Intersectionality theory highlights the importance of the interplay of multiple social group memberships in shaping individual mental well-being. This article investigates elements of adolescent mental well-being (life dissatisfaction and psychosomatic complaints) from an intersectional perspective. It tests mental well-being consequences of membership in combinations of multiple social groups and examines to what extent such intersectional effects depend on the national context (immigration and integration policies, national-level income, and gender equality). Using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy, we assessed the role of the national context in shaping the interplay between immigration background, socioeconomic status, and gender, using data from 33 countries from the 2017/2018 Health Behaviour in School-aged Children survey. We found no uniform intersectionality effects across all countries. However, when allowing the interplay to vary by national context, results did point toward some intersectional effects. Some aggravated negative effects were found for members of multiple disadvantaged social groups in countries with low levels of income equality and restrictive migration policies, whereas enhanced positive effects were found for members of multiple advantaged groups in these countries. Similarly, mitigated negative effects of membership in multiple disadvantaged groups were shown in countries with higher levels of income equality and more inclusive migration policies, whereas mitigated positive effects were found for multiply advantaged individuals. Although for national-level gender equality results pointed in a similar direction, girls' scores were counterintuitive. High national-level gender equality disproportionately benefitted groups of disadvantaged boys, whereas advantaged girls were doing worse than expected, and reversed effects were found for countries with low gender equality. To fully understand social inequalities in adolescent mental well-being, the interplay between individual-level and national-level indicators must be explored.

Many adolescents struggle with adequately assessing their weight-status, often leading to unnecessary weight-related interventions or preventing necessary ones. The prevalence of weight-status over- and underestimation differs considerably cross-nationally, suggesting that individual weight-status assessment is informed by cross-nationally differing standards of evaluation. For adolescents with a migration background, this brings up the possibility of a simultaneous influence of origin- and receiving country standards. The current study examines the magnitude of both influences using data from the 2014 Health Behaviour in School-Aged Children study. The cross-national design of the study enabled us to aggregate weight-evaluation standards for 41, primarily European, countries. Subsequently, we identified a sample of 8 124 adolescents with a migration background whose origin as well as receiving country participated in the study. Among those adolescents, we assessed the effects of origin and receiving country weight-evaluation standards using cross-classified multilevel regression analyses. Descriptive analyses revealed considerable differences in weight-evaluation standards between the countries. Regression analyses showed that both origin- and receiving country weight-evaluation standards were significantly associated cross-sectionally with weight-status assessment among the immigrant adolescents, with a stronger impact of receiving country standards. Results illustrate the context-sensitivity of adolescent weight-status assessment and reinforce the theoretical notion that immigrant adolescent development is not only informed by factors pertaining to their receiving country but also, albeit to a lesser extent, by those pertaining to their origin country.

Although the school-class is known to be an important setting for adolescent risk behavior, little is known about how the ethnic composition of a school-class impacts substance use among pupils with a migration background. Moreover, the few existing studies do not distinguish between co-ethnic density (i.e., the share of immigrants belonging to one’s own ethnic group) and immigrant density (the share of all immigrants). This is all the more surprising since a high co-ethnic density can be expected to protect against substance use by increasing levels of social support and decreasing acculturative stress, whereas a high immigrant density can be expected to do the opposite by facilitating inter-ethnic conflict and identity threat. This study analyses how co-ethnic density and immigrant density are correlated with smoking among pupils of Portuguese origin in Luxembourg. A multi-level analysis is used to analyze data from the Luxembourg Health Behavior in School-Aged Children study (N = 4268 pupils from 283 classes). High levels of co-ethnic density reduced current smoking. In contrast, high levels of immigrant density increased it. Thus, in research on the health of migrants, the distinction between co-ethnic density and immigrant density should be taken into account, as both may have opposite effects.

