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.

Perspectives of US Youth During Initial Month of the COVID-19 Pandemic.

PURPOSE: Asymptomatic youth in the United States acting as "silent spreaders" during the coronavirus disease 2019 (COVID-19) pandemic are an ongoing public health concern, particularly given their depiction as unengaged with recommendations. Our goal was to understand the knowledge, beliefs, and experiences of US youth at the onset of the COVID-19 pandemic. METHODS: We posed 2 open-ended surveys to the national MyVoice text message cohort of youth, aged 14-24 years. On March 6, 2020, 4 questions were asked regarding knowledge and experiences during the COVID-19 pandemic with 3 questions repeated on March 20, 2020. Qualitative responses were coded using thematic analysis and summarized with descriptive statistics. RESULTS: Of 1,174 youth, 1,087 responded to at least 1 question (response rate of 88%). The average age of respondents was 19 (SD 2.8) years with 52% female and 56% non-Hispanic White respondents. On March 6, 2020, most (70%) respondents reported knowing about COVID-19 and primarily cited the news (46%) as their source of information. Nearly all (95%) respondents reported impact by March 20, 2020, and respondents expressing worry increased from 25% to 51%. In both surveys, worried youth primarily cited concern for others (26% and 34%). Regarding preparation, respondents primarily reported doing nothing (36%) on March 6, 2020, and practicing social distancing (50%) on March 20, 2020. CONCLUSIONS: Many youths in our sample are engaged with the COVID-19 pandemic and most are feeling knowledgeable, are concerned about its impacts on others, and are practicing social distancing. Sustained public health efforts should focus on maintaining youth engagement with accurate public information and youth-centered messaging promoting prevention measures to protect the health and well-being of youth and their friends and family.

Perceptions of Breastfeeding Among Adolescents and Young Adults.

Purpose: We aimed to understand adolescents' and young adults' perceptions and the extent of their knowledge about breastfeeding. Methods: Participants (adolescents and young adults in the United States, 14-24 years of age) were texted five open-ended questions about their perceptions of various aspects of breastfeeding including their initial reaction to breastfeeding, the impact on the infant and parent, how it compares with formula, and whether they were breastfed. The responses were analyzed for themes using an inductive content analysis approach. Responses were compared using χ2 tests to assess if knowledge and education about breastfeeding differed according to gender identity and age. Results: Among 1,283 participants, 829 responded (response rate = 64.4%). The average age was 18.8 (standard deviation [SD] = 2.9), with 53% female and 10% Black. Most adolescents and young adults understand there are health benefits of breastfeeding for the breastfeeding dyad (n = 589; 78.8%), yet also indicate an awareness of negative aspects (n = 256; 36.1%). Participants who identified as female or gender-variant and those who were older were more likely to refer to the emotional and bonding connections breastfeeding creates (p = 0.0011 and p = 0.0002). Males were more likely to have less knowledge about breastfeeding effects on the breastfeeding person but have more negative attitudes toward formula (p = 0.0298 and p = 0.0543). Younger respondents tended to indicate that formula was better than breast milk (p = 0.0534). Conclusion: We found a mix of positive and negative perceptions of breastfeeding among adolescents and young adults. Understanding how youth view breastfeeding can inform targeted education for this population that includes all genders and can begin before pregnancy.