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Millions of U.S. adults join online support groups to attain health goals, but the social ties they form are often too weak to provide the support they need. What impedes the strengthening of ties in such groups? We explore the role of demographic differences in causing the impediment and demographic self-disclosure in removing it. Using a field study of online quit-smoking groups complemented by three laboratory experiments, we find that members tend to hide demographic differences, concerned about poor social integration that will weaken their ties. However, the self-disclosures of demographic differences that naturally occur during group member discussions actually strengthen their ties, which in turn facilitates attainment of members’ health goals. In other words, social ties in online groups are weak not because members are demographically different, but because they are reluctant to self-disclose their differences. If they do self-disclose, this breeds interpersonal connection, trumping any demographic differences among them. Data from both laboratory and field about two types of demographic difference—dyad-level dissimilarity and group-level minority status—provide convergent support for our findings.

Adolescents face exceptional challenges and opportunities that may have a lifelong impact on their consumption and personal and societal well-being. Parents, community members (schools and neighborhoods), and policymakers play major roles in shaping adolescents and influencing their engagement in consumption behaviors that are either developmentally problematic (e.g., drug use and unhealthy eating) or developmentally constructive (e.g., academic pursuits and extracurricular activities). In this article, we discuss two main topics: (a) the challenges and opportunities that characterize adolescence, based primarily on research in epidemiology and neuroscience, and (b) the ways that parents, community members, and policymakers can facilitate positive adolescent development, based on research from many disciplines including marketing, psychology, sociology, communications, public health, and education. Our goal is to summarize the latest scientific findings that can be used by various stakeholders to help adolescents navigate this turbulent period and become well-adjusted, thriving adults.

The effects of hyperopia and frugality on spending have not been directly compared. Moreover, previous research on hyperopia has focused on the avoidance of luxury spending, rather than spending on routine consumer goods. We address these gaps in the literature by comparing how hyperopia and frugality affect monthly spending, and spending on ordinary consumer goods. Our survey indicates that both tendencies relate to lower monthly spending. Our shopping experiment extends these findings by showing that both hyperopic and frugal consumers avoid purchasing higher priced consumer goods when lower priced substitutes are available. Our findings contribute to the literature, which suggests that hyperopic consumers avoid indulgent luxuries, by showing that they also avoid higher priced routine consumer goods and exhibit lower monthly spending, similar to frugal consumers, but for fundamentally different reasons. Hyperopia inhibits spending by lowering the motivation to spend, while frugality inhibits spending by increasing the motivation to save.

In a series of studies, consumers reviewed over-the-counter (OTC) drug packages and evaluated these drugs for concurrent use. The authors investigate whether the consumers utilized the active ingredients listed on the package and recognized the risks of double dosing when using two drugs with the same active ingredient. Both novice and expert consumers used the active ingredients to assess drug similarity, indicating that the information was accessible. However, only medically trained experts used this information to assess the risks of taking two drugs concurrently, indicating that they understood its diagnosticity or relevancy. Novices' failure to view double dosing as risky suggests that they might hold a naive belief that OTC drugs are relatively risk free; thus, the authors test interventions to increase active ingredient diagnosticity versus accessibility. One intervention considered by OTC drug manufacturers makes active ingredients more accessible on packages using icons. However, the authors found this approach alone to be ineffective, whereas interventions enhancing the diagnosticity of ingredients through public service messages or package warnings yielded promising results. Thus, interventions may benefit by going beyond accessibility to also highlight active ingredient diagnosticity.

Two studies on consumer information search and decision strategies involved in the selection of family health care providers are reported. The first study examined the selection process for both adults and children within the family. Factors associated with dissatisfaction with provider were identified. The second study explored differences among individuals in self-reported presence of a regular health care provider and use of recent innovations in health care such as walk-in clinics and HMOs.

