Skin cancer prevention: knowledge and perceptions of a nationwide sample of youth.

Context: Skin cancer is the most common type of cancer in the United States and incidence continues to rise. The leading risk factor for skin cancer is sun exposure in adolescence. Given this, sun protection in young adults is an effective way to reduce the occurrence of skin cancer. The goal of this study is to identify knowledge, behaviors, and barriers among young adults toward the use of sunscreen. Primary care physicians interact with a large number of young adults and have the ideal opportunity to counsel this population. Objective: To identify youths' knowledge and experiences with sun protection and elicit recommendations to increase protection usage. Study Design: Data was obtained using MyVoice, a national poll of youth (www.hearmyvoicenow.org). Five open-ended questions were sent via text message to 1,151 youth on April 9, 2021. Responses were analyzed by two independent investigators after using a modified grounded theory approach to iteratively develop codes based on salient themes. Setting: Participants are youth from the United States aged 14-24 years old who were recruited from social media to meet national benchmarks based on weighted samples of the American Community Survey. Results: Of 1,151 youth, 977 responded to at least one question (response rate= 84.9%). Respondents' mean age was 19.3 years (SD=2.4), 48.1% identified as male, and 62.2% as non-Hispanic white. Nearly all respondents stated "It is very important" or "It's important!" (62.1%, 25.5% respectively) to protect your skin from the sun. The most frequently reported reason for using sun protection was to "reduce the risk of getting skin cancer" (51.7%). Nearly all (90.1%) youth reported use of sunscreen, but 81.1% of respondents have had at least one sunburn and 28.4% have had 5 or more "Many [sunburns], and yes some have blistered". Participants commonly recommended emphasizing the consequences of sun exposure to encourage sun protection use, "Inform people about the dangers of not wearing sun protection" (41.1%). Conclusions: Youth in our nationwide sample understand both the short and long term risks of sun exposure and believe that sun protection is important. Though nearly all reported sunscreen use, youth struggle with implementation of consistent sun protective behaviors with a large number reporting numerous sunburns. These youth reported insights can inform more effective strategies to improve the use of sun protection by youth.

Perspectives of US Adolescents on Diverted Stimulant Use.

OBJECTIVE: To evaluate perspectives of youth regarding diverted stimulant use among a contemporary sample of adolescents and young adults. STUDY DESIGN: This study used MyVoice, a longitudinal national text message survey of American youth. In February 2019, 1228 MyVoice youth were asked 4 open-ended questions to elicit their perspectives on diverted stimulant use. Responses were assessed using thematic analysis, and quantitative results were summarized using descriptive statistics. RESULTS: Of 1228 youth, 906 responded to at least one survey question (relative risk, 74%). Respondents' ages ranged from 14 to 24 years with a mean age of 18.8 ± 2.9 years, 57% were female, and 66% identified as White. Peer pressure and coping were commonly perceived reasons for diversion, and respondents believed that many youth misuse stimulants. Many were aware of health risks of misuse, but few mentioned potential legal consequences. Youth thought stimulants could be obtained from peers, people with a prescription, dealers, and family, and some mentioned access through unnecessary prescriptions. CONCLUSIONS: The perspectives of a national sample of youth suggest that stimulant diversion continues to be a significant problem among American youth, with many noting that diverted stimulants are easy to obtain and are used to self-treat mental health issues. Standardized interventions at schools and in healthcare settings, as well as universal screening for diversion and mental health conditions, may combat this public health concern.

"Stay home so this can be over:" A national study of youth perspectives on social distancing during the COVID-19 pandemic.

Social distancing is an important public health recommendation that has been implemented to reduce the spread of COVID-19. Infections are rising among younger populations, but relatively little is known about youth social distancing behavior. Our qualitative study aims to examine youth engagement with social distancing and elucidate the reasons why guidelines are followed and broken. Members of the national MyVoice Text Message Cohort (aged 14-24) were surveyed from April 24 to April 30, 2020, through an open-ended text message poll. Responses were inductively coded and analyzed with descriptive statistics. Of the 944 youth who responded (response rate = 81.2%), 95% self-reported social distancing. However, 62% recalled instances of themselves or others breaking the guidelines and 19% expressed misconceptions about the rules. Notably, 14% of youth said they would encourage their friends to social distance by telling them it will accelerate a return to normal life. Feelings of social isolation were the most frequently cited (55%) negative impact of social distancing. Overall, responses from youth indicate significant variation in the interpretation of social distancing guidelines. Public health communications may need to address several critical misconceptions which impact the social distancing behaviors of youth. Further, safe methods for youth to interact with peers during periods of social distancing are necessary to prevent mental health impacts and to ensure adherence to social distancing guidelines.