Jaime E. Sidani

ASSOCIATION BETWEEN SOCIAL MEDIA USE AND DEPRESSION AMONG U.S. YOUNG ADULTS

Social media (SM) use is increasing among U.S. young adults, and its association with mental well‐being remains unclear. This study assessed the association between SM use and depression in a nationally representative sample of young adults.

Tobacco, Marijuana, and Alcohol Use in University Students: A Cluster Analysis.

Abstract Objective: Segmentation of populations may facilitate development of targeted substance abuse prevention programs. The authors aimed to partition a national sample of university students according to profiles based on substance use. Participants: The authors used 2008–2009 data from the National College Health Assessment from the American College Health Association. The sample consisted of 111,245 individuals from 158 institutions. Methods: The sample was partitioned using cluster analysis according to current substance use behaviors. The association of cluster membership with individual and institutional characteristics was examined. Results: Cluster analysis yielded 6 distinct clusters. Three individual factors—gender, year in school, and fraternity/sorority membership—were the most strongly associated with cluster membership. Conclusions: In a large sample of university students, the authors were able to identify 6 distinct patterns of substance abuse. It may be valuable to target specific populations of college-aged substance users based on individual factors. However, comprehensive intervention will require a multifaceted approach.

The association between social media use and sleep disturbance among young adults

INTRODUCTION Many factors contribute to sleep disturbance among young adults. Social media (SM) use is increasing rapidly, and little is known regarding its association with sleep disturbance. METHODS In 2014 we assessed a nationally representative sample of 1788 U.S. young adults ages 19-32. SM volume and frequency were assessed by self-reported minutes per day spent on SM (volume) and visits per week (frequency) using items adapted from the Pew Internet Research Questionnaire. We assessed sleep disturbance using the brief Patient-Reported Outcomes Measurement Information System (PROMIS®) sleep disturbance measure. Analyses performed in Pittsburgh utilized chi-square tests and ordered logistic regression using sample weights in order to estimate effects for the total U.S. RESULTS In models that adjusted for all sociodemographic covariates, participants with higher SM use volume and frequency had significantly greater odds of having sleep disturbance. For example, compared with those in the lowest quartile of SM use per day, those in the highest quartile had an AOR of 1.95 (95% CI=1.37-2.79) for sleep disturbance. Similarly, compared with those in the lowest quartile of SM use frequency per week, those in the highest quartile had an AOR of 2.92 (95% CI=1.97-4.32) for sleep disturbance. All associations demonstrated a significant linear trend. DISCUSSION The strong association between SM use and sleep disturbance has important clinical implications for the health and well-being of young adults. Future work should aim to assess directionality and to better understand the influence of contextual factors associated with SM use.

Associations Between Smoking and Media Literacy in College Students

Organizations recommend media literacy to reduce tobacco use, and higher media literacy has been associated with lower smoking among high school students. The relationship between smoking media literacy and tobacco use, however, has not been systematically studied among college students. The purpose of this study was to determine the association between smoking and smoking media literacy among college students. We conducted the National College Health Assessment (NCHA) at a large, urban university, adding six items measuring smoking media literacy. A total of 657 students responded to this random sample e-mail survey. We used multiple logistic regression to determine independent associations between smoking media literacy items and current smoking. The media literacy scale was internally consistent (α = 0.79). Of the respondents, 21.5% reported smoking cigarettes over the past 30 days. In a fully adjusted multivariate model, participants with medium media literacy had an odds ratio (OR) for current smoking of 0.45 (95% CI = 0.29, 0.70), and those with high media literacy had an OR for current smoking of 0.38 (95% CI = 0.20, 0.70). High smoking media literacy is independently associated with lower odds of smoking. Smoking media literacy may be a valuable construct to address in college populations.

