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Burke JG, Baumann SE, Shensa A, Joshi N, Jones JR, Lhaki P. Introducing the Power In Nepali Girls (PING) empowerment scale. Glob Public Health 2023; 18:2276866. [PMID: 38015724 DOI: 10.1080/17441692.2023.2276866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/24/2023] [Indexed: 11/30/2023]
Abstract
The multi-dimensional concept of empowerment is context specific, uniquely defined in various cultures, and challenging to measure. The aim of this study was to develop a scale for measuring empowerment among adolescent girls in Nepal. Twenty-nine items related to empowerment were drawn from formative, participatory research conducted in southern Nepal to comprise a draft empowerment scale. A case/control survey among 300 adolescent Nepali girls was then conducted to refine the scale. Factor analysis determined the most parsimonious scale and identified the underlying structure of items, resulting in the The Power In Nepali Girls (PING), a two-factor, 16-item empowerment scale. Factor 1 items address decision-making power and treatment in family and society. Factor 2 items address knowledge, education, and skills development. We used the 16-item scale to assess the impact of a social and financial skills program on empowerment among adolescent girls residing in southern Nepal. The PING scale is a culturally- and population-specific measure that can be used to quantify the impact of empowerment programs in Nepal among adolescent girls. The methods used also serve as a template for future work aiming to design context-specific measures of empowerment using community-engaged approaches.
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Affiliation(s)
| | - Sara E Baumann
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ariel Shensa
- Johns G. Rangos Sr School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Niva Joshi
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Pema Lhaki
- Nepal Fertility Care Center, Kathmandu, Nepal
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2
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Singer RB, Johnson AK, Zemlak JL, Shensa A, Singer RM, Costales C, Chiu K, Stamps J. Monkeypox Prevention and Protecting Sex Workers: A Call to Action. Arch Sex Behav 2022; 51:3659-3662. [PMID: 36169775 DOI: 10.1007/s10508-022-02428-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Randi Beth Singer
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, 845 S. Damen Ave., MC 802, Chicago, IL, USA.
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Amy K Johnson
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | - Ariel Shensa
- Department of Health Administration and Public Health, Duquesne University, Pittsburgh, PA, USA
| | - Rebecca M Singer
- Population Health Nursing Science, University of Illinois at Chicago, College of Nursing, Chicago, IL, USA
| | - Cocoa Costales
- CLEARS-HIV & CDPH Data Enclave, Northwestern University, Chicago, IL, USA
| | - Kathleen Chiu
- New York City Department of Health, Sexual Health Clinic, New York, NY, USA
| | - Jahari Stamps
- Southside Health Advocacy Resource Partnership, Chicago, IL, USA
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Colditz JB, Shensa A, Kennedy AJ, Woods MS, Sidani JE, Primack BA. Acceptability and Efficacy of the SMARxT Media Literacy Education Program to Counter Pharmaceutical Marketing Influences among Medical Trainees. Interdiscip J Virtual Learn Med Sci 2022; 13:213-220. [PMID: 37139240 PMCID: PMC10152519 DOI: 10.30476/ijvlms.2022.95137.1151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Background Evidence-based prescribing (EBP) results in decreased morbidity and reduces medical costs. However, pharmaceutical marketing influences medication requests and prescribing habits, which can detract from EBP. Media literacy, which teaches critical thinking, is a promising approach for buffering marketing influences and encouraging EBP. The authors developed the "SMARxT" media literacy education program around marketing influences on EBP decision-making. The program consisted of six videos and knowledge assessments that were delivered as an online educational intervention through the Qualtrics platform. Methods In 2017, we assessed program feasibility, acceptability, and efficacy of enhancing knowledge among resident physicians at the University of Pittsburgh. Resident physicians (n=73) responded to pre-test items assessing prior knowledge, viewed six SMARxT videos, and responded to post-test items. A 6-month follow-up test was completed to quantitatively assess sustained changes in knowledge and to qualitatively assess summative feedback about the program (n=54). Test scores were assessed from pre- to post-test and from pre-test to follow-up using paired-sample t-tests. Qualitative results were synthesized through content analysis. Results Proportion of correct knowledge responses increased from pre-test to immediate post-test (31% to 64%, P<0.001) at baseline. Correct responses also increased from pre-test to 6-month follow-up (31% to 43%, P<0.001). Feasibility was demonstrated by 95% of enrolled participants completing all baseline procedures and 70% completing 6-month follow-up. Quantitative measures of acceptability yielded positive scores and qualitative responses indicated participants' increased confidence in understanding and countering marketing influences due to the intervention. However, participants stated they would prefer shorter videos, feedback about test scores, and additional resources to reinforce learning objectives. Conclusion The SMARxT media literacy program was efficacious and acceptable to resident physicians. Participant suggestions could be incorporated into a subsequent version of SMARxT and inform similar clinical education programs. Future research should assess program impact on real-world prescribing practices.
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Affiliation(s)
- Jason B. Colditz
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Corresponding author: Jason B. Colditz, PhD, MEd; School of Medicine, University of Pittsburgh, 230 McKee Place #600, Pittsburgh, PA, 15213, USA, Tel: 1-412-802-6296,
| | - Ariel Shensa
- John G. Rangos Sr. School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | | | | | - Jaime E. Sidani
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brian A. Primack
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Reuman H, Kerr K, Sidani J, Felker J, Escobar-Viera C, Shensa A, Maurer SH. Living in an online world: Social media experiences of adolescents and young adults with cancer. Pediatr Blood Cancer 2022; 69:e29666. [PMID: 35293691 DOI: 10.1002/pbc.29666] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/17/2022] [Accepted: 02/27/2022] [Indexed: 11/07/2022]
Abstract
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.
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Affiliation(s)
- Hannah Reuman
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Jaime Sidani
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - James Felker
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pediatrics, Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - César Escobar-Viera
- Center for Behavioral Health, Media, and Technology, Pittsburgh, Pennsylvania.,Internet Delivered Interventions on LGBTQA+ Mental Health, Pittsburgh, Pennsylvania
| | - Ariel Shensa
- Department of Health Administration and Public Health, Duquesne University, Pittsburgh, Pennsylvania
| | - Scott H Maurer
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pediatrics, Division of Hematology/Oncology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.,Department of Pediatrics, Division of Palliative Medicine and Supportive Care, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
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5
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Sidani JE, Hoffman B, Colditz JB, Wolynn R, Hsiao L, Chu KH, Rose JJ, Shensa A, Davis E, Primack B. Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19: Qualitative Analysis of Twitter Content. JMIR Form Res 2022; 6:e26335. [PMID: 35311684 PMCID: PMC9009382 DOI: 10.2196/26335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/14/2021] [Accepted: 03/14/2022] [Indexed: 01/19/2023] Open
Abstract
Background Misinformation and conspiracy theories related to COVID-19 and electronic nicotine delivery systems (ENDS) are increasing. Some of this may stem from early reports suggesting a lower risk of severe COVID-19 in nicotine users. Additionally, a common conspiracy is that the e-cigarette or vaping product use–associated lung injury (EVALI) outbreak of 2019 was actually an early presentation of COVID-19. This may have important public health ramifications for both COVID-19 control and ENDS use. Objective Twitter is an ideal tool for analyzing real-time public discussions related to both ENDS and COVID-19. This study seeks to collect and classify Twitter messages (“tweets”) related to ENDS and COVID-19 to inform public health messaging. Methods Approximately 2.1 million tweets matching ENDS-related keywords were collected from March 1, 2020, through June 30, 2020, and were then filtered for COVID-19–related keywords, resulting in 67,321 original tweets. A 5% (n=3366) subsample was obtained for human coding using a systematically developed codebook. Tweets were coded for relevance to the topic and four overarching categories. Results A total of 1930 (57.3%) tweets were coded as relevant to the research topic. Half (n=1008, 52.2%) of these discussed a perceived association between ENDS use and COVID-19 susceptibility or severity, with 42.4% (n=818) suggesting that ENDS use is associated with worse COVID-19 symptoms. One-quarter (n=479, 24.8%) of tweets discussed the perceived similarity/dissimilarity of COVID-19 and EVALI, and 13.8% (n=266) discussed ENDS use behavior. Misinformation and conspiracy theories were present throughout all coding categories. Conclusions Discussions about ENDS use and COVID-19 on Twitter frequently highlight concerns about the susceptibility and severity of COVID-19 for ENDS users; however, many contain misinformation and conspiracy theories. Public health messaging should capitalize on these concerns and amplify accurate Twitter messaging.
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Affiliation(s)
- Jaime E Sidani
- Center for Social Dynamics and Community Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Beth Hoffman
- Center for Social Dynamics and Community Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Jason B Colditz
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Riley Wolynn
- Kenneth P Dietrich School of Arts & Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lily Hsiao
- Kenneth P Dietrich School of Arts & Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kar-Hai Chu
- Center for Social Dynamics and Community Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Jason J Rose
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Ariel Shensa
- Department of Health Administration and Public Health, John G Rangos Sr School of Health Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Esa Davis
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Brian Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, AZ, United States
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6
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Abstract
Background. Twitter provides an opportunity to examine misperceptions about nicotine and addiction as they pertain to electronic nicotine delivery systems (ENDS). The purpose of this study was to systematically examine a sample of ENDS-related tweets that presented information about nicotine or addiction for the presence of potential misinformation.Methods. A total of 10.1 million ENDS-related tweets were obtained from April 2018 through March 2019 and were filtered for unique tweets containing keywords for nicotine and addiction. A subsample (n = 3,116) were human coded for type of account (individual, group, commercial, or news) and presence of potential misinformation.Results. Of tweets that presented ENDS-related nicotine or addiction information (n = 904), 41.7% (n = 377) contained potential misinformation coded as anti-vaping exaggeration, pro-vaping exaggeration, nicotine is not addictive or is never harmful, or unproven health benefits.Conclusions. Anti-vaping exaggeration tweets distorted or embellished claims about ENDS nicotine and addiction; pro-vaping exaggeration tweets misinterpreted results from scientific studies. Misinformation that nicotine is not addictive or is never harmful or has unproven health benefits appeared less but are potentially problematic. ENDS-related messaging should be designed to be easily understood by the public and monitored to detect the spread of misinterpretation or misinformation on social media.
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Affiliation(s)
- Jaime E Sidani
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Beth L Hoffman
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jason B Colditz
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Eleanna Melcher
- Medical Scientist Training Program, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Sanya Bathla Taneja
- Intelligent Systems Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ariel Shensa
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, Arkansas, USA
| | - Esa Davis
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kar-Hai Chu
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Primack BA, Shensa A, Sidani JE, Escobar-Viera CG, Fine MJ. Temporal Associations Between Social Media Use and Depression. Am J Prev Med 2021; 60:179-188. [PMID: 33309454 PMCID: PMC8261713 DOI: 10.1016/j.amepre.2020.09.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/01/2020] [Accepted: 09/16/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Previous studies have demonstrated cross-sectional associations between social media use and depression, but their temporal and directional associations have not been reported. METHODS In 2018, participants aged 18-30 years were recruited in proportion to U.S. Census characteristics, including age, sex, race, education, household income, and geographic region. Participants self-reported social media use on the basis of a list of the top 10 social media networks, which represent >95% of social media use. Depression was assessed using the 9-Item Patient Health Questionnaire. A total of 9 relevant sociodemographic covariates were assessed. All measures were assessed at both baseline and 6-month follow-up. RESULTS Among 990 participants who were not depressed at baseline, 95 (9.6%) developed depression by follow-up. In multivariable analyses conducted in 2020 that controlled for all covariates and included survey weights, there was a significant linear association (p<0.001) between baseline social media use and the development of depression for each level of social media use. Compared with those in the lowest quartile, participants in the highest quartile of baseline social media use had significantly increased odds of developing depression (AOR=2.77, 95% CI=1.38, 5.56). However, there was no association between the presence of baseline depression and increasing social media use at follow-up (OR=1.04, 95% CI=0.78, 1.38). Results were robust to all sensitivity analyses. CONCLUSIONS In a national sample of young adults, baseline social media use was independently associated with the development of depression by follow-up, but baseline depression was not associated with an increase in social media use at follow-up. This pattern suggests temporal associations between social media use and depression, an important criterion for causality.
