Twitter Surveillance at the Intersection of the Triangulum.

INTRODUCTION: A holistic public health surveillance approach can help capture the public's tobacco and marijuana-related attitudes and behaviors. Using publicly available data from Twitter, this is one of the first studies to describe key topics of discussions related to each intersection (e-cigarette, combustible tobacco, and marijuana) of the Triangulum framework. AIMS AND METHODS: Twitter posts (n = 999 447) containing marijuana, e-cigarette, and combustible tobacco terms were collected from January 1, 2018 to December 23, 2019. Posts to Twitter with co-occurring mentions of keywords associated with the Triangulum were defined as an intersection (e-cigarettes and combustible tobacco, combustible tobacco and marijuana, e-cigarettes and marijuana, and marijuana, e-cigarettes and combustible tobacco). Text classifiers and unsupervised machine learning were used to identify predominant topics in posts. RESULTS: Product Features and Cartridges were commonly referenced at the intersection of e-cigarette and marijuana-related conversations. Blunts and Cigars and Drugs and Alcohol were commonly referenced at the intersection of combustible tobacco and marijuana-related discussions. Flavors and Health Risks were discussed at the intersection of e-cigarette and combustible-related conversations, while discussions about Illicit products and Health risks were key topics of discussion when e-cigarettes, combustible tobacco, and marijuana were referenced all together in a single post. CONCLUSION: By examining intersections of marijuana and tobacco products, this study offers inputs for designing comprehensive FDA regulations including regulating product features associated with appeal, improving enforcement to curb sales of illicit products, and informing the FDA's product review and standards procedures for tobacco products that can be used with marijuana. IMPLICATIONS: This study is the first to leverage the Triangulum framework and Twitter data to describe key topics of discussions at the intersection of e-cigarette, combustible tobacco, and marijuana. Real-time health communication interventions can identify Twitter users posting in the context of e-cigarettes, combustible tobacco, and marijuana by automated methods and deliver tailored messages. This study also demonstrates the utility of Twitter data for surveillance of complex and evolving health behaviors.

Psychosocial factors and multiple health risk behaviors among early adolescents: a latent profile analysis.

Early adolescence is a pivotal developmental period when multiple health risk behaviors, such as obesity and substance use, are often established. Several psychosocial factors, often considered traits, have been independently associated with these increases, including executive function (EF), mindfulness disposition (MD), perceived stress, distress tolerance (DT), and anhedonia. However, these factors have not been evaluated for their conjoint relationships to determine whether different patterns may signal greater or lesser risk for obesity and substance use, and whether the same patterns relate to obesity and substance use in the same ways (same magnitude of risk). To evaluate these patterns, a latent profile analysis was conducted, resulting in a three-profile model. Profile 1 (8% of sample) was characterized by the lowest levels of EF, MD, DT and highest levels of stress and anhedonia, profile 2 (44%) intermediate levels, and profile 3 (48%) the highest levels of EF, MD, DT and lowest levels of stress and anhedonia. Youth classified to profile 1 reported significantly greater levels of both obesogenic and substance use behaviors relative to other profiles. Findings suggest that adolescents engaging in obesogenic and substance use behaviors may share common profiles of psychosocial risk.

Factors in the perceived stress scale differentially associate with mindfulness disposition and executive function among early adolescents.

OBJECTIVES: The first aim was to test the factor structure and item-loadings of the 10-item Perceived Stress Scale (PSS) when administered to early adolescents. The second aim was to examine associations between PSS factors, mindfulness disposition, and executive function. METHODS: We analyzed data collected from 331 students in grade seven (M age=12.4, 48.9% female, 47.1% White, 26.0% Hispanic, 37.8% received free-lunch) classrooms from two ethnically/racially and socio-economically diverse schools. Participants completed paper and pencil self-report measures of stress (PSS), mindfulness disposition (Mindful Awareness Attention Scale, MAAS), and executive function (Behavior Rating Inventory of Executive Function, BRIEF). We tested the statistical association between two factors of the PSS: perceived coping and perceived distress with MAAS and BRIEF. RESULTS: A two-factor model of the PSS, inclusive of perceived coping and perceived distress, fit the data better than a one-dimensional model. MAAS and BRIEF scores were inversely associated with PSS distress scores (ß = -.62, p <.0001 and ß = -.66, p <.0001, respectively), but not PSS coping scores (ß = -.04, p = .21 and ß = -.02, p = .57, respectively) in a model adjusted for sex, race, and socio-economic status. CONCLUSIONS: Two factors in the PSS emerged among early adolescents and differentially associated with mindfulness disposition and executive function to similar magnitudes. Findings encourage future assessment of perceived stress in a more refined manner across developmental stages in order to examine trajectories of perceived distress versus perceived coping in relation to mindfulness disposition and executive function.

Improving substance use prevention efforts with executive function training.

