Friends' Alcohol-Related Social Networking Site Activity Predicts Escalations in Adolescent Drinking: Mediation by Peer Norms

Food-Related Online Media (Mukbang and Cookbang) Exposure and Dietary Risk Behaviors in Korean Adolescents

BACKGROUND

Studies have shown that prolonged smartphone use is associated with dietary risk behaviors among adolescents. However, little is known about whether the exposure to food-related online media contents, such as mukbang (eating broadcast) and cookbang (cooking broadcast), is associated with unhealthy dietary behaviors, independent of overall duration of smartphone use.

OBJECTIVES

This study investigated the associations between the frequency of mukbang/cookbang watching and dietary risk behaviors among Korean adolescents, using nationally representative survey data.

METHODS

In this cross-sectional study, we examined the data from 50,044 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2022. Participants reported their frequency of mukbang/cookbang watching, average duration of smartphone use, frequency of breakfast eating, frequency of nighttime eating, and intakes of fast foods, sugar-sweetened beverages (SSBs), and high-caffeine drinks. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between mukbang/cookbang watching and dietary risk behaviors, accounting for complex survey sampling and adjusting for potential confounders.

RESULTS

Frequent mukbang/cookbang watching (≥5 times/wk compared with never) was positively associated with dietary risk behaviors, including frequent breakfast skipping (OR: 1.20; 95% CI: 1.13, 1.28), frequent nighttime eating (OR: 1.43; 95% CI: 1.33, 1.54), and frequent intakes of fast foods (OR: 1.69; 95% CI: 1.58, 1.80), SSBs (OR: 1.47; 95% CI: 1.30, 1.66), and high-caffeine drinks (OR: 1.41; 95% CI: 1.33, 1.50), adjusting for duration of smartphone use. All mukbang/cookbang viewers, including those who perceived that mukbang/cookbang videos had "no influence" on their dietary behavior, had higher prevalence of dietary risk behaviors than nonviewers (perceived "no influence" compared with nonviewers-OR: 1.18; 95% CI: 1.10, 1.26, breakfast skipping; OR: 1.15; 95% CI: 1.06, 1.24, nighttime eating; OR: 1.40; 95% CI: 1.30, 1.50, fast foods; OR: 1.22; 95% CI: 1.07, 1.38, SSBs; OR: 1.28; 95% CI: 1.20, 1.37, high-caffeine drinks).

CONCLUSIONS

Our findings suggest that frequent mukbang/cookbang watching may be associated with unhealthy dietary behaviors among Korean adolescents.

Risk perception and interpersonal discussion on risk: A systematic literature review

Risk perception research has long been attentive to the fact that risk is a social construction. Nevertheless, this fact has not been integrated into empirical research in any systematic manner. Empirical studies that do focus on the social construction of risk often do so from very different positions and with different objectives in mind. Interpersonal discussion, while considered an important medium of social construction, is rarely given consideration. This systematic literature review aims to provide a coherent foundation for empirical studies of interpersonal discussion on risk. Specifically, it summarizes existing research into the reciprocal relationship between interpersonal discussion on risk and individual-level risk perception. The systematic literature review adheres to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. A total of 843 unique articles were identified, of which 60 are included in the review. A majority of the articles in the corpus found a positive association between interpersonal discussion on risk and risk perception. This association, however, lacks robustness, especially in terms of the direction of causality. Three theoretical interpretations of the relationship are found in the corpus: (1) interpersonal discussion as a conduit for risk information, (2) risk perception as shared social schemata, and (3) interpersonal discussion on risk as a facilitator of similarity between network members. Implications for future research are discussed. This literature review concludes with six guiding principles for future research into the interpersonal discussion-risk perception relationship.

Cross-substance Effects of Adolescent Exposure to Alcohol Content in Popular Movies on Cannabis Initiation

Objective

Alcohol is the most frequently depicted substance in the media, and adolescent exposure to alcohol in the media predicts alcohol use. There is relatively little research on exposure to cannabis in the media, but exposure to alcohol content may exert cross-substance effects on cannabis use. Given the social and health risks associated with early cannabis use, the present study aims to assess the cross-substance effects of exposure to alcohol media content on age of cannabis initiation.

Method

A sample of 830 middle school students (53% female) reported on movie alcohol exposure and cannabis initiation longitudinally until high school completion. Discrete-time survival models examined whether movie alcohol exposure predicted subsequent initiation among students who were cannabis-naïve at baseline, controlling for demographic, social, and behavioral covariates. The interaction between sex and movie alcohol exposure was also explored.

Results

One third (33%) of participants reported cannabis initiation with a mean of 5.57 estimated hours (SD = 4.29) of movie alcohol exposure. A 1-hour increase in movie exposure predicted a significant 16% increased probability of cannabis initiation in models adjusted for demographic variables and a significant 14% increase in models adjusted for demographic, behavioral, and social variables. No differences were observed across sex.

Conclusions

Greater adolescent exposure to alcohol content in the media was associated with earlier cannabis initiation above and beyond other etiologically relevant demographic, behavioral, and social variables. The influence of cross-substance media exposures warrants further exploration and should be taken into consideration in the development of preventive interventions for youth substance use.

Characteristics of Adolescents' and Young Adults' Exposure to and Engagement with Nicotine and Tobacco Product Content on Social Media

To inform policy and messaging, this study examined characteristics of adolescents' and young adults' (AYAs') exposure to and engagement with nicotine and tobacco product (NTP) social media (SM) content. In this cross-sectional survey study, AYAs aged 13-26 (N=1,163) reported current NTP use, SM use frequency, and exposure to and engagement with SM content promoting and opposing NTP use (i.e. frequency, source[s], format[s], platform[s]). Participants who used NTPs (vs. did not use) were more likely to report having seen NTP content (p-values<.001). Prevalent sources were companies/brands (46.6%) and influencers (44.4%); prevalent formats were video (65.4%) and image (50.7%). Exposure to content promoting NTP use was prevalent on several popular platforms (e.g. TikTok, Instagram, Snapchat); exposure to content opposing NTP use was most prevalent on YouTube (75.8%). Among those reporting content engagement (i.e. liking, commenting on, or sharing NTP content; 34.6%), 57.2% engaged with influencer content. Participants reported engaging with content promoting and opposing NTP use on popular platforms (e.g. TikTok, Instagram, YouTube). Participants with (versus without) current NTP use were significantly more likely to use most SM platforms and to report NTP content exposure and engagement (p-values<.05). Results suggest that NTP education messaging and enforcement of platforms' content restrictions are needed.

Association Between Social Media Use and Substance Use Among Middle and High School-Aged Youth

Purpose: The purpose of our study was to identify whether different aspects of social media use were associated with substance use among middle- and high school-aged youth. Methods: Participants were recruited from four Northeast U.S. middle schools and invited to complete an online survey in Fall 2019 and Fall 2020. We conducted separate adjusted logistic mixed effects models the substance use outcomes: ever use of alcohol, cannabis, e-cigarettes, tobacco cigarettes, prescription drugs, and multiple substances. Our sample included N = 586 participants (52.7% female, 58% White). Results: Seeing a social media post about drugs/alcohol in the past-12-months was significantly associated with higher odds of ever using alcohol, cannabis, e-cigarettes, and multiple substance use. Total number of social media sites ever used was significantly associated with higher odds of ever using cannabis, cigarettes, e-cigarettes, and multiple substances. Checking social media every hour or more was significantly associated with higher odds of ever using alcohol. Higher problematic internet use score was significantly associated with higher odds of ever using cannabis, e-cigarettes, and multiple substances. Online social support seeking score was not associated substance use. Conclusions: Our findings support the need for substance use prevention and social media literacy education and screening to begin early, ideally in elementary school before youth are using social media and substances.

Social Media Use and Alcohol Sipping in Early Adolescents: A Prospective Cohort Study

BACKGROUND

Social media can influence alcohol initiation behaviors such as sipping, which can lead to future adverse alcohol-related outcomes. Few studies have examined the role of problematic social media use, characterized by addiction, mood modification, tolerance, withdrawal, conflict, and relapse, especially in early adolescence.

OBJECTIVE

To examine the prospective association between social media use and sipping alcohol in a nationwide sample of early adolescents, and the extent to which problematic social media use mediates the association.