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Affiliation(s)
- Brian A Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, Arkansas.
| | - Ariel Shensa
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jaime E Sidani
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - César G Escobar-Viera
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Michael J Fine
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
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Escobar-Viera CG, Shensa A, Sidani J, Primack B, Marshal MP. Association Between LGB Sexual Orientation and Depression Mediated by Negative Social Media Experiences: National Survey Study of US Young Adults. JMIR Ment Health 2020; 7:e23520. [PMID: 33270041 PMCID: PMC7746493 DOI: 10.2196/23520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/19/2020] [Accepted: 11/03/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Lesbian, gay, and bisexual (LGB) persons are disproportionately affected by depression and have high social media use rates. Negative social media experiences may modify depressive symptoms among LGB persons. We sought to assess the potential influence of negative social media experiences on the association between LGB orientation and depression. OBJECTIVE The aim of this study was to assess the potential influence of negative social media experiences on the association between LGB orientation and depression. METHODS We performed a web-based survey of a national sample of US young adults aged 18-30 years. We assessed the respondents' LGB orientation, negative social media experiences, and depression using the 9-item Patient Health Questionnaire. We used generalized structural equation modeling to assess both the direct and indirect effects (via negative social media experiences) of LGB orientation on depression while controlling for relevant demographic and personal characteristics. RESULTS We found a conditional indirect effect (ab path) of LGB orientation on depressive symptoms via negative social media experience (a: observed coefficient 0.229; P<.001; bias-corrected bootstrapped 95% CI 0.162-0.319, and b: observed coefficient 2.158; P<.001; bias-corrected bootstrapped 95% CI 1.840-2.494). The results show that among LGB respondents, for those who reported negative social media experiences in the past year, a 1 unit increase in these experiences was associated with a 0.494 unit increase in depressive symptomatology. CONCLUSIONS Our results suggest that higher rates of depression among LGB young adults are partially explained by negative social media experiences; these results could help inform future patient/provider conversations about mental health risk and protective factors related to social media use. Reducing these experiences and increasing positive social media experiences among LGB persons may mitigate depressive symptomatology in this population.
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Affiliation(s)
- César G Escobar-Viera
- Center for Research on Behavioral Health, Media, and Technology, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ariel Shensa
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jaime Sidani
- Center for Research on Behavioral Health, Media, and Technology, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brian Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, AR, United States
| | - Michael P Marshal
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
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Hoffman BL, Shensa A, Escobar-Viera CG, Sidani JE, Miller E, Primack BA. “Their Page is Still Up”: Social Media and Coping with Loss. Journal of Loss and Trauma 2020. [DOI: 10.1080/15325024.2020.1820227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Beth L. Hoffman
- Center for Behaviorial Health, Media, and Technology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Behavioral and Community Health Sciences, Gradaute School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ariel Shensa
- Center for Behaviorial Health, Media, and Technology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - César G. Escobar-Viera
- Center for Behaviorial Health, Media, and Technology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jaime E. Sidani
- Center for Behaviorial Health, Media, and Technology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Department of Behavioral and Community Health Sciences, Gradaute School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Brian A. Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, Arkansas, USA
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Rzewnicki DI, Shensa A, Levenson JC, Primack BA, Sidani JE. Associations between positive and negative social media experiences and sleep disturbance among young adults. Sleep Health 2020; 6:671-675. [PMID: 32335040 DOI: 10.1016/j.sleh.2020.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 02/13/2020] [Accepted: 02/21/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We sought to examine the association of positive and negative experiences using social media (SM) and sleep disturbance in a national survey of U.S. young adults. METHODS Experiences using SM were assessed with 2 items asking participants about the percentage of time using SM that involved a negative/positive experience that they were personally involved in. Sleep disturbance was assessed using the validated PROMIS 4-item short form. Ordinal logistic regression was used to examine associations between positive and negative SM experiences and high sleep disturbance, while controlling for relevant covariates. RESULTS Although reporting high levels of negative experiences was significantly associated with greater odds of high sleep disturbance (AOR = 1.49, 95%CI = 1.18-1.89), reporting high levels of positive experiences was not associated with sleep disturbance. CONCLUSIONS These findings suggest that more robust examinations of negative SM experiences-especially as they relate to sleep disturbance-may be warranted.
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Affiliation(s)
- Daniel I Rzewnicki
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brian A Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, AR
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
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11
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Chu KH, Shensa A, Colditz JB, Sidani JE, Hoffman BL, Sinclair D, Krauland MG, Primack BA. Integrating Social Dynamics Into Modeling Cigarette and E-Cigarette Use. Health Educ Behav 2020; 47:191-201. [PMID: 32090652 DOI: 10.1177/1090198119876242] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background. The use of electronic cigarettes (e-cigarette) offers potential to facilitate cigarette smoking cessation, yet potentially increases risk of cigarette smoking initiation. This relationship has been primarily modeled in mathematical ways that often do not represent real-world complexities, which could inform decisions regarding local prevention programs or policies. Aims. To develop a model of cigarette and e-cigarette use that combines current research on tobacco use and incorporates real-world geographic and demographic data. Method. We used a platform for developing agent-based models with demographic information representative of the population in Pennsylvania. We developed three models of cigarette and e-cigarette use. The primary outcome for each was the total number of users for cigarette, e-cigarette, and total nicotine. The first model applied current cigarette and e-cigarette data, the second tested the effect of implementing a program of e-cigarette education and policies, and the third considered a social contagion factor, where local schools functioned as a transmission vector. Results. The baseline and social contagion models found an overall decline in cigarette use but an increase in e-cigarette and total nicotine use. The education/policies model had declines in all categories. Sensitivity analysis suggested the importance of nuanced e-cigarette/cigarette interactions when modeling tobacco use. Discussion. Public health campaigns that focus on reducing youth e-cigarette usage can have a large effect. Social contagion should be strongly considered when studying e-cigarette spread. Conclusion. Targeted public health campaigns focused on reducing school prevalence of e-cigarette use may be particularly valuable.
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Affiliation(s)
- Kar-Hai Chu
- University of Pittsburgh, Pittsburgh, PA, USA
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Hoffman BL, Cafferty LA, Jain P, Shensa A, Rosenthal EL, Primack BA, Sidani JE. Patient-centered Communication Behaviors on Primetime Television. J Health Commun 2020; 25:170-179. [PMID: 32013787 DOI: 10.1080/10810730.2020.1723040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Previous research suggests that television programming may influence viewers' health-related knowledge, perceptions, and behaviors but has yet to examine patient-provider interactions on the most popular primetime television programs. We aimed to characterize the frequency and nature of patient-centered communication (PCC) behaviors on these programs, as cultivation and social cognitive theories suggest that these depictions may influence viewers' expectations of real-life health-care experiences. We examined 203 patient-provider interactions across 84 episodes of 22 primetime television programs-both medical and non-medical-that aired during the spring of 2016 and spring of 2017. Each interaction was analyzed for the presence of 21 optimal PCC behaviors. This study found that the most frequently observed PCC behaviors focused on the provider making good eye contact and displaying good manners. However, PCC behaviors related to managing patient uncertainty and self-management were rare. Overall, providers in medical programs were significantly more likely to exhibit certain PCC behaviors, such as asking a patient questions, having good manners, and self-disclosing personal information, compared to providers in non-medical programs. Implications of these findings include the potential for such depictions to influence patient expectations of real-life experiences and health outcomes. Future research is needed to examine these potential influences.
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Affiliation(s)
- Beth L Hoffman
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Lauren A Cafferty
- Military Primary Care Research Network, Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Parul Jain
- E.W. Scripps School of Journalism, Scripps College of Communication, Ohio University, Athens, Ohio, USA
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Erica L Rosenthal
- Hollywood, Health & Society, Annenberg School for Communication and Journalism, University of Southern California, Beverly Hills, California, USA
| | - Brian A Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, Arkansas, USA
| | - Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Shensa A, Sidani JE, Escobar-Viera CG, Switzer GE, Primack BA, Choukas-Bradley S. Emotional support from social media and face-to-face relationships: Associations with depression risk among young adults. J Affect Disord 2020; 260:38-44. [PMID: 31493637 PMCID: PMC7383439 DOI: 10.1016/j.jad.2019.08.092] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Emotional support is highly protective against poor mental health. Though several measures of emotional support exist, none specifically addresses social media (SM) as a source of emotional support. Therefore, the objectives of this study were to determine if SM-based emotional support is an extension of or distinct construct from face-to-face (FTF) emotional support and to assess the independent associations between each domain of emotional support and depression risk among U.S. young adults. METHODS In March 2018, we surveyed 2408 18-30 year olds. We assessed perceived FTF emotional support with the brief PROMIS emotional support scale and perceived SM-based emotional support using a new four-item measure. Depression risk was assessed using the PHQ-9. We performed factor analysis (FA) to determine the underlying factor structure of all items and to develop composite scales. Multivariable logistic regression was used to examine the independent association between each resulting emotional support scale and depression risk. RESULTS FA revealed two distinct constructs. FTF emotional support was associated with 43% lower odds of depression per 1-unit increase on the 5-point scale (AOR = 0.57, 95% CI = 0.52-0.63). However, SM-based emotional support was significantly associated with 20% greater odds of depression per 1-unit increase on the 5-point scale (AOR = 1.20, 95% CI = 1.09-1.32). LIMITATIONS This study utilized a cross-sectional design and self-report data. CONCLUSIONS While FTF emotional support was associated with slightly lower odds of depression, SM-based emotional support was associated with slightly greater odds of depression. It may be valuable for clinicians treating individuals with depression to ask about sources of emotional support.
