September 7, 2023 • 21 mins
Dr. Jason Nagata shares the compelling findings on sexual minority adolescents' screen habits and other insights from his new research study, "Associations between sexual orientation and early adolescent screen use: findings from the Adolescent Brain Cognitive Development (ABCD) Study," published in the June 2023 issue (Vol. 82) of Annals of Epidemiology.
Read the full article here:
https://www.sciencedirect.com/science/article/pii/S1047279723000534
To access the ABCD Data Repository from the NIMH, visit:
https://nda.nih.gov/abcd/
Episode Credits:
- Executive Producer: Sabrina Debas
- Technical Producer: Paula Burrows
- Annals of Epidemiology is published by Elsevier.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Patrick Sullivan (00:10):
Hi, you're listening to EPITalk
Paper, a monthly podcast fromthe Annals of Epidemiology.
I'm Patrick Sullivan,Editor-in-Chief of the journal,
and in this series we take youbehind the scenes of some of the
latest publications featured inour journal.
Today we're talking with DrJason Nagata about his article
(00:41):
"Associations Between SexualOrientation and Early Adolescent
Screen Use (00:45):
findings from the Adolescent Brain Cognitive
Development (ABCD) study.
" You can find the full articleonline in the June 2023 issue of
the journal at www.
annalsofepidemiology.
org.
So Dr.
Jason Nagata is an AssociateProfessor of Pediatrics in the
Division of Adolescent and YoungAdult Medicine at UCSF San
(01:05):
Francisco, and AffiliatedFaculty with the Institute for
Global Health Sciences and theCenter for Sexual and Gender
Minority Health.
He's also a co-founder of theInternational Association for
Adolescent Health YoungProfessionals Network.
Dr Nagata's research interestsinclude digital technology,
eating behaviors and disorders,food security, nutrition,
alcohol use, cardiovasculardisease, HIV and LGBTQ+ health.
(01:29):
Dr Nagata, thank you so muchfor joining us today.
Jason Nagata (01:32):
Yeah, thanks so much, and thanks for featuring
and doing this recording duringPride Month.
Patrick Sullivan (01:38):
So we're at least recording this during June
, which is Pride Month, and Ithink it's a really great
opportunity and I'm so excitedto see your focus on not just
LGBTQ+ health, but particularlyin sort of younger people, and I
wonder if you could just startout by describing some of the
main findings from your paper.
Jason Nagata (01:58):
Our main findings were we looked at lesbian, gay
and bisexual adolescents aged 10to 14 years old and we found
that, overall, LGBT youth hadsignificantly more recreational
screen time per day than theirheterosexual peers.
This ended up being about fourmore hours per day actually,
which is quite a large amount ifyou think about it.
(02:19):
We actually looked across alldifferent modalities, so not
just television viewing, whichprior literature has really
focused on, but really morecontemporary modalities like
social media, video chat,internet texting and video games
, and essentially across all ofthese modalities, gay and
lesbian youth had morerecreational screen use
(02:40):
throughout the day.
Patrick Sullivan (02:41):
Yeah, I mean that four hour figure just
struck me, I mean as an effectsize in the context of how many
hours we have to spend in theday.
It's really an incredible chunkof time.
I mean, with respect to thatdifference, you sort of talk
about the fact that sexualminority youth had a lot more
screen time and the discussionyou point out, because this is
(03:03):
really a sort of observationalstudy, it's a little hard to
know what that represented andyou sort of propose that maybe
this is a defensive mechanism ormaybe it's some kind of a
resilience mechanism.
So can you say a little bitmore about how you thought about
that association and what itmight mean?
Jason Nagata (03:19):
Yeah, I think you're absolutely right.
We do have the measure of thetime difference, but we really
don't know from this study,especially due to its
observational nature sort of thecontent and the quality of that
four hours that was being spent.
So I think you're absolutelyright.
Some of the things that wethought about were that in
general, we know that sexualminority youth maybe more likely
(03:40):
to experience school-basedbullying or exclusion from peer
groups due to their sexualorientation, and they may
actually be able to find some ofthat connection and support
through online means.
You can imagine that,particularly in a smaller
community or a more ruralcommunity, sexual minority youth
may be the only person in theirclass or cohort who is out and
(04:03):
so it may be very isolating interms of their in-person
dynamics, but they may be ableto find connection and support
through virtual means and haveaccess to more people.
So I think there coulddefinitely be beneficial and
social support mechanisms thatare part of this additional
screen use.
But we did actuallyspecifically measure a
problematic screen use measure.
(04:24):
So there have been thesevalidated questionnaires looking
at problematic video game use,social media use and mobile
phone use, and some of thequestions in that measure assess
qualities of problematic, say,social media use, such as using
it too much, having conflictsrelated to use, having takeover
more of your time and also evenhaving difficulty with school
(04:46):
work or other work due to thatoveruse of that modality.