METHODS

We analyzed prospective data from the Adolescent Brain Cognitive Development Study (N = 7514; ages 9-10 years at baseline; 2016-2018) to estimate associations between social media time (Year 1) and alcohol sipping (Year 3) using modified Poisson regression, adjusting for confounders and testing problematic social media use (Year 2) as a mediator.

RESULTS

Social media time (Year 1) was prospectively associated with 1.31 (95% confidence interval 1.20-1.43) times higher risk of new-onset sipping (Year 3). The association between social media time and new-onset alcohol sipping was partially mediated by problematic social media use at Year 2 (25.0% reduction in the association between the former two factors after adding problematic social media use, p = 0.002).

CONCLUSIONS

Time spent on social media was associated with a higher risk of alcohol sipping in a diverse national sample of early adolescents, and the association was partially mediated by problematic social media use. Media literacy education and family media use plans could advise early adolescents about exposure to alcohol content on social media and warning signs for problematic use.

Subjective norms as a mediator between exposure to online alcohol and marijuana content and offline use among adolescents

INTRODUCTION

While adolescent substance use (SU) may be viewed as normative, SU can quickly escalate leading to consequences. Social media use may increase SU risk. Despite using social media to connect with others, adolescents also view depictions of glamorised SU by both peers and influential figures. Exposure to online alcohol and marijuana content may impact subjective norms (i.e., injunctive and descriptive) ultimately leading to increased offline SU. Data from a multi-wave project was collected to assess whether subjective norms-mediated associations between exposure to alcohol and marijuana content by peers and influential figures on Instagram and Snapchat and offline SU.

METHODS

At Wave 1, participants were 264 adolescents (Mage  = 14.91, 51% female, 86% White, 85% Hispanic/Latino/a/x).

RESULTS

Injunctive norms significantly mediated associations between exposure to alcohol content posted by peers and influential figures on Instagram and Snapchat and offline alcohol use. Injunctive norms significantly mediated associations between exposure to marijuana content posted by peers and influential figures on Instagram, and peers on Snapchat and offline marijuana use. Descriptive norms significantly mediated associations between exposure to alcohol content posted by peers on Instagram, as well as peers and influential figures on Snapchat and offline alcohol use.

DISCUSSION AND CONCLUSION

Increased exposure to online SU content was more consistently associated with injunctive norms rather than descriptive norms. Future research should examine which social media features (e.g., the like button) contribute to increased subjective norms. Overall, findings suggest that social media may strongly convey approval of SU behaviours rather than actual use.

A qualitative analysis of adolescents' perspectives on peer and influencer alcohol-related posts on social media

INTRODUCTION

Adolescent exposure to alcohol-related content on social media is common and associated with alcohol use and perceived norms; however, little is known about how exposure differs by the source of the content (e.g., peer or 'influencer'). The purpose of this study was to utilise qualitative methods to compare adolescent perspectives on peer- versus influencer-generated alcohol content on social media.

METHODS

Nine virtual semi-structured focus groups were conducted with adolescents (aged 15-19 years), following a general script aimed at ascertaining adolescent comparative perspectives on peer and influencer alcohol-related media content and the contexts in which it occurs.

RESULTS

Five main themes emerged: (i) although both influencers and peers post predominantly positively-valenced alcohol content online, adolescents perceived some differences between these posts; (ii) adolescents perceived their peers to be more cautious and strategic when posting about alcohol than influencers are; (iii) the decision to engage with peer or influencer alcohol-related posts is influenced by a number of factors; (iv) both peer and influencer posts were perceived to send the message that drinking is acceptable, normal or cool; and (v) adolescents believed they are more likely to be influenced by peers' alcohol posts than influencers' alcohol posts, with some exceptions.

DISCUSSION AND CONCLUSIONS

Future studies should aim to further understand the unique attributes and circumstances in which exposure to peer and influencer alcohol-related posts impact adolescent alcohol-related cognitions and behaviours. This knowledge will inform prevention and intervention efforts, such as media literacy training and media-specific parenting practices.

A systematic review and meta-analysis of the relationship between youth drinking, self-posting of alcohol use and other social media engagement (2012-21)

BACKGROUND AND AIM

Social networking sites (SNS) are interactive internet-based social platforms that facilitate information sharing. A growing body of literature on exposure to, and self-posting of, alcohol-related content on SNS has examined the relationship between SNS use and alcohol consumption in young people. This study aims to synthesise the literature exploring the relationship between exposure (i.e. viewing or listening of alcohol-related media) and self-posting (i.e. uploading images or text of alcohol content) of alcohol-related media on SNS on alcohol consumption.

METHODS

A pre-registered systematic review was conducted in June 2022 within PubMed, Scopus, PsycINFO and Web of Science. Original prospective and cross-sectional studies assessing youth and young adults (≤ 24 years of age) that measured exposure to alcohol-related media or posting of alcohol-related content on SNS and self-reported alcohol consumption outcomes were included. Meta-analyses were conducted on comparable methodologies.

RESULTS

Thirty studies were included (n = 19,386). Meta-analyses of cross-sectional studies showed both greater exposure (five studies; pooled β = 0.34, 95% confidence interval [CI] = 0.23, 0.44, i2 = 27.7%) and self-posting of alcohol-related content (six studies; pooled β = 0.57, 95%CI = 0.25,0.88, i2 = 97.8%) was associated with greater alcohol consumption. Meta-analyses of three prospective studies also identified that greater exposure predicted greater future alcohol consumption (three studies; pooled β = 0.13, 95%CI = 0.11,0.15, i2 = 0.0%). Narrative analyses of studies that could not be meta-analysed due to incompatible methodologies were also conducted. Most studies (all four prospective, one of two cross-sectional) identified positive associations between exposure to alcohol-related content and greater average consumption. Most studies (three of four prospective, four of six cross-sectional) reported a positive association between of alcohol-related self-posting and greater average alcohol consumption.

CONCLUSIONS

Both exposure to, and self-posting of, alcohol-related content on social networking sites are positively associated with current average consumption, problem drinking, and drinking frequency.

Social media use and health risk behaviours in young people: systematic review and meta-analysis

OBJECTIVES

To examine the association between social media use and health risk behaviours in adolescents (defined as those 10-19 years).

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

EMBASE, Medline, APA PsycINFO, SocINDEX, CINAHL, SSRN, SocArXic, PsyArXiv, medRxiv, and Google Scholar (1 January 1997 to 6 June 2022).

METHODS

Health risk behaviours were defined as use of alcohol, drugs, tobacco, electronic nicotine delivery systems, unhealthy dietary behaviour, inadequate physical activity, gambling, and anti-social, sexual risk, and multiple risk behaviours. Included studies reported a social media variable (ie, time spent, frequency of use, exposure to health risk behaviour content, or other social media activities) and one or more relevant outcomes. Screening and risk of bias assessments were completed independently by two reviewers. Synthesis without meta-analysis based on effect direction and random-effects meta-analyses was used. Effect modification was explored using meta-regression and stratification. Certainty of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluations).

RESULTS

Of 17 077 studies screened, 126 were included (73 included in meta-analyses). The final sample included 1 431 534 adolescents (mean age 15.0 years). Synthesis without meta-analysis indicated harmful associations between social media and all health risk behaviours in most included studies, except inadequate physical activity where beneficial associations were reported in 63.6% of studies. Frequent (v infrequent) social media use was associated with increased alcohol consumption (odds ratio 1.48 (95% confidence interval 1.35 to 1.62); n=383 068), drug use (1.28 (1.05 to 1.56); n=117 646), tobacco use (1.85, 1.49 to 2.30; n=424 326), sexual risk behaviours (1.77 (1.48 to 2.12); n=47 280), anti-social behaviour (1.73 (1.44 to 2.06); n=54 993), multiple risk behaviours (1.75 (1.30 to 2.35); n=43 571), and gambling (2.84 (2.04 to 3.97); n=26 537). Exposure to content showcasing health risk behaviours on social media (v no exposure) was associated with increased odds of use of electronic nicotine delivery systems (1.73 (1.34 to 2.23); n=721 322), unhealthy dietary behaviours (2.48 (2.08 to 2.97); n=9892), and alcohol consumption (2.43 (1.25 to 4.71); n=14 731). For alcohol consumption, stronger associations were identified for exposure to user generated content (3.21 (2.37 to 4.33)) versus marketer generated content (2.12 (1.06 to 4.24)). For time spent on social media, use for at least 2 h per day (v <2 h) increased odds of alcohol consumption (2.12 (1.53 to 2.95); n=12 390). GRADE certainty was moderate for unhealthy dietary behaviour, low for alcohol use, and very low for other investigated outcomes.

