Objectives: The purpose of this study was to examine the associations between frequent social media use and tobacco, alcohol, and drug use among US high school students in grades 9 through 12. Methods: Data from the 2023 national Youth Risk Behavior Survey (N = 20 103) were analyzed to assess the associations between frequent social media use and current tobacco or nicotine use, current alcohol use, current binge drinking, ever marijuana use, ever prescription opioid misuse, and ever select illicit drug use. Frequent social media use was defined as using social media several times a day, about once an hour, or more than once an hour. Quasi-Poisson regression models estimated adjusted prevalence ratios (APRs) comparing substance use behaviors among students with frequent social media use versus infrequent or no social media use, overall and by sex. Models were adjusted for race and ethnicity and grade. Results: Compared with students reporting infrequent or no social media use, students with frequent social media use were more likely to report current tobacco or nicotine use (APR = 1.88; 95% CI, 1.25-2.83), current alcohol use (APR = 2.07; 95% CI, 1.54-2.78), current binge drinking (APR = 2.55; 95% CI, 1.45-4.48), and ever marijuana use (APR = 2.09; 95% CI, 1.68-2.60). Associations were observed among female and male students. Conclusions: Frequent social media use was associated with several substance use behaviors among US high school students. Future research should examine mechanisms, including type of social media platform used, exposure to substance use–related content, and peer influences, to inform prevention strategies.
Objectives: People impacted by the criminal–legal system face challenges to securing and sustaining permanent housing. This study was designed to deliver an integrated housing, medical, and behavioral health services intervention to individuals with criminal–legal involvement. Methods: After a baseline needs assessment, participants were linked to services and completed quarterly study visits for up to 12 months. We used descriptive statistics to assess frequency and multivariate logistic regression to assess correlates of housing status at last follow-up. Results: Between June 2019 and November 2023, 187 participants were enrolled in Project CHANGE (Comprehensive Housing and Addiction Treatment Network of Greater New Haven). At baseline, 43% of participants were unstably housed, 37% were homeless, and the remaining resided in a shelter or institution. At the time of last follow-up, 49 participants (26.2%) reported improved housing outcomes, and an additional 121 participants’ (64.7%) housing situation did not worsen. In multivariate models, individuals who were older (adjusted odds ratio [AOR] = 1.1; 95% CI, 1.0-1.1), unstably housed at baseline (AOR = 7.6; 95% CI, 3.8-15.9), and enrolled in the study for longer (AOR = 1.2; 95% CI, 1.1-1.3) had higher odds of being housed at last follow-up, whereas those with high-severity substance use had lower odds of being housed (AOR = 0.3; 95% CI, 0.1-0.6). Conclusions: In this comprehensive program, integrated housing and health services were time and cost intensive but were associated with positive housing outcomes. People involved in the criminal–legal system face unique barriers to housing, particularly when compounded by substance use.
Objective: Nonspecific low back pain (ns-LBP) is a widespread health challenge, and opioids were frequently prescribed upon first LBP presentation in the United States during the opioid epidemic. We assessed temporal changes in quarterly (Q) opioid prescriptions for new-onset ns-LBP from 2012 through 2024 at a California medical center amid evolving voluntary federal recommendations and mandatory state regulations. Methods: We analyzed opioid prescription rates (prescription within 6 months of diagnosis) for ns-LBP patients diagnosed in all departments and stratified by emergency department (ED), and we compared high- versus low-dose prescription (≥50 morphine mg equivalents/day). Change point detection identified transitions without policy priors, and interrupted time series regression quantified level changes and trend modifications. Results: Of 31 940 ns-LBP patients, 2077 (6.5%) received opioids (mean [SD] age, 51.0 [17.6] y; 45.3% male; 53.7% White). Change points occurred at 2015 Q2 and 2018 Q4. Prescribing odds declined 2.7% per quarter from 2012 Q1 through 2024 Q4 (95% CI, 0.4%-5.0%; P = .02). ED patients (16.5% prescribed opioids vs 5.8% non-ED) showed a 54.2% immediate reduction at 2015 Q2 (95% CI, 18.8%-74.2%; P = .008), declining from 27.4% to 12.2% before plateauing; non-ED patients showed a 42.8% reduction at 2018 Q4 (95% CI, 27.5%-54.9%; P < .001). High-dose prescribing remained unchanged among opioid recipients. Conclusion: Change points coincided with anticipatory adoption of the 2016 Centers for Disease Control and Prevention recommendations and 2018 California mandatory drug monitoring implementation. ED settings showed disproportionate reductions at 2015 Q2, consistent with knowledge diffusion of voluntary guidelines in settings with frequent opioid prescribing, while non-ED reductions coincided with immediate regulatory compliance at 2018 Q4. This distinction can guide future policy selection to address environment-specific adoption barriers.
Objectives: In 2024, an increase in human parvovirus B19 (B19) infections among pregnant patients resulting in severe fetal complications highlighted the lack of routine surveillance methods for nonreportable infections. We examined the utility of electronic health record (EHR) data for investigating statewide trends in nonreportable infections, using B19 as a case study. Methods: We used EHR data from 10 health systems aggregated by the Minnesota Electronic Health Record Consortium to analyze statewide B19 trends in Minnesota. We mapped health system data to a common data model using concept identifiers, a standardized medical coding vocabulary. We examined the frequency of B19-associated laboratory testing, diagnoses, and pregnancy complications among Minnesota residents from January 2019 through September 2024, focusing on females of reproductive age (15-44 y) when examining B19-associated pregnancy complications. Results: B19 testing and test positivity increased in 2024 compared with the preceding 60 months. From January 2019 through September 2024, 47 females of reproductive age had B19-associated pregnancy complications within 60 days of a B19 diagnosis or positive laboratory test result. Of these, 19 (40.4%) occurred from January through September 2024 and 28 (59.6%) occurred during the preceding 60 months. Conclusions: These findings support the use of EHR data for disease trend analyses, particularly for rare conditions, care processes, and nonreportable diseases.