And we did also see across theboard that sexual minority youth
did report higher problematicuse scores across social media
and mobile phones and videogames.
Patrick Sullivan (04:59):
Yeah, thanks for that additional information.
I mean, I wonder if you couldhave whatever NIH grant you want
and you wanted to answer thisquestion about.
Are these really defensiveversus resilience or a mix of
that?
What kind of next steps mightyou take or how would you like
to answer that question?
Jason Nagata (05:18):
Yeah, that's a really great question.
I think right now the availabledata from this Adolescent Brain
Development study cohort reallyis limited to the time measure,
so we know how much time peopleare reporting, that they're
spending on it, but we reallydon't know the content and the
quality.
However that's a great questionthat you asked the NIH actually
is supporting in future yearsan app that will actually be
(05:41):
passively scraping these kids'mobile phone use throughout the
day for a three week period, andso actually during that time we
will get a little bit moreobjective data and device-based
measurement on specifically whattypes of apps people are using,
and I think in my idealscenario, if we actually could
get the exact content you knowwhat people are typing in
searches and the exact type ofinteractions then we might be
(06:04):
able to better answer exactlywhat the content and quality of
the interactions thatparticularly sexual minority
youth are engaging in on theseonline platforms.
Patrick Sullivan (06:15):
Yeah, that's great.
I think one of the interestingthings here is that you took the
adolescent brain development'sABCD, this larger study, which
really wasn't focused on sexualand gender minority youth, and
just used a subset, and youstill had enough sort of
respondents in that to get somepretty significant findings.
Was it challenging to sort of,or what was your process, to ask
(06:39):
about access to these data andto propose this and to get
access to this data set?
Jason Nagata (06:44):
Yeah, the ABCD study is a large study across 21
different sites.
That's funded by the NIH, butthe data availability is open to
actually anyone with a data useagreement, and so you can apply
through the National Instituteof Mental Health Data Archive to
get access.
And I actually first learnedabout it because I was trying to
(07:05):
study screen use and physicalactivity in adolescence as part
of a career development award aK award as I started as a junior
faculty and I was looking fordifferent cohorts to analyze,
and I came across the ABCD studycohort and was put into contact
with the principal investigatorin Northern California, where
I'm from, and it just so happensthat her name is Dr.
(07:28):
Fiona Baker.
That the PI for the NorthernCalifornia site is also the
co-chair of the digitaltechnology working group, and so
she really is the one whodecides with, along with her
committee, what digitaltechnology and screen measures
are assessed at each year, andso it ended up being a very nice
collaboration, because she waslocal but also had the content
(07:49):
expertise of this digitaltechnology and social media use,
and so we've been working a loton analyzing the digital
technology data from ABCD.
Patrick Sullivan (07:58):
That's great.
I appreciate you sharing thatbecause I think for a lot of
folks, especially like studentsor people who are earlier in
their careers, finding reallyrich data to do these kind of
analyses with can feel like achallenge.
But a lot of these federal bigdata collections you can get
access to and I'm going to reachout to you after and make sure
that we put a link in the shownotes to if there's a website or
(08:21):
a way to get more informationabout this particular dataset,
because it sounds like peoplecan actually come with ideas.
So that'd be a real generouspiece for you to share and for
us to pass on in the show notes.
So you talked some about thelimitations of using the
secondary data analysis and yetyou found some really in epi
terms, some pretty strongassociations and some some
(08:42):
pretty relatable associations interms of these behaviors.
So I wonder what implicationsyou feel like.
Is there anything policy wiseyet, or is it mostly to inform
future research or who needs toknow about this?
Jason Nagata (08:55):
I mean I think that there are any kind of
research these days onadolescent social media use is
very policy revelant.
Actually, just a few weeks ago,the US Surgeon General issued
an advisory on youth socialmedia and links to mental health
.
This actually just came acouple of years after the
initial Surgeon General advisoryon youth mental health more
broadly in the context of thepandemic and actually our very
(09:18):
first ABCD study, which showedthat youth screen time doubled
during the pandemic.
So, at baseline of the ABCDstudy in 2016, at that time the
cohort was nine to 10 years old.
They had about, on average,four hours of recreational
screen use per day and by May2020, so, like the first few
months of the pandemic that haddoubled to almost eight hours
(09:39):
per day.
And that was recreationalscreen use.
That didn't count.
You know people were in zoomschool or doing remote school
work, and so actually that wasthe first article that was cited
in the Surgeon General's reportbeing, like you know, there's
this huge increase in screen use.
I mean understandably, ofcourse, given the context, but
still, as you were saying, ifyou think about kids spending
eight hours of theirrecreational time every day on
(10:01):
screens, which you know doesmake sense, but what you know
what impacts that might have.
You know both.
There are certainly ourbenefits, but there are
certainly our potential risks.
