Risk Factors for Suicide Ideation Among Rhode Island College Students.

OBJECTIVES: This study aimed to identify individual and relational risk factors for suicide ideation among students enrolled in 2- and 4-year colleges. METHODS: A cross-sectional analysis was conducted using N=685 college students from the 2022 Rhode Island Young Adult Survey. RESULTS: 13.7% (N = 94) reported suicide ideation, 7.6% (N = 52) reported making a suicide plan, and 3.2% (N = 22) reported at least one suicide attempt. Sexual and gender minorities had 300% (95%CI: 47%, 987%) increased odds relative to cisgender heterosexual males, students living on campus had 56% (95%CI: 79%, 10%) lower odds compared to those living off campus with a parent, and students with insomnia had 156% (57%, 320%) increased odds of suicide ideation. CONCLUSIONS: Interventions to 1) cultivate identity- affirming communities for sexual and gender minority students, 2) create a sense of belonging for students living off campus, and 3) improve sleep health are needed.

Smartphone Addiction and Mental Illness In Rhode Island Young Adults.

BACKGROUND: Smartphone addiction is a rising problem in the United States. The current study estimated the prevalence of smartphone addiction in Rhode Island young adults and its associations with mental illness. METHODS: The 2022 Rhode Island Young Adult Survey measured smartphone addiction, depression, anxiety, and suicide ideation. Covariates included age, sex/gender minority status, race/ethnicity, and social status. RESULTS: The prevalence of smartphone addiction was 34%. Odds of experiencing depression (OR[95%CI]=2.69 [2.05,3.52]), anxiety (OR[95%CI]=2.06 [1.58,2.69]), and suicide ideation (OR[95%CI]=1.55 [1.08,2.20]) were greater in participants with smartphone addiction. The relationship between smartphone addiction and depression was strongest in heterosexual cis-males (OR[95%CI] = 8.45 [3.53, 20.3]). DISCUSSION: Smartphone addiction is prevalent among Rhode Island's young adults and may be associated with depression, anxiety, and suicide ideation. Heterosexual cis-males may be particularly vulnerable. Screening programs and interventions to reduce smartphone use for all young adults, and particularly young men, should be considered.

Depressive and anxiety symptoms in first generation college students.

Objectives: Depression and anxiety contribute to the burden of disease among college students. The current study determined if depressive and anxiety symptoms were more prevalent in first generation students and if social and emotional support moderated this relationship. Methods: Depressive and anxiety symptoms were measured in 432 U.S. college students via an online survey. Single items determined student generation status and available social support. The CES-D10 and GAD-7 measured depression and anxiety, respectively. Structural equation modeling was used to identify significant effects. Results: First generation status was associated with increased cognitive-emotional (p = 0.036) and somatic (p = 0.013) anxiety symptoms, but not depression. High social and emotional support appeared to suppress somatic anxiety symptoms experienced by first generation students (p = 0.004). Conclusions: Greater anxiety symptoms in first generation students may be due to increased general and acculturative stress, although more research is needed. Large national surveys of college students should consider adding a question about first generation status.

Correlates of gambling and gambling problems among Rhode Island young adults: a cross-sectional study.

BACKGROUND: Numerous states in the USA have legalized sports betting due to recent legal decisions by the US Supreme Court. Here, sociodemographic correlates of current gambling and specific gambling activities associated with symptoms of gambling problems were identified. METHODS: Cross-sectional data were obtained from the 2020 Rhode Island Young Adult Survey (RIYAS). RIYAS participants (n = 540) were a convenience sample of 18 to 25 year olds who lived in Rhode Island for at least part of 2020. Data were collected from May to October 2020. Four gambling activities were assessed (i.e. sports betting; betting on races; gaming tables at a casino; poker machines at a casino). Logistic regression models assessed main effects. RESULTS: 22.4% engaged in one or more gambling activities. 11.5% of participants had any gambling problems. Odds of gambling activities were higher among men; Black, Indigenous, People of Color; older young adults; and essential workers. Odds of gambling problems were 2.4 times higher among participants who engaged with sports betting. CONCLUSIONS: Gambling activities are common among several population subgroups, and participation in sports betting may be a risk factor for the development of problem gambling. Comprehensive prevention policies are needed.

Exposure to Alcohol Marketing and Alcohol-Related Consequences in Young Adults.

BACKGROUND: Exposure to alcohol marketing is positively associated with alcohol consumption. However, few research studies have tested alcohol marketing's effect on other alcohol-related outcomes. Consequently, the current study sought to identify associations between exposure to alcohol marketing and alcohol-related consequences in young adults. Methods: A secondary analysis of the 2020 Rhode Island Young Adult Survey was conducted. Participants were lifetime drinkers (n = 390) who were 18 to 25 years old and lived in Rhode Island for at least part of 2020. Past 30 day exposure to 6 forms of alcohol marketing was assessed. Alcohol consequences were measured using 8 items from the Brief Young Adult Alcohol Consequences Questionnaire. Logistic regression models were adjusted for AUDIT score, age, race/ethnicity, gender, sexual orientation, employment status, and enrollment in school. Results: 92.3% of participants reported past 30 days exposure to any form of alcohol marketing. 43.6% of participants reported experiencing any alcohol-related consequence. Exposure to any form of alcohol marketing was positively associated with experiencing alcohol-related consequences (OR[95% CI] = 3.35 [1.19, 9.44]). After disaggregation by marketing type, only television exposure remained significantly associated with alcohol-related consequences (OR[95% CI] = 1.85 [1.06, 3.24]). Conclusions: Exposure to alcohol advertising on television may be positively associated with experiencing negative alcohol consequences in young adults. If confirmed, the findings may renew interest in strengthening alcohol marketing guidelines and regulations.

