Ariel Shensa

University of Pittsburgh | Pitt · Center for Research on Media,Technology, and Health

Background: Evidence-based prescribing (EBP) results in decreased morbidity and reduces medical costs. However, pharmaceutical marketing influences medication requests and prescribing habits, which can detract from EBP. Media literacy, which teaches critical thinking, is a promising approach for buffering marketing influences and encouraging EBP....

Background: Despite widespread use, little is known about how adolescents and young adults (AYA) with cancer use social media (SM). This research characterized use and self-reported SM experiences among AYA with cancer. Procedure: AYA, aged 12-26 years, receiving cancer care completed a mixed-methods survey regarding SM experiences. Clinical inf...

Background. Twitter provides an opportunity to examine misperceptions about nicotine and addiction as they pertain to electronic nicotine delivery systems (ENDS). The purpose of this study was to systematically examine a sample of ENDS-related tweets that presented information about nicotine or addiction for the presence of potential misinformation...

The impact of social media interactions on mental health is not fully understood, despite increasing use. This qualitative investigation explored positive and negative effects of social media for individuals with and without depressive symptoms. The authors conducted an online survey of US adults ages 18–30 in March 2018. Two open-ended questions a...

Background In response to growing anti-vaccine activism on social media, the #DoctorsSpeakUp event was designed to promote pro-vaccine advocacy. This study aimed to analyze Twitter content related to the event to determine (1) characteristics of the Twitter users who authored these tweets, (2) the proportion of tweets expressing pro-vaccine compare...

BACKGROUND There exists an alarming amount of misinformation and conspiracy theories related to COVID-19 and electronic nicotine delivery systems (ENDS). Some of this may stem from early reports suggesting a lower risk of severe COVID-19 in nicotine users. Additionally, a common conspiracy is that the E-cigarette, or Vaping Product Use-Associated L...

Background Lesbian, gay, and bisexual (LGB) persons are disproportionately affected by depression and have high social media use rates. Negative social media experiences may modify depressive symptoms among LGB persons. We sought to assess the potential influence of negative social media experiences on the association between LGB orientation and de...

We aimed to assess associations between parental social media comparison (PSMC)—the degree to which individuals compare their parenting with others on social media (SM)—and depressive symptoms. In March 2018 we conducted a survey of 528 parents ages 18-30 with children under the age of 18. Participants were asked about SM use, PSMC, and depressive...

Introduction Previous studies have demonstrated cross-sectional associations between social media use and depression, but their temporal and directional associations have not been reported. Methods In 2018, participants aged 18–30 years were recruited in proportion to U.S. Census characteristics, including age, sex, race, education, household inco...

Young adults use social media (SM) to share life events, including loss of loved ones. In a national sample of U.S. young adults (n = 1,119), “grievers” were identified as those who had experienced the loss of a loved one who had a SM account (n = 415, 37%). Logistic regression analyses found that grievers and non-grievers did not differ by sociode...

BACKGROUND Lesbian, gay, and bisexual (LGB) persons are disproportionately affected by depression and have high social media (SM) use rates. Negative SM experiences might modify depressive symptoms among LGB persons. OBJECTIVE We sought to assess the potential influence of negative SM experiences on the association between LGB identity and depress...

Objectives We sought to examine the association of positive and negative experiences using social media (SM) and sleep disturbance in a national survey of U.S. young adults. Methods Experiences using SM were assessed with 2 items asking participants about the percentage of time using SM that involved a negative/positive experience that they were p...

Background. The use of electronic cigarettes (e-cigarette) offers potential to facilitate cigarette smoking cessation, yet potentially increases risk of cigarette smoking initiation. This relationship has been primarily modeled in mathematical ways that often do not represent real-world complexities, which could inform decisions regarding local pre...

Previous research suggests that television programming may influence viewers’ health-related knowledge, perceptions, and behaviors but has yet to examine patient–provider interactions on the most popular primetime television programs. We aimed to characterize the frequency and nature of patient-centered communication (PCC) behaviors on these progra...

Previous research suggests that television programming may influence viewers’ health-related knowledge, perceptions, and behaviors but has yet to examine patient–provider interactions on the most popular primetime television programs. We aimed to characterize the frequency and nature of patient-centered communication (PCC) behaviors on these progra...

