Leveraging Digital Media to Promote Youth Mental Health: Flipping the Script on Social Media-Related Risk.

Purpose of Review: Despite growing public concern about the negative impact of digital media for mental health problems, there are key ways in which digital media can be leveraged to prevent such outcomes. This article reviews research exploring the ways that digital media, particularly social media, can be used to prevent negative mental health outcomes and promote youth mental health and well-being. Recent findings: Research indicates that media can be protective against mental health problems and promote mental health by enabling social support and destigmatizing mental illness, especially for youth with limited resources. Media also can be leveraged to identify those at risk, to educate, provide resources, and promote well-being, and to track symptoms and intervene to prevent or mitigate negative mental health outcomes. There is limited research on interventions designed to reduce the negative effects of digital media on mental health, especially those that harness media itself, a critical area of future research. Summary: This article provides a summary of the current evidence on this topic, highlights key directions for future research, and provides evidence-based recommendations for adolescents, families, educators, clinicians, industry, and policy-makers to prevent mental health problems related to media.

Refining CycleGAN with attention mechanisms and age-Aware training for realistic Deepfakes.

In the evolving landscape of deep learning technologies, the emergence of Deepfakes and synthetic media is becoming increasingly prominent within digital media production. This research addresses the limitations inherent in existing face image generation algorithms based on Generative Adversarial Networks (GAN), particularly the challenges of domain irrelevancy and inadequate facial detail representation. The study introduces an enhanced face image generation algorithm, aiming to refine the CycleGAN framework. The enhancement involves a two-fold strategy: firstly, the generator's architecture is refined through the integration of an attention mechanism and adaptive residual blocks, enabling the extraction of more nuanced facial features. Secondly, the discriminator's accuracy in distinguishing real from synthetic images is improved by incorporating a relative loss concept into the loss function. Additionally, this study presents a novel model training approach that incorporates age constraints, thereby mitigating the effects of age variations on the synthesized images. The effectiveness of the proposed algorithm is empirically validated through comparative analysis with existing methodologies, utilizing the CelebA dataset. The results demonstrate that the proposed algorithm significantly enhances the realism of generated face images, outperforming current methods in terms of Peak Signal-to-Noise Ratio (PSNR) and Structural Similarity Index Measure (SSIM), while also achieving notable improvements in subjective visual quality. The implementation of this advanced method is anticipated to substantially elevate the efficiency and quality of digital media production, contributing positively to the broader field of digital media creation.

Preference for digital media use, biobehavioral attention bias, and anxiety symptoms in adolescents.

Adolescence is a critical developmental period of biological and social change during which 1 in 3 youth experience significant anxiety symptoms. The social-emotional lives of the majority of adolescents are largely conducted via digital media use (DMU; e.g., social media, text messaging). Yet the past decade of research on DMU and anxiety has yielded mixed results (e.g., Keles et al., 2020 review), leaving the complex role that DMU might play in the emergence and maintenance of anxiety poorly understood. A key step forward is to leverage psychophysiology to identify individual differences in cognitive and emotional processes that confer vulnerability to potential negative effects of DMU. Further, given the ubiquity of DMU, a greater focus is needed on measurements that move beyond sheer frequency to capture DMU in comparison to face-to-face (FTF) social interactions. This study examined attention bias (AB), characterized by selective and exaggerated attention toward or away from threat, as a moderator of the link between DMU and anxiety in adolescents (N = 75; 42 female) aged 12-14 years (M = 13.28, SD = 0.87). AB was indexed during a dot probe task using reaction time metrics (i.e., trial-level bias) and via ERPs capturing attentional selection and discrimination (N170) and cognitive control (N2) to threat compared to neutral faces. AB moderated associations between DMU and anxiety. A greater preference to use DMU vs FTF predicted greater anxiety among those with a greater behavioral bias away from threat, blunted N170, and blunted N2 in the presence of threat. Future research should examine potential causal and bidirectional links between DMU and anxiety and explore whether preferences for technology-mediated interactions and individual differences in threat processing increase risk.

