{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:59Z","timestamp":1787014379872,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T00:00:00Z","timestamp":1694304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005326","name":"Yale University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Mental Health Nurs"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Mental health challenges appear common among adolescents in American Samoa. There is a community\u2010identified need to better understand the health burden and identify opportunities to strengthen the mental health system to better meet adolescent mental health needs. The goal of this qualitative study was to gather community stakeholders' perceptions of common mental health problems among adolescents in American Samoa, identify existing services for adolescent mental health, and highlight strength\u2010based opportunities to enhance care. Using the\n                    <jats:italic>Fa'afaletui<\/jats:italic>\n                    research framework, semi\u2010structured in\u2010depth interviews (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200928) were conducted between October 2020 and February 2021 using Zoom. Key informants were adults living in American Samoa, sampled for diversity in profession, age, gender, education, and region of residence. Transcripts were coded in duplicate and analysed using deductive thematic analysis. Participants reported that suicide, depression, anxiety, and post\u2010traumatic stress disorder are the conditions of highest burden. Participants identified an impressive amount of infrastructure and community mobilization, but also limitations in these services in addressing adolescents' health needs. Four themes arose related to the need to: (1) strengthen existing infrastructure; (2) reduce barriers to treatment access; (3) improve sustainability; and (4) encourage collaboration among leaders. Policymakers should prioritize the allocation of resources to strengthen infrastructure, public education, and stakeholder collaboration to improve adolescent mental health in American Samoa.\n                  <\/jats:p>","DOI":"10.1111\/inm.13223","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T01:37:20Z","timestamp":1694396240000},"page":"85-92","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["\u201cThere are still broken or fragmented systems\u201d: Qualitative assessment of needs to strengthen adolescent mental health services in American Samoa"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5667-1394","authenticated-orcid":false,"given":"Emma J.","family":"Mew","sequence":"first","affiliation":[{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Blas","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Winschel","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Yale School of Public Health Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leiema","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Health American Samoa Government  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si'itia","family":"Soliai\u2010Lemusu","sequence":"additional","affiliation":[{"name":"Department of Health American Samoa Government  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Health American Samoa Government  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah R.","family":"Lowe","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Yale School of Public Health Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mata'uitafa","family":"Faiai","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Naseri","sequence":"additional","affiliation":[{"name":"Obesity, Lifestyle, And Genetic Adaptations (OLAGA) Study Group  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L. M.","family":"Toelupe","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francine","family":"Ipou","sequence":"additional","affiliation":[{"name":"Portland State University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moelili'a","family":"Seui","sequence":"additional","affiliation":[{"name":"Intersections, Inc.  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trude","family":"Ledoux\u2010Sunia","sequence":"additional","affiliation":[{"name":"Christopher James Foeoletini Ledoux Foundation  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiafia","family":"Sunia","sequence":"additional","affiliation":[{"name":"Christopher James Foeoletini Ledoux Foundation  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Galea\u2019i","sequence":"additional","affiliation":[{"name":"Behavioral Health Clinic Lyndon B. Johnson (LBJ) Tropical Medical Center  American Samoa Pago Pago USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhayna","family":"Poulin","sequence":"additional","affiliation":[{"name":"Yale College Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2601-3454","authenticated-orcid":false,"given":"Nicola L.","family":"Hawley","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Epidemiology, Yale School of Public Health Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jueta","family":"McCutchan\u2010Tofaeono","sequence":"additional","affiliation":[{"name":"Empowering Pacific Island Communities (EPIC)  Pago Pago American Samoa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_12_3_1","unstructured":"American Samoa Department of Commerce. (2016)Population by age group. Available from:https:\/\/americansamoa.prism.spc.int\/social\/demography\/population\u2010by\u2010age\u2010group.html[Accessed 28th June 2022]."},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2011.628913"},{"key":"e_1_2_12_6_1","unstructured":"Central Intelligence Agency. (2023)American Samoa. Available from:https:\/\/www.cia.gov\/the\u2010world\u2010factbook\/countries\/american\u2010samoa\/[Accessed 18th January 2023]."},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558689820985948"},{"issue":"4","key":"e_1_2_12_8_1","first-page":"1","article-title":"Youth risk behavior surveillance\u2013United States, 2013","volume":"63","author":"Kann L.","year":"2014","journal-title":"MMWR Supplements"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752\u20104458\u20105\u20104"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental\u20102021\u2010300254"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(09)60827\u20108"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127\u2010018\u20101578\u2010y"},{"issue":"3","key":"e_1_2_12_13_1","first-page":"3351","article-title":"Doing a thematic analysis: a practical, step\u2010by\u2010step guide for learning and teaching scholars","volume":"9","author":"Maguire M.","year":"2017","journal-title":"All Ireland Journal of Higher Education"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-87763-7_4"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010018\u20101115\u20106"},{"key":"e_1_2_12_16_1","unstructured":"Radio New Zealand. (2016)American Samoa official appeals for help with suicide cases. Available from:https:\/\/www.rnz.co.nz\/international\/pacific\u2010news\/313982\/american\u2010samoan\u2010official\u2010appeals\u2010for\u2010help\u2010with\u2010suicide\u2010cases[Accessed 28th June 2022]"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(18)31615\u20105"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/j.1440\u20101614.2005.01572.x"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsw\/bcz160"},{"key":"e_1_2_12_20_1","unstructured":"US Census Bureau. (2021)Census Bureau Releases 2020 Census Population and Housing Unit Counts for American Samoa. Available from:https:\/\/www.census.gov\/newsroom\/press\u2010releases\/2021\/2020\u2010census\u2010american\u2010samoa.html[Accessed 18th January 2023]"},{"key":"e_1_2_12_21_1","unstructured":"US Centers for Disease Control. (2014)Youth Risk Behavior Surveillance Survey \u2013 American Samoa. Available from:https:\/\/nccd.cdc.gov\/Youthonline\/App\/Default.aspx[Accessed 18th January 2023]"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/appy.12452"},{"key":"e_1_2_12_23_1","unstructured":"World Health Organization. (2016)mhGAP intervention guide for mental neurological and substance use disorders in non\u2010specialized health settings: mental health Gap Action Programme (mhGAP) \u2013 Version 2.0. Available from:https:\/\/www.who.int\/publications\/i\/item\/9789241549790[Accessed 28th June 2022]"}],"container-title":["International Journal of Mental Health Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/inm.13223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T01:42:19Z","timestamp":1705714939000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/inm.13223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,10]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/inm.13223"],"URL":"https:\/\/doi.org\/10.1111\/inm.13223","archive":["Portico"],"relation":{},"ISSN":["1445-8330","1447-0349"],"issn-type":[{"value":"1445-8330","type":"print"},{"value":"1447-0349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,10]]},"assertion":[{"value":"2023-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}