Purpose Although there is evidence of associations between social media (SM) use and mental well-being among the general population, these associations among lesbian, gay, and bisexual (LGB) persons are poorly understood. This study compared the influence of SM experiences on mental well-being between LGB and non-LGB persons. Design and Setting On...

Background: Emotional support is highly protective against poor mental health. Though several measures of emotional support exist, none specifically addresses social media (SM) as a source of emotional support. Therefore, the objectives of this study were to determine if SM-based emotional support is an extension of or distinct construct from face...

Background: JUUL-a novel electronic nicotine delivery system (ENDS)-comprises most of the ENDS market share. Additionally, JUUL has a high nicotine content and utilizes a patented nicotine salt formulation aimed to speed absorption. Many JUUL users are not aware of the nicotine content and therefore may not be expecting acute nicotine effects or p...

Background. Waterpipe tobacco smoking (WTS or “hookah”) is common among adolescents and college students in the United States. However, there has not yet been a large-scale, nationally-representative study independently examining WTS among young adults who are not in college. Objective. This study sought to examine associations between attitudes, n...

Background: Due in part to declining vaccination rates, in 2018 over 20 states reported at least one case of measles, and over 40,000 cases were confirmed in Europe. Anti-vaccine posts on social media may be facilitating anti-vaccination behaviour. This study aimed to systematically characterize (1) individuals known to publicly post anti-vaccinat...

Purpose: To examine the association between positive and negative experiences on social media (SM) and perceived social isolation (PSI). Design: Cross-sectional survey. Setting: One large mid-Atlantic University. Participants: A total of 1178 students aged 18 to 30 were recruited in August 2016. Measures: Participants completed an online s...

Purpose: The increasing popularity of the JUUL electronic nicotine delivery system among youth poses several potential public health concerns. Social media can be used to better understand the spread of information related to JUUL. This study examined whether adolescents (age < 18) are following JUUL's official Twitter account and subsequently sha...

Depression and anxiety, the leading causes of morbidity worldwide, are increasing in prevalence. Social media use, which is also rapidly increasing worldwide, has a complex relationship with mental health conditions such as depression and anxiety. For example, some studies suggest that having a larger social media audience has been associated with...

Background: Over 90% of adults in the United States have at least one social media account, and lesbian, gay, and bisexual (LGB) persons are more socially active on social media than heterosexuals. Rates of depression among LGB persons are between 1.5- and 2-fold higher than those among their heterosexual counterparts. Social media allows users to...

Social media allows users to explore self-identity and express emotions or thoughts. Research looking into the association between social media use (SMU) and mental health outcomes, such as anxiety or depressive symptoms, have produced mixed findings. These contradictions may best be addressed by examining different patterns of SMU as they relate t...

1 Background Social media (SM) may confer emotional benefits via connection with others. However, epidemiologic studies suggest that overall SM is paradoxically associated with increased depressive symptoms. To better understand these findings, we examined the association between positive and negative experiences on SM and depressive symptoms. 2 M...

Background: Waterpipe tobacco smoking (WTS or 'hookah') is common among adolescents and college students in the USA. However, there has not yet been a large-scale, nationally representative study independently examining WTS among young adults who are not in college. Objective: This study sought to examine associations between attitudes, normativ...

Introduction Use of waterpipe tobacco smoking (WTS, or hookah smoking) and electronic nicotine delivery systems (ENDS, such as e-cigarettes) is rapidly increasing. However, legislatures have been slow to update policy measures related to them. Therefore, we aimed to assess knowledge, attitudes and likelihood to take future action regarding WTS and...

Although increased social media use (SMU) has been linearly associated with increased real-life social isolation (SI), it is unknown whether these associations differ by personality characteristics. With a nationally-representative sample of 1768 U.S. young adults aged 19–32, we assessed SI using a 4-item Patient-Reported Outcomes Measurement Infor...

While medical television programs are popular among health profession trainees, it is not clear to what extent these programs affect their knowledge, perceptions, and/or behaviors. Therefore, we conducted a systematic review of research evaluating associations between program exposure and outcomes. We conducted systematic literature searches in Pub...

Objectives: Individuals use social media with varying quantity, emotional, and behavioral at- tachment that may have differential associations with mental health outcomes. In this study, we sought to identify distinct patterns of social media use (SMU) and to assess associations between those patterns and depression and anxiety symptoms. Methods:...

