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INTRODUCTION: The use of hashtags is a common way to promote e-cigarette content on social media. Analysis of hashtags may provide insight into e-cigarette promotion on social media. However, the examination of text data is complicated by the voluminous amount of social media data. This study used machine learning approaches (i.e., Bidirectional Encoder Representations from Transformers [BERT] topic modeling) to identify e-cigarette content on TikTok. METHODS: We used 13 unique hashtags related to e-cigarettes (e.g., #vape) for data collection. The final analytic sample included 12,573 TikTok posts. To identify the best fitting number of topic clusters, we used both quantitative (i.e., coherence test) and qualitative approaches (i.e., researchers checked the relevance of text from each topic). We, then, grouped and characterized clustered text to each theme. RESULTS: We evaluated that N=18 was the ideal number of topic clusters. The 9 overarching themes were identified: Social media and TikTok-related features (N=4; "duet", "viral"), Vape shops and brands (N=3; "store"), Vape tricks (N=3; "ripsaw"), Modified use of e-cigarettes (N=1; "coil", "wire"), Vaping and girls (N=1; "girl"), Vape flavors (N=1; "flavors"), Vape and cigarettes (N=1; "smoke"), Vape identities and communities (N=1; "community"), and Non-English language (N=3; Romanian and Spanish). CONCLUSIONS: This study used a machine learning method, BERTopic modeling, to successfully identify relevant themes on TikTok. This method can inform future social media research examining other tobacco products, and tobacco regulatory policies such as monitoring of e-cigarette marketing on social media. IMPLICATIONS: This study can inform future social media research examining other tobacco products, and tobacco regulatory policies such as monitoring of e-cigarette marketing on social media.
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BACKGROUND: Electronic nicotine delivery systems (ENDS) are the most used tobacco product among adolescents and young adults (AYAs) and are increasingly used to vape cannabis. It is unclear what vaping devices and ENDS modifications are used most frequently by AYAs who vape both nicotine and cannabis. METHODS: AYAs (aged 14-29) reporting ENDS use in the past 30 days were recruited via Qualtrics (N = 1,011). We conducted three multivariable logistic regression models examining differences in likelihood of: 1) vaping cannabis in the past 30 days; 2) mixing cannabis and nicotine liquids; and 3) using nicotine devices to vape cannabis; based on type of vaping device used most often, controlling for age, socio-economic status, gender, race, frequency of ENDS use, and other cannabis use. RESULTS: 40 % (n = 405) of AYAs reported vaping both nicotine and cannabis in the past 30 days. AYAs who used vape pens most often were more likely to have vaped cannabis concentrates in the past 30 days compared to individuals using disposable vapes (aOR = 2.72, 95 %CI = 1.75-4.21, p < 0.001). AYAs who used open systems most often (i.e., vape pens, mods, or e-hookah) were more likely than individuals using closed systems (i.e., disposable vapes, rechargeable pods or cigalikes) to combine nicotine and cannabis e-liquids (aOR = 2.03, 95 %CI = 1.43-2.89, p < 0.001) or use a nicotine device to vape cannabis (aOR = 1.66, 95 %CI = 1.17-2.34, p = 0.005). IMPLICATIONS: Co-use of cannabis and nicotine via similar devices, particularly vape pens and other open-systems, warrants collaborative regulatory efforts to mitigate co-use of both substances, with a particular need for increased regulation of cannabis vaping products.
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Sistemas Electrónicos de Liberación de Nicotina , Vapeo , Humanos , Vapeo/epidemiología , Masculino , Adolescente , Femenino , Adulto Joven , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Adulto , NicotinaRESUMEN
OBJECTIVES: We assessed awareness and perceptions of, information sources about, and engagement in modifying electronic nicotine delivery systems (ENDS) among adolescents and young adults (AYAs). METHODS: AYAs (N = 1018) endorsing past-month ENDS use completed a survey on awareness and use of the following modifications: (1) refilling rechargeable cartridges/pods or (2) disposable pods, (3) rewicking or (4) recharging disposable pods, (5) modifying nicotine e-liquids (eg, changing propylene glycol/vegetable glycerin, nicotine), (6) combining nicotine and cannabis for simultaneous vaping, and (7) putting cannabis in ENDS designed for nicotine vaping. Logistic regression assessed how sources of information (eg, friends, social media, nonsocial media Web sites, vape shops) about and perceptions of ENDS modifications associated with ENDS modifications. RESULTS: Refilling (69.0% heard, 40.1% tried) and recharging the battery (66.4% heard, 35.8% tried) of disposable pods were most common. Friends (64.4%) and social media (46.7%) were the most common sources of information. Notable significant associations between information sources and modifications were: 1. nonsocial media Web sites and vape shops with rewicking and recharging disposable devices and modifying nicotine e-liquid; 2. nonsocial media Web sites with refilling rechargeable cartridges/pods and disposable pods; and 3. social media with recharging disposable devices and mixing nicotine and cannabis liquids. Perceptions of reduced harm and "coolness" were associated with various modifications. DISCUSSION: AYAs are aware of and modify ENDS for purposes unintended by manufacturers. ENDS policies should consider unintended ENDS use to safeguard public health. Prevention efforts should communicate about the potential harms of ENDS modifications.