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Affiliation(s)
- Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States.
| | - Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - César G Escobar-Viera
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Galen E Switzer
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States
| | - Brian A Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, AK, United States
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Escobar-Viera C, Shensa A, Hamm M, Melcher EM, Rzewnicki DI, Egan JE, Sidani JE, Primack BA. "I Don't Feel Like the Odd One": Utilizing Content Analysis to Compare the Effects of Social Media Use on Well-Being Among Sexual Minority and Nonminority US Young Adults. Am J Health Promot 2019; 34:285-293. [PMID: 31698919 DOI: 10.1177/0890117119885517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE Although there is evidence of associations between social media (SM) use and mental well-being among the general population, these associations among lesbian, gay, and bisexual (LGB) persons are poorly understood. This study compared the influence of SM experiences on mental well-being between LGB and non-LGB persons. DESIGN AND SETTING Online cross-sectional survey. PARTICIPANTS National sample of 2408 US adults aged 18 to 30 years. METHOD We asked participants to provide examples of when SM affected their well-being separately in good and bad ways. We coded, summed, and used rate ratios (RRs) to compare responses of LGB and non-LGB individuals. Thematically similar codes were described and grouped into categories. RESULTS Most responses described positive SM effects. However, of 6 codes that were significantly more frequent among LGB respondents, only social capital (RR = 1.58, 95% confidence interval [CI], 1.17-2.12) described a positive effect. Five codes described negative effects of SM for LGB users: negative emotional contagion (RR = 1.28, 95% CI, 1.04-1.58), comparison with others (RR = 1.28, 95% CI, 1.01-1.62), real-life repercussions (RR = 1.86, 95% CI, 1.18-2.94), envy (RR = 2.49, 95% CI, 1.48-4.19), and need for profile management (RR = 2.32, 95% CI, 1.07-5.03). CONCLUSION These findings suggest that, for LGB persons, gaining social capital from SM is valuable for establishing and maintaining connections. Increased negative SM experiences may pose a risk for the mental well-being of LGB individuals.
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Affiliation(s)
| | - Ariel Shensa
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Megan Hamm
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | | | - James E Egan
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jaime E Sidani
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brian A Primack
- College of Education and health Professions, University of Arkansas Fayetteville, Fayetteville, AR, USA
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Sidani JE, Colditz JB, Barrett EL, Shensa A, Chu KH, James AE, Primack BA. I wake up and hit the JUUL: Analyzing Twitter for JUUL nicotine effects and dependence. Drug Alcohol Depend 2019; 204:107500. [PMID: 31499242 PMCID: PMC6878169 DOI: 10.1016/j.drugalcdep.2019.06.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND JUUL-a novel electronic nicotine delivery system (ENDS)-comprises most of the ENDS market share. Additionally, JUUL has a high nicotine content and utilizes a patented nicotine salt formulation aimed to speed absorption. Many JUUL users are not aware of the nicotine content and therefore may not be expecting acute nicotine effects or potential for dependence. This study sought to analyze Twitter messages ("tweets") regarding nicotine, symptoms of dependence, and withdrawal related to JUUL use. METHODS Data were collected from Twitter's Filtered Streams interface 4/11-6/16/2018 by retrieving tweets matching the terms "juul," "juuls," and "juuling" that also used words consistent with nicotine effects, symptoms of dependence, and withdrawal. A random 5% subsample (n = 1986) was coded by 2 independent coders. Cohen's κ for inter-rater reliability ranged 0.62-1.00 for all coded variables. Tweets were assessed using a qualitative content analysis approach. RESULTS A total of 335 tweets mentioned dependence-related themes, including use upon waking and compulsion to use. A total of 189 tweets mentioned themes related to nicotine, with almost 15% of these tweets describing physical effects. Additionally, 42 tweets mentioned themes related to quitting JUUL and/or withdrawal from JUUL. DISCUSSION This qualitative analysis suggests that users of JUUL are experiencing symptoms of nicotine exposure and dependence. Considering the high nicotine content of JUUL and the rising popularity among young people, more research around initiation of and dependence on JUUL, as well as the impact of recent FDA policy changes, should be conducted.
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Affiliation(s)
- Jaime E Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States.
| | - Jason B Colditz
- Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States
| | - Erica L Barrett
- Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States
| | - Kar-Hai Chu
- Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States
| | - A Everette James
- Health Policy Institute, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261, United States
| | - Brian A Primack
- College of Education and Health Professions, University of Arkansas, 324 Graduate Education Building, Fayetteville, AR, 72701, United States
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16
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Hoffman BL, Felter EM, Chu KH, Shensa A, Hermann C, Wolynn T, Williams D, Primack BA. It's not all about autism: The emerging landscape of anti-vaccination sentiment on Facebook. Vaccine 2019; 37:2216-2223. [PMID: 30905530 DOI: 10.1016/j.vaccine.2019.03.003] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Due in part to declining vaccination rates, in 2018 over 20 states reported at least one case of measles, and over 40,000 cases were confirmed in Europe. Anti-vaccine posts on social media may be facilitating anti-vaccination behaviour. This study aimed to systematically characterize (1) individuals known to publicly post anti-vaccination content on Facebook, (2) the information they convey, and (3) the spread of this content. METHODS Our data set consisted of 197 individuals who posted anti-vaccination comments in response to a message promoting vaccination. We systematically analysed publicly-available content using quantitative coding, descriptive analysis, social network analysis, and an in-depth qualitative assessment. The final codebook consisted of 26 codes; Cohen's κ ranged 0.71-1.0 after double-coding. RESULTS The majority (89%) of individuals identified as female. Among 136 individuals who divulged their location, 36 states and 8 other countries were represented. In a 2-mode network of individuals and topics, modularity analysis revealed 4 distinct sub-groups labelled as "trust," "alternatives," "safety," and "conspiracy." For example, a comment representative of "conspiracy" is that poliovirus does not exist and that pesticides caused clinical symptoms of polio. An example from the "alternatives" sub-group is that eating yogurt cures human papillomavirus. Deeper qualitative analysis of all 197 individuals' profiles found that these individuals also tended to post material against other health-related practices such as water fluoridation and circumcision. CONCLUSIONS Social media outlets may facilitate anti-vaccination connections and organization by facilitating the diffusion of centuries old arguments and techniques. Arguments against vaccination are diverse but remain consistent within sub-groups of individuals. It would be valuable for health professionals to leverage social networks to deliver more effective, targeted messages to different constituencies.
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Affiliation(s)
- Beth L Hoffman
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States; Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, United States.
| | - Elizabeth M Felter
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, United States.
| | - Kar-Hai Chu
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States.
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States.
| | - Chad Hermann
- Kids Plus Pediatrics, 4070 Beechwood Blvd., Pittsburgh, PA 15217, United States.
| | - Todd Wolynn
- Kids Plus Pediatrics, 4070 Beechwood Blvd., Pittsburgh, PA 15217, United States.
| | - Daria Williams
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States.
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, United States; Health Policy Institute, University of Pittsburgh, 311 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, United States; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, 1218 Scaife Hall, 35505 Terrace Street, Pittsburgh, PA 15261, United States.
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Abstract
BACKGROUND Waterpipe tobacco smoking (WTS or 'hookah') is common among adolescents and college students in the USA. However, there has not yet been a large-scale, nationally representative study independently examining WTS among young adults who are not in college. OBJECTIVE This study sought to examine associations between attitudes, normative beliefs, certain socio-demographic factors and current WTS among young adults not in college and compare them to young adults in college. METHODS A total of 3131 US adults ages 18-30 completed an online survey about WTS behaviour, attitudes, normative beliefs and relevant socio-demographic factors. Multivariable logistic regression was used to examine independent associations between these variables and current WTS stratified by student status. RESULTS Ever WTS was reported by 29% of young adults not in college and by 35% of those in college, and current use rates were 3 and 7%, respectively. Multivariable models demonstrated that positive attitudes and perceived peer acceptability of WTS were significantly associated with increased current WTS for both young adults not in college [adjusted odds ratio (AOR) = 2.72; 95% CI: 2.00-3.71 and AOR = 2.02; 95% CI: 1.50-2.71, respectively] and young adults in college (AOR = 3.37; 95% CI: 2.48-4.58 and AOR = 2.05; 95% CI: 1.49-2.83, respectively). The magnitude of these associations was not significantly different when comparing individuals in college and not in college. CONCLUSIONS Among young adults, WTS is common in non-college-based populations as well as in college-based populations. Therefore, prevention programming should extend to all young adults, not only to those in college.
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Affiliation(s)
- Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, PA, USA
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, PA, USA
| | - Jonathan Yabes
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carl Fertman
- Department of Health and Physical Activity, University of Pittsburgh School of Education, Pittsburgh, PA, USA
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, PA, USA.,Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,University Honors College, University of Pittsburgh, Pittsburgh, PA, USA
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18
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Primack BA, Karim SA, Shensa A, Bowman N, Knight J, Sidani JE. Positive and Negative Experiences on Social Media and Perceived Social Isolation. Am J Health Promot 2019; 33:859-868. [PMID: 30661371 DOI: 10.1177/0890117118824196] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To examine the association between positive and negative experiences on social media (SM) and perceived social isolation (PSI). DESIGN Cross-sectional survey. SETTING One large mid-Atlantic University. PARTICIPANTS A total of 1178 students aged 18 to 30 were recruited in August 2016. MEASURES Participants completed an online survey assessing SM use and PSI. We assessed positive and negative experiences on SM by directly asking participants to estimate what percentage of their SM experiences involved positive and negative experiences, respectively. Social isolation was measured using the established Patient-Reported Outcomes Measures Information System scale. ANALYSIS We used multivariable logistic regression to assess associations between both positive and negative experiences on SM and PSI. Primary models controlled for sex, age, race/ethnicity, educational status, relationship status, and living situation. RESULTS Participants had an average age of 20.9 (standard deviation = 2.9) and were 62% female. Just over one-quarter (28%) were nonwhite. After controlling for all sociodemographic covariates, each 10% increase in positive experiences was not significantly associated with social isolation (adjusted odds ratio [AOR] = 0.97; 95% confidence interval [CI]: 0.93-1.005). However, each 10% increase in negative experiences was associated with a 13% increase in odds of PSI (AOR = 1.13; 95% CI: 1.05-1.21). CONCLUSION Having positive experiences on SM is not associated with lower social isolation, whereas having negative experiences on SM is associated with higher social isolation. These findings are consistent with the concept of negativity bias, which suggests that humans tend to give greater weight to negative entities compared with positive ones.
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Affiliation(s)
- Brian A Primack
- 1 Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,2 Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,3 University Honors College, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sabrina A Karim
- 1 Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ariel Shensa
- 1 Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,2 Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nicholas Bowman
- 4 Department of Communication, University of West Virginia, Morgantown, WV, USA
| | - Jennifer Knight
- 4 Department of Communication, University of West Virginia, Morgantown, WV, USA
| | - Jaime E Sidani
- 1 Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,2 Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Shensa A, Sidani JE, Escobar-Viera CG, Chu KH, Bowman ND, Knight JM, Primack BA. Real-life closeness of social media contacts and depressive symptoms among university students. J Am Coll Health 2018; 66:747-753. [PMID: 29452042 DOI: 10.1080/07448481.2018.1440575] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To examine the association between degree of real-life closeness of social media (SM) contacts and depressive symptoms. PARTICIPANTS Students ages 18-30 (N = 1124) were recruited in August 2016. METHODS Participants completed an online survey assessing SM use and depression. We used multivariable logistic regression to assess associations between real-life closeness of SM contacts and depressive symptoms. RESULTS After controlling for covariates, each 10% increase in the proportion of SM friends with whom participants had no face-to-face relationship was associated with a 9% increase in odds of depressive symptoms (AOR = 1.09; 95% CI = 1.05-1.13). However, each 10% increase in the proportion of SM friends with whom participants had a close face-to-face relationship was associated with a 7% decrease in depressive symptoms (AOR = 0.93; 95% CI = 0.89-0.97). CONCLUSIONS Having no in-person relationship with SM contacts is associated with increased depressive symptoms; however, having close in-person relationships with SM contacts is associated with decreased depressive symptoms.
