Internet, App-Based, and Casino Gambling: Associations Between Modality, Problem Gambling, and Substance Use.

Technology-based gambling prevalence is not well understood since relevant questions are not included in health and disease surveillance studies. The current study sought to estimate the prevalence of internet-based and smartphone app-based gambling, along with casino gambling, in a sample of U.S. young adults and determine if gambling modality was associated with problem gambling symptoms or substance use. The 2022 Rhode Island Young Adult Survey included N = 1,022 students between the ages of 18 to 25 years old who had lived in Rhode Island, with n = 414 lifetime gamblers (40.5%) included in this study. Odds of gambling via a smartphone app and on the internet, respectively, were greater in heterosexual cis-males compared to heterosexual cis-females (OR[95%CI] = 3.14 [1.25,7.91]; OR[95%CI] = 6.30 [2.05,19.3]). Internet gambling amongst employed students was less common than among those who were not a student and not employed (OR[95%CI] = 0.25 [0.06,1.00]). Odds of problem gambling symptoms were higher among those who gambled via a smartphone app (OR[95%CI] = 3.23 [1.21,8.60]). All forms of gambling were associated with alcohol consumption, although the strength of the association was stronger in app and internet gamblers. Casino gamblers were more likely to be high risk marijuana and illicit drug users. The rising availability of app gambling coupled with its social, psychological, and cultural context may presents an alternative pathway to problem gambling. Bans on internet gambling and/or strict guidelines on the frequency of wagers and cash placed per wager, should be considered as viable methods to mitigate associated consequences.

Impact of alcohol home delivery and other methods of obtaining alcohol in young adults.

AIMS: To estimate the use of home alcohol delivery and other methods of obtaining alcohol, rates of ID checking for home alcohol delivery purchases, and associations with alcohol-related consequences. METHODS: Surveillance data from 784 lifetime drinkers participating in the 2022 Rhode Island Young Adult Survey were used. The method of obtaining alcohol (e.g. type of purchase, gifted, theft) was assessed. The Alcohol Use Disorders Identification Test, Brief Young Adults Alcohol Consequences Questionnaire, and a drinking and driving question were used to measure high-risk drinking behaviors, experiencing negative alcohol questions, and history of drinking and driving. Logistic regression models adjusting for sociodemographic variables were used to estimate main effects. RESULTS: About 7.4% of the sample purchased alcohol through a home delivery or to-go purchase; 12.1% of participants who obtained alcohol this way never had their ID checked during the purchase attempt, and 10.2% of these purchases were completed by participants under the legal purchase age. Home delivery/to-go purchases were associated with high-risk drinking. Alcohol theft was associated with high-risk drinking, experiencing negative alcohol consequences, and drinking and driving. CONCLUSIONS: Home alcohol delivery and to-go purchases may provide an opportunity for underage access to alcohol, but their current use as a method of obtaining alcohol is rare. Stronger ID checking policies are needed. Alcohol theft was linked to several negative alcohol outcomes, and home-based preventive interventions should be considered.

Correlates of gambling and gambling problems among Rhode Island young adults: a cross-sectional study.

BACKGROUND: Numerous states in the USA have legalized sports betting due to recent legal decisions by the US Supreme Court. Here, sociodemographic correlates of current gambling and specific gambling activities associated with symptoms of gambling problems were identified. METHODS: Cross-sectional data were obtained from the 2020 Rhode Island Young Adult Survey (RIYAS). RIYAS participants (n = 540) were a convenience sample of 18 to 25 year olds who lived in Rhode Island for at least part of 2020. Data were collected from May to October 2020. Four gambling activities were assessed (i.e. sports betting; betting on races; gaming tables at a casino; poker machines at a casino). Logistic regression models assessed main effects. RESULTS: 22.4% engaged in one or more gambling activities. 11.5% of participants had any gambling problems. Odds of gambling activities were higher among men; Black, Indigenous, People of Color; older young adults; and essential workers. Odds of gambling problems were 2.4 times higher among participants who engaged with sports betting. CONCLUSIONS: Gambling activities are common among several population subgroups, and participation in sports betting may be a risk factor for the development of problem gambling. Comprehensive prevention policies are needed.

Substance Misuse among Sexual and Gender Minorities: The Role of Everyday Discrimination and Identity.