CONCLUSIONS

Social media use is associated with adverse health risk behaviours in young people, but further high quality research is needed to establish causality, understand effects on health inequalities, and determine which aspects of social media are most harmful.

STUDY REGISTRATION

PROSPERO, CRD42020179766.

Adolescents' Drinking Behavior Off- and Online: Disentangling Exposure Effects and Selective Exposure in Networked Communication Structures

This article applies a network approach to better understand the often-demonstrated link between adolescents' drinking behavior and their exposure to alcohol-related content on social media. Focusing on social dynamics among adolescents and their peers, we investigate the causes and consequences of exposure to individual peers who share alcohol-related content online. Drawing on social network literature and the perspective of networked communication online, we distinguish between exposure effects and selective exposure as the two core dynamics that can explain the association between drinking behavior and exposure to alcohol-related content online. Based on a two-wave network survey among adolescents aged 14 to 17 (n = 277), we applied a longitudinal network analysis to test both dynamics simultaneously. The findings indicate no exposure effects but robust evidence for selective exposure. This means that drinking adolescents are more likely to become exposed to peers who post alcohol-related content. The stochastic actor-oriented model hereby controls for rivaling explanations, such as the tendency to be exposed to friends, classmates, and peers of the same gender. In addition to these empirical findings, we discuss the value of the network approach, outlining the implications for future research and prevention strategies.

Trait mindfulness weakens the relationship between Snapchat use and alcohol-related outcomes

Objective:Previous studies identified Snapchat as the most likely social media platform for depictions of excessive drinking and consequences. We sought to further examine this relationship and the possible protective impact of trait mindfulness.Method:A sample of 838 college students completed a survey assessing self-reported alcohol use, alcohol-related consequences, trait mindfulness, and individual and peer alcohol-related Snapchat posts.Results:Viewing more peer's Snapchats was associated with increased alcohol-related consequences, except at high levels of trait mindfulness. When controlling for the individual's Snapchat posts, the significant relationship between peer's Snapchats and consequences remained at low levels of trait mindfulness but not for moderate levels. The protective effect of high levels of trait mindfulness endured.Conclusion:Increasing trait mindfulness may help buffer the negative influence of viewing peer's alcohol-related Snapchats on alcohol-related consequences. Further examining how trait mindfulness interacts with peer norms offers important avenues for future research.

Adolescents' perceptions of alcohol portrayals in the media and their impact on cognitions and behaviors

OBJECTIVE

Exposure to alcohol in the media is pervasive and may influence adolescents' perceptions and use of alcohol. The purpose of this study was to better understand how adolescents perceive alcohol-related content in both entertainment and social media, with a focus on the valence of portrayals (i.e., positive, negative) and impacts on cognitions and behaviors.

METHOD

Participants were 40 high school students (60% female). Nine focus groups were conducted via videoconferencing, stratified by grade (9th/10th, 11th/12th) and gender. Transcripts were analyzed via template-style thematic analyses to identify themes.

RESULTS

Six themes were developed, including (a) some portrayals of alcohol may increase likelihood of using alcohol, (b) some portrayals of alcohol in the media can discourage drinking, (c) sometimes truly negative consequences of alcohol are portrayed positively or downplayed, (d) media portrayals of alcohol are perceived to be based in reality but are at times exaggerated, (e) adolescent and adult alcohol use is portrayed differently in entertainment media, and (f) the extent to which adolescents are influenced by the media may depend on their preexisting attitudes, beliefs, and education.

CONCLUSIONS

Adolescents have awareness of media portrayals of alcohol, both positive and negative, and their associated impacts. Findings highlight the need for much more work to understand the conditions under which, and for whom, exposure to different types of positive portrayals of alcohol in the media translate into positive expectancies about alcohol or drinking motives. Such work may ultimately inform intervention targets to reduce early initiation and/or risky drinking among adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Experimental Test of Abstaining-and-Drinking Social Media Content on Adolescent and Young Adult Social Norms and Alcohol Use

OBJECTIVE

Experimental research has demonstrated that when alcohol-related content is viewed on social media, adolescents and young adults tend to have favorable attitudes toward alcohol use. However, limited research focuses on social media norms for abstaining from alcohol use. The current study examined the role of descriptive and injunctive alcohol-abstaining-and-drinking norms via experimentally manipulated social media profiles. Experimental effects on descriptive and injunctive normative perceptions and subsequent behavior were tested.

METHOD

Participants (N = 306; ages 15-20 years) were recruited from the Seattle metropolitan area to complete a baseline survey and view researcher-fabricated social media profiles. Using stratified random assignment (birth sex and age), participants were randomized into one of three conditions: (a) alcohol abstaining and drinking, (b) alcohol abstaining, and (c) attention control.

RESULTS

The alcohol-abstaining-and-drinking condition reported greater drinking descriptive norms compared with participants in either the alcohol-abstaining or the attention-control conditions at post-experiment and 1-month follow-up. The alcohol-abstaining-and-drinking condition reported lower abstaining descriptive norms (i.e., perceiving fewer peers abstain) compared with those in the alcohol-abstaining condition at post-experiment and lower abstaining injunctive norms compared with those in the attention-control condition at 1-month follow-up.

CONCLUSIONS

Exposure to social media profiles containing both alcohol-drinking and alcohol-abstaining messages was respectively associated with individuals perceiving that peers were consuming alcohol more often and that fewer peers were abstaining. The present findings are consistent with prior experimental research that indicates alcohol displays on social media are associated with riskier drinking cognitions.

Characteristics Associated with Young Adults' Intentions to Engage with Anti-Vaping Instagram Posts

The purpose of this study was to identify behavioral and sociodemographic factors associated with intentions to engage with anti-vaping Instagram posts among a young adult population. This study proposes the following research questions: (1) Does e-cigarette use status influence intentions to engage with anti-vaping Instagram posts?, and (2) How are e-cigarette use and social media use associated? We recruited a convenience sample of young adults (N = 459; aged 18-30 years) in July of 2022 into an online experimental study from Prolific. Participants saw five image-based Instagram posts about the health harms of using e-cigarettes. Participants were then asked about their intentions to engage ("Comment on", "Reshare", "DM/Send this to a friend", "Like", and/or "Take a screenshot of") with the posts. We used logistic regression to run adjusted models for each engagement outcome, which included fixed effects for sociodemographics, tobacco use, and social media/internet use. For the sum of the engagement outcome, we used Poisson regression. Total number of social media sites used was associated with intentions to "Like" the posts (p = 0.025) and the overall engagement score (p = 0.019), respectively. Daily internet use was associated with intentions to "Comment on" (p = 0.016) and "Like" (p = 0.019) the posts. Young adults who reported past 30-day e-cigarette use had higher odds of using Twitter (p = 0.013) and TikTok (p < 0.001), and a higher total number of social media sites used (p = 0.046), compared to young adults who reported never use e-cigarettes. The initial evidence from our exploratory research using a convenience sample suggests that social media campaigns about the harms of e-cigarette use may be an effective way to engage younger audiences, a generation that frequents social media. Efforts to disseminate social media campaigns should consider launching on multiple platforms, such as Twitter and TikTok, and consider e-cigarette use status when posting.

Frequency and Timing of Sent and Received Alcohol-Related Text Messages: Associations with Alcohol Use and Related Consequences among Adolescents and Young Adults

Background: Research supports the notion that adolescents and young adults communicate about alcohol via text messages and that this form of communication is associated with alcohol use. However, little is known about how this compares to social media content sharing or about the timing of sending and receiving alcohol-related text messages and associations with alcohol-related outcomes. The present study aimed to 1) document whether adolescents and young adults are willing to share alcohol content via text messages they are not willing to share via social media, and 2) determine associations between frequency and timing of alcohol-related text messages (both sent and received) with self-reported alcohol use and consequences. Methods: A total of 409 participants (63.30% female; age 15-25, M = 21.10, SD = 2.69) completed a baseline survey as part of a larger study. Results: While 84.50% of participants reported that they were willing to send text messages referencing alcohol that they would not share on social media, 90.00% reported that their friends would be willing to do so. Results of negative binomial regressions indicated that sending and receiving more alcohol-related text messages per week and sending and receiving text messages before and during drinking, but not after drinking, were positively associated with typical drinks per week. Neither frequency of sending and receiving text messages or timing (before, during, after) were associated with negative consequences. Conclusions: Results suggest that frequency and timing of alcohol-related text messaging may provide insights into alcohol consumption patterns among adolescents and young adults and warrants future research.

