Leveraging Health Behavior and Communication Theories to Support Adolescent and Young Adults: Conceptualizing Social Media Wellness in Relation to Disordered Eating

Social media platforms like Instagram serve as an important mechanism for transmitting social information and influence. However, the nature and use of these platforms are known to perpetuate eating disorders (EDs) or further disorder eating symptoms. This concept paper proposes merging health behavior and communication theory to create a comprehensive and applicable framework for remediating pro-eating disorder social media content among people who have eating disorders. To this end, the Social Media Wellness Model, which is adapted from the Health Belief Model, the Uses and Gratifications approach, the MAIN model of media affordances, and media literacy training, is proposed. This paper shows how theoretical model components can be mapped back to behaviors typified by individuals with EDs, or those predisposed to developing EDs. Subsequently, we propose a training intervention to highlight salient literacy cues, and outline next steps for testing and developing this model with the ongoing support of a community advisory board (CAB). Creating a CAB with individuals who have lived experience of an ED or disordered eating, and who use social media, will be vital to testing the applicability of this conceptual Social Media Wellness Model for ED recovery

Adolescent distinctions between quality of life and self-rated health in quality of life research

BACKGROUND: In adult quality of life (QOL) research, the QOL construct appears to differ from self-rated health status. Although increased QOL continues to be recognized as an important outcome in health promotion and medical intervention, little research has attempted to explore adolescent perceptual differences between self-rated health and QOL. METHODS: Correlational analyses were performed between self-rated health, physical health days and mental health days, and QOL. Data were collected from two different public high school adolescent samples during two different time periods (1997 & 2003) in two different geographic regions in the USA (a southern & midwestern state) with two different sample sizes (N = 5,220 and N = 140, respectively) using the CDC Youth Risk Behavior Survey (YRBS). The Centers for Disease Control and Preventions' health-related quality of life scale (HRQOL) provided estimates of self-rated health, physical health days and mental health days, and QOL. RESULTS: All correlation coefficients were significant in both samples (p ≤ .0001), suggesting sample size was not a contributing factor to the significant correlations. In both samples, adolescent QOL ratings were more strongly correlated with the mean number of poor mental health days (r = .88, southern sample; r = .89, midwestern sample) than with the mean number of poor physical health days (r = .75, southern sample; r = .79, midwestern sample), consistent with adult QOL research. However, correlation coefficients in both samples between self-rated health and the mean number of poor physical health days was slightly smaller (r = .24, southern, r = .32, midwestern) than that between self-rated health and the mean number of poor mental health days (r = .25, southern, r = .39 midwestern), which is contrary to adult QOL research. CONCLUSION: Similar to adults, these results suggest adolescents are rating two distinct constructs, and that self-rated health and QOL should not be used interchangeably. QOL, in the context of public high school adolescents, is based largely upon self-reported mental health and to a lesser extent on self-reported physical health. Conversely, although self-reported mental health and self-reported physical health both contribute significantly to adolescent self-rated health, mental health appears to make a greater contribution, which is contrary to observations with adults. Health promoting efforts for adolescents may need to focus more on mental health than physical health, when considering population needs and type of micro or macro intervention

Not all developmental assets are related to positive health outcomes in college students

<p>Abstract</p> <p>Background</p> <p>The purpose of this investigation was to model the relationships between developmental assets, life satisfaction, and health-related quality of life (HRQOL) among a stratified, random sample (<it>n </it>= 765, 56% response rate) of college students.</p> <p>Methods</p> <p>Structural equation modeling techniques were employed to test the relationships using Mplus v4.21; Model evaluations were based on 1) theoretical salience, 2) global fit indices (chi-square goodness of fit, comparative fit index: CFI and Tucker-Lewis Index: TLI), 3) microfit indices (parameter estimates, root mean squared error of approximation: RMSEA and residuals) and 4) parsimony.</p> <p>Results</p> <p>The model fit the data well: χ²(<it>n </it>= 581, 515) = 1252.23, CFI = .94, TLI = .93 and RMSEA = .05. First, participants who reported increased Family Communication also reported higher levels of life satisfaction. Second, as participants reported having more Non-Parental Role Models, life satisfaction decreased and poor mental HRQOL days increased. Finally increased Future Aspirations was related to increased poor mental HRQOL days. Results were variant across gender.</p> <p>Conclusions</p> <p>Preliminary results suggest not all developmental assets are related to positive health outcomes among college students, particularly mental health outcomes. While the findings for Family Communication were expected, the findings for Non-Parental Role Models suggest interactions with potential role models in college settings may be naturally less supportive. Future Aspirations findings suggest college students may harbor a greater temporal urgency for the rigors of an increasingly competitive work world. In both cases, these assets appear associated with increased poor mental HRQOL days.</p

