Perspectives on Education From Gastrointestinal (GI) Cancer Patients in the Deep South: Qualitative Analysis.

Adverse Childhood Experiences (ACEs) are linked to physical, mental, and social health problems in adolescents (Gajos et al., ; Swedo, ). Male and female adolescents show distinct patterns of ACE exposure and sequelae (Haahr‐Pedersen et al., ). Relative to males, females are more likely to report physical abuse and sexual assault and to exhibit related internalizing symptoms, including self‐harm, suicidal ideation and attempts (Duke et al., ), social isolation, and loneliness (Leban, ). These stress‐related withdrawn social behaviors are associated with psychiatric outcomes, such as depression and anxiety (Loades et al., ), as well as adverse cardiovascular outcomes, including coronary heart disease and stroke (Valtorta et al., ). The latter association is largely attributed to chronic activation of the hypothalamic–pituitary–adrenal (HPA) axis and sympathetic nervous system. Over time, this chronic activation dysregulates autonomic nervous system functioning, promotes chronic inflammation, and elevates risk for cardiovascular disease in adulthood (Porges, ; Shonkoff et al., ). Collectively, these findings underscore the urgent need for early interventions that address ACEs before they contribute to the development of chronic mental and physical illness. Racial and ethnic minority youth are at a high risk of ACEs, including both family and community‐related ACEs (Zhen‐Duan et al., ). Risk factors for ACEs among minoritized adolescents include racism, discrimination, and systemic oppression (Bernard et al., ). Latinx youth are at elevated risk of ACEs (e.g., immigration‐related exposure to violence and abuse) (Zetino et al., ) and have reported more ACEs compared to other ethnic groups (e.g., non‐Hispanic white, Somali, Hmong) (Landry et al., ). ACEs are highly correlated with suicidality in racially and ethnically minoritized youth, including Latinx females (Jewett et al., ). These compounding vulnerabilities highlight the importance of addressing the unique ACE profiles of Latinx and other racially and ethnically minoritized adolescents. Social connectedness (SC) is a protective factor against negative impacts of ACEs, including stress, anxiety, depression, and suicidality (Arango et al., ; Landry et al., ; Weisblum et al., ). Defined as the sense of belonging and feeling close to others, SC reflects an individual's subjective awareness of being part of an interconnected social world. It captures the degree to which individuals perceive themselves as meaningfully integrated into their social environment rather than feeling separate or alienated from others (Lee & Robbins, ). With Latinx adolescents reporting lower peer connectedness than their non‐Hispanic counterparts (Arango et al., ), SC is an especially relevant interventional target for this population for reducing ACE‐related health disparities.