Exposure to e-cigarette content on social media and e-cigarette use: An ecological momentary assessment study.

This pilot ecological momentary assessment (EMA) study tested the associations between exposure to anti-e-cigarette content on social media and e-cigarette use behavior. For exposure to anti-e-cigarette posts, participants were asked to follow the study account on Instagram, on which anti-e-cigarette content were posted regularly. In addition, we assessed participants' exposure to pro-e-cigarette content in their daily lives and examined the effects of such exposure on behavior. Participants were 29 diverse young adult current e-cigarette users (18-30 year olds; 54% women), who provided data 3 times daily, for 3 weeks via a mobile phone based EMA application. Relative to no exposure, exposure to anti-e-cigarette content was associated with decreased recent e-cigarette use frequency at the next assessment time-point (p < 0.05; 2-tailed). In addition, a statistically significant concurrent association was found between exposure to pro-e-cigarette content (relative to no exposure) and higher e-cigarette use (p < 0.05; 2-tailed). The current data are some of the first to show that exposure to anti-e-cigarette content on social media may have real time effects on decreased e-cigarette use among young adults as they go about their daily lives. Policies and efforts designed to regulate pro-e-cigarette and promote anti-e-cigarette content on social media may help reduce e-cigarette use among young people.

Exploring the Relationship between Foster Care Experiences and Social Network Engagement Among a Sample of Homeless Former Foster Youth.

INTRODUCTION: Recent research has begun to demonstrate high rates of poor behavioral health outcomes among homeless former foster, but with relatively little attention in the scientific literature. Because social networks have been shown to impact behavioral health outcomes, we need to better understand the network characteristics of homeless young adults with a history of foster care. METHODS: Data were collected from 184 homeless former foster youth at a drop-in center in Hollywood, California. A series of logistic regressions were conducted for network engagement behaviors that may be impacted by foster care experiences. RESULTS: Youth were largely African American, Latino, and Mixed race, approximately 22 years old, and majority male. Significant results from the logistic regressions indicated that youth experiencing homelessness for the first time before exiting foster care were more likely to have alters engaging in condomless sex, and youth with higher numbers of foster care placements were more likely to have alters engaging in methamphetamine use. CONCLUSION: These results suggest that certain foster care experiences impact the types of alters with which youths engage. Time spent in placement was significantly associated with alter behaviors, evident from homeless experiences and multiple foster care placements, negatively impacting the types of alters with which youths are connected, and thusly the risk factors for the youth themselves. Frequent network disruptions may be associated with engagement with risky alters. Included are intervention-based implications for providers as well as structural-based implications for child welfare systems.

Exploring the Relationship Between Foster Care Experiences and HIV Risk Behaviors Among a Sample of Homeless Former Foster Youth.

Recent research shows high rates of poor behavioral health outcomes among homeless former foster youth, including increased risk for HIV-risk behaviors. In the current study, data were collected from 184 youth at drop-in centers in Los Angeles using behavioral health questionnaires to explore the relationships between specific aspects of foster care experiences and engagement in HIV-risk behaviors. Results indicated that youth whose first homelessness experience occurred before leaving foster care were significantly more likely to engage in drug use with sex and exchange sex than those whose first homelessness experience occurred after leaving foster care. Intervention services targeting HIV-risk behaviors should consider the aspects of foster care placements that may increase the risk of these behaviors, such as long periods of placement or experiencing homelessness before exiting foster care, as well as those that may decrease the risk of these behaviors, such as exiting placement at an older age.

Exploring the impact of network characteristics on substance use outcomes among homeless former foster youth.

OBJECTIVES: This study examined network structure differences between homeless youth with and without a history of foster care and the impact of network position and location on substance use outcomes among former foster youth specifically. METHODS: Sociometric and individual-level data were collected from a cross-sectional community-based sample (n = 814) of homeless youth from drop-in centers in Los Angeles across three points in time. To determine the structure and position of foster youth in the larger homeless network, structural variables and regressions examining the impact of network structure on substance use were calculated. RESULTS: Results indicated that former foster youth were more likely to have low connectivity compared to homeless youth without a history of foster care. Furthermore, the impact of structure on substance use among former foster youth varied by panel; location in the core was significantly associated with recent and lifetime rates of substance use. CONCLUSIONS: Results highlight the need for a more in-depth understanding of the impact of network changes over time and their effect on substance use outcomes in this population.

Bidirectional Intimate Partner Violence and Drug Use Among Homeless Youth.