This article addresses the following issues: Can an anti-smoking campaign that depends largely on mass media vehicles effectively reduce adolescent tobacco use? Why is an integrated campaign recommended and what are the steps in designing such a campaign? How should the campaign be evaluated? Specific topics include recommended campaign expenditures, target audience identification, selection of persuasive message content, executional (stylistic) considerations, media buying decisions, the use of focus group research and advertising copytesting research, and outcome evaluations. It is concluded that comprehensive strategic planning and extensive research at all phases of the campaign are essential to success. [ABSTRACT FROM AUTHOR]

Education and patient education literature provide evidence that time spent in instruction, particularly when the student or patient is actively involved, is positively related to understanding. Time spent on other tasks is not positively related to outcomes. The way in which health professionals and patients spend their time together, however, has not been adequately researched. A system is described for assessing how patients spend their time in environments where health care is delivered. When the system was employed in a multidisciplinary diabetes clinic, it was found that almost two-thirds of patient nonwaiting time was spent in assessment. Only 20% or 12 to 15 minutes, was spent in instruction; in only four of these minutes wee patients actively involved. Although it may be common sense that people learn better when actively participating in an instructional session, these data suggest that common sense may not be common patient education practice. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to identify cannabis products according to their appeal among young adults and measure product sales trends., Design, Setting and Participants: This was a retrospective comparative study using point-of-sale data from licensed recreational cannabis retailers that include buyer age with birth year entered by retailers, set in California, USA. Cannabis purchases by young adults (aged 21-24, GenZ) were compared with older adults (age 25+) over 4 years (2018-21)., Measurements: Sales for six cannabis product categories were analyzed using a commercial data set with imputations and a raw data set. Age-appeal metrics were dollar and unit sales to young adults, and dollar and unit share ratios (young adults/older adults), where a share ratio of 100 denotes age-appeal comparability. A product category was considered more young-adult appealing than others if its mean on a metric was at least one standard deviation above the grand mean across all product categories., Findings: Flower (cannabis plant material) and vapor pen appealed to young adults based on absolute dollar sales, dominating young-adult spending compared with other cannabis products (37.24 and 31.83%, respectively). Vapor pen and concentrate appealed to young adults based on dollar share ratios of 152, meaning these products comprised a 52% greater share of young-adult cannabis spending relative to older-adult spending (31.83/20.97% and 10.47/6.88%, respectively). Less appealing to young adults were pre-roll, edible/beverage and absorbable products (tincture/sublingual, capsule and topical). Flower showed the largest dollar sales growth (B = +$3.50 million/month), next to vapor pen (B = +$1.55 million/month). Vapor pen tied for highest growth in the percent of product dollars from the largest package size (B = +0.85%/month) and showed the steepest price decline (B = -0.53 price per gram/month)., Conclusions: In California, USA, from 2018 to 2021, relative to older adults, young adults spent a greater share of their cannabis dollars on vapor pen and concentrate (products with high potency of delta-9-tetrahydrocannabinol)., (© 2024 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Introduction: The 2019 outbreak of e-cigarette or vaping product use-associated lung injury (EVALI) is believed to have been caused by vitamin E acetate, an additive used in some cannabis vaporizer products. Previous studies have primarily focused on changes in sales of electronic nicotine delivery systems following the initial advisory issued by the Centers for Disease Control (CDC) on August 17, 2019. The present study is intended to examine variation by age groups in sales of regulated cannabis vape products in the state of California before, during, and after the outbreak. Methods: Weekly sales revenue of cannabis vape products (from January 1, 2018, to December 31, 2020) was obtained from a sample of recreational cannabis retailers licensed in California. An interrupted time series analysis, using AutoRegressive, Integrated, Moving Average methods, was employed to estimate changes in the sales and market share of cannabis vape products in the weeks following the CDC advisory. Results: The total volume of regulated cannabis vape product sales increased substantially over the 3-year study period (2018-2020). Sales and market share of cannabis vape products, however, declined in both young and older adults immediately following the advisory, rebounding to pre-EVALI levels only for the young adults. For sales, the potential EVALI effect following the CDC's advisory equates to an 8.0% and 2.2% decline below expected levels in the older and young adults, respectively. Conclusions: The differential age effect on sales may reflect concerns regarding health effects of cannabis vaping products and greater awareness of the outbreak among older adults. Findings highlight the importance of informing consumers about health risks associated with using cannabis vape products acquired from regulated versus illicit sources.

