Social Media Use and Alcohol Sipping in Early Adolescents: A Prospective Cohort Study.

BACKGROUND: Social media can influence alcohol initiation behaviors such as sipping, which can lead to future adverse alcohol-related outcomes. Few studies have examined the role of problematic social media use, characterized by addiction, mood modification, tolerance, withdrawal, conflict, and relapse, especially in early adolescence. OBJECTIVE: To examine the prospective association between social media use and sipping alcohol in a nationwide sample of early adolescents, and the extent to which problematic social media use mediates the association. METHODS: We analyzed prospective data from the Adolescent Brain Cognitive Development Study (N = 7514; ages 9-10 years at baseline; 2016-2018) to estimate associations between social media time (Year 1) and alcohol sipping (Year 3) using modified Poisson regression, adjusting for confounders and testing problematic social media use (Year 2) as a mediator. RESULTS: Social media time (Year 1) was prospectively associated with 1.31 (95% confidence interval 1.20-1.43) times higher risk of new-onset sipping (Year 3). The association between social media time and new-onset alcohol sipping was partially mediated by problematic social media use at Year 2 (25.0% reduction in the association between the former two factors after adding problematic social media use, p = 0.002). CONCLUSIONS: Time spent on social media was associated with a higher risk of alcohol sipping in a diverse national sample of early adolescents, and the association was partially mediated by problematic social media use. Media literacy education and family media use plans could advise early adolescents about exposure to alcohol content on social media and warning signs for problematic use.

"Whenever you need support, you first turn to the group": motivations and functions of WhatsApp groups for youth living with HIV.

Social support is a critical component of achieving positive health outcomes for youth living with HIV (YLWH). Mobile health (mHealth) has significant potential for providing social support to YLWH. However, little is known about the domains of social support most needed by YLWH which mHealth interventions might address. Drawing on the spontaneous creation of WhatsApp support groups by YLWH in Nairobi, Kenya, we characterized Kenyan YLWH's social support needs and potential roles of social media groups in meeting them. We conducted interviews and focus-groups with 68 YLWH, 24 caregivers and 20 healthcare workers, and observed two YLWH-led WhatsApp groups for 6 weeks. Youth reported that existing support systems, including family and healthcare workers, already provided informational and instrumental support. However, they emphasized unmet companionship and emotional support needs, leading to isolation, hopelessness, and medication adherence challenges. Participants identified connection with other YLWH as a unique source of emotional and companionship support that allowed them to feel more secure and less isolated. Interviews and observed WhatsApp chats demonstrated that WhatsApp groups were a desirable medium for companionship support that overcame barriers to in-person connection.

Does Exposure to Pediatrician or Parent Blog Content Influence Infant Safe Sleep Practices?

OBJECTIVE: To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices. METHODS: We conducted a pilot randomized controlled trial via Qualtrics, a web-based platform, with a national sample of parents of children < 1 year old. Survey questions about infant sleep practices included: bed-sharing, location, position and objects present. Safe sleep was defined as not bed-sharing, in a crib, bassinet or playard, back positioning, and no other objects present except pacifiers. Participants were randomized to read one of the following: (1) pediatrician blog post, (2) parent blog post, or (3) no blog post. The blog posts contained the same content about infant sleep but varied by identified authorship. All participants received links to online content about safe sleep. Participants received a follow-up survey 2-4 weeks later with the same questions about infant sleep practices. We compared responses in pre- and post-surveys by type of blog post exposure using multivariable logistic regression models. RESULTS: The average infant age (n = 1500) was 6.6 months (Standard Deviation 3.3). Most participants (74%) were female; 77% were married; 65% identified as white Non-Hispanic, 12% were black and 17% were Hispanic. 47% (n = 711) completed both surveys. We identified no differences in the odds of any of the four safe sleep practices after exposure to safe sleep recommendations in blog post format. CONCLUSION: Although in-person advice has been associated with improved safe sleep practices, we did not identify changes in infant sleep practices after exposure to safe sleep advice using blog posts.