Knowledge, Attitudes, and Normative Beliefs As Predictors of Hookah Smoking Initiation: A Longitudinal Study of University Students

INTRODUCTION While cross-sectional studies have shown that hookah tobacco smoking (HTS) is an increasingly popular behavior among university students, little is known about factors associated with initiation. This study sought to determine associations between knowledge, attitudes, and normative beliefs and initiation of HTS among university students. METHODS Data were from a prospective longitudinal cohort study of 569 randomly selected first- and second-year university students. Online questionnaires that were developed in accordance with our composite theoretical model were completed in September 2010 and April 2011. RESULTS About one-seventh (13%) of participants initiated HTS by follow-up. Positive attitudes and favorable normative beliefs were associated with increased adjusted odds of initiation (AOR = 4.12, 95% CI = 2.56, 6.59; and AOR = 2.01, 95% CI = 1.35, 2.99, respectively), while negative attitudes were associated with decreased adjusted odds (AOR = 0.62, 95% CI = 0.48, 0.80). Correct knowledge regarding toxicants associated with HTS was not significantly associated with initiation. CONCLUSIONS While positive attitudes and favorable normative beliefs are associated with initiation of HTS in a cohort of never-users, increased knowledge about toxins is not associated with lower initiation. It may be particularly valuable for educational interventions to attempt to alter positive attitudes and normative beliefs related to HTS.

Use of multiple social media platforms and symptoms of depression and anxiety

IntroductionWhile increased time spent on social media (TSSM) has been associated with depression and anxiety, the independent role of using multiple social media (SM) platforms is unclear. MethodsWe surveyed a nationally-representative sample of 1787 U.S. young adults ages 1932. Depression and anxiety symptoms were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS). We assessed use of multiple SM platforms with an adapted Pew Internet Research scale. We used ordered logistic regression models to assess associations between use of multiple SM platforms and mental health outcomes while controlling for eight covariates, including overall TSSM. ResultsCompared to those who used 02 social media platforms, participants who used 711 social media platforms had substantially higher odds of having increased levels of both depression (Adjusted Odds Ratio [AOR]=3.0, 95% CI=1.94.8) and anxiety symptoms (AOR=3.2, 95% CI=2.05.1). Associations were linear (p<0.001 for all) and robust to all sensitivity analyses. ConclusionsUse of multiple SM platforms is independently associated with symptoms of depression and anxiety, even when controlling for overall TSSM. These associations are strong enough that it may be valuable for clinicians to ask individuals with depression and anxiety about multiple platform use and to counsel regarding this potential contributing factor. We found a linear association between the number of platforms used and depression.We found a linear association between the number of platforms used and anxiety.Associations remained strong after controlling for total time of social media use.

Social Media Use and Perceived Social Isolation Among Young Adults in the U.S

INTRODUCTION Perceived social isolation (PSI) is associated with substantial morbidity and mortality. Social media platforms, commonly used by young adults, may offer an opportunity to ameliorate social isolation. This study assessed associations between social media use (SMU) and PSI among U.S. young adults. METHODS Participants were a nationally representative sample of 1,787 U.S. adults aged 19-32 years. They were recruited in October-November 2014 for a cross-sectional survey using a sampling frame that represented 97% of the U.S. POPULATION SMU was assessed using both time and frequency associated with use of 11 social media platforms, including Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, and Reddit. PSI was measured using the Patient-Reported Outcomes Measurement Information System scale. In 2015, ordered logistic regression was used to assess associations between SMU and SI while controlling for eight covariates. RESULTS In fully adjusted multivariable models that included survey weights, compared with those in the lowest quartile for SMU time, participants in the highest quartile had twice the odds of having greater PSI (AOR=2.0, 95% CI=1.4, 2.8). Similarly, compared with those in the lowest quartile, those in the highest quartile of SMU frequency had more than three times the odds of having greater PSI (AOR=3.4, 95% CI=2.3, 5.1). Associations were linear (p<0.001 for all), and results were robust to all sensitivity analyses. CONCLUSIONS Young adults with high SMU seem to feel more socially isolated than their counterparts with lower SMU. Future research should focus on determining directionality and elucidating reasons for these associations.

