Abstract Background Each year, hundreds of thousands of firearms are stolen, and vehicles are the leading source of firearm thefts in the United States. A precursor to these events is leaving a firearm in a vehicle unattended. Yet, the correlates and patterns of leaving firearms unattended in vehicles remain poorly understood. The purpose of this study was to examine the prevalence, correlates, and patterns of leaving firearms unattended in vehicles among US firearm owners. Methods Using a cross-sectional survey of firearm-owning adults administered online by YouGov in February–March 2026 (n = 1,856), ordinal logistic regression examined correlates of leaving firearms in unattended vehicles, including sociodemographic, perceptions of safety, strength of state firearm policies, and geographic factors. Among those reporting vehicle firearm storage (n = 468), firearm type, storage location, and reasons for leaving firearms in vehicles were descriptively examined. Results Overall, 73.2% of respondents reported never leaving a firearm in a vehicle unattended, 14.7% reported rarely, 5.7% reported sometimes, 3.2% reported most of the time, and 3.2% reported always. Male sex (v. female) (aOR = 1.48; 95% CI, 1.07–2.06), non-Hispanic Black race/ethnicity (v. non-Hispanic White) (aOR = 2.06; 95% CI, 1.17–3.61), prior firearm theft (v. no prior firearm theft) (aOR = 2.54; 95% CI, 1.60–4.03), higher perception of fear of being shot (aOR = 1.09, 95% CI = 1.03, 1.15), higher perceived likelihood of defensive gun use (1.08, 95% CI = 1.03, 1.14), conservative ideology (v. very liberal) (aOR = 2.46, 95% CI = 1.34, 4.52), and rural residence (v. metropolitan) (aOR = 2.21; 95% CI, 1.49–3.26) were associated with higher odds of leaving firearms in a vehicle more frequently. Among respondents who reported leaving firearms in vehicles unattended, handguns were the most common type of firearm left in vehicles (74.5%). Respondents most commonly reported leaving a firearm in the center console (24.6%) or the glovebox (16.7%); 19.7% used a designed for firearm storage. Top reasons for storing in a vehicle included legal carry restrictions, wanting a firearm nearby, and convenience. Conclusions Future research, intervention development, and testing are needed to reduce the leaving of firearms in vehicles unattended.

Introduction Adolescence is a critical period during which exposures to cardiovascular disease risk factors and related pathophysiologic changes begin. Yet neighborhood-level factors shaping cardiovascular health from adolescence onward remain understudied. The American Heart Association’s Life’s Essential 8 (LE8) is a composite cardiovascular health score, encompassing diet, physical activity, body mass index, blood pressure, and other factors. Area Deprivation Index (ADI), Social Vulnerability Index (SVI), and Childhood Opportunity Index (COI) estimate neighborhood disadvantage. This study examines associations between neighborhood disadvantage and LE8 cardiovascular risk factors in early adolescents. Methods We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, including 8,160 early adolescents with behavioral subcomponent scores and 1,125 with overall LE8 and health factors subcomponent scores. Neighborhood disadvantage indices (ADI, SVI, COI) were derived from geospatial data. Multivariable linear regression models assessed associations between ADI, SVI, and COI at baseline (2016–2018) and LE8 scores at Year 2 (2018–2020) and Year 3 (2019–2021), adjusted for age, sex, and race/ethnicity. Results Higher neighborhood disadvantage was associated with lower (less healthy) LE8 cardiovascular health scores in early adolescents, driven mainly by behavioral factors. Overall LE8 scores were 9.45 points lower for the most deprived ADI quintile (95% CI: -11.86, -7.05; p<0.001), 6.95 points lower for the most vulnerable SVI quintile (95% CI: -9.09, -4.82; p<0.001), and 8.45 points lower for the lowest opportunity COI quintile (95% CI: -10.77, -6.12; p<0.001). Conclusion Higher neighborhood deprivation was associated with poorer LE8 cardiovascular health scores in early adolescence.

PURPOSE:This study examined the relationship between fatal and non-fatal gun violence exposure (GVE) and hypertension among adults residing in the 100 largest United States cities. METHODS:Data were from Wave V (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health biomarker subsample linked to census tract-level counts of fatal and non-fatal shootings from the American Violence Project (n = 1030). Multiple logistic regression models estimated associations between the census-tract fatal and non-fatal shooting prevalence and respondent hypertension, adjusting for sociodemographic (age, sex, race/ethnicity, marital status, education, household income), personal victimization, neighborhood-level (tract poverty rate, population density), and health-related (body mass index, tobacco smoking) covariates. Separate stratified models were estimated by respondent sex and race/ethnicity. RESULTS:Overall, 54.5% of respondents were classified as hypertensive (>130/80 mmHg), and the mean census tract shooting prevalence was 2.49 per 10,000 residents. The shooting prevalence was not associated with hypertension in the full sample. In stratified analyses, however, a higher census tract shooting prevalence was associated with greater odds of hypertension among non-Hispanic Black respondents (adjusted odds ratio [aOR] = 2.019, 95% Confidence Interval [CI] = 1.248-3.264). CONCLUSIONS:Fatal and non-fatal GVE were associated with greater odds of hypertension among non-Hispanic Black adults. These findings highlight the need for targeted interventions and structural investments that mitigate the potential cardiovascular health consequences of proximal gun violence among affected populations.

OBJECTIVE:To investigate the association between parental incarceration and housing insecurity among a recent, nationally representative sample of children in the US. STUDY DESIGN:Data from the 2024 National Survey of Children's Health, a nationally representative survey of noninstitutionalized US children aged 0-17 years, were examined. Weighted multinomial and logistic regression models were estimated to examine associations between parental incarceration and several indicators of housing insecurity (eg, frequent moves, homelessness, caregiver eviction stress, missed housing payments), adjusting for various child, caregiver, household, and neighborhood characteristics. RESULTS:Findings revealed substantial disparities in housing insecurity among children exposed to parental incarceration. Children with incarcerated parents disproportionately resided in households experiencing housing insecurity relative to peers, including higher rates of missed housing payments (31.66% vs 13.68%), caregiver eviction stress (22.30% vs 8.85%), lifetime childhood homelessness (17.44% vs 1.95%), and lifetime moves (41.81% vs 10.77% reporting four or more moves). These associations were robust to multiple confounders. CONCLUSIONS:Addressing housing insecurity among children with incarcerated parents represents an important opportunity to reduce pediatric health inequities. Future research should prioritize efforts to characterize further this relationship, implement and test screenings in clinical settings, foster community partnerships, and support policies that reduce inequities in housing insecurity and parental incarceration for these children.

INTRODUCTION:Adolescence is a critical period of ongoing cognitive and behavioral development. Problematic social media use is a potentially important factor that shapes cognitive development during this period. This study examined the associations between problematic social media use trajectories and cognitive performance. METHODS:A total of 4,809 adolescents (mean age = 12 years, 48.9% female, 73.6% White) from the Adolescent Brain Cognitive Development Study were assessed from Year 2 (2018-2020) to Year 4 (2020-2022). Group-based trajectory modeling estimated patterns of problematic social media use in adolescents aged 10-16 years. Cognition was assessed at Year 4 (aged 12-16 years) using 5 of the 7 subtests of the NIH Toolbox Cognition Battery. Multiple linear regression models estimated the associations between problematic social media use trajectories and cognitive performance, adjusting for demographics, cognitive scores, mental health symptoms, and study site. RESULTS:Three problematic social media use trajectories were identified: no/low increasing, low-to-moderate, and moderate-to-high trajectories. Adolescents in the low-to-moderate trajectory demonstrated lower scores on the Picture Sequence Memory Test (β [standardized beta]= -0.10, 95% CI= -0.16, -0.03, p=0.003) and Picture Vocabulary Test (β= -0.11, 95% CI= -0.16, -0.07, p<0.001) than those in the no/low increasing trajectory. Adolescents in the moderate-to-high trajectory demonstrated lower scores on the Picture Sequence Memory Test (β= -0.24, 95% CI= -0.35, -0.13, p<0.001) and Picture Vocabulary Test (β= -0.17, 95% CI= -0.25, -0.09, p<0.001). CONCLUSIONS:Increasing trajectories of problematic social media use were associated with lower cognitive performance in the memory and language domains, highlighting the importance of developing effective interventions to address problematic social media use behaviors and support cognitive development.