Adults' social network ties serve multiple functions and play prominently in quitting smoking. We examined three types of adults' egocentric social networks, including family, friends, and friends online to investigate how two network characteristics with major relevance to health behavior, network size and tie closeness, related to the emotional and confidant support and to pro- and anti-smoking social influence these ties may transmit. We also examine whether the social support and social influence constructs related to smoking abstinence. We utilized baseline and 7-day abstinence survey data from 123 adult current smokers attempting to quit prior to the start of a randomized controlled quit-smoking trial of a social support intervention for quitting smoking on Twitter. To examine study relationships, we estimated Negative Binomial Regression models and Logistic Regression models. For all networks, network size and tie closeness related positively to most of the social support and social influence constructs, with tie closeness related most strongly, especially for online friends. Family pro-smoking social influence related negatively to smoking abstinence, and there were marginally negative relationships for family emotional support and family confidant support. Online friend emotional support had a marginally positive relationship with smoking abstinence. Overall, our findings indicated the importance of the social support and social influence functions of each type of network tie, with larger networks and closer ties related to higher levels of social support and social influence. Moreover, family network pro-smoking social influence may compromise abstinence while emotional support from online friend network ties may reinforce it., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lakon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

US schools have fast-food restaurants nearby, encouraging student patronage, unhealthy consumption, and weight gain. Geographers have developed an activity space framework which suggests this nearby location effect will be moderated by whether people perceive the location as their activity space. Therefore, we study whether students perceive a fast-food restaurant near school as their activity space, and whether social marketing messages can change that perception. We conducted six studies: a secondary data analysis with 5986 students, a field experiment with 188 students, and four lab experiments with 188, 251, 178, and 379 students. We find that students who strongly identify with their student community patronize a fast-food restaurant near school (vs. farther away) because they view it as their activity space, while students who weakly identify do not. For example, in our field experiment, 44% vs. 7% of students who strongly identified with the student community patronized the near versus farther restaurant, while only 28% versus 19% of students who weakly identified patronized the near and farther restaurants comparably. We also find that to deter the strong identifiers, messages should convey that patronage is a social liability, e.g., portray student activism against fast food. We show that standard health messages do not change perceptions of restaurants as social activity spaces. Thus, to combat the problem of fast-food restaurants near schools causing unhealthy consumption, policy and educational interventions should focus on students who strongly identify with their student community and find ways to weaken their perceptions that fast-food restaurants near schools are their activity spaces.

Purpose: We aimed to better understand hesitancy to use nicotine replacement therapy (NRT) to quit smoking., Design: We content coded and analyzed NRT-related posts in online quit smoking support groups to understand NRT-use hesitancy and to examine associations with health outcomes., Setting: NRT posts were analyzed in unmoderated social-media support groups with free NRT., Sample: Adults who smoked daily (n = 438) and posted about NRT were studied, 339 of whom reported on NRT usage and 403 reported on smoking abstinence., Measures: Surveys at 1-month post-quit date assessed NRT usage and smoking abstinence., Analysis: Relationships among NRT posts, NRT usage and smoking abstinence were analyzed using GEE models accounting for support group and covariates., Results: Nearly all (96.17%) participants reported using the study-provided NRT once, most (70.21%) used NRT during the past week, but less than half (45.72%) used NRT daily for the full month as recommended. Nearly two-thirds (65.34%) of NRT posts were negative. Posts reflecting dislike or no longer needing NRT were associated with a lower likelihood of using NRT in the past week at least once (B = -.66, P = .005 and B = -.37, P = .045), use occasions (B = -1.86, P = .018 and B = -1.10, P = .016) and used daily for full month (B = -.56, P = .044 and B = -.53, P = .009). Posts related to the effectiveness of NRT related to past-week NRT used at least once (B = .15, P = .023), used daily for full month (B = .25, P = .001), and smoking abstinence (B = .27, P = .002)., Conclusion: Strategies are needed to address dislike of NRT and strengthen perceptions of NRT efficacy, especially on social media where posts may be amplified.