Life satisfaction among a clinical eating disorder population

Background The primary objective was to understand life satisfaction (LS) of patients with eating disorders (EDs) in relation to eating pathology severity, personal/familial ED history, and key demographic and anthropometric variables. Methods Participants (N = 60) completed the Satisfaction with Life Scale (SWLS), the Eating Pathology Severity Index (EPSI), and demographic questionnaires. Bivariate associations via correlations and multiple linear regression models were used to explore these relationships. Results The SWLS mean score was 3.7 out of 7, suggesting it is below the population-based norm. LS was positively statistically significantly associated with private insurance, past ED, EPSI muscle building, EPSI restricted eating, and EPSI negative attitudes. When included in multiple linear regression, the model explained 33% of the variability of LS [F (7, 56) = 3.4, p = 0.0054, R2 = 0.33]. EPSI muscle building remained the strongest predictor (β = 0.13, p = 0.04). Conclusions Based on the data, individuals who have/have had EDs scored lower on the SWLS than the general population. Individuals scoring within this range typically experience significant issues in several areas of life or a substantial issue in one area

The Relationship between School Climate and Faith Engagement

The study of school climate has gained increased attention over the past 25 years, with research indicating significant relationships between school climate and a number of social, emotional and academic outcomes for students. An aspect of school climate that has seen little attention, however, is the relationship between the development of faith and positive school climate. This study analyses data from 368 students in one faith-based school in Australia, utilising self-reported measures of school climate and faith engagement. A significant relationship is found between these variables, indicating the potential impact that school climate and faith engagement may have on each other. The study discusses the implications of these findings and makes suggestions in relation to the strengthening of these two areas within faith-based schools

Faith Engagement at School

The ability of teachers to engage and develop the faith journey of students is seen as a central endeavour in faith-based schools. Much has been written in the literature regarding approaches that may be effective in facilitating this process. This study analysed qualitative data collected from 368 Year 5–12 students from one faith-based school in Australia. Students reported on the key areas they believe assist in developing their faith, in addition to aspects they believe could be improved in this regard. A significant difference was found between the attitudes of those who reported not having a faith background and those who did. This chapter builds onto findings reported in the previous chapter

Barriers to using new needles encountered by rural Appalachian people who inject drugs: implications for needle exchange

Background Using a new needle for every injection can reduce the spread of infectious disease among people who inject drugs (PWID). No previous study has examined new needle use barriers among PWIDs residing in the rural Appalachian part of the United States, an area currently in the midst of a heroin epidemic. Objective Therefore, our primary aim was to explore self-reported barriers to using a new needle by PWID attending a needle exchange program (NEP). Methods We conducted a cross-sectional survey of PWID attending two NEPs in rural West Virginia located in the heart of Central Appalachia. A convenience sample of PWID (n = 100) completed the Barriers to Using New Needles Questionnaire. Results The median number of barriers reported was 5 (range 0–19). Fear of arrest by police (72% of PWID “agreed” or “strongly agreed”) and difficulty with purchasing needles from a pharmacy (64% “agreed” or “strongly agreed”) were the most frequently cited barriers. Conclusions/Importance Congruent with previous findings from urban locations, in rural West Virginia, the ability of PWID to use a new needle obtained from a needle exchange for every injection may be compromised by fear of arrest. In addition, pharmacy sales of new needles to PWID may be blunted by an absence of explicit laws mandating nonprescription sales. Future studies should explore interventions that align the public health goals of NEPs with the occupational safety of law enforcement and health outreach goals of pharmacists

Qualitative case study of needle exchange programs in the Central Appalachian region of the United States