Objectives To form population-level comparisons of total smoke volume, tar, carbon monoxide and nicotine consumed from waterpipe tobacco smoking (WTS) and cigarette smoking using data from a nationally representative sample of smokers and non-smokers aged 18–30 years. Methods In March and April 2013, we surveyed a nationally representative sample...

Objective: To examine the association between degree of real-life closeness of social media (SM) contacts and depressive symptoms. Participants: Students ages 18-30 (N = 1124) were recruited in August 2016. Methods: Participants completed an online survey assessing SM use and depression. We used multivariable logistic regression to assess asso...

Background: While electronic cigarettes (e-cigarettes) may help some smokers quit, some young adult never-smokers are now using e-cigarettes recreationally, potentially increasing their risk for initiation of smoking. We aimed to determine the association between baseline e-cigarette use and subsequent initiation of cigarette smoking among initial...

Study Objectives Social media (SM) use has been positively associated with disturbed sleep among young adults. However, previous studies have not elucidated the specific importance of SM use immediately before bed. We aimed to determine the independent association of SM use during the 30 minutes before bed and disturbed sleep while controlling for...

Introduction While increased time spent on social media (TSSM) has been associated with depression and anxiety, the independent role of using multiple social media (SM) platforms is unclear. Methods We surveyed a nationally-representative sample of 1787 U.S. young adults ages 19–32. Depression and anxiety symptoms were measured using the Patient-R...

Rationale: Depression is the leading cause of disability worldwide. The suggested association between social media use (SMU) and depression may be explained by the emerging maladaptive use pattern known as problematic social media use (PSMU), characterized by addictive components. Objective: We aimed to assess the association between PSMU and de...

Fictional medical television programs have long been a staple of television programming, and they remain popular today. We aimed to examine published literature assessing the influence of medical television programs on health outcomes. We conducted systematic literature searches in PubMed, PsychINFO and CINAHL. Selected studies had to be scholarly...

Introduction: Perceived social isolation (PSI) is associated with substantial morbidity and mortality. Social media platforms, commonly used by young adults, may offer an opportunity to ameliorate social isolation. This study assessed associations between social media use (SMU) and PSI among U.S. young adults. Methods: Participants were a nation...

Background: Waterpipe tobacco smoking (WTS) is increasing in popularity despite evidence of harm and potential for dependence. Intervention development has been hampered by a lack of longitudinal, nationally-representative data on usage patterns and factors independently associated with WTS initiation. Therefore, we aimed to characterize key trans...

Professional social networking websites are commonly used among young professionals. In light of emerging concerns regarding social networking use and emotional distress, the purpose of this study was to investigate the association between frequency of use of LinkedIn, the most commonly used professional social networking website, and depression an...

Low emotional support is associated with poor health outcomes. Engagement with face-to-face social networks is one way of increasing emotional support. However, it is not yet known whether engagement with proliferating electronic social networks is similarly associated with increased emotional support. Thus, the purpose of this study was to assess...

Background: The etiology of eating concerns is multifactorial, and exposure to media messages is considered to be a contributor. Although traditional media, such as television and magazines, have been examined extensively in relation to eating concerns risk, the influence of social media has received relatively less attention. Objective: To exam...

Hookah tobacco smoking is prevalent, widespread, and associated with large amounts of toxicants. Hookah tobacco smoking may be viewed differently by males and females. For example, females have been drawn to types of tobacco that are flavored, milder, and marketed as more social and exotic. Individuals often use the growing segment of anonymous soc...

Background: Social media (SM) use is increasing among U.S. young adults, and its association with mental well-being remains unclear. This study assessed the association between SM use and depression in a nationally representative sample of young adults. Methods: We surveyed 1,787 adults ages 19 to 32 about SM use and depression. Participants wer...

Introduction: Many factors contribute to sleep disturbance among young adults. Social media (SM) use is increasing rapidly, and little is known regarding its association with sleep disturbance. Methods: In 2014 we assessed a nationally-representative sample of 1788U.S. young adults ages 19-32. SM volume and frequency were assessed by self-report...