Background College campuses have policies restricting smoking/vaping on campus. Previous studies involving mostly European-American students showed smoking prevalence declines following implementation of such policies. Objective To evaluate a social media campaign promotive of stronger campus support for an existing campus no-smoking/no-vaping policy where most (∼75%) of the undergraduates were non-European-American. A demographically comparable university served as a no-intervention control. Participants Target was 200 random intercept surveys at each university during fall 2016, spring 2017. Of 800 respondents, 681 were undergraduates. Methods Baseline and post-intervention surveys assessed awareness of and support for campus-wide smoke-free/vape-free policies. Staged smoke-free/vape-free policy violations assessed students' propensity to intervene in support of the policy. Results Respondent support for the no-smoking/no-vaping policy did not change. Conclusions The social media campaign and Policy Ambassadors program did not increase support for the campus no-smoking/no-vaping policy. Most (∼90%) respondents agreed that the campus no-smoking/no-vaping policy was important for public health.

Background: Facebook's advertising platform reaches most US households and has been used for health-related research recruitment. The platform allows for advertising segmentation by age, gender, and location; however, it does not explicitly allow for targeting by race or ethnicity to facilitate a diverse participant pool., Objective: This study looked at the efficacy of zip code targeting in Facebook advertising to reach blacks/African Americans and Hispanics/Latinos who smoke daily for a quit-smoking web-based social media study., Methods: We ran a general market campaign for 61 weeks using all continental US zip codes as a baseline. Concurrently, we ran 2 campaigns to reach black/African American and Hispanic-/Latino-identified adults, targeting zip codes ranked first by the percentage of households of the racial or ethnic group of interest and then by cigarette expenditure per household. We also ran a Spanish language campaign for 13 weeks, targeting all continental US zip codes but utilizing Facebook's Spanish language targeting. The advertising images and language were common across campaigns. Costs were compared for advertisement clicks, queries, applications, and participants, and yields were compared for the final three outcomes. We examined outcomes before and after the Cambridge Analytica scandal that broke in March 2018. Finally, we examined 2 promoted Facebook features: lookalike audiences and audience network placement., Results: Zip code targeting campaigns were effective for yielding the racial or ethnic groups of interest. The black-/African American-focused versus general market campaign increased black/African American weekly queries (mean 9.48, SD 5.69 vs general market mean 2.83, SD 2.05; P<.001) and applicants (mean 1.11, SD 1.21 vs general market mean 0.54, SD 0.58; P<.001). The Hispanic-/Latino-focused versus general market campaign increased Hispanic/Latino weekly queries (mean 3.10, SD 2.16 vs general market mean 0.71, SD 0.48; P<.001) and applicants (mean 0.36, SD 0.55 vs general market mean 0.10, SD 0.14; P=.001). Cost metrics did not differ between campaigns at generating participants (overall P=.54). Costs increased post- versus prescandal for the black-/African American-focused campaign for queries (mean US $8.51, SD 3.08 vs US $5.87, SD 1.89; P=.001) and applicants (mean US $59.64, SD 35.63 vs US $38.96, SD 28.31; P=.004) and for the Hispanic-/Latino-focused campaign for queries (mean US $9.24, SD 4.74 vs US $7.04, SD 3.39; P=.005) and applicants (mean US $61.19, SD 40.08 vs US $38.19, SD 21.20; P=.001)., Conclusions: Zip code targeting in Facebook advertising is an effective way to recruit diverse populations for health-based interventions. Audience network placement should be avoided. The Facebook lookalike audience may not be necessary for recruitment, with drawbacks including an unknown algorithm and unclear use of Facebook user data, and so public concerns around data privacy should be considered., Trial Registration: ClinicalTrial.gov NCT02823028; https://clinicaltrials.gov/ct2/show/NCT02823028., (©Cornelia Pechmann, Connor Phillips, Douglas Calder, Judith J. Prochaska. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.06.2020.)