Practices and Attitudes Regarding Pediatric Cholesterol Screening Recommendations Differ Between Pediatricians and Family Medicine Clinicians.

Pediatricians had higher rates of ordering pediatric cholesterol screening than family medicine (FM) clinicians. This study aims to compare knowledge, attitude, and practices of clinicians' pediatric cholesterol screening practices and attitudes between these two specialties. A 14-item electronic survey using Likert scales was sent to all clinicians in the institution's Departments of Pediatrics and FM between 2018 and 2019. Chi-square and t-tests were used to compare pediatricians and FM clinicians. 22 clinicians from Pediatrics and 111 from FM completed the survey. Compared to FM clinicians, pediatricians were more familiar with the National Heart, Lung, and Blood Institute guidelines, which are more vigorous in their recommendation of universal cholesterol screening. Pediatricians reported being more supportive of universal cholesterol screening in children (p < 0.05). In practice, pediatricians reported screening almost two thirds (64.8%) of eligible patients during the past year, while FM clinicians reported screening approximately one third (34.1%) of eligible patients (p < 0.001). Pediatricians were more likely to screen based on patient-specific risk factors and their practice decisions were more heavily influenced by published guidelines, institutional education, availability of non-fasting blood to be used for screening, and the availability of an institutional pediatric lipid clinic (p < 0.05). The differences in knowledge, attitudes, and practices of cholesterol screening may contribute to different screening rates among clinicians from FM and pediatrics. To improve patient care and reduce gaps, it is important to implement interventions at the institutional level as well as to adopt uniform guideline recommendations at the national level.

Typology of Adolescents Exposed to Non-medical Cannabis Marketing and Associations with Consumption Patterns.

Latent class analysis (LCA) identified subtypes of cannabis marketing exposure among adolescents and assessed whether the classes were associated with three cannabis use outcomes: past 28-day use, poly-cannabis use, and symptoms of cannabis use disorder (CUD). Survey data were from 471 adolescents (aged 15-19 years) who lived in four states with legal non-medical cannabis in 2018. Measures included social media engagement and cannabis outcomes. LCA with robust maximum likelihood estimation identified latent classes. Chi-squared tests assessed whether empirically derived classes differed across demographics, and logistic regression tested associations with cannabis use outcomes. Three classes were identified: digitally engaged (35.5%), digitally unengaged (36.5%), and traditional (28.0%). Both digitally engaged and unengaged classes were exposed to marketing on social media platforms, but youth in the engaged class interacted with posts and brands. Class membership differed by age (χ2 = 14.89, p < 0.001) and school type, with the digitally engaged group older and not in school or in non-traditional schools (χ2 = 16.22, p=0.01). As compared to the traditional class, youth in the digitally engaged class had 10.63 times the odds of past 28-day cannabis use (95% CI: 5.25, 21.51), 7.84 times the odds of poly-cannabis use (95% CI: 3.54, 17.33), and 13.85 times the odds of symptoms of CUD (95% CI: 3.96, 48.48). Youth in the digitally engaged class had higher odds of all cannabis use behaviors than the traditional class. These findings point to the possible use of algorithmic marketing to adolescents and suggest a need for monitoring and possible restrictions on digital cannabis marketing.

Change in Risk Score and Behaviors of Soft Contact Lens Wearers After Targeted Patient Education.