Development and validation of the alcohol-related content poster prototype scale: Exploring the impact of social media prototypes on college students' drinking

BACKGROUND

Drinking is a public health concern among college students. Viewing and posting alcohol-related content (ARC) on social media may influence students' favorable prototypes of people who post, thereby impacting their drinking. This study created a measure to explore students' ARC poster prototypes. We validated our measure by examining the prototypes as mediators of the associations between viewing and posting ARC and drinking behaviors.

METHODS

Students (N = 8065) were asked to complete measures related to viewing and posting ARC, drinking behaviors, and adjectives that described their perceptions of the prototypical college student who posts ARC on social media.

RESULTS

Exploratory and confirmatory factor analysis yielded three prototypical images of students who post ARC on social media: hedonistic, despondent, and sociable. There were significant pathways between viewing and posting ARC and drinking. The sociable prototype emerged as a significant mediator of the association between ARC viewing and posting and drinking.

CONCLUSIONS

Understanding the role of students' poster prototypes may be important for informing targeted interventions. Our results indicate that the underlying reason for increased drinking among students with greater ARC engagement is that they perceived other ARC viewers and posters as being more sociable. Future research may focus on modifying these perceptions.

The Impact of Social Media Use and Gaming on Initiation of Smokeless Tobacco Use Among Rural Male Youth

PURPOSE

Smokeless tobacco (SLT) use is more common among White male youth in rural locations than among other youth. Previous literature documents risk factors for SLT use (e.g., perceived harm). However, no research has examined whether SLT initiation is associated with the use of social media and video games, despite the high prevalence of those behaviors among adolescent males.

METHODS

As part of the evaluation of "The Real Cost" smokeless prevention campaign, we conducted a baseline survey of a cohort of US males aged 11-16 in 2016 and four follow-up surveys conducted approximately every 8 months. We used discrete-time survival analysis to examine factors associated with SLT initiation. Logistic regression estimated the odds of initiation as a function of lagged values of key predictors (social media use in tertiles and frequency of gaming) and other baseline and lagged correlates. The model controlled for campaign exposure.

RESULTS

Relative to the lowest tertile of social media use, moderate (odds ratio [OR] = 1.80) or high use (OR = 2.77) was associated with increased risk of SLT initiation at the subsequent survey wave. Relative to playing every few weeks or less, playing video games once a day (OR = 0.50) or several times a day (OR = 0.33) was associated with decreased risk of SLT initiation.

DISCUSSION

SLT initiation was positively associated with social media use and negatively associated with gaming. Future research should explore reasons for the protective nature of gaming (e.g., social support, improved mood) and whether parental supervision of social media use could mitigate its negative impact.

Using social network methodology to examine the effects of exposure to alcohol-related social media content on alcohol use: A critical review

Peer social influence is a robust predictor of problematic drinking among young adults and adolescents; it is typically assessed by collecting nonspecific social network information (i.e., behaviors of peers globally) or specific social network information (i.e., behaviors of named friends). Socialization happens both in-person and online through social media. Exposure to alcohol-related social media content is consistently related to alcohol consumption in cross-sectional and longitudinal studies alike. Previous research has often not focused on who specifically is sharing the alcohol-related social media content with most examining effects of exposure to content posted by nonspecific network members (e.g., peers, friends) and individual alcohol consumption. The purpose of the current critical review is to describe how exposure to alcohol-related social media content is commonly measured and how including a specific social network assessment may explain more variance in alcohol use. The review found inconsistencies in the reference groups used when assessing frequency of exposure and found that specific modalities of content exposure were often not assessed. Of the 30 published studies reviewed, 15 used cross-sectional designs, which is regrettable considering that the composition of adolescent and young adult peer groups have been found to change over time possibly affecting the content viewed. Understanding factors which affect the relationship between exposure to alcohol-related social media content and individual alcohol use has implications for tailoring drinking interventions to address the unique social influence of social media content. Gaps in the literature are summarized and future directions for research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

What factors matter in the amount of alcohol consumed? An analysis among Brazilian adolescents

Alcohol consumption in the under-18 age group has been growing in recent years, leading to various health risks. Considering the problems this habit brings, the present study contributes to the literature dedicated to categorizing different types of drinkers. The study objective is to verify the factors associated with the intensity of alcohol use among elementary school students in the year 2015. The dataset came from the National Adolescent School-based Health Survey (PeNSE). The applied methodology was a logit model of sequential response (continuation ratio). The main results are as follows. It was found that being female is associated with a lesser chance of having consumed alcohol in the reference period, however, with a greater chance of consuming five or more doses. Economic condition and formal paid employment are positively associated with alcohol consumption, which increases with the progression of the student's age. The number of friends who drink alcohol and consumption of products originating from tobacco and illicit drugs, are good predictors of alcohol use by students. The time spent practicing physical activities increased the chance of male students consuming alcohol. The results showed that, in general, the characteristics associated with different alcohol consumption profiles remain similar but differ between genders. Intervention strategies aimed at preventing alcohol consumption by minors are suggested in order to reduce the negative effects of substance use and abuse.

Adolescent (mis)perceptions of peer alcohol posts on social media: Prospective associations with alcohol attitudes and use

BACKGROUND

Social media is a central context in which teens interact with their peers, creating opportunities for them to view, post, and engage with alcohol content. Because adolescent peer interactions largely occur on social media, perceptions of peer alcohol content posting may act as potent risk factors for adolescent alcohol use. Accordingly, the preregistered aims of this study were to (1) compare perceived friend, typical person, and an adolescent's own posting of alcohol content to social media and (2) examine how these perceptions prospectively relate to alcohol willingness, expectancies, and use after accounting for offline perceived peer alcohol use.

METHODS

This longitudinal study included 435 adolescents (Mage  = 16.91) in 11th (48%) and 12th grade (52%). Participants completed measures of alcohol content social media posts, perceived peer alcohol use, willingness to drink alcohol, alcohol expectancies, and alcohol use at two time points, 3 months apart.

RESULTS

Consistent with preregistered hypotheses, adolescents reported that 60.3% of the typical person their age and 30.6% of their friends post alcohol content on social media. By contrast, only 7% of participants reported that they themselves posted such content to social media. After accounting for offline perceived peer drinking norms, neither perceived friend nor typical person alcohol content social media posts were prospectively associated with willingness to drink or positive or negative alcohol expectancies. Perceived friend alcohol content posts were prospectively positively associated with past 30-day alcohol consumption even after controlling for offline perceived peer drinking norms.

CONCLUSIONS

Adolescents misperceived the frequency of alcohol-related posting to social media among their peers, and perceptions of friend alcohol content posts prospectively predicted alcohol use. Given the results from the current study and the ubiquity of social media among adolescents, prevention efforts may benefit from addressing misperceptions of alcohol-related posting to social media.

The association between social network members sharing alcohol-related social media content and alcohol outcomes among college student drinkers

BACKGROUND

College-aged young adults (e.g., 18 to 29-year-olds) use social media more than any other age group. An emerging body of literature shows that higher exposure to alcohol-related social media content is associated with greater alcohol consumption among college students. However, most studies assess exposure to peer drinking on social media using global measures, rather than measuring the exposure to alcohol-related posts of identified specific close peers. We examined whether having a higher proportion of important peers (i.e., social network members) who post alcohol-related social media content is associated with greater alcohol consumption and alcohol-related consequences. We also investigated the extent to which the qualities of network members who share alcohol-related content are associated with participants' alcohol outcomes.

METHODS

Participants were 130 college students (86.2% female, 56.9% White) with an average age of 23.39 years (SD = 5.63) who had consumed at least one alcoholic drink in the past week. Participants completed measures of their social media use, alcohol consumption, alcohol-related consequences, and characteristics of important peers in their social network, including their alcohol-related social media posting.

RESULTS

Having a higher proportion of social network members who post alcohol-related social media content was positively related to participants' drinks per week and peak number of drinks. Higher network proportions of drinking buddies posting alcohol-related content were also associated with a greater frequency of alcohol use. Having a higher proportion of friends who post alcohol content and from whom the participants seek advice was linked to more alcohol-related consequences.