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Affiliation(s)
- Ariel Shensa
- a Division of General Internal Medicine, Department of Medicine , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
- b Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Jaime E Sidani
- a Division of General Internal Medicine, Department of Medicine , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
- b Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - César G Escobar-Viera
- a Division of General Internal Medicine, Department of Medicine , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
- b Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Kar-Hai Chu
- a Division of General Internal Medicine, Department of Medicine , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
- b Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
| | - Nicholas D Bowman
- c Department of Communication Studies , West Virginia University , Morgantown , West Virginia , USA
| | - Jennifer M Knight
- c Department of Communication Studies , West Virginia University , Morgantown , West Virginia , USA
| | - Brian A Primack
- a Division of General Internal Medicine, Department of Medicine , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
- b Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
- d Division of Adolescent Medicine, Department of Pediatrics , University of Pittsburgh School of Medicine , Pittsburgh , Pennsylvania , USA
- e University Honors College, University of Pittsburgh , Pittsburgh , Pennsylvania , USA
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Chu KH, Colditz JB, Primack BA, Shensa A, Allem JP, Miller E, Unger JB, Cruz TB. JUUL: Spreading Online and Offline. J Adolesc Health 2018; 63:582-586. [PMID: 30348280 PMCID: PMC6201306 DOI: 10.1016/j.jadohealth.2018.08.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 08/07/2018] [Accepted: 08/07/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE The increasing popularity of the JUUL electronic nicotine delivery system among youth poses several potential public health concerns. Social media can be used to better understand the spread of information related to JUUL. This study examined whether adolescents (age < 18) are following JUUL's official Twitter account and subsequently sharing (retweeting) JUUL's posts to their followers. We also assessed various patterns in which adolescents share information on JUUL with each other. METHODS We collected 3,239 tweets from JUUL's official Twitter account (@JUULVapor) for one full year from February 2017 to January 2018. These tweets were shared by Twitter users to their followers 1,124times by 721 unique users. Users were determined to be either adolescent (age <18) or adult (≥18) based on a systematic procedure involving double coding. We used social network analysis to explore the relationships between users retweeting JUUL. RESULTS One-quarter (25%) of users were determined to be adolescents. Social network analysis revealed a maximum path length of 4 and a positive assortativity (r = .29). There were 25 (9%) instances of an adolescent retweeting content from another adolescent, 35 (12%) of an adolescent retweeting from an adult, and 30 (11%) of an adult retweeting from an adolescent. CONCLUSIONS JUUL's official Twitter account is being followed-and its messages are being shared-by adolescents. Rigorous policies and prevention programs are needed to curb adolescent exposure to JUUL content and discussions online.
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Affiliation(s)
- Kar-Hai Chu
- Center for Research on Media, Technology, and Health, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Jason B. Colditz
- Center for Research on Media, Technology, and Health, Department of Medicine, School of Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213
| | - Brian A. Primack
- Center for Research on Media, Technology, and Health, Department of Medicine, School of Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, Department of Medicine, School of Medicine, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213
| | - Jon-Patrick Allem
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Health Sciences Campus, Los Angeles, CA 9003
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh, 3420 Fifth Ave, Pittsburgh, PA 15213
| | - Jennifer B. Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Health Sciences Campus, Los Angeles, CA 9003
| | - Tess Boley Cruz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Health Sciences Campus, Los Angeles, CA 9003
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Primack BA, Bisbey MA, Shensa A, Bowman ND, Karim SA, Knight JM, Sidani JE. The association between valence of social media experiences and depressive symptoms. Depress Anxiety 2018; 35:784-794. [PMID: 29877002 DOI: 10.1002/da.22779] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/19/2018] [Accepted: 05/12/2018] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Social media (SM) may confer emotional benefits via connection with others. However, epidemiologic studies suggest that overall SM is paradoxically associated with increased depressive symptoms. To better understand these findings, we examined the association between positive and negative experiences on SM and depressive symptoms. METHODS We conducted a cross-sectional survey of 1,179 full-time students at the University of West Virginia, aged 18 to 30, in August 2016. Independent variables were self-reported positive and negative experiences on SM. The dependent variable was depressive symptoms as measured using the Patient-Reported Outcomes Measurement Information System. We used multivariable logistic regression to assess associations between SM experiences and depressive symptoms controlling for sociodemographic factors including age, sex, race/ethnicity, education, relationship status, and living situation. RESULTS Of the 1,179 participants, 62% were female, 28% were non-White, and 51% were single. After controlling for covariates, each 10% increase in positive experiences on SM was associated with a 4% decrease in odds of depressive symptoms, but this was not statistically significant (adjusted odds ratio [AOR] = 0.96; 95% confidence interval [CI] = 0.91-1.002). However, each 10% increase in negative experiences was associated with a 20% increase in odds of depressive symptoms (AOR = 1.20; 95% CI = 1.11-1.31). When both independent variables were included in the same model, the association between negative experiences and depressive symptoms remained significant (AOR = 1.19, 95% CI = 1.10-1.30). CONCLUSIONS Negative experiences online may have higher potency than positive ones because of negativity bias. Future research should examine temporality to determine if it is also possible that individuals with depressive symptomatology are inclined toward negative interactions.
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Affiliation(s)
- Brian A Primack
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,University Honors College, University of Pittsburgh, Pittsburgh, PA, USA
| | - Meghan A Bisbey
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nicholas D Bowman
- Department of Communication, West Virginia University, Morgantown, WV, USA
| | - Sabrina A Karim
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jennifer M Knight
- Department of Communication, West Virginia University, Morgantown, WV, USA
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Escobar-Viera CG, Whitfield DL, Wessel CB, Shensa A, Sidani JE, Brown AL, Chandler CJ, Hoffman BL, Marshal MP, Primack BA. For Better or for Worse? A Systematic Review of the Evidence on Social Media Use and Depression Among Lesbian, Gay, and Bisexual Minorities. JMIR Ment Health 2018; 5:e10496. [PMID: 30037786 PMCID: PMC6079300 DOI: 10.2196/10496] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/18/2018] [Accepted: 06/01/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Over 90% of adults in the United States have at least one social media account, and lesbian, gay, and bisexual (LGB) persons are more socially active on social media than heterosexuals. Rates of depression among LGB persons are between 1.5- and 2-fold higher than those among their heterosexual counterparts. Social media allows users to connect, interact, and express ideas, emotions, feelings, and thoughts. Thus, social media use might represent both a protective and a risk factor for depression among LGB persons. Studying the nature of the relationship between social media use and depression among LGB individuals is a necessary step to inform public health interventions for this population. OBJECTIVE The objective of this systematic review was to synthesize and critique the evidence on social media use and depression among LGB populations. METHODS We conducted a literature search for quantitative and qualitative studies published between January 2003 and June 2017 using 3 electronic databases. Articles were included if they were peer-reviewed, were in English, assessed social media use either quantitatively or qualitatively, measured depression, and focused on LGB populations. A minimum of two authors independently extracted data from each study using an a priori developed abstraction form. We assessed appropriate reporting of studies using the Strengthening the Reporting of Observational Studies in Epidemiology and the Consolidated Criteria for Reporting Qualitative Research for quantitative and qualitative studies, respectively. RESULTS We included 11 articles in the review; 9 studies were quantitative and cross-sectional and 2 were qualitative. Appropriate reporting of results varied greatly. Across quantitative studies, we found heterogeneity in how social media use was defined and measured. Cyberbullying was the most studied social media experience and was associated with depression and suicidality. Qualitative studies found that while social media provides a space to disclose minority experiences and share ways to cope and get support, constant surveillance of one's social media profile can become a stressor, potentially leading to depression. In most studies, sexual minority participants were identified inconsistently. CONCLUSIONS This review supports the need for research on the role of social media use on depression outcomes among LBG persons. Using social media may be both a protective and a risk factor for depression among LGB individuals. Support gained via social media may buffer the impact of geographic isolation and loneliness. Negative experiences such as cyberbullying and other patterns of use may be associated with depression. Future research would benefit from more consistent definitions of both social media use and study populations. Moreover, use of larger samples and accounting for patterns of use and individuals' experiences on social media may help better understand the factors that impact LGB mental health disparities.
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Affiliation(s)
- César G Escobar-Viera
- Center for Research on Media, Technology, and Health, School of Medicine, University of Pittburgh, Pittsburgh, PA, United States.,Center for LGBT Health Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Darren L Whitfield
- Center for LGBT Health Research, University of Pittsburgh, Pittsburgh, PA, United States.,School of Social Work, University of Pittsburgh, Pittsburgh, PA, United States.,Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Charles B Wessel
- Health Sciences Library, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, School of Medicine, University of Pittburgh, Pittsburgh, PA, United States
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, School of Medicine, University of Pittburgh, Pittsburgh, PA, United States
| | - Andre L Brown
- Center for LGBT Health Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Cristian J Chandler
- Center for LGBT Health Research, University of Pittsburgh, Pittsburgh, PA, United States
| | - Beth L Hoffman
- Center for Research on Media, Technology, and Health, School of Medicine, University of Pittburgh, Pittsburgh, PA, United States
| | - Michael P Marshal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brian A Primack
- Center for Research on Media, Technology, and Health, School of Medicine, University of Pittburgh, Pittsburgh, PA, United States
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Escobar-Viera CG, Shensa A, Bowman ND, Sidani JE, Knight J, James AE, Primack BA. Passive and Active Social Media Use and Depressive Symptoms Among United States Adults. Cyberpsychology, Behavior, and Social Networking 2018; 21:437-443. [DOI: 10.1089/cyber.2017.0668] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- César G. Escobar-Viera
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Health Policy Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Nicholas D. Bowman
- Department of Communication Studies, West Virginia University, Morgantown, West Virginia
| | - Jaime E. Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jennifer Knight
- Department of Communication Studies, West Virginia University, Morgantown, West Virginia
| | - A. Everette James
- Health Policy Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brian A. Primack
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Primack BA, Shensa A, Sidani JE, Tulikangas MC, Roberts MS, Colditz JB, Mor MK, James AE, Fine M. Comparison of toxicant load from waterpipe and cigarette tobacco smoking among young adults in the USA. Tob Control 2018:tobaccocontrol-2017-054226. [PMID: 29773707 PMCID: PMC9299954 DOI: 10.1136/tobaccocontrol-2017-054226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/08/2018] [Accepted: 03/21/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To form population-level comparisons of total smoke volume, tar, carbon monoxide and nicotine consumed from waterpipe tobacco smoking (WTS) and cigarette smoking using data from a nationally representative sample of smokers and non-smokers aged 18-30 years. METHODS In March and April 2013, we surveyed a nationally representative sample of 3254 US young adults to assess the frequency and volume of WTS and cigarette smoking. We used Monte Carlo analyses with 5000 repetitions to estimate the proportions of toxicants originating from WTS and cigarette smoking. Analyses incorporated survey weights and used recent meta-analytic data to estimate toxicant exposures associated with WTS and cigarette smoking. RESULTS Compared with the additive estimates of WTS and cigarette smoking combined, 54.9% (95% CI 37.5% to 72.2%) of smoke volume was attributed to WTS. The proportions of tar attributable to WTS was 20.8% (95% CI 6.5% to 35.2%), carbon monoxide 10.3% (95% CI 3.3% to 17.3%) and nicotine 2.4% (95% CI 0.9% to 3.8%). CONCLUSIONS WTS accounted for over half of the tobacco smoke volume consumed among young US adult waterpipe and cigarette smokers. Toxicant exposures to tar, carbon monoxide and nicotine were lower, but still substantial, for WTS alone compared with WTS and cigarette smoking. Public health and policy interventions to reduce harm from tobacco smoking in young US adults should explicitly address WTS toxicant exposures.