Associations between shared book reading, daily screen time and infants' vocabulary size.

In the current pre-registered study, we examined the associations between shared book reading, daily screen time, and vocabulary size in 1,442 12- and 24-month-old Norwegian infants. Our results demonstrate a positive association between shared reading and vocabulary in both age groups, and a negative association between screen time and vocabulary in 24-month-olds. Exploratory analyses revealed that the positive relationship between shared reading and expressive vocabulary in 12-month-olds was stronger in lower SES groups, suggesting that shared reading may act as a compensatory mechanism attenuating potentially impoverished learning environment and parent-infant interactions in low-SES families.

Perceptions of Food Marketing and Media Use among Canadian Teenagers: A Cross-Sectional Survey.

Despite the prevalence of digital food marketing to teenagers and its potential impact on food preferences and consumption, little is known about the specific food advertisements teenagers see in Canada and how they perceive them. Further, few studies consult teenagers directly about their perceptions of teen-specific food marketing content. To shed light on such issues, this study examines perceptions of food marketing and self-reported media use of Canadian teenagers via an online survey. Four hundred and sixty-four teenagers (ages 13-17) participated. Overall, teenagers identified Instagram and TikTok as the most popular social media platforms. The top food or beverage brands that teens felt specifically targeted them were McDonald's, Starbucks, Coca-Cola and Tim Hortons, while Instagram was deemed the most important media platform when it comes to teen-targeted food marketing. Teens deemed "celebrity" and "visual style" as the most important (food and beverage) advertising techniques when it comes to persuading teenagers to buy. Overall, the study provides insights into teen media use and brand preference, including the brands teens feel target them most directly and what they consider to be salient in terms of the food advertising they see. It also provides valuable details for researchers seeking to further identify and measure elements of teen-targeted food marketing.

Developing language in a digital world.

Young children's screen time is increasing, raising concerns about its negative impact on language development, particularly vocabulary. However, digital media is used in a variety of ways, which likely differentially impact language development. Instead of asking 'how much' screen time, the focus should be on how digital media is used.

Digital Media Usage Behavior and Its Impact on the Physician-Patient Relationship: Cross-Sectional Study Among Individuals Affected by Psoriasis in Germany.

BACKGROUND: Psoriasis is a chronic skin disorder with a high burden of disease. People affected with psoriasis increasingly use the internet for health-related reasons, especially those with younger age, higher education, and higher disease severity. Despite advantages such as enhancing the individuals' knowledge with the use of digital media for health-related issues, disadvantages were also present such as quality control, and variability in the individuals' health information literacy. While patients with psoriasis within medical settings generally trust physicians over digital media, they commonly withhold their web-based research findings from health care providers. OBJECTIVE: The study aims to (1) identify further factors associated with regular psoriasis-related internet use, (2) rank specific digital media platforms used, and (3) examine digital media within the physician-patient relationship among individuals with and without dermatological treatment. METHODS: A cross-sectional, questionnaire-based study was conducted among individuals with self-reported psoriasis in Germany between September 2021 and February 2022. Participants were recruited via digital media platforms and in person at a University Hospital Department of Dermatology in southern Germany. The questionnaire asked about demographic and medical information, individual psoriasis-related digital media use, and the impact of digital media on the physician-patient relationship. Data were analyzed descriptively, and logistic regression models were performed to assess the factors associated with regular psoriasis-related internet use. RESULTS: Among 321 individuals with a median age of 53 (IQR 41-61) years (nonnormally distributed; females: 195/321), female sex, shorter disease duration, moderate mental burden of disease, and good self-assessed psoriasis-related knowledge were associated with regular psoriasis-related internet use. Of the 188 participants with a mean age of 51.2 (SD 13.9) years (normally distributed) who used digital media 106 (56.4%) usually searched for information on psoriasis-based websites and 98 (52.1%) on search engines, primarily for obtaining information about the disease and therapy options, while social media were less frequently used (49/188, 26.1%). Nearly two-thirds of internet users (125/188) claimed that their physicians did not recommend digital media platforms. About 44% (82/188) of the individuals reported to seek for additional information due to the insufficient information provided by their physician. CONCLUSIONS: This study revealed the importance of digital media in the context of psoriasis, especially among women, individuals with shorter disease duration, and moderate mental disease severity. The lack of physicians' digital media recommendations despite their patients' desire to receive such and being more involved in health-related decisions seems to be a shortcoming within the physician-patient relationships. Physicians should guide their patients on digital media by recommending platforms with evidence-based information, thereby potentially creating an adequate framework for shared decision-making. Future research should focus on strategies to prevent the spread of false information on digital media and address the needs of patients and physicians to enhance health-related digital media offerings.