CONCLUSIONS

Having more important peers who post alcohol-related content on social media is associated with alcohol outcomes among college students. Harm-reduction focused alcohol interventions delivered on college campuses that incorporate information about the influence of viewing and sharing alcohol-related content could help to reduce alcohol consumption and alcohol-related consequences among students.

Application of behavioral economics for understanding health behaviors among adolescents and young adults

PURPOSE OF REVIEW

Behavioral economics (BE) concepts have become well studied tools in addressing patient issues, such as weight loss, smoking cessation, and medication adherence. Although predominantly studied in adult populations, emerging literature has shown BE's utility for adolescent/young adult (AYA) populations, offering a practical framework to safeguard AYA health and influence healthy decision making.

RECENT FINDINGS

We identified substantive areas in which BE concepts have been applied in AYA populations (e.g., substance use) and outline how these concepts have been used as a tool to identify individuals at risk for poor outcomes and to leverage behavioral insights to improve health behaviors.

SUMMARY

BE research holds significant promise as a tool for clinicians and researchers to encourage healthy decision making in AYA populations. Yet, there are opportunities for BE research to expand further into current trends impacting adolescent health, such as electronic nicotine delivery systems, social media apps, and coronavirus disease 2019 vaccinations. Furthermore, the full degree of BE utility remains to be explored, as few studies demonstrate the translation of associative findings into direct interventions. Additional work is needed to formalize BE techniques into best practices that clinicians can implement in their daily practice.

Social media, peer norms, and betel nut susceptibility and use: Evidence from early adolescents in Guam

Betel (areca) nut is an addictive psychoactive substance considered to be carcinogenic. Yet not much is known about factors that may be promoting betel nut use. To fill this void, the present study examines the roles of exposure to betel nut-related posts on social media and peer norms regarding betel nut use in explaining betel nut susceptibility and use among adolescents. We conducted a representative survey of early adolescents (N = 673) attending all public middle schools on Guam, a United States-Affiliated Pacific Island in the Western Pacific. Results showed that exposure to betel nut-related posts on social media was positively associated with peer descriptive norms regarding betel nut use. Specifically, the more frequent early adolescents were exposed to betel nut posts on social media, the more likely they were to perceive betel nut use to be more prevalent among their general peers and close friends. Additionally, early adolescents' exposure to betel nut-related posts on social media was positively associated with both their susceptibility to use betel nut and reported use. Descriptive norms regarding close friends' betel nut use was also positively associated with both susceptibility to and use of betel nut. However, descriptive norms regarding general peers' betel nut use was unrelated with either betel nut susceptibility or use. Descriptive norms regarding close friends' betel nut use mediated the relationships that exposure to betel nut posts on social media had with both betel nut susceptibility and betel nut use. Implications are discussed.

The Association of Internet Use Intensity and Lifestyle Behaviors During the COVID-19 Pandemic: A Cross-Sectional Study in Chinese Adults

The COVID-19 pandemic substantially increased the intensity of internet use in humans, which has made public opinion around health and public perceptions of it more vital, and this phenomenon has had a significant impact on human lifestyle behavior. This study used cross-sectional data during the COVID-19 pandemic to explore how internet use intensity influenced lifestyle behaviors among adults, and compared the differences between samples of different ages. The findings showed that the internet use intensity among adults increased the probability of physical activity, staying up late, and high-quality eating behaviors, and that they had a statistically significant positive association. Such associations were also found in independent younger, middle-aged, and older samples. However, the internet use intensity elevated the probability of body weight gain only in the independent samples of younger, middle-aged, and older adults. Besides, internet use intensity was able to increase the probability of smoking & drinking only among the younger sample. Notably, the effect of internet use intensity on lifestyle behaviors, including body weight gain, physical activity, staying up late, and a high-quality diet, was strongest among the elderly, followed by the middle-aged, and weakest among the younger. In the process of rural and urban governance regarding citizens' health, public health agencies should remind citizens to spend a reasonable amount of time on internet use to reduce the probability of unhealthy lifestyle behaviors and improve their physical health.

Introduction to the special section on susceptibility to peer influence

This introduction outlines the goals for the special section on susceptibility to peer influence and articulates aims for the next research steps. We emphasize the difference between state and trait definitions of conformity, a distinction that helps clarify the contributions of specific research findings and delineates areas in need of greater research attention.

The Moderating Effects of Social Media Activities on the Relationship Between Effort-Reward Imbalance and Health and Wellbeing: A Case Study of the Oil and Gas Industry in Malaysia

Background

Social media activities affect every aspect of human life, be it personal, social or professional. Previous studies have confirmed the role of social media in affecting health in terms of releasing stress and providing social support. Increased occupational health disorders and increased time spent on social media activities motivate us to investigate this phenomenon in the context of occupational health. Therefore, the objective of this study is to measure the effects of social media activities related to personal and social life as well as work-life on health and wellbeing of office employees, on their job efforts and job rewards, and in moderating the effect of effort-reward imbalance on health and wellbeing.

Methods

Initially, to develop constructs related to social media activities, web-based structured interviews were conducted with five office employees working in the oil and gas industry for the last 5 years. Then, using an online questionnaire survey, data was collected from 424 office employees working in the oil and gas industry in Malaysia. Using statistical software for social science (SPSS) and Smart PLS, exploratory factor analysis and confirmatory factor analysis were conducted to identify reliability and validity (discriminant validity, convergent validity and composite validity) of the constructs. Following this, path analysis was conducted and the moderating effects were identified.

Results

Social media activities related to work-life decrease health and wellbeing by 11% and weaken the negative effect of effort-reward-imbalance on health and wellbeing by 17.6% at a 1% level of significance. The results of social media activities related to personal and social life strengthen the negative effect of effort-reward imbalance on health and wellbeing by 12% and negatively affects health and wellbeing and job rewards by 13, 55%, respectively. The direct effect of effort-reward imbalance and job efforts is significantly negative on health and wellbeing by 59 and 10%, respectively.

Conclusion

It is concluded that social media activities of the office employees significantly moderate the effect of effort-reward imbalance on health and wellbeing and intervene in job rewards in the organizations. Hence, the effect of social media activities reduces the health and wellbeing of office employees.

Mapping the complex causal mechanisms of drinking and driving behaviors among adolescents and young adults

BACKGROUND

The proportion of motor vehicle crash fatalities involving alcohol-impaired drivers declined substantially between 1982 and 1997, but progress stopped after 1997. The systemic complexity of alcohol-impaired driving contributes to the persistence of this problem. This study aims to identify and map key feedback mechanisms that affect alcohol-impaired driving among adolescents and young adults in the U.S.

METHODS

We apply the system dynamics approach to the problem of alcohol-impaired driving and bring a feedback perspective for understanding drivers and inhibitors of the problem. The causal loop diagram (i.e., map of dynamic hypotheses about the structure of the system producing observed behaviors over time) developed in this study is based on the output of two group model building sessions conducted with multidisciplinary subject-matter experts bolstered with extensive literature review.

RESULTS

The causal loop diagram depicts diverse influences on youth impaired driving including parents, peers, policies, law enforcement, and the alcohol industry. Embedded in these feedback loops are the physical flow of youth between the categories of abstainers, drinkers who do not drive after drinking, and drinkers who drive after drinking. We identify key inertial factors, discuss how delay and feedback processes affect observed behaviors over time, and suggest strategies to reduce youth impaired driving.

CONCLUSION

This review presents the first causal loop diagram of alcohol-impaired driving among adolescents and it is a vital first step toward quantitative simulation modeling of the problem. Through continued research, this model could provide a powerful tool for understanding the systemic complexity of impaired driving among adolescents, and identifying effective prevention practices and policies to reduce youth impaired driving.

“#BingeDrinking: Using Social Media to Understand College Binge Drinking (Preprint)

Background

Objective

Methods

Results

Conclusions

Nutritional Analysis of Foods and Beverages Posted in Social Media Accounts of Highly Followed Celebrities

IMPORTANCE

Celebrity social media posts engage millions of young followers daily, but the nutritional quality of foods and beverages in such posts, sponsored and unsponsored, is unknown.

OBJECTIVE

To quantify the nutritional quality of foods and beverages depicted in social media accounts of highly followed celebrities and assess whether nutritional quality is associated with post sponsorship, celebrity profession or gender, and followers' likes and comments.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study analyzed the content of food- and beverage-containing posts from Instagram (a photo- and video-sharing social media platform) accounts of 181 highly followed athletes, actors, actresses, television personalities, and music artists. Data were collected from May 2019 to March 2020.