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Affiliation(s)
- Brian A. Primack
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jaime E. Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Megan C. Tulikangas
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA
- Health Policy Institute, University of Pittsburgh, Pittsburgh, PA
| | - Mark S. Roberts
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Health Policy Institute, University of Pittsburgh, Pittsburgh, PA
- Center for Health Equity and Research Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Jason B. Colditz
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Maria K. Mor
- Center for Health Equity and Research Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - A. Everette James
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA
- Health Policy Institute, University of Pittsburgh, Pittsburgh, PA
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Michael Fine
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Center for Health Equity and Research Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
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Hoffman BL, Tulikangas MC, James AE, Shensa A, Colditz JB, Sidani JE, Primack BA. Pennsylvania policymakers' knowledge, attitudes and likelihood for action regarding waterpipe tobacco smoking and electronic nicotine delivery systems. Tob Prev Cessat 2018; 4:14. [PMID: 32411842 PMCID: PMC7205063 DOI: 10.18332/tpc/89624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Use of waterpipe tobacco smoking (WTS, or hookah smoking) and electronic nicotine delivery systems (ENDS, such as e-cigarettes) is rapidly increasing. However, legislatures have been slow to update policy measures related to them. Therefore, we aimed to assess knowledge, attitudes and likelihood to take future action regarding WTS and ENDS among Pennsylvania legislators. METHODS We approached all Standing Members of key Pennsylvania House and Senate health and welfare committees to complete a survey about substances of abuse, including WTS and ENDS. Closed-ended knowledge, attitude and action items used a 100-point scale. Responses to open-ended items were assessed using thematic analysis by three independently working researchers. RESULTS We received responses from 13 of 27 eligible policymakers (48%). Participants answered a mean of only 27% (SD=20%) of knowledge items correctly. When asked to rank by priority eight issues in substance abuse, WTS ranked eighth (least urgent) and ENDS ranked fifth. Participants reported low likelihood to introduce legislation on WTS (mean=29, median=25) and/or ENDS (mean=28, median=10). Thematic analysis revealed that participants readily acknowledged lack of understanding of WTS and ENDS, and were eager for additional information. CONCLUSIONS Policymakers exhibit a lack of knowledge concerning newer forms of tobacco and nicotine delivery systems and consider them to be relatively low legislative priorities. However, respondents expressed a desire for more information, suggesting the potential for public health entities to promote effective policy development via improved dissemination of information.
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Affiliation(s)
| | | | | | - Ariel Shensa
- University of Pittsburgh, Pittsburgh, United States
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Levenson JC, Shensa A, Sidani JE, Colditz JB, Primack BA. Social Media Use Before Bed and Sleep Disturbance Among Young Adults in the United States: A Nationally Representative Study. Sleep 2018; 40:3926043. [PMID: 28934521 DOI: 10.1093/sleep/zsx113] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Study Objectives Social media (SM) use has been positively associated with disturbed sleep among young adults. However, previous studies have not elucidated the specific importance of SM use immediately before bed. We aimed to determine the independent association of SM use during the 30 minutes before bed and disturbed sleep while controlling for covariates including total SM use throughout the day. Methods We assessed a nationally representative sample of 1763 US young adults aged 19-32. Participants estimated to what extent they used SM in the 30 minutes before bed. We assessed sleep disturbance using the brief Patient-Reported Outcomes Measurement Information System (PROMIS®) Sleep Disturbance measure. After testing the proportional odds assumption, we used ordered logistic regression to compute the independent association between SM use before bed and sleep disturbance controlling for covariates, including total SM use. Results Compared with those who rarely or very rarely check SM in the 30 minutes before bed, those who often or very often check SM at that time had an adjusted odds ratio of 1.62 (95% confidence interval = 1.31-2.34) for increased sleep disturbance. Additionally, we found a significant linear trend in the odds ratios between the frequency of checking SM in the 30 minutes before bed and increased sleep disturbance (p = .007). Results were consistent in all sensitivity analyses. Conclusions SM use in the 30 minutes before bed is independently associated with disturbed sleep among young adults. Future work should use qualitative and experimental methods to further elucidate the directionality of-and mechanisms underlying-this association.
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Affiliation(s)
- Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA.,Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA.,Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jason B Colditz
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA.,Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brian A Primack
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA.,Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Whaite EO, Shensa A, Sidani JE, Colditz JB, Primack BA. Social media use, personality characteristics, and social isolation among young adults in the United States. Personality and Individual Differences 2018. [DOI: 10.1016/j.paid.2017.10.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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28
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Primack BA, Shensa A, Sidani JE, Hoffman BL, Soneji S, Sargent JD, Hoffman RM, Fine MJ. Initiation of Traditional Cigarette Smoking after Electronic Cigarette Use Among Tobacco-Naïve US Young Adults. Am J Med 2018; 131:443.e1-443.e9. [PMID: 29242110 PMCID: PMC7054856 DOI: 10.1016/j.amjmed.2017.11.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 04/25/2017] [Accepted: 11/03/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although electronic cigarettes (e-cigarettes) may help some smokers quit, some young adult never-smokers are now using e-cigarettes recreationally, potentially increasing their risk for initiation of smoking. We aimed to determine the association between baseline e-cigarette use and subsequent initiation of cigarette smoking among initially never-smoking young adults. METHODS We conducted a prospective cohort study with assessments at baseline (March 2013) and follow-up (October 2014). We used sampling frames representing 97% of the US population to recruit a nationally representative sample of never-smoking young adults aged 18 to 30 years. The independent variable was baseline ever use of e-cigarettes. The main outcome measure was initiation of traditional cigarette smoking between baseline and 18-month follow-up. RESULTS Baseline surveys were completed by 1506 never-smoking young adults, of whom 915 (60.8%) completed follow-up. There were no demographic differences between responders and nonresponders. After applying survey weights-which accounted for both nonresponse and overcoverage or undercoverage-2.5% of the represented population of never-smokers (801,010 of 32,040,393) used e-cigarettes at baseline. Cigarette smoking was initiated by 47.7% of e-cigarette users and 10.2% of nonusers (P = .001). In fully adjusted multivariable models, e-cigarette use at baseline was independently associated with initiation of smoking at 18 months (adjusted odds ratio, 6.8; 95% confidence interval, 1.7-28.3). Results remained similar in magnitude and statistically significant in all sensitivity analyses. CONCLUSIONS Baseline e-cigarette use was independently associated with initiation of traditional cigarette smoking at 18 months. This finding supports policy and educational interventions designed to decrease use of e-cigarettes among nonsmokers.
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Affiliation(s)
- Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pa; University of Pittsburgh Honors College, University of Pittsburgh, Pittsburgh, Pa.
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Beth L Hoffman
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa
| | - Samir Soneji
- C. Everett Koop Institute at Dartmouth, Geisel School of Medicine, Hanover, NH; Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - James D Sargent
- C. Everett Koop Institute at Dartmouth, Geisel School of Medicine, Hanover, NH; Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH; Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH
| | | | - Michael J Fine
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, Pa; VA Pittsburgh Healthcare System, Pittsburgh, Pa
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Shensa A, Sidani JE, Dew MA, Escobar-Viera CG, Primack BA. Social Media Use and Depression and Anxiety Symptoms: A Cluster Analysis. Am J Health Behav 2018; 42:116-128. [PMID: 29458520 DOI: 10.5993/ajhb.42.2.11] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Individuals use social media with varying quantity, emotional, and behavioral at- tachment that may have differential associations with mental health outcomes. In this study, we sought to identify distinct patterns of social media use (SMU) and to assess associations between those patterns and depression and anxiety symptoms. METHODS In October 2014, a nationally-representative sample of 1730 US adults ages 19 to 32 completed an online survey. Cluster analysis was used to identify patterns of SMU. Depression and anxiety were measured using respective 4-item Patient-Reported Outcome Measurement Information System (PROMIS) scales. Multivariable logistic regression models were used to assess associations between clus- ter membership and depression and anxiety. RESULTS Cluster analysis yielded a 5-cluster solu- tion. Participants were characterized as "Wired," "Connected," "Diffuse Dabblers," "Concentrated Dabblers," and "Unplugged." Membership in 2 clusters - "Wired" and "Connected" - increased the odds of elevated depression and anxiety symptoms (AOR = 2.7, 95% CI = 1.5-4.7; AOR = 3.7, 95% CI = 2.1-6.5, respectively, and AOR = 2.0, 95% CI = 1.3-3.2; AOR = 2.0, 95% CI = 1.3-3.1, respectively). CONCLUSIONS SMU pattern characterization of a large population suggests 2 pat- terns are associated with risk for depression and anxiety. Developing educational interventions that address use patterns rather than single aspects of SMU (eg, quantity) would likely be useful.
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Affiliation(s)
- Ariel Shensa
- Center for Research on Media, Technology, and Health, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Mary Amanda Dew
- Departments of Psychiatry, Psychology, Epidemiology, and Biostatistics, University of Pittsburgh, Pittsburgh, PA
| | - César G. Escobar-Viera
- Center for Research on Media, Technology, and Health, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brian A. Primack
- Center for Research on Media, Technology, and Health, University Honors College, Division of Adolescent Medicine, Department of Pediatrics, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh
School of Medicine, University of Pittsburgh, Pittsburgh, PA
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Hoffman BL, Hoffman R, Wessel CB, Shensa A, Woods MS, Primack BA. Use of fictional medical television in health sciences education: a systematic review. Adv Health Sci Educ Theory Pract 2018; 23:201-216. [PMID: 28083814 DOI: 10.1007/s10459-017-9754-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 01/06/2017] [Indexed: 06/06/2023]
Abstract
While medical television programs are popular among health profession trainees, it is not clear to what extent these programs affect their knowledge, perceptions, and/or behaviors. Therefore, we conducted a systematic review of research evaluating associations between program exposure and outcomes. We conducted systematic literature searches in Pubmed, CINAHL, and PsycINFO. Selected studies were required to be scholarly research, involve exposure to fictionalized medical television programming by health professional students, and assess associations between exposure and outcomes. Studies were classified according to quality and factors related to population, exposure, and outcomes. Of 3541 studies identified, 13 met selection criteria. Six studies involved undergraduate medical students, one involved nursing students, two involved both medical and nursing students, two involved medical residents, one involved medical students, residents and attending physicians, and one involved graduate epidemiology students. Mean study quality according to the MERSQI was 8.27. The most commonly assessed television programs were ER and Grey's Anatomy (six each). Five studies assessed regular viewing habits, and found that fictional medical programs are popular among students and that students recall health topics from episodes. The eight studies that assessed the association with outcomes when using clips as educational tools reported high satisfaction and increased knowledge of the presented health topics. While relatively few published studies have explored influences of fictional medical television on health professional students, those conducted suggest that students often view these television programs independently and that integration of this programming into medical education is feasible and acceptable.
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Affiliation(s)
- Beth L Hoffman
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Charles B Wessel
- Health Sciences Library System, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Michelle S Woods
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, 230 McKee Place Suite 600, Pittsburgh, PA, 15213, USA.
