Interpersonal and Community-Level Influences Across the PrEP Cascade Among Young Adult Latinx Men who Have Sex with Men Living in a US-Mexico Border Region: A Qualitative Study.

Latinx men who have sex with men (MSM) are an at-risk population for new HIV diagnoses. Pre-exposure prophylaxis (PrEP) is a suite of biomedical approaches to prevent HIV infection. Latinx MSM are less likely to take PrEP compared to non-Latinx White MSM. This qualitative study identified interpersonal- and community-level barriers and facilitators of PrEP among young adult Latinx MSM. Using stratified purposeful sampling, 27 Latinx men, ages 19-29 years and living in a US-Mexico border region, completed self-report demographic surveys and participated in semi-structured in-depth interviews assessing barriers and facilitators to PrEP. Directed content analysis was used to identify both a priori and emerging themes. Most participants reported that other people, including peers, friends, partners, and health care providers were both supportive and discouraging of PrEP use. Participants' intersectional identities as members of both Latinx and LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer) communities both hindered and facilitated PrEP use.

Rethinking peer influence and risk taking: A strengths-based approach to adolescence in a new era.

The ways that psychopathology manifests in adolescence have shifted dramatically over the past twenty-five years, with rates of many externalizing behaviors declining substantially while rates of anxiety and depressive disorders have skyrocketed. This paper argues that understanding these changes requires rethinking the field's historically somewhat negative views of intense peer connections, peer influences, and adolescent risk-taking behavior. It is argued that intense peer connections are critical to development, and that peer influence and risk taking have important, often overlooked, adaptive components. The shift in observed manifestations of adolescent psychopathology over this period can be viewed at least partly in terms of a shift away from strong peer connections and toward greater risk aversion. Implications for research and intervention based on a focus on the adaptive aspects of peer influences and risk taking are discussed.

Is it all due to peers? The influence of peers on children's snack purchase decisions.

The objective of this study is to examine whether the presence of peers has an impact on children's snack purchasing decisions. In particular, the research analyzes whether the company of a classmate or friend influences children's brand awareness and price perception, and how these factors affect their snack purchases. An incentive-based discrete choice experiment was conducted with snacks varying in price, brand, and healthiness, using the presence or absence of peers as a between-subject treatment. The data was analyzed using mixed logit models and a multinomial logit model. A total of 128 primary school children aged 8 to 10 years were included in the final data analysis. The findings show that the presence of peers strongly influences children's snack purchase decisions, particularly with respect to product type and price. The results highlight that children tend to conform to the group's decision, highlighting that social influence plays a crucial role in shaping children's decision-making processes. This study is the first to investigate the influence of peers on children's actual purchase decisions, thereby extending previous knowledge of the impact of peers on primary school children to the market domain.

YouTube vloggers set the stage: How public (non)compliance with COVID-19 regulations affects adolescents.

INTRODUCTION: YouTube vloggers may be important socialization figures, yet their influence on adolescents' health-related behaviors and cognitions is largely untested. In this two-study mixed-method project, we first assessed the extent of (non)compliance to COVID-19 regulations by vloggers on YouTube and how viewers reacted to this. Second, we experimentally assessed the effects of vlogger behavior paired with viewer evaluations on adolescents' COVID-19-related attitudes, intentions, and behavior. METHODS: For Study 1, we coded 240 vlogs of eight popular Dutch vloggers on YouTube recorded in the period of February 2020-March 2021. For our 2 × 2 between-subjects experiment in Study 2, Dutch adolescents (N = 285, Mage = 12.99, SD = 1.02, 41.8% girls) were randomly assigned to conditions in which they saw vlogs showing either compliance or noncompliance to COVID-19 regulations, and to conditions in which they saw either supportive or dismissive comments under these vlogs. RESULTS: Study 1: Vloggers' noncompliance with COVID-19 regulations was not uncommon and received relatively more viewer support than compliance, suggesting that portrayed noncompliance may be potentially influential. Study 2: Adolescents were more worried about COVID-19 after they watched a compliant (vs. noncompliant) vlogger. Also, vlogger noncompliance decreased adolescents' perceived importance of COVID-19 regulations and rule-setting for adolescents who identified strongly with the vloggers they watched. CONCLUSIONS: Vloggers' (non)compliance affects adolescents' COVID-19-related worrying, and attitudes and behavior of adolescents who identify with vloggers strongly. This seems concerning given the sometimes harmful and risky behaviors vloggers portray online but could potentially also be employed to encourage healthy behaviors.