PURPOSE:To determine associations between media parenting practices and cyberbullying in a national cohort of early adolescents. METHODS:We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (N = 9,686; 48.2% female, 44.7% non-White), Year 3 (2019-2022, 11-15 years). Media parenting practices were assessed for the following: screen time modeling, mealtime screen use, bedroom screen use, screen use for behavior management, monitoring screen time, and limiting screen time. Logistic regression models were used to determine associations between media parenting practices and cyberbullying victimization and perpetration, adjusting for sociodemographic characteristics. RESULTS:Parental allowance of mealtime screen use (adjusted odds ratio [AOR] 1.14), bedroom screen use (AOR 1.31), and screen use for behavior management (AOR 1.18) were associated with higher odds of cyberbullying victimization. Greater allowance of bedroom screen use was associated with higher odds of cyberbullying perpetration (AOR 1.44). Greater restriction of screen time (AOR 0.80) was associated with lower odds of cyberbullying victimization. Daily active screen time partially mediated these associations. DISCUSSION:Media parenting practices had stronger associations with cyberbullying victimization compared to perpetration. The significant mediation effect of active screen time indicates the importance of the amount of time on screens, which likely enables greater exposure to cyberbullying behaviors. Based on current pediatrics guidelines, parents may consider discussing how to safely navigate digital media and promote positive, respectful digital environments to minimize cyberbullying exposure behaviors. Our findings reinforce elements of the American Academy of Pediatrics' family media plan, including considering limiting bedroom, mealtime, and general screen use.

Loneliness is a growing public health concern, particularly among older persons and U.S. military veterans, yet little is known about how specific life experiences contribute to persistent loneliness over time. This study examines whether a history of arrest is associated with loneliness patterns over time among low-income veterans. Using five waves (2021–2025) of data from the nationally representative NV-HOPE study (n = 674), group-based trajectory modeling identified four loneliness trajectories: no loneliness (22.8

This study examines the prevalence, characteristics, and behavioral responses associated with firearm thefts from vehicles in the United States. Data are from a national survey of firearm owners conducted by YouGov in February–March 2026 (n = 1,976). Overall, 2.7

BackgroundFirearm secure storage (ie, storing firearms unloaded and locked) is recommended to reduce unintentional injuries and suicides. However, the relationship between psychological states, such as social isolation, and firearm secure storage practices is under-researched.MethodsData are from 7136 individuals with firearms in their households from the 2022 Behavioral Risk Factor Surveillance System. Multinomial logistic regression was used to explore the relationship between social isolation and firearm storage.ResultsAmong respondents, 71.6% reported storing firearms unloaded, 14.2% stored firearms loaded and locked and 14.2% stored firearms loaded and unlocked. Most respondents reported feeling ‘never’ (40.7%) or ‘rarely’ (33.3%) socially isolated, with 18.7% reporting ‘sometimes’, 4.3% ‘usually’ and 3.0% ‘always’ feeling socially isolated. Covariate-adjusted multinomial logistic regression analysis revealed that respondents who felt ‘always’ socially isolated had an over threefold greater risk of storing firearms loaded and unlocked (relative risk ratio=3.733, 95% CI 1.443 to 9.662, p=0.007) compared with unloaded.ConclusionResults suggest a link between feelings of social isolation and unsecured firearm storage. Public health strategies should address both firearm safety education and the underlying issue of social isolation.

