, el estridentismo entre otros para innovar la escritura dentro de la literatura del siglo XX. Las estrategias del vanguardismo consistían en las múltiples imágenes insólitas fragmentadas, lo arbitrario de la sintaxis, la preferencia por el léxico para reproducir un contenido caótico, ilógico e irracional absurdo de ideas ensambladas, que permitieron al estilo innovador integrarse tanto en lo poético como en la narrativa. Sin embargo, durante el movimiento vanguardista prevaleció la escritura masculina de renombrados autores como Vicente Huidobro, Jorge Luis Borges, y Manuel Maples Arce. Ellos fueron los privilegiados del canon y de la crítica literaria de la época de la vanguardia. En este ámbito literario era difícil que sobresalieran las plumas literarias femeninas quienes también proponían la postura crítica a través de los Ismos de lo que acontecía durante los años 20. En este reto investigativo se puede comprobar que la crítica de ese período mantenía en las sombras a las voces femeninas a quienes ignoraban por medio de la paráfrasis sobre la aportación femenina literaria durante la vanguardia, por ello, las poetas reforzaban esfuerzos para establecerse dentro del canon y sobresalir con su habilidad literaria por medio de la pluma poética.
A pesar de ello, la gnosis femenina alcanza proyectarse en el ámbito de la literatura a pesar del predomino intelectual masculino; y por lo tanto, la evidencia fehaciente es que la poesía de Winétt de Rokha, Magda Portal, Norah Lange y Ernestina Champourcín, logran dejar huella a través de su poesía vanguardista y consiguen la fusión de los Ismos en sus respectivas obras poéticas como Cantoral (1925-1936) de Winétt de Rokha, Una esperanza i el mar (1927) de Magda Portal, y en La calle de la tarde (1925) y Los días y las noches (1926) de Norah Lange, y en conexión desde Europa, España en Ahora (1928) y La voz en el viento (1931) de Ernestina de Champourcín quienes tienen coincidencias en su poética por la estética futurista, y a su vez la voz poética establece una crítica de la transformación mecanizado del espacio de la sociedad quienes coinciden de que la orbe moderna daña el ecosistema.
Es por esa razón que esta investigación explora el arte poético de estas poetas quienes lograron dejar huella a través de su poesía vanguardista, ya que se integraron intelectualmente a esta preocupación de renovar los géneros literarios desde sus respectivos países en los años 20. Por consiguiente, sus poesías aluden a moldes poéticos de experimentación que innovan con imágenes de emociones profundas y de alto contenido fragmentado con un tono melancólico ante la modernidad. Por esa razón, es esencial los Ismos que crearon y promovieron los intelectuales como: Filippo Tommaso Marinetti (1876-1944), Vicente Huidobro (1893-1948) Jorge Luis Borges (1899-1986), Manuel Maples Arce (1900-1981) y el objetivo de la vanguardia era promover e innovar la estética en la escritura literaria, aunque la voz poética femenina crítica el orbe moderno debido a las secuelas que ocasiona al establecer ante la sociedad. Y estos acercamientos textuales de la poética de las voces femeninas subyace ese Yo lírico vanguardista que está presente al asentir que desde su estética también nace la aportación desde la escritura femenina vanguardista para contribuir como afecta el ecosistema esa modernidad futurista que llega a los espacios públicos como la ciudad y también lo rural
Utilizing Technology to Support Collaborative Problem-Solving of K-12 Students in STEM Education: A Multivariate Multi-level Meta-analysis
Get PDFAs classrooms in the 21st -century increasingly incorporate digital tools, educators and researchers have turned their attention to the promising potential of technology in enhancing essential competencies such as collaborative problem-solving (CPS) skills (OECD, 2017). CPS skills, including joint decision-making and coordinated problem resolution, are necessary for success in both academic and real-world contexts. While many studies have investigated individual problem-solving in technology-enhanced learning environments, the collaborative dimension remains underexplored (Graesser et al. 2018b). This dissertation addresses that gap by conducting a multivariate multi-level meta-analysis to examine the overall effects of technology use on K–12 students’ CPS skills in STEM education and to identify the instructional and learner-related variables that moderate these effects.
A total of 23 empirical studies met the inclusion criteria, spanning a variety of educational technologies (e.g., simulations, games, collaborative platforms), grade levels, geographic contexts, and study designs. The analysis revealed a statistically significant and positive overall effect of technology use on CPS outcomes, indicating that digital interventions can support the development of collaborative competencies when implemented with intentional pedagogical design.
Moderator analyses uncovered key trends. Structured and guided learning environments, including scaffolding, prompts, or scripts, tended to yield larger gains than minimally guided approaches, although differences across treatment types were not statistically significant. Interventions targeting cognitive outcomes showed the most reliable effects, while motivational and social outcomes demonstrated positive but less consistent gains. Studies incorporating teacher feedback yielded statistically significant gains, although the difference from interventions without feedback was insignificant. Learner- and context-related moderators also influenced outcomes: triads (3-member groups) demonstrated the most consistent benefits, and students with intermediate technology proficiency experienced statistically significant gains. Middle school learners showed the most reliable improvements, though all grade bands benefited.