And I just think that you know,given the Surgeon General
advisory that just came out afew weeks ago, and there's
actually tons of legislationright now at the federal and
state level about social mediaand adolescents right now, about
(10:23):
, you know, age limits.
You know currently the agelimit is 13.
You technically need to be 13years old to have an account,
but there's no robust ageverification so anyone can
actually lie about their age andget an account.
One other finding from the ABCDstudy was that at baseline, you
know, these nine to 10 yearolds, about 20% had a social
media account, although none ofthem technically should have
(10:45):
been able to.
So that was also a finding thatall 20% of this national sample
had lied about their age to.
You know, get an account, whichjust reiterates that.
You know the age verificationprocess is not really robust.
So I think that there are lotsof implications for any of these
ABCD studies just becausethere's so much ongoing
legislation about social mediain teens and particularly the
(11:09):
early adolescents.
Patrick Sullivan (11:11):
Yeah, thanks for that.
I also feel like, from aperspective of a person who
writes grants also, that thisseems like a real opportunity,
you know, for sort of mHealth ordigital health based
interventions.
You know, we say we want tomeet people where they are with
public health services and, ifanything, this just suggests
that, although there areparticular challenges
(11:32):
experienced by these LGBT or, inyour study, sexual minority
youth participants, there alsois this highly prevalent device
access and a lot of time and alot of opportunity if the
interventions can be developedthat then are effective in being
delivered through that format.
So I mean, I think there's riskand there's also opportunity.
(11:53):
It seems like, yes, absolutelyAll right.
So we're going to pivot just alittle bit, because part of the
subtitle of the podcast isbehind the paper and so I always
think it's interesting just totalk to people a little bit
about the process.
I think, especially forstudents, for people who are
earlier in their careers, a lotof times they want to ask
(12:14):
questions about like how do youcome up with ideas and how do
you get that done and how do youget your colleagues on board,
and just like the process ofproducing this kind of research.
So I wonder if you could justtalk a little bit about, like,
what was your most exciting partof conducting this particular
research.
Like there's always some datacleaning and some IRB approvals
or some you know, but where wasthe excitement for you and
(12:37):
discovery in your process?
Jason Nagata (12:39):
Yeah, thanks for covering these topics about
behind the paper.
I actually think that myfavorite part about this
involves students.
So the second and third authorof this paper, or respectively,
a medical student at UCSF and amaster's of public health
student at UC Berkeley, and overthe summer we host a number of
summer students who do full-timeresearch.
(13:01):
It just ends up being like howmost of the academic calendars
work, for, like the med students, they usually have the summers
off to do research, similar forthe masters and public health
students, and so we wereactually.
The main objective of my K awardis not necessarily looking at
sexual minority health.
It was more broadly looking atdownstream effects of social
(13:21):
media and screen use andphysical activity.
But as a gay man myself andsomebody who has interest in
LGBT or sexual minority research, this sort of came up as a side
project because I had a coupleof students who are interested
in the topic and LGBT healthmore broadly and we had already
analyzed all the screen data forother prospective analyses, and
(13:43):
so it just so happened that wewere like, oh, we should look to
see if there's any associationswith sexual orientation and
screen use, and so this actuallywas like a summer research
project from last summer thatkind of came about from a
collaboration with two reallyspectacular students.
Patrick Sullivan (13:59):
That's great, and thank you both for making
those opportunities available toearlier career colleagues and I
think for me it's some of themost joyful work that I do is
working with earlier careerpeople who are in that process
of like devouring the methods,the substance and producing
these things and for identifyingyourself as a gay man, as I am,
(14:22):
and we also bring our own livedexperiences to this work and
sharing that, I think, is alsogenerous.
There's a time in my careerwhere I'm probably much, much
older, but the time when I wasmuch more reserved about my
personal life and so questionsdidn't get asked.
So I think it's a feature ofour identities and our
(14:43):
willingness to share them thatit opens up areas of inquiry
that just didn't happen before.
So thank you for both of thosecounts and thanks for
recognizing your earlier careercolleagues and their
contributions to the paper.
And I'm just asked one morequestion about your own path.
So, in terms of your training,your development, how did you
(15:03):
get involved in this particulararea of research and adolescent
health, young adult health,lgbtq health, and was that sort
of a place you were aimingtowards?
Or for a lot of us, it's aplace that we find ourselves,
where we land because of theworld and stuff.
So what was your journey tohave this particular focus in
your research?
Jason Nagata (15:23):
Yeah, I think it was a little bit of a mix of
many of luck and interest.
Adolescent health and medicine.
I really like it because it hasthis intersection of physical
health issues and mental healthand there's just so much
excitement during adolescence,there's so much growth and
development and people arebecoming, or transitioning
(15:44):
towards becoming, adults, and Iguess I would say that my first
influence was really my parents.