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Sistemas Electrónicos de Liberación de Nicotina , Vapeo , Humanos , Adolescente , Adulto Joven , Masculino , Femenino , Nicotina/administración & dosificaciónRESUMEN
BACKGROUND: With high rates of both e-cigarette and social media use among adolescents and young adults (AYAs), social media influencers who promote e-cigarettes are particularly concerning but are understudied. We examined the association between AYAs' use of 11 different social media platforms (e.g. Facebook, Twitter, Instagram, TikTok, and YouTube) and exposure to social media e-cigarette influencers. OBJECTIVES: From November 2022 to February 2023, we conducted an online, US national survey of AYAs (14-29 years) who endorsed past-30-day e-cigarette use. We used binomial logistic regression to examine associations between the frequency of use of each social media platform and following e-cigarette influencers, controlling for age, sex, race, ethnicity, e-cigarette use frequency, and other tobacco and substance use (i.e., alcohol and cannabis). The model was stratified by adolescents (14-17 years; n = 293) and young adults (18-29 years; n = 654). RESULTS: The most frequently used social media platforms were Snapchat, TikTok and Instagram among adolescents, and YouTube, Instagram and TikTok among young adults. In adjusted models, following e-cigarette influencers was associated with more frequent use of TikTok (adjusted odds ratio [95% CI]; 1.33 [1.05, 1.68]) and Pinterest (1.18 [1.02, 1.38]) among adolescents, and more frequent use of Twitter (1.17 [1.06, 1.29]) among young adults. CONCLUSIONS: The use of different platforms was associated with exposure to e-cigarette influencers: TikTok and Pinterest among adolescents and Twitter among young adults. These findings can inform tobacco regulatory policy and social media platform restrictions of e-cigarette influencers on the platforms that are popular among AYAs.
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Sistemas Electrónicos de Liberación de Nicotina , Medios de Comunicación Sociales , Vapeo , Humanos , Medios de Comunicación Sociales/estadística & datos numéricos , Adolescente , Adulto Joven , Femenino , Masculino , Adulto , Vapeo/epidemiología , Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Estados Unidos/epidemiologíaRESUMEN
INTRODUCTION: Previous research has identified abundant e-cigarette content on social media using primarily text-based approaches. However, frequently used social media platforms among youth, such as TikTok, contain primarily visual content, requiring the ability to detect e-cigarette-related content across large sets of videos and images. This study aims to use a computer vision technique to detect e-cigarette-related objects in TikTok videos. AIMS AND METHODS: We searched 13 hashtags related to vaping on TikTok (eg, #vape) in November 2022 and obtained 826 still images extracted from a random selection of 254 posts. We annotated images for the presence of vaping devices, hands, and/or vapor clouds. We developed a YOLOv7-based computer vision model to detect these objects using 85% of extracted images (Nâ =â 705) for training and 15% (Nâ =â 121) for testing. RESULTS: Our model's recall value was 0.77 for all three classes: vape devices, hands, and vapor. Our model correctly classified vape devices 92.9% of the time, with an average F1 score of 0.81. CONCLUSIONS: The findings highlight the importance of having accurate and efficient methods to identify e-cigarette content on popular video-based social media platforms like TikTok. Our findings indicate that automated computer vision methods can successfully detect a range of e-cigarette-related content, including devices and vapor clouds, across images from TikTok posts. These approaches can be used to guide research and regulatory efforts. IMPLICATIONS: Object detection, a computer vision machine learning model, can accurately and efficiently identify e-cigarette content on a primarily visual-based social media platform by identifying the presence of vaping devices and evidence of e-cigarette use (eg, hands and vapor clouds). The methods used in this study can inform computational surveillance systems for detecting e-cigarette content on video- and image-based social media platforms to inform and enforce regulations of e-cigarette content on social media.