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Abstract
Low emotional support is associated with poor health outcomes. Engagement with face-to-face social networks is one way of increasing emotional support. However, it is not yet known whether engagement with proliferating electronic social networks is similarly associated with increased emotional support. Thus, the purpose of this study was to assess associations between social media use and perceived emotional support in a large, nationally-representative sample. In October 2014, we collected data from 1796 U.S. adults ages 19-32. We assessed social media use using both total time spent and frequency of visits to each of the 11 most popular social media platforms. Our dependent variable was perceived emotional support as measured by the brief Patient-Reported Outcomes Measurement Information System (PROMIS) emotional support scale. A multivariable model including all sociodemographic covariates and accounting for survey weights demonstrated that, compared with the lowest quartile of time on social media, being in the highest quartile (spending two or more hours per day) was significantly associated with decreased odds of having higher perceived emotional support (AOR 0.62, 95 % CI 0.40, 0.94). However, compared with those in the lowest quartile, being in the highest quartile regarding frequency of social media use was not significantly associated with perceived emotional support (AOR 0.70, 95 % CI 0.45, 1.09). In conclusion, while the cross-sectional nature of these data hinder inference regarding directionality, it seems that heavy users of social media may actually feel less and not more emotional support.
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Affiliation(s)
- Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place Suite 600, Pittsburgh, PA, 15213, USA.
| | - Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place Suite 600, Pittsburgh, PA, 15213, USA
| | - Liu Yi Lin
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nicholas D Bowman
- Department of Communication Studies, West Virginia University, Morgantown, WV, USA
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place Suite 600, Pittsburgh, PA, 15213, USA.,Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Primack BA, Shensa A, Sidani JE, Whaite EO, Lin LY, Rosen D, Colditz JB, Radovic A, Miller E. Social Media Use and Perceived Social Isolation Among Young Adults in the U.S. Am J Prev Med 2017; 53:1-8. [PMID: 28279545 PMCID: PMC5722463 DOI: 10.1016/j.amepre.2017.01.010] [Citation(s) in RCA: 177] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 12/05/2016] [Accepted: 01/05/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Perceived social isolation (PSI) is associated with substantial morbidity and mortality. Social media platforms, commonly used by young adults, may offer an opportunity to ameliorate social isolation. This study assessed associations between social media use (SMU) and PSI among U.S. young adults. METHODS Participants were a nationally representative sample of 1,787 U.S. adults aged 19-32 years. They were recruited in October-November 2014 for a cross-sectional survey using a sampling frame that represented 97% of the U.S. POPULATION SMU was assessed using both time and frequency associated with use of 11 social media platforms, including Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, and Reddit. PSI was measured using the Patient-Reported Outcomes Measurement Information System scale. In 2015, ordered logistic regression was used to assess associations between SMU and SI while controlling for eight covariates. RESULTS In fully adjusted multivariable models that included survey weights, compared with those in the lowest quartile for SMU time, participants in the highest quartile had twice the odds of having greater PSI (AOR=2.0, 95% CI=1.4, 2.8). Similarly, compared with those in the lowest quartile, those in the highest quartile of SMU frequency had more than three times the odds of having greater PSI (AOR=3.4, 95% CI=2.3, 5.1). Associations were linear (p<0.001 for all), and results were robust to all sensitivity analyses. CONCLUSIONS Young adults with high SMU seem to feel more socially isolated than their counterparts with lower SMU. Future research should focus on determining directionality and elucidating reasons for these associations.
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Affiliation(s)
- Brian A Primack
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Erin O Whaite
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Liu Yi Lin
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; UPMC McKeesport Family Medicine and Psychiatry Residency Program, Pittsburgh, Pennsylvania
| | - Daniel Rosen
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; School of Social Work, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jason B Colditz
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ana Radovic
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Shensa A, Escobar-Viera CG, Sidani JE, Bowman ND, Marshal MP, Primack BA. Problematic social media use and depressive symptoms among U.S. young adults: A nationally-representative study. Soc Sci Med 2017; 182:150-157. [PMID: 28446367 DOI: 10.1016/j.socscimed.2017.03.061] [Citation(s) in RCA: 178] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/20/2017] [Accepted: 03/31/2017] [Indexed: 02/07/2023]
Abstract
RATIONALE Depression is the leading cause of disability worldwide. The suggested association between social media use (SMU) and depression may be explained by the emerging maladaptive use pattern known as problematic social media use (PSMU), characterized by addictive components. OBJECTIVE We aimed to assess the association between PSMU and depressive symptoms-controlling for overall time and frequency of SMU-among a large sample of U.S. young adults. METHODS In October 2014, participants aged 19-32 (N = 1749) were randomly selected from a nationally-representative U.S. probability-based panel and subsequently invited to participate in an online survey. We assessed depressive symptoms using the validated Patient-Reported Outcomes Measurement Information System (PROMIS) brief depression scale. We measured PSMU using an adapted version of the Bergen Facebook Addiction Scale to encompass broader SMU. Using logistic regression models, we tested the association between PSMU and depressive symptoms, controlling for time and frequency of SMU as well as a comprehensive set of socio-demographic covariates. RESULTS In the multivariable model, PSMU was significantly associated with a 9% increase in odds of depressive symptoms (AOR [adjusted odds ratio] = 1.09; 95% CI [confidence interval]: 1.05, 1.13; p < 0.001.) Increased frequency of SMU was also significantly associated with increased depressive symptoms, whereas SMU time was not (AOR = 1.01; 95% CI: 1.00, 1.01; p = 0.001 and AOR = 1.00; 95% CI: 0.999-1.001; p = 0.43, respectively). CONCLUSION PSMU was strongly and independently associated with increased depressive symptoms in this nationally-representative sample of young adults. PSMU largely explained the association between SMU and depressive symptom, suggesting that it may be how we use social media, not how much, that poses a risk. Intervention efforts aimed at reducing depressive symptoms, such as screenings for maladaptive SMU, may be most successful if they address addictive components and frequency-rather than time-of SMU.
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Affiliation(s)
- Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States.
| | - César G Escobar-Viera
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States; Health Policy Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Nicholas D Bowman
- Department of Communication Studies, West Virginia University, Morgantown, WV, United States
| | - Michael P Marshal
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States
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Hoffman BL, Shensa A, Wessel C, Hoffman R, Primack BA. Exposure to fictional medical television and health: a systematic review. Health Educ Res 2017; 32:107-123. [PMID: 28334962 DOI: 10.1093/her/cyx034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 01/26/2017] [Indexed: 06/06/2023]
Abstract
Fictional medical television programs have long been a staple of television programming, and they remain popular today. We aimed to examine published literature assessing the influence of medical television programs on health outcomes. We conducted systematic literature searches in PubMed, PsychINFO and CINAHL. Selected studies had to be scholarly research, to involve exposure to fictionalized medical television programming, and to assess associations between exposures and outcomes. Of 3541 unique studies identified, nineteen met selection criteria. The most commonly studied programs were ER (73%), Grey's Anatomy (58%) and House M.D. (37%). Outcomes included knowledge, perceptions and behaviors related to topics as diverse as organ donation, cancer screening, sexually transmitted infections, and heart disease. Viewing fictional medical television programs had a negative influence on viewers' health-related knowledge, perceptions and/or behavior in 11% of studies, a positive influence in 32% of studies, and mixed influence in 58%. While most studies (58%) were characterized as having fair quality in terms of rigor of study design, 21% were classified as good and 21% were classified as poor. As such, medical television can affect health education and outcomes. Future work should utilize randomization, more longitudinal assessments, and more direct assessments of health education and behavioral outcomes.
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Affiliation(s)
- Beth L Hoffman
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Charles Wessel
- University of Pittsburgh, Health Sciences Library System, Pittsburgh, PA 15213, USA
| | - Robert Hoffman
- Department of Medicine, VA Pittsburgh Healthcare System, Pittsburgh, PA 15213, USA
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Primack BA, Shensa A, Escobar-Viera CG, Barrett EL, Sidani JE, Colditz JB, James AE. Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among U.S. young adults. Computers in Human Behavior 2017. [DOI: 10.1016/j.chb.2016.11.013] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sidani JE, Shensa A, Naidu MR, Yabes JG, Primack BA. Initiation, Progression, and Sustained Waterpipe Use: A Nationally Representative Longitudinal Study of U.S. Young Adults. Cancer Epidemiol Biomarkers Prev 2017; 26:748-755. [PMID: 28082346 DOI: 10.1158/1055-9965.epi-16-0687-t] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/28/2016] [Accepted: 12/13/2016] [Indexed: 11/16/2022] Open
Abstract
Background: Waterpipe tobacco smoking (WTS) is increasing in popularity despite evidence of harm and potential for dependence. Intervention development has been hampered by a lack of longitudinal, nationally representative data on usage patterns and factors independently associated with WTS initiation. Therefore, we aimed to characterize key transitions between WTS states in a nationally representative group of young adults, with particular attention to factors independently associated with initiation.Methods: Participants were randomly selected from a national probability-based panel representing 97% of the United States. A total of 1,785 adults ages 18 to 30 at baseline completed two Web-based surveys 18 months apart in 2013 and 2014. Assessments included knowledge of waterpipe tobacco smoke composition, positive and negative attitudes toward WTS, normative beliefs, intention to use waterpipe, and WTS behavior. We used multivariable logistic regression to assess the association between predictive factors and subsequent WTS initiation.Results: In fully adjusted models, overall knowledge about toxicants associated with WTS was not associated with subsequent WTS initiation. Similarly, negative attitudes and normative beliefs were not associated with WTS uptake. However, baseline positive attitudes were strongly and significantly associated with WTS initiation [adjusted OR (AOR) = 1.7; 95% confidence interval (CI), 1.2-2.3]. Similarly, baseline intention to use WTS was strongly associated with subsequent initiation (AOR = 7.0; 95% CI, 3.5-13.7).Conclusions: Prevention efforts may be most successful if they target individuals with clear intentions to use WTS and challenge positive attitudes surrounding WTS.Impact: Surveillance of WTS trajectories will help inform health care and policy surrounding this emerging risk behavior among U.S. young adults. Cancer Epidemiol Biomarkers Prev; 26(5); 748-55. ©2017 AACR.
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Affiliation(s)
- Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania. .,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maharsi R Naidu
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan G Yabes
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania.,Center for Research on Health Care Data Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, Pennsylvania.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Jones JR, Colditz JB, Shensa A, Sidani JE, Lin LY, Terry MA, Primack BA. Associations Between Internet-Based Professional Social Networking and Emotional Distress. Cyberpsychol Behav Soc Netw 2016; 19:601-608. [PMID: 27732077 DOI: 10.1089/cyber.2016.0134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Professional social networking websites are commonly used among young professionals. In light of emerging concerns regarding social networking use and emotional distress, the purpose of this study was to investigate the association between frequency of use of LinkedIn, the most commonly used professional social networking website, and depression and anxiety among young adults. In October 2014, we assessed a nationally representative sample of 1,780 U.S. young adults between the ages of 19-32 regarding frequency of LinkedIn use, depression and anxiety, and sociodemographic covariates. We measured depression and anxiety using validated Patient-Reported Outcomes Measurement Information System measures. We used bivariable and multivariable logistic regression to assess the association between LinkedIn use and depression and anxiety, while controlling for age, sex, race, relationship status, living situation, household income, education level, and overall social media use. In weighted analyses, 72% of participants did not report use of LinkedIn, 16% reported at least some use, but less than once each week, and 12% reported use at least once per week. In multivariable analyses controlling for all covariates, compared with those who did not use LinkedIn, participants using LinkedIn at least once per week had significantly greater odds of increased depression (adjusted odds ratio [AOR] = 2.10, 95% confidence interval [CI] = 1.31-3.38) and increased anxiety (AOR = 2.79, 95% CI = 1.72-4.53). LinkedIn use was significantly related to both outcomes in a dose-response manner. Future research should investigate directionality of this association and possible reasons for it.
