Adolescent Peer Influence on Eating Behaviors via Social Media: Scoping Review

BACKGROUND

The influence of social media among adolescent peer groups can be a powerful change agent.

OBJECTIVE

Our scoping review aimed to elucidate the ways in which social media use among adolescent peers influences eating behaviors.

METHODS

A scoping review of the literature of articles published from journal inception to 2019 was performed by searching PubMed (ie, MEDLINE), Embase, CINAHL, PsycINFO, Web of Science, and other databases. The review was conducted in three steps: (1) identification of the research question and clarification of criteria using the population, intervention, comparison, and outcome (PICO) framework; (2) selection of articles from the literature using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines; and (3) charting and summarizing information from selected articles. PubMed's Medical Subject Headings (MeSH) and Embase's Emtree subject headings were reviewed along with specific keywords to construct a comprehensive search strategy. Subject headings and keywords were based on adolescent age groups, social media platforms, and eating behaviors. After screening 1387 peer-reviewed articles, 37 articles were assessed for eligibility. Participant age, gender, study location, social media channels utilized, user volume, and content themes related to findings were extracted from the articles.

RESULTS

Six articles met the final inclusion criteria. A final sample size of 1225 adolescents (aged 10 to 19 years) from the United States, the United Kingdom, Sweden, Norway, Denmark, Portugal, Brazil, and Australia were included in controlled and qualitative studies. Instagram and Facebook were among the most popular social media platforms that influenced healthful eating behaviors (ie, fruit and vegetable intake) as well as unhealthful eating behaviors related to fast food advertising. Online forums served as accessible channels for eating disorder relapse prevention among youth. Social media influence converged around four central themes: (1) visual appeal, (2) content dissemination, (3) socialized digital connections, and (4) adolescent marketer influencers.

CONCLUSIONS

Adolescent peer influence in social media environments spans the spectrum of healthy eating (ie, pathological) to eating disorders (ie, nonpathological). Strategic network-driven approaches should be considered for engaging adolescents in the promotion of positive dietary behaviors.

Early Emotion Knowledge and Later Academic Achievement Among Children of Color in Historically Disinvested Neighborhoods

This study examined longitudinal relations between emotion knowledge (EK) in pre-kindergarten (pre-K; M_age  = 4.8 years) and math and reading achievement 1 and 3 years later in a sample of 1,050 primarily Black children (over half from immigrant families) living in historically disinvested neighborhoods. Participants were part of a follow-up study of a cluster randomized controlled trial. Controlling for pre-academic skills, other social-emotional skills, sociodemographic characteristics, and school intervention status, higher EK at the end of pre-K predicted higher math and reading achievement test scores in kindergarten and second grade. Moderation analyses suggest that relations were attenuated among children from immigrant families. Findings suggest the importance of enriching pre-K programs for children of color with EK-promotive interventions and strategies.

Use of Technology to Promote Child Behavioral Health in the Context of Pediatric Care: A Scoping Review and Applications to Low- and Middle-Income Countries

Background: The burden of mental, neurological, and substance (MNS) disorders is greater in low- and middle-income countries (LMICs). The rapid growth of digital health (i.e., eHealth) approaches offer new solutions for transforming pediatric mental health services and have the potential to address multiple resource and system barriers. However, little work has been done in applying eHealth to promote young children's mental health in LMICs. It is also not clear how eHealth has been and might be applied to translating existing evidence-based practices/strategies (EBPs) to enable broader access to child mental health interventions and services. Methods: A scoping review was conducted to summarize current eHealth applications and evidence in child mental health. The review focuses on 1) providing an overview of existing eHealth applications, research methods, and effectiveness evidence in child mental health promotion (focused on children of 0-12 years of age) across diverse service contexts; and 2) drawing lessons learned from the existing research about eHealth design strategies and usability data in order to inform future eHealth design in LMICs. Results: Thirty-two (32) articles fitting our inclusion criteria were reviewed. The child mental health eHealth studies were grouped into three areas: i) eHealth interventions targeting families that promote child and family wellbeing; ii) eHealth for improving school mental health services (e.g., promote school staff's knowledge and management skills); and iii) eHealth for improving behavioral health care in the pediatric care system (e.g., promote use of integrated patient-portal and electronic decision support systems). Most eHealth studies have reported positive impacts. Although most pediatric eHealth studies were conducted in high-income countries, many eHealth design strategies can be adapted and modified to fit LMIC contexts. Most user-engagement strategies identified from high-income countries are also relevant for populations in LMICs. Conclusions: This review synthesizes patterns of eHealth use across a spectrum of individual/family and system level of eHealth interventions that can be applied to promote child mental health and strengthen mental health service systems. This review also summarizes critical lessons to guide future eHealth design and delivery models in LMICs. However, more research in testing combinations of eHealth strategies in LMICs is needed.

Understanding relations among early family environment, cortisol response, and child aggression via a prevention experiment

This study examined relations among family environment, cortisol response, and behavior in the context of a randomized controlled trial with 92 children (M = 48 months) at risk for antisocial behavior. Previously, researchers reported an intervention effect on cortisol response in anticipation of a social challenge. The current study examined whether changes in cortisol response were related to later child aggression. Among lower warmth families, the intervention effect on aggression was largely mediated by the intervention effect on cortisol response. Although the intervention also resulted in significant benefits on child engaging behavior, cortisol response did not mediate this effect. These findings demonstrate meaningful associations between cortisol response and aggression among children at familial risk for antisocial behavior.

An experimental test of parenting practices as a mediator of early childhood physical aggression

BACKGROUND

Parenting practices predict early childhood physical aggression. Preventive interventions that alter parenting practices and aggression during early childhood provide the opportunity to test causal models of early childhood psychopathology. Although there have been several informative preventive intervention studies that test mediation models in older children, no such studies have been conducted with younger children at high risk for psychopathology.

METHOD

Within the context of a randomized controlled trial, we examined whether changes in parenting practices mediate the effects of a family intervention on observed physical aggression among African American and Latino younger siblings of adjudicated youths.

RESULTS

Improved parenting practices partially mediated the intervention effect on physical aggression. Improvements in harsh parenting, responsive parenting, and stimulating parenting explained a significant amount of the intervention effect on child physical aggression observed in the context of parent-child interactions. Parenting practices accounted for 38% of the intervention effect on physical aggression.

CONCLUSIONS

There was support for the hypothesized model of the prevention of physical aggression during early childhood. Intervention benefits on parenting practices partially accounted for intervention effects on physical aggression in young high-risk children.

Effortful control, social competence, and adjustment problems in children at risk for psychopathology

This study explored the factor structure and developmental trajectory of effortful control (EC), its relations with child adjustment, and the moderating role of age and gender in 75 4- to 6-year-old children at risk for psychopathology. Confirmatory factor analyses revealed two subcomponents of effortful control: Suppress/Initiate (the ability to inhibit a dominant response while initiating a new response) and Motor Control (inhibiting fine and gross motor activity). EC performance improved with age, and both subcomponents were associated with greater social competence at all ages. Associations with internalizing problems were moderated by child age such that greater EC was linked to fewer problems at age 4 but did not relate to problems at ages 5 or 6.

Effects of a psychosocial family-based preventive intervention on cortisol response to a social challenge in preschoolers at high risk for antisocial behavior

CONTEXT

Salivary cortisol levels during social challenge relate to adaptive functioning in children and adults. Low cortisol levels have been related to conduct problems and antisocial behavior. Although studies in rodents implicate early-life social experience in cortisol regulation, no studies with humans have examined the effects of an experimentally manipulated early-life social experience on cortisol regulation.

OBJECTIVE

To examine the effects of experimental manipulations of social experience on cortisol response to a social challenge in preschoolers at risk for antisocial behavior.

DESIGN

Randomized controlled trial.

SETTING

Department of Child and Adolescent Psychiatry, New York University School of Medicine.

PARTICIPANTS

Ninety-two preschool-age siblings of youths adjudicated for delinquent acts. Intervention Family-based intervention included 22 weekly group sessions for parents and preschoolers and 10 biweekly home visits conducted during a 6- to 8-month period.

MAIN OUTCOME MEASURES

Salivary cortisol levels before and after a social challenge (entry into an unfamiliar peer group).

RESULTS

Relative to controls, children in the intervention condition had increased cortisol levels in anticipation of the peer social challenge. Increases were relative to both preintervention cortisol levels during the challenge and cortisol levels in the home, which were not altered by the intervention.

CONCLUSIONS

A family-based preventive intervention for children at high risk for antisocial behavior alters stress response in anticipation of a peer social challenge. The experimentally induced change in cortisol levels parallels patterns found in normally developing, low-risk children.

Assessing peer entry and play in preschoolers at risk for maladjustment

This study evaluated the psychometric properties of an observational rating system for assessing preschoolers' peer entry and play skills: Observed Peer Play in Unfamiliar Settings (OPPUS). Participants were 84 preschoolers at risk for psychopathology. Reliability and concurrent validity are reported. The 30-min paradigm yielded reliable indexes of engaging and disruptive behavior. Adequate interrater reliability and stability were obtained with minimally trained observers. OPPUS scores were related in expected ways to independent observations of disruptive and engaging behavior during parent-child interactions. OPPUS scores were associated with parent-rated self-control and internalizing behaviors. OPPUS scores were associated with parent ratings of play skills for children with school experience and assertiveness for children without school experience. The OPPUS is a useful, brief method for assessing peer entry and play behaviors in preschoolers.

Prevention for preschoolers at high risk for conduct problems: immediate outcomes on parenting practices and child social competence

This study investigated the immediate impact of an 8-month center- and home-based prevention program for preschoolers at high risk for conduct problems. We report immediate program effects on observed and self-rated parenting practices and observed child behavior with peers. Ninety-nine preschool-age siblings of adjudicated youths and their families were randomly assigned to an enhanced version of the Incredible Years Series (Webster-Stratton, 1989; n = 50) or to a no-intervention control condition (n = 49). In an intent-to-treat design, the intervention yielded significant effects on negative parenting, parental stimulation for learning, and child social competence with peers. Improvements in negative parenting, stimulation for learning, and child social competence support the potential of the intervention to prevent later conduct problems in high-risk children.

Older siblings benefit from a family-based preventive intervention for preschoolers at risk for conduct problems

This study evaluated sibling effects of a family-based intervention aimed at preventing conduct problems in preschool-age siblings of adjudicated youths. Ninety-two families of preschoolers who had older siblings adjudicated for delinquent acts were randomly assigned to intervention and control conditions. Of these, 47 families had nontargeted school-age (5-11 years) or adolescent siblings (12-17 years) living at home. These families were considered in this report. The authors hypothesized group differences on antisocial behavior and positive peer relations for older siblings of targeted preschoolers. The authors examined outcomes of parent- and teacher-reported behavior immediately postintervention and 8 months postintervention. Findings revealed significant intervention effects 8 months following intervention for adolescent siblings on parent-reported antisocial behavior and positive peer relations. Teacher reports confirmed group differences for antisocial behavior immediately postintervention. Findings document benefits for adolescent siblings.

Children, stress, and context: integrating basic, clinical, and experimental prevention research

Findings from the Watamura, Donzella, Alwin, and Gunnar (this issue) study support the growing recognition of the importance of context on physiology and affective and behavioral regulation early in human development. This discussion focuses on the role of context and development on hypothalamic-pituitary-adrenal (HPA) axis regulation in young children. Discussed in this article are the Watamura et al. findings with regard to relevant animal studies, extension of these observations to samples of children at elevated risk for psychopathology, and experimental prevention studies with young children. It is contended that environmental factors operating at key points in development may shape affective and behavioral regulation as well as HPA axis function in children, much as environmental factors have been shown to shape HPA axis regulation in animals.