Does Exposure to Pediatrician or Parent Blog Content Influence Infant Safe Sleep Practices?

OBJECTIVE: To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices. METHODS: We conducted a pilot randomized controlled trial via Qualtrics, a web-based platform, with a national sample of parents of children < 1 year old. Survey questions about infant sleep practices included: bed-sharing, location, position and objects present. Safe sleep was defined as not bed-sharing, in a crib, bassinet or playard, back positioning, and no other objects present except pacifiers. Participants were randomized to read one of the following: (1) pediatrician blog post, (2) parent blog post, or (3) no blog post. The blog posts contained the same content about infant sleep but varied by identified authorship. All participants received links to online content about safe sleep. Participants received a follow-up survey 2-4 weeks later with the same questions about infant sleep practices. We compared responses in pre- and post-surveys by type of blog post exposure using multivariable logistic regression models. RESULTS: The average infant age (n = 1500) was 6.6 months (Standard Deviation 3.3). Most participants (74%) were female; 77% were married; 65% identified as white Non-Hispanic, 12% were black and 17% were Hispanic. 47% (n = 711) completed both surveys. We identified no differences in the odds of any of the four safe sleep practices after exposure to safe sleep recommendations in blog post format. CONCLUSION: Although in-person advice has been associated with improved safe sleep practices, we did not identify changes in infant sleep practices after exposure to safe sleep advice using blog posts.

Safe Sleep Behaviors and Factors Associated With Infant Second Sleep Practices.

OBJECTIVES: To examine the prevalence and safety of infant second-sleep practices. METHODS: A cross-sectional online survey of parents with infants ≤12 months assessed parent-reported sleep practices: position, use of a separate sleep surface, and sleep location at 2 time points (sleep onset and after nighttime waking). A composite score examined if all 3 safe sleep practices were used at each time point. Safe sleep was defined as: supine position, sleeping in a separate space, and in a crib, bassinet, cradle, or playard. Wilcoxon sign rank test was used to examine changes between the time points. Poisson regression models compared parents who reported a second-sleep location with those who did not. RESULTS: Of participants (n = 1500), 74% were female, 65% were White, 12% were Black, and 17% were of Hispanic ethnicity. Thirty-nine percent (n = 581) reported a second-sleep practice. Of parents who reported a second-sleep practice, 28% (n = 137) met all 3 safe sleep criteria at sleep onset; 9% (n = 42) met all 3 safe sleep criteria at both time points. A higher proportion of changes in sleep practices were to less-safe practices (P <.001). Factors associated with a second-sleep practice were parental age <25 years, parental race and ethnicity, first-time parents, homes with smoke exposure, and infants born at <37 weeks. CONCLUSIONS: Less than 10% of infants met all 3 safe sleep criteria at sleep onset and after nighttime waking. Interventions focused on safe sleep should highlight the importance of safe sleep practices after nighttime waking.

Adolescent and parent emotions and perceptions regarding news media stories about bullying: A qualitative study.

News articles covering bullying have often focused on tragic situations. The purpose of this study was to understand adolescents' and parents' emotions and perceptions related to bullying news media coverage. Participants were recruited as adolescent-parent dyads from pediatric clinics. During qualitative interviews, participants read and commented on two news article excerpts: 1) a tragic 'fear-based' individual bullying news story; 2) a public health-oriented bullying news story. Qualitative analysis used the constant comparative approach. Our 50 participants included 25 adolescents with mean age 16.1 years (SD=0.97), 44% female and 72% Caucasian, and 25 parents with mean age 49.2 (SD=6.7) years, 80% female and 76% Caucasian. After reading the fear-based news excerpt, 19 adolescents (76%) and 18 parents (72%) responded that they felt negatively. For the public health-oriented excerpt, 12 adolescents (48%) and 20 parents (80%) felt positively. Further, over half of participants felt the news articles related to their lived experiences. Our data support that fear-based articles were associated with feeling sadness and hopelessness while public health-oriented news articles contributed to positive feelings and perceptions. This finding supports the potential of news media about bullying to serve as a venue for education or empowerment for families.

Linguistic analysis of pediatric residency personal statements: gender differences.