Breaking Down Barriers: Young Adult Interest and Use of Telehealth for Behavioral Health Services.

OBJECTIVES: Use of telehealth for behavioral health services has increased since the start of the COVID-19 pandemic. This study examines which young adults in Rhode Island were using these telehealth services and are interested in its use. METHODS: This cross-sectional web-based survey was administered in the midst of the COVID-19 pandemic, from May to October 2020. RESULTS: Results suggest sexual and gender minorities and those with low social status were more likely to access these services, highlighting its effectiveness at reaching disadvantaged young adults. Those with mental health symptoms were more likely to utilize telehealth, but those with substance use were not. CONCLUSIONS: There is a missed opportunity to target substance use telehealth services to this willing and interested population. Continued coverage and use of telehealth for mental health and substance use services is essential in breaking down barriers to care for young adults in Rhode Island.

Technology-based nutrition interventions using the Mediterranean diet: a systematic review.

CONTEXT: Over the past 2 decades, overweight and obesity rates have increased exponentially, along with related comorbidities including type 2 diabetes, hypertension, cardiovascular disease, and some cancers. The Mediterranean Diet (MDiet) has been suggested as a potential way to mitigate the health burdens related to overweight and obesity. OBJECTIVE: For this review, the literature on MDiet-focused digital interventions was examined to determine efficacy, best practices, and potential limitations. DATA SOURCES: The search was conducted across 15 databases for relevant publications published through April 2020 in English, French, Spanish, Arabic, or Italian. DATA EXTRACTION: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using a combination of keywords and phrases and evaluated independently for relevance, merit, and inclusion and exclusion criteria. DATA ANALYSIS: The systematic literature review resulted in 15 articles that met the search criteria. Ten interventions were delivered online, and 5 were delivered via smartphone using an app. The majority of online MDiet-focused interventions were effective, particularly when modeled after evidence-based and best-practice online nutrition education interventions. Such interventions also are effective for promoting positive health behaviors and health outcomes, such as increased physical activity, increased levels of high-density lipoprotein cholesterol, and a lower total high-density lipoprotein cholesterol ratio. CONCLUSION: Technology-based interventions to educate and promote adherence to the MDiet are successful in helping individuals achieve the stated outcomes. More research is needed to determine the efficacy of MDiet interventions delivered via smartphone apps.

Inequities Laid Bare: The Mental Health of Young Adults in Rhode Island During the COVID-19 Pandemic.

This study documents disparities in the mental health burden of young adults in Rhode Island during the COVID-19 pandemic as it pertains to essential worker status, sexual orientation, gender identity, and childhood trauma. A cross-sectional web-based survey of young adults aged 18 to 25 years conducted between May and October of 2020 assessed anxiety symptoms, depressive symptoms, and thoughts of suicide. In fully adjusted regression models, (n =528 young adults) being an essential worker, a sexual minority, having lower relative SES, and having more adverse childhood experiences were significantly associated with negative mental health outcomes. In models adjusted for individual ACEs, exposure to mental illness in the household, physical violence between adults in the household, emotional abuse, and sexual abuse were independently associated with all three outcomes. Young adults most vulnerable and stigmatized in the community are also those who are most severely affected in terms of mental health.

Exposure to Digital Alcohol Marketing and Alcohol Use: A Systematic Review.

OBJECTIVE: Alcohol marketing has proliferated on digital media, such as websites, social media, and apps. A systematic review was conducted to examine studies of associations between exposure to digital alcohol marketing and alcohol consumption. METHOD: Eight electronic databases were searched for "alcohol" and "marketing" through 14 February 2017. Studies were included if exposure to digital alcohol marketing and alcohol consumption, or related attitudes and intentions, were assessed. Studies were excluded if they only measured exposure to alcohol depictions posted online by family and friends. Study quality was also assessed. RESULTS: In all, 25 studies were included, including 2 randomized controlled trials, 15 cross-sectional studies, and 8 prospective cohort studies. There was a consistent finding across studies that participation and engagement with digital alcohol marketing--such as clicking on an alcohol ad, visiting an alcohol-branded website, liking or sharing an ad on social media, or downloading alcohol-branded content--was positively associated with alcohol use. The effects of simple exposure to digital alcohol advertising were inconclusive. Proper blinding of subjects, measuring exposures before the outcomes, and measuring the exposures multiple times would improve study quality. CONCLUSIONS: Although more research is needed, existing studies suggest that engagement with digital alcohol marketing is positively associated with increased alcohol consumption and increased binge or hazardous drinking behavior. Governments should consider implementing digital alcohol marketing regulations under the precautionary principle as the alcohol industry's self-regulated marketing codes are likely ineffective at protecting populations vulnerable to alcohol-related harm.