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1. A National Study of Homelessness, Social Determinants of Health, and Treatment Engagement Among Outpatient Medication for Opioid Use Disorder-Seeking Individuals in the United States

   https://doi.org/10.1177/08897077231167291  

   Gaeta Gazzola, Marina ; Carmichael, Iain D. ; Christian, Nicholaus J. ; Zheng, Xiaoying ; Madden, Lynn M. ; Barry, Declan T. ( May 2023 , Substance Abuse)

   Homelessness is an important social determinant of health (SDOH), impacting health outcomes for many medical conditions. Although homelessness is common among people with opioid use disorder (OUD), few studies systematically evaluate homelessness and other SDOH among people enrolled in standard of care treatment for OUD, medication for opioid use disorder (MOUD), or examine whether homelessness affects treatment engagement.

   Using data from the 2016 to 2018 U.S. Treatment Episode Dataset Discharges (TEDS-D), patient demographic, social, and clinical characteristics were compared between episodes of outpatient MOUD where homelessness was reported at treatment enrollment versus independent housing using pairwise tests adjusted for multiple testing. A logistic regression model examined the relationship between homelessness and treatment length and treatment completion while accounting for covariates.

   There were 188 238 eligible treatment episodes. Homelessness was reported in 17 158 episodes (8.7%). In pairwise analysis, episodes involving homelessness were significantly different from those involving independent living on most demographic, social, and clinical characteristics, with significantly greater social vulnerability in most SDOH variables ( P’s < .05). Homelessness was significantly and negatively associated with treatment completion (coefficient = −0.0853, P < 0.001, 95% CI = [−0.114, −0.056], OR = 0.918) and remaining in treatment for greater than 180 days (coefficient = −0.3435, P < 0.001, 95% CI = [−0.371, −0.316], OR = 0.709) after accounting for covariates.

   Patients reporting homelessness at treatment entry in outpatient MOUD in the U.S. represent a clinically distinct and socially vulnerable population from those not reporting homelessness. Homelessness independently predicts poorer engagement in MOUD confirming that homelessness may be an independent predictor for MOUD treatment discontinuation nationally.

    

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2. Reframing rangeland systems science research in Kenya: a synthesis of social-science mixed methods to inform integrative analysis of landscape pattern and process

   https://doi.org/10.1007/s10980-023-01723-w  

   Unks, Ryan ( July 2023 , Landscape Ecology)

   Interdisciplinary borrowing between ecology and the social sciences has produced numerous insights about pastoral livelihood practices and rangeland ecology, demonstrating how people practicing pastoralism constantly modify their practices to adapt to social, political, economic, and biophysical change.

   I outline an approach for integrating research on pastoral livelihoods into a landscape ecology framework. I focus on access to land and resources, and an integrative approach to scale, to assess the relationship between landscape and social processes.

   I use remotely sensed data and ethnographic analysis of livelihood change in two semi-arid contexts in Kenya to compare broad scale changes in pastoral mobility to spatio-temporal patterns of variability in rainfall and vegetation productivity. I then synthesize the political, economic, and social relations that have most prominently influenced access to land and restructured landscape process at finer scales.

   Spatial controls have been imposed on land use that have increasingly partitioned landscapes and concentrated pastoral access to land. Access to land has also been influenced by changes in social norms, employment, and market relations. Informal rules and norms, social differentiation, and exclusionary partitions have produced socially differentiated land use intensity gradients and novel landscape processes that have not previously been considered in landscape analyses in Kenya.

   Understanding access, land use, and landscape processes as intertwined, with uneven processes of land and resource capture at different scales, would enable landscape ecologists to choose observational scales relevant to rural livelihoods and sensitive to power asymmetries, creating robust analytical linkages between social and ecological processes.

    

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3. Mental health during the COVID-19 pandemic: Impacts of disease, social isolation, and financial stressors

   https://doi.org/10.1371/journal.pone.0277562  

   Kraut, Robert E. ; Li, Han ; Zhu, Haiyi ( November 2022 , PLOS ONE)

   Nabi, Mohammad Hayatun (Ed.)

   Although research shows that the Covid-19 pandemic has led to declines in mental health, the existing research has not identified the pathways through which this decline happens.

   The current study identifies the distinct pathways through which COVID-induced stressors (i.e., social distancing, disease risk, and financial stressors) trigger mental distress and examines the causal impact of these stressors on mental distress.

