Content and Commentary: HPV Vaccine and YouTube.

STUDY OBJECTIVE: Human papillomavirus (HPV) vaccination has shown efficacy, however, many vaccine-eligible persons remain unvaccinated. YouTube is a popular video-sharing platform with several topics, including the HPV vaccine. Our purpose was to examine the tone of YouTube videos toward the HPV vaccine, accuracy of the information displayed, and content of commentary. DESIGN: In this observational study we investigated publicly available content regarding the HPV vaccine on the video-sharing Web site YouTube (www.youtube.com). Videos and comments were collected between June 22, 2014 and December 19, 2014. A total of 35 videos, with the 100 most recent comments for each video were collected and coded by a single researcher. A 25% subsample were coded by a second researcher to ensure inter-rater agreement of greater than 80%. SETTING, PARTICIPANTS, AND INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Videos were evaluated for 4 types of information: descriptive information, tone toward the vaccine (anti- or pro-vaccine), content, and commentary content, sorted according to 11 frequently identified themes. RESULTS: Most videos were negative in tone toward the vaccine. The tone of the video was not a predictor of video popularity. Pro-vaccine videos were 4 times more likely to report information accurately than anti-vaccine videos. Anti-vaccine videos were more likely to report information incorrectly and omit information. The most frequent commentary themes were concerning serious side effects, conspiracy theories, and vaccines generally being unhealthy. CONCLUSION: The Internet is an important resource for the general population; widely viewed YouTube videos contain erroneous and incomplete information. Anti-vaccine ideology is prevalent in video content and commentary.

Emerging adults' use of alcohol and social networking sites during a large street festival: A real-time interview study.

BACKGROUND: Emerging adults have high rates of heavy episodic drinking (binge drinking) and related risks including alcohol-impaired driving. To understand whether social networking sites (SNSs) used on mobile devices represent a viable platform for real-time interventions, this study measured emerging adults' use of two popular SNSs (Facebook and Twitter) during the Mifflin Street Block Party. This annual festival is held in Madison, Wisconsin and is known for high alcohol consumption. FINDINGS: Event attendees ages 18-23 years were recruited by young adult research assistants (>21 years). Participants completed a brief in-person interview assessing drinking intensity, use of SNSs, and use of SNSs to plan transportation. Analyses included t-tests, chi-squared tests, and Fisher's exact tests. At the event, nearly all of the 200 participants (97 %) consumed alcohol and 18 % met criteria for heavy episodic drinking. Approximately one-third of participants had used Facebook or Twitter on the day of the event. Facebook use (23 %) was more prevalent than Twitter use (18 %), especially among heavy episodic drinkers. Use of either SNS was 41 % among females and 24 % among males (χ (2)=6.01; df=1; p=0.01). Plans to use a SNS to arrange transportation were relatively uncommon (4 %), but this was more frequent among heavy episodic drinkers (11 %) compared to non-heavy episodic drinkers (2 %) (Fisher's exact p=0.02). CONCLUSIONS: These results indicate that SNSs are used during alcohol consumption and warrant exploration as a way to facilitate connections to resources like safe ride services.

Using A Facebook Group As An Adjunct To A Pilot mHealth Physical Activity Intervention: A Mixed Methods Approach.

In the United States, most adolescents do not obtain the recommended amounts of physical activity for optimal health. Around 80% of adolescents own a mobile device, and social media is frequently used by adolescents on mobile devices. Few studies have examined the use of social media as part of an intervention to promote physical activity. The purpose of this study was to evaluate the use of a Facebook group as part of a mHealth physical activity intervention trial. Adolescents, ages 14-18 years, were recruited for a four week physical activity intervention using the FitBit Flex. Participants were also given the option to join a private Facebook group where they could interact and were given badges for fitness accomplishments. The research assistant moderator posted on the Facebook group an average of 25.3 times (SD=7.2). Post-intervention, participants completed a phone interview about their experience. Of 30 intervention participants (avg age 16.0 (SD=1.1), 60.0% female), 17 opted to join the Facebook group (avg age 16.3 (SD=1.2), 47.0% female) of which 10 completed a qualitative interview. Participants averaged 4.9 interactions (SD=8.7) on the Facebook group wall throughout the intervention. From the interview responses, major themes included enjoying the badge feature of the Facebook group and wanting more content and interaction. In conclusion, participants used and enjoyed having the Facebook group, particularly the badge feature of the group, as an adjunct to the physical activity intervention.

