z The Impact of Digital Behavior on Poly-substance Use Among American High School Students: An Analysis using YRBS 2017 to 2021 Laggy George MPH Brooks College of Health INTRODUCTION § Poly-Substance Use (PSU): Significant public health concern especially among adolescents. • Age of Onset: 15-19 years critical for substance use initiation (Blanco et al.,2018). • Poly substance use is more prevalent than single substance use (CDC,2023). • Screen Time (ST): Associated with physical, social, and psychosocial health impacts (Connolly et al., 2024 ) • Explore the association between screen time and PSU in American High School students, using a cross-sectional analysis with YRBS 2021 data. • PSU includes concurrent use of 2 or more drugs intentionally or unintentionally (CDC,2023). • Excess screen time defined as more than 2h/day apart from course work ((AACAP, 2024) OBJECTIVE • Data Source: YRBS 2017-2021, (N=45,132). • Dependent: PSU (concurrent use of substances). • Independent: Screen time, Socio-demographic (gender, age, race/ethnicity, grade), Lifestyle factors (mental health, physical activity, sleep, smoking, alcohol use, opioid misuse). • Statistical Analysis: Chi-square and Multiple logistic regression Using SAS 9.4 English. RESULTS • Baseline characteristics: • Final sample size n=7,251 • 48% females, 52% males. • Majority aged 16-17 years (24%). • Non-Hispanic Whites 53%, Hispanics 25%. • PSU: 21%, and Screen Time >2 h: 91% • ST and PSU Association: • Higher odds of PSU with >2 h per day of ST (AOR = 1.6, 95% CI = 1.03-2.54) Increased odds of PSU also with: • Dose response with age, >18yrs, (AOR = 27.7, 95% CI = 5.84-131.9) • Opioid misuse and Alcohol 3 times higher odds, while smoking 10 times higher odds. • Gender and Race differences: Males, non- Hispanic Blacks had higher odds (Table 1) • Physical activity 5 days a week for 60 mins/day (AOR = 0.8, 95% CI = 0.68-0.99) • Trends (2017, 2019, 2021): • PSU higher odds 2019 (AOR = 1.3, 95% CI 1.05-1.56, p=0.015) • Excess Screen Time: Significant predictor of PSU; higher likelihood of PSU. • Mental Health: Poor mental health linked to higher likelihood of PSU. • Smoking, alcohol, opioid misuse increased the likelihood of PSU. • Physical Activity: Protective effect against PSU. • Prevention Strategies: Focus on reducing screen time, promoting physical activity, and integrating mental health services. METHOD Table 1 Multiple Logistic Regression Analysis Note: n = unweighted sample size. % = weighted percentage. Significant at p<0.05 • Target lifestyle modifications, including physical activity in highschoolers to reduce screen time. • Health education for parents and adolescents regarding prescription misuse, and substance misuse. • Emphasis on High-risk subgroups. 10% 68% 11% 55% 17% 51% 15% 21% 90% 32% 89% 45% 83% 94% 85% 79% NONE CURRENT ALCOHOL NONE CURRENT OPIOID MISUSE NONE PRESENT SCREEN TIME <=2 H/D >2H Prevalence of Polysubstance Use among High School Students in the United States from 2017-2021 Poly Substance Use (No) Poly Substance Use (Yes) • Chi-square analysis • All values significant at p <0.05 Smoking Variable Odds ratio 95% CI Gender Female reference Male 1.3 1.04-1.63 Age (years) >12-13 reference 14-15 21.7 4.92-95.76 16-17 24.5 5.40-111.24 >18 27.7 5.84- 131.91 Race NH White reference NH Black 1.8 1.24- 2.47 Physical Activity >= 1h/day <5 days a week reference >=5days 0.8 0.68-0.99 Mental Health Good reference Not good 1.9 1.47-2.37 Current Smoking <=30 days None reference Current 9.7 7.78- 12.09 Current Alcoholism <=30 days None reference Current 3.4 2.58-4.54 Prescription Opioid Misuse No reference Yes 3.1 2.50-3.72 Screen time <2h per day reference >2h per day 1.6 1.03-2.54 REFERENCES ACKNOWLEDGEMENTS • Aacap. (n.d.). Screen Time and Children. • Blanco, C., Flórez-Salamanca, L., Secades-Villa, R., Wang, S., & Hasin, D. S. (2018). • Centers For Disease Control and Prevention. (2023). • Connolly, S., Govoni, T. D., Jiang, X., Terranella, A., Guy, G. P., Gr