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Background: Adolescent substance use is a national health concern. While the literature is clear on the prevalence of substance use during the adolescent developmental period, a dearth of literature is available on the developmental contexts, particularly the influence of school factors, in which substance use occurs. Objectives: This study examined the intermediary role of substance use attitudes on the relationship between school racial composition and alcohol and marijuana use in a sample of sixth to eighth graders. Methods: The sample consisted of 4228 middle school students (89% White; 53% female) in the Midwest. A moderated mediation analysis was conducted on the relationship between school racial composition, substance use attitudes, and substance use, with race as the moderator. Results: Results indicated a significant relationship between the percentage of White or Black students in a school and alcohol or marijuana use and that this relationship was mediated by substance use attitudes. These relationships did not differ significantly by student race. Conclusions/Importance: Preliminary findings indicate the importance of considering school racial composition as a systems level risk or promotive factor for attitudes toward substance use as well as substance use outcomes.  相似文献   
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There has been a surge in vaccine hesitancy following the Coronavirus pandemic. This study measured the prevalence of and identified factors associated with vaccine hesitancy and social media use. An online survey was administered (n?=?1050) between May and July 2021. Chi-square tests were used to examine bivariate associations with vaccine hesitancy (partially vaccinated and unvaccinated participants). Logistic regression was used to identify associations between social media use and vaccine hesitancy. Chi-square tests showed women (69.7% vs 28.2% men, padjusted?=?.002), African American participants (52.3% vs 17.8% white, padjusted?<?.001), high school diploma (54.4% vs 38.6% college degree, padjusted?<?.001), political unaffiliated (15.8% vs 14.5% republican, padjusted?<?.001), Muslim (10.0% vs 0% Jewish, padjusted?<?.001), and never married/single (53.9% vs 17.0% married, padjusted?<?.001) were more likely to be vaccine hesitant. Controlling for all demographic variables (age, race, gender, and education), more frequent use of social media for reading news was associated with lower vaccine hesitancy (OR 0.35, 99% CI 0.20, 0.63, p?<?0.001). However, using social media as a source of vaccine information without any other trusted source (health department, doctor, CDC,) was associated with higher odds of being vaccine hesitant (OR 2.00, 99% CI 1.15, 3.46, p?=?0.001). People who use social media without referencing trusted sources may be particularly vulnerable to disinformation or vaccine hesitant persons are more likely exposed to non-trusted social media sites as their only information source.

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