Objective: Waterpipe tobacco smoking (WTS) is an emerging trend worldwide. To inform public health policy and educational programming, we systematically reviewed the biomedical literature to compute the inhaled smoke volume, nicotine, tar, and carbon monoxide (CO) associated with a single WTS session and a single cigarette. Methods: We searched...

Feasibly implemented Web-based smoking media literacy (SML) programs have been associated with improving SML skills among adolescents. However, prior evaluations have generally had weak experimental designs. We aimed to examine program efficacy using a more rigorous crossover design. Seventy-two ninth grade students completed a Web-based SML progra...

Introduction: Use of waterpipe tobacco smoking (WTS) is now prevalent among U.S. adolescents. However, the more clinically relevant questions are whether users exhibit sustained patterns of use and whether use is increasing over time relative to other tobacco products. We aimed to examine factors associated with sustained WTS among U.S. adolescent...

Background and AimsWaterpipe tobacco smoking (WTS) is increasingly prevalent in the U.S., especially among young adults. We aimed to (1) adapt items from established dependence measures into a WTS dependence scale for U.S. young adults (the “U.S. Waterpipe Dependence Scale”), (2) determine the factor structure of the items, and (3) assess associati...

Introduction: Water pipe tobacco smoking (WTS) is associated with substantial toxicant exposure. Water pipe steam stones (WSS) are marketed as a healthier alternative. The purpose of this study was to determine, in a nationally representative sample, young adults' familiarity with, perceptions regarding, and use of WSS. Methods: A survey about W...

While the Lebanon Waterpipe Dependence Scale (LWDS-11) has shown promise in assessing dependence on water pipe tobacco smoking (WTS) in Lebanon among adult users, it would be valuable to identify WTS addiction earlier and to explore reliability and validity of these items in other populations. In 2010-2012, we conducted a multiyear survey of 5,853...

We surveyed a random sample of 852 students at a large university in 2010-2011 to clarify associations between waterpipe tobacco smoking (WTS), ethnicity, and religion. Current (past 30day) WTS was reported by 116 (14%) students, and 331 (39%) reported ever WTS. Middle Eastern ethnicity was associated with current WTS (odds ratio [OR] = 2.37; 95% c...

While cross-sectional studies have shown that hookah tobacco smoking (HTS) is an increasingly popular behavior among university students, little is known about factors associated with initiation. This study sought to determine associations between knowledge, attitudes, and normative beliefs and initiation of HTS among university students. Data were...

To determine associations between positive and negative attitudes and hookah tobacco smoking (HTS) among college students. Among a random sample of university students (N = 852), multivariable logistic regression models assessed associations between positive and negative attitudes toward HTS. Positive attitudes were associated with adjusted odds of...

Hookah tobacco smoking is increasing among US college students, including those who would not otherwise use tobacco. Part of hookah's appeal is attributed to the perception that hookah is less harmful than cigarettes. The aims of this study were to assess knowledge of harmful exposures associated with hookah smoking relative to cigarette smoking an...

Hookah tobacco smoking is associated with substantial toxicant exposures and is increasing among college students in the United States. Greek (fraternity/sorority) students, especially those living in Greek housing, have high rates of risky alcohol use. The extent to which this is true for other substances, including hookah tobacco smoking, is not...

Segmentation of populations may facilitate development of targeted substance abuse prevention programs. The authors aimed to partition a national sample of university students according to profiles based on substance use. The authors used 2008-2009 data from the National College Health Assessment from the American College Health Association. The sa...

INTRODUCTION: While cigarette use is declining, smoking tobacco with a waterpipe is an emerging trend. We aimed to determine the prevalence of waterpipe use in a large diverse sample of U.S. university students and to assess the association of waterpipe use with individual and institution-related characteristics. METHODS: We assessed students from...

OBJECTIVE: YouTube is now the second most visited site on the internet. The authors aimed to compare characteristics of and messages conveyed by cigarette- and hookah-related videos on YouTube. METHODS: Systematic search procedures yielded 66 cigarette-related and 61 hookah-related videos. After three trained qualitative researchers used an iterat...

Establishments dedicated to hookah tobacco smoking recently have proliferated and helped introduce hookah use to U.S. communities. To conduct a comprehensive, qualitative assessment of websites promoting these establishments. In June 2009, a systematic search process was initiated to access the universe of websites representing major hookah tobacco...