BACKGROUND: Executive function (EF) includes emotional regulation, planning and decision-making, and behavioral impulse control. Improving youth substance use (SU) prevention by targeting EF poses challenges including determining whether specific sub-domains of EF are more associated with SU than others, whether EF is related to some types of SU more than others, and whether EF programs might be enhanced by inclusion of mindfulness training. METHODS: Data were drawn from two studies from the Pathways to Health project: a randomized controlled trial of 4th-6th graders and a cross-sectional pilot study of the relationship of EF to specific types of SU in a sample of 7th graders. Survey measures included assessment of the EF subdomains of inhibitory control (IC), emotional control, working memory, organization/planning, lifetime SU (tobacco and alcohol use), and mindfulness. Analyses included multivariate and multiple group path analysis. RESULTS: Results suggested that the EF sub-domain of IC was the strongest and most consistent predictor of SU, particularly cigarette and e-cigarette use, though emotional control was predictive of alcohol use among late-elementary school students. In the 7th grade sample, IC was predictive of alcohol, cigarette, and e-cigarette use only among students in the low 75% of mindfulness. CONCLUSIONS: Findings from the present studies suggest that improvements in SU prevention efforts may result from increased curricular emphasis on IC and its application to multiple substance use prevention, and systematically integrating mindfulness with EF skills training. Future research should examine whether EF-SU relationships vary across patterns of SU and types of measures used to assess EF.

Associations among dispositional mindfulness, self-compassion, and executive function proficiency in early adolescents.

The study objective was to examine the effects of two conceptually related constructs, self-compassion and dispositional mindfulness, on executive function (EF) proficiency among early adolescents. Executive function refers to a set of psychological processes governing emotional regulation, organization, and planning. While the benefits of positive psychology appear evident for mental health and wellness, little is known about the etiological relationship between dispositional mindfulness and self-compassion in their associations with EF. Two hundred and ten early adolescents attending middle school (age M=12.5 years; SD=0.5; 21% Hispanic, 18% Mixed/bi-racial, 47% White, and 9% Other/Missing; 37.1% on free lunch program) self-reported levels of dispositional mindfulness (Mindful Attention Awareness Scale; MAAS), self-compassion (Self-Compassion Scale; SCS; self-judgment and self-kindness domains), and EF proficiency (Behavior Rating Inventory of Executive Function; BRIEF-SR). A sequential linear regression stepwise approach was taken entering the independent variables as separate models in the following order: self-kindness, self-judgement, and dispositional mindfulness. All models controlled for participant age and sex. SCS self-kindness was not associated with EF proficiency, but SCS self-judgment (reverse-coded) contributed to the variance in EF (ß=0.40, p<.001). When adding MAAS to the model, MAAS scores were significantly associated with EF (ß=0.64, p<.001) and accounted for the initial variance explained by SCS. When considering the influence of positive psychology constructs on EF proficiency in adolescents, the measure of dispositional mindfulness appears to outweigh that of specific self-compassion domains, when independent of contemplative training.

Shared health characteristics in Hispanic colorectal cancer patients and their primary social support person following primary diagnosis.

PURPOSE: The aim of this paper was to determine individual and shared levels of psychosocial, behavioral, and symptomological health characteristics among Hispanics with recent history of cancer and their primary social support person (PSSP) in the years following diagnosis. PATIENTS AND METHODS: Recruited from a population-based cohort study were 409 Hispanic patients with a previous diagnosis of colorectal cancer. Forty-seven patients identified a PSSP, who assists with medical decision-making and health-related matters, who also participated in the study. Current behavioral (smoking, alcohol use, physical activity, and complementary and alternative medicine use), psychosocial (stress and mindfulness), and physical symptom (fatigue) data were obtained using validated instruments. Analyses tested the individual and shared (between patients and PSSPs) variance in these health measures. RESULTS: The sample was diagnosed on average 3.1 years (standard deviation = 1.7) prior to assessment. PSSPs were mainly spouses/partners (63%) or children (28%) of patients. Among patients, stress was positively associated with being a current smoker (p < 0.01) and with fatigue (r = 0.45, p < 0.001); stress was negatively correlated with mindfulness (r = -0.41, p < 0.001); mindfulness was negatively associated with smoking (odds ratio (OR) = 0.72, p < 0.01) and alcohol consumption (OR = 0.83, p < 0.05); the inverse relationship between mindfulness and fatigue was partially mediated through lower levels of stress (ß = -0.17, p < 0.001). Similar patterns were observed among PSSPs. Patient mindfulness was negatively correlated with PSSP stress (r = -0.45, p < 0.01). Complementary and alternative medicine use showed interdependence between patients and PSSPs for use of herbal remedies (OR = 6.2; p < 0.01) and bodywork (OR = 8.3, p < 0.05). CONCLUSION: Hispanic colorectal cancer patients and their PSSP share a common health milieu in the years following a cancer diagnosis, offering opportunities for advancing interpersonal intervention approaches in cancer care. Copyright © 2015 John Wiley & Sons, Ltd.