Rupam Mitra

Background: Sociodemographic and structural inequities shape the risk of alcohol-related harms among underage individuals. This study assessed disparities in alcohol-related emergency department (ED) visits, using the COVID-19 pandemic as a contextual backdrop to examine how these inequities shifted during a period of widespread disruption. Methods: This repeated cross-sectional study used pooled Nationwide Emergency Department Sample (NEDS) data (January 2019–December 2021) for individuals aged 12–20, comparing pre-COVID-19 (January 2019–March 2020) and during-COVID-19 (April 2020–December 2021) periods. Alcohol-related visits were identified via ICD-10-CM codes. Survey-weighted multivariable logistic regression estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for demographic, socioeconomic, and geographic factors, with interaction terms assessing period-related changes in disparities. Results: Sociodemographic disparities were the primary drivers of alcohol-related ED visits. Native American youth had markedly higher odds than White youth (OR = 3.68, 95% CI: 3.52–3.86), while Black, Hispanic, and Asian youth had lower odds. Uninsured (OR = 1.43) and charity-care youth also showed elevated odds. COVID-19 itself was not significantly associated with overall visits (OR = 1.03, p = 0.053), but disparities widened for Native American youth (OR = 1.20) and narrowed modestly for Black (OR = 1.04) and Medicaid-insured (OR = 1.05) youth, while other disparities remained unchanged. Conclusions: Persistent structural disparities, particularly by race/ethnicity and insurance status, drive underage alcohol-related ED utilization far more than the pandemic itself, underscoring the need for equity-focused prevention strategies targeting systemic barriers to care.

Cannabis use among adolescents and young adults has increased alongside legalization, commercialization, and higher product potency. However, evidence regarding the effectiveness of interventions to prevent or reduce cannabis use remains heterogeneous. To systematically synthesize evidence from randomized controlled trials (RCTs) evaluating behavioral, educational, psychosocial, family-based, and digital interventions targeting cannabis use among adolescents and young adults. Following PRISMA guidelines, MEDLINE, PsycINFO, CINAHL, Embase, and Web of Science were searched for randomized or cluster-randomized controlled trials involving participants aged 12–25 years. Study characteristics, intervention approaches, outcomes, and effectiveness were synthesized qualitatively. Of 973 records, 15 RCTs met the inclusion criteria. Studies varied in setting, intervention characteristics, delivery modality, and follow-up duration (2 months–7 years). School-based cognitive-behavioral interventions demonstrated the most consistent reductions in cannabis use and related harms by strengthening emotional regulation, problem-solving, coping skills, and social competence. Motivational interviewing, family-based, and digital interventions showed beneficial but variable effects. Behavioral interventions, particularly school-based cognitive-behavioral approaches, provide the strongest and most consistent evidence for reducing cannabis use and related harms among adolescents and young adults. However, methodological heterogeneity limits direct comparisons. Future well-powered RCTs with standardized outcome measures, longer follow-up, and implementation evaluations are needed to strengthen evidence-based prevention strategies.

Background/Objectives: Use of social media among college students is ubiquitous. Excessive use of social media has been linked to distractions, reduced academic focus, and poor mental health outcomes such as anxiety and depression. The determinants of social media use among college students are not well understood. Hence, the purpose of this study was to conduct a scoping review on the behavioral, demographic, and psychosocial determinants, explore theoretical frameworks, and suggest evidence-based recommendations. Methods: This scoping review was conducted between January 2024 and May 2025 following PRISMA-ScR guidelines, using MEDLINE (PubMed), CINAHL, and ERIC databases. Peer-reviewed studies were included if they focused on college students (ages 18–30), investigated determinants of social media use, and met predefined inclusion criteria. Results: A total of 22 studies met the inclusion criteria. Studies were conducted in Bangladesh, Canada, China, Egypt, India, Nigeria, Pakistan, Saudi Arabia, Turkey, and the United States, and the majority used cross-sectional designs (n = 20). A consistent finding across the reviewed studies was the strong association between social media overuse and symptoms of depression, anxiety, stress, and emotional dysregulation. Very few theoretical frameworks for understanding the determinants of social media were used. According to the reviewed studies, factors such as fear of missing out, sleep quality, and prolonged social media use consistently emerged as significant predictors of adverse mental health outcomes (p < 0.05). Conclusions: In this study, problematic social media use (PSMU) was linked to increased mental health issues, suggesting that students frequently engage in social comparison and experience feelings of missing out (FoMO), which exacerbate emotional distress. There is a need for integrated approaches in addressing PSMU within educational environments, particularly in fostering healthier digital habits among students. There is a need to conduct more concerted research using longitudinal designs and contemporary theoretical frameworks in this area.