Problematic Internet Use and Technology Interactions Among Transgender Adolescents.

Purpose: To compare risk of problematic internet use (PIU) and importance of digital media interactions for transgender and cisgender adolescents. Methods: A nationally representative group of adolescents took an online survey that included a measure of PIU (Problematic and Risky Internet Use Screening Scale-3 [PRIUSS-3]) and technology interactions (Adolescent Digital Technology Interactions and Importance scale). We compared mean scores for these scales and their subscales and rates of positive screens for PIU for transgender and cisgender adolescents. Results: Of 4575 adolescents participating, 53 (1.2%) were transgender, nonbinary, and gender-diverse (TNG) adolescents. TNG adolescents had higher PRIUSS-3 scores and higher mean scores for importance of technology to explore identity/go outside their offline environment. Conclusions: TNG adolescents report higher PIU risk, which may relate to differences in technology importance for this group.

Enhancing Digital Health Engagement in Chronic Disease: The Role of Doctor-Patient Communication and Media Use in Acceptance of Digital Health Care Among End-Stage Kidney Disease Patients.

This study examines digital health challenges among end-stage kidney disease (ESKD) patients, a population characterized by older age, lower socioeconomic status, and limited access to modern technologies. Drawing from the Mere Exposure Effect, the Technology Acceptance Model, and insights from doctor-patient communication literature, our study implemented a month-long intervention across three distinct groups. The Digital Media Exposure Group watched doctor-recommended videos on YouTube using a tablet PC twice weekly for four weeks. The Digital Media Exposure with Doctor-Patient Communication Group engaged in physician-led discussions about the viewed content during their medical visits in addition to the activities in the first group. The Control Group received printed medical information that mirrored the content of the videos. Participants in this study, all of whom were diagnosed with ESKD, were recruited from a university hospital in South Korea (n = 88, Mage = 64.8). Their perceptions, attitudes, and behavioral intentions regarding digital health care were measured and compared between groups. The results unveiled significant group differences [Wilk's Λ = 0.829, F(8, 164) = 2.02, p = 0.047, partial η2 = 0.090], with variations in attitudes, perceived ease of use, and intentions among groups, and effect sizes ranging from 0.069 to 0.096.These findings underscore the importance of tailored interventions to address digital health disparities, particularly among underserved demographic groups. Strategies that prioritize user-friendly interfaces and clear communication between doctors and patients are advocated to promote digital health engagement, ensuring equitable access and improved outcomes for patients with chronic disease.

A Multidimensional Approach for Evaluating Reality in Social Media: Mixed Methods Study.

