A social media intervention for high-intensity drinking among emerging adults: a pilot randomized controlled trial

The Relationship Between Alcohol-Related Content on Social Media and Alcohol Outcomes in Young Adults: A Scoping Review

BACKGROUND

Alcohol-related content (ARC) is pervasive across social media. Existing research suggests that posting of and exposure to such content may affect young adults' drinking and alcohol-related problems. However, a scoping review has yet to examine the literature within this field of research.

OBJECTIVES

This scoping review delineates and describes the existing peer-reviewed quantitative research examining the associations between ARC posting and exposure and drinking and alcohol-related problems among young adults ages 18 to 30. Specifically, the authors sought to investigate (1) methodological trends in how exposure to and posting of ARC is assessed; (2) potential moderators of the association between exposure to and posting of ARC and drinking outcomes; (3) how exposure to and posting of ARC is associated with alcohol consumption and alcohol-related problems; and (4) potential gaps in the literature.

ELIGIBILITY CRITERIA

This review includes original, empirical, quantitative studies, published in English from 2006 to 2023, that measured alcohol consumption and/or alcohol-related problems and the use of ARC on social media in 18- to 30-year-olds.

SOURCES OF EVIDENCE

The authors systematically searched the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Scopus databases on May 30, 2023, and reran the searches on November 1, 2023.

CHARTING METHODS

The authors designed a form to extract data and statistics related to alcohol drinking and ARC measures. Pairs of authors extracted the data for each study independently, and then a third author reviewed their work to resolve differences.

RESULTS

In total, 3,112 papers were selected via preliminary search terms. After removing duplicates and other articles deemed ineligible based on screening articles at the title and abstract level as well as assessing full-text articles for eligibility (n = 3,079), the final review included 33 studies. Overall, the results of the scoping review revealed a lack of consistent definitions and standardized assessments related to ARC. Despite these factors, the authors uncovered robust positive relationships between posting ARCand drinking and alcohol-related problems. The literature also mostly found positive, significant linkages between exposure to ARC and drinking and alcohol-related problems.

CONCLUSIONS

This scoping review highlights the need for consistentoperationalization and empirically validated measures related to ARC. In addition, the authors propose a theoretical model that may serve as a road map for future interventions targeting young adults.

Promoting mental health in the age of new digital tools: balancing challenges and opportunities of social media, chatbots, and wearables

The promotion of mental health is essential for global health, affecting millions with disorders such as anxiety and depression. Although stigma and discrimination hinder progress, these conditions are often preventable or manageable at minimal cost. The adoption of digital tools in mental health promotion, including telemedicine, online therapy, social media, and wearables, offers promising new avenues to address these issues. This review proposes a framework that focuses on the use of digital tools to enhance health literacy, foster behavioral change, and support sustained positive health behaviors. Platforms such as TikTok, Facebook, and Instagram can effectively disseminate health information, increase awareness, and enhance social accountability. Artificial intelligence-driven virtual agents offer personalised mental health interventions, providing motivational support and customised advice. Additionally, wearable technology (e.g., fitness trackers and smartwatches) enables real-time monitoring of vital health metrics, encouraging ongoing healthy activities. Nonetheless, these technologies introduce challenges including privacy issues, data security, and equitable access to digital resources, raising a new class of rights to protect mental privacy, guard against algorithm bias, and prevent personality-changing manipulations. The absence of human interaction in fully digital solutions also raises concerns about a lack of empathy and emotional connection. For optimal use of digital tools in mental health, integration with conventional care practices and adaptation to diverse cultural and social backgrounds are necessary. The results of this review suggest that digital tools, when carefully implemented, can significantly improve mental health outcomes by making care more accessible, tailored, and effective, especially for underserved communities.

A Novel Instagram Intervention for College Students Who Binge Drink

OBJECTIVE

The current study tested the feasibility and acceptability of a novel, Instagram-based intervention designed to reduce alcohol use and promote mindfulness and protective behavioral strategies among young adults who binge drink.

