Social media literacy: A conceptual framework.

Concerns over the harmful effects of social media have directed public attention to media literacy as a potential remedy. Current conceptions of media literacy are frequently based on mass media, focusing on the analysis of common content and evaluation of the content using common values. This article initiates a new conceptual framework of social media literacy (SoMeLit). Moving away from the mass media-based assumptions of extant approaches, SoMeLit centers on the user's self in social media that is in dynamic causation with their choices of messages and networks. The foci of analysis in SoMeLit, therefore, are one's selections and values that influence and are influenced by the construction of one's reality on social media; and the evolving characteristics of social media platforms that set the boundaries of one's social media reality construction. Implications of the new components and dimensions of SoMeLit for future research, education, and action are discussed.

Recruitment Methods, Inclusion, and Successful Participation in a Longitudinal Clinical Trial Using Ecological Momentary Assessment.

Underrepresentation of historically marginalized populations in clinical trials continues to threaten the validity of health intervention research. Evidence supports the merits of intercept and other proactive forms of recruitment for achieving more equitable representation. However, researchers also report lower retention and adherence to protocols among these populations, particularly in longitudinal studies. Few studies have compared recruitment methods for longitudinal randomized trials testing health interventions, with even fewer having done so for trials involving ecological momentary assessment (EMA). As intervention research integrates EMA and other data collection approaches requiring substantial participant effort, it is critical to better understand the effectiveness and implications of strategies to improve the representativeness of health research. This secondary data analysis compared outcomes of proactive and reactive recruitment strategies (mobile lab intercepts and internet/flyer advertising, respectively) in study inclusion, task completion, and retention within a 14-day randomized controlled trial that used EMA to evaluate cigarette package health messages. Proactive recruitment resulted in higher proportions of participants with low income and education, limited health literacy, and of diverse racial/ethnic makeup. However, this recruitment method also resulted in lower task completion, especially in the second week of the trial period, and lower retention, although group differences were not explained by participant sociodemographic characteristics targeted by inclusion efforts. We conclude that proactive recruitment via intercepts is an effective strategy for health intervention research that aims to include stakeholders from historically marginalized groups but that researchers and funders must recognize these methods require additional resources, considerations, and capacity to address non-trivial challenges to successful participation.

Prospective validation of smartphone-based heart rate and respiratory rate measurement algorithms.

Background: Measuring vital signs plays a key role in both patient care and wellness, but can be challenging outside of medical settings due to the lack of specialized equipment. Methods: In this study, we prospectively evaluated smartphone camera-based techniques for measuring heart rate (HR) and respiratory rate (RR) for consumer wellness use. HR was measured by placing the finger over the rear-facing camera, while RR was measured via a video of the participants sitting still in front of the front-facing camera. Results: In the HR study of 95 participants (with a protocol that included both measurements at rest and post exercise), the mean absolute percent error (MAPE) ± standard deviation of the measurement was 1.6% ± 4.3%, which was significantly lower than the pre-specified goal of 5%. No significant differences in the MAPE were present across colorimeter-measured skin-tone subgroups: 1.8% ± 4.5% for very light to intermediate, 1.3% ± 3.3% for tan and brown, and 1.8% ± 4.9% for dark. In the RR study of 50 participants, the mean absolute error (MAE) was 0.78 ± 0.61 breaths/min, which was significantly lower than the pre-specified goal of 3 breaths/min. The MAE was low in both healthy participants (0.70 ± 0.67 breaths/min), and participants with chronic respiratory conditions (0.80 ± 0.60 breaths/min). Conclusions: These results validate the accuracy of our smartphone camera-based techniques to measure HR and RR across a range of pre-defined subgroups.

Assessing the impact of COVID-19 on psychiatric clinical trials.

