Jason B. Colditz

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.

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.

Bridges and Barriers Adolescent Perceptions of Student–Teacher Relationships

In urban secondary schools where underpreparation and dropping out are real world concerns, students understand that their relationships with teachers affect their learning. Using descriptive coding and thematic analysis of focus group data, we explore adolescents’ perceptions of the bridges that foster and the barriers that inhibit supportive relationships with teachers, and the boundary expectations that function as both. The characteristics of supportive student–teacher relationships identified by youth participants suggest a number of teacher practices capable of meeting adolescents’ developmental needs and, as such, are likely to positively influence adolescents’ developmental and academic trajectories.

Item banks for alcohol use from the Patient-Reported Outcomes Measurement Information System (PROMIS®): Use, consequences, and expectancies

BACKGROUND We report on the development and calibration of item banks for alcohol use, negative and positive consequences of alcohol use, and negative and positive expectancies regarding drinking as part of the Patient-Reported Outcomes Measurement Information System (PROMIS). METHODS Comprehensive literature searches yielded an initial bank of more than 5000 items from over 200 instruments. After qualitative item analysis (including focus groups and cognitive interviewing), 141 items were included in field testing. Items for alcohol use and consequences were written in a first-person, past-tense format with a 30-day time frame and 5 response options reflecting frequency. Items for expectancies were written in a third-person, present-tense format with no time frame specified and 5 response options reflecting intensity. The calibration sample included 1407 respondents, 1000 from the general population (ascertained through an internet panel) and 407 from community treatment programs participating in the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN). RESULTS Final banks of 37, 31, 20, 11, and 9 items (108 total items) were calibrated for alcohol use, negative consequences, positive consequences, negative expectancies, and positive expectancies, respectively, using item response theory (IRT). Seven-item static short forms were also developed from each item bank. CONCLUSIONS Test information curves showed that the PROMIS item banks provided substantial information in a broad range of severity, making them suitable for treatment, observational, and epidemiological research.

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.

Measuring nonspecific factors in treatment: item banks that assess the healthcare experience and attitudes from the patient’s perspective

PurposeNonspecific factors that accompany healthcare treatments, such as patients’ attitudes and expectations, are important parts of the experience of care and can influence outcomes. However, no precise, concise, and generalizable instruments to measure these factors exist. We report on the development and calibration of new item banks, titled the Healing Encounters and Attitudes Lists (HEAL), that assess nonspecific factors across a broad range of treatments and conditions.MethodsThe instrument development methodology of the Patient-Reported Outcomes Measurement Information System (PROMIS®) was used. Patient focus groups and clinician interviews informed our HEAL conceptual model. Literature searches of eight databases yielded over 500 instruments and resulted in an initial item pool of several thousand items. After qualitative item analysis, including cognitive interviewing, 296 items were included in field testing. The calibration sample included 1657 respondents, 1400 obtained through an Internet panel and 257 from conventional and integrative medicine clinics. Following exploratory and confirmatory factor analyses, the HEAL item banks were calibrated using item response theory.ResultsThe final HEAL item banks were Patient–Provider Connection (57 items), Healthcare Environment (25 items), Treatment Expectancy (27 items), Positive Outlook (27 items), and Spirituality (26 items). Short forms were also developed from each item bank. A six-item short form, Attitudes toward Complementary and Alternative Medicine (CAM), was also created.ConclusionsHEAL item banks provided substantial information across a broad range of each construct. HEAL item banks showed initial evidence of predictive and concurrent validity, suggesting that they are suitable for measuring nonspecific factors in treatment.

Pain and emotional distress among substance-use patients beginning treatment relative to a representative comparison group.

Objectives:A secondary analysis assessed health-related quality-of-life (HRQOL) characteristics (ie, anxiety, depression, fatigue, and types of pain) among patients entering substance-use treatment and identified characteristics specific to treatment modalities relative to a representative comparison group. Methods:As part of a larger alcohol bank assessment, substance-use patients (n = 406) beginning methadone treatment (n = 170) or other outpatient treatment (n = 236) and a comparison group representative of the general population (n = 1000) completed a survey measuring anxiety, depression, fatigue, pain interference, and pain in the last 7 days. Previous studies lacked comparable and concurrent assessments across these 3 groups. Results:Patients entering substance-use treatment had relatively high levels of emotional distress and poorer HRQOL relative to the general population. Among treatment modalities, patients beginning methadone treatment reported the highest levels of pain interference and pain behavior and the poorest physical functioning. Before the potentially modifying effects of methadone maintenance, patients beginning agonist therapy reported the greatest levels of compromised quality of life. Conclusions:These data present the magnitude of differences in HRQOL characteristics between treatment and comparison groups using the same assessment rubric and may help inform the design and timing of treatment modalities, thereby enhancing treatment efficacy for patients.

World Vaping Day: Contextualizing Vaping Culture in Online Social Media Using a Mixed Methods Approach:

Few studies have demonstrated the use of mixed methods research to contextualize health topics using primary data from social media. To address this gap in the methodological literature, we present research about electronic nicotine delivery systems, using Twitter data from “World Vaping Day.” To engage with the quantitative breadth and qualitative depth of 5,149 collected tweets, we utilized a convergent parallel mixed methods framework, integrating thematic prevalence estimates with phenomenological contextualization. Sentiment was more positive than negative across all categories except policy related. A total of 23% of tweets were promotional and relatively few tweets related to tobacco use (4.9%) or health concerns (4.2%). Salient themes included modifying or upgrading electronic nicotine delivery systems devices, and general mistrust of public health advocates and tobacco companies.

Measurement of Social Capital among Clinical Research Trainees

While physical and human capital are established as important predictors of success among early‐career clinical investigators, less is known about the role of social capital. The authors aimed to develop a brief scale to assess social capital in this population and test its reliability and validity. A three‐item assessment was developed based on a conceptual framework and measures of social capital from other fields and was administered to 414 clinical research trainees at the University of Pittsburgh in 2007–2012. The measure exhibited good internal consistency reliability (α = 0.71) and a normal distribution. On a 10‐point scale, mean social capital was 6.4 (SD = 1.7). Social capital was significantly associated with 7 of the 9 expected constructs: sex, age, confidence in research skills, work‐related motivation, burnout, and social support. Exploratory multivariable regression analysis demonstrated that social capital was most strongly associated with higher research confidence (β = 0.35, p < 0.001), higher extrinsic motivation (β = 0.50, p = 0.003), and lower burnout (ptrend = 0.02). This three‐item scale measures social capital in this population with adequate internal consistency reliability, face validity, and construct validity. This brief assessment provides a tool that may be valuable to benchmark social capital of clinical research trainees and to better contextualize programmatic and trainee outcomes.