The study also applied the (M)UTOS framework to organize moderator variables across methodological, learner, treatment, outcome, and setting dimensions. This theory-driven approach enhanced the interpretability and conceptual clarity of the findings. While the study offers robust insights, limitations include the relatively small number of studies, variability in measurement instruments, and inconsistent reporting across primary sources.
This dissertation contributes to the growing research on technology-enhanced collaborative learning by offering a quantitative synthesis and practical recommendations. It highlights the need for intentional instructional design, developmentally appropriate supports, and ongoing evaluation of technology integration. Recommendations for future research include examining emerging technologies such as AI-powered platforms, conducting longitudinal studies, and incorporating qualitative meta-syntheses to better understand students’ lived experiences in CPS contexts. Ultimately, this work aims to inform educators, instructional designers, and policymakers as they seek to foster meaningful collaboration through technology in K–12 STEM education
Developing Concepts in Second Language (L2) Science from ‘Bits and Pieces’ of Prior Knowledge: A Multiple Case Study of Spanish-Speaking 4th and 5th Graders
Get PDFEarth science concepts sit at the intersection of the compounding difficulties English language learners’ (ELLs) face in content-integrated instruction. Emerging first language (L1) skills, emerging L2 language, and the difficulty of science terms interact with second language (L2) content learning. Moreover, L2 science concepts rarely develop incidentally through L2 socialization and instruction in the same naturalistic way as they do in the L1. Leveraging L1 resources may help ELLs in this process, yet there is a dearth of studies that consistently do so. This dissertation explores how, and the extent to which, leveraging ELLs’ pre-existing knowledge may support science and L2 language in a mutually supportive way (Kecskés et al., 2020). To this end, the study piloted a tutoring program—the Concept Learning Procedure (CLP)— to ‘grow’ L2 science connections and complexity by pulling together ‘bits and pieces’ of pre-existing knowledge through socially-mediated tasks. The double goal of leveraging resources and fostering development translated into a teaching implementation emphasizing explicit, linguistically-motivated, conceptually-driven, language-focused strategies. The CLP tried to promote a reduced set of eight, fourth- and fifth-grade science words and their central conceptual relationships, embedded in two cohesive, cognitively-challenging earth science units, with gradual decontextualization and support from the L1. This multiple-case study explored how sixteen upper-elementary, Spanish-speaking participants developed those eight concepts in comparison to six Controls in regular instruction in a dual program (RIDP). The initial iterative, qualitative coding of observations collected with a four-mode assessment protocol tentatively revealed a large volume of modifications and incorporations, and a relatively common emergent-target learning trajectory, both of which preliminarily underscore the potential benefits of the CLP. Analysis of students’ pre- and post-test conceptual knowledge using holistic rating found that those ELLs with emerging knowledge at pre-test could show larger quantitative gains even if more emerging. In contrast, advanced students may experience marginal quantitative gains, with greater qualitative restructuring and conceptual connections. In addition, English proficiency (EP) and length of stay (LS) impacted students’ pre-test knowledge levels, reinforcing the previously observed exponential, reverse trends. Yet, neither seemed to limit ELLs’ access to science content in CLP instruction, given its translanguaging mode. The study also showed that the CLP tentatively reconceptualized students’ pre-existing knowledge —even lack of— as a function of concept complexity, not task type. Aligned with the literature, synonymous concepts had higher reconceptualization potential than polysemic ones, likely due to differences in their nature and cognitive effort. Yet, dual-meaning concepts emerged as unique in complexity and cognitive demands. Finally, science concepts introduced in the CLP preliminarily outperformed Control counterparts, potentially due to the overall CLP method, and, in particular, to three strategies —referred to as MEM-SFA: leveraging morpho-etymology (ME), creating and extending metaphors (M), and examining core conceptual features (SFA). Case studies of three students showed the potential of these strategies, although emerging learners tended to use decontextualized definitions, and connections across concepts less frequently. Finally, the study could not corroborate the pilot’s parallel theory of quantitative and qualitative learning gains between prior knowledge, EP and LS. An alternative two-dimensional model was proposed to account for the data in the study and the apparent reconciliation problems. Future research should refine CLP strategies, increase instructional intensity, and isolate the impact of each task. Overall, this study highlights the tentative benefits of a tutoring program leveraging prior knowledge and employing a translanguaging mode. While results are not generalizable, this study might provide insights to support emerging ELLs in content-integrated science instruction
Multimorbidity in Adolescents: The Longitudinal Impact of Childhood Socioeconomic Trajectories and Health Risk in Adulthood
No full textAbstract
Background:
Multimorbidity, defined as the co-occurrence of two or more health conditions (physical, mental, or both), has been thought of as a disease of the elderly, with most studies of multimorbidity focusing on adults and the elderly population. However, co-occurring (multimorbid) health conditions are common in adolescence, and it is important to understand the profiles and patterns of multimorbidity during adolescence, a critical developmental period with long-term implications. Social determinants of health, especially lower socioeconomic status (SES), are linked to higher risk of multimorbidity and poor outcomes in adulthood. However, most of the past studies that have looked at the influence of family SES on multimorbidity were cross-sectional, consisted of small samples in a primary care setting, had limited generalizability, and were largely not conducted in the US. Furthermore, growing evidence suggests that adolescent multimorbidity can negatively impact adult health outcomes. Unaddressed health problems in adolescence can have lasting consequences on physical and mental wellbeing in later life. Hence, it is crucial to investigate the profiles of multimorbidity in adolescence, the long-term influence of childhood family SES on multimorbidity and the extent to which adolescent multimorbidity can predict risk of adverse adult health outcomes. Understanding these relationships and the factors that moderate them will also help to identify effective points of prevention and intervention to reduce the burden of multimorbidity in this vulnerable population and its long-term consequences.