My mom was a pediatric nurseand my father was a mental
health social worker, so in someways I basically am doing the
intersection of their twocareers.
So I don't know, maybe I wasdestined for it.
But as I went through collegeand medical school, I actually
(16:06):
was very interested in nutritionissues and I think that
pediatrics is a time whennutrition is really important,
and so I initially becameinterested in pediatrics because
I was looking at sort ofbehavioral nutrition research.
I liked the pediatric populationand then when I was a third
year medical student that's whenyou start your clinical
training I was actually justplaced in the teen clinic, so
(16:30):
mostly dealing with primary carefor teenagers and also
specialty care related to eatingdisorders and other mental
health issues and teens, and Ijust loved it because I think
you could really interact andtalk and engage with the
teenagers themselves, but theywere still in need of guidance,
and so I just really enjoyedthat patient population and then
(16:51):
I think from there, noted thatyou know, adolescent medicine is
actually a relatively newspecialty in pediatrics, only
within the last 30 or so years.
There's just so much, I think,research gaps in the field that
it seemed like it was a good fitbecause it was a relatively new
field.
There's a lot of research thatstill needs to be done and I
just enjoy working with apopulation clinically.
Patrick Sullivan (17:12):
Yeah, thanks, and I think there's also you'd
know better than I would, but Ithink there's also a higher
prevalence of eating disordersin sexual gender, minority youth
.
Is that right?
Jason Nagata (17:23):
Yes, absolutely.
I should have also mentionedthat I guess I sort of have two
lines of work.
One is this sort ofpopulation-based epi research,
looking at the ABCD study andother cohorts focused on
adolescents.
But my clinical research isalmost exclusively now focused
on eating disorders andparticularly in sexual and
gender minority youth andactually boys and men.
Patrick Sullivan (17:45):
Great.
Well, I'm going to give you thefinal word here, and just I've
sort of mentioned a couple timesthat the later I get in my
career, the more I'm focused onearlier career people and young
researchers and aspiringstudents.
So do you have any advice foryoung researchers or students
who may have an interest in thistopical area and who want to
pursue research and who are notsure how to get on that path?
(18:07):
What advice would you give?
Jason Nagata (18:10):
Yeah, I think that my best advice is to choose a
topic that you're passionateabout and then really persevere.
I was going to mention that oneof the biggest challenges, I
think, for this research wasgetting that initial NIH funding
, and so, for the K award that Ihad mentioned, that I applied
for in order to allow me toconduct these analyses of the
(18:30):
ABCD study and other adolescentcohorts, I think I had to apply
for it three times before it wasfinally funded, but now that it
is funded, it's just beenreally amazing.
I think I chose the sort oftopic that I really wanted to
delve into and I reallyappreciated being able to have a
lot of protected time now torun these analyses in the ABCD
(18:52):
study, and I think that becauseI continued to try, despite
critical reviews, I'm reallyhappy that I didn't change
topics, but I still, like youknow, worked on revising until
it was in a fundable range.
Patrick Sullivan (19:07):
Yeah, and that is an important message for
those folks who are in that sortof PhD to K transition.
I think that is much more thannorm of the experience is
multiple cycles of review andupdate, and I know it can feel
discouraging, but it's also likethat gives you that really
great runway in which, to youknow, get your own program of
(19:30):
research started and focus onwhat you want to.
So congratulations on that.
So do you have any other lastthoughts that you'd like to
share with our listeners, oranything else that I haven't
asked you about your researchthat you think is important to
share?
Jason Nagata (19:43):
No, I think that this has been a really wonderful
conversation and thanks so muchfor featuring our work, and I
do hope that we'll be able tolook at other insights related
to sexual minority disparitiesin the ABCD study and other
cohorts and adolescents, becauseI do think that there's a lot
of topics that really haven'tbeen explored at all in the
research field in terms ofsexual minority disparities.
(20:06):
I think there's been relativelymore on sexual health and maybe
mental health and substance use, but I think there are so many
other areas of physical healththat are collected in ABCD and
other cohorts that really needto be explored and identified
more in the scientificliterature.
Patrick Sullivan (20:23):
Thanks, and I'll leave a little Easter egg
for people who've listened allthe way through, which is that
we're going to be launching aspecial issue of Annals on
Health and Equities, and one ofthe explicit calls will be
around sexual and genderminority, as well as race,
ethnicity, economic inequities.
So you might line up and have agreat next paper, as the Health
Equity Issue Calls forManuscripts.
(20:45):
So that brings us to the end ofthe episode.
Thanks again, Dr.
Nagata, for joining us today.
It was such a pleasure to haveyou on the podcast and thanks
again for the work that you doin making time to tell us about
it.
Jason Nagata (20:58):
Thanks so much for having me.
Patrick Sullivan (21:05):
I'm your host, Patrick Sullivan.
