PROJECT SUMMARY – PROJECT 1 Adolescence is a critical time period for the development of health behaviors such as physical activity and risk behaviors such as alcohol use. One way adolescents learn about and model their behaviors is via technology and digital media (TDM), particularly social media. Adolescent behavior can be influenced by content that adolescents display (self-generated) on social media, as well as content they consume (other-generated). The long-term goal of this research is to understand mechanisms by which social media influence health and risk behavior towards the development of interventions to promote healthy behavior and reduce risk behavior. The objective of this Project 1 is to understand patterns and content of displayed health and risk behavior on social media that is created by, and consumed by, adolescents. We will determine connections between three key concepts through our Specific Aims, including: 1) what adolescents display on TDM about their own health and risk behaviors via self-generated content, 2) the displayed TDM content adolescents are exposed to in real-time about health and risk behaviors, and 3) adolescents’ self-reported health and risk behavior attitudes, social norms intentions and actions. Our third aim will assess neural processes underlying how created and consumed TDM content is processed and associated with health and risk behavior. The PI, Co-I and consultant on this Project bring over a decade of work in the area of adolescent behaviors displayed on social media, including several NIH-funded studies in this area. Our preliminary data indicates that for older adolescents, self-generated risk behavior content on TDM closely aligns with self-reported behavior, and that Ecological Momentary Assessment (EMA) is feasible to use with adolescent populations to assess real-time TDM use and content exposure. This study will use a longitudinal study design, collecting data over 2 years. The shared participant pool for this P01 program will be leveraged to recruit the sample of 400 adolescents aged 13-15 years at enrollment. Data collection approaches will include social media observation of health and risk behaviors, including self-generated and other-generated. This social media observational data will be linked to self-report survey data including attitudes, social norms, intentions and behaviors. Moderators will include technology importance and parent involvement. Data collection will also include Ecological Momentary Assessment (EMA) to determine adolescents’ exposure to self-generated and other-generated content across TDM in real-time. Finally, investigators will utilize social media data during a fMRI scan to determine whether self-generated and other-generