Social Media Use and Depressive Symptoms Among United States Adolescents

PurposeDepression is increasingly common among US adolescents; the extent to which social media exposure contributes to this increase remains controversial.MethodsWe used Monitoring the Future data from 8th and 10th grade students (n = 74,472), 2009–2017, to assess the relationship between daily social media use and depressive symptoms. Self-reported depressive symptom score (range: 4–20) was assessed continuously using a log-transformed outcome and at varying cut scores with logistic regression analyses. First, these outcomes were examined overall, comparing adolescents using social media daily to adolescents who were not. We then estimated predicted depressive symptom scores using 26 predictors in order to establish underlying depression risk. We partitioned students into depression risk quintiles to control for confounding due to underlying depression risk and examine heterogeneity in the association between social media use and depressive symptoms. Sensitivity analyses were used to test the robustness of results with different configurations of the predicted score model, and overall associations were examined in two-year groups to identify differences in effects.ResultsFor girls, in adjusted risk-stratified analysis, daily social media use was not associated with high (vs. low) depressive symptoms. For boys, results were inconsistent, suggesting a protective effect of daily social media use at some cut scores. Results were consistent across sensitivity analyses, and any potential harmful effects appear to be limited to 2009–2010, limiting the evidence supporting social media as a current risk factor for depressive symptoms.ConclusionsAmong US adolescents, daily social media use is not a strong or consistent risk factor for depressive symptoms.     

Emergency Department Services Use Among Immigrant and Non-immigrant Groups in the United States

Immigrants have disproportionate lack of access to healthcare and insurance. Emergency departments could serve as a healthcare substitute and increased demand can negatively affect the US emergency services system. Medical Expenditures Panel Survey (2000–2008) data was modeled to compare emergency departments (ED) use between non-citizens, foreign-born (naturalized), and US-born citizens. Group differences were assessed using non-linear decomposition techniques. Non-citizens were less likely to use ED services (8.7 %) compared to naturalized immigrants (10.6 %) and US-born Americans (14.7 %). Differences in ED use persisted after adjusting for the Behavioral Model covariates. Healthcare need and insurance partially explained the differences in ED use between the groups. Between 2000 and 2008 non-citizen immigrants used markedly less ED services compared to US citizens, regardless of their nation of origin. We also found that demographic and healthcare need profiles contributed to the divergence in use patterns between groups. A less restrictive healthcare policy environment can potentially contribute to lower population disease burden and greater efficiencies in the US health care system.     

Dual Use of Condoms With Other Contraceptive Methods Among Adolescents and Young Women in the United States

PurposeTo estimate the prevalence of and factors associated with dual method use (i.e., condom with hormonal contraception or an intrauterine device) among adolescents and young women in the United States.MethodsWe used 2006–2010 National Survey of Family Growth data from 2,093 unmarried females aged 15–24 years and at risk for unintended pregnancy. Using multivariable logistic regression, we estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to assess the associations between dual method use at last sex and sociodemographic, behavioral, reproductive history, and sexual behavior factors.ResultsAt last sex, 20.7% of adolescents and young women used dual methods, 34.4% used condoms alone, 29.1% used hormonal contraception or an intrauterine device alone, and 15.8% used another method or no method. Factors associated with decreased odds of dual method use versus dual method nonuse included having a previous pregnancy (aOR = .44, 95% CI .27–.69), not having health insurance coverage over the past 12 months (aOR = .41, 95% CI .19–.91), and having sex prior to age 16 (aOR = .49, 95% CI .30–.78).ConclusionsThe prevalence of dual method use is low among adolescents and young women. Adolescents and young women who may have a higher risk of pregnancy and sexually transmitted infections (e.g., those with a previous pregnancy) were less likely to use dual methods at last sex. Interventions are needed to increase the correct and consistent use of dual methods among adolescents and young women who may be at greater risk for unintended pregnancy and sexually transmitted infections.     

Use of MenACWY-CRM in Adolescents in the United States

Adolescents constitute a high-risk group for invasive meningococcal disease. MenACWY-CRM (Menveo, Novartis Vaccines, Cambridge, MA) is a quadrivalent meningococcal conjugate vaccine indicated to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, W-135, and Y. It has been approved for use in persons age 2–55 years. The tolerability and immunogenicity of MenACWY-CRM in adolescents have been ascertained in phase 2 and 3 trials against MPSV4 (Menomune, sanofi pasteur, Swiftwater, PA), an unconjugated quadrivalent meningococcal vaccine, and MenACWY-D (Menactra, sanofi pasteur), another conjugated quadrivalent meningococcal vaccine. Clinical trials also have demonstrated that MenACWY-CRM is well tolerated and immunogenic when administered to adolescents concomitantly with the combined tetanus, diphtheria, and acellular pertussis vaccine (Boostrix, GlaxoSmithKline Biologicals, Rixensart, Belgium) and the quadrivalent human papillomavirus vaccine (Gardasil, Merck & Co., Inc., Whitehouse Station, NJ).     

Promoting Physical Activity Participation among Children and Adolescents

With global increases in the prevalence of overweight and obesityamong children and adolescents, there has never been a moreurgent need for effective physical activity programs. The aimof this narrative review is to summarize the evidence of theeffectiveness of interventions that report physical activityoutcomes in children aged 4–12 years and adolescents aged13–19 years. A systematic search of electronic databasesidentified 76 interventions. Most interventions were deliveredvia the school setting (57 interventions), nine through thefamily setting, six via primary care, and four in community-or Internet-based settings. Children's physical activity interventionsthat were most effective in the school setting included somefocus on physical education, activity breaks, and family strategies.Interventions delivered in the family setting were not highlyeffective, but many were pilot studies. The use of motivationallytailored strategies and program delivery in the primary caresetting showed promise among adolescents. Many studies had methodologicaland reporting flaws (e.g., no baseline data, poor study design,physical activity measures of unknown reliability and validity,and poor reporting of sample size, response rates, attrition/retention,compliance, year of intervention, and duration of intervention).Publications reporting the results of evaluations of interventionstudies should follow the Consolidated Standards of ReportingTrials guidelines or, for nonrandomized studies, should followthe Transparent Reporting of Evaluations with NonrandomizedDesigns guidelines. Further evidence of the effectiveness ofinterventions promoting young people's physical activity infamily and community settings is needed. adolescent • child • exercise • health education • health promotion • motor activity • program evaluation • schools     

Relationship of Maternal Employment Status and Support for Resilience with Child Resilience Among Korean Immigrant Families in the United States

The relationship between child resilience and maternal employment status among Korean families who live in the United States was assessed through interviews developed by the Civitan Resilience Project. A questionnaire was administered via individual interviews with each mother in 99 two-parent Korean families. The analyses involve a comparison between maternal report on a checklist of resilience for preschool (4-6 years) and schoolage (9-11 years) children of employed vs. non-employed mothers. Overall, maternal employment status did not have a significant impact on reported children's resilience. When the mother's attitude toward her status as employed or at home was positive, the children had a higher level of reported resilience (r = 28, p - .005). When husbands were perceived as supportive of their wife's employment status, mothers were more likely to perceive their children as resilient (r = 22, p = .03). When mothers were satisfied with their child-care arrangements, they were also more likely to rate their children as more resilient (r = .20, p = .05). There is a trend toward significance such that more resilience-promoting mothers tended more to have resilient children [F(1, 98) = 3.08, p = .083]. Korean male children were as resilient and/or vulnerable as Korean female children. Korean older children (9-11 years old) were as resilient and/or vulnerable as younger children (4-6 years old). This study indicates that maternal personal variables are more important than structural variables in terms of their effects on reported child resilience.     

Awareness and Knowledge of Pre-exposure Prophylaxis Among Sexual and Gender Minority Adolescents Assigned Male at Birth in the United States

Archives of Sexual Behavior - Sexual and gender minority (SGM) adolescents assigned male at birth are at increased risk for HIV infection. Pre-exposure prophylaxis (PrEP) is a daily pill taken to...