METHODS

Participants were 50 college students with active Instagram accounts who reported regular binge drinking over the past 3 months. Participants followed the Instagram intervention page for forty-two consecutive days. Intervention content contained at least one of the following motivational interviewing or cognitive behavioral therapy techniques: affirmations, norm referencing, protective behavioral strategies, and mindfulness exercises. Participants were instructed to 'like' the study posts as they appeared on their newsfeed. Some participants were exposed to additional story posts ('Stories') during the intervention. Feasibility was measured using retention rates. Acceptability of intervention content was measured using 5-point Likert scales across six dimensions. Alcohol consumption, alcohol-related consequences, protective behavioral strategies, and mindfulness practices were assessed before and after the intervention.

RESULTS

Over half of eligible participants (61.4%) completed the baseline survey. The vast majority of participants (98%) followed the study Instagram page at baseline. Of those who followed the study page, all stayed followed for the intervention duration. Most participants completed the mid-intervention (90%) and post-intervention (84%) surveys. Participants rated the intervention as moderately-to-very acceptable. Preliminary analyses indicate post-intervention decreases in past-month total drinks, drinking days, binge drinking episodes, and mindfulness practices.

CONCLUSIONS

Data support the feasibility and acceptability of delivering this intervention to college students. Future directions include testing intervention efficacy, increasing engagement, and optimizing dose.

A mobile health intervention for emerging adults with regular cannabis use: A micro-randomized pilot trial design protocol

BACKGROUND

Emerging adult (EA) cannabis use is associated with increased risk for health consequences. Just-in-time adaptive interventions (JITAIs) provide potential for preventing the escalation and consequences of cannabis use. Powered by mobile devices, JITAIs use decision rules that take the person's state and context as input, and output a recommended intervention (e.g., alternative activities, coping strategies). The mHealth literature on JITAIs is nascent, with additional research needed to identify what intervention content to deliver when and to whom.

METHODS

Herein we describe the protocol for a pilot study testing the feasibility and acceptability of a micro-randomized trial for optimizing MiWaves mobile intervention app for EAs (ages 18-25; target N = 120) with regular cannabis use (≥3 times per week). Micro-randomizations will be determined by a reinforcement learning algorithm that continually learns and improves the decision rules as participants experience the intervention. MiWaves will prompt participants to complete an in-app twice-daily survey over 30 days and participants will be micro-randomized twice daily to either: no message or a message [1 of 6 types varying in length (short, long) and interaction type (acknowledge message, acknowledge message + click additional resources, acknowledge message + fill in the blank/select an option)]. Participants recruited via social media will download the MiWaves app, and complete screening, baseline, weekly, post-intervention, and 2-month follow-up assessments. Primary outcomes include feasibility and acceptability, with additional exploratory behavioral outcomes.

CONCLUSION

This study represents a critical first step in developing an effective mHealth intervention for reducing cannabis use and associated harms in EAs.

Keeping you connected or keeping you addicted? Weekly use of social media platforms is associated with hazardous alcohol use and problem gambling among adults

AIMS

A wide variety of social media platforms exist, each offering tailored solutions to attract specific target audiences based on their social media needs and interests. This diversity may pose a risk factor for the development or perpetuation of harmful behaviors. Research has established a connection between social media use and increased health risk behaviors. This six-wave exploratory longitudinal study investigated the associations between active social media use, hazardous alcohol use, and problem gambling among adult social media users.

METHODS

Data were collected via surveys in 6-month intervals, starting in March-April 2021 (T1: N = 1530; Mage = 46.67; SD = 16.42; 50.33% male). Of the T1 respondents, 58.10% participated in T6 (n = 889). Measures included the frequency of use of different social media platforms, the 3-item Alcohol Use Disorders Identification Test (AUDIT-C), and the Problem Gambling Severity Index (PGSI). Hybrid multilevel regression models were used for analyses.

RESULTS

We found positive within-person effects of weekly Facebook use and between-person effects of weekly use of Facebook, TikTok, and gambling-related online communities on drinking. These results suggest an increase in hazardous alcohol consumption over time among the platforms' active users. Weekly Instagram use had a negative between-person effect on hazardous alcohol use. Individuals using TikTok or gambling communities weekly were more prone to problem gambling compared to non-weekly users.

CONCLUSIONS

There are risks involved in the active use of some social media services among adult users. Prevention work, including digital health interventions, should be targeted according to the appropriate user group.