BACKGROUND: Misinformation is a threat to public health. The effective countering of misinformation may require moving beyond the binary classification of fake versus fact to capture the range of schemas that users employ to evaluate social media content. A more comprehensive understanding of user evaluation schemas is necessary. OBJECTIVE: The goal of this research was to advance the current understanding of user evaluations of social media information and to develop and validate a measurement instrument for assessing social media realism. METHODS: This research involved a sequence of 2 studies. First, we used qualitative focus groups (n=48). Second, building on the first study, we surveyed a national sample of social media users (n=442). The focus group data were analyzed using the constant comparison approach. The survey data were analyzed using confirmatory factor analyses and ordinary least squares regression. RESULTS: The findings showed that social media reality evaluation involves 5 dimensions: falsity, naturality, authenticity, resonance, and social assurance. These dimensions were differentially mapped onto patterns of social media use. Authenticity was strongly associated with the existing global measure of social media realism (P<.001). Naturality, or the willingness to accept artificiality and engineered aspects of social media representations, was linked to hedonic enjoyment (P<.001). Resonance predicted reflective thinking (P<.001), while social assurance was strongly related to addictive use (P<.001). Falsity, the general belief that much of what is on social media is not real, showed a positive association with both frequency (P<.001) and engagement with (P=.003) social media. These results provide preliminary validity data for a social media reality measure that encompasses multiple evaluation schemas for social media content. CONCLUSIONS: The identification of divergent schemas expands the current focus beyond fake versus fact, while the goals, contexts, and outcomes of social media use associated with these schemas can guide future digital media literacy efforts. Specifically, the social media reality measure can be used to develop tailored digital media literacy interventions for addressing diverse public health issues.

Screens and Preschools: The Bilingual English Language Learner Assessment as a Curriculum-Compliant Digital Application.

BACKGROUND/OBJECTIVES: The increase in digital tools in early childhood education highlights the need for evidence-based assessments that support cognitive development and align with educational requirements and technological advances. This study contributes to the evaluation of the Bilingual English Language Learner Assessment (BELLA), designed to enhance early learning through curriculum-aligned tasks in preschool-aged children. METHODS: Data were collected from 17 schools, including 506 preschool children, using a mixed-model approach to assess BELLA's capacity to appraise early numeracy, literacy, science, and social/emotional development. Analyses included a three-way ANOVA to examine the effects of sex, age, and sub-domain on pass rates and mixed-effects models to evaluate interactions between age and domain. RESULTS: The results indicated a significant effect of age on performance across all domains, with older children demonstrating higher pass rates (p < 0.0001). No significant gender bias was detected. The interaction between age and domain was also significant (p < 0.0001), suggesting domain-specific age-related performance trends, which aligns with internal validity requirements. CONCLUSION: These findings position BELLA within the growing body of literature on digital media use in early childhood assessment and education, highlighting its potential as a curriculum-compliant digital assessment tool that evaluates and supports cognitive development without a gender bias. This study contributes to the field by providing empirical evidence of BELLA's effectiveness and suggesting future research directions, including the exploration of its bilingual (and potentially multilingual) applications and external validation against existing evidence-based assessments.

Investigating Parental Factors for Adolescent Problematic Gaming and Social Media Use - A Cross-sectional and Longitudinal Approach.

PURPOSE: Increasing concern has been raised on the addictive potential of digital games and socialmedia platforms, especially in adolescent users. Hence, investigating the etiology of problematic gaming (PG) and problematic social-media use (PSMU) is of great scientific and clinical interest. Parental factors have not been sufficiently addressed yet. Therefore, this study aims to investigate the predictive values of parental demographic, psychological, parenting, and role model factors for adolescent PG/PSMU. METHODS: In a representative parent-child (10-17 years) sample parental factors and adolescent PG/PSMU were assessed cross-sectionally (Ndyads = 1221) and longitudinally (Ndyads = 659) using online-questionnaires at two measurement points 14 months apart. Parental factors included parental media-use patterns, sociodemographic aspects, (digital) emotion regulation, stress perception, (digital) parental self-efficacy, and media rules. Best subset linear regression models were estimated to identify parental factors with greatest predictive values. These were included in prospective linear regression analyses. RESULTS: At the cross-sectional level, 18% of model variance predicting PG and 24% predicting PSMU could be explained by parental media-use patterns, media rules, and (digital) parental self-efficacy after controlling for adolescent age. Longitudinally, 33% of variance in the PG model and 34% of variance of the PSMU model could be explained by parental media-use patterns and parental self-efficacy after controlling for adolescent age and baseline PG/PSMU. DISCUSSION: This study is the first to differentially investigate parental factors in the context of adolescent PG/PSMU in a prospective representative parent-child study. Aspects of digital parental role modeling and parenting could be identified as promising anchors for prevention and treatment.

