Examining within-person associations between alcohol and cannabis use and hooking up among adolescents and young adults in the United States.

OBJECTIVE: This study examined daily associations between alcohol use, cannabis use, and simultaneous alcohol and cannabis/marijuana (SAM) use with the likelihood of hooking up (uncommitted sexual encounter that may or may not include intercourse). METHOD: We used a longitudinal measurement burst ecological momentary assessment (EMA) design with 3-week EMA bursts with daily measurements repeated quarterly across 12 months. 1,009 (57 % female, Mean age = 20.00 [SD = 3.21]) Texan adolescents and young adults ages 15-25 participated in the study. Mixed effects logistic regression models were estimated using maximum likelihood estimation to evaluate the associations between substance use and hooking up. RESULTS: Within-person results indicated that participants were more likely to hook up on days with alcohol use and on days with cannabis use, but not on days with SAM use. Participants were also more likely to hook up on drinking days with higher-than-usual alcohol use. Between-person results indicated that participants who used alcohol more often or cannabis more often on average were more likely to hook up, and participants who tended to drink more on drinking days were more likely to hook up. CONCLUSIONS: Given the significant daily-level associations between alcohol and cannabis use and hooking up behavior, public health initiatives should focus on developing interventions to reduce alcohol and cannabis use and promote safer hooking up behavior among adolescents and young adults.

The impact of self-monitoring physical and mental health via an mHealth application on postpartum weight retention: Data from the INTER-ACT RCT.

Background: Postpartum weight retention (PPWR) has many health risks. Digital self-monitoring of weight can potentially make postpartum weight management easier. We aim to test to what extent the self-monitoring of weight, steps and mental health through an mHealth application increases postpartum weight loss and reduces the odds of substantial PPWR (≥5 kg). Methods: Participants were mothers in the intervention arm of the INTER-ACT multicenter randomized controlled trial (RCT), an inter-pregnancy lifestyle intervention among mothers with excessive gestational weight gain. Participants (n=288) had access to an mHealth application to log their weight, steps and mental health between 6 weeks and 6 months postpartum. A linear multiple regression model and a logistic regression model were run to test to what extent self-monitoring via the app increases postpartum weight loss and reduces the risk of substantial PPWR. Results: Women who logged their weight more often lost more weight (B=0.03, ß=0.26, CIB =[0.01,0.05], P<0.01), and had reduced odds of substantive PPWR (OR=0.99, CIOR =[0.98, 0.999], P<.05). Mental health logging reduced the odds of substantive PPWR (OR=0.98, CIOR =[0.97, 1.00], P<0.05), but was unrelated to the amount of weight loss. Steps logging was unrelated to either weight loss or substantive PPWR. Conclusion: Mothers with excessive gestational weight gain can benefit from app-based lifestyle interventions to reduce PPWR by self-monitoring their weight. More attention to mental health in PPWR interventions is needed.

'I had to Educate Myself': A thematic analysis of online stillbirth stories to improve obstetric care.

OBJECTIVE: To examine which met and unmet needs are discussed in stillbirth stories shared on YouTube with the aim to improve obstetric care. DESIGN: Inductive thematic analysis of 19 English-language stillbirth stories uploaded to YouTube. SETTING: Online setting, YouTube video content. SAMPLE: Women who experienced stillbirth and shared a video on YouTube talking about their experience. METHODS: We conducted a thorough textual reading of the transcripts following Braun and Clarke's guidelines for thematic analysis. MAIN OUTCOME MEASURES: Codes were developed and grouped into themes. RESULTS: Although some women actively used their birth videos to call out shortcomings in their care, most others used their platform for other purposes such as destigmatisation, awareness and support, and rather unintentionally provided insight into their met and unmet needs. When analysing their birth stories, three major themes emerged: choice and decision-making, education and information, and behaviour of healthcare providers. CONCLUSIONS: This study demonstrates the value of birth stories in research. We identified three major opportunities for improvement of obstetric care: being provided with options and being able to make choices in the decision-making process are clearly valued, but there are some caveats: women and other childbearing individuals need timely and continuous information, and more attention is needed for emotional intelligence training of healthcare providers.

Daily level examination indicates that positive affect, but not negative affect, is associated with alcohol and marijuana use among adolescents and young adults.