Thanks for tuning in to thisepisode and see you next time on
EPI Talk behind the paper.
EPI Talk is brought to you byAnnals of Epidemiology, the
official journal of the AmericanCollege of Epidemiology.
For a transcript of thispodcast or to read the article
featured on this episode andmore from the journal, you can
(21:26):
visit us online at www.
annalsofepidemiology.
org.
Hi, you're listening to EPITalk
Paper, a monthly podcast fromthe Annals of Epidemiology.
I'm Patrick Sullivan,Editor-in-Chief of the journal,
and in this series we take youbehind the scenes of some of the
latest publications featured inour journal.
Today we're talking with DrJason Nagata about his article
(00:41):
"Associations Between SexualOrientation and Early Adolescent
Screen Use (00:45):
findings from the Adolescent Brain Cognitive
Development (ABCD) study.
" You can find the full articleonline in the June 2023 issue of
the journal at www.
annalsofepidemiology.
org.
So Dr.
Jason Nagata is an AssociateProfessor of Pediatrics in the
Division of Adolescent and YoungAdult Medicine at UCSF San
(01:05):
Francisco, and AffiliatedFaculty with the Institute for
Global Health Sciences and theCenter for Sexual and Gender
Minority Health.
He's also a co-founder of theInternational Association for
Adolescent Health YoungProfessionals Network.
Dr Nagata's research interestsinclude digital technology,
eating behaviors and disorders,food security, nutrition,
alcohol use, cardiovasculardisease, HIV and LGBTQ+ health.
(01:29):
Dr Nagata, thank you so muchfor joining us today.
Jason Nagata (01:32):
Yeah, thanks so much, and thanks for featuring
and doing this recording duringPride Month.
Patrick Sullivan (01:38):
So we're at least recording this during June
, which is Pride Month, and Ithink it's a really great
opportunity and I'm so excitedto see your focus on not just
LGBTQ+ health, but particularlyin sort of younger people, and I
wonder if you could just startout by describing some of the
main findings from your paper.
Jason Nagata (01:58):
Our main findings were we looked at lesbian, gay
and bisexual adolescents aged 10to 14 years old and we found
that, overall, LGBT youth hadsignificantly more recreational
screen time per day than theirheterosexual peers.
This ended up being about fourmore hours per day actually,
which is quite a large amount ifyou think about it.
(02:19):
We actually looked across alldifferent modalities, so not
just television viewing, whichprior literature has really
focused on, but really morecontemporary modalities like
social media, video chat,internet texting and video games
, and essentially across all ofthese modalities, gay and
lesbian youth had morerecreational screen use
(02:40):
throughout the day.
Patrick Sullivan (02:41):
Yeah, I mean that four hour figure just
struck me, I mean as an effectsize in the context of how many
hours we have to spend in theday.
It's really an incredible chunkof time.
I mean, with respect to thatdifference, you sort of talk
about the fact that sexualminority youth had a lot more
screen time and the discussionyou point out, because this is
(03:03):
really a sort of observationalstudy, it's a little hard to
know what that represented andyou sort of propose that maybe
this is a defensive mechanism ormaybe it's some kind of a
resilience mechanism.
So can you say a little bitmore about how you thought about
that association and what itmight mean?
Jason Nagata (03:19):
Yeah, I think you're absolutely right.
We do have the measure of thetime difference, but we really
don't know from this study,especially due to its
observational nature sort of thecontent and the quality of that
four hours that was being spent.
So I think you're absolutelyright.
Some of the things that wethought about were that in
general, we know that sexualminority youth maybe more likely
(03:40):
to experience school-basedbullying or exclusion from peer
groups due to their sexualorientation, and they may
actually be able to find some ofthat connection and support
through online means.
You can imagine that,particularly in a smaller
community or a more ruralcommunity, sexual minority youth
may be the only person in theirclass or cohort who is out and
(04:03):
so it may be very isolating interms of their in-person
dynamics, but they may be ableto find connection and support
through virtual means and haveaccess to more people.
So I think there coulddefinitely be beneficial and
social support mechanisms thatare part of this additional
screen use.
But we did actuallyspecifically measure a
problematic screen use measure.
(04:24):
So there have been thesevalidated questionnaires looking
at problematic video game use,social media use and mobile
phone use, and some of thequestions in that measure assess
qualities of problematic, say,social media use, such as using
it too much, having conflictsrelated to use, having takeover
more of your time and also evenhaving difficulty with school
(04:46):
work or other work due to thatoveruse of that modality.
And we did also see across theboard that sexual minority youth
did report higher problematicuse scores across social media
and mobile phones and videogames.
Patrick Sullivan (04:59):
Yeah, thanks for that additional information.
I mean, I wonder if you couldhave whatever NIH grant you want
and you wanted to answer thisquestion about.
Are these really defensiveversus resilience or a mix of
that?