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Sistemas Electrónicos de Liberación de Nicotina , Medios de Comunicación Sociales , Adolescente , Humanos , Simulación por Computador , Computadores , Aprendizaje AutomáticoRESUMEN
BACKGROUND: E-cigarettes are frequently promoted on social media and portrayed in ways that are attractive to youth. While the COVID-19 pandemic significantly affected people's lives, less is known about how the pandemic influenced e-cigarette-related marketing and information on social media. This study examined how e-cigarettes were portrayed on youtube, one of the most popular social media platforms during the COVID-19 pandemic. METHODS: We searched for combinations of search terms related to e-cigarettes (e.g., "electronic cigarette" and "vape") and COVID-19 (e.g., "corona" and "COVID") in July of 2021. To be included in analyses, videos must be: uploaded after February 1, 2020, in English, related to e-cigarettes and COVID-19, and less than 30 min in length. We conducted a content analysis of included videos, coding for uploader characteristics, what e-cigarette products were showcased, and specific themes that intersected between e-cigarettes and COVID-19. RESULTS: We examined N = 307 videos and found that N = 220 (73.6%) discussed the health effects of e-cigarette use on COVID-19, followed by videos on how COVID-19 affects e-cigarette sales (N = 40, 12.9%), face mask-related videos (N = 16, 5.1%; e.g., vape tricks including masks) and instructional videos (N = 10, 3.2%; e.g., sanitizing vape devices during COVID-19). Instructional videos had the highest number of likes (Median = 23; IQR = 32) and comments (Median = 10; IQR = 7). CONCLUSIONS: Our findings support the need for continuous surveillance and research on novel vaping-related content in reaction to policies and events, such as the global pandemic. More research is needed to understand the impact of this content on young people's perceptions and use of e-cigarettes.
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COVID-19 , Sistemas Electrónicos de Liberación de Nicotina , Medios de Comunicación Sociales , Productos de Tabaco , Adolescente , Humanos , PandemiasRESUMEN
Importance: Electronic nicotine delivery systems (ENDS) were created to vape nicotine e-liquids; however, social media demonstrates increased ENDS modifications to vape cannabis. Analysis of social media content helps with understanding ENDS modifications for cannabis use, overlapping markets for ENDS and cannabis, and the need for additional regulation. Objective: To analyze online videos for use, modification, and marketing of ENDS to vape cannabis. Design, Setting, and Participants: In this qualitative study, 10 searches were performed on YouTube on July 14, 2022, using different combinations of relevant search terms to identify videos depicting modifications to ENDS and e-liquids to vape cannabis. The first 40 videos from each search (400 videos total, 152 without duplicates) were extracted, of which 59 included depiction or discussion of cannabis vaping content. Content analysis of videos included iterative development of codes, consensus building across team members, and reliability checks. Main Outcomes and Measures: Metadata (ie, video length, number of likes, comments, and views) were extracted for included videos. Coding was performed for uploader type, modifications to ENDS and e-liquids, devices used, cannabis products vaped, age restriction, purchasing links, health claims, and discussion of warning messages and cannabis regulations. Results: Of the 59 videos analyzed, 34 (58%) included tetrahydrocannabinol; 33 (56%), cannabidiol; and 8 (14%), both. A total of 21 videos (36%) were age-restricted, while 25 (42%) included purchasing links for cannabis products, 20 (34%) for ENDS, and 7 (12%) for nicotine e-liquids. Twenty-six videos (44%) made claims about health benefits of vaping cannabis. Forty-one videos (69%) demonstrated vaping manufacturer-made cannabis products (eg, cannabis concentrates) with no modifications needed. Eighteen videos (31%) depicted modifications to e-liquids or ENDS for cannabis use. The most frequent modification was mixing e-liquids with cannabis products to be compatible with ENDS. The most frequently reported reason for modifications was to vape cannabis in public by using the same devices used for nicotine. Conclusions and Relevance: This qualitative study of online videos found high frequencies of statements about health benefits from vaping cannabis, frequent purchasing links, and inadequate age restrictions. Exposure to such content on social media platforms may increase risk of cannabis vaping among youth. Use of the same devices for multiple substances may also enable dual use and complicate the US Food and Drug Administration's regulation of ENDS.