OBJECTIVE: Although there is growing evidence that alcohol use at the daily level is associated with positive but not negative affect, results are mixed when examining marijuana use and simultaneous alcohol and marijuana (SAM) use (i.e., use with overlapping effects). In addition, less is known about these daily level associations among diverse samples of adolescents and young adults. The present study will address these gaps. METHOD: Participants (N = 1,006; 57.3% female, 43.1% White, Non-Hispanic, ages 15-25; Mage = 20.0) were part of a study on substance use that consisted of a 3-week ecological momentary assessment (EMA) burst design (eight surveys per week, up to 2×/day) that was repeated quarterly over a 12-month period. RESULTS: Within-person results indicated that on days with elevated positive affect, participants reported consuming more drinks, whereas positive affect was not significant for hours high from marijuana. In addition, on days with elevated negative affect, participants reported fewer hours high from marijuana. No association was found between negative affect and number of drinks. Finally, within-person results indicated that on alcohol or marijuana days with elevated positive affect, individuals were more likely to report SAM use. There was no association found between negative affect and SAM use. CONCLUSIONS: Results have implications such that in-the-moment interventions for alcohol and SAM use may be more salient when individuals have higher positive affect than average, whereas such interventions may be more relevant for marijuana use when negative affect is lower compared to average levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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

OBJECTIVE: Experimental research has demonstrated that when alcohol-related content is viewed on social media, adolescents and young adults tend to have favorable attitudes toward alcohol use. However, limited research focuses on social media norms for abstaining from alcohol use. The current study examined the role of descriptive and injunctive alcohol-abstaining-and-drinking norms via experimentally manipulated social media profiles. Experimental effects on descriptive and injunctive normative perceptions and subsequent behavior were tested. METHOD: Participants (N = 306; ages 15-20 years) were recruited from the Seattle metropolitan area to complete a baseline survey and view researcher-fabricated social media profiles. Using stratified random assignment (birth sex and age), participants were randomized into one of three conditions: (a) alcohol abstaining and drinking, (b) alcohol abstaining, and (c) attention control. RESULTS: The alcohol-abstaining-and-drinking condition reported greater drinking descriptive norms compared with participants in either the alcohol-abstaining or the attention-control conditions at post-experiment and 1-month follow-up. The alcohol-abstaining-and-drinking condition reported lower abstaining descriptive norms (i.e., perceiving fewer peers abstain) compared with those in the alcohol-abstaining condition at post-experiment and lower abstaining injunctive norms compared with those in the attention-control condition at 1-month follow-up. CONCLUSIONS: Exposure to social media profiles containing both alcohol-drinking and alcohol-abstaining messages was respectively associated with individuals perceiving that peers were consuming alcohol more often and that fewer peers were abstaining. The present findings are consistent with prior experimental research that indicates alcohol displays on social media are associated with riskier drinking cognitions.

First Comes Substance Use, Then Comes Social Media Posts? Examining the Temporal Ordering and Relative Strength of Relations Across Alcohol, Tobacco and Marijuana Use and Posting Behavior.

Social media posts represent a major route by which youth share their substance use cognitions and experiences with others. Extant research has primarily examined relations between alcohol-related posts and posters' own alcohol use, yet little is known about the role of social media in the use of less socially accepted substances, namely tobacco and marijuana. Our study represents the first to examine the relative strength of this relation across alcohol, tobacco, and marijuana. The current research used a one-month time lag to tease apart the temporal ordering of substance-use-posting and participants' own substance use. A sample of 282 15-20-year-olds (Mage = 18.4, SD = 1.3, 52.9% female) in the United States completed two self-report surveys, one month apart. Results of a cross-lagged panel model revealed significant effects of alcohol and marijuana consumption on subsequent alcohol- and marijuana-related posting, respectively (i.e., selection effects). However, reverse relations (i.e., self-effects) were not significant. Further, we found no differences in the strength of selection effects across substances, suggesting they are similar for both more (alcohol) and less (marijuana and tobacco) socially acceptable substances. Results point to the importance of using young people's social media posts as a way to help identify individuals at risk for heightened substance use and social media as a mechanism for targeted prevention programming.

I See, Therefore I am: Exposure to Alcohol References on Social Media, but Not on Traditional Media, Is Related to Alcohol Consumption via Drinking and Non-Drinking Identity.