Identifying High-Risk Alcohol Users in First-Year College Students: Attitude, Intention, and Facebook.

PURPOSE: It is challenging to identify older adolescents at risk for alcohol dependence. This study investigated first-year college students who scored as dependent alcohol users (DAU), and examined their alcohol use and Facebook displays. MATERIALS AND METHODS: This longitudinal study recruited college students at two universities to complete a phone interview prior to college (Time 1) and one year later (Time 2). Interviews assessed lifetime and current alcohol use, and attitude (scale of 0=very negative to 6=very positive) and intention (scale of 0=not at all likely to 5=very likely) toward alcohol use. The alcohol use disorders identification test (AUDIT) was administered at Time 2. Facebook profiles were evaluated for the presence of references to alcohol use and intoxication/problematic drinking (I/PD) prior to and throughout the participants first year at the university. Analyses included Chi-squared tests and Wilcoxon sign rank tests. RESULTS: Of 315 participants in the study, a total of 21 (6.7%) of participants met criteria as a DAU at Time 2. DAUs were 54.5% female, 86.4% Caucasian, and 73.7% from University A. At Time 1 all DAUs reported lifetime alcohol use and 91.1% were current drinkers. At Time 2, 95.7% were current drinkers. At Time 1, DAU's mean attitude toward alcohol was 4.0 (SD=1.0) and mean intention was 4.0 (SD=1.4); by Time 2 attitude was 4.6 (SD=0.9), p=0.02, and intention was 4.9 (SD=0.3). At Time 1, 39.1% of DAUs displayed alcohol references on Facebook but only one referenced I/PD. By Time 2, 20 DAU profile owners (90.4%) displayed some reference to alcohol and 52.2% referenced I/PD. DISCUSSION: Findings suggest areas in which dependence could be identified early, specifically attitude towards alcohol and assessment of Facebook profiles for references to alcohol. These findings have the potential to guide future intervention efforts for this high-risk population.

Hookah's new popularity among US college students: a pilot study of the characteristics of hookah smokers and their Facebook displays.

OBJECTIVES: (1) To confirm the prevalence of hookah use among US college students. (2) To identify substances commonly smoked in hookahs and other substance use characteristics of hookah smokers. (3) Given the powerful influence of Facebook and its potential role in promoting behaviours, to assess the prevalence of hookah references on Facebook profiles. DESIGN: Cross-sectional study. SETTING: Two large US universities; www.Facebook.com. PARTICIPANTS: 307 Facebook profiles were coded and 216 of these profile owners completed an online survey. On average, participants were 18.8 years old (SD=0.7), women (54%), Caucasian (70.4%) and approximately half were from each university. OUTCOME MEASURES: Lifetime and frequency of hookah use, substance smoked in hookah, cigarette and marijuana use, hookah references displayed on Facebook. RESULTS: 27.8% of participants endorsed hookah use; there were no significant differences between age, gender, race or university for hookah use. Hookah users reported smoking tobacco (78%), hash (12%) and both tobacco and marijuana/hash (10%) in their hookah. Compared with non-hookah smokers, hookah smokers were more likely to report using cigarettes (OR=3.41, 95%CI=1.2 to 9.64) and marijuana (OR=15.01, 95%CI=6.5 to 34.65). Hookah references were present on 5% of Facebook profiles. CONCLUSIONS: More than one quarter of college students smoke hookah. Most smoke tobacco in their hookah, and hookah smoking is associated with polysubstance use. Hookah may present new risks for nicotine addiction in this population.