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Cannabis , Sistemas Electrónicos de Liberación de Nicotina , Alucinógenos , Vapeo , Adolescente , Humanos , Nicotina , Reproducibilidad de los Resultados , Agonistas de Receptores de CannabinoidesRESUMEN
The COVID-19 pandemic has amplified preexisting challenges for educators as manifested in high rates of work-related stress and burnout, and educators leaving the profession in higher numbers than ever before. In this article, we highlight the urgency for work-related well-being supports for educators, with a particular focus on system changes. Individual self-care is necessary, yet insufficient. To this end, we recommend the use of a multitiered system of support framework to promote a supportive and balanced work environment for all educators, tailored to local needs. We provide a rationale for the use of a tiered model and give specific recommendations for implementation and sustainability of a continuum of supports for school-wide educator well-being. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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School climate consistently predicts youth academic success, social-emotional well-being, and substance use, and positive school climate can buffer the negative effects of community violence exposure on youth development. Various structural school and neighborhood factors have been associated with school climate, but prior research has not examined these relations comprehensively. We examined the relation between 18 school building and school neighborhood factors with student-reported school climate among 15,833 students in 124 public schools in a large, urban district in the United States. In this sample, attendance rate was most consistently associated with school climate (ß = 0.015; p < .001). Teacher years of experience, mobility rate, number of students in special education, adult arrests in the school neighborhood, and service calls for shootings and dirty streets and alleys in the school neighborhood were also significantly associated with various domains of school climate. These findings highlight the need for future longitudinal research on the influence of both school building and school neighborhood factors on school climate for public schools. Schools in our sample had a wide range of school climate scores despite consistently high crime rates and other structural risk factors such as low socioeconomic status throughout the city, so there are implications for researchers and education leaders to work together to identify opportunities for schools to foster positive school climate despite systemic school and/or neighborhood risk factors.
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Ongoing pressure for public schools to prioritize academics has increased attention on after-school settings as a critical space for social-emotional learning (SEL). After-school programs are uniquely positioned to build protective and promotive factors that contribute to positive future orientation, especially within communities where systemic inequities create barriers to high school graduation, higher education, employment, and earnings. This study examines Fit2Lead Youth Enrichment and Sports (YES), a county-funded, parks-based after-school collaboration for middle schoolers that merges mental health and recreation to promote healthy trajectories. Eight Miami neighborhood parks were selected based on county data indicating high rates of violence. An open trial design (N = 9 parks, 198 youth; ages 9-15; 40.5% female; 66.5% Black/African American, 24.9% Hispanic/Latinx, and 76.3% low-income) tested hypotheses that participation for adolescents exposed to community violence would disrupt a commonly reported decline in self-regulation and self-efficacy, and mitigate risk for anxiety and depression. Youth completed questionnaires at the beginning and end of one school year. Paired t-tests revealed no changes from pre to post, and no differences by baseline levels of youth and parent mental health. Findings highlight the promise of prevention programs to disrupt downward trajectories for youth during the risky time of early adolescence.
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Estado de Salud , Instituciones Académicas , Adolescente , Negro o Afroamericano , Niño , Femenino , Humanos , Masculino , Salud Mental , ViolenciaRESUMEN
Both organizational culture and climate are associated with service quality and outcomes across youth-service settings. Increasing evidence indicates capacity of organizational interventions to promote a positive and effective culture and climate. Less is known about common intervention components across studies and service settings. The current systematic review reviewed 9223 citations and identified 31 studies, across six youth-service settings, measuring changes over time in organizational culture and climate following implementation of an organizational or workforce support intervention. Results highlight the promise of organizational interventions, a need for more comparison and randomized designs, and future directions for maximizing capacity of organizations to promote health for frontline providers and the children they serve.
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Servicios de Salud Mental/organización & administración , Cultura Organizacional , Lugar de Trabajo/psicología , Adolescente , Centros Comunitarios de Salud Mental/organización & administración , Derecho Penal/organización & administración , Administración de los Servicios de Salud , Humanos , Instituciones Académicas/organización & administraciónRESUMEN
Organized after-school programs can mitigate risk and build resilience for youth in urban communities. Benefits rely on high-quality developmental experiences characterized by a supportive environment, structured youth-adult interactions, and opportunities for reflective engagement. Programs in historically disenfranchised communities are underfunded; staff are transient, underpaid, and undertrained; and youth exhibit significant mental health problems which staff are variably equipped to address. Historically, after-school research has focused on behavior management and social-emotional learning, relying on traditional evidence-based interventions designed for and tested in schools. However, after-school workforce and resource limitations interfere with adoption of empirically supported strategies and youth health promotion. We have engaged in practice-based research with urban after-school programs in economically vulnerable communities for nearly two decades, toward building a resource-efficient, empirically informed multitiered model of workforce support. In this paper, we offer first-person accounts of four academic-community partnerships to illustrate common challenges, variability across programs, and recommendations that prioritize core skills underlying risk and resilience, align with individual program goals, and leverage without overextending natural routines and resources. Reframing obstacles as opportunities has revealed the application of mental health kernels to the after-school program workforce support and inspired lessons regarding sustainability of partnerships and practice.