Background:Evidence on screen time and cognition is mixed, with few longitudinal studies on social media patterns and memory. This study aimed to examine how social media trajectories relate to cognitive performance in early adolescence. Methods:We analyzed a prospective cohort (N = 7528, 51.1% male, mean age: 10 years (8-13 years), 41.8% non-White) from the Adolescent Brain Cognitive Development (ABCD) Study (baseline (2016-2018) to Year 2 (2018-2020)). Group-based trajectory modeling estimated patterns of daily social media use from baseline-Year 2. Three social media time trajectories: (1) no or very low use, (2) low but increasing use, and (3) high and increasing use were identified. Cognitive functioning was measured using the Little Man Task (LMT) and the Rey Auditory Verbal Learning Test (RAVLT). Linear regression models estimated the association between social media time trajectories and cognitive functioning at Year 2, adjusting for baseline age, sex, race, ethnicity, household income, parent education, attention-deficit/hyperactivity symptoms, depressive symptoms, respective baseline cognitive measures, non-social media screen use, and study site. Findings:Compared to no or very low social media use, low increasing social media use was associated with lower performance on the RAVLT Initial Trials (B: -1.38; 95% CI: -1.82, -0.94), RAVLT Retroactive Interference Trial (B: -0.38; 95% CI: -0.52, -0.25), and RAVLT Long Delay Trial (B: -0.41; 95% CI: -0.55, -0.26). Compared to no or very low social media use, high increasing social media use was associated with lower accuracy on the LMT (B: -0.03; 95% CI: -0.05, -0.01), and lower performance on the RAVLT Initial Trials (B: -1.90; 95% CI: -2.76, -1.04), RAVLT Retroactive Interference Trial (B: -0.61; 95% CI: -0.89, -0.32), and RAVLT Long Delay Trial (B: -0.55; 95% CI: -0.84, -0.27). Interpretation:Increases in social media time were prospectively associated with lower cognitive performance two years later. Monitoring digital use, implementing a Family Media Use Plan, and balancing screen time with cognitively enriching activities may help mitigate these effects. Future studies should examine the effects of various contemporary media on cognitive functioning. Funding:The research was supported by the Doris Duke Foundation (2022056).

INTRODUCTION:Functional limitations are a key indicator of ageing, associated with quality of life, independence and the need for caregiving and long-term support. Research shows that formerly incarcerated older adults have more functional limitations than those who have never been incarcerated, yet there is a lack of research on prior incarceration and changes in functional limitations over time. METHODS:Data come from 8377 adults aged ≥55 who participated in the Health and Retirement Study and were followed biennially from 2012 to 2022. Self-reported functional limitations were measured at each wave as a count of nine functional tasks. Group-based trajectory modelling identified subgroups characterised by patterns of functional limitations over time. Multinomial logistic regression was used to estimate the association between self-reported prior incarceration and trajectory group membership. RESULTS:We identified five distinct trajectories of functional limitations: low (23.8%), low-increasing (26.8%), moderate-increasing (24.2%), high-increasing (16.6%), and persistent-high (8.5%). Relative to the consistently low group, formerly incarcerated individuals (v. never incarcerated individuals) had a higher relative risk of membership in the moderate-increasing group (RRR=1.588, 95% CI 1.096 to 2.302), the high-increasing group (RRR=2.122, 95% CI 1.450 to 3.107), and the persistent-high group (RRR=2.181, 95% CI 1.207 to 3.940) after adjusting for covariates. CONCLUSIONS:These findings suggest that incarceration may be an important life-course marker of elevated risk for late-life functional limitations and highlight the need for targeted clinical and policy interventions to support functional health among formerly incarcerated older adults.