   We combined evidence of objective pandemic-related stressors collected at the county level (e.g., lack of social contact, infection rates, and unemployment rates) with self-reported survey data from over 11.5 million adult respondents in the United States collected daily for eight months. We used mediation analysis to examine the extent to which the objective stressors influenced mental health by influencing individual respondents’ behavior and fears.

   County-level, day-to-day social distancing predicted significantly greater mental distress, both directly and indirectly through its effects on individual social contacts, worries about getting ill, and concerns about finances. Economic hardships were indirectly linked to increased mental distress by elevating people’s concerns about their household’s finances. Disease threats were both directly linked to mental distress and indirectly through its effects on individual worries about getting ill. Although one might expect that social distancing from people outside the home would have a greater influence on people who live alone, sub-analyses based on household composition do not support this expectation.

   This research provides evidence consistent with the thesis that the COVID-19 pandemic harmed the mental well-being of adults in the United States and identifies specific stressors associated with the pandemic that are responsible for increasing mental distress.

    

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4. An Investigation on the Portrayal of Blue Whale Challenge on YouTube and Twitter

   https://doi.org/10.1177/1071181319631179  

   Khasawneh, Amro ; Chalil Madathil, Kapil ; Dixon, Emma ; Wisniewski, Pamela ; Zinzow, Heidi ; Roth, Rebecca ( November 2019 , Proceedings of the Human Factors and Ergonomics Society Annual Meeting)

   Introduction Social media has created opportunities for children to gather social support online (Blackwell et al., 2016; Gonzales, 2017; Jackson, Bailey, & Foucault Welles, 2018; Khasawneh, Rogers, Bertrand, Madathil, & Gramopadhye, 2019; Ponathil, Agnisarman, Khasawneh, Narasimha, & Madathil, 2017). However, social media also has the potential to expose children and adolescents to undesirable behaviors. Research showed that social media can be used to harass, discriminate (Fritz & Gonzales, 2018), dox (Wood, Rose, & Thompson, 2018), and socially disenfranchise children (Page, Wisniewski, Knijnenburg, & Namara, 2018). Other research proposes that social media use might be correlated to the significant increase in suicide rates and depressive symptoms among children and adolescents in the past ten years (Mitchell, Wells, Priebe, & Ybarra, 2014). Evidence based research suggests that suicidal and unwanted behaviors can be promulgated through social contagion effects, which model, normalize, and reinforce self-harming behavior (Hilton, 2017). These harmful behaviors and social contagion effects may occur more frequently through repetitive exposure and modelling via social media, especially when such content goes “viral” (Hilton, 2017). One example of viral self-harming behavior that has generated significant media attention is the Blue Whale Challenge (BWC). The hearsay about this challenge is that individuals at all ages are persuaded to participate in self-harm and eventually kill themselves (Mukhra, Baryah, Krishan, & Kanchan, 2017). Research is needed specifically concerning BWC ethical concerns, the effects the game may have on teenagers, and potential governmental interventions. To address this gap in the literature, the current study uses qualitative and content analysis research techniques to illustrate the risk of self-harm and suicide contagion through the portrayal of BWC on YouTube and Twitter Posts. The purpose of this study is to analyze the portrayal of BWC on YouTube and Twitter in order to identify the themes that are presented on YouTube and Twitter posts that share and discuss BWC. In addition, we want to explore to what extent are YouTube videos compliant with safe and effective suicide messaging guidelines proposed by the Suicide Prevention Resource Center (SPRC). Method Two social media websites were used to gather the data: 60 videos and 1,112 comments from YouTube and 150 posts from Twitter. The common themes of the YouTube videos, comments on those videos, and the Twitter posts were identified using grounded, thematic content analysis on the collected data (Padgett, 2001). Three codebooks were built, one for each type of data. The data for each site were analyzed, and the common themes were identified. A deductive coding analysis was conducted on the YouTube videos based on the nine SPRC safe and effective messaging guidelines (Suicide Prevention Resource Center, 2006). The analysis explored the number of videos that violated these guidelines and which guidelines were violated the most. The inter-rater reliabilities between the coders ranged from 0.61 – 0.81 based on Cohen’s kappa. Then the coders conducted consensus coding. Results & Findings Three common themes were identified among all the posts in the three social media platforms included in this study. The first theme included posts where social media users were trying to raise awareness and warning parents about this dangerous phenomenon in order to reduce the risk of any potential participation in BWC. This was the most common theme in the videos and posts. Additionally, the posts claimed that there are more than 100 people who have played BWC worldwide and provided detailed description of what each individual did while playing the game. These videos also described the tasks and different names of the game. Only few videos provided recommendations to teenagers who might be playing or thinking of playing the game and fewer videos mentioned that the provided statistics were not confirmed by reliable sources. The second theme included posts of people that either criticized the teenagers who participated in BWC or made fun of them for a couple of reasons: they agreed with the purpose of BWC of “cleaning the society of people with mental issues,” or they misunderstood why teenagers participate in these kind of challenges, such as thinking they mainly participate due to peer pressure or to “show off”. The last theme we identified was that most of these users tend to speak in detail about someone who already participated in BWC. These videos and posts provided information about their demographics and interviews with their parents or acquaintances, who also provide more details about the participant’s personal life. The evaluation of the videos based on the SPRC safe messaging guidelines showed that 37% of the YouTube videos met fewer than 3 of the 9 safe messaging guidelines. Around 50% of them met only 4 to 6 of the guidelines, while the remaining 13% met 7 or more of the guidelines. Discussion This study is the first to systematically investigate the quality, portrayal, and reach of BWC on social media. Based on our findings from the emerging themes and the evaluation of the SPRC safe messaging guidelines we suggest that these videos could contribute to the spread of these deadly challenges (or suicide in general since the game might be a hoax) instead of raising awareness. Our suggestion is parallel with similar studies conducted on the portrait of suicide in traditional media (Fekete & Macsai, 1990; Fekete & Schmidtke, 1995). Most posts on social media romanticized people who have died by following this challenge, and younger vulnerable teens may see the victims as role models, leading them to end their lives in the same way (Fekete & Schmidtke, 1995). The videos presented statistics about the number of suicides believed to be related to this challenge in a way that made suicide seem common (Cialdini, 2003). In addition, the videos presented extensive personal information about the people who have died by suicide while playing the BWC. These videos also provided detailed descriptions of the final task, including pictures of self-harm, material that may encourage vulnerable teens to consider ending their lives and provide them with methods on how to do so (Fekete & Macsai, 1990). On the other hand, these videos both failed to emphasize prevention by highlighting effective treatments for mental health problems and failed to encourage teenagers with mental health problems to seek help and providing information on where to find it. YouTube and Twitter are capable of influencing a large number of teenagers (Khasawneh, Ponathil, Firat Ozkan, & Chalil Madathil, 2018; Pater & Mynatt, 2017). We suggest that it is urgent to monitor social media posts related to BWC and similar self-harm challenges (e.g., the Momo Challenge). Additionally, the SPRC should properly educate social media users, particularly those with more influence (e.g., celebrities) on elements that boost negative contagion effects. While the veracity of these challenges is doubted by some, posting about the challenges in unsafe manners can contribute to contagion regardless of the challlenges’ true nature. 