BACKGROUND: Sexual and gender minorities (SGMs) often deal with discrimination which can result in maladaptive coping like substance misuse, yet few studies have examined the association between everyday discrimination and various types of substance misuse among SGMs or whether there is heterogeneity in substance misuse or this relationship by SGM identity. METHODS: Data from 1316 adult SGMs in the United States were recruited from Reddit between February and March 2022. SGM identities (sexual minorities assigned male at birth (AMAB), sexual minorities assigned female at birth (AFAB), gender minorities AMAB, gender minorities AFAB), everyday discrimination, depressive symptoms, marijuana and alcohol misuse, over-the-counter drug misuse, prescription drug misuse, and heroin use were measured, along with demographics. Multivariable logistic regressions examined relationships between everyday discrimination and each substance misuse outcome, adjusting for SGM identity, race/ethnicity, age, income, and depressive symptoms. Interaction terms between everyday discrimination and SGM identities were added to each model to test for moderation. RESULTS: In fully adjusted models, with each additional unit of everyday discrimination score, there were significantly increased odds of substance misuse for all outcomes. SGM by everyday discrimination interactions was significant for alcohol misuse, over-the-counter drug misuse, and heroin use, with the association between everyday discrimination and substance misuse stronger among gender minorities. CONCLUSIONS: Substance misuse varied by SGM identity. Everyday discrimination was associated with substance misuse, but there was heterogeneity in this relationship between SGM identity and substance. Substance use disorder treatment and prevention among SGMs should consider heterogeneity by SGM identity and substance.

The Impact of Police Response on Intimate Partner Violence Victims' Social, Emotional, and Physical Well-Being: Results From the National Crime Victimization Survey.

This study examined whether police involvement in intimate partner violence (IPV) incidents is associated with victims' socio-emotional problems, and emotional and physical toll symptoms for 1 month or longer post-victimization. Data from the 2010-2019 National Crime Victimization Survey suggest that police investigational effort, later contact with the police, suffering severe injury during victimization, and repeated victimization were positively associated with experiencing socio-emotional problems. Later contact with police and severe injury were positively associated with both emotional and physical toll symptoms, while the female sex was positively associated with emotional toll symptoms. The arrest of the abuser was negatively associated with physical toll symptoms. Findings highlight the need for policies and practices in response to IPV that consider the diverse needs of survivors of partner abuse to help reduce IPV-related trauma.

Occupational Injustice and the Right to Play: A Systematic Review of Accessible Playgrounds for Children With Disabilities.

IMPORTANCE: Playgrounds facilitate important opportunities for growth and development during childhood. Despite accessibility regulations, these experiences are not afforded to children with disabilities as a result of environmental and societal barriers. OBJECTIVE: To identify and synthesize existing research on the relationship between key areas of development and accessible play settings for children with disabilities to inform evidence-based interventions and advocacy work. DATA SOURCES: The following databases were searched on January 30, 2021: Academic Search Complete/EBSCO, CINAHL/EBSCO, Education Research Complete/EBSCO, ERIC, OTseeker, and PubMed. STUDY SELECTION AND DATA COLLECTION: This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were peer-reviewed, included children with disabilities ages 3 to 12 in an accessible play setting, and had outcomes related to areas of childhood development. Validated tools were used to determine risk of bias and quality of evidence. FINDINGS: Nine articles met inclusion criteria: 1 Level 3b matched case-control study, 4 Level 4 cross-sectional studies, 3 Level 5 qualitative studies, and 1 mixed-methods study with Levels 4 and 5 evidence. Eight of 9 studies reported that social participation, play participation, and motor skills development were negatively affected despite playgrounds being labeled accessible. CONCLUSIONS AND RELEVANCE: Children with disabilities have decreased engagement in activities that provide opportunities for play, social participation, and motor skills development. Practitioners should address occupational injustice in the playground setting by engaging in program development, policy, and playground design to reduce stigma and increase accessibility. What This Article Adds: By addressing play accessibility, occupational therapy practitioners could significantly reduce instances of play inequity. Creating interdisciplinary teams to address accessible playground design locally would allow occupational therapy practitioners the opportunity to make a lasting impact for the children in their community.

Exposure to Alcohol Marketing and Alcohol-Related Consequences in Young Adults.