Intimate partner violence (IPV) among homeless youth (HY) is common, yet it has continuously been understudied, especially in relation to substance use. As part of a longitudinal study of Los Angeles area HY, drop-in service seeking youth completed a self-administered questionnaire. The presented results are from the third panel of data collection ( N = 238), and the Revised Conflict Tactics Scale (CTS2) was used to assess IPV behavior regarding the participant's most recent intimate relationship. Approximately 38% of participants reported IPV behavior in their most recent relationship, and the majority of this behavior was bidirectional. It was unlikely that a HY was only a victim or only a perpetrator. Multivariable models revealed that bidirectional IPV was related to increased odds of recent methamphetamine; whereas sole perpetration was associated with an increased likelihood of ecstasy use. Specific substance use and IPV are closely related to risk behaviors for HY. Comprehensive interventions should be developed to address both these risk behaviors.

Social Networking Technology Use and Engagement in HIV-Related Risk and Protective Behaviors Among Homeless Youth.

Preliminary studies with homeless youth have found surprisingly pervasive social media use and suggest that youth's online interactions may be associated with their HIV-related risk and protective behaviors. As homeless youth are transient and difficult to engage in place-based services, social media may represent a novel venue for intervention. A critical 1st step in intervention development is gaining greater understanding of how homeless youth use social media, especially as it relates to who they connect to and around what topics. Given the salience of social networking sites in the lives of these otherwise difficult-to-reach adolescents, and their potential to disseminate prevention interventions, this study assessed associations between online social networking technology use and HIV risk behaviors among homeless youth in Los Angeles, California. Homeless youth ages 13 through 24 (N = 1,046) were recruited through 3 drop-in centers and surveyed about their social media use and self-reported HIV-related risk behaviors. Results suggest that social media use is widely prevalent among this population, and the content of these online interactions is associated with whether youth engage in risk or protective behaviors. Implications for interventions and further research are discussed.

Sociometric network structure and its association with methamphetamine use norms among homeless youth.

Homeless youths' social networks are consistently linked with their substance use. Social networks influence behavior through several mechanisms, especially social norms. This study used sociometric analyses to understand whether social norms of drug use behaviors are clustered in network structures and whether these perceived norms (descriptive and injunctive) influence youths' drug use behaviors. An event-based approach was used to delineate boundaries of the two sociometric networks of homeless youth, one in Los Angeles, CA (n = 160) and the other in Santa Monica, CA (n = 130). Network characteristics included centrality (i.e., popularity) and cohesiveness (location in dense subnetworks). The primary outcome was recent methamphetamine use. Results revealed that both descriptive and injunctive norms influenced methamphetamine use. Network cohesion was found to be associated with perception of both descriptive and injunctive norms in both networks, however in opposite directions. Network interventions therefore might be effective if designed to capitalize on social influence that naturally occurs in cohesive parts of networks.

Methamphetamine Use among Homeless Former Foster Youth: The Mediating Role of Social Networks.

OBJECTIVES: Social network analysis can provide added causal insight into otherwise confusing epidemiologic findings in public health research. Although foster care and homelessness are risk factors for methamphetamine use, current research has failed to explicate why homeless youth with foster care experience engage in methamphetamine use at higher rates than other homeless young adults. This study examined the mediating effect of network engagement and time spent homeless on the relationship between foster care experience and recent methamphetamine use among homeless youth in Los Angeles. METHODS: Egocentric network data from a cross-sectional community-based sample (n = 652) of homeless youth aged 13-25 were collected from drop-in centers in Los Angeles. Questions addressed foster care experience, time spent homeless, methamphetamine use, and perceived drug use in social networks. Path analysis was performed in SAS to examine mediation. RESULTS: Controlling for all other variables, results of path analysis regarding recent methamphetamine use indicated a direct effect between foster care experience and recent methamphetamine use (B = .269, t = 2.73, p < .01). However, this direct effect became statistically nonsignificant when time spent homeless and network methamphetamine use were added to the model, and indirect paths from time spent homeless and network methamphetamine use became statistically significant. CONCLUSIONS: Foster care experience influenced recent methamphetamine use indirectly through time spent homeless and methamphetamine use by network members. Efforts to reduce methamphetamine use should focus on securing stable housing and addressing network interactions among homeless former foster youth.

Preventing severe and fatal child maltreatment: making the case for the expanded use and integration of data.

In this article we examine risk factors for severe and fatal child maltreatment. These factors emerge from studies based on different data sources, including official child maltreatment data, emergency department and hospitalization data, death certificates, and data from child death review teams. The empirical literature reflects a growing effort to overcome the measurement uncertainties of any one individual data system. After review and reflection upon what is known, we consider how integrating this information can advance efforts to protect children, providing examples where the use and linkage of multiple sources of data may enhance surveillance, improve front-end decisionmaking, and support cost-effective research and evaluation.