MAIN OUTCOMES AND MEASURES

The nutritional quality of foods and beverages posted in celebrity social media accounts was rated using the Nutrient Profile Index (NPI) based on the sugar, sodium, energy, saturated fat, fiber, protein, and fruit and/or vegetable content per 100-g sample (a score of 0 indicated least healthy and 100, healthiest); foods with scores less than 64 and beverages with scores less than 70 were rated as "less healthy." Secondary outcomes were whether the nutritional quality of foods and beverages in social media posts was associated with post sponsorship, celebrity profession or gender, and followers' likes and comments. Mixed-effects regression models were used to estimate how outcomes differed across fixed effects.

RESULTS

The sample included social media accounts of 181 celebrities (66 actors, actresses, and television personalities [36.5%]; 64 music artists [35.4%]; and 51 athletes [28.2%]). A total of 102 celebrities (56.4%) were male, and the median age was 32 years (range, 17-73 years). Among 3065 social media posts containing 5180 total foods and beverages (2467 foods [47.6%]; 2713 beverages [52.4%]), snacks and sweets (920 [37.3%] of the foods) and alcoholic beverages (1375 [50.7%] of the beverages) were most common. Overall, 158 celebrity social media accounts (87.3%) earned a less healthy overall food nutrition score and 162 (89.5%) earned a less healthy overall beverage nutrition score, which would be unhealthy enough to fail legal youth advertising limits in the UK. For foods, social media posts with healthier nutrition scores were associated with significantly fewer likes (b, -0.003; 95% CI, -0.006 to 0.000; P = .04) and comments (b, -0.006; 95% CI, -0.009 to -0.003; P < .001) from followers. For beverages, nutrition scores were not significantly associated with likes (b, -0.010; 95% CI, -0.025 to 0.005; P = .18) or comments (b, -0.003; 95% CI, -0.022 to 0.016; P = .73). Only 147 food- or beverage-containing posts (4.8%) were sponsored by food- or beverage-relevant companies. Beverages in sponsored posts contained more than twice as much alcohol as those in nonsponsored posts (10.8 g [95% CI, 9.3 g to 12.3 g] per 100 g of beverage vs 5.3 g [95% CI, 4.7 g to 5.9 g] per 100 g of beverage).

CONCLUSIONS AND RELEVANCE

In this cross-sectional study, most highly followed celebrity social media accounts depicted an unhealthy profile of foods and beverages, primarily in nonsponsored posts. These results suggest that influential depictions of unhealthy food and beverage consumption on social media may be a sociocultural problem that extends beyond advertisements and sponsorships, reinforcing unhealthy consumption norms.

Associations Between Multiple Health-Promoting Behaviors and Subjective Well-Being in High School Age Youth

BACKGROUND

Conceptualizations of health have expanded to include indicators of adolescents' physical and mental wellness, rather than solely the absence of diseases or disorders. Although extensive research has identified links between mental and physical wellness, few studies have investigated the relationship between health promotion and happiness, particularly in adolescent populations who may be at particular risk for engaging in health-compromising behaviors, such as alcohol consumption.

METHODS

This cross-sectional study examined the relationship between 12 health-promoting behaviors and subjective well-being in a sample of 450 high school students from 2 states. Participants reported on their diet, physical activity, sleep hygiene habits, as well as abstinence from tobacco and alcohol products, and completed a multidimensional assessment of subjective well-being.

RESULTS

Findings demonstrated that 7 of the 12 health-promoting behaviors were significantly correlated with adolescents' subjective well-being. A sizeable portion of the variance in adolescents' subjective well-being (39.8%) was accounted for by the linear combination of the 12 health-promoting behaviors of interest. Increased physical activity, sleep hygiene cognitive/emotional factors, and bedtime routine all were identified as unique predictors of subjective well-being.

CONCLUSIONS

These findings bring attention to the salience of daily physical activity and sleep hygiene and their associations with adolescents' happiness.

Exposure to Parental Alcohol Use Is Associated with Adolescent Drinking Even When Accounting for Alcohol Exposure of Best Friend and Peers

AIMS

To further disentangle the role of exposure to drinking of role models (parents, peers, best friends) in the development of young adolescent alcohol use, the current study examined (a) whether parent's alcohol use exposure was associated with alcohol use outcomes among adolescents and (b) whether this association remained significant when including best friend and peer drinking exposure.

METHODS

A longitudinal study followed 765 adolescents from the Netherlands over 3 years. Adolescents (45.6% male, Mage = 11.78, standard deviation = 0.49 at baseline) completed questionnaires every 6 months, resulting in seven measurement waves. Adolescents reported their own alcohol use and exposure to parental, best friend and peers drinking.

RESULTS

Multilevel regression analyses indicated that parental alcohol use exposure was positively associated with a higher likelihood of adolescent alcohol use in the past 6 months, drinking in the last month and binge drinking in the last month. These associations remained significant when including exposure to peer and best friend's alcohol use, also when controlling for alcohol use at the previous timepoint (i.e. change in drinking). These associations were also consistent for boys and girls.

CONCLUSIONS

Throughout early adolescence, parental alcohol exposure matters for their offspring's alcohol use, independently of whether peers or their best friend expose them to alcohol or not. Parental alcohol exposure should be considered in prevention efforts to further decrease the number of adolescents that engage in early alcohol use and binge drinking.

How Do Social Network Sites Influence Workout Intentions: A Social Norm Approach

People share their workout experiences on social network sites (SNSs). The present study examined how perceived exposure to these workout-related SNS posts may affect individuals' engagement in physical activities through perceived descriptive and injunctive norms of workout in their network, and how self-efficacy in workout moderated the effect of perceived descriptive norm on their workout intention, which was measured in general and specific ways. An online survey was conducted with a convenience sample of 807 responses in China. Results show that perceived descriptive norm of workout in one's network mediated the relationship between perceived exposure to workout-related SNS posts and perceived injunctive norm. In addition, self-efficacy in workout moderated the effect of perceived descriptive norm on workout intention-both general and specific-but the normative influence was stronger at a low level of self-efficacy compared to a high level. Furthermore, perceived injunctive norm only predicted the general rather than specific workout intention, suggesting that the perception of most people's approval might not be priority when people consider details about workout. These findings develop the theory of normative social behavior by illustrating the relationship between perceived descriptive and injunctive norm and shed light on the relative strength of the motivating factors of workout in different situations.

Digital Public Health Surveillance Tools for Alcohol Use and HIV Risk Behaviors

There is a need for real-time and predictive data on alcohol use both broadly and specific to HIV. However, substance use and HIV data often suffer from lag times in reporting as they are typically measured from surveys, clinical case visits and other methods requiring extensive time for collection and analysis. Social big data might help to address this problem and be used to provide near real-time assessments of people's alcohol use and/or alcohol. This manuscript describes three types of social data sources (i.e., social media data, internet search data, and wearable device data) that might be used in surveillance of alcohol and HIV, and then discusses the implications and potential of implementing them as additional tools for public health surveillance.

Mothers Matter: Using Regression Tree Algorithms to Predict Adolescents' Sharing of Drunk References on Social Media

Exposure to online drinking on social media is associated with real-life alcohol consumption. Building on the Theory of planned behavior, the current study substantially adds to this line of research by identifying the predictors of sharing drunk references on social media. Based on a cross-sectional survey among 1639 adolescents with a mean age of 15 (59% female), this study compares and discusses multiple regression tree algorithms predicting the sharing of drunk references. More specifically, this paper compares the accuracy of classification and regression tree, bagging, random forest and extreme gradient boosting algorithms. The analysis indicates that four concepts are central to predicting adolescents' sharing of drunk references: (1) exposure to them on social media; (2) the perceived injunctive norms of the mother towards alcohol consumption; (3) the perceived descriptive norms of best friends towards alcohol consumption; and (4) willingness to drink alcohol. The most accurate results were obtained using extreme gradient boosting. This study provides theoretical, practical, and methodological conclusions. It shows that maternal norms toward alcohol consumption are a central predictor for sharing drunk references. Therefore, future media literacy interventions should take an ecological perspective. In addition, this analysis indicates that regression trees are an advantageous method in youth research, combining accurate predictions with straightforward interpretations.