BACKGROUND: Exposure to alcohol marketing is positively associated with alcohol consumption. However, few research studies have tested alcohol marketing's effect on other alcohol-related outcomes. Consequently, the current study sought to identify associations between exposure to alcohol marketing and alcohol-related consequences in young adults. Methods: A secondary analysis of the 2020 Rhode Island Young Adult Survey was conducted. Participants were lifetime drinkers (n = 390) who were 18 to 25 years old and lived in Rhode Island for at least part of 2020. Past 30 day exposure to 6 forms of alcohol marketing was assessed. Alcohol consequences were measured using 8 items from the Brief Young Adult Alcohol Consequences Questionnaire. Logistic regression models were adjusted for AUDIT score, age, race/ethnicity, gender, sexual orientation, employment status, and enrollment in school. Results: 92.3% of participants reported past 30 days exposure to any form of alcohol marketing. 43.6% of participants reported experiencing any alcohol-related consequence. Exposure to any form of alcohol marketing was positively associated with experiencing alcohol-related consequences (OR[95% CI] = 3.35 [1.19, 9.44]). After disaggregation by marketing type, only television exposure remained significantly associated with alcohol-related consequences (OR[95% CI] = 1.85 [1.06, 3.24]). Conclusions: Exposure to alcohol advertising on television may be positively associated with experiencing negative alcohol consequences in young adults. If confirmed, the findings may renew interest in strengthening alcohol marketing guidelines and regulations.

Food insecurity and obesity among US young adults: the moderating role of biological sex and the mediating role of diet healthfulness.

OBJECTIVE: To examine the association between food insecurity (FI) and obesity, measured by BMI and waist circumference (WC), among young adults and test the moderating role of biological sex and the mediating role of diet healthfulness (DH). DESIGN: Cross-sectional. SETTING: National Health and Nutrition Examination Survey 2011-2016. PARTICIPANTS: The sample included 4667 young adults aged 18-35 years. RESULTS: Given the interaction terms between sex and FI, biological sex was a moderator between both FI and WC (P = 0·031) and FI and BMI (P = 0·007) among young adults. FI was associated with a 1·16 kg/m2 higher BMI (95 % CI 0·27, 2·05) and a 2·09 cm larger WC (95 % CI 0·05, 4·14) among young female adults, while FI was associated with a 0·26 kg/m2 higher BMI (95 % CI -0·65, 1·16) and a 0·78 cm larger WC (95 % CI -1·13, 2·89) among young male adults. DH mediated the relationships between both FI and BMI (indirect effect ß = 0·14; 95 % CI 0·05, 0·23) and FI and WC (indirect effect ß = 0·31; 95 % CI 0·10, 0·51) among females. Females with FI had poorer DH and thus had higher BMI and larger WC. CONCLUSIONS: Young female adults with FI were more likely to experience overall and abdominal obesity compared with their male counterparts. Results also suggest that females with FI had poorer DH and thus had increased risk of both abdominal and overall obesity.

A missense variant in CREBRF is associated with taller stature in Samoans.

OBJECTIVES: Studies have demonstrated that rs373863828, a missense variant in CREBRF, is associated with a number of anthropometric traits including body mass index (BMI), obesity, percent body fat, hip circumference, and abdominal circumference. Given the biological relationship between height and adiposity, we hypothesized that the effect of this variant on BMI might be due in part to an association of this variant with height. METHODS: We tested the hypothesis that minor allele of rs373863828 is associated with height in a Samoan population in two adult cohorts and in a separate cohort of children (age 5-18 years old) using linear mixed modeling. RESULTS: We found evidence of a strong relationship between rs373863828 and greater mean height in Samoan adults (0.77 cm greater average height for each copy of the minor allele) with the same direction of effect in Samoan children. CONCLUSIONS: These results suggest that the missense variant rs373863828 in CREBRF, first identified through an association with larger BMI, may be related to an underlying biological mechanism affecting overall body size including stature.

Oritavancin (Orbactiv): A New-Generation Lipoglycopeptide for the Treatment Of Acute Bacterial Skin and Skin Structure Infections.

Oritavancin (Orbactiv): a new-generation lipoglycopeptide for the treatment of acute bacterial skin and skin structure infections.

A feasibility study on using smartphones to conduct short-version verbal autopsies in rural China.