In August 2006, U.S. District Court Judge Gladys Kessler ordered four tobacco companies to disseminate court-approved corrective statements on five topics pertaining to health hazards of cigarette smoking. Based on the 2018 Health Information National Trends Survey (HINTS), approximately 50% of U.S. smokers viewed at least one corrective statement via television or newspaper during the first six months of the airings/publications (November 2017-April 2018). Using televised gross rating points (GRPs) and cross-sectional data from the 2018 HINTS (n = 3484) and 2019 HINTS (n = 3331), the current study extends previous ones by estimating broadcast reach/frequency and the moderating effect of survey year on smokers' exposure to a corrective statement. The weighted percentage of participants who viewed a corrective statement was significantly greater in the 2019 versus 2018 HINTS for smokers (64.3% vs. 50.5%, χ 2 1df  = 5.85, p  = .01), but not for non-smokers (39% in 2018/2019, χ 2 1df  = 0.02; p  = .88); this differential effect was evidenced by a significant interaction term (OR = 2.0(1.2, 3.2), p  < .001). This study also revealed that the televised reach of the corrective statements to the U.S. population (43.5 GRPs/43.5%) was comparable to the published estimate from the 2018 HINTS (40.6%). The frequency of exposure to any corrective statement in the first six months of televised airings was only 0.68 exposures/month, an estimate that does not meet CDC Best Practices. Yet, as evidenced by the significant interaction with survey year, it is likely that the addition of messages to tobacco company websites and cigarette package onserts may have contributed to smokers' greater exposure to a corrective statement., (© 2020 The Author(s).)