OBJECTIVES: To determine if targeted education can influence the behaviors and scores of soft contact lens (SCL) wearers via the Contact Lens Risk Survey (CLRS). METHODS: This was a multicenter, prospective, case-control study. Cases were symptomatic red eye SCL wearers (age, 18-39 years), and controls were age , sex, and site matched. Participants completed the CLRS and were provided targeted patient education at three time points: baseline, one, and six months. Change in scores and behaviors were analyzed using the Wilcoxon signed rank test. RESULTS: Forty-one cases and 71 controls were analyzed. The mean risk score (mean±SE) from baseline to follow-up improved (reduced) for all participants (-1.96±0.73; P =0.01), mostly driven by the improvement among cases (-2.55±1.32; P =0.05). Case subjects reported a decrease in frequency of wearing lenses while showering (-0.32±0.07; P <0.0001), discarding lens solution (-0.13±0.06; P =0.03), and rinsing lenses with tap water (-0.19±0.08; P =0.02) after targeted education. CONCLUSIONS: Targeted patient education can influence some behaviors of SCL wearers, especially those who experienced a red eye event. Further study is needed to determine how to improve other risk behaviors and whether these changes are sustained long term.

Adolescents' Digital Technology Interactions and Importance: Associations with Demographics and Social Media Frequency.

The Adolescents' Digital Technology Interactions and Importance (ADTI) scale evaluates perceived importance of technology interactions. Adolescents were recruited via Qualtrics panels for an online survey. Among 4592 participants, findings illustrated positive associations between ADTI scores and use frequency. Findings further validate the ADTI and contribute baseline scales by groups.

Differences in pediatric cholesterol screening rates between family physicians and pediatricians correlate with conflicting guidelines.

Conflicting guidelines regarding universal pediatric cholesterol screening were released between 2011 and 2019, but the impact on screening rates remains understudied. The purpose of this study was to examine trends in pediatric cholesterol screening rates within a single institution in the United States and their association with release of national guidelines, local educational tools, and electronic health record (EHR) modifications. Order placement was defined as ordering a high-density lipoprotein cholesterol level in a patient aged 9-21 years with ≥1 well visit in prior 3 years. Order placement rate (OPR) was calculated per month using 3 months' moving average smoothing and analyzed based on date, patient age, and specialty of ordering clinician. Timing of educational tools, EHR modifications, and national guideline release were analyzed for changes in OPR. Prior to release of 2011 guidelines recommending universal pediatric cholesterol screening, pediatrician OPR was 35% (95% CI: 29-43%) compared to 8% (7-11%) for family physicians. For both specialties, OPR increased after 2011 guidelines, educational initiatives, and EHR changes, but decreased after 2016, with a larger decrease for family physicians (p < 0.001 for all). OPR was consistently higher for pediatricians than for family physicians during the study period, with largest OPR changes correlating with release of guidelines. The findings from the study suggest that conflicting guidelines may contribute to lower overall OPR, and to different screening rates for children cared for by pediatricians compared to family physicians.

Association of experienced and internalized stigma with self-disclosure of HIV status by youth living with HIV.

We examined patterns of disclosure among youth living with HIV (YLHIV) in Kenya, and the association between self-disclosure and antiretroviral therapy adherence, stigma, depression, resilience, and social support. Of 96 YLHIV, 78% were female, 33% were ages 14-18, and 40% acquired HIV perinatally. Sixty-three (66%) YLHIV had self-disclosed their HIV status; 67% to family and 43% to non-family members. Older YLHIV were 75% more likely to have self-disclosed than those 14-18 years. Of the 68 either married or ever sexually active, 45 (66%) did not disclose to their partners. Those who had self-disclosed were more likely to report internalized stigma (50% vs. 21%, prevalence ratio [PR] 2.3, 1.1-4.6), experienced stigma (26% vs. 3%, PR 11.0, 1.4-86), and elevated depressive symptoms (57% vs. 30%, PR 1.8, 1.0-3.1). The association with stigma was stronger with self-disclosure to family than non-family. Support should be provided to YLHIV during self-disclosure to mitigate psychosocial harms.

Receptiveness and Responsiveness Toward Using Social Media for Safe Firearm Storage Outreach: Mixed Methods Study.