BACKGROUND: Currently there are two main sources of mortality data with cause of death assignments in China. Both sources-the Ministry of Health-Vital Registration system and the Chinese Disease Surveillance Point system-present their own challenges. A new approach to cause of death assignment is a smartphone-based shortened version of a verbal autopsy survey. This study evaluates the feasibility and acceptability of this new method conducted by township health care providers (THP) and village doctors (VD) in rural China, where a large proportion of deaths occur in homes and cause of death data are inaccurate or lacking. METHODS: The Population Health Metrics Research Consortium mobile phone-based shortened verbal autopsy questionnaire was made available on an Android system-based application, and cause of death was derived using the Tariff method (Tariff 2.0); we called this set of tools "msVA." msVA was administered to relatives of the deceased by six THPs and six VDs in 24 villages located in six townships of Luquan County, Hebei Province, China. Subsequently, interviews were conducted among 12 interviewers, 12 randomly selected respondents, and five study staff to assess the feasibility and acceptability of using msVA for mortality data collection. RESULTS: Between July 2013 and August 2013, 268 deaths took place in the study villages. Among the 268 deaths, 227 VAs were completed (nine refusals, 31 migrations and one loss of data due to breakdown of the smartphone). The average time for a VA interview was 21.5 ± 3.4 min (20.1 ± 3.5 min for THP and 23.2 ± 4.1 min for VD). Both THPs and VDs could be successful interviewers; the latter needed more training but had more willingness to implement msVA in the future. The interviews revealed that both interviewers and relatives of the deceased found msVA to be feasible, acceptable, and more desirable than traditional methods. The cost of conducting a new VA was $8.87 per death. CONCLUSIONS: Conduction of msVA by VDs in their own villages was feasible and acceptable in rural northern China. Broader implementation of msVA across rural China could potentially improve the coverage and quality of cause of death data, allowing for better national health evaluation and program planning.

Cigarette smoking and emergency care utilization among asthmatic adults in the 2011 Asthma Call-back Survey.

OBJECTIVE: Estimate the association between smoking and emergency care in the past 12 months among asthmatic adults in a nationally representative sample. METHODS: Using the 2011 Asthma Call-Back Survey, the association between smoking status and emergency department (ED) and urgent visits among asthmatic adults (n = 12 339) was assessed through multivariable logistic regression by a cross-sectional study design. Analyses used survey weights for US population-based estimates. Attributable and population attributable risk were calculated to describe the potential benefits of smoking cessation. RESULTS: Adjusting for potential confounders, during the past 12 months former smokers had 1.30 (95% CI: 0.97, 1.74) times the odds and current smokers had 1.46 (95% CI: 1.05, 2.03) times the odds of visiting the ED compared to never smokers. Former smokers had 1.28 (95% CI: 0.99, 1.65) times the odds and current smokers had 1.29 (95% CI: 0.96, 1.73) times the odds of urgent visits compared to never smokers. Among adult asthmatics, an estimated 9% of ED visits and 6% of urgent visits can be attributed to current smoking while 7% of ED visits and 7% of urgent visits can be attributed to former smoking. CONCLUSIONS: Current and former smokers are more likely to need emergency care than never smokers. About 10% of emergency care visits among asthmatics can be attributed to smoking assuming smoking is causally related to emergency care. Long-term effective management of asthma, particularly the prevention and cessation of smoking, could reduce emergency care use and health care costs.

Sexual minority status, illicit drug use, and depressive symptoms.

Youth who are lesbian, gay, bisexual, and who identify with other sexual orientations (LGB+) are at higher risk for illicit drug use and have higher rates of mental illness. The current study examined the prevalence of illicit drug use among LGB+ persons and assessed the moderating effect of mental illness. Cross-sectional data from the 2015, 2017, and 2019 Youth Risk Behavioral Surveillance System were aggregated. The outcome was any reported use of cocaine, inhalants, heroin, methamphetamines, ecstasy, or hallucinogens. The primary exposure was self-reported sexual orientation category (i.e., heterosexual, gay/lesbian, bisexual, not sure). Self-reported depressive symptoms were tested as a moderator. Logistic regression models assessed main and interactive effects. Gay or lesbian students [AOR=1.87 95%CI: 1.45,2.43], bisexual students [AOR=2.07 95%CI: 1.77,2.42], and those unsure of their sexual orientation [AOR=1.99 95%CI: 1.65,2.39] had increased odds of illicit drug use. Odds were higher among LGB+ youth who did not have depressive symptoms (p<0.001). Odds of illicit substance use was significantly greater in youth identifying as gay and lesbian, bisexual, and students who were not sure about their sexual orientation and among LGB+ youth without depressive symptoms. Targeted, but non-stigmatizing, prevention programs are needed.

Digital Alcohol and Cannabis Ads, Consumption Frequency, and Driving Under the Influence.