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Affiliation(s)
- Jacquelynn R Jones
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health , Pittsburgh, Pennsylvania.,Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Jason B Colditz
- Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh, Pennsylvania.,Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh, Pennsylvania.,Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh, Pennsylvania.,Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Liu Yi Lin
- Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh, Pennsylvania.,Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Martha Ann Terry
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health , Pittsburgh, Pennsylvania
| | - Brian A Primack
- Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh, Pennsylvania.,Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
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Sidani JE, Shensa A, Hoffman B, Hanmer J, Primack BA. The Association between Social Media Use and Eating Concerns among US Young Adults. J Acad Nutr Diet 2016; 116:1465-1472. [PMID: 27161027 DOI: 10.1016/j.jand.2016.03.021] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 03/21/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The etiology of eating concerns is multifactorial, and exposure to media messages is considered to be a contributor. Although traditional media, such as television and magazines, have been examined extensively in relation to eating concerns risk, the influence of social media has received relatively less attention. OBJECTIVE To examine the association between social media use and eating concerns in a large, nationally representative sample of young adults. DESIGN Cross-sectional survey. PARTICIPANTS/SETTING Participants were 1,765 young adults aged 19 to 32 years who were randomly selected from a national probability-based online nonvolunteer panel. OUTCOME MEASURES An eating concerns scale was adapted from two validated measures: the SCOFF Questionnaire and the Eating Disorder Screen for Primary Care. Social media use (including Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, and Reddit) was assessed using both volume (time per day) and frequency (visits per week). STATISTICAL ANALYSES To examine associations between eating concerns and social media use, ordered logistic regression was used, controlling for all covariates. RESULTS Compared with those in the lowest quartile, participants in the highest quartiles for social media volume and frequency had significantly greater odds of having eating concerns (adjusted odds ratio 2.18, 95% CI 1.50 to 3.17 and adjusted odds ratio 2.55, 95% CI 1.72 to 3.78, respectively). There were significant positive overall linear associations between the social media use variables and eating concerns (P<0.001). CONCLUSIONS The results from this study indicate a strong and consistent association between social media use and eating concerns in a nationally representative sample of young adults aged 19 to 32 years. This association was apparent whether social media use was measured as volume or frequency. Further research should assess the temporality of these associations. It would also be useful to examine more closely the influence of specific characteristics of social media use, including content-related and contextual features.
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Sidani JE, Shensa A, Shiffman S, Switzer GE, Primack BA. Public health implications of waterpipe tobacco use in the United States warrant initial steps towards assessing dependence. Addiction 2016; 111:937-8. [PMID: 26987303 PMCID: PMC5127591 DOI: 10.1111/add.13316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 01/19/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Jaime E. Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Suite W933, Pittsburgh, PA 15213,Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213,Corresponding Author: Jaime E. Sidani, PhD, MPH, Center for Research on Media, Technology, and Health, 230 McKee Place Suite 600, Pittsburgh, PA 15213, , 412-864-3192 (phone); 412-692-4838 (fax)
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Suite W933, Pittsburgh, PA 15213,Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213
| | - Saul Shiffman
- Pinney Associates, 201 North Craig Street, Suite 320, Pittsburgh, PA 15213
| | - Galen E. Switzer
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15213,Departments of Medicine, Psychiatry, Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA 15213
| | - Brian A. Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Suite W933, Pittsburgh, PA 15213,Center for Research on Media, Technology, and Health, University of Pittsburgh, 230 McKee Place, Suite 600, Pittsburgh, PA 15213,Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, 3420 Fifth Avenue, Pittsburgh, PA 15213
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Lin LY, Sidani JE, Shensa A, Radovic A, Miller E, Colditz JB, Hoffman BL, Giles LM, Primack BA. ASSOCIATION BETWEEN SOCIAL MEDIA USE AND DEPRESSION AMONG U.S. YOUNG ADULTS. Depress Anxiety 2016; 33:323-31. [PMID: 26783723 PMCID: PMC4853817 DOI: 10.1002/da.22466] [Citation(s) in RCA: 342] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/19/2015] [Accepted: 12/24/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Social media (SM) use is increasing among U.S. young adults, and its association with mental well-being remains unclear. This study assessed the association between SM use and depression in a nationally representative sample of young adults. METHODS We surveyed 1,787 adults ages 19 to 32 about SM use and depression. Participants were recruited via random digit dialing and address-based sampling. SM use was assessed by self-reported total time per day spent on SM, visits per week, and a global frequency score based on the Pew Internet Research Questionnaire. Depression was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression Scale Short Form. Chi-squared tests and ordered logistic regressions were performed with sample weights. RESULTS The weighted sample was 50.3% female and 57.5% White. Compared to those in the lowest quartile of total time per day spent on SM, participants in the highest quartile had significantly increased odds of depression (AOR = 1.66, 95% CI = 1.14-2.42) after controlling for all covariates. Compared with those in the lowest quartile, individuals in the highest quartile of SM site visits per week and those with a higher global frequency score had significantly increased odds of depression (AOR = 2.74, 95% CI = 1.86-4.04; AOR = 3.05, 95% CI = 2.03-4.59, respectively). All associations between independent variables and depression had strong, linear, dose-response trends. Results were robust to all sensitivity analyses. CONCLUSIONS SM use was significantly associated with increased depression. Given the proliferation of SM, identifying the mechanisms and direction of this association is critical for informing interventions that address SM use and depression.
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Affiliation(s)
- Liu yi Lin
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Jaime E. Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Ana Radovic
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA,Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA,Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jason B. Colditz
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Beth L. Hoffman
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Leila M. Giles
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Brian A. Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA,Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA,Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA,Corresponding Author: Brian A. Primack, M.D., Ph.D., 230 McKee Place Suite 600, Pittsburgh, PA 15213, , 412-586-9789 (phone); 412-692-4838 (fax)
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Levenson JC, Shensa A, Sidani JE, Colditz JB, Primack BA. The association between social media use and sleep disturbance among young adults. Prev Med 2016; 85:36-41. [PMID: 26791323 PMCID: PMC4857587 DOI: 10.1016/j.ypmed.2016.01.001] [Citation(s) in RCA: 150] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/24/2015] [Accepted: 01/03/2016] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Many factors contribute to sleep disturbance among young adults. Social media (SM) use is increasing rapidly, and little is known regarding its association with sleep disturbance. METHODS In 2014 we assessed a nationally representative sample of 1788 U.S. young adults ages 19-32. SM volume and frequency were assessed by self-reported minutes per day spent on SM (volume) and visits per week (frequency) using items adapted from the Pew Internet Research Questionnaire. We assessed sleep disturbance using the brief Patient-Reported Outcomes Measurement Information System (PROMIS®) sleep disturbance measure. Analyses performed in Pittsburgh utilized chi-square tests and ordered logistic regression using sample weights in order to estimate effects for the total U.S. RESULTS In models that adjusted for all sociodemographic covariates, participants with higher SM use volume and frequency had significantly greater odds of having sleep disturbance. For example, compared with those in the lowest quartile of SM use per day, those in the highest quartile had an AOR of 1.95 (95% CI=1.37-2.79) for sleep disturbance. Similarly, compared with those in the lowest quartile of SM use frequency per week, those in the highest quartile had an AOR of 2.92 (95% CI=1.97-4.32) for sleep disturbance. All associations demonstrated a significant linear trend. DISCUSSION The strong association between SM use and sleep disturbance has important clinical implications for the health and well-being of young adults. Future work should aim to assess directionality and to better understand the influence of contextual factors associated with SM use.
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Affiliation(s)
- Jessica C Levenson
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Ariel Shensa
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA 15260, USA; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Jaime E Sidani
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA 15260, USA; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Jason B Colditz
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA 15260, USA; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Brian A Primack
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA 15260, USA; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
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Abstract
Hookah tobacco smoking is prevalent, widespread, and associated with large amounts of toxicants. Hookah tobacco smoking may be viewed differently by males and females. For example, females have been drawn to types of tobacco that are flavored, milder, and marketed as more social and exotic. Individuals often use the growing segment of anonymous social networking sites, such as Tumblr, to learn about potentially dangerous or harmful behaviors. We used a systematic process involving stratification by time of day, day of week, and search term to gather a sample of 140 Tumblr posts related to hookah tobacco smoking. After a structured codebook development process, 2 coders independently assessed all posts in their entirety, and all disagreements were easily adjudicated. When data on poster sex and age were available, we found that 77% of posts were posted by females and 35% were posted by individuals younger than 18. The most prominent features displayed in all posts were references to or images of hookahs themselves, sexuality, socializing, alcohol, hookah smoke, and tricks performed with hookah smoke. Compared with females, males more frequently posted images of hookahs and alcohol-related images or references. This information may help guide future research in this area and the development of targeted interventions to curb this behavior.
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Affiliation(s)
- Brian A. Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Wesley Davis
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Center for Research on Media, Technology, and Health, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Michele D. Levine
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Shensa A, Phelps-Tschang J, Miller E, Primack BA. A randomized crossover study of web-based media literacy to prevent smoking. Health Educ Res 2016; 31:48-59. [PMID: 26675176 PMCID: PMC4883031 DOI: 10.1093/her/cyv062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 10/16/2015] [Indexed: 05/31/2023]
Abstract
Feasibly implemented Web-based smoking media literacy (SML) programs have been associated with improving SML skills among adolescents. However, prior evaluations have generally had weak experimental designs. We aimed to examine program efficacy using a more rigorous crossover design. Seventy-two ninth grade students completed a Web-based SML program based on health behavior theory and implemented using a two-group two-period crossover design. Students were randomly assigned by classroom to receive media literacy or control interventions in different sequences. They were assessed three times, at baseline (T0), an initial follow-up after the first intervention (T1) and a second follow-up after the second intervention (T2). Crossover analysis using analysis of variance demonstrated significant intervention coefficients, indicating that the SML condition was superior to control for the primary outcome of total SML (F = 11.99; P < 0.001) and for seven of the nine individual SML items. Results were consistent in sensitivity analyses conducted using non-parametric methods. There were changes in some exploratory theory-based outcomes including attitudes and normative beliefs but not others. In conclusion, while strength of the design of this study supports and extends prior findings around effectiveness of SML programs, influences on theory-based mediators of smoking should be further explored.