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Educación , Tutoría , Parques Recreativos , Recursos Humanos , Niño , Cuidado del Niño , Práctica Clínica Basada en la Evidencia , Promoción de la Salud , Recursos en Salud , Humanos , Instituciones Académicas , Aprendizaje Social , Población UrbanaRESUMEN
One-to-one instruction is a critical component of evidence-based instruction for students with autism spectrum disorder, but is not used as often as recommended. Student characteristics may affect teachers' decisions to select a treatment and/or implement it. This study examined the associations between students' clinical and demographic characteristics and teachers' reported use of discrete trial training (DTT) and pivotal response training (PRT). Children's higher sensory symptoms, lower social approach, lower verbal skills and higher self-regulation difficulties were associated with more frequent 1:1 DTT and PRT. Results suggest that teachers give more frequent 1:1 instruction to children with more observable impairments, do not match children to type of 1:1 intervention, and may inadvertently neglect other students for whom individualized intervention may still be beneficial.
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Trastorno del Espectro Autista/psicología , Toma de Decisiones , Maestros/psicología , Estudiantes/psicología , Niño , Femenino , Humanos , MasculinoRESUMEN
This study examined the association between (1) beginning-of-the-year emotional exhaustion and use of three evidence-based practices (EBP) for children with autism spectrum disorder; and (2) use of these EBP and end-of-year emotional exhaustion among 46 kindergarden to 2nd grade autism support teachers participating in a randomized trial. Emotional exhaustion was measured at the end and beginning of the school year using a subscale of the Maslach Burnout Inventory. Fidelity was measured using monthly observations, coded by research assistants trained to reliability. Correlations were used to examine unadjusted associations and ordinary least squares regression was used to examine associations adjusted for beginning-of-year burnout, years teaching, and average change in student cognitive functioning. Emotional exhaustion at the beginning of the year was not associated with EBP use. Greater fidelity to each EBP was associated with lower end-of-year emotional exhaustion (coefficients ranging from - .34 to - 1.13, all p's < .05). Results indicate that helping teachers implement EBP with greater fidelity may help reduce burnout, a substantial challenge in the field.
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Trastorno del Espectro Autista/epidemiología , Agotamiento Profesional/epidemiología , Maestros/psicología , Formación del Profesorado/organización & administración , Adulto , Femenino , Guías como Asunto , Humanos , Masculino , Formación del Profesorado/normas , Factores de TiempoRESUMEN
Schools remain among the most frequent providers of children's mental health services, particularly in low-income urban settings. Several decades of research have focused on training teachers to implement evidence-based interventions for minimizing disruptive behavior. Studies consistently demonstrate robust improvements in student behavior and learning; however, the impact on teachers' work-related stress or satisfaction is not well understood. Six urban, high-poverty elementary schools were randomly assigned to a school mental health services model (Links to Learning; L2L) for referred, disruptive students or to services and professional development as usual (SAU). Teachers (n = 71, K-4 general education teachers) in L2L schools participated in professional development and consultation in two universal and two targeted interventions to reduce disruptive behaviors and promote learning. Teachers (n = 65) in SAU schools participated in professional development as usual. Multiple regression models examined teacher reports of individual-level self-efficacy, classroom-level student functioning, and school-level organizational health as predictors of stress and satisfaction. Findings revealed no significant difference between conditions on teacher work-related stress or satisfaction. Organizational health was the strongest predictor of stress and satisfaction. Training on and implementation of evidence-based classroom interventions did not appear to significantly impact teachers' work-related stress or satisfaction. Instead, findings point to organizational climate and teacher connectedness as potential levers for change, supporting prior work on teacher stress and satisfaction in schools. The significance of targeting organizational factors may be particularly significant in urban school districts.
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Docentes/organización & administración , Docentes/psicología , Estrés Laboral/psicología , Satisfacción Personal , Instituciones Académicas/organización & administración , Población Urbana , Niño , Femenino , Humanos , Masculino , Estrés Laboral/diagnóstico , Estrés Laboral/epidemiología , Autoinforme , Estudiantes/psicologíaRESUMEN
This study sought to validate a new measure, the Classroom Cohesion Survey (CCS), designed to examine the relationship between teachers and classroom assistants in autism support classrooms. Teachers, classroom assistants, and external observers showed good inter-rater agreement on the CCS and good internal consistency for all scales. Simple factor structures were found for both teacher- and classroom assistant-rated scales, with one-factor solutions for both scales. Paired t tests revealed that on average, classroom assistants rated classroom cohesion stronger than teachers. The CCS may be an effective tool for measuring cohesion between classroom staff and may have an important impact on various clinical and implementation outcomes in school settings.