OBJECTIVE: Little is known about the consequences of substance-related advertising on driving under the influence of alcohol (DUIA) or cannabis (DUIC). This study seeks to estimate associations between substance-related digital advertising exposures and DUIA and DUIC in a sample of young adults. METHOD: The Rhode Island Young Adult Survey 2022 was a cross-sectional web-based survey of 1,022 adults ages 18-25 years. Analyses were conducted among lifetime alcohol users (n = 824) and lifetime cannabis users (n = 471). Prevalence of past-30-day digital ad exposure to alcohol and cannabis was assessed, as well as the prevalence of past-month DUIA and DUIC. Multivariable logistic regressions examined the association between digital ad exposure and substance use among lifetime users, and ad exposure and DUI among current users. RESULTS: In all, 54.4% of participants reported past-30-day exposure to digital alcohol advertising, and 33.5% reported exposure to digital cannabis advertising. Exposure to social media alcohol advertising was associated with higher odds of DUIA after adjustment for sociodemographic variables (odds ratio [95% CI] = 2.14 [1.07, 4.28]) but not after accounting for frequency of use. Odds of DUIC remained significantly higher for those exposed to app-based cannabis advertising after adjusting for sociodemographic variables (odds ratio [95% CI] = 4.36 [1.76, 10.8]) and frequency of use (odds ratio [95% CI] = 3.96 [1.53, 10.2]). CONCLUSIONS: Since social media alcohol ad exposure may be indirectly linked with DUIA, and app-based cannabis ad exposure may be directly linked to frequency of use and DUIC, legislators should consider comprehensive substance-related ad regulations and bans.

Driving after substance use in Rhode Island adolescents: A cross-sectional analysis of surveillance data.

OBJECTIVE: Existing literature on driving under the influence during adolescence is sparse, especially for driving after the use of non-medical prescription drugs (DAP). This study examines the prevalence of driving after use of alcohol (DAA), cannabis (DAC), and DAP, and examines the role of several potential risk and protective factors. METHODS: This was a secondary analysis of the 2022 Rhode Island Study Survey, a cross-sectional survey of middle and high school students. Separate multivariable regressions were conducted for each outcome among lifetime users for each substance, controlling for current substance use, individual-, perceived parental-, and perceived friend-substance use risk perception, age, sexual/gender minority (SGM) status, race, ethnicity, school level, and town poverty level. RESULTS: Among lifetime users of alcohol (n = 3849), cannabis (n = 2289), and non-medical prescription drugs (n = 611), the prevalence of DAA, DAC, and DAP was 4.9, 14.3, and 16.9%, respectively. Current substance use, high individual risk perception, being nonwhite, and being Hispanic were risk factors for DAA while perceiving parent's risk perception as negative and being heterosexual cisgender-female were protective. Current substance use, negative individual risk perception, and being nonwhite were risk factors for DAC while perceiving parent's risk perception as negative and being in high school were protective. Current substance use and older age were risk factors for DAP while perceiving parent's risk perception as negative and perceiving friend's risk perception as negative were protective. CONCLUSIONS: Driving under the influence is a concern among adolescent substance users. Current substance use and perceived parental risk perception as negative are common risks and protective factors, respectively. Findings suggest substance-specific, heterogeneous interventions are needed. For example, interventions focusing on peer perceptions are most relevant for DAP, while shifting personal perceptions of harm are most relevant for DAC.

Self-esteem only goes so far: the moderating effect of social media screen time on self-esteem and depressive symptoms.

This study assessed the independent association of self-esteem and social media screen time on depressive symptoms, as well as the moderating role of social media screen time in the relationship between self-esteem and depressive symptoms. The Mobile Screen Time Project was a cross-sectional, web-based survey conducted from March to May of 2019. 437 U.S. college students were recruited via social networks from two institutions of higher education. Multivariable logistic regression assessed the associations between self-esteem and average daily social media time with depressive symptoms; an interaction effect was explored. Self-esteem had an inverse association (AOR = 0.87, 95% CI: 0.80-0.94) and daily social media time had a significant association with depressive symptoms (AOR = 1.11, 95% CI: 1.02-1.22) after adjusting for sexual and gender status, race/ethnicity, age, social status, and insomnia. We found a significant moderating effect (p = 0.016) of daily social media time. The more time spent on social media, the less protective self-esteem was against depressive symptoms. Those suffering from depressive symptoms or low self-esteem may benefit from reducing their social media use, intentionally exposing themselves to positive content and leveraging peer-to-peer social support through social media to create a sense of belonging.

Depressive and anxiety symptoms in first generation college students.