PURPOSE:This study examined the associations between social media use trajectories and eating disorder symptoms across early adolescence. METHODS:Data from 10,735 United States adolescents (48.9% female, mean baseline age 10 ± 0.7 years) participating in the Adolescent Brain Cognitive Development Study were analyzed. Adolescents self-reported social media use (average daily hours) from baseline (2016-2018) through Year 4 (2020-2022). Parent-reported eating disorder symptoms (experienced by adolescents) were assessed at baseline and Year 4: binge-eating symptoms, self-worth tied to weight, inappropriate compensatory behaviors to prevent weight gain, worry about weight gain, and any eating disorder symptom. Group-based trajectory modeling identified social media trajectories from baseline to Year 4. Logistic regression models estimated associations between social media use trajectories and eating disorder symptoms at Year 4, adjusting for covariates, including baseline eating disorder symptoms. RESULTS:Three social media use trajectories emerged: (1) no/very low use, (2) moderate, gradual increasing, and (3) rapid increasing. Compared with those in the no/very low use trajectory, adolescents in the moderate, gradual increasing, and rapid increasing trajectories had significantly higher odds of experiencing most eating disorder symptoms. CONCLUSIONS:Adolescents with increasing social media use were more likely to experience a range of eating disorder symptoms.

The popularity of dating apps has grown significantly among younger demographics. Despite evidence on the relationship between online dating and mental health in adults, little research exists on underage online dating app use in adolescents. This study examines the association between dating app use and depression symptoms in a U.S. sample of 13–16-year-old adolescents. We examined cross-sectional data from Year 5 (2021–2023) of the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,530). Multivariable linear regression analyses using cluster-robust (heteroskedasticity-consistent) standard errors were used to estimate the association between dating app use and depression symptoms, adjusting for potential confounders including sociodemographic factors (age, sex, race/ethnicity, household income, parent education) and study site. In this demographically diverse sample of adolescents (47.9

INTRODUCTION:This study examined the relationship between the state firearm policy context and household firearm storage in 13 U.S. states. METHODS:Data were from the 13 states that participated in the firearm module of the 2023 Behavioral Risk Factor Surveillance System (N=24,936). State firearm policy context was measured using a categorical indicator from the 2023 Giffords Law Center Gun Law Scorecard, with states graded A, B, D, or F (no states with a C grade were included in the sample). Multiple logistic regression models estimated the associations between state firearm policy context and whether a household stored a firearm as loaded and unlocked. Analyses were performed in August 2025-January 2026. RESULTS:Among firearm-owning households, 17.9% (95% CI=17.2%, 18.6%) reported residing in a household with a firearm stored loaded and unlocked. Respondents living in states with more restrictive firearm policy contexts were significantly less likely to reside in households with firearms stored loaded and unlocked, including those in D states (AOR=0.84, 95% CI=0.72, 0.98), B states (AOR=0.54, 95% CI=0.44, 0.67), and A states (AOR=0.24, 95% CI=0.17, 0.32), than respondents living in states rated F on the Giffords Scorecard. CONCLUSIONS:More restrictive state firearm policy environments are associated with a lower likelihood of residing in a household with a firearm stored loaded and unlocked. These findings highlight the relevance of considering the broader firearm policy landscape for firearm storage research and health promotion efforts.

To investigate sex differences in prospective associations between eating disorder (ED) symptoms and changes in body mass index (BMI) percentile in early adolescence. This prospective study used survey data from 7111 participants aged 10–12 years at Year 1 from the Adolescent Brain Cognitive Development (ABCD) Study—a diverse, national sample of adolescents from 21 sites across the United States (US). Multivariable linear regression models were used to assess the prospective associations between ED symptoms at Year 1 and BMI percentile at Year 2, adjusting for covariates and BMI percentile at Year 1. Effect moderation was explored in sex-stratified models. Sex modified the relationship between ED symptoms and changes in BMI percentile. Having binge eating symptoms (B = 3.65, 95