Background: Adolescents and young adults (AYAs) in low- and middle-income countries (LMICs) are at high risk of harmful sexual and reproductive health (SRH) practices due to limited knowledge, low availability or acceptability of modern contraceptives, gender inequality and cultural practices like child marriage. Preventive and educational interventions by lay health workers or through technological means are a cost-effective and scalable solution. Unfortunately, too little is currently known about the scope, content and conditions of the effectiveness and sustainability of these approaches and synthetic evidence on this topic is scarce. To help fill this knowledge gap and to identify where further research is needed, we will conduct a scoping review of technology-based or lay health-worker delivered preventive and educational SRH interventions targeting AYAs in LMICs. This information is valuable to both policymakers and researchers as it provides a synthesis of existing interventions, highlights best practices for their implementation and identifies potential avenues for future research. Methods: This review will include studies on SRH preventive and educational interventions targeting AYAs aged 10–24 years in LMICs. It encompasses interventions delivered by lay health workers or via technological means, assessing various outcomes including but not limited to SRH literacy, sexual risk behaviours, pregnancies, sexually transmitted infections and gender-based violence. Key databases, including PubMed via MEDLINE and Embase , will be searched from 1 January 2000 up to 23 January 2024, using a comprehensive search strategy. Screening will be conducted using Covidence software. Data extraction will cover study details, methods, intervention strategies, outcomes and findings. A narrative synthesis will be conducted following synthesis without meta-analysis guidelines. Ethics and dissemination: The scope of this scoping review is limited to publicly accessible databases that do not require prior ethical approval for access. The findings will be disseminated through peer-reviewed journal publications, as well as presentations at national and international conferences and stakeholder meetings in LMICs. Scoping review registration: The final protocol is prospectively registered with the Open Science Framework on 7 May 2024 (osf.io/vna2z).

Background: Adolescents and young adults (AYAs) in low- and middle-income countries (LMICs) are at high risk of harmful sexual and reproductive health (SRH) practices. Preventive and educational interventions by lay health workers or through technological means are a cost-effective and scalable solution. Unfortunately, to date, there is too little synthesised evidence on available lay health-worker delivered or technology-based interventions, their target populations and content, their implementation and effect on different SRH outcomes as well as facilitators and barriers to intervention effectiveness. Objectives: To help fill this knowledge gap and to identify where further research is needed, we conducted a scoping review of technology-based or lay health-worker delivered preventive and educational SRH interventions targeting AYAs in LMICs. Design: Scoping review. Data sources: We searched MEDLINE (through PubMed) and Embase for eligible studies published from 1 January 2000 until 19 January 2026. Eligibility: Eligible were studies assessing the effect of preventive and educational lay health-worker delivered or technology-based interventions on any SRH outcomes among AYAs (aged 10–24 years) in LMICs published in English in peer-reviewed journals. Data extraction: Data extraction covers study details, methods, intervention strategies, outcomes and findings. Results: The scoping review includes 101 studies based on 95 research projects evaluating 94 unique interventions. Studies were conducted in 40 different countries and most (n=65) were published since 2020. Included interventions range from single-session interventions lasting less than half an hour in total to multiyear whole-of-community interventions. Most (n=54) employ technological means such as websites or social media pages (n=18), smartphone apps (n=6), text-messaging (n=15), videos (n=11) or mass-media campaigns (n=4) for intervention delivery, while the remaining (n=47) typically centre around regular face-to-face educational sessions and are delivered by peers (n=23), adult community members (n=15) or a combination of both (n=9). Included studies investigate intervention effects on a wide range of SRH outcomes, with those pertaining to SRH knowledge or attitudes getting most attention. Most studies report significant improvements for most assessed outcomes. This is particularly true for SRH knowledge, while results are slightly more mixed when it comes to some SRH behavioural or physiological outcomes. No noticeable differences in intervention effectiveness were observed between lay health-worker delivered and technology-based interventions. Identified facilitators of intervention effectiveness include the role of community outreach, as practised by some of the lay health-worker delivered interventions, in overcoming culturally grounded resistance to SRH education of AYAs. Important gaps in the literature include a scarcity of interventions tailored to male or out-of-school AYAs and a lack of attention to the extent to which improvements in SRH knowledge and attitudes translate to improvements in behavioural and physiological outcomes. Conclusion: We identified a diverse variety of lay health-worker delivered and technology-based SRH interventions showing positive effects on many different SRH outcomes among AYAs in LMICs, testifying to the great potential of those approaches. However, more research is needed focusing on so-far understudied groups and outcomes. Trial registration details: This scoping review adheres to a protocol previously published in this journal and that is registered on the Open Science Framework website ( http://osf.io/vna2z ).