Objectives: Depression and anxiety contribute to the burden of disease among college students. The current study determined if depressive and anxiety symptoms were more prevalent in first generation students and if social and emotional support moderated this relationship. Methods: Depressive and anxiety symptoms were measured in 432 U.S. college students via an online survey. Single items determined student generation status and available social support. The CES-D10 and GAD-7 measured depression and anxiety, respectively. Structural equation modeling was used to identify significant effects. Results: First generation status was associated with increased cognitive-emotional (p = 0.036) and somatic (p = 0.013) anxiety symptoms, but not depression. High social and emotional support appeared to suppress somatic anxiety symptoms experienced by first generation students (p = 0.004). Conclusions: Greater anxiety symptoms in first generation students may be due to increased general and acculturative stress, although more research is needed. Large national surveys of college students should consider adding a question about first generation status.

Effect of COVID-19 Lockdown on Substance Use Among Middle School and High School Students: A Natural Experiment.

OBJECTIVE: Research on COVID-19's effect on substance use is mixed, and few studies have focused on adolescents. We assessed whether implementation of the COVID-19 lockdown affected substance use and changed perceptions of psychoactive substance availability in middle and high school students. METHODS: We assessed self-reported use and perceived availability of alcohol, tobacco cigarettes, electronic cigarettes, marijuana, synthetic marijuana, nonprescribed prescription drugs, and illicit drugs (heroin, inhalants) among middle and high school respondents aged 11-18 years to the Rhode Island Student Survey (N = 17 751). An administrative pause because of COVID-19 lockdowns allowed us to divide results into surveys completed before (January through March 2020; n = 13 259) and after (November 2020 through May 2021; n = 4492) the lockdown implementation. We determined the effects of the COVID-19 lockdown using logistic regression models, adjusting for age, gender/sexual orientation, middle/high school level, and city/town classification. RESULTS: After the COVID-19 lockdown implementation, the odds of respondents using psychoactive substances decreased, with the largest decreases occurring for prescription drugs (odds ratio [OR] = 0.39; 95% CI, 0.28-0.54) and inhalants (OR = 0.37; 95% CI, 0.26-0.53). The odds of respondents perceiving difficulties in obtaining psychoactive substances significantly increased after lockdown implementation, with the largest increases occurring for prescription drugs (OR = 1.53; 95% CI, 1.39-1.69) and illicit drugs (OR = 1.65; 95% CI, 1.44-1.88). CONCLUSIONS: COVID-19 lockdown implementation was associated with a decreased perception of availability of psychoactive substances and use of psychoactive substances. Decreases in substance use may be because of decreased perceived availability and increased parental support and oversight. Interventions that focus on parental oversight and strengthened policies to disrupt the licit and illicit drug markets are needed.

The Mental Health Consequences of Losing a Loved One to COVID-19.

OBJECTIVES: This study examined the association between loss of a loved one to COVID-19 and depression, anxiety and suicide ideation among Rhode Island young adults. METHODS: The 2022 Rhode Island Young Adult Survey recruited 1,022 young adults aged 18-25 years who lived in Rhode Island. Logistic regression models were used to estimate the odds of depression, anxiety, and suicide ideation due to experiencing a loss due to COVID-19. RESULTS: The odds of anxiety and suicide ideation were 57% (OR[95% CI] = 1.57 [1.13, 2.18]) and 79% (OR[95% CI] = 1.79 [1.19, 2.70]) greater among participants who lost a close friend or family member due to COVID-19. CONCLUSIONS: Losing a loved one to COVID-19 increases the risk of anxiety or suicide ideation among young adults in RI. Prevention measures such as screening for mental health symptoms and incorporating mental health awareness into college, university and workplace settings should be instituted.

Pornography: A Concealed Behavior with Serious Consequences.

OBJECTIVES: The purpose of the current study was to estimate prevalence of pornography use and addiction in Rhode Island young adults, identify sociodemographic disparities, and determine if use and addiction were associated with mental illness. METHODS: Data from n=1022 participants of the Rhode Island Young Adult Survey were used. Pornography use and addiction, depression, anxiety, and suicide ideation were assessed. Multivariable logistic regressions controlled for age, social status, sex, gender, sexual orientation, and race/ethnicity. RESULTS: 54% indicated pornography use; 6.2% met the criteria for addiction. Odds of pornography use were 5 times higher (95%CI=3.18,7.71), and addiction 13.4 times higher (95%CI=5.71,31.4) among heterosexual cis-males. Pornography addiction was associated with increased odds of depression (OR=1.92, 95%CI=1.04,3.49) and suicide ideation (OR=2.34, 95%CI=1.24,4.43). CONCLUSIONS: Pornography use is highly prevalent, and addiction may be associated with mental illness. New screenings, media literacy training, and developing new therapeutic interventions should be considered.