Mechanisms Underlying Associations between Media Alcohol Exposure, Parenting, and Early Adolescent Drinking: A Moderated Sequential Mediation Model

Exposure to alcohol content in the media, especially in movies, is a demonstrated risk factor for adolescent alcohol use. This paper examines processes underlying this association and whether parenting mitigates such harms. A mediational model of parental restriction of mature media (W1), alcohol content exposure (W2), alcohol expectancies, peer norms (W3), and alcohol outcomes (W4) was tested using annual assessments from a study of adolescent drinking (N = 879; 52% female; 21% Non-White; 12% Hispanic). When restrictions are not in place, adolescents report greater exposure to alcohol content, leading to higher perceived peer drinking. Parental monitoring did not buffer the link between exposure and peer norms. Parental media restriction and perceptions about peers comprise mechanisms by which alcohol-saturated media influences youth drinking.

An examination of the prospective associations between objectively assessed exposure to alcohol-related Instagram content, alcohol-specific cognitions, and first-year college drinking

Previous research suggests that exposure to alcohol-related content on social media sites (SMSs) may inflate perceptions of drinking norms, thereby increasing drinking among college students and potentially undermining popular social norms-based alcohol interventions. However, prior research on exposure has used subjective measures of alcohol exposure and has focused mostly on Facebook. The current study focused on Instagram, a popular SMS among college students, and utilized objective time tracking and newsfeed sampling methods to rigorously examine the prospective relationship between exposure to alcohol-related Instagram content (ARIC), alcohol cognitions, and drinking. Participants were 309 matriculating college students (Mage = 18.1, SD = 0.26; 62.1% female; 46.9% White/Caucasian; 17.5% Hispanic) who had their Instagram use tracked and newsfeeds sampled via a macro several times during the transition into college (August & September), and completed a baseline survey and two follow-up surveys. A sequential mediation model examined theoretically derived pathways between objective ARIC exposure and alcohol use. Results revealed that objective ARIC exposure during the transition to college was positively associated with drinking at the end of the first year of college, and subjective frequency of ARIC exposure mediated this relationship between objective ARIC exposure and later drinking. Subjective frequency of ARIC exposure also mediated the association between objective ARIC exposure and perceptions of descriptive norms, which, in turn, predicted later drinking. These findings illustrate that greater objective ARIC exposure during the transition into college may increase risky drinking over the first year via increased subjective frequency of ARIC and elevated perceptions of drinking norms. Priority directions for future research are discussed and several novel ways in which social norms-based interventions for first-year students may be enhanced to better combat ARIC-related influences are introduced.

Profiles of Parenting in the Digital Age: Associations With Adolescent Alcohol and Marijuana Use

OBJECTIVE

This study assessed parental communication and behavior related to children's Internet and social media usage to delineate profiles of parenting regarding these newer forms of media and associated those profiles with youth alcohol and marijuana use.

METHOD

Using data from 748 adolescents (mean age = 15.8, 52% female, 25% non-White) and their parents, latent class analysis was performed to identify classes based on items concerning device ownership, monitoring, and communication of online activities. The associations between class membership and ever use of alcohol and marijuana were then tested, controlling for screen time, general parenting, substance availability, and deviance.

RESULTS

We identified five classes: high media parenting (23%), low media parenting (20%), moderate media parenting with limited device access (11%), moderate media parenting with high device access (25%), and low monitoring but high communication about online activities (21%). Probability of class membership was differentially associated with contemporaneous and 1-year prospective alcohol and marijuana use. The low-device-access class had the highest percentage of abstainers at both time points. The lowest rate of abstaining was associated with membership in the high-device-access class but moderate levels of monitoring. Membership in the low media parenting class was associated with use of both substances.

CONCLUSIONS

This study provides a novel exploration of media parenting, an important construct in the context of increased access to personalized media devices that allow for streaming of mature media content related to substance use.

Preference uncertainty accounts for developmental effects on susceptibility to peer influence in adolescence

Adolescents are prone to social influence from peers, with implications for development, both adaptive and maladaptive. Here, using a computer-based paradigm, we replicate a cross-sectional effect of more susceptibility to peer influence in a large dataset of adolescents 14 to 24 years old. Crucially, we extend this finding by adopting a longitudinal perspective, showing that a within-person susceptibility to social influence decreases over a 1.5 year follow-up time period. Exploiting this longitudinal design, we show that susceptibility to social influences at baseline predicts an improvement in peer relations over the follow-up period. Using a Bayesian computational model, we demonstrate that in younger adolescents a greater tendency to adopt others’ preferences arises out of a higher uncertainty about their own preferences in the paradigmatic case of delay discounting (a phenomenon called ‘preference uncertainty’). This preference uncertainty decreases over time and, in turn, leads to a reduced susceptibility of one’s own behaviour to an influence from others. Neuro-developmentally, we show that a measure of myelination within medial prefrontal cortex, estimated at baseline, predicts a developmental decrease in preference uncertainty at follow-up. Thus, using computational and neural evidence, we reveal adaptive mechanisms underpinning susceptibility to social influence during adolescence.

People often change their preferences to conform with others. Using a longitudinal design, the authors show that such conformity decreases over the course of adolescence and that this reduction in conformity is accompanied by a decreasing degree of uncertainty about what to like.

Social media use and emotional and behavioural outcomes in adolescence: Evidence from British longitudinal data

We investigate the relationship between social media use and emotional and behavioural outcomes in adolescence using data from a large and detailed longitudinal study of teenagers from the UK. We use individual fixed effects, propensity score matching and treatment effects with Inverse Probability Weighted Regression Adjustment, controlling for a rich set of children's and family's characteristics and using comprehensive sensitivity analyses and tests to assess the potential role of unobserved variables. Our results show that prolonged use of social media (more than 4 hours per day) is significantly associated with poor emotional health and increased behavioural difficulties, and in particular decreased perception of self-value and increased incidence of hyperactivity, inattention and conduct problems. However, limited use of social media (less than 3 h per day) compared to no use has some moderate association with positive peer relationships.

Residents perceptions of the alcohol environment: A participatory photovoice project in two districts with different socio-economic status in a large city

The purpose of this study was to present the alcohol environment as perceived by its residents in two districts of Madrid using the Photovoice participatory methodology. Secondly, we compared the results according to the socio-economic status of the districts. The study was conducted in the city of Madrid, Spain, in two districts with different socio-economic status. A total of 26 people participated, who took and discussed photographs about their alcohol environment. They grouped them into 33 final categories, such as the socialising role of alcohol or the alcohol advertising. Co-authors further grouped participants final categories into seven general areas. The participants in the Photovoice project have helped to deepen the understanding of the alcohol urban environment. These results may help to design more effective policies to prevent hazardous alcohol consumption.

Prospective Association of Digital Media Use with Alcohol Use Initiation and Progression Among Adolescents

BACKGROUND

Although adolescents commonly use digital media and consume alcohol , longitudinal evidence of the association between these behaviors is scant. This study examined the association between the frequency of digital media use and the subsequent initiation or progression of alcohol use. We also examined whether these associations were moderated by gender and race/ethnicity.

METHODS

The study included 2,473 adolescents from a prospective cohort in the Los Angeles, CA area who were surveyed in fall 2015 (11th grade, baseline for the current study) and every 6 months through the end of high school (Spring 2017, 12th grade). At baseline, youth self-reported the total number of 14 digital media activities (e.g., checking social media, streaming music/videos, texting) they engaged in at a high frequency (i.e., many times a day) over the past week. Scores ranged from 0 (i.e., no reported high-frequency digital media use) to 14 (i.e., reported engagement in all 14 digital media activities at a high frequency). Self-report measures of ever using alcohol, number of days of alcohol use in the past 30 days (0 to 30), binge drinking (yes/no), and covariates (i.e., demographics and measures of behavioral health and other substance use) were assessed at each time point.

RESULTS

Among respondents who at baseline reported never using alcohol (n = 1,214), high-frequency engagement in each additional digital media activity was associated with 4% higher odds of initiating alcohol use (aOR = 1.04, 95% CI: 1.01 to 1.07) across follow-up. Among respondents who at baseline reported ever using alcohol (n = 1,259), baseline high-frequency engagement in each additional digital media activity was associated at follow-up with 3% more days of alcohol use in the past 30 days (aIRR = 1.03, 95% CI: 1.00 to 1.06). Digital media use and binge drinking were not statistically significantly associated at follow-up. There was no evidence of moderation by gender or race/ethnicity.

CONCLUSIONS

Digital media use frequency was modestly associated with increased risk of initiation and progression of alcohol use in adolescence. Additional research is needed to determine potential mechanisms for these associations.