BACKGROUND: All US residency programs require applicants to submit personal statements. Prior studies showed gender differences in personal statement writing, which has implications for gender bias in the application process, but previous studies have not considered the dual influence of specialty-specific values on personal statement writing by applicants of each gender. OBJECTIVE: To understand gender differences in pediatric residency personal statements. METHODS: From 2017 to 2018, we performed linguistic analysis of personal statements written by interviewees at a mid-size US pediatrics residency during two prior academic years. We assessed writing tone, communal language, and agentic language. We performed t-tests to evaluate for gender differences, p < 0.05. RESULTS: We analyzed personal statements from 85 male and 85 female interviewees. Average word count was 676 words. Personal statements demonstrated analytic writing style with authentic and positive emotional tone. We found no gender differences in communal language for social affiliation (p = 0.31), adjectives (p = 0.49), or orientation (p = 0.48), which deviates from typical gender norms for male language use. Males used agentic language of reward more frequently (p = 0.02). CONCLUSIONS: Findings suggest that social language is valued in pediatrics, a predominantly female specialty, regardless of applicant gender. Use of reward language by males is consistent with previous findings. Future studies should evaluate gender differences in residency applications across specialties to advance understanding of the role gender plays in the application process.

Applying Natural Language Processing to Evaluate News Media Coverage of Bullying and Cyberbullying.

Bullying events have frequently been the focus of coverage by news media, including news stories about teens whose death from suicide was attributed to cyberbullying. Previous work has shown that news media coverage is influential to readers in areas such as suicide, infectious disease outbreaks, and tobacco use. News media may be an untapped resource to promote bullying prevention messages, though current news media approaches to describing bullying and cyberbullying remain unexplored. The purpose of this study was to evaluate the current state of news media coverage of bullying and cyberbullying. A sample of newspaper articles covering bullying or cyberbullying across regional and national US newspapers from 6 recent years was identified. A content analysis using natural language processing was conducted with the Linguistic Inquiry and Word Count (LIWC) software program for key variables including affective, social, and cognitive processes. Evaluation included the percentage of words that represented Fear-based reporting such as alarmist words (e.g., epidemic, tragic), as well as words that represent Public Health-oriented messages such as prevention. A total of 463 newspaper articles met inclusion criteria, including 140 cyberbullying articles and 323 bullying articles. Findings indicated that cyberbullying articles scored higher on affective processes such as measures of anxiety (Mdn = 0.34) compared to bullying articles (Mdn = 0.22). A greater number of cyberbullying articles were Fear-based (41.4%) than were bullying articles (19.5%). An equivalent number of cyberbullying articles (50.0%) and bullying articles (49.8%) were Public Health-oriented. Findings may be used to collaborate with journalists toward optimizing prevention-oriented reporting.

A Novel Approach to Evaluating Mobile Smartphone Screen Time for iPhones: Feasibility and Preliminary Findings.

BACKGROUND: Increasingly high levels of smartphone ownership and use pose the potential risk for addictive behaviors and negative health outcomes, particularly among younger populations. Previous methodologies to understand mobile screen time have relied on self-report surveys or ecological momentary assessments (EMAs). Self-report is subject to bias and unreliability, while EMA can be burdensome to participants. Thus, a new methodology is needed to advance the understanding of mobile screen time. OBJECTIVE: The objective of this study was to test the feasibility of a novel methodology to record and evaluate mobile smartphone screen time and use: battery use screenshot (BUS). METHODS: The BUS approach, defined for this study as uploading a mobile phone screenshot of a specific page within a smartphone, was utilized within a Web-based cross-sectional survey of adolescents aged 12-15 years through the survey platform Qualtrics. Participants were asked to provide a screenshot of their battery use page, a feature within an iPhone, to upload within the Web-based survey. Feasibility was assessed by smartphone ownership and response rate to the BUS upload request. Data availability was evaluated as apps per BUS, completeness of data within the screenshot, and five most used apps based on battery use percentage. RESULTS: Among those surveyed, 26.73% (309/1156) indicated ownership of a smartphone. A total of 105 screenshots were evaluated. For data availability, screenshots contained an average of 10.2 (SD 2.0) apps per screenshot and over half (58/105, 55.2%) had complete data available. The most common apps or functions included Safari and Home and Lock Screen. CONCLUSIONS: Study findings describe the BUS as a novel approach for real-time data collection focused on iPhone screen time and use among young adolescents. Although feasibility showed some challenges in the upload capacity of young teens, data availability was generally strong across this large dataset. These data from screenshots have the potential to provide key insights into precise mobile smartphone screen use and time spent per mobile app. Future studies could explore the use of the BUS methodology on other mobile smartphones such as Android phones to correlate mobile smartphone screen time with health outcomes.