OBJECTIVE: COVID-19 and associated measures to control the spread of the COVID-19 has significantly impacted clinical research. This study aimed to determine the impact COVID-19 has had on psychiatric clinical trials and to assess whether certain trial areas or trial types were differentially affected. METHODS: We used information from ClinicalTrials.gov, the largest online database of clinical trial information, to examine changes in psychiatric clinical trials from January 2010-December 2020. RESULTS: Clinical trial initiation decreased in 2020, with a year-on-year percent change in trial initiation of -5.4% versus an expected percent change based on forecasting observed trends from 2010 to 2019 of 8.6%. When broken down by disease area, the distribution of trials observed in 2020 was significantly different from the predicted distribution (p < 0.00001). The greatest decrease in trial initiation was seen in Schizophrenia-specific trials, with an observed percent change of -29.2% versus an expected percent change of 3.2%. Conversely, anxiety trials saw a significant increase in trial initiation during 2020, with an observed percent change of 24.6% versus an expected percent change of 16.0%. When assessing interventional versus observational studies, data showed a significant increase in initiation of observational psychiatric clinical trials (p < 0.05), and a significant decrease in initiation of interventional psychiatric clinical trials (p < 0.01). When data was analyzed on a month-by-month time scale, 7/12 months in 2020 showed significant decreases when compared to initiation during matching months over prior years, and a single month, June, showed a significant increase. CONCLUSION: COVID-19 has had significant impacts on the initiation of psychiatric clinical trials over 2020, and this decrease in trial initiation may have long-term impacts on the development and assessment of psychiatric treatments and therapeutics.

Perceptions of Arguments in Support of Policies to Reduce Sugary Drink Consumption Among Low-Income White, Black and Latinx Parents of Young Children.

PURPOSE: To test for racial/ethnic differences in perceived argument strength in favor of structural interventions to curb childhood obesity among lower-income parents of young children. DESIGN: Cross-sectional, self-report. SETTING: Online research panel, national sample of 1485 US adults in Fall 2019. PARTICIPANTS: Parents of children (age 0-5 years) with an annual income <$40,000, stratified by White, Black and/or Latinx race/ethnicity. MEASURES: SSB consumption, policy support, and strength of arguments in favor of marketing restrictions and a penny-per-ounce tax. ANALYSIS: Descriptive statistics, multivariable OLS models. RESULTS: Race/ethnicity was not a significant predictor of the perceived strength of a composite of marketing arguments (pBlack = 0.07; pLatinx = 0.10), however it was a significant predictor of the perceived strength of tax arguments (pBlack = 0.01; pLatinx = 0.01). Perceptions of strength of 12 of 35 discrete SSB tax arguments differed by race/ethnicity (p < .05). Arguments regarding industry targeting of Black children (marketing: pBlack < .001; pLatinx = .001; tax: pBlack < .001; pLatinx = .001), were particularly demonstrative of this difference. In contrast, arguments that these policies would provide support for parents (marketing: pBlack = 0.20; pLatinx = 0.84) and communities (tax: pBlack = 0.24; pLatinx = 0.58) were seen as strong arguments across groups. CONCLUSIONS: Black and Hispanic/Latinx parents may be more prepared to move toward SSB policy support than white parents. Emphasizing community benefits of policy may be effective in moving constituents toward policy support across groups.

Testing three explanations for stigmatization of people of Asian descent during COVID-19: maladaptive coping, biased media use, or racial prejudice?

OBJECTIVE: To investigate factors associated with the stigmatization of people of Asian descent during COVID-19 in the United States and factors that can mitigate or prevent stigmatization. DESIGN: A national sample survey of adults (N = 842) was conducted online between May 11 and May 19, 2020. Outcome variables were two dimensions of stigmatization, responsibility and persons as risk. Hierarchical regression analyses were performed. RESULTS: Racial prejudice, maladaptive coping, and biased media use each explained stigmatization. Racial prejudice, comprising stereotypical beliefs and emotion toward Asian Americans, was a stronger predictor of stigmatization than maladaptive coping or biased media use. Fear concerning the ongoing COVID-19 situation and the use of social media and partisan cable TV also predicted stigmatization. Low self-efficacy in dealing with COVID-19, when associated with high estimated harm of COVID-19, increased stigmatization. High perceived institutional efficacy in the handling of COVID-19 increased stigmatization when linked to high estimated harm of COVID-19. On the other hand, high perceived collective efficacy in coping with COVID-19 was associated with low stigmatization. More indirect contacts with Asians via the media predicted less stigmatization. CONCLUSIONS: Efforts to reduce stigmatization should address racial stereotypes and emotions, maladaptive coping, and biased media use by providing education and resources to the public. Fostering collective efficacy and media-based contacts with Asian Americans can facilitate these efforts.

