Megan A. Moreno

Emergence and predictors of alcohol reference displays on Facebook during the first year of college

The purpose of this study was to investigate the emergence of displayed alcohol references on Facebook for first-year students from two universities. Graduated high school seniors who were planning to attend one of the two targeted study universities were recruited. Participants Facebook profiles were evaluated for displayed alcohol references at baseline and every four weeks throughout the first year of college. Profiles were categorized as Non-Displayers, Alcohol Displayers or Intoxication/Problem Drinking Displayers. Analyses included logistic regression, univariate and multivariate Cox proportional hazard analysis and multi-state Markov modeling. A total of 338 participants were recruited, 56.1% were female, 74.8% were Caucasian, and 58.8% were from University A. At baseline, 68 Facebook profiles (20.1%) included displayed alcohol references. During the first year of college, 135 (39.9%) profiles newly displayed alcohol. In multivariate Cox proportional hazard analysis, university (University B versus A, HR = 0.47, 95% CI: 0.28-0.77, p = 0.003), number of Facebook friends (HR = 1.19, 95% CI: 1.09-1.28, p < 0.001 for every 100 more friends), and average monthly status updates (HR = 1.03, 95% CI: 1.002-1.05, p = 0.033) were identified as independent predictors for new alcohol display. Findings contribute to understanding the patterns and predictors for displayed alcohol references on Facebook.

Secret Society 123: Understanding the Language of Self-Harm on Instagram

PURPOSEnNonsuicidal self-injury (NSSI) content is present on social media and may influence adolescents. Instagram is a popular site among adolescents in which NSSI-related terms are user-generated as hashtags (words preceded by a #). These hashtags may be ambiguous and thus challenging for those outside the NSSI community to understand. The purpose of this study was to evaluate the meaning, popularity, and content advisory warnings related to ambiguous NSSI hashtags on Instagram.nnnMETHODSnThis study used the search term #selfharmmm to identify public Instagram posts. Hashtag terms co-listed with #selfharmmm on each post were evaluated for inclusion criteria; selected hashtags were then assessed using a structured evaluation for meaning and consistency. We also investigated the total number of Instagram search hits for each hashtag at two time points and determined whether the hashtag prompted a Content Advisory warning.nnnRESULTSnOur sample of 201 Instagram posts led to identification of 10 ambiguous NSSI hashtags. NSSI terms included #blithe, #cat, and #selfinjuryy. We discovered a popular image that described the broader community of NSSI and mental illness, called #MySecretFamily. The term #MySecretFamily had approximately 900,000 search results at Time 1 and >1.5 million at Time 2. Only one-third of the relevant hashtags generated Content Advisory warnings.nnnCONCLUSIONSnNSSI content is popular on Instagram and often veiled by ambiguous hashtags. Content Advisory warnings were not reliable; thus, parents and providers remain the cornerstone of prompting discussions about NSSI content on social media and providing resources for teens.

#Proana: Pro-Eating Disorder Socialization on Twitter.

PURPOSEnPro-eating disorder (ED) online movements support engagement with ED lifestyles and are associated with negative health consequences for adolescents with EDs. Twitter is a popular social media site among adolescents that provides a unique setting for Pro-ED content to be publicly exchanged. The purpose of this study was to investigate Pro-ED Twitter profiles references to EDs and how their social connections (followers) reference EDs.nnnMETHODSnA purposeful sample of 45 Pro-ED profiles was selected from Twitter. Profile information, all tweets, and a random sample of 100 of their followers profile information were collected for content analysis using the Twitter Application Programming Interface. A codebook based on ED screening guidelines was applied to evaluate ED references. For each Pro-ED profile, proportion of tweets with ED references and proportion of followers with ED references in their own profile were evaluated.nnnRESULTSnIn total, our 45 Pro-ED profiles generated 4,245 tweets for analysis. A median of 36.4% of profiles tweets contained ED references. Pro-ED profiles had a median of 173 followers, and a median of 44.5% of followers had ED references. Pro-ED profiles with more tweets with ED references also tended to have more followers with ED references (βxa0= .37, p < .01).nnnCONCLUSIONSnFindings suggest that profiles which self-identify as Pro-ED express disordered eating patterns through tweets and have an audience of followers, many of whom also reference ED in their own profiles. ED socialization on Twitter might provide social support, but in the Pro-ED context this activity might also reinforce an ED identity.