BACKGROUND: Childhood and adolescent firearm injury and death rates have increased over the past decade and remain major public health concerns in the United States. Safe firearm storage has proven to be an effective measure to prevent firearm injury and death among youth. Social media has been used as an avenue to promote safe firearm storage, but perceptions of this tool remain unknown. OBJECTIVE: The aim of this study was to determine receptiveness and responsiveness in promoting firearm lock box and trigger lock giveaway events on social media, and to describe the characteristics of participants who learned of these events through social media. METHODS: We performed a mixed methods study combining a content analysis of Facebook event post comments, quantitative analysis of positive and negative feedback on social media, and a descriptive analysis of event participant characteristics. Through a qualitative content analysis approach, we thematically coded comments from each event's social media page posting. Interrater reliability and κ statistics were calculated. We calculated the prevalence of positive and negative feedback data. Further, we calculated descriptive statistics for demographic characteristics gathered from day-of-event intake surveys. Differences between collected measures were analyzed with χ2 and t tests according to how the participant found out about the event (social media vs other means). Using concurrent analysis, we synthesized the results from both the qualitative and quantitative aims. RESULTS: Through qualitative content analysis, 414 comments from 13 events were coded. Seven themes emerged through the comment coding process with the most common being "positive receptiveness" (294/414, 71.0%). From quantitative analysis of the social media content, we found higher levels of positive feedback compared to negative feedback. The average number of event post "likes" was 1271.3 per event, whereas the average count in which "hide post" was clicked was 72.3 times per event. Overall, 35.9% (1457/4054) of participants found out about the event through social media. The participants who learned about the event through social media were on average significantly younger than those who learned about the event through other means (-6.4 years, 95% CI -5.5 to -7.3). Among the group that learned of the event through social media, 43.9% (629/1433) identified as female, whereas 35.5% (860/2420) identified as female among the group that learned of the event through other means. CONCLUSIONS: There was overall positive receptiveness and responsiveness toward firearm lock box and trigger lock giveaway events when promoted on social media. Compared with other promotional tools, social media has the ability to reach those who are younger and those who identify as female. Future studies should extend this research to determine whether there is a difference between rural and urban settings, and consider other social media platforms in the analysis.

Vaccination Discussion among Parents on Social Media: A Content Analysis of Comments on Parenting Blogs.

Despite the effectiveness of vaccines, parents are increasingly opting for non-medical exemption. For health advice on such topics, many parents are now more likely to look to online communities than rely on medical expertise. There is scant literature outlining how parents contribute to online discussion of vaccination. The purpose of this study was to analyze parent vaccination opinions expressed online. Using a codebook adapted from previous research, content analysis was conducted to evaluate comments on parenting blog posts related to vaccination. Variables included stance, argument rhetoric, and accuracy of information. Comments recognized as aggressive or accusatory were recorded into an "attack" category. Descriptive statistics were used to assess trends in comment content. Nine blogs were included, from which 244 comments were analyzed. The most common argument rhetoric was providing, requesting, or evaluating source credibility for both pro- and anti-vaccine comments (24% and 36%). 25% of comments were considered inaccurate health information; 27% fell into the "attack" category, of which 60% were pro-vaccination. The high percentage of "attack" comments and inaccurate information is evidence that blog comments may not be reliable for information-seeking parents. Clinicians should use this data to understand anti-vaccination arguments in efforts to improve vaccine communication.

Linguistic Predictors of Problematic Drinking in Alcohol-related Facebook Posts.

Emerging adults often increase problematic drinking during college. Although they generally do not seek help for problematic drinking, college students discuss their drinking on social media. This study followed college students' Facebook profiles from the inception of their attendance at a university and identified alcohol-related posts. Within 28 days of their first alcohol-related Facebook post, participants were interviewed to assess problematic drinking (binge drinking episodes and number of drinks). Linguistic analysis of alcohol-related Facebook posts found that use of negative emotion language and swear words were related to problematic drinking, in support of proposed hypotheses. Results are situated within alcohol use disorder and health research examining the link between problematic drinking and anxiety, deviant behavior, and negative emotions.