How to drive heavily polluting companies to fulfill environmental responsibility? The synergy between environmental regulation and digital media coverage.

This paper addresses the question of how environmental regulation and digital media coverage, as formal and informal external monitoring mechanisms, affect corporate environmental responsibility fulfillment. Using the data of Shanghai and Shenzhen A-share listed companies in China's heavily polluting industries, this study showed that both environmental regulation and digital media coverage significantly improve responsive and strategic environmental responsibility fulfillment. After distinguishing the media tone, it was found that positive digital media coverage promotes the fulfillment of both responsive and strategic environmental responsibilities. In contrast, negative digital media coverage only stimulates the fulfillment of responsive environmental responsibility, which reflected an asymmetrical effect of media tone. Further, the hierarchy of governance amplifies the role of environmental regulation in triggering the fulfillment of responsive environmental responsibility but weakens its value to strategic environmental responsibility. Inconsistent with our predictions, the relationship between digital media coverage and corporate environmental responsibility fulfillment could not be significantly moderated by Confucian culture. In addition, environmental regulation and digital media coverage only existed in companies with separate chairperson and manager positions, which indicated that an excellent internal governance environment is a prerequisite for external monitoring mechanisms to play a role in environmental governance. This study enriches the literature on how to drive responsive and strategic environmental responsibility by uncovering an external governance effect of environmental regulation and digital media coverage on the fulfillment of corporate environmental responsibility, and provides inspiration for multiple environmental governance actors to promote the construction of ecological civilization collaboratively.

Association of digital media use with sleep habits in school children: A cross-sectional study.

Background: The use of digital media (DM) is increasing among school-children, which can affect their sleep habits. The primary objective of this study was to evaluate the association of DM use with sleep habits in school-children. Methods: It was a cross-sectional study of healthy school children. Sleep habits and DM use were assessed using the Children's Sleep Habits Questionnaire (CSHQ) and SCREENS-Q, respectively. The Pearson correlation coefficient was used to establish the correlation between the two variables. Logistic regression analysis was performed to quantify the extent of association between variables. A p-value <0.05 was considered statistically significant. Results: A total of 205 children were enrolled with a mean (SD) age of 7.1 (2.1) years. The mean (SD) sleep duration was 7.58 (0.80) hours. The mean (SD) CSHQ score was 50.6 (5.1). Use of DM was observed in 204 (99.5 %) children. On multivariate logistic regression analysis, DM use ≥2 h/day was significantly associated with higher CSHQ score (OR 1.28, 95%CI 1.18-1.40; p = 0.001). Sleep domains significantly affected by DM use ≥2 h/day were bedtime resistance (OR 1.55, 95 % CI 1.24-1.94; p < 0.001), sleep duration (OR 0.40, 95 % CI 0.28-0.58:p < 0.001), sleep anxiety (OR 1.69, 95%CI 1.40-2.04:p < 0.001), night awakening (OR 4.81 95 % CI 2.98-7.78:p < 0.001), parasomnias (OR 1.86, 95 % CI 1.45-2.38:p < 0.001), and daytime sleepiness (OR1.89,95 % CI 1.52-2.36: p < 0.001). DM use 30 min before bedtime was significantly associated with a higher CSHQ score (OR 1.32, 95 % CI 1.20-1.45; p < 0.001). In bivariate regression analysis, DM use ≥2 h/day was associated with poor academic performance (OR 2.36 95 % CI 1.28-4.35; p 0.006). Conclusion: This study has shown that the average sleep duration in children was shorter than the recommended duration. DM use was common in school children and it has a significant association with sleep habits especially with use of ≥2 h/day and 30 mints before bedtime. It was also associated with poor academic performance. Public awareness on effect of DM use in school children is the need of the hour.