In recent years, the role of media in individuals' alcohol consumption has been touched upon by several researchers. Nevertheless, the underlying processes explaining the relationship between media use and alcohol consumption, as well as the differences in strength of the associations between social and traditional media use and alcohol consumption remain understudied. The present exploratory cross-sectional study (N = 381) among emerging adults (M = 21.83, SD = 2.04, 75.3% females, 67.7% college students) examined drinking identity and non-drinking identity as underlying mechanisms of the relationship between alcohol-related media use and alcohol consumption, while comparing the role of social and traditional media in these processes. We found no associations between traditional media use and drinking identity, non-drinking identity or alcohol consumption. In contrast, social media use was both directly and indirectly related to alcohol consumption via drinking identity and non-drinking identity. This demonstrates that social media can play a socializing role in emerging adults' alcohol consumption.

Self-Reported versus Actual Alcohol-Related Communication on Instagram: Exploring the Gap.

Numerous studies have highlighted the relation between drinking behavior and alcohol references on social media. However, most studies on substance-use-related social media effects rely on self-report data, and it remains unclear whether individuals can accurately report their online alcohol-related communication. This study contributes to this line of research by examining whether individuals accurately report their alcohol-related self-sharing behavior on social media and what factors contribute to a misestimation of this behavior. A sample of 149 Belgian college students (64.3% females, Mage = 21.33, SD = 1.49) participated in this study, who were asked survey questions on their general and alcohol-related social media use. In addition, all posts they shared on their Instagram profiles between April 1st, 2019, and March 31st, 2020, were captured and coded. The results indicated a positive association between the counted and self-reported frequencies of sharing alcohol posts on Instagram. However, most participants overestimated how often they shared this content. The perceived injunctive norms and sharing alcohol posts for entertainment motives were the only significant predictors of this overestimation. We conclude that this overestimation may be a result of subtle social desirability processes and a misremembrance of what has been shared.

Drinking Buddies: The Importance of Proximal Norms in Emerging Adults' Alcohol-Related Private and Public Social Media Use.

Exposure to alcohol posts on social media has been found to be associated with emerging adults' alcohol use. An important mechanism through which this association seems to occur are social norms. Thus far, however, research has not differentiated between proximal and distal norms and has not accounted for the private (e.g. Instagram private features, Snapchat) and public media outlets (e.g. Instagram public features) through which these norms might have been constructed. The results of our online survey among emerging adults (N = 789, Mage = 21.46, SDage = 1.88, 56.4% female), therefore, showed that exposure to alcohol posts on private SNS features in combination with descriptive proximal norms, instead of more public SNS features and distal norms, played an important role in emerging adults' alcohol use. As such, future research should focus more thoroughly on the interrelations between SNS private features and proximal normative perceptions and try to better understand on which social cues normative perceptions of proximal other's alcohol consumption are based.

Polysubstance use among young adults and differences in negative alcohol-related sexual experiences.

This study aimed to compare negative alcohol-related sexual experiences among individuals who used (1) alcohol only, (2) alcohol plus marijuana, and (3) alcohol plus marijuana and stimulants. Participants in the analytic sample (N = 1,015; Mean age = 19.16 (SD = 0.79); 45.42% male) completed an online baseline survey as part of an intervention study. A hurdle negative binomial model examined the associations between polysubstance use and negative alcohol-related sexual experiences. Models examined if experiences varied by demographic factors. Compared to participants that only used alcohol, those who used alcohol plus marijuana and stimulants reported a higher likelihood and average number of negative alcohol-related sexual experiences in the past 3 months. Participants that used alcohol plus marijuana had a higher likelihood of having a negative alcohol-related sexual experience in the past 3 months compared to those who only used alcohol. These findings suggest the number and risk for negative alcohol-related sexual experiences increases with the number of substances being used.

A Parent-Based Intervention for Reducing High-risk Social Media Cognitions, Alcohol Use, and Negative Consequences Among Adolescents: Protocol for a Randomized Controlled Pilot Study.

BACKGROUND: The prevalence of adolescent alcohol use continues to be a public health concern. Although adolescents spend an increasing amount of time with their friends, parents remain an important source of support and continue to play a key role in the lives of their adolescents. Extensive research in this area has resulted in parent-based intervention (PBI) efforts to prevent or reduce adolescent alcohol use. However, one major limitation of PBIs is that they do not currently consider the large role that social media plays in adolescents' lives and in relation to their alcohol use. We will add to the literature by developing and refining a web-based PBI designed to reduce both high-risk social media cognitions and alcohol use among adolescents. OBJECTIVE: The central goal of the proposed study is to develop, refine, and pilot a web-based PBI to reduce both high-risk social media cognitions and alcohol use among adolescents. METHODS: A total of 100 parent-teen dyads will be randomly assigned to one of the following 2 conditions: intervention or control. Parents in the intervention group will be given access to the web-based PBI and suggestions for working through the PBI modules with their teens. The parent-teen dyads will fill out 3 questionnaires: a baseline questionnaire, 1-month questionnaire, and 6-month questionnaire. RESULTS: Recruitment and enrollment will begin in August 2022. Upon completion of the intervention trial, we will examine the feasibility, acceptability, and preliminary effect sizes of the newly developed web-based PBI. CONCLUSIONS: This study has the potential to open doors for future studies examining the clinical implications of an efficacious web-based PBI to reduce alcohol use and high-risk cognitions about alcohol displays on social media. TRIAL REGISTRATION: ClinicalTrials.gov NCT04333966; https://clinicaltrials.gov/ct2/show/NCT04333966. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/38543.