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Affiliation(s)
- Ariel Shensa
- Center for Research on Media, Technology, and Health,
| | | | - Elizabeth Miller
- Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
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Sidani JE, Shensa A, Shiffman S, Switzer GE, Primack BA. Behavioral associations with waterpipe tobacco smoking dependence among US young adults. Addiction 2016; 111:351-9. [PMID: 26417942 PMCID: PMC4715762 DOI: 10.1111/add.13163] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/11/2015] [Accepted: 09/04/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Waterpipe tobacco smoking (WTS) is increasingly prevalent in the United States, especially among young adults. We aimed to (1) adapt items from established dependence measures into a WTS dependence scale for US young adults (the US Waterpipe Dependence Scale), (2) determine the factor structure of the items and (3) assess associations between scale values and behavioral use characteristics known to be linked to dependence. DESIGN Cross-sectional survey. SETTING United States. PARTICIPANTS A total of 436 past-year waterpipe tobacco users ages 18-30 years selected at random from a national probability-based panel. MEASUREMENTS Participants responded to six tobacco dependence items adapted for WTS in US populations. Behavioral use characteristics included factors such as frequency of use and age of initiation. FINDINGS Principal components analysis yielded an unambiguous one-factor solution. Approximately half (52.9%) of past-year waterpipe tobacco users received a score of 0, indicating that none of the six WTS dependence items were endorsed. Approximately one-quarter (25.4%) endorsed one dependence item and 22.7% endorsed two or more items. Higher WTS dependence scores were associated significantly with all five behavioral use characteristics. For example, compared with those who endorsed no dependence items, those who endorsed two or more had an adjusted odds ratio (AOR) of 3.90 [95% confidence interval (CI) = 1.56-9.78] for having had earlier age of initiation and an AOR of 32.75 (95% CI = 9.76-109.86) for more frequent WTS sessions. CONCLUSIONS Scores on a six-item waterpipe tobacco smoking dependence scale (the US Waterpipe Dependence Scale) correlate with measures that would be expected to be related to dependence, such as amount used and age of initiation.
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Affiliation(s)
- Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Galen E Switzer
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Departments of Medicine, Psychiatry, Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA, USA.,Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, USA.,Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, 3420 Fifth Avenue, Pittsburgh, PA, USA
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Primack BA, Carroll MV, Weiss PM, Shihadeh AL, Shensa A, Farley ST, Fine MJ, Eissenberg T, Nayak S. Systematic Review and Meta-Analysis of Inhaled Toxicants from Waterpipe and Cigarette Smoking. Public Health Rep 2016; 131:76-85. [PMID: 26843673 PMCID: PMC4716475 DOI: 10.1177/003335491613100114] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Waterpipe tobacco smoking (WTS) is an emerging trend worldwide. To inform public health policy and educational programming, we systematically reviewed the biomedical literature to compute the inhaled smoke volume, nicotine, tar, and carbon monoxide (CO) associated with a single WTS session and a single cigarette. METHODS We searched seven biomedical bibliographic databases for controlled laboratory or natural environment studies designed to mimic human tobacco consumption. Included studies quantified the mainstream smoke of a single cigarette and/or single WTS session for smoke volume, nicotine, tar, and/or CO. We conducted meta-analyses to calculate summary estimates for the inhalation of each unique substance for each mode of tobacco consumption. We assessed between-study heterogeneity using chi-squared and I-squared statistics. RESULTS Sufficient data from 17 studies were available to derive pooled estimates for inhalation of each exposure via each smoking method. Two researchers working independently abstracted measurement of smoke volume in liters, and nicotine, tar, and CO in milligrams. All numbers included in meta-analyses matched precisely between the two researchers (100% agreement, Cohen's k=1.00). Whereas one WTS session was associated with 74.1 liters of smoke inhalation (95% confidence interval [CI] 38.2, 110.0), one cigarette was associated with 0.6 liters of smoke (95% CI 0.5, 0.7). One WTS session was also associated with higher levels of nicotine, tar, and CO. CONCLUSIONS One WTS session consistently exposed users to larger smoke volumes and higher levels of tobacco toxicants compared with one cigarette. These computed estimates may be valuable to emphasize in prevention programming.
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Affiliation(s)
| | | | - Patricia M. Weiss
- University of Pittsburgh Health Sciences Library System, Pittsburgh, PA
| | | | - Ariel Shensa
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | | | | | - Smita Nayak
- Swedish Center for Research and Innovation, Swedish Health Services, Seattle, WA
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Sidani JE, Shensa A, Primack BA. Water pipe steam stones: familiarity and use among US young adults. Nicotine Tob Res 2015; 17:114-8. [PMID: 25145376 PMCID: PMC4318932 DOI: 10.1093/ntr/ntu137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/06/2014] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Water pipe tobacco smoking (WTS) is associated with substantial toxicant exposure. Water pipe steam stones (WSS) are marketed as a healthier alternative. The purpose of this study was to determine, in a nationally representative sample, young adults' familiarity with, perceptions regarding, and use of WSS. METHODS A survey about WTS was completed by 3,253 members of an online nonvolunteer access panel. Four items specifically addressed WSS. RESULTS Of the 228 individuals who had heard of WSS, 17% (n = 41) reported using them. Use was associated with ever (adjusted odds ratio [AOR] = 7.7, 95% confidence interval [CI] = 2.7-21.8) and current (AOR = 16.1, 95% CI = 5.1-51.5) WTS. Compared with those who thought that WSS had about the same harm as WTS, those who thought that WSS was "a lot less harmful" to a person's health had substantially higher odds of having tried WSS (AOR = 6.8, 95% CI = 2.0-23.1). CONCLUSIONS Approximately 1 in 6 young adults who have heard of WSS used them. WSS use is associated with the perception of reduced harm.
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Affiliation(s)
- Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA;
| | - Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA; Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Abstract
We surveyed a random sample of 852 students at a large university in 2010-2011 to clarify associations between waterpipe tobacco smoking (WTS), ethnicity, and religion. Current (past 30 day) WTS was reported by 116 (14%) students, and 331 (39%) reported ever WTS. Middle Eastern ethnicity was associated with current WTS (odds ratio [OR] = 2.37; 95% confidence interval [CI] = 1.06, 5.34) and ever WTS (OR = 2.59; 95% CI = 1.22, 5.47). South Asian ethnicity was associated with lower odds for ever WTS (OR = 0.42; 95% CI = 0.21, 0.86), but there was no significant association between South Asian ethnicity and current WTS. Being an atheist and having lower religiosity were associated with both WTS outcomes.
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Affiliation(s)
- Brian A Primack
- a Division of General Internal Medicine and the Division of Adolescent Medicine, Department of Pediatrics , University of Pittsburgh School of Medicine, and the Program for Research on Media and Health, University of Pittsburgh , Pittsburgh , Pennsylvania
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Primack BA, Khabour OF, Alzoubi KH, Switzer GE, Shensa A, Carroll MV, Azab M, Eissenberg T. The LWDS-10J: reliability and validity of the Lebanon Waterpipe Dependence Scale among university students in Jordan. Nicotine Tob Res 2014; 16:915-22. [PMID: 24571810 DOI: 10.1093/ntr/ntu002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION While the Lebanon Waterpipe Dependence Scale (LWDS-11) has shown promise in assessing dependence on waterpipe tobacco smoking (WTS) in Lebanon among adult users, it would be valuable to identify WTS addiction earlier and to explore reliability and validity of these items in other populations. METHODS In 2010-2012, we conducted a multiyear survey of 5,853 students from 4 Jordanian universities. We measured WTS, sociodemographic data, and the LWDS-11 items. We conducted exploratory factor analysis with half of the sample and confirmed the resulting model using confirmatory factor analysis with the other half. We examined construct validity with regression models assessing associations between the modified scale and 5 constructs conceptually expected to be associated with dependence. RESULTS WTS rates were 35% in the past 30 days and 56% ever. Principal-components analysis of LWDS items in the first half of the sample yielded 10 items representing 3 factors labeled physical dependence, relaxation/pleasure, and social aspects. Cronbach's α was .77 for the total scale and was .75, .70, and .67 for each individual subscale. Confirmatory factor analysis in a structural equation modeling framework confirmed good fit (root mean squared error of approximation = 0.068, and comparative fit index = 0.937). Dependence according to the resulting scale (LWDS-10J) was strongly associated with each of the 5 expected constructs, whether the dependent variable was treated as categorical or continuous. CONCLUSIONS The LWDS-11 items exhibited a different factor structure in our sample. However, the modified scale (LWDS-10J) showed promising reliability and construct validity in this population.
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Affiliation(s)
- Brian A Primack
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA;
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University for Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Jordan University for Science and Technology, Irbid, Jordan
| | - Galen E Switzer
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Center for Health Equity Research and Promotion, VA Healthcare System, Pittsburgh, PA
| | - Ariel Shensa
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Mary V Carroll
- Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Mohammed Azab
- Department of Community Medicine, Pathology and Forensic Toxicology, Faculty of Medicine, Hashemite University, Zarqa, Jordan
| | - Thomas Eissenberg
- Department of Psychology and Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA
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Sidani JE, Shensa A, Barnett TE, Cook RL, Primack BA. Knowledge, attitudes, and normative beliefs as predictors of hookah smoking initiation: a longitudinal study of university students. Nicotine Tob Res 2013; 16:647-54. [PMID: 24323574 DOI: 10.1093/ntr/ntt201] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION While cross-sectional studies have shown that hookah tobacco smoking (HTS) is an increasingly popular behavior among university students, little is known about factors associated with initiation. This study sought to determine associations between knowledge, attitudes, and normative beliefs and initiation of HTS among university students. METHODS Data were from a prospective longitudinal cohort study of 569 randomly selected first- and second-year university students. Online questionnaires that were developed in accordance with our composite theoretical model were completed in September 2010 and April 2011. RESULTS About one-seventh (13%) of participants initiated HTS by follow-up. Positive attitudes and favorable normative beliefs were associated with increased adjusted odds of initiation (AOR = 4.12, 95% CI = 2.56, 6.59; and AOR = 2.01, 95% CI = 1.35, 2.99, respectively), while negative attitudes were associated with decreased adjusted odds (AOR = 0.62, 95% CI = 0.48, 0.80). Correct knowledge regarding toxicants associated with HTS was not significantly associated with initiation. CONCLUSIONS While positive attitudes and favorable normative beliefs are associated with initiation of HTS in a cohort of never-users, increased knowledge about toxins is not associated with lower initiation. It may be particularly valuable for educational interventions to attempt to alter positive attitudes and normative beliefs related to HTS.
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Affiliation(s)
- Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, UPMC Montefiore Hospital, Pittsburgh, PA
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Abstract
OBJECTIVE YouTube is now the second most visited site on the internet. The authors aimed to compare characteristics of and messages conveyed by cigarette- and hookah-related videos on YouTube. METHODS Systematic search procedures yielded 66 cigarette-related and 61 hookah-related videos. After three trained qualitative researchers used an iterative approach to develop and refine definitions for the coding of variables, two of them independently coded each video for content including positive and negative associations with smoking and major content type. RESULTS Median view counts were 606,884 for cigarettes-related videos and 102,307 for hookah-related videos (p<0.001). However, the number of comments per 1000 views was significantly lower for cigarette-related videos than for hookah-related videos (1.6 vs 2.5, p=0.003). There was no significant difference in the number of 'like' designations per 100 reactions (91 vs 87, p=0.39). Cigarette-related videos were less likely than hookah-related videos to portray tobacco use in a positive light (24% vs 92%, p<0.001). In addition, cigarette-related videos were more likely to be of high production quality (42% vs 5%, p<0.001), to mention short-term consequences (50% vs 18%, p<0.001) and long-term consequences (44% vs 2%, p<0.001) of tobacco use, to contain explicit antismoking messages (39% vs 0%, p<0.001) and to provide specific information on how to quit tobacco use (21% vs 0%, p<0.001). CONCLUSIONS Although internet user-generated videos related to cigarette smoking often acknowledge harmful consequences and provide explicit antismoking messages, hookah-related videos do not. It may be valuable for public health programmes to correct common misconceptions regarding hookah use.
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Affiliation(s)
- Mary V Carroll
- Center for Research on Health Care, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA
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