The Association between Social Media Use and Eating Concerns among US Young Adults

BACKGROUND The etiology of eating concerns is multifactorial, and exposure to media messages is considered to be a contributor. Although traditional media, such as television and magazines, have been examined extensively in relation to eating concerns risk, the influence of social media has received relatively less attention. OBJECTIVE To examine the association between social media use and eating concerns in a large, nationally representative sample of young adults. DESIGN Cross-sectional survey. PARTICIPANTS/SETTING Participants were 1,765 young adults aged 19 to 32 years who were randomly selected from a national probability-based online nonvolunteer panel. OUTCOME MEASURES An eating concerns scale was adapted from two validated measures: the SCOFF Questionnaire and the Eating Disorder Screen for Primary Care. Social media use (including Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, and Reddit) was assessed using both volume (time per day) and frequency (visits per week). STATISTICAL ANALYSES To examine associations between eating concerns and social media use, ordered logistic regression was used, controlling for all covariates. RESULTS Compared with those in the lowest quartile, participants in the highest quartiles for social media volume and frequency had significantly greater odds of having eating concerns (adjusted odds ratio 2.18, 95% CI 1.50 to 3.17 and adjusted odds ratio 2.55, 95% CI 1.72 to 3.78, respectively). There were significant positive overall linear associations between the social media use variables and eating concerns (P<0.001). CONCLUSIONS The results from this study indicate a strong and consistent association between social media use and eating concerns in a nationally representative sample of young adults aged 19 to 32 years. This association was apparent whether social media use was measured as volume or frequency. Further research should assess the temporality of these associations. It would also be useful to examine more closely the influence of specific characteristics of social media use, including content-related and contextual features.

Behavioral associations with waterpipe tobacco smoking dependence among US young adults.

BACKGROUND AND AIMS Waterpipe tobacco smoking (WTS) is increasingly prevalent in the United States, especially among young adults. We aimed to (1) adapt items from established dependence measures into a WTS dependence scale for US young adults (the US Waterpipe Dependence Scale), (2) determine the factor structure of the items and (3) assess associations between scale values and behavioral use characteristics known to be linked to dependence. DESIGN Cross-sectional survey. SETTING United States. PARTICIPANTS A total of 436 past-year waterpipe tobacco users ages 18-30 years selected at random from a national probability-based panel. MEASUREMENTS Participants responded to six tobacco dependence items adapted for WTS in US populations. Behavioral use characteristics included factors such as frequency of use and age of initiation. FINDINGS Principal components analysis yielded an unambiguous one-factor solution. Approximately half (52.9%) of past-year waterpipe tobacco users received a score of 0, indicating that none of the six WTS dependence items were endorsed. Approximately one-quarter (25.4%) endorsed one dependence item and 22.7% endorsed two or more items. Higher WTS dependence scores were associated significantly with all five behavioral use characteristics. For example, compared with those who endorsed no dependence items, those who endorsed two or more had an adjusted odds ratio (AOR) of 3.90 [95% confidence interval (CI) = 1.56-9.78] for having had earlier age of initiation and an AOR of 32.75 (95% CI = 9.76-109.86) for more frequent WTS sessions. CONCLUSIONS Scores on a six-item waterpipe tobacco smoking dependence scale (the US Waterpipe Dependence Scale) correlate with measures that would be expected to be related to dependence, such as amount used and age of initiation.

Reigniting tobacco ritual: waterpipe tobacco smoking establishment culture in the United States.

INTRODUCTION Waterpipe tobacco smoking (WTS) is an increasingly prevalent form of tobacco use in the United States. Its appeal may stem from its social, ritualistic, and aesthetic nature. Our aim in this study was to understand WTS as a social ritual with the goal of informing prevention efforts. METHODS We conducted a covert observational study consisting of 38 observation sessions in 11 WTS establishments in 3 U.S. cities. Data collection was based on an established conceptual framework describing ritualistic elements of tobacco use. Iterative codebook development and qualitative thematic synthesis were used to analyze data. RESULTS Atmospheres ranged from quiet coffee shop to boisterous bar party environments. While some children and older adults were present, the majority of clientele were young adults. Men and women were evenly represented. However, there were 19 occurrences of a male smoking by himself, but no women smoked alone. The vast majority (94%) of the clientele were actively smoking waterpipes. All 83 observed groups manifested at least 1 of the ritual elements of our conceptual framework, while 41 of the 83 observed groups (49%) demonstrated all 4 ritual elements. CONCLUSIONS Despite its heterogeneity, WTS is often characterized by 1 or more established elements of a tobacco-related social ritual. It may be valuable for clinical and public health interventions to acknowledge and address the ritualistic elements and social function of WTS.