Pro-eating disorder communities provide a refuge for individuals with eating disorders (EDs) who are ambivalent about seeking treatment. We investigated a pro-ED community on Reddit, an anonymous social networking platform with topical forums, to identify expression of behaviors aligned with ED symptoms and support for these behaviors. A content analysis on four weeks of topic-specific discussion threads (N=125 comments, 115 replies to comments) was conducted to identify behaviors consistent with ED psychopathology and support for these behaviors (informational, tangible assistance, esteem/emotional support). Results indicated that the content aligned with expressions of clinically relevant ED psychopathology, with eating concerns (49/125) and shape concerns (47/125) being most prevalent. The majority (92/115) of replies provided esteem/emotional support to the comment author. Online interventions and/or recovery programs are needed to counteract reinforcing dialogue that occurs on social media sites, like Reddit, and promote ED recovery through supportive messages on these platforms.

Marijuana product advertising will become more common, as the use of medical and/or recreational marijuana becomes increasingly legal in the USA. In this study, we investigate the marketing tactics being used on marijuana dispensary websites in the USA that could influence substance use behaviors. One hundred dispensary websites were randomly selected from 10 states that allowed the legal use of medical or recreational marijuana and had at least 10 operational dispensaries. Three dispensaries were excluded due to non-functioning websites, leaving a sample of 97 dispensaries. Content analysis was conducted on these dispensaries' websites, with the primary areas of focus including website age verification, marijuana effects, warnings, and promotional tactics. Among the 97 dispensaries, 75% did not include age verification. Roughly 30% offered online ordering and 21% offered delivery services. Sixty-seven percent made health claims pertaining to medical conditions that could be treated by their marijuana products, with moderate or conclusive evidence to support their claims. Less than half of the dispensaries (45%) advised consumers of possible side effects, and only 18% included warnings about contraindications. Nearly half (44%) offered reduced prices or coupons, 19% offered "buy one get one free" offers, and 16% provided giveaways or free samples. Our findings indicate that marijuana dispensary websites are easily accessible to youth. In addition, only a small amount of the websites advised consumers about possible side effects or contraindications. This study suggests the need for surveillance of marijuana commercialization and online advertising especially in the context of state policy reforms.

There is increasing concern about online communities that promote eating disorder (ED) behaviors through messages and/or images that encourage a “thin ideal” (i.e., promotion of thinness as attractive) and harmful weight loss/weight control practices. The purpose of this paper is to assess the content of body image and ED-related content on Twitter and provide a deeper understanding of EDs that may be used for future studies and online-based interventions. Tweets containing ED or body image-related keywords were collected from January 1-January 31, 2015 (N = 28,642). A random sample (n = 3000) was assessed for expressions of behaviors that align with subscales of the Eating Disorder Examination (EDE) 16.0. Demographic characteristics were inferred using a social media analytics company. The comprehensive research that we conducted indicated that 2,584 of the 3,000 tweets were ED-related; 65% expressed a preoccupation with body shape, 13% displayed issues related to food/eating/calories, and 4% expressed placing a high level of importance on body weight. Most tweets were sent by girls (90%) who were ≤19 years old (77%). Our findings stress a need to better understand if and how ED-related content on social media can be used for targeting prevention and intervention messages towards those who are in-need and could potentially benefit from these efforts.

Continued research on concentrates use in the US is needed. Research-informed policies that foster safe and responsible use of concentrates are necessary to protect users, especially those who use concentrates frequently, from potential negative side effects.

Background: Decisional conflict is the state of uncertainty about the course of action to take. The decisional conflict scale measures personal perceptions of uncertainty in choosing options. Because experts in the medical community disagree about whether men should get screened for prostate cancer, the decision to get screened is often less certain than that for other tests. In order to make the best decisions about prostate cancer screening, patients must be well-informed of both the risks and benefits of screening. In this study, we assessed whether talking to a doctor about risks and benefits was associated with decisional conflict. Methods: A total of 86 African-American men recruited in community-based and faith-based settings completed a baseline survey as part of a prostate cancer education program. The survey incorporated a revised version of the Decisional Conflict Scale. Participants responded “yes”, “unsure” or “no”, and these were scored as 1, 2, and 3 respectively. Scores for each of 10 items were averaged to obtain a decisional conflict score. The survey also included demographic information, questions about participants' experiences with prostate cancer screening, questions about past communication with physicians about screening, knowledge about prostate cancer, and health practices. All responses were self-reported. After the survey, participants took part in an in-depth prostate cancer information session lead by a physician or a community health worker. For this study, analyses were limited to responses from the baseline survey. Results: The demographics of this sample include African American males of mean age 57.8 (sd 12.4), the majority of whom have at least some college education (72.0%). Most participants completed prostate cancer screening in the past year (57.4%). Half of the men completed a PSA test in the past year (49.4%), and 41% completed DRE. The majority of participants had discussed prostate cancer screening with their doctors (75.6%), and had discussed the benefits of screening with their doctors (67.4%). However, less than half (44.2%) had discussed the risks of prostate cancer screening with their doctors, and even fewer had doctors who informed them that experts disagree about whether men should have a PSA test (26.7%). We found that decisional conflict was negatively associated with having a previous PSA test (β=-0.378, p=0.007), having a doctor who talked with the participant about the benefits of testing (β=-0.424, p=0.002), having a doctor who talked with the participant about the risks of participating (β=-0.392, p=0.001), and with having a doctor who informed them that experts disagree on the need for PSA testing (β=-0.601, p<0.001). No association was found between having a previous DRE and decisional conflict. All associations remained significant after adjusting for age and education. Conclusions: Well-informed patients experience lower decisional conflict. While few participants discussed risks or the lack of consensus about whether men should be screened with their doctors, we found that discussing the risks and disagreement about testing, in addition to the benefits of testing, were significantly associated with having lower decisional conflict scores compared to those who had not had such conversations with their doctors. In addition, previous PSA testing was associated with lower decisional conflict. These results suggest that, to facilitate better decisions about this controversial topic among black men, doctors should consider more open discussion about prostate cancer screening, and that they include the risks, benefits, and controversies in their conversations with patients. Citation Format: Michael Fenstermaker, Theodore Hickman, Heather Gold, Danil Makarov, Stacy Loeb, Helen Cole, Elizabeth Cahn, Joseph Ravenell. How does doctor-patient communication about prostate cancer screening influence African-American patients' decisional conflict around screening decisions? [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A15.