Introduction: Recent studies have separately examined the content and demographic reach of the advertising of electronic nicotine delivery systems (ENDS). No study to our knowledge has linked the two in investigating whether racial/ethnic groups are differentially exposed to the comparative messages conveyed in online ENDS advertisements., Methods: 932 unique ENDS advertisements (6311 total), which were posted on 3435 websites between December, 2009 and October, 2015, were categorized as either comparative or non-comparative with respect to the traditional cigarette. The race/ethnicity of website visitors was obtained from a proprietary source and used in constructing variables for racial/ethnic viewership. The variables for advertising content and website racial/ethnic viewership were then linked yielding a final sample of 551 unique ENDS advertisements (2498 total) on 1206 websites. A two-level hierarchical generalized linear model, used in estimating website racial/ethnic viewership as a predictor of comparative advertising, accounted for the nesting of advertisements (level 1) within 152 ENDS brands (level 2)., Results: In contrast to racial/ethnic minorities, a greater proportion of non-Hispanic whites visited websites with ENDS advertisements than the overall proportion of nonHispanic white U.S. Internet users. Yet, it was the advertisements on websites that appealed to Hispanics that had greater odds of comparing ENDS to traditional cigarettes., Conclusions: The lower exposure to ENDS advertising among racial/ethnic minorities versus non-Hispanic whites is consistent with survey data. Yet, the greater odds of comparative advertising of ENDS on websites that appeal to racial/ethnic minorities (ie, Hispanics) could impact the longterm health of minority smokers., Implications: This study's findings have important implications for the uptake of ENDS among minority smokers. If the comparative advertising yields greater interest and eventual use of ENDS, then minority smokers could either benefit from smoking cessation because they switch to ENDS, or adopt dual tobacco use. The fate of comparative advertising of ENDS versus the traditional cigarette will depend on the Food and Drug Administration enforcement of its deeming rules and the ensuing changes in the ENDS marketplace., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: We evaluated a novel Twitter-delivered intervention for smoking cessation, Tweet2Quit, which sends daily, automated communications to small, private, self-help groups to encourage high-quality, online, peer-to-peer discussions., Design: A 2-group randomised controlled trial assessed the net benefit of adding a Tweet2Quit support group to a usual care control condition of nicotine patches and a cessation website., Participants: Participants were 160 smokers (4 cohorts of 40/cohort), aged 18-59 years, who intended to quit smoking, used Facebook daily, texted weekly, and had mobile phones with unlimited texting., Intervention: All participants received 56 days of nicotine patches, emails with links to the smokefree.gov cessation website, and instructions to set a quit date within 7 days. Additionally, Tweet2Quit participants were enrolled in 20-person, 100-day Twitter groups, and received daily discussion topics via Twitter, and daily engagement feedback via text., Measures: The primary outcome was sustained abstinence at 7, 30 and 60 days post-quit date., Results: Participants (mean age 35.7 years, 26.3% male, 31.2% college degree, 88.7% Caucasian) averaged 18.0 (SD=8.2) cigarettes per day and 16.8 (SD=9.8) years of smoking. Participants randomised to Tweet2Quit averaged 58.8 tweets/participant and the average tweeting duration was 47.4 days/participant. Tweet2Quit doubled sustained abstinence out to 60 days follow-up (40.0%, 26/65) versus control (20.0%, 14/70), OR=2.67, CI 1.19 to 5.99, p=0.017. Tweeting via phone predicted tweet volume, and tweet volume predicted sustained abstinence (p<0.001). The daily autocommunications caused tweeting spikes accounting for 24.0% of tweets., Conclusions: Tweet2Quit was engaging and doubled sustained abstinence. Its low cost and scalability makes it viable as a global cessation treatment., Trial Registration Number: NCT01602536., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Background: Latinos are the largest minority group in the United States, and in California they outnumber non-Hispanic whites. Smoking cessation programs tailored for Latino culture, and this population's specific smoking patterns, are needed. Online social networks for smoking cessation have high potential for Latinos, but have not been tested to date., Objective: Building a research program on social media apps for cancer prevention in diverse populations, this qualitative study assessed acceptability of tobacco treatment that was distributed via social media for Latino smokers., Methods: We conducted three focus groups with Latino adults who were former and current smokers recruited from Santa Clara County, California in 2015 (N=32). We assessed participants' smoking histories, attempts to quit, social media exposure, and receptivity to a social media-based smoking cessation intervention. Audio transcripts were translated and coded for themes., Results: Participants reported factors driving their tobacco use and motivations to quit, and emphasized the importance of community and family in influencing their smoking initiation, cravings and triggers, attempts to quit, and abstinence. Participants valued the communal aspect of social media and suggested strategically tailoring groups based on key features (eg, age, gender, language preference). Participants reported preferring visual, educational, and motivational messages that were connected with existing services., Conclusions: Participants generally voiced acceptability of a social media-delivered intervention to help them quit smoking, viewed the intervention as well-equipped for catering to the strong community orientation of Latinos, and suggested that the platform was able to address variation within the population through strategic group creation. As a group member reflected, "Podemos hacerlo juntos" (We can do it together)., (©Beatriz Anguiano, Cati Brown-Johnson, Lisa G. Rosas, Cornelia Pechmann, Judith J. Prochaska. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 08.02.2017.)

The Female Genital Mutilation (FGM) is still practiced in many countries and mainly performed for traditional reasons. In this study, the relationship of the FGM type (type I and type III) with anxiety, depression, and posttraumatic stress disorder as well as the attitude toward FGM was analyzed. For this purpose the data of N=109 of FGM type I and III affected women from Ethiopia were collected. Analyses show moderation effects. It was found that the symptoms of depression and PTSD were less pronounced with a positive attitude towards the FGM in the sample of severely mutilated women (type III). It seems that the attitude toward FGM plays a major role in enhancing social recognition of those affected, thus better coping can take place. As well, this study shows the importance of the attitude of FGM tradition in the population to protect young girls prone for FGM., (© Georg Thieme Verlag KG Stuttgart · New York.)

We examined engagement in novel quit-smoking private social support networks on Twitter, January 2012 to April 2014. We mapped communication patterns within 8 networks of adult smokers (n = 160) with network ties defined by participants' tweets over 3 time intervals, and examined tie reciprocity, tie strength, in-degree centrality (popularity), 3-person triangles, 4-person cliques, network density, and abstinence status. On average, more than 50% of ties were reciprocated in most networks and most ties were between abstainers and nonabstainers. Tweets formed into more aggregated patterns especially early in the study. Across networks, 35.00% (7 days after the quit date), 49.38% (30 days), and 46.88% (60 days) abstained from smoking. We demonstrated that abstainers and nonabstainers engaged with one another in dyads and small groups. This study preliminarily suggests potential for Twitter as a platform for adult smoking-cessation interventions.