Generative artificial intelligence in healthcare from the perspective of digital media: Applications, opportunities and challenges.

Introduction: The emergence and application of generative artificial intelligence/large language models (hereafter GenAI LLMs) have the potential for significant impact on the healthcare industry. However, there is currently a lack of systematic research on GenAI LLMs in healthcare based on reliable data. This article aims to conduct an exploratory study of the application of GenAI LLMs (i.e., ChatGPT) in healthcare from the perspective of digital media (i.e., online news), including the application scenarios, potential opportunities, and challenges. Methods: This research used thematic qualitative text analysis in five steps: firstly, developing main topical categories based on relevant articles; secondly, encoding the search keywords using these categories; thirdly, conducting searches for news articles via Google ; fourthly, encoding the sub-categories using the elaborate category system; and finally, conducting category-based analysis and presenting the results. Natural language processing techniques, including the TermRaider and AntConc tool, were applied in the aforementioned steps to assist in text qualitative analysis. Additionally, this study built a framework, using for analyzing the above three topics, from the perspective of five different stakeholders, including healthcare demanders and providers. Results: This study summarizes 26 applications (e.g., provide medical advice, provide diagnosis and triage recommendations, provide mental health support, etc.), 21 opportunities (e.g., make healthcare more accessible, reduce healthcare costs, improve patients care, etc.), and 17 challenges (e.g., generate inaccurate/misleading/wrong answers, raise privacy concerns, lack of transparency, etc.), and analyzes the reasons for the formation of these key items and the links between the three research topics. Conclusions: The application of GenAI LLMs in healthcare is primarily focused on transforming the way healthcare demanders access medical services (i.e., making it more intelligent, refined, and humane) and optimizing the processes through which healthcare providers offer medical services (i.e., simplifying, ensuring timeliness, and reducing errors). As the application becomes more widespread and deepens, GenAI LLMs is expected to have a revolutionary impact on traditional healthcare service models, but it also inevitably raises ethical and security concerns. Furthermore, GenAI LLMs applied in healthcare is still in the initial stage, which can be accelerated from a specific healthcare field (e.g., mental health) or a specific mechanism (e.g., GenAI LLMs' economic benefits allocation mechanism applied to healthcare) with empirical or clinical research.

Effectiveness of a program to lower unwanted media screens among 2-5-year-old children: a randomized controlled trial.

Background: Limited interventions exist on reducing unwanted screen time (ST) among children from low- and middle-income countries (LMICs), so we developed and assessed the effectiveness of the program to lower unwanted media screen time (PLUMS) among children aged 2-5 years in Chandigarh, Union Territory, North India. Methods: An open-label randomized control parallel group trial per CONSORT guidelines was conducted among randomly selected 340 families with children aged 2-5 (±3 months) years in Chandigarh, India. PLUMS was implemented at the family level with a focus on modifying the home media environment and targeted individual-level interventions using parent and child modules for 2 months. A post-intervention (immediately) and a follow-up assessment after 6 months was done. During the follow-up period, the interaction was done passively via WhatsApp groups. The control group received routine healthcare services. Validated and standardized tools, including a digital screen exposure questionnaire with a physical activity component, preschool child behavior checklist, and sleep disturbance scale for children, were used to collect data at baseline, post-intervention, and follow-up periods. The primary outcome was the mean difference in ST (minutes/day) among children in the intervention group versus the control group. Generalized estimating equation (GEE) analysis was performed to adjust for clustering. Results: An equal number of families (n = 170) were randomly assigned to the intervention and control arms. In the post-intervention assessment, 161 and 166 families continued while, at the follow-up assessment, 154 and 147 were in the intervention and control arm, respectively. The mean difference in ST on a typical day [27.7 min, 95% Confidence Interval (CI) 5.1, 50.3] at the post-intervention assessment significantly (p < 0.05) decreased in the intervention (102.6 ± 98.5 min) arm as compared with the control (130.3 ± 112.8 min) arm. A significant reduction in ST (ß = -35.81 min, CI -70.6, -1.04) from baseline (ß = 123.1 min) to follow-up phase (ß = 116 min) was observed in GEE analysis. The duration of physical activity increased both at post-intervention (ß = 48.4 min, CI = +6.6, +90.3) and follow-up (ß = 73.4 min, CI = 36.2, 110.5) assessments in the intervention arm. Conclusion: The PLUMS intervention significantly reduced the children's mean ST on a typical day and increased the physical activity immediately post-intervention and during the 6-month follow-up period. These results might guide the policymakers to include strategies in the national child health programs in the Southeast Asia Region to reduce unwanted ST.Clinical trial registration: https://clinicaltrials.gov/, identifier CTRI/2017/09/009761.