Marijuana promotions on social media: adolescents' views on prevention strategies.

BACKGROUND: Youth exposure to positive marijuana messages increases their risk of marijuana use. Since Washington State legalized recreational marijuana in 2012, marijuana businesses have used social media business pages to promote their products. Regulations to prevent youth access and targeting by marijuana businesses on social media in Washington State are absent. The purpose of this study was to engage youth in conceptualizing prevention approaches to limit youth exposure to marijuana business promotions on social media. METHODS: Towards our goal of generating novel prevention approaches and promoting youth interaction to build ideas, we used focus groups. Adolescents ages 15-20 years in Washington State were recruited through purposeful sampling to achieve a diverse sample from six schools across two counties. During focus groups, trained facilitators used a semi-structured guide to prompt discussion about marijuana business presence on social media. In the latter half of focus groups, facilitators showed example social media posts from marijuana businesses. All focus groups were audio recorded and manually transcribed. Qualitative analysis was conducted using the constant comparative method. RESULTS: A total of 32 adolescents with average age 17 years (SD = 0.6), 71% female, 43.8% Asian and 21.9% mixed race, participated in 5 focus groups. Recommendations for prevention focused in two main thematic areas. First, participants supported policies to restrict underage access to marijuana social media pages, an example quote was: "you have access to [the social media page] without being 21 and I think that's a problem." Second, participants proposed regulation of content that marijuana companies can post on social media, an example quote was: "I'm thinking they shouldn't be allowed to use children or anything associated with children and the memes that they post." CONCLUSIONS: Our findings indicate two strategies to limit youth exposure to marijuana content on social media. These specific strategies represent potential avenues to revise state policies and test the effectiveness of these approaches for states that permit recreational marijuana.

Social Media Posts by Recreational Marijuana Companies and Administrative Code Regulations in Washington State.

Importance: Recreational marijuana use was legalized in the state of Washington in 2012, and the Washington Administrative Code (WAC) 314-55-155 was implemented to limit the exposure of youths to marijuana advertisements. Objectives: To evaluate the content of social media posts by marijuana companies and to assess the compliance of these posts with WAC regulations. Design, Setting, and Participants: In a cross-sectional study, a content analysis of 1027 social media posts was conducted to identify and assess compliance of WAC regulations with the business pages of recreational marijuana companies located on Facebook and Twitter platforms in the state of Washington from December 1, 2015, through November 30, 2016. Main Outcomes and Measures: Application of coding based on WAC regulations to focus on the prohibition of language that promoted the overconsumption of marijuana, that described its curative or therapeutic benefits, or that was designed to appeal to youths; and the requirements for warnings about intoxication, driving, health risks, and age restrictions for marijuana. Results: Of the 1027 posts on Facebook and Twitter from business pages of 6 marijuana companies, Facebook followers ranged from 342 to 1592 persons and Twitter followers ranged from 374 to 2915 persons per company. Findings for WAC regulations included 17 posts (1.7%) that encouraged overconsumption; 137 posts (13.3%) that promoted therapeutic benefits; and 9 posts (0.01%) that appealed to youths. Requirements for warnings addressing intoxication, driving, health risks, and age restrictions were present on 110 posts (10.7%). Some businesses repeatedly violated particular regulations; 7 of 17 (41.2%) posts encouraging overconsumption derived from 1 marijuana company. Conclusions and Relevance: Most social media posts by marijuana companies were consistent with WAC regulations that prohibit particular messages, but few companies provided required warning messages. Findings can be used toward implementation strategies for marijuana prevention to address these influential media messages.