Aim: The purpose of this article is an analysis of the association between resilience, age and gender with psychological distress through anxiety and depression., Methods: In a sample of 3784 individuals, the association of resilience with anxiety and depression was examined using a linear regression model. In addition to resilience, age and gender as well as the combination of these factors and their effects on resilience were analyzed., Results: Low resilience predicts both anxiety and depression. Gender moderates this association. In male persons a stronger association between resilience and depression was found., Conclusion: In practice, these results should be considered in treatment., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: The medical field seeks to use social media to deliver health interventions, for example, to provide low-cost, self-directed, online self-help groups. However, engagement in online groups is often low and the informational content may be poor., Objective: The specific study aims were to explore if sending automessages to online self-help groups encouraged engagement and to see if overall or specific types of engagement related to abstinence., Methods: We conducted a Stage I Early Therapy Development Trial of a novel social media intervention for smoking cessation called Tweet2Quit that was delivered online over closed, 20-person quit-smoking groups on Twitter in 100 days. Social media such as Twitter traditionally involves non-directed peer-to-peer exchanges, but our hybrid social media intervention sought to increase and direct such exchanges by sending out two types of autocommunications daily: (1) an "automessage" that encouraged group discussion on an evidence-based cessation-related or community-building topic, and (2) individualized "autofeedback" to each participant on their past 24-hour tweeting. The intervention was purposefully designed without an expert group facilitator and with full automation to ensure low cost, easy implementation, and broad scalability. This purely Web-based trial examined two online quit-smoking groups with 20 members each. Participants were adult smokers who were interested in quitting and were recruited using Google AdWords. Participants' tweets were counted and content coded, distinguishing between responses to the intervention's automessages and spontaneous tweets. In addition, smoking abstinence was assessed at 7 days, 30 days, and 60 days post quit date. Statistical models assessed how tweeting related to abstinence., Results: Combining the two groups, 78% (31/40) of the members sent at least one tweet; and on average, each member sent 72 tweets during the 100-day period. The automessage-suggested discussion topics and participants' responses to those daily automessages were related in terms of their content (r=.75, P=.012). Responses to automessages contributed 22.78% (653/2867) of the total tweets; 77.22% (2214/2867) were spontaneous. Overall tweeting related only marginally to abstinence (OR 1.03, P=.086). However, specific tweet content related to abstinence including tweets about setting of a quit date or use of nicotine patches (OR 1.52, P=.024), countering of roadblocks to quitting (OR 1.76, P=.008) and expressions of confidence about quitting (OR 1.71, SE 0.42, P=.032). Questionable, that is, non-evidence-based, information about quitting did not relate to abstinence (OR 1.12, P=.278)., Conclusions: A hybrid social media intervention that combines traditional online social support with daily automessages appears to hold promise for smoking cessation. This hybrid approach capitalizes on social media's spontaneous real-time peer-to-peer exchanges but supplements this with daily automessages that group members respond to, bolstering and sustaining the social network and directing the information content. Highly engaging, this approach should be studied further., Trial Registration: Clinicaltrials.gov NCT01602536; https://clinicaltrials.gov/ct2/show/NCT01602536 (Archived by WebCite at http://www.webcitation.org/6WGbt0o1K).