Methods:
This analysis was conducted using data from the Future of Families and Child Wellbeing Study (FFCWS). The FFCWS is a longitudinal birth cohort study that has collected information on focal children from birth (Wave 1) through adolescence (Wave 6; age 15) and young adulthood (Wave 7; age 22), along with interviews with mothers, fathers, and primary caregivers. In my Aim #1 analysis, I conducted latent class analysis (LCA) to identify adolescent multimorbidity profiles at age 15 based on the thirteen health conditions reported by the youth participant or their primary caregiver (PCG). Racial/ethnic disparities in the multimorbidity profiles were assessed. For aim #2, semi-parametric group-based trajectory modeling was conducted to identify childhood family socioeconomic status (SES) trajectories from birth through age 9 years. Multinomial logistic regression was used to assess the associations between childhood SES trajectories and multimorbidity latent class membership in adolescence. Effect modification by physical activity was also assessed. Finally, for aim #3, logistic regression models were used to estimate if multimorbidity latent class membership (at Wave 6) was associated with young adult health outcomes (at Wave 7) and if the associations were moderated by adolescent household income.
Results:
In Aim #1, the latent class analysis revealed three distinct multimorbidity profiles in the adolescent population. Class 1 (4.7%), the mental health conditions class, exhibited high probabilities for depression and anxiety; Class 2 (88.2%), the normative class, showed low probability of any health conditions, and Class 3 (7.1%), the physical and developmental conditions class, was characterized by asthma, ADHD, obesity/overweight and learning disability. Female adolescents had 1.57 times (95% CI = 1.01–2.45) the odds of Class 1 membership and 0.40 times (95% CI = 0.26–0.59) the odds of Class 3 membership. For adolescents with a low birth weight, the odds of being in class 3 were 1.66 times (95% CI = 1.14–2.41) those without low birth weight. Race/ethnicity was not associated with class membership.
In Aim #2, three income trajectories, including low (74.9%), medium (19.0%) and high (6.1%), were identified across early-to-middle childhood (birth through age 9). After adjusting for key sociodemographic characteristics, children in the low-income trajectory had increased odds (OR = 1.84, 95% CI: 1.15–2.97) of belonging to the Class 3 multimorbidity profile characterized by physical and developmental conditions. Females had lower odds of being in Class 3 compared to males (OR = 0.36, 95% CI: 0.24–0.54). Children with low birth weight had 1.63 times higher odds (95% CI: 1.11–2.38) of being in Class 3. Children who engaged in high physical activity (5-7 days in a typical week) had lower odds (OR = 0.62, 95% CI: 0.41–0.93) of being in Class 3 compared to children who engaged in low physical activity; however, there was no evidence of effect modification of the relation between family income trajectories and adolescent multimorbidity by physical activity.
In Aim #3, when adjusted for sociodemographic characteristics, Class 1 membership at Wave 6 was associated with increased risk for depression (OR: 2.18; 95% CI: 1.04 -4.57) and anxiety (OR: 2.21; 95% CI: 1.03-4.77) at Wave 7 in young adulthood. The association did not differ significantly by income level.
Conclusion:
The findings highlight the need for early and tailored interventions to address adolescent multimorbidity and its long-term implications. The accumulation of multimorbidity during adolescence could be prevented or mitigated by mental health screening for girls before adolescence and early developmental assessments for boys and low birth weight children. Public health policies that lessen the long-term exposure of children to adverse SES may lower the risk of adolescents developing physical and developmental multimorbidity. Furthermore, early identification and treatment of mental health issues during adolescence may promote improved health outcomes in young adulthood