Applying Social Network Theory to Vaping in High School: Implications for Person-Centered Intervention.

BACKGROUND: Peer influence on risky behavior is particularly potent in adolescence and varies by gender. Smoking prevention programs focused on peer-group leaders have shown great promise, and a social influence model has proven effective in understanding adult smoking networks but has not been applied to adolescent vaping until 2023. This work aims to apply a social influence model to analyze vaping by gender in a high school network. METHODS: A high school's student body was emailed an online survey asking for gender, age, grade level, vape status, and the names of three friends. Custom Java and MATLAB scripts were written to create a directed graph, compute centrality measures, and perform Fisher's exact tests to compare centrality measures by demographic variables and vape status. RESULTS: Of 192 students in the school, 102 students responded. Students who vape were in closer-knit friend groups than students who do not vape (p < .05). Compared to males who vape, females who vape had more social ties to other students who vape, exhibiting greater homophily (p < .01). Compared to females who do not vape, females who vape were in closer-knit friend groups (p < .05) and had more ties to other students who vape (p < .01). CONCLUSION: Differences in vaping by social connectedness and gender necessitate school and state policies incorporating the social aspect of vaping in public health initiatives. Large-scale research should determine if trends can be generalized across student bodies, and more granular studies should investigate differences in motivations and social influence by demographic variables to individualize cessation strategies.

Investigating psychological distress and peer influence in the longitudinal path linking food insecurity to adolescent substance use: a nationwide low-income cohort study.

Food insecurity (FI), defined as the limited or uncertain availability of nutritionally adequate and safe foods, remains a major life concern among many poor subpopulations. Few investigations have been made into the mechanism underlying its impact on adolescent substance use. This study aimed to examine the longitudinal relationship between FI and cigarette and alcohol use among economically disadvantaged adolescents and then explore the role of psychological distress and peer substance use in the aforementioned association. Data of 1,243 adolescents (Mage = 13.3 years; 645 males) were obtained from a nationwide cohort study on Taiwanese adolescents from low-income families. Multiple hierarchical regression analyses based on generalized linear mixed-effects models with binomial distribution found that FI was consistently associated with cigarette smoking (ß = 0.458, p < 0.001) but not alcohol drinking (ß = 0.142, p = 0.143) when both psychological distress and peer substance use were adjusted. In the moderated mediation analysis based on bootstrap methods, we observed that psychological distress mediated the association between food insecurity and alcohol drinking (ß = 0.036, 95% CI = 0.015-0.063) but not cigarette smoking (ß = 0.018, 95% CI =-0.001-0.037). Furthermore, the indirect effects varied by peer drinking status (index of moderated mediation = 0.04, 95% CI 0.015-0.072). Clinical and public health attention should be given to evaluating food-insecure adolescents' psychological well-being and peer influence when counseling their substance use issues.

Peer Influences on (Dis)Engagement in Early Adolescence: the Role of Friendship, Social Status, and Academic Status.

Academic engagement in adolescence is shaped by influences from the peer environment, yet the types of peers impacting engagement remain unclear. This study explores the roles of friends, popular students, and intelligent students in shaping peers' behavioral and emotional (dis)engagement. Data were analyzed from 3409 Flemish eighth-grade students (Mage = 13.48 years, SD = 0.46, 50.09% female), utilizing self-reports and peer nominations to measure (dis)engagement and map friendship, popularity, and intelligence networks in the fall and spring. Longitudinal network analysis revealed that, while accounting for selection and network structure, friends influenced all dimensions of engagement. Popular students influenced emotional disengagement, and intelligent students impacted emotional engagement. These findings underscore the intricate nature of peer dynamics, highlighting the need for a multidimensional approach to studying peer influences on engagement.

The Social Dynamics of Fun: Can Fun Youth Bring Peers Together and Positively Influence Their Friends?

There is a critical gap in our understanding of how peer relationships contribute to positive youth development. To address this gap the current study uses longitudinal social network data to examine if fun youth were socially desirable, inclusive of peers, and positive agents of social influence during the transition to adolescence. Participants were 210 students (47% female; Mage = 11.55 years at the outset) from 8 classes in 3 schools in a small Lithuanian city. Each child received a fun score consisting of nominations from classmates as "someone who is fun to be around". Participants also nominated up to five classmates as friends. Fun students received more friendship nominations than their peers and they maintained higher levels of social desirability over time. Fun youth appeared to be inclusive of their peers in that fun youth did not appear to have preferences to befriend only those like themselves. The friends of fun youth were positively influenced such that they were perceived to be more fun over time. The findings suggests that fun youth may promote positive social change within peer groups.

Do Adolescents Adopt the Prosocial Behaviors of the Classmates They Like? A Social Network Analysis on Prosocial Contagion.

While the influence of high-status peers on maladaptive behaviors is well-documented, socialization processes of prosocial behavior through high-status peers remain understudied. This study examined whether adolescents' prosocial behavior was influenced by the prosocial behavior of the peers they liked and whether this effect was stronger when the peers they liked were also well-liked by their classmates. Three waves of data, six months apart, were collected among Chilean early adolescents who completed peer nominations and ratings at Time 1 (n = 294, Mage = 13.29, SD = 0.62; 55.1% male), Time 2 (n = 282), and Time 3 (n = 275). Longitudinal social network analyses showed that adolescents adopted the prosocial behavior of the classmates they liked - especially if these classmates were well-liked by peers in general. In addition, adolescents low in likeability were more susceptible to this influence than adolescents high in likeability. The influence resulted both in increases and - especially - decreases in prosocial behavior, depending on the level of prosociality of the liked peer. Findings suggest that likeability represents an important aspect of peer status that may be crucial for understanding the significance of peer influence with respect to prosocial behaviors during adolescence. Pre-Registration: https://osf.io/u4pxm .

The Social Processes of Excessive Online Gaming Homophily: Peer Selection or Influence?

Adolescents who befriend online game using peers may be at risk for initiated and continued excessive game use (online gaming use homophily). The present article examined how adolescents' severity of online gaming use related to their friends' online gaming behavior bi-directionally across a semester (peer selection or peer influence effect). Students from two universities completed three waves of online surveys within four and a half months (N = 3079; 33.6% female; Mage = 19.16; SD = 0.97). Random-intercepts, Cross-Lagged Panel Model (RI-CLPM) analyses revealed that peer selection and peer influence both promote online gaming use homophily in adolescents' friendship groups. Furthermore, participants were more likely to form new friendships with peers exhibiting similar online gaming behavior as their behavior, subsequently reinforcing their online gaming use behaviors within these relationships. These social processes may exhibit a time lag among girls, which needs to be confirmed through longer-term follow-up. In general, findings suggest that effective prevention programs targeting excessive online gaming should not only focus on promoting social influence skills but also consider the structure of peer environments.

Effect of peer education on knowledge and frequency of smoking among high school students in disadvantaged districts: A quasi-experimental study.

OBJECTIVE: To evaluate the effectiveness of peer education on changing the knowledge and frequency of smoking of high school students. METHODS: The quasi-experimental study was conducted at the Vocational and Technical Anatolian High School, Turkey, during the 2021-22 academic year, and comprised students of either gender from the 9th to the 11th grade. After baseline assessment, training that blended peer education with the photovoice technique was administered between March 2021 and January 2022. Post-intervention assessment included smoking frequency, cigarette exposure and health literacy. Data was analysed using R version 4.0.5. RESULTS: Of the 465 students available, 395(84.95%) were part of the baseline assessment, while 434(93.3%) took the postintervention assessment. At the baseline, 365(93.8%) participants were males and 24(6.2%) were femaes. The overall median age was 15 years (interquartile range: 15-16 years). Post-training, smoking rate and indoor exposure to cigarette smoke among the students were statistically lower than the baseline values (p<0.05). The mean health literacy score postintervention was significantly higher than the baseline score (p<0.05). CONCLUSIONS: Photovoice combined with peer education seemed beneficial in terms of positive effect on smoking behaviour among youths.

Effectiveness of Peer-Based and Conventional Video Education in Reducing Perioperative Depression and Anxiety Among Coronary Artery Bypass Grafting Patients: A Randomized Controlled Trial.

PURPOSE: Depression and anxiety are common comorbidities in patients undergoing coronary artery bypass grafting (CABG), with potential adverse effects on surgical outcomes. Effective interventions to reduce depression and anxiety in these patients are therefore warranted. This study investigated the effectiveness of peer-based video education compared to conventional video education in reducing perioperative depression and anxiety in CABG patients. DESIGN: A three-arm, parallel, randomized, controlled trial design was employed. METHODS: A total of 114 participants were randomly assigned to 1 of 3 groups (n = 38 per group): standard education (control), conventional video education, and peer-based video education. State anxiety levels were measured using the Spielberger State Anxiety Questionnaire at 1 day before surgery (baseline), 1 hour before surgery, and 4 weeks after surgery. Depression levels were measured using the Beck Depression Inventory Short-Form at baseline and 4 weeks after surgery. Statistical analyses, including χ2, Fisher's exact test, one-way analysis of variance, and repeated-measures analysis of variance, were applied to analyze the collected data. FINDINGS: Both peer-based and conventional video education groups demonstrated lower preoperative anxiety levels compared to the control group. However, only the peer-based video education group exhibited a statistically significant difference (P < .05). Four weeks after surgery, anxiety and depression levels decreased in all participants compared to baseline, with no statistically significant differences among the three groups. CONCLUSIONS: Our findings suggest that peer-based video education is more effective in controlling preoperative anxiety in patients undergoing CABG than conventional video education and standard education. Moreover, video-based education, whether conventional or peer-based, appears to be as effective as standard education in reducing anxiety and depression 4 weeks after CABG surgery. Further research is warranted to investigate the influence of content and presentation methods on patient outcomes and explore the potential long-term benefits of video-based education in promoting patient care.

Resistance to peer influence, smoking friends, cigarette and betel nut use, and gender among Pacific Islander youth.

The present study examined the relationships between resistance to peer influence and cigarette and betel nut use, as well as the potential mediating role of friends who use cigarettes and betel nut, among boys and girls in Guam. This study included 673 ethnically diverse students (49% female; M age = 12.7, SD = 0.89) from eight public middle schools. The mediation analysis demonstrated that higher resistance to peer influence for both cigarette and betel nut use was associated with lower cigarette and betel nut use directly and that this association was mediated by friends who used cigarette and betel nut products. That is, low resistance to peer influence for both cigarette and betel nut use was associated with a greater number of friends who smoke and use betel nut, which was linked with more cigarette and betel nut use. The moderated mediation analysis revealed no gender difference in the indirect effect (i.e., the mediation of friends who used cigarettes and betel nut). These findings can be used to inform the design and implementation of intervention and prevention programs for at-risk youth, regardless of gender, who are vulnerable to substance use in the Pacific.

Task-independent neural bases of peer presence effect on cognition in children and adults.

There is ample behavioral evidence that others' mere presence can affect any behavior in human and non-human animals, generally facilitating the expression of mastered responses while impairing the acquisition of novel ones. Much less is known about i) how the brain orchestrates the modulation of such a wide array of behaviors by others' presence and ii) when these neural underpinnings mature during development. To address these issues, fMRI data were collected in children and adults alternately observed and unobserved by a familiar peer. Subjects performed a numerosity comparison task and a phonological comparison task. While the former involves number-processing brain areas, the latter involves language-processing areas. Consistent with previous behavioral findings, adults' and children's performance improved in both tasks when observed by a peer. Across all participants, task-specific brain regions showed no reliable change in activity under peer observation. Rather, we found task-independent changes in domain-general brain regions typically involved in mentalizing, reward, and attention. Bayesian analyses singled out the attention network as the exception to the close child-adult resemblance of peer observation neural substrates. These findings suggest that i) social facilitation of some human education-related skills is primarily orchestrated by domain-general brain networks, rather than by task-selective substrates, and ii) apart from attention, peer presence neural processing is largely mature in children.

Neural similarity in nucleus accumbens during decision-making for the self and a best friend: Links to adolescents' self-reported susceptibility to peer influence and risk taking.

Adolescence is marked by increased peer influence on risk taking; however, recent literature suggests enormous individual variation in peer influence susceptibility to risk-taking behaviors. The current study uses representation similarity analysis to test whether neural similarity between decision-making for self and peers (i.e., best friends) in a risky context is associated with individual differences in self-reported peer influence susceptibility and risky behaviors in adolescents. Adolescent participants (N = 166, Mage = 12.89) completed a neuroimaging task in which they made risky decisions to receive rewards for themselves, their best friend, and their parents. Adolescent participants self-reported peer influence susceptibility and engagement in risk-taking behaviors. We found that adolescents with greater similarity in nucleus accumbens (NACC) response patterns between the self and their best friend reported greater susceptibility to peer influence and increased risk-taking behaviors. However, neural similarity in ventromedial prefrontal cortex (vmPFC) was not significantly associated with adolescents' peer influence susceptibility and risk-taking behaviors. Further, when examining neural similarity between adolescents' self and their parent in the NACC and vmPFC, we did not find links to peer influence susceptibility and risk-taking behaviors. Together, our results suggest that greater similarity for self and friend in the NACC is associated with individual differences in adolescents' peer influence susceptibility and risk-taking behaviors.

Adding Up Peer Beliefs: Experimental and Field Evidence on the Effect of Peer Influence on Math Performance.

We studied how gendered beliefs about intellectual abilities transmit through peers and differentially impact girls' academic performance relative to boys'. Study 1 (N = 8,029; 208 classrooms) exploited randomly assigned variation in the proportion of a child's middle school classmates who believe that boys are innately better than girls at learning math. An increase in exposure to peers who report this belief generated losses for girls and gains for boys in math performance. This peer exposure also increased children's likelihood of believing the gender-math stereotype, increased the perceived difficulty of math, and reduced aspirations among girls. Study 2 (N = 547) provided proof of concept that activating a gender-math performance gap among college students reduces women's math performance but not verbal performance. Men's task performance was not affected. Our findings highlight how the prevalence of stereotypical beliefs in one's ambient and peer environment, even when readily contradictable, can shape children's beliefs and academic ability.

The Influence of Peers, Romantic Partners, and Families on Emerging Adults' Sexual Behavior.

Prior research acknowledges that families and peers influence adolescents' sexual behaviors. Far fewer studies have explored whether and how families and peers influence sexual behaviors among emerging adults, especially among those in committed intimate partnerships, while also accounting for dynamics specific to the intimate relationship and respondents' sociodemographic characteristics. Even less is known about whether and how previous romantic relationship experiences might influence emerging adults' future sexual behavior both within and outside the confines of committed intimate partnerships. Drawing on longitudinal data from the Toledo Adolescent Relationships Study, we examined how emerging adults' family backgrounds, peers' sexual attitudes and behaviors, and past and current relationship experiences influenced their engagement in casual sex and sexual non-exclusivity. We found that each of these contexts was significant predictors of emerging adults' casual sex, and that both peers and romantic relationship experiences significantly influenced the likelihood of engaging in sexually non-exclusive behaviors among those in committed dating, cohabiting, and marital partnerships. We discuss potential theoretical mechanisms linking these relationships and provide suggestions for future research.