Measuring Interests Not Minutes: Development and Validation of the Adolescents' Digital Technology Interactions and Importance Scale (ADTI).

BACKGROUND: Interactive digital technology use is integral to adolescents' lives and has been associated with both health benefits and risks. Previous studies have largely focused on measuring the quantity of technology use or understanding the use of specific platforms. To better understand adolescents' interactive digital technology use, we need new approaches that consider technology interactions and their importance. OBJECTIVE: This study aimed to develop an assessment tool to evaluate adolescents' digital technology interactions and their perceived importance. METHODS: We used a validated scale development approach comprising 2 initial steps to create an item pool: item pool development and item pool refinement. These steps relied upon empirical literature review and an expert convening. We then evaluated the item pool using a Web-based survey. Data were collected via Qualtrics panel recruitment from a national sample of 12- to 18-year-olds. Participant data were randomly split into a development subsample for exploratory factor analysis (EFA) and a test subsample for confirmatory factor analysis (CFA). We assessed Cronbach alpha as well as model fit characteristics including root mean square error of approximation (RMSEA) and comparative fit index (CFI). RESULTS: Our initial item pool had 71 items and the refined item pool contained 40. A total of 761 adolescents assessed the item pool via Web-based survey. Participants had a mean age of 14.8 (SD 1.7) years and were 52.8% (402/761) female and 77.5% (590/761) white. The EFA analysis included 500 participants and an 18-item draft scale was created. The CFA included 261 participants to test the draft scale. Adequate model fit for the scale was indicated by an RMSEA of 0.063 and a CFI of 0.95. The final scale included 18 items in a 3-factor model, with Cronbach alpha for the 3 factors of .87 (factor 1), .90 (factor 2) and .82 (factor 3). The 3 factors were named (1) technology to bridge online and offline experiences, (2) technology to go outside one's identity or offline environment, and (3) technology for social connection. CONCLUSIONS: The resulting Adolescents' Digital Technology Interactions and Importance (ADTI) scale is a promising and psychometrically validated tool for identifying the importance of distinct technology interactions. The scale is informed by relevant theory and expert input. The 3 subscales have utility for future studies to understand whether certain subscale score ranges are associated with health or well-being outcomes.

Social media use predicts later sleep timing and greater sleep variability: An ecological momentary assessment study of youth at high and low familial risk for depression.

INTRODUCTION: Social media (SM) use has been increasingly recognized as a potential contributor to poor sleep. Few studies have examined SM use and sleep using ecological momentary assessment (EMA), compared different types of media use (SM, television, gaming), or examined whether youth at high and low familial risk for depression are differentially affected by SM use. METHODS: The current study included 76 youth (46% female; Mean age = 11.28 years) who were recruited based on parental history of recurrent depression (N = 35 high risk; N = 41 low risk) in the United States. Youth completed a 9-day EMA protocol, which included current activity at time of prompt and daily sleep onset and offset times. Regression and multilevel models were conducted to examine the effects of media use on sleep. RESULTS: Results indicated that youth who used more SM (mean and number of days) went to sleep later, but did not have shorter sleep duration. Youth with more SM use also had higher levels of variability of both sleep timing and sleep duration across the 9-day period. There were no effects of gaming or TV on sleep, and youth at high risk for depression did not have differences in SM use or its effects on sleep compared to low-risk youth. CONCLUSIONS: These findings indicate a unique impact of SM use on sleep timing and variability for youth (regardless of risk status), which may suggest a unique and modifiable pathway through which SM use contributes to poor health.

Social Media Intervention Design: Applying an Affordances Framework.