Exploring depression and problematic internet use among college females

Display Omitted We examined depression, problematic internet use (PIU) and internet use time.Participants risk for PIU increased by 27% with each additional 30min spent online.PIU risk was greatly increased among those who met criteria for severe depression.Symptoms of trouble concentrating and suicidal ideation were strongly associated with PIU.College health centers should consider dual screening for depression and PIU. ObjectiveThe purpose of this study was to assess associations between depression and problematic internet use (PIU) among female college students, and determine whether Internet use time moderates this relationship. MethodThis cross-sectional survey included 265 female college students from four U.S. universities. Students completed the Patient Health Questionnaire-9 (PHQ-9), the Problematic and Risky Internet Use Screening Scale (PRIUSS) and self-reported daily Internet use. Analyses included multivariate analysis of variance and Poisson regression. ResultsParticipants reported mean age of 20.2years (SD=1.7) and were 84.9% Caucasian. The mean PHQ-9 score was 5.4 (SD=4.6); the mean PRIUSS score was 16.4 (SD=11.1). Participants risk for PIU increased by 27% with each additional 30min spent online using a computer (RR=1.27, 95% CI: 1.14-1.42, p<.0001). Risk for PIU was significantly increased among those who met criteria for severe depression (RR=8.16 95% CI: 4.27-15.6, p<.0001). The PHQ-9 items describing trouble concentrating, psychomotor dysregulation and suicidal ideation were most strongly associated with PIU risk. ConclusionsThe positive relationship between depression and PIU among female college students supports screening for both conditions, particularly among students reporting particular depression symptoms.

A Fitbit and Facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors: A pilot study

Physical activity (PA) may be important for preventing chronic diseases for adolescent and young adult (AYA) childhood cancer survivors. Randomized controlled trials (RCTs) of PA interventions for AYA survivors are sparse, but necessary to determine effective programs for increasing PA among this population. Thus, we conducted a pilot RCT, testing the feasibility of a mobile health (mHealth) intervention to promote PA among AYA survivors.

Friending adolescents on social networking websites: a feasible research tool

ObjectiveSocial networking sites (SNSs) are increasingly used for research. This paper reports on two studies examining the feasibility of friending adolescents on SNSs for research purposes.MethodsStudy 1 took place on http://www.MySpace.com where public profiles belonging to 18-year-old adolescents received a friend request from an unknown physician. Study 2 took place on http://www.Facebook.com where college freshmen from two US universities, enrolled in an ongoing research study, received a friend request from a known researcher’s profile. Acceptance and retention rates of friend requests were calculated for both studies.ResultsStudy 1: 127 participants received a friend request; participants were 18xa0years-old, 62.2% male and 51.8% Caucasian. 49.6% accepted the friend request. After 9xa0months, 76% maintained the online friendship, 12.7% defriended the study profile and 11% deactivated their profile. Study 2: 338 participants received a friend request; participants were 18xa0years-old, 56.5% female and 75.1% Caucasian. 99.7% accepted the friend request. Over 12xa0months, 3.3% defriended the study profile and 4.1% deactivated their profile. These actions were often temporary; the overall 12-month friendship retention rate was 96.1%.ConclusionFriending adolescents on SNSs is feasible and friending adolescents from a familiar profile may be more effective for maintaining online friendship with research participants over time.

Social media use by physicians: a qualitative study of the new frontier of medicine

BackgroundA growing number of physicians are using social media as a professional platform for health communication. The purpose of this study was to understand perspectives and experiences of these “early adopter” physician bloggers and social media users.MethodsThis was an exploratory qualitative study involving in-depth semi-structured telephone interviews of physicians who were early adopters, defined as physicians who used social media to distribute health information. Participants were recruited through snowball sampling. Interview transcripts were manually analyzed for common themes by three separate investigators who came to common conclusions via the constant comparative method.ResultsSeventeen physicians participated in this study, including 35xa0% females, 76xa0% pediatricians and 76xa0% bloggers. Participants identified multiple perceived benefits and barriers to social media use by physicians; further, four major themes were identified. First, participants often saw themselves as rugged individualists who set their own rules for social media health communications. Second, participants expressed uncertainty about boundaries or strategies for social media use. Third, participants described using social media much like traditional media, as a one-way communication platform, rather than as an interactive forum. Finally, participants expressed disparate views regarding the time involved in participating in social media; some felt that time spent on social media was unproblematic to fit into their day while others felt that it was an impediment to patient care.ConclusionsUncertainty remains regarding roles and responsibilities of physicians providing medical content within social media forums and few providers appeared to be using the platform to its full potential. Future studies may inform best practices to optimize social media health communication to benefit patients.