Mechanisms of Social Media Effects on Attitudes Toward E-Cigarette Use: Motivations, Mediators, and Moderators in a National Survey of Adolescents.

BACKGROUND: Exposure to risk behavior on social media is associated with risk behavior tendencies among adolescents, but research on the mechanisms underlying the effects of social media exposure is sparse. OBJECTIVE: This study aimed to investigate the motivations of social media use and the mediating and moderating mechanisms of their effects on attitude toward electronic cigarette (e-cigarette) use among adolescents. METHODS: Using data from a national sample survey of adolescents (age=14-17 years, N=594), we developed and validated a social media use motivation scale. We examined the roles of motivations in the effect of social media use on risk exposure and risk attitude. RESULTS: Motivations for social media use included agency, self-expression, realism, social learning, social comparison, and filter. These motivations were associated differentially with the frequency of use of Facebook, Instagram, Snapchat, and YouTube. Frequency of social media use was positively associated with exposure to e-cigarette messages across the four platforms (Ps<.001). Exposure to e-cigarette messages on Instagram (P=.005) and Snapchat (P=.03) was positively associated with attitude toward e-cigarette use. Perceived social media realism moderated the effects of e-cigarette message exposure such that when realism was high, the exposure effect was amplified, but when realism was low, the effect was mitigated (P<.001). A three-way interaction effect (P=.02) among exposure, social learning motivation, and social norm on attitude toward e-cigarette use was found. When perceived social norm was high, the moderating effect of social learning motivation on e-cigarette use attitude was amplified, but when social norm was low, the social learning motivation effect was attenuated. CONCLUSIONS: Because perceived social media realism moderates the effect of exposure to e-cigarette messages on attitude toward e-cigarette use, future intervention efforts should address the realism perceptions. The three-way interaction among exposure, social learning motivation, and social norm indicates the importance of addressing both the online and offline social environments of adolescents. The social media use motivation scale, reflecting perceived affordances, is broadly applicable. Understanding social media use motivations is important, as they indirectly influence attitude toward e-cigarette use via frequency of social media use and/or frequency of exposure to e-cigarette messages on social media.

Efficacy of a Media Literacy Intervention for Indoor Tanning Prevention.

Indoor tanning leads to melanoma, the fifth most common cancer in the USA. The highest rate of indoor tanning is among young women whose exposure to tanned images in the media is linked to protanning attitudes. This study evaluated the efficacy of a media literacy intervention for reducing young women's indoor tanning. Intervention participants analyzed the content and functions of the media influencing protanning attitudes and produced counter-messages to help themselves and peers resist harmful media effects. The message production was of two types: digital argument production or digital story production. The control group received assessments only. This three-group randomized design involved 26 sorority chapters and 247 members in five Midwestern states where indoor tanning is prevalent. At 2- and 6-month follow-up assessments, those in the two intervention conditions were less likely to be indoor tanners (p = .033) and reported lower indoor tanning intentions (p = .002) compared to those in the control condition. No difference between the two intervention groups was found for behavior. Although the argument group exhibited slightly weaker indoor tanning intentions than the story group, the difference was not significant. The results provide the first evidence of the efficacy of a media literacy intervention for indoor tanning reduction. Implications for participative engagement interventions are discussed.

Metal worker's lung: spatial association with Mycobacterium avium.

