Today's children and adolescents are immersed in both traditional and new forms of digital media. Research on traditional media, such as television, has identifi ed health concerns and negative outcomes that correlate with the duration and content of viewing. Over the past decade, the use of digital media, including interactive and social media, has grown, and research evidence suggests that these newer media offer both benefi ts and risks to the health of children and teenagers. Evidence-based benefi ts identifi ed from the use of digital and social media include early learning, exposure to new ideas and knowledge, increased opportunities for social contact and support, and new opportunities to access health promotion messages and information. Risks of such media include negative health effects on sleep, attention, and learning; a higher incidence of obesity and depression; exposure to inaccurate, inappropriate, or unsafe content and contacts; and compromised privacy and confi dentiality. This technical report reviews the literature regarding these opportunities and risks, framed around clinical questions, for children from birth to adulthood. To promote health and wellness in children and adolescents, it is important to maintain adequate physical activity, healthy nutrition, good sleep hygiene, and a nurturing social environment. A healthy Family Media Use Plan (www. healthychildren. org/ MediaUsePlan) that is individualized for a specifi c child, teenager, or family can identify an appropriate balance between screen time/online time and other activities, set boundaries for accessing content, guide displays of personal information, encourage age-appropriate critical thinking and digital literacy, and support open family communication and implementation of consistent rules about media use.

Background Depression is common and frequently undiagnosed among college students. Social networking sites are popular among college students and can include displayed depression references. The purpose of this study was to evaluate college students' Facebook disclosures that met DSM criteria for a depression symptom or a major depressive episode (MDE). Methods We selected public Facebook profiles from sophomore and junior undergraduates and evaluated personally written text: “status updates.” We applied DSM criteria to one year of status updates from each profile to determine prevalence of displayed depression symptoms and MDE criteria. Negative binomial regression analysis was used to model the association between depression disclosures and demographics or Facebook use characteristics. Results A total of 200 profiles were evaluated, profile owners were 43.5% female with a mean age of 20 years. Overall, 25% of profiles displayed depressive symptoms and 2.5% met criteria for MDE. Profile owners were more likely to reference depression if they averaged at least one online response from their friends to a status update disclosing depressive symptoms (exp(B)=2.1, p<0.001), or if they used Facebook more frequently (p<0.001). Conclusion College students commonly display symptoms consistent with depression on Facebook. Our findings suggest that those who receive online reinforcement from their friends are more likely to discuss their depressive symptoms publicly on Facebook. Given the frequency of depression symptom displays on public profiles, SNSs could be an innovative avenue for combating stigma surrounding mental health conditions, or for identifying students at risk for depression.

This mHealth PA intervention was feasible and acceptable to AYA childhood cancer survivors and warrants a fully powered RCT.

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Social media Websites (SMWs) are increasingly popular research tools. These sites provide new opportunities for researchers, but raise new challenges for Institutional Review Boards (IRBs) that review these research protocols.As of yet, there is little-to-no guidance regarding how an IRB should review the studies involving SMWs. The purpose of this article was to review the common risks inherent in social media research and consider how researchers can consider these risks when writing research protocols. We focused this article on three common research approaches: observational research, interactive research, and survey/interview research. Concomitant with these research approaches, we gave particular attention to the issues pertinent to SMW research, including privacy, consent, and confidentiality. After considering these challenges, we outlined key considerations for both researchers and reviewers when creating or reviewing SMW IRB protocols. Our goal in this article was to provide a detailed examination of relevant ethics and regulatory issues for both researchers and those who review their protocols.

Media, from television to the “new media” (including cell phones, iPads, and social media), are a dominant force in children’s lives. Although television is still the predominant medium for children and adolescents, new technologies are increasingly popular. The American Academy of Pediatrics continues to be concerned by evidence about the potential harmful effects of media messages and images; however, important positive and prosocial effects of media use should also be recognized. Pediatricians are encouraged to take a media history and ask 2 media questions at every well-child visit: How much recreational screen time does your child or teenager consume daily? Is there a television set or Internet-connected device in the child’s bedroom? Parents are encouraged to establish a family home use plan for all media. Media influences on children and teenagers should be recognized by schools, policymakers, product advertisers, and entertainment producers.

The study included undergraduate students (age range, 18-20 years) at 2 state universities with public Facebook profiles. Main Exposures:The profiles were categorized into 1 of 3 distinct categories: Nondisplayers, Alcohol Displayers, and I/PD Displayers.Outcome Measures: An online survey measured problem drinking using the Alcohol Use Disorders Identification Test (AUDIT) scale. Analyses examined associations between alcohol display category and (1) AUDIT problem drinking category using logistic regression, (2) AUDIT score using negative binomial regression, and (3) alcohol-related injury using the Fisher exact test.Results: Among 307 profiles identified, 224 participants completed the survey (73% response rate). The average age was 18.8 years; 122 (54%) were female; 152 (68%) were white; and approximately 50% were from each university. Profile owners who displayed I/PD were more likely (odds ratio, 4.4; 95% CI, 2.0-9.4) to score in the problem drinking category of the AUDIT scale, had 64.0% (incidence rate ratio, 1.64; 95% CI, 1.27-11.0) higher AUDIT scores overall, and were more likely to report an alcohol-related injury in the past year (P=.002).Conclusions: Displayed references to I/PD were positively associated with AUDIT scores suggesting problem drinking as well as alcohol-related injury. Results suggest that clinical criteria for problem drinking can be applied to Facebook alcohol references.

Purpose Nonsuicidal self-injury (NSSI) content is present on social media and may influence adolescents. Instagram is a popular site among adolescents in which NSSI-related terms are user-generated as hashtags (words preceded by a #). These hashtags may be ambiguous and thus challenging for those outside the NSSI community to understand. The purpose of this study was to evaluate the meaning, popularity, and content advisory warnings related to ambiguous NSSI hashtags on Instagram. Methods This study used the search term “#selfharmmm” to identify public Instagram posts. Hashtag terms co-listed with #selfharmmm on each post were evaluated for inclusion criteria; selected hashtags were then assessed using a structured evaluation for meaning and consistency. We also investigated the total number of Instagram search hits for each hashtag at two time points and determined whether the hashtag prompted a Content Advisory warning. Results Our sample of 201 Instagram posts led to identification of 10 ambiguous NSSI hashtags. NSSI terms included #blithe, #cat, and #selfinjuryy. We discovered a popular image that described the broader community of NSSI and mental illness, called “#MySecretFamily.” The term #MySe-cretFamily had approximately 900,000 search results at Time 1 and >1.5 million at Time 2. Only one-third of the relevant hashtags generated Content Advisory warnings. Conclusions NSSI content is popular on Instagram and often veiled by ambiguous hashtags. Content Advisory warnings were not reliable; thus, parents and providers remain the cornerstone of prompting discussions about NSSI content on social media and providing resources for teens.