Social media interventions are a growing area of internet research, particularly for adolescent health. Researchers developing social media intervention approaches face the task of selecting a social media platform for their intervention. In this paper, we present the theoretical framework of affordances to help guide social media platform selection for intervention research. Affordances are a concept often used in fields associated with design and by those systematically studying the impact of a design of an object. Thus, the affordances approach is often used by those considering the impact of information technology and the design of social media platforms. Affordances are often described as properties of artifacts that can be recognized by users and contribute to their function or items that present an action possibility. We describe common affordances that can be applied to intervention design as well as current evidence and an intervention case example for each affordance. A scientific approach for the selection of the appropriate social media platform for a given intervention is an important research priority to advance the field of internet research.

Adolescent Perspectives on the Use of Social Media to Support Type 1 Diabetes Management: Focus Group Study.

BACKGROUND: A majority of adolescents report the use of some form of social media, and many prefer to communicate via social networking sites. Social media may offer new opportunities in diabetes management, particularly in terms of how health care teams provide tailored support and treatment to adolescents with diabetes. OBJECTIVE: The aim of this study was to explore the experiences and perspectives of adolescents with type 1 diabetes on the feasibility of social media use as a tool to collaboratively manage their diabetes with their diabetes care team. METHODS: Focus groups of adolescents with type 1 diabetes were conducted in the Seattle metropolitan area in Washington State. Semistructured questions were used to elicit views around the preferred means of communication with the adolescents' diabetes care team, how to best support diabetes self-management, and how social media could be used outside of the clinic setting by the diabetes care team to engage with adolescents with type 1 diabetes. Focus groups were audio recorded and transcribed verbatim. Qualitative content analysis was carried out, and emergent themes were subsequently mapped onto 4 domains of feasibility, which included acceptability, demand, implementation, and practicality. RESULTS: Participants included 45 adolescents with type 1 diabetes (mean age 15.9, SD 1.7 years; 58% male; diabetes duration mean 6.2, SD 3.6 years; 76% on insulin pumps; 49% wore continuous glucose monitors; 93% reported use of social media; 84% used smartphones as the primary means for social media access). A total of 7 major topics were identified and mapped onto areas consistent with our focus on feasibility. For acceptability and demand, participants expressed how communication over social media could help facilitate (1) improved communication outside of clinic visits to optimize diabetes management, (2) independence in diabetes self-management, (3) connection to other youth with diabetes for additional diabetes support, and (4) delivery of more timely and personalized care. Addressing implementation and practicality, participants shared the need to (1) ensure patient privacy, (2) maintain professional nature of provider-patient relationship, and (3) recognize that social media is not currently used for medical care by youth with diabetes. CONCLUSIONS: Adolescents with type 1 diabetes expressed interest in the use of social media as a tool to support diabetes management and increase engagement with their diabetes care team. Specific implementation measures around privacy and professionalism should be considered when developing a social media intervention to facilitate communication between adolescents and care teams.

Applying Natural Language Processing to Evaluate News Media Coverage of Bullying and Cyberbullying.

Bullying events have frequently been the focus of coverage by news media, including news stories about teens whose death from suicide was attributed to cyberbullying. Previous work has shown that news media coverage is influential to readers in areas such as suicide, infectious disease outbreaks, and tobacco use. News media may be an untapped resource to promote bullying prevention messages, though current news media approaches to describing bullying and cyberbullying remain unexplored. The purpose of this study was to evaluate the current state of news media coverage of bullying and cyberbullying. A sample of newspaper articles covering bullying or cyberbullying across regional and national US newspapers from 6 recent years was identified. A content analysis using natural language processing was conducted with the Linguistic Inquiry and Word Count (LIWC) software program for key variables including affective, social, and cognitive processes. Evaluation included the percentage of words that represented Fear-based reporting such as alarmist words (e.g., epidemic, tragic), as well as words that represent Public Health-oriented messages such as prevention. A total of 463 newspaper articles met inclusion criteria, including 140 cyberbullying articles and 323 bullying articles. Findings indicated that cyberbullying articles scored higher on affective processes such as measures of anxiety (Mdn = 0.34) compared to bullying articles (Mdn = 0.22). A greater number of cyberbullying articles were Fear-based (41.4%) than were bullying articles (19.5%). An equivalent number of cyberbullying articles (50.0%) and bullying articles (49.8%) were Public Health-oriented. Findings may be used to collaborate with journalists toward optimizing prevention-oriented reporting.