In a cross-sectional study the influence of social inequality on resilience and psychological distress was investigated in a sample of N=4 142 adults. A social stratum was created, including education, financial income and job-status, as well as age (≥ 25 years). Multivariate analysis of variance (MANOVA) showed influences of gender, social status and age on resilience (RS-11) and psychological distress: depression (PHQ-2), anxiety (GAD-7), life satisfaction (FLZ(M)). In contrast to the most continuous influence of the social background in women across any age-group, older males (≥ 65 years) were not affected by their social background. In both sexes members of the social underclass had the lowest resilience. The results indicate the need for specific intervention as to prevention., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: Widely popular, Twitter, a free social networking and micro-blogging service, offers potential for health promotion. This study examined the activity of Twitter quit smoking social network accounts., Design: A cross-sectional analysis identified 153 activated Twitter quit smoking accounts dating back to 2007 and examined recent account activity for the month of August 2010., Results: The accounts had a median of 155 followers and 82 total tweets per account; 49% of accounts had >100 tweets. Posted content was largely inconsistent with clinical guidelines; 48% linked to commercial sites for quitting smoking and 43% had tweets on e-cigarettes. In August 2010, 81 of the accounts (53%) were still active., Conclusions: Though popular for building quit smoking social networks, many of the Twitter accounts were no longer active, and tweet content was largely inconsistent with clinical guidelines. Future research is needed to examine the effectiveness of Twitter for supporting smoking cessation.

Nearly all work aimed at optimizing the ability of labeling to communicate over-the-counter (OTC) drug information has focused on back-of-the-package characteristics, such as the Drug Facts label. The effects of front of the package, or principal display panel (PDP) factors, have largely been neglected by researchers. Similarly, heterogeneity in consumers' approach to new information has received scant attention in the context of OTC drugs. This preliminary study tested the hypothesis that display of a drug's brand name on the PDP and individuals' need for cognition influence comprehension of Drug Facts label information. University students (n = 212) that had experienced heartburn but not used the drug class being studied constituted the primary analysis cohort. Students were randomly assigned to review one of two PDPs (brand name or generic), followed by a Drug Facts label and a series of questions related to selection and usage of the drug. Participants with low need for cognition were influenced by the brand name PDP, as those exposed to a PDP featuring a brand (vs. generic) spent less time reading the Drug Facts label and demonstrated lower comprehension of the label information on proper drug selection. These findings suggest that further research is needed to understand the impact of PDP contents and cognitive characteristics of consumers on the communication of OTC drug information. Health care providers should consider communication strategies that account for the challenges patients face in using OTC drugs properly.

Objectives: We examined the relationship between exposure to the Above the Influence antidrug campaign in 210 US media markets and adolescent marijuana and alcohol use from 2006 to 2008., Methods: We analyzed monthly advertising exposure (targeted rating points) data from the Office of National Drug Control Policy and drug use data from the Monitoring the Future study. We estimated multivariate logistic regression models of marijuana use for students in grades 8, 10, and 12, with controls for individual, family, and media market characteristics and year and regional fixed effects., Results: For eighth-grade adolescent girls, greater exposure to antidrug advertisements was associated with lower rates of past-month marijuana use (adjusted odds ratio [AOR] = 0.67; 95% confidence interval [CI] = 0.52, 0.87) and lower rates of lifetime marijuana use (AOR = 0.76; 95% CI = 0.62, 0.93), but not alcohol use (AOR = 1.00; 95% CI = 0.84, 1.19). Associations were not significant for adolescent boys or for students in grades 10 and 12., Conclusions: Antidrug advertising may be an effective way to dissuade eighth-grade adolescent girls from initiating marijuana use.

Objectives: We used a validated copy test method to examine the effectiveness of 8 types of antismoking advertisements representing health, counterindustry, and industry approaches. We tested the hypothesis that health ads about tobacco victims can lower most adolescents' intent to smoke if the ads elicit disgust and anti-industry feelings rather than fear. We hypothesized null effects for adolescents with conduct disorder because of their abnormally low empathy., Methods: Ninth-grade students from 8 California public schools (n=1725) were randomly assigned to view 1 of 9 videotapes containing a TV show with ads that included either a set of antismoking ads or a set of control ads. Participants completed baseline measures assessing personality traits and postexposure measures assessing smoking intent, feelings, beliefs, and ad evaluations., Results: Ads focusing on young victims suffering from serious tobacco-related diseases elicited disgust, enhanced anti-industry motivation, and reduced intent to smoke among all but conduct-disordered adolescents. Counterindustry and industry ads did not significantly lower smoking intention., Conclusions: Sponsors of tobacco use prevention ad campaigns should consider using ads showing tobacco-related disease and suffering, not just counterindustry ads. Ads should be copy tested before airing.