BACKGROUND AND OBJECTIVES:Social media exposure may influence early nicotine experimentation, a behavior linked to later nicotine dependence and health risks. Few studies have examined the role of smoking expectancies (i.e., beliefs about the anticipated positive or negative effects of nicotine) as a pathway underlying this association, especially in early adolescence. The objective of this study is to examine the prospective association between social media use and nicotine experimentation in early adolescence, and whether smoking expectancies mediate this relationship. METHODS:Using longitudinal data from the Adolescent Brain Cognitive Development Study (N = 8292; mean age 12.0 years at Year 2; 2018-2020), we estimated associations between social media time (Year 2) and nicotine experimentation (Year 4), adjusting for confounders and testing positive and negative smoking expectancies (Year 3) as mediators using generalized structural equation modeling. RESULTS:Social media time at Year 2 was associated with nicotine experimentation at Year 4. Positive smoking expectancies (but not negative expectancies) were associated with nicotine experimentation. Positive smoking expectancies mediated 5.97% (95% CI: 1.27%-10.67%, p = .013) of the social media-nicotine experimentation association. DISCUSSION AND CONCLUSIONS:Early social media exposure may be associated with favorable beliefs about nicotine, increasing adolescents' risk of experimentation. Regulatory policies, clinical screening, and prevention programs could mitigate early nicotine use. Future research should explore how these relationships evolve across adolescence. SCIENTIFIC SIGNIFICANCE:This study advances understanding of how social media use contributes to early nicotine experimentation in adolescents by identifying positive smoking expectancies as a potential pathway.

To assess whether (1) household firearm ownership and, among firearm-owning households, (2) household firearm storage are associated with healthcare engagement. Data were from the 2024 Behavioral Risk Factor Surveillance System from 19 US states (N = 145,720), including a subsample of respondents living in firearm-owning households (n = 54,125). Four indicators of healthcare engagement were assessed: health insurance status, having a personal healthcare provider, cost as a barrier to care, and time since last routine checkup. Multiply imputed, weighted multivariable logistic regression models were used to estimate associations between (1) household firearm ownership and (2) household firearm storage (unloaded, loaded and locked, and loaded and unlocked) and healthcare engagement, adjusting for age, sex, race/ethnicity, marital status, educational attainment, income, presence of a child in the home, military veteran, bad physical health days, urban-rural classification, and state of residence. In covariate-adjusted models, household firearm ownership was associated with a higher odds of having a personal health care provider (adjusted odds ratio [aOR] = 1.12, 95

OBJECTIVE:To evaluate the association between Prescription Drug Monitoring Programs (PDMPs) and postpartum opioid prescribing from 2007 to 2015, prior to the 2016 Centers for Disease Control and Prevention opioid prescribing guidelines, and to assess differences between low- and high-risk populations. STUDY SETTING AND DESIGN:This cross-sectional study captures delivery episodes across the United States, primarily from commercially insured patients. The exposure was the implementation of PDMPs at the state level from 2007 to 2015, with states classified by whether implementation occurred before or after 2016. We used a difference-in-difference design for analysis. The primary outcome included: (1) morphine milligram equivalents (MME) per day; (2) pills dispensed; (3) average days' supply, and (4) total number of prescriptions filled during the postpartum period (42 days after delivery). DATA SOURCES AND ANALYTIC SAMPLE:We analyzed secondary data from IQVIA PharMetrics, an administrative claims database from 2006 to 2015. We identified reproductive-age patients (ages 12-59) with a documented delivery and stratified them into low and high-risk groups by postpartum prescribing and pre-delivery opioid exposure. PRINCIPAL FINDINGS:Among 361,165 delivery episodes (9.9% cesarean, 90.1% vaginal), PDMP implementation was not associated with changes in postpartum opioid prescribing. In an age-and comorbidity-adjusted analysis by risk groups, PDMP implementation was not associated with statistically significant changes in MME per day per delivery in either low-risk (-0.35; 95% CI, -3.27 to 2.57) or high-risk groups (1.11; 95% CI, -7.46 to 9.68) in the implementation year, and results for pills dispensed, days' supply, and total prescriptions were similarly null, with confidence intervals spanning zero. CONCLUSION:State-level PDMP implementation was not associated with changes in postpartum opioid prescribing. These findings suggest PDMPs alone may be insufficient to influence postpartum prescribing, highlighting the need for alternative strategies to optimize pain management and reduce opioid-related risks.