A novel social media approach to #identification and #screening for hazardous drinking among diverse non-college young adults

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PROJECT SUMMARY Young adults have higher rates of alcohol use and experience more alcohol-related harms than other age groups, but are less likely to seek treatment. Further, young adults not attending college, who are more likely to be from non-White racial/ethnic groups, may be particularly underserved with respect to alcohol screening and intervention efforts. As such, it is critical that we expand alcohol screening strategies to reach non-college young adults, a traditionally underrepresented group. Social Networking Sites (SNS; e.g., Twitter, Instagram) are exciting platforms through which to identify at-risk young adults from diverse backgrounds, many of whom use SNS. Consistent with Self-Presentation Theory, it is common for young adults to publicly post about serious alcohol-related consequences (e.g., alcohol-related blackouts), which may reflect their actual drinking behavior and therefore signal the need for intervention. Despite their potential to be used for screening, SNS have rarely been leveraged for this purpose. Thus, our broad goals are to determine maximally sensitive and specific keywords within non-college young adults’ SNS posts that can be used in automated surveillance and/or screening efforts, and to determine how to maximize acceptability of SNS-based screening for diverse samples of heavy drinking non-college young adults. In Aim 1, we will determine content of public SNS posts that serves as a marker of hazardous drinking across a diverse group of non-college young adults by conducting online surveys with n=800 young adults who endorse posting about alcohol on SNS. Participants will report on their alcohol use, alcohol-related consequences, and whether they meet criteria for hazardous drinking (via the Alcohol Use Disorder Identification Test; AUDIT). They will also provide permission to collect their public SNS posts from the prior month. We will identify alcohol-related keywords/phrases in SNS posts that have the highest sensitivity and specificity in identifying hazardous drinking (i.e., AUDIT score >8). We will also explore whether certain terms are used more often, or are more sensitive/specific indicators of hazardous drinking, among respondents from different sex/gender and racial/ethnic groups. In Aim 2, we will conduct 80- 96 individual interviews with non-college young adults (stratified by racial/ethnic group and sex/gender) to obtain feedback from potential target individuals on how to maximize acceptability of and engagement with SNS-based contact for screening and intervention. By addressing these aims, the proposed R21 will provide a blueprint for future use of SNS to identify and potentially provide brief intervention for hazardous drinkers in an automated fashion. Such methods have great potential to improve public health by reducing alcohol misuse and negative consequences among non-college young adults across the US, with particular value for those from traditionally underrepresented racial and ethnic groups.