What kind of next steps mightyou take or how would you like
to answer that question?
Jason Nagata (05:18):
Yeah, that's a really great question.
I think right now the availabledata from this Adolescent Brain
Development study cohort reallyis limited to the time measure,
so we know how much time peopleare reporting, that they're
spending on it, but we reallydon't know the content and the
quality.
However that's a great questionthat you asked the NIH actually
is supporting in future yearsan app that will actually be
(05:41):
passively scraping these kids'mobile phone use throughout the
day for a three week period, andso actually during that time we
will get a little bit moreobjective data and device-based
measurement on specifically whattypes of apps people are using,
and I think in my idealscenario, if we actually could
get the exact content you knowwhat people are typing in
searches and the exact type ofinteractions then we might be
(06:04):
able to better answer exactlywhat the content and quality of
the interactions thatparticularly sexual minority
youth are engaging in on theseonline platforms.
Patrick Sullivan (06:15):
Yeah, that's great.
I think one of the interestingthings here is that you took the
adolescent brain development'sABCD, this larger study, which
really wasn't focused on sexualand gender minority youth, and
just used a subset, and youstill had enough sort of
respondents in that to get somepretty significant findings.
Was it challenging to sort of,or what was your process, to ask
(06:39):
about access to these data andto propose this and to get
access to this data set?
Jason Nagata (06:44):
Yeah, the ABCD study is a large study across 21
different sites.
That's funded by the NIH, butthe data availability is open to
actually anyone with a data useagreement, and so you can apply
through the National Instituteof Mental Health Data Archive to
get access.
And I actually first learnedabout it because I was trying to
(07:05):
study screen use and physicalactivity in adolescence as part
of a career development award aK award as I started as a junior
faculty and I was looking fordifferent cohorts to analyze,
and I came across the ABCD studycohort and was put into contact
with the principal investigatorin Northern California, where
I'm from, and it just so happensthat her name is Dr.
(07:28):
Fiona Baker.
That the PI for the NorthernCalifornia site is also the
co-chair of the digitaltechnology working group, and so
she really is the one whodecides with, along with her
committee, what digitaltechnology and screen measures
are assessed at each year, andso it ended up being a very nice
collaboration, because she waslocal but also had the content
(07:49):
expertise of this digitaltechnology and social media use,
and so we've been working a loton analyzing the digital
technology data from ABCD.
Patrick Sullivan (07:58):
That's great.
I appreciate you sharing thatbecause I think for a lot of
folks, especially like studentsor people who are earlier in
their careers, finding reallyrich data to do these kind of
analyses with can feel like achallenge.
But a lot of these federal bigdata collections you can get
access to and I'm going to reachout to you after and make sure
that we put a link in the shownotes to if there's a website or
(08:21):
a way to get more informationabout this particular dataset,
because it sounds like peoplecan actually come with ideas.
So that'd be a real generouspiece for you to share and for
us to pass on in the show notes.
So you talked some about thelimitations of using the
secondary data analysis and yetyou found some really in epi
terms, some pretty strongassociations and some some
(08:42):
pretty relatable associations interms of these behaviors.
So I wonder what implicationsyou feel like.
Is there anything policy wiseyet, or is it mostly to inform
future research or who needs toknow about this?
Jason Nagata (08:55):
I mean I think that there are any kind of
research these days onadolescent social media use is
very policy revelant.
Actually, just a few weeks ago,the US Surgeon General issued
an advisory on youth socialmedia and links to mental health
.
This actually just came acouple of years after the
initial Surgeon General advisoryon youth mental health more
broadly in the context of thepandemic and actually our very
(09:18):
first ABCD study, which showedthat youth screen time doubled
during the pandemic.
So, at baseline of the ABCDstudy in 2016, at that time the
cohort was nine to 10 years old.
They had about, on average,four hours of recreational
screen use per day and by May2020, so, like the first few
months of the pandemic that haddoubled to almost eight hours
(09:39):
per day.
And that was recreationalscreen use.
That didn't count.
You know people were in zoomschool or doing remote school
work, and so actually that wasthe first article that was cited
in the Surgeon General's reportbeing, like you know, there's
this huge increase in screen use.
I mean understandably, ofcourse, given the context, but
still, as you were saying, ifyou think about kids spending
eight hours of theirrecreational time every day on
(10:01):
screens, which you know doesmake sense, but what you know
what impacts that might have.
You know both.
There are certainly ourbenefits, but there are
certainly our potential risks.
And I just think that you know,given the Surgeon General
advisory that just came out afew weeks ago, and there's
actually tons of legislationright now at the federal and
state level about social mediaand adolescents right now, about
(10:23):
, you know, age limits.
You know currently the agelimit is 13.
You technically need to be 13years old to have an account,
but there's no robust ageverification so anyone can
actually lie about their age andget an account.