Mutual pathways between peer and own e-cigarette use among youth in the United States: a cross-lagged model.

BACKGROUND: Electronic cigarettes (e-cigarettes) have become the most common tobacco product used among adolescents in the United States (US). Prior research has shown that peer e-cigarette use was associated with increased risk of own e-cigarette use. Nonetheless, there is little empirical evidence on the directionality of these associations-if peer use predicts own use (peer influence) or if own use predicts peer use (peer selection). METHODS: We estimated the association between peer and own e-cigarette use among US adolescents 12-17 years of age. We used the cross-lagged model to investigate the mutual relationship between peer and own e-cigarette use over time using data from a population-based longitudinal study, Population Assessment of Tobacco and Health. Stratified analyses were conducted by sex and age subgroups. RESULTS: Results from a cross-lagged model showed a statistically significant predicting path leading from peer use at the prior time point to own use at the following time point, but not vice versa. CONCLUSIONS: We found strong relationships between peer e-cigarette use and own e-cigarette use at within-individual levels. Peer influence paths were more robust than peer selection paths for e-cigarette use. Incorporating peers into prevention and intervention programs may help enhance these strategies.

Perceptions of friendship, peers and influence on adolescent smoking according to tobacco control context: a systematic review and meta-ethnography of qualitative research.

BACKGROUND: A relationship between smoking and interpersonal influences has been well established within the literature. There have been cultural shifts in denormalisation and a reduction in tobacco smoking in many countries. Hence there is a need to understand social influences on adolescents' smoking across smoking normalisation contexts. METHODS: The search was conducted in July 2019 and updated in March 2022 within 11 databases and secondary sources. Search terms included schools, adolescents, smoking, peers, social norms and qualitative research. Screening was conducted by two researchers independently and in duplicate. Study quality was assessed using the eight-item Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-centre) tool for the appraisal of qualitative studies. Results were synthesised using a meta-narrative lens for meta-ethnography and compared across smoking normalisation contexts. RESULTS: Forty one studies were included and five themes were developed, mapping onto the socio ecological model. The social processes by which adolescents take up smoking differed according to a mixture of school type, peer group structure and the smoking culture within the school, as well as the wider cultural context. Data available from smoking denormalised contexts, described changes in social interactions around smoking to cope with its stigmatisation. This was manifested through i) direct peer influence, whereby subtle techniques were employed, ii) group belonging whereby smoking was less likely to be seen as a key determinant of group membership and smoking was less commonly reported to be used as a social tool, and iii) popularity and identity construction, whereby smoking was perceived more negatively in a denormalised context, compared with a normalised context. CONCLUSIONS: This meta-ethnography is the first study to demonstrate, drawing on international data, that peer processes in adolescent smoking may undergo changes as smoking norms within society change. Future research should focus on understanding differences across socioeconomic contexts, to inform the adaptation of interventions.

Valuation of peers' safe choices is associated with substance-naïveté in adolescents.

Social influences on decision-making are particularly pronounced during adolescence and have both protective and detrimental effects. To evaluate how responsiveness to social signals may be linked to substance use in adolescents, we used functional neuroimaging and a gambling task in which adolescents who have and have not used substances (substance-exposed and substance-naïve, respectively) made choices alone and after observing peers' decisions. Using quantitative model-based analyses, we identify behavioral and neural evidence that observing others' safe choices increases the subjective value and selection of safe options for substance-naïve relative to substance-exposed adolescents. Moreover, the effects of observing others' risky choices do not vary by substance exposure. These results provide neurobehavioral evidence for a role of positive peers (here, those who make safer choices) in guiding adolescent real-world risky decision-making.