PROJECT SUMMARY Concurrent with a dramatic rise in social media use, youth in the United States are reporting high rates of peer victimization and mental distress. Treatment-modifiable elements of the relationship between online social messaging, mental distress, and peer victimization are unclear. This lack of clarity is partly because prior work relies primarily on “snapshots” of these social connections, in which youth self-report on their social media use and related experiences at a single point in time. More intensive sampling and real-time characterization of adolescents’ social worlds is needed to develop better interventions and guidance for clinicians, youth, and parents. This work is particularly urgent among youth with high rates of online and in-person victimization. We have previously recruited and retained high-risk samples of youth from the emergency department (ED), who report high cross-sectional and longitudinal rates of peer victimization, mental distress, and social media use, for both intervention and cohort studies. This research project, developed in response to PA 19-373, proposes an innovative combination of methods from our prior work. We will enroll 240 adolescents (age 13-17) presenting to the ED for any medical or injury complaint in a 6-month cohort study. Using recruitment, sampling, and follow-up methods similar to our prior work, we will intensively collect online social messaging (“OSM”), in-person interactions (using the Electronically Activated Recorder, or “EAR”, which collects snippets of codable audio), and self-perceived mood, loneliness, and peer victimization (using ecological momentary assessments, or “EMA”) for 1 month. We will administer validated self-report surveys at 0, 1, 3, and 6 months. Finally, we will collect continuous OSM data from 2 weeks prior to recruitment to the end of the 6-month study. We will use advanced computational modeling, as previously piloted by our group, to align and integrate OSM, EAR, and EMA data, and develop nuanced descriptions of at-risk youth’s social connection and isolation. We will then examine the relationship between their social connectedness, peer victimization, and future psychological well-being, and will explore how demographic and other vulnerability factors influence this relationship. SIGNIFICANCE: Consistent with the NICHD strategic plan, our methodology as well as the unique composition of our research team ensures that our research is aimed at identification of “targets for behavioral intervention.” Our findings will inform future in-person and population-level interventions to improve patterns of social connectedness, reduce peer victimization, and improve well-being among at-risk adolescents.

PROJECT NARRATIVE NICHD has called for improved descriptions of the relationship between real-time social connectedness, peer victimization, and psychological well-being. This innovative 6-month cohort study will use multiple methods of real-time measurement of social media use, in-person interactions, and self-perceptions to identify patterns of social connectivity, peer victimization, and psychological well-being among a high-risk sample of adolescents. Results will inform future in-person and population-level interventions for youth, parents, and communities.