One other finding from the ABCDstudy was that at baseline, you
know, these nine to 10 yearolds, about 20% had a social
media account, although none ofthem technically should have
(10:45):
been able to.
So that was also a finding thatall 20% of this national sample
had lied about their age to.
You know, get an account, whichjust reiterates that.
You know the age verificationprocess is not really robust.
So I think that there are lotsof implications for any of these
ABCD studies just becausethere's so much ongoing
legislation about social mediain teens and particularly the
(11:09):
early adolescents.
Patrick Sullivan (11:11):
Yeah, thanks for that.
I also feel like, from aperspective of a person who
writes grants also, that thisseems like a real opportunity,
you know, for sort of mHealth ordigital health based
interventions.
You know, we say we want tomeet people where they are with
public health services and, ifanything, this just suggests
that, although there areparticular challenges
(11:32):
experienced by these LGBT or, inyour study, sexual minority
youth participants, there alsois this highly prevalent device
access and a lot of time and alot of opportunity if the
interventions can be developedthat then are effective in being
delivered through that format.
So I mean, I think there's riskand there's also opportunity.
(11:53):
It seems like, yes, absolutelyAll right.
So we're going to pivot just alittle bit, because part of the
subtitle of the podcast isbehind the paper and so I always
think it's interesting just totalk to people a little bit
about the process.
I think, especially forstudents, for people who are
earlier in their careers, a lotof times they want to ask
(12:14):
questions about like how do youcome up with ideas and how do
you get that done and how do youget your colleagues on board,
and just like the process ofproducing this kind of research.
So I wonder if you could justtalk a little bit about, like,
what was your most exciting partof conducting this particular
research.
Like there's always some datacleaning and some IRB approvals
or some you know, but where wasthe excitement for you and
(12:37):
discovery in your process?
Jason Nagata (12:39):
Yeah, thanks for covering these topics about
behind the paper.
I actually think that myfavorite part about this
involves students.
So the second and third authorof this paper, or respectively,
a medical student at UCSF and amaster's of public health
student at UC Berkeley, and overthe summer we host a number of
summer students who do full-timeresearch.
(13:01):
It just ends up being like howmost of the academic calendars
work, for, like the med students, they usually have the summers
off to do research, similar forthe masters and public health
students, and so we wereactually.
The main objective of my K awardis not necessarily looking at
sexual minority health.
It was more broadly looking atdownstream effects of social
(13:21):
media and screen use andphysical activity.
But as a gay man myself andsomebody who has interest in
LGBT or sexual minority research, this sort of came up as a side
project because I had a coupleof students who are interested
in the topic and LGBT healthmore broadly and we had already
analyzed all the screen data forother prospective analyses, and
(13:43):
so it just so happened that wewere like, oh, we should look to
see if there's any associationswith sexual orientation and
screen use, and so this actuallywas like a summer research
project from last summer thatkind of came about from a
collaboration with two reallyspectacular students.
Patrick Sullivan (13:59):
That's great, and thank you both for making
those opportunities available toearlier career colleagues and I
think for me it's some of themost joyful work that I do is
working with earlier careerpeople who are in that process
of like devouring the methods,the substance and producing
these things and for identifyingyourself as a gay man, as I am,
(14:22):
and we also bring our own livedexperiences to this work and
sharing that, I think, is alsogenerous.
There's a time in my careerwhere I'm probably much, much
older, but the time when I wasmuch more reserved about my
personal life and so questionsdidn't get asked.
So I think it's a feature ofour identities and our
(14:43):
willingness to share them thatit opens up areas of inquiry
that just didn't happen before.
So thank you for both of thosecounts and thanks for
recognizing your earlier careercolleagues and their
contributions to the paper.
And I'm just asked one morequestion about your own path.
So, in terms of your training,your development, how did you
(15:03):
get involved in this particulararea of research and adolescent
health, young adult health,lgbtq health, and was that sort
of a place you were aimingtowards?
Or for a lot of us, it's aplace that we find ourselves,
where we land because of theworld and stuff.
So what was your journey tohave this particular focus in
your research?
Jason Nagata (15:23):
Yeah, I think it was a little bit of a mix of
many of luck and interest.
Adolescent health and medicine.
I really like it because it hasthis intersection of physical
health issues and mental healthand there's just so much
excitement during adolescence,there's so much growth and
development and people arebecoming, or transitioning
(15:44):
towards becoming, adults, and Iguess I would say that my first
influence was really my parents.
My mom was a pediatric nurseand my father was a mental
health social worker, so in someways I basically am doing the
intersection of their twocareers.
So I don't know, maybe I wasdestined for it.
But as I went through collegeand medical school, I actually
(16:06):
was very interested in nutritionissues and I think that
pediatrics is a time whennutrition is really important,
and so I initially becameinterested in pediatrics because
I was looking at sort ofbehavioral nutrition research.