Testing Young Adults' Reactions to Facebook Cues and Their Associations with Alcohol Use.

Background: Alcohol cues on social media may influence young adults' drinking patterns, these cues may be pro-social or pro-alcohol in nature. The influence of individual Facebook cues on young adults' drinking intentions and behaviors remains unknown. Objectives: The purpose of this study was to assess how Facebook cues influence intention to drink, and how intention was associated with Theory of Reasoned Action constructs including alcohol-related attitudes and norms, and future behavior. Methods: Incoming university students completed a pre-college and a 2-year follow-up phone interview. A vignette presented individual Facebook cues representing "pro-social" or "pro-alcohol" sentiments. Participants indicated intention to drink alcohol and their rationale for this intention after each cue. Additional measures included TRA constructs of alcohol-related attitudes and norms, and problem alcohol use. Analyses included a qualitative approach to examine rationales for intention to drink in response to Facebook cues, and linear mixed effects models. Results: Of 338 participants, 56.1% were female, 74.8% were Caucasian. Alcohol-related attitudes and norms were positively associated with intention to drink in response to pro-social and pro-alcohol Facebook cues. Participants' intention to drink in response to pro-alcohol cues was positively associated with problem alcohol use two years later. Conclusions/importance: Findings illuminate the influence of social media on alcohol-related behaviors and highlight potential future screening approaches.

Linguistic analysis of pediatric residency personal statements: gender differences.

BACKGROUND: All US residency programs require applicants to submit personal statements. Prior studies showed gender differences in personal statement writing, which has implications for gender bias in the application process, but previous studies have not considered the dual influence of specialty-specific values on personal statement writing by applicants of each gender. OBJECTIVE: To understand gender differences in pediatric residency personal statements. METHODS: From 2017 to 2018, we performed linguistic analysis of personal statements written by interviewees at a mid-size US pediatrics residency during two prior academic years. We assessed writing tone, communal language, and agentic language. We performed t-tests to evaluate for gender differences, p < 0.05. RESULTS: We analyzed personal statements from 85 male and 85 female interviewees. Average word count was 676 words. Personal statements demonstrated analytic writing style with authentic and positive emotional tone. We found no gender differences in communal language for social affiliation (p = 0.31), adjectives (p = 0.49), or orientation (p = 0.48), which deviates from typical gender norms for male language use. Males used agentic language of reward more frequently (p = 0.02). CONCLUSIONS: Findings suggest that social language is valued in pediatrics, a predominantly female specialty, regardless of applicant gender. Use of reward language by males is consistent with previous findings. Future studies should evaluate gender differences in residency applications across specialties to advance understanding of the role gender plays in the application process.

Research strategy for health sciences: Facebook friend request is non-differentially accepted in a diverse, young adult population.

Social media is being used for recruitment and the study of health-care choices and behavior, and could be particularly helpful to reach young adult populations outside of a 4 year college setting. The aim of this study was to report on overall success of recruiting young adults in diverse settings with respect to education and employment into a study using Facebook (FB). Young adults (n = 380, 50% male, 44% white) who had been involved in a longitudinal research project received a friend request from the research study group's profile. Acceptance rates of friend requests and sociodemographic and mental health factors associated with acceptance were evaluated. Approximately 67% of 318 participants who received a friend request accepted the request. Sociodemographic and mental health characteristics were similar between those who did and did not accept friend requests, suggesting non-differential recruitment through FB. Friending through FB is a feasible way to reach young adults involved in health and behavioral research, and could be a way to expand the populations that are studied in health science research to maximize generalizability of the conclusions drawn.