BACKGROUND: Outbreaks of hypersensitivity pneumonitis (HP) are not uncommon in workplaces where metal working fluid (MWF) is used to facilitate metal turning. Inhalation of microbe-contaminated MWF has been assumed to be the cause, but previous investigations have failed to establish a spatial relationship between a contaminated source and an outbreak. OBJECTIVES: After an outbreak of five cases of HP in a UK factory, we carried out blinded, molecular-based microbiological investigation of MWF samples in order to identify potential links between specific microbial taxa and machines in the outbreak zone. METHODS: Custom-quantitative PCR assays, microscopy and phylogenetic analyses were performed on blinded MWF samples to quantify microbial burden and identify potential aetiological agents of HP in metal workers. MEASUREMENTS AND MAIN RESULTS: MWF from machines fed by a central sump, but not those with an isolated supply, was contaminated by mycobacteria. The factory sump and a single linked machine at the centre of the outbreak zone, known to be the workstation of the index cases, had very high levels of detectable organisms. Phylogenetic placement of mycobacterial taxonomic marker genes generated from these samples indicated that the contaminating organisms were closely related to Mycobacterium avium. CONCLUSIONS: We describe, for the first time, a close spatial relationship between the abundance of a mycobacterium-like organism, most probably M. avium, and a localised outbreak of MWF-associated HP. The further development of sequence-based analytic techniques should assist in the prevention of this important occupational disease.

Occupational asthma often goes unrecognised.

Occupational asthma is induced de novo by an airborne agent encountered in the workplace. The risk of occupational asthma is greater in those with a prior atopic history. Work-exacerbated asthma is the provocation of pre-existing, or coincidental, disease by one or more irritant exposures at work. Distinguishing occupational from work-exacerbated asthma can be difficult but it is important since the two have very different clinical, occupational and legal implications. Occupational asthma is underrecognised, the disease often develops in young people who are otherwise fit. They may not recognise their symptoms as anything out of the ordinary, or may confuse them with hay fever or a cold. It is sensible to consider occupational and work-exacerbated asthma in every working adult who has asthma or who presents with suggestive symptoms such as rhinitis. Occupational asthma almost always arises from an immediate-type hypersensitivity reaction to a respiratory sensitising agent in the workplace. The disease has a short latency with symptoms developing 6 to 36 months after employment in a new job. Rhinitis is common and in those working in an environment with airborne proteins the absence of rhinitis effectively rules out occupational asthma. In occupational asthma, symptoms (including nasal symptoms) improve away from work. Once the disease is established symptoms are provoked by even very small exposures at work and begin to be provoked by a wide variety of irritant exposures both at, and away from, work. It is good practice to enquire into the employment of every working-age adult with asthma, or rhinitis, and particularly in those presenting with new symptoms or symptoms that have become more difficult to manage. Patients should routinely be asked whether their symptoms improve when they are not at work.

Occupational asthma in antibiotic manufacturing workers: case reports and systematic review.

Background. The risks of occupational asthma (OA) from antibiotics are uncertain. We report 4 new cases and a systematic review of the literature. Methods. Cases were identified through a specialist clinic, each underwent specific provocation testing (SPT). We subsequently reviewed the published literature. Results. The patients were employed in the manufacture of antibiotics; penicillins were implicated in three cases, in the fourth erythromycin, not previously reported to cause OA. In two, there was evidence of specific IgE sensitisation. At SPT each developed a late asthmatic reaction and increased bronchial hyperresponsiveness. 36 case reports have been previously published, 26 (citing penicillins or cephalosporins). Seven cross-sectional workplace-based surveys found prevalences of 5-8%. Conclusions. OA in antibiotic manufacturers may be more common than is generally recognised. Its pathogenesis remains unclear; immunological tests are of uncertain value and potential cases require confirmation with SPT. Further study of its frequency, mechanisms, and diagnosis is required.

"They're still in control enough to be in control": Paradox of power in dementia caregiving.

Based on an interview study of 26 employed women dementia caregivers, we have found that caregiving involves a complex relationship that is characterized as a paradox in which the exercise of power creates an experience of powerlessness on the part of the caregiver; that the care recipients are not powerless, but encourage as well as resist attempts at providing care; and this relationship occurs in the context of a culture that influences and controls the family through the production of knowledge that is used to shape the caregiving relationship and give direction to the caregiver's actions. The control achieved by the use of knowledge of medicine and gender is incomplete and is thus embraced yet resisted by caregivers who see the inadequacy of the knowledge for achieving the goal of loving, dignified care.