Background The Central Appalachian region of the United States is in the midst of a hepatitis C virus epi- demic driven by injection of opioids, particularly heroin, with contaminated syringes. In response to this epidemic, several needle exchange programs (NEP) have opened to pro- vide clean needles and other supplies and services to people who inject drugs (PWID). How- ever, no studies have investigated the barriers and facilitators to implementing, operating, and expanding NEPs in less populous areas of the United States. Methods This qualitative case study consisted of interviews with program directors, police chiefs, law enforcement members, and PWID affiliated with two NEPs in the rural state of West Virginia. Interview transcripts were coded inductively and analyzed using qualitative data analysis software. Final common themes related to barriers and facilitators of past program open- ings, current program operations, and future program plans, were derived through a consen- sus of two data coders. Results Both NEPs struggled to find existing model programs, but benefited from broad community support that facilitated implementation. The largest operational barrier was the legal conun- drum created by paraphernalia laws that criminalize syringe possession. However, both PWID and law enforcement appreciated the comprehensive services provided by these pro- grams. Program location and transportation difficulties were additional noted barriers. Future program operations are threatened by funding shortages and bans, but necessitated by unexpected program demand. Conclusion Despite broad community support, program operations are threatened by growing partici- pant volumes, funding shortages, and the federal government’s prohibition on the use of funds to purchase needles. Paraphernalia laws create a legal conundrum in the form of criminal sanctions for the possession of needles, which may inadvertently promote needle sharing and disease transmission. Future studies should examine additional barriers to using clean needles provided by rural NEPs that may blunt the effectiveness of NEPs in pre- venting disease transmission

Waking up every day in a body that is not yours: a qualitative research inquiry into the intersection between eating disorders and pregnancy

Background Women with eating disorders are more likely to negatively react to finding out they are pregnant, although this difference in attitudes between women with eating disorders and controls disappears at 18-weeks’ gestation. Those with anorexia also are twice as likely to have an unplanned pregnancy and those with bulimia have a 30-fold increased chance compared with healthy controls. Therefore, due to these considerations, pregnancy and the transition to motherhood can be an extremely challenging time for these women both psychologically and physically. The purpose of this qualitative descriptive study was to understand the intersection between eating disorders and pregnancy from the lived experience of women who have been pregnant or want to or do not want to become pregnant. Methods A total of 15 women with a current or past history of an eating disorder were recruited, including nine women who have had previous pregnancies as well as six nonparous women. Interviews were the primary unit of data collection, in addition to document analysis of diaries or blogs. Data analysis was based on verbatim transcripts from audio recordings. NVIVO 11© was used to manage the data from these interviews and thematic analysis was then conducted for emergence of major and sub themes. Results A total of six themes emerged from the iterative process of coding and categorizing. They were: Control, Disclosure to Others, Battle between Mothering & Eating Disorder, Fear of Intergenerational Transmission, Weight and Body Image Concerns, and Coping Strategies. One theme, Battle between Mothering & Eating Disorder also had three sub-themes: Decision to Have Child, Emotions Towards Pregnancy, and Focus on Child/Greater Good. Conclusions It is hoped that quotes and themes derived from this study will help inform both prenatal and postnatal care and interventions, as well as addressing intergenerational transmission concerns among mothers with eating disorders

Adverse Childhood Experiences Among Females in Substance Use Treatment and Their Children: A Pilot Study

Women with substance use disorder (SUD) often have experienced adverse childhood experiences (ACEs). The intergenerational nature of ACEs also put their children at risk for experiencing ACEs. However, no research has explored the prevalence of ACEs in children whose mothers have SUD. This study assessed ACE scores in mothers with SUD and their children and compared them with non-SUD participants. Females with SUD were recruited from a treatment center (n = 50) and compared to females without SUD from the same area (n = 50). The ACE scores of the participants and their children were measured as well as sociodemographic variables. ANOVA and Fisher’s Exact tests were used to examine univariate differences. Multivariate regression models assessed the difference in ACE scores between the groups and their children and the relationship between maternal and child ACE scores while including sociodemographic confounders. The mean ACE score was significantly higher in SUD participants (4.9, SD = 2.9) when compared to non-SUD participants (1.9, SD = 2.0) after controlling for sociodemographic variables (p \u3c .01). Children of treatment participants also had significantly higher mean ACE scores (3.9, SD = 2.3) than children of comparison participants (1.3, SD = 2.0, p \u3c .01). Maternal ACE score was positively related to children’s ACE score after controlling for sociodemographic variables. Given the intergenerational nature of ACEs and their high burden in both mothers and children in substance use treatment, these preliminary findings suggest that mother–child trauma-informed interventions may be appropriate for this population