Perceptions of Pediatric Residents Regarding Counseling About Use of Social Networking Sites

A Cluster Randomized Controlled Trial of a Primary Care Provider-Delivered Social Media Counseling Intervention

PURPOSE

Evidence and clinical policy support that providers screen and counsel for media use for youth, but most pediatricians lack this training. The purpose of this study was to test a primary care provider (PCP)-delivered intervention to promote safe social media use among youth.

METHODS

We enrolled pediatric PCP practices for this clinical trial to test a social media counseling intervention (SMCI) between 2011 and 2013. Youth were recruited during clinic visits; follow-up interviews were conducted at 6 months. Outcomes included media behaviors and caregiver communication. Multivariate regression models examined associations between social media counseling and PCP counseling score. Multivariate logistic regression evaluated four social media behavior outcomes.

RESULTS

A total of 120 practices enrolled; PCPs in the SMCI were more likely to provide social media counseling (B = 1.43, 95% confidence interval [CI]: 1.1-1.7). Youth whose PCP received the SMCI were twice as likely to report a decrease in online "friending" of strangers (adjusted odds ratio = 2.23, 95% CI 1.17-4.25) and were more likely to report communication with their caregivers about their social media use (adjusted odds ratio = 1.2; 95% CI: 1.1-1.4) compared to youth whose PCPs were in the active control group.

DISCUSSION

Youth whose PCP had received social media counseling training reported a higher receipt of counseling about social media and improved safety behaviors.

Paediatricians' awareness of Canadian screen time guidelines, perception of screen time use, and counselling during the COVID-19 pandemic

Objectives

Paediatricians are essential in guiding families on screen time use as digital media becomes increasingly prevalent. While this has been highlighted through the COVID-19 pandemic there is no literature on paediatricians' awareness of Canadian screen time guidelines, or perception of these guidelines during this time. The aim of this study was to assess pediatricians' knowledge, attitudes, and comfort with the Canadian Paediatric Society's (CPS) screen time guidelines, specifically during the COVID-19 pandemic.

Methods

Our survey was developed by a paediatric resident and paediatric endocrinologist, reviewed by local experts, and sent electronically to members of the CPS Community and Developmental Paediatrics sections.

Results

All 53 respondents were aware of current CPS screen time guidelines, and the majority self-reported fair to excellent knowledge of guidelines for both age groups (<5 years and school-aged children/adolescents). Over 80% noticed increased screen use during the pandemic, and 98% were somewhat or very concerned about screen use and their patients' health and well-being. Pediatricians reported concerns about associations between increased screen time with worsening behaviour, mental health concerns, obesity, and sedentary lifestyle. The greatest barrier to reducing screen time was perceived insufficient motivation or support from caregivers/families.

Conclusions

Responding Canadian paediatricians are knowledgeable and comfortable with current screen time guidelines in Canada. Despite this, there is increasing concern with health outcomes associated with screen use. These results highlight paediatricians' important role in counselling patients and may encourage further local advocacy and public education around screen use and associated health risks in children.

Living in an online world: Social media experiences of adolescents and young adults with cancer

BACKGROUND

Despite widespread use, little is known about how adolescents and young adults (AYA) with cancer use social media (SM). This research characterized use and self-reported SM experiences among AYA with cancer.

PROCEDURE

AYA, aged 12-26 years, receiving cancer care completed a mixed-methods survey regarding SM experiences. Clinical information was obtained from the electronic medical record. Data were analyzed with descriptive statistics, t tests, and qualitative content analysis.

RESULTS

Thirty-nine AYA with average age 16 (SD = 3.2) years participated. Most were Caucasian (92%) males (54%). Participants had leukemia/lymphoma (56%), solid tumors (33%), and brain tumors (10%). Nearly all (97%) used SM, with YouTube, Snapchat, and Instagram being the most popular. AYA self-reported lower SM use than their smartphone data indicated (2.8 hours/day, SD = 1.2 vs 3.4 hours/day, SD = 1.3; P < 0.001). Participants used SM to obtain information about their cancer (45%), post about cancer (47%), and read about others' cancer experience (50%). One-third made a friend with cancer through SM (32%). Qualitative results indicated that AYA had positive cancer-related SM experiences, including feelings of support (54%), community (27%), distraction (8%), and inspiration (8%). Most denied negative experiences (78%); however, 17% reported cyberbullying related to cancer.

CONCLUSIONS

AYA with cancer avidly use SM, noting it provides a sense of support and community. However, one-sixth reported cancer-related cyberbullying. AYA oncology providers have an opportunity to enhance positive and blunt negative SM interactions by addressing and guiding SM use in AYA patients.