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5. Mental health in undergraduate engineering students: Identifying facilitators and barriers to seeking help

   https://doi.org/10.1002/jee.20551  

   Wright, Courtney J. ; Wilson, Sarah A. ; Hammer, Joseph H. ; Hargis, Lucy E. ; Miller, Melanie E. ; Usher, Ellen L. ( July 2023 , Journal of Engineering Education)

   Engineering students encounter high levels of stress, which may negatively impact their mental health. Nevertheless, engineering students who experience mental health distress are less likely than their peers to seek professional help, even when controlling for gender and race/ethnicity.

   We examined beliefs that undergraduate engineering students have about barriers and facilitators to seeking professional help for their mental health. We also sought to identify cultural and systemic factors within and beyond engineering that might affect help‐seeking. Together, these beliefs influence students' sense of personal agency around seeking mental health care.

   We implemented a pragmatic qualitative design that incorporated the integrated behavioral model to investigate engineering students' (N = 33) professional mental health help‐seeking beliefs. We used thematic analysis to analyze help‐seeking beliefs and perceived barriers and facilitators that students described during interviews.

   We identified four themes: Navigating the system impacts personal agency; sacrifices associated with help‐seeking act as a barrier; engineering culture acts as a barrier to help‐seeking; and student confidence in help‐seeking varies significantly. These themes portray the effect of perceived barriers and facilitators on students' personal agency for accessing mental health care. Our findings have implications for engineering departments and university counseling centers that want to minimize barriers to help‐seeking.

   Engineering stakeholders must improve access to professional help for engineering students. Implementing changes to normalize help‐seeking behaviors, enhance personal agency, and facilitate engagement with mental health resources will create better conditions for engineers. Further research is necessary to understand how other beliefs (e.g., attitudes, perceived norms) inform the relationships between student mental health, professional help seeking, and engineering culture.

    

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