Development and Testing of a 3-Item Screening Tool for Problematic Internet Use

OBJECTIVEnTo develop and validate the Problematic and Risky Internet Use Screening Scale (PRIUSS)-3 screening scale, a short scale to screen for Problematic Internetxa0Use.nnnSTUDY DESIGNnThis scale development study applied standard processes using separate samples for training and testing datasets. We recruited participants from schools and colleges in 6 states and 2 countries. We selected 3 initial versions of a PRIUSS-3 using correlation to the PRIUSS-18 score. We evaluated these 3 potential screening scales for conceptual coherence, factor loading, sensitivity, and specificity. We selected a 3-item screening tool and evaluated it in 2 separate testing sets using receiver operating curves.nnnRESULTSnOur study sample included 1079 adolescents and young adults. The PRIUSS-3 included items addressing anxiety when away from the Internet, loss of motivation when on the Internet, and feelings of withdrawal when away from the Internet. This screening scale had a sensitivity of 100% and specificity of 69%. A score of ≥3 on the PRIUSS-3 was the threshold to follow up with the PRIUSS-18.nnnDISCUSSIONnSimilar to other clinical screening tools, the PRIUSS-3 can be administered quickly in a clinical or research setting. Positive screens should be followed by administering the full PRIUSS-18. Given the pervasive presence of the Internet in youths lives, screening and counseling for Problematic Internet Use can be facilitated by use of this validated screening tool.

Marijuana experiences, voting behaviors, and early perspectives regarding marijuana legalization among college students from 2 states

ABSTRACT Objective: The purpose of this mixed-methods study was to understand college students (1) views and experiences regarding marijuana, (2) voting behaviors, and (3) early perceptions of the impact of legislation. Participants: College students from Washington and Wisconsin were interviewed between May and September 2013. Methods: Participants completed phone interviews assessing marijuana attitudes, intentions, behaviors, voting behaviors or intentions, and perceptions of the impact of legislation. Results: A total of 283 participants completed the interview (83.7% retention rate): 56.8% were female, 57.2% were from Wisconsin, and 74.6% were Caucasian. Almost half of Washington participants (46.3%) indicated that they voted for marijuana legalization. Participants most commonly responded that the legislation did not change their attitudes towards marijuana, although some participants discussed perceived safety of the product because legislation passed. Conclusions: Findings indicate similarities in views and experiences among college students from states affected and unaffected by legalization; legalization may increase perceptions of safety.

Family Engagement in Pediatric Sickle Cell Disease Visits.

ABSTRACT Adults with sickle cell disease (SCD) report problems in relationship building and information exchange during clinic visits. To explore the origin of these communication challenges, we compare communication in pediatric SCD, diabetes, and asthma visits. We collected visit videos and parent surveys from 78 children ages 9–16 years with SCD, asthma, or diabetes. Coders assessed child, parent, and physician utterances reflecting relationship building, information giving, and information gathering. Associations of engagement with type of chronic disease visit were performed with negative binomial regression. Compared to SCD visits, children in diabetes visits spoke 53% more relationship-building utterances (p < .05) and physicians in asthma visits spoke 48% fewer relationship building utterances to the child (p < .01). In diabetes visits, physicians gave almost twice as much information to children and gave 48% less information to parents (both p < .01) compared to SCD visits. Compared to SCD visits, physicians spoke fewer information-gathering utterances to parents in diabetes and asthma visits (85% and 72% respectively, both p < .001). SCD visits reflect less engagement of the children and greater physician effort to gather information from parents. These differences highlight opportunities to enhance engagement as a mechanism for ultimately improving SCD care.