I liked the pediatric populationand then when I was a third
year medical student that's whenyou start your clinical
training I was actually justplaced in the teen clinic, so
(16:30):
mostly dealing with primary carefor teenagers and also
specialty care related to eatingdisorders and other mental
health issues and teens, and Ijust loved it because I think
you could really interact andtalk and engage with the
teenagers themselves, but theywere still in need of guidance,
and so I just really enjoyedthat patient population and then
(16:51):
I think from there, noted thatyou know, adolescent medicine is
actually a relatively newspecialty in pediatrics, only
within the last 30 or so years.
There's just so much, I think,research gaps in the field that
it seemed like it was a good fitbecause it was a relatively new
field.
There's a lot of research thatstill needs to be done and I
just enjoy working with apopulation clinically.
Patrick Sullivan (17:12):
Yeah, thanks, and I think there's also you'd
know better than I would, but Ithink there's also a higher
prevalence of eating disordersin sexual gender, minority youth
.
Is that right?
Jason Nagata (17:23):
Yes, absolutely.
I should have also mentionedthat I guess I sort of have two
lines of work.
One is this sort ofpopulation-based epi research,
looking at the ABCD study andother cohorts focused on
adolescents.
But my clinical research isalmost exclusively now focused
on eating disorders andparticularly in sexual and
gender minority youth andactually boys and men.
Patrick Sullivan (17:45):
Great.
Well, I'm going to give you thefinal word here, and just I've
sort of mentioned a couple timesthat the later I get in my
career, the more I'm focused onearlier career people and young
researchers and aspiringstudents.
So do you have any advice foryoung researchers or students
who may have an interest in thistopical area and who want to
pursue research and who are notsure how to get on that path?
(18:07):
What advice would you give?
Jason Nagata (18:10):
Yeah, I think that my best advice is to choose a
topic that you're passionateabout and then really persevere.
I was going to mention that oneof the biggest challenges, I
think, for this research wasgetting that initial NIH funding
, and so, for the K award that Ihad mentioned, that I applied
for in order to allow me toconduct these analyses of the
(18:30):
ABCD study and other adolescentcohorts, I think I had to apply
for it three times before it wasfinally funded, but now that it
is funded, it's just beenreally amazing.
I think I chose the sort oftopic that I really wanted to
delve into and I reallyappreciated being able to have a
lot of protected time now torun these analyses in the ABCD
(18:52):
study, and I think that becauseI continued to try, despite
critical reviews, I'm reallyhappy that I didn't change
topics, but I still, like youknow, worked on revising until
it was in a fundable range.
Patrick Sullivan (19:07):
Yeah, and that is an important message for
those folks who are in that sortof PhD to K transition.
I think that is much more thannorm of the experience is
multiple cycles of review andupdate, and I know it can feel
discouraging, but it's also likethat gives you that really
great runway in which, to youknow, get your own program of
(19:30):
research started and focus onwhat you want to.
So congratulations on that.
So do you have any other lastthoughts that you'd like to
share with our listeners, oranything else that I haven't
asked you about your researchthat you think is important to
share?
Jason Nagata (19:43):
No, I think that this has been a really wonderful
conversation and thanks so muchfor featuring our work, and I
do hope that we'll be able tolook at other insights related
to sexual minority disparitiesin the ABCD study and other
cohorts and adolescents, becauseI do think that there's a lot
of topics that really haven'tbeen explored at all in the
research field in terms ofsexual minority disparities.
(20:06):
I think there's been relativelymore on sexual health and maybe
mental health and substance use, but I think there are so many
other areas of physical healththat are collected in ABCD and
other cohorts that really needto be explored and identified
more in the scientificliterature.
Patrick Sullivan (20:23):
Thanks, and I'll leave a little Easter egg
for people who've listened allthe way through, which is that
we're going to be launching aspecial issue of Annals on
Health and Equities, and one ofthe explicit calls will be
around sexual and genderminority, as well as race,
ethnicity, economic inequities.
So you might line up and have agreat next paper, as the Health
Equity Issue Calls forManuscripts.
(20:45):
So that brings us to the end ofthe episode.
Thanks again, Dr.
Nagata, for joining us today.
It was such a pleasure to haveyou on the podcast and thanks
again for the work that you doin making time to tell us about
it.
Jason Nagata (20:58):
Thanks so much for having me.
Patrick Sullivan (21:05):
I'm your host, Patrick Sullivan.
Thanks for tuning in to thisepisode and see you next time on
EPI Talk behind the paper.
EPI Talk is brought to you byAnnals of Epidemiology, the
official journal of the AmericanCollege of Epidemiology.
For a transcript of thispodcast or to read the article
featured on this episode andmore from the journal, you can
(21:26):
visit us online at www.
annalsofepidemiology.
org.
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