Social interactions offset the detrimental effects of digital media use on children's vocabulary.

Young children's rapid vocabulary growth during the first few years is supported by input during social interactions with caregivers and, increasingly, from digital media. However, the amount of exposure to both sources can vary substantially across socioeconomic classes, and little is known about how social interactions and digital media use together predict vocabulary in the first few years of life. The current study takes a first step toward examining whether increased social interactions with other individuals may buffer the potentially detrimental effects of digital media use on language among a socioeconomically diverse sample. 305 caregivers of children between 17 and 30-months completed questionnaires about their family demographics, their child's technology use, and the child's daily routines and social interactions. Findings suggest children who experience fewer human interactions and greater technology exposure have smaller vocabularies than their peers who socialize more and use less technology, and this disparity becomes greater as children get older. Moreover, the number of social interactions moderates the link between SES, digital media, and vocabulary such that the negative impact of digital media on vocabulary for children from low SES households can be offset with increased social interactions. Together, this suggests that increasing the amount of human interactions may serve as a protective factor for vocabulary outcomes in a world where digital media use is prominent.

Child and adolescent exposure to unhealthy food marketing across digital platforms in Canada.

BACKGROUND: Children and adolescents are exposed to a high volume of unhealthy food marketing across digital media. No previous Canadian data has estimated child exposure to food marketing across digital media platforms. This study aimed to compare the frequency, healthfulness and power of food marketing viewed by children and adolescents across all digital platforms in Canada. METHODS: For this cross-sectional study, a quota sample of 100 youth aged 6-17 years old (50 children, 50 adolescents distributed equally by sex) were recruited online and in-person in Canada in 2022. Each participant completed the WHO screen capture protocol where they were recorded using their smartphone or tablet for 30-min in an online Zoom session. Research assistants identified all instances of food marketing in the captured video footage. A content analysis of each marketing instance was then completed to examine the use of marketing techniques. Nutritional data were collected on each product viewed and healthfulness was determined using Health Canada's 2018 Nutrient Profile Model. Estimated daily and yearly exposure to food marketing was calculated using self-reported device usage data. RESULTS: 51% of youth were exposed to food marketing. On average, we estimated that children are exposed to 1.96 marketing instances/child/30-min (4067 marketing instances/child/year) and adolescents are exposed to 2.56 marketing instances/adolescent/30-min (8301 marketing instances/adolescent/year). Both children and adolescents were most exposed on social media platforms (83%), followed by mobile games (13%). Both age groups were most exposed to fast food (22% of marketing instances) compared to other food categories. Nearly 90% of all marketing instances were considered less healthy according to Health Canada's proposed 2018 Nutrient Profile Model, and youth-appealing marketing techniques such as graphic effects and music were used frequently. CONCLUSIONS: Using the WHO screen capture protocol, we were able to determine that child and adolescent exposure to the marketing of unhealthy foods across digital media platforms is likely high. Government regulation to protect these vulnerable populations from the negative effects of this marketing is warranted.

Media Use and Its Associations With Paranoia in Schizophrenia and Bipolar Disorder: Ecological Momentary Assessment.