Perceptions surpass reality: Self-reported alcohol-related communication on Instagram is more strongly related with frequency of alcohol consumption and binge drinking than actual alcohol-related communication.

Mounting research finds that sharing alcohol references on social media is related to higher levels of alcohol consumption. The present study aims to improve our understanding of potential biases when using self-report measures, to provide more insight in the differences between background and foreground alcohol references, and to examine different drinking patterns. We examined the Instagram profiles of 128 Belgian college students (Mage = 21.31, SD = 1.50; 64.8 % women) and compared how the observed number of pictures depicting alcohol in the background or in the foreground as well as self-reports on their frequency of sharing alcohol-related content was associated with frequency of alcohol consumption, typical quantity consumed and frequency of binge drinking. Results demonstrated that self-reported frequency of sharing alcohol references and observed number of alcohol-in-the-foreground references were positively related to participants' alcohol consumption. However, self-reports were a stronger predictor of alcohol consumption than alcohol-in-the-foreground references, and were most strongly related to binge drinking. Alcohol-in-the-background references were not significant. This means that the relationship between sharing alcohol posts and drinking behavior is overinflated in studies relying solely on self-report data.

Disposition-Content Congruency in Adolescents' Alcohol-Related Social Media (Self-) Effects: The Role of the Five-Factor Model.

OBJECTIVE: Accumulating evidence indicates that social networking sites play an increasingly important role in young people's drinking behavior. The present study adds to this research by assessing the conditionality of the relationships between exposure to and self-sharing of alcohol-related content on social media and adolescents' drinking behavior. Specifically, the moderating role of the five-factor model of personality is determined. METHOD: A cross-sectional survey study was conducted among 866 mid-adolescents (Msubsample = 14.85 years, SD = 0.71, 57.5% girls). Polynomial regression analysis with response surface modeling was used to test the interactions. RESULTS: Exposure, but not self-sharing, was directly associated with more alcohol consumption. However, it appeared that the act of sharing was more important than the frequency of sharing. Next, the relationship between exposure and consumption was not found to be moderated by personality. In contrast, there were significant linear and nonlinear interactions between self-sharing and all five personality traits. Individuals who are predisposed to engage in more alcohol consumption experience a stronger association between self-sharing and their drinking behavior. CONCLUSIONS: Social media can play a role in adolescents' drinking behavior, but this role is partially dependent on temperamental predispositions.

Strategic Self-Presentation or Authentic Communication? Predicting Adolescents' Alcohol References on Social Media.

OBJECTIVE: The current study is one of the first to examine how self-reported alcohol consumption, friends' perceived alcohol consumption, and the perceived number of friends sharing alcohol references on social networking sites (SNS) is associated with adolescents' sharing of alcohol references on SNS. METHOD: A cross-sectional paper-and-pencil survey was administered among 3,172 adolescents (n = 3,133 used for analyses, mean age = 17.16 years, SD = 0.93; 50.7% male). Structural equation modeling was used to test the hypotheses. RESULTS: First, the results indicated that both self-reported drinking behavior and the perceived number of friends sharing alcohol references were related to sharing alcohol references on SNS, but the perceived number of friends sharing alcohol references was a stronger predictor than self-reported drinking behavior. Friends' perceived drinking behavior was not a significant predictor. In the second place, self-reported drinking behavior was a stronger predictor for girls than for boys, whereas the perceived number of friends sharing alcohol references was a stronger predictor for boys than for girls. CONCLUSIONS: Adolescents' alcohol-related self-representation is in line with their alcohol consumption and is also strongly related to what their friends are sharing. Thus, adolescents appear to communicate authentically about their drinking experiences, but the decision to do so is heavily influenced by the prevailing social norm regarding alcohol-related communication.