Adolescents' Perceived Drinking Norms Toward Alcohol Misuse: An Integrative Review

The purpose of this integrative review is to synthesize prior research on the relationship between adolescents' perceived subjective and descriptive drinking norms and their drinking intention and behaviors. Four databases (CINAHL, PubMed, Cochrane, and Sociological Abstracts) were searched to identify relevant articles. Thirty-one peer-reviewed articles published from 2010 to 2020 were reviewed. The results highlight that adolescents' perceived drinking norms derived from their parents and peers, such as approving or disapproving attitudes, significantly influence adolescents' drinking intention and behaviors. Moreover, pro-drinking messages, advertisements, and postings from electronic media (i.e., TV, movies, and the Internet) and online social networks (e.g., Facebook, Instagram, and Twitter) shape adolescents' drinking intention and encourage adolescents to initiate alcohol consumption early and/or escalate their drinking. Thus, future interventions should focus on subjective drinking norms that stem from interpersonal relationships in combination with perceived descriptive drinking norms derived from various media exposure.

Examining Associations Between Social Networking Site Alcohol-Specific Social Norms, Posting Behavior, and Drinking to Cope During the COVID-19 Pandemic

Emerging research suggests that there may be important links between social networking site (SNS) use and alcohol consumption specific to COVID-19. In addition, substantial research indicates that descriptive normative perceptions are a strong predictor of drinking behavior more generally. However, less is known about SNS-specific norms and how they might be associated with health-related behavior. Thus, the primary goal of this study was to determine whether descriptive normative perceptions for alcohol posting related to COVID-19 on SNSs are associated with both personal SNS posting behavior and drinking to cope with COVID-19-related stress, among a sample of 587 adults (48.4 percent women; mean age = 48.7 years) across the United States. All study procedures were approved by the local IRB. Results indicate that perceiving same-age peers to be posting on SNSs about their alcohol use to cope with pandemic-related stress/boredom is associated with both an increased likelihood of making such postings oneself and increased drinking to cope with the pandemic. Results have important implications for prevention and intervention efforts aimed to curb risky drinking during the pandemic and suggest that SNS behavior and norms should be incorporated into these strategies.

Online Peers and Offline Highs: An Examination of Online Peer Groups, Social Media Homophily, and Substance Use

Research indicates that youths are particularly susceptible to peer influence and that identifying with substance using peer groups predicts substance use. Today, youth spend more time interacting with distal peer groups via the Internet and have increased access to online drug cultures. Theoretically, this should have important implications for substance use. This study employs a nationally representative sample of U.S. youth (n = 1212), ages 15-25 years old, to examine whether online peer group identification and social media homophily predict substance use. Results indicate that online belonging and social media homophily are associated with some forms of substance use. While these factors were not significantly associated with regular marijuana or alcohol use among those who had initiated use, they predicted regular stimulant and opioid use among substance users. This suggests that online peer groups may promote progression into more problematic forms of substance use. Additional analyses of adolescent and young adult subgroups revealed important similarities and differences among the groups. The findings imply several directions for future research, and suggest that prevention policies and programs should continue to consider the role of online peers, and the Internet generally, in substance use initiation, escalation, and prevention.

Double Vision on Social Media: How Self-Generated Alcohol-Related Content Posts Moderate the Link between Viewing Others' Posts and Drinking

A robust finding is the positive association between self-generated alcohol-related content (SG-ARC) on social media (SM) and drinking among emerging adults; however, the reasons for this relationship are still unclear. A factor that has yet to be explored in combination with SG-ARC is how viewing others' alcohol-related content (ARC) may be impacting young adults' drinking. This cross-sectional study conducted across two universities asked students (N = 780; M = 20.80 years old; SD = 2.29; 67.82% female) to self-report how many SG-ARC posts they posted, to estimate how much they saw others' ARC, and how much they drank weekly. SG-ARC was then evaluated as a moderator of the association between viewing others' ARC and drinking. A negative binomial regression model with robust sandwich estimators was employed. Results revealed that both SG-ARC and viewing others' ARC were positively associated with drinking. A significant two-way interaction between SG-ARC and others' ARC emerged such that viewing others' posts appeared to exert an influence on drinking, particularly for students who did not post as many SG-ARC posts. These findings provide evidence that seeing others' ARC may be socially influencing students to drink, especially if they do not post as much SG-ARC themselves, by altering their internalized drinking norms.

Opportunities and peer support for aggression and delinquency during adolescence in nine countries

This study tested culture-general and culture-specific aspects of adolescent developmental processes by focusing on opportunities and peer support for aggressive and delinquent behavior, which could help account for cultural similarities and differences in problem behavior during adolescence. Adolescents from 12 cultural groups in 9 countries (China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States) provided data at ages 12, 14, and 15. Variance in opportunities and peer support for aggression and delinquency, as well as aggressive and delinquent behavior, was greater within than between cultures. Across cultural groups, opportunities and peer support for aggression and delinquency increased from early to mid-adolescence. Consistently across diverse cultural groups, opportunities and peer support for aggression and delinquency predicted subsequent aggressive and delinquent behavior, even after controlling for prior aggressive and delinquent behavior. The findings illustrate ways that international collaborative research can contribute to developmental science by embedding the study of development within cultural contexts.

Social Media Use and Mental Health and Well-Being Among Adolescents - A Scoping Review

Introduction: Social media has become an integrated part of daily life, with an estimated 3 billion social media users worldwide. Adolescents and young adults are the most active users of social media. Research on social media has grown rapidly, with the potential association of social media use and mental health and well-being becoming a polarized and much-studied subject. The current body of knowledge on this theme is complex and difficult-to-follow. The current paper presents a scoping review of the published literature in the research field of social media use and its association with mental health and well-being among adolescents. Methods and Analysis: First, relevant databases were searched for eligible studies with a vast range of relevant search terms for social media use and mental health and well-being over the past five years. Identified studies were screened thoroughly and included or excluded based on prior established criteria. Data from the included studies were extracted and summarized according to the previously published study protocol. Results: Among the 79 studies that met our inclusion criteria, the vast majority (94%) were quantitative, with a cross-sectional design (57%) being the most common study design. Several studies focused on different aspects of mental health, with depression (29%) being the most studied aspect. Almost half of the included studies focused on use of non-specified social network sites (43%). Of specified social media, Facebook (39%) was the most studied social network site. The most used approach to measuring social media use was frequency and duration (56%). Participants of both genders were included in most studies (92%) but seldom examined as an explanatory variable. 77% of the included studies had social media use as the independent variable. Conclusion: The findings from the current scoping review revealed that about 3/4 of the included studies focused on social media and some aspect of pathology. Focus on the potential association between social media use and positive outcomes seems to be rarer in the current literature. Amongst the included studies, few separated between different forms of (inter)actions on social media, which are likely to be differentially associated with mental health and well-being outcomes.

An Instagram-Based Study to Understand Betel Nut Use Culture in Micronesia: Exploratory Content Analysis

BACKGROUND

A 2012 World Health Organization report recognizes betel nut use as an urgent public health threat faced by the Western Pacific region. However, compared with other addictive substances, little is known about how betel nuts are depicted on social media platforms. In particular, image-based social media platforms can be powerful tools for health communication. Studying the content of substance use on visual social media may provide valuable insights into public health interventions.

OBJECTIVE

This study aimed to explore and document the ways that betel nut is portrayed on the photo-sharing site Instagram. The analysis focuses on the hashtag #pugua, which refers to the local term for betel nut in Guam and other parts of Micronesia.

METHODS

An exploratory content analysis of 242 Instagram posts tagged #pugua was conducted based on previous research on substance use and Instagram and betel nut practices in Micronesia. In addition, the study examined the social engagement of betel nut content on the image-based platform.

RESULTS

The study findings revealed content themes referencing the betel nut or betel nut tree, betel nut preparation practices, and the unique social and cultural context surrounding betel nut activity in Guam and Micronesia. In addition, certain practices and cultural themes encouraged social engagement on Instagram.

CONCLUSIONS

The findings from this study emphasize the cultural relevance of betel nut use in Micronesia. These findings provide a basis for empirically testing hypotheses related to the etiological roles of cultural identity and pride in shaping betel nut use behavior among Micronesians, particularly youths and young adults. Such research is likely to inform the development of culturally relevant betel nut prevention and cessation programs.