Background: Paranoia is a spectrum of fear-related experiences that spans diagnostic categories and is influenced by social and cognitive factors. The extent to which social media and other types of media use are associated with paranoia remains unclear. Objective: We aimed to examine associations between media use and paranoia at the within- and between-person levels. Methods: Participants were 409 individuals diagnosed with schizophrenia spectrum or bipolar disorder. Measures included sociodemographic and clinical characteristics at baseline, followed by ecological momentary assessments (EMAs) collected 3 times daily over 30 days. EMA evaluated paranoia and 5 types of media use: social media, television, music, reading or writing, and other internet or computer use. Generalized linear mixed models were used to examine paranoia as a function of each type of media use and vice versa at the within- and between-person levels. Results: Of the 409 participants, the following subgroups reported at least 1 instance of media use: 261 (63.8%) for using social media, 385 (94.1%) for watching TV, 292 (71.4%) for listening to music, 191 (46.7%) for reading or writing, and 280 (68.5%) for other internet or computer use. Gender, ethnoracial groups, educational attainment, and diagnosis of schizophrenia versus bipolar disorder were differentially associated with the likelihood of media use. There was a within-person association between social media use and paranoia: using social media was associated with a subsequent decrease of 5.5% (fold-change 0.945, 95% CI 0.904-0.987) in paranoia. The reverse association, from paranoia to subsequent changes in social media use, was not statistically significant. Other types of media use were not significantly associated with paranoia. Conclusions: This study shows that social media use was associated with a modest decrease in paranoia, perhaps reflecting the clinical benefits of social connection. However, structural disadvantage and individual factors may hamper the accessibility of media activities, and the mental health correlates of media use may further vary as a function of contents and contexts of use.

Retrospecting Digital Media Use, Negative Emotions, and Trust Gaps During the COVID-19 Pandemic in China: Cross-Sectional Web-Based Survey.

BACKGROUND: Retrospecting the trust gaps and their dynamics during the pandemic is crucial for understanding the root causes of postpandemic challenges and offers valuable insights into preparing for future public health emergencies. The COVID-19 pandemic eroded people's trust in strangers and acquaintances, while their trust in family members remained relatively stable. This resulted in 2 trust gaps, namely, the family members-strangers trust gap and the family members-acquaintances trust gap. Widening trust gaps impede social integration and undermine the effective management of public health crises. However, little is known about how digital media use shaped trust gaps during a pandemic. OBJECTIVE: This study aims to investigate the relationships between digital media use, negative emotions, the family members-strangers trust gap, and the family members-acquaintances trust gap during the COVID-19 pandemic in China. We test the mediating role of negative emotions between digital media use and 2 trust gaps and compare the indirect effect of digital media use on 2 trust gaps through negative emotions. METHODS: A cross-sectional web-based survey was conducted in China between January 31, 2020, and February 9, 2020. A total of 1568 adults participated in the survey. Questions related to digital media use, negative emotions, trust in family members, trust in acquaintances, and trust in strangers during the pandemic were asked. Regression analyses were performed to test the associations between the examined variables. We used a 95% bootstrap CI approach to estimate the mediation effects. RESULTS: Digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), which in turn were positively associated with the family members-strangers trust gap (B=0.15, SE 0.03; P<.001). Likewise, digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), while negative emotions were positively associated with the family members-acquaintances trust gap (B=0.08, SE 0.03; P=.01). Moreover, the indirect effect of digital media use on the family members-strangers trust gap (B=0.03, SE 0.01; 95% CI 0.01-0.04) was stronger than that on the family members-acquaintances trust gap (B=0.01, SE 0.01; 95% CI 0.003-0.027). CONCLUSIONS: The results demonstrate that negative emotions resulting from the frequent use of digital media are a key factor that accounts for the widening trust gaps. Considering the increasing reliance on digital media, the findings indicate that the appropriate use of digital media can prevent the overamplification of negative emotions and curb the enlargement of trust gaps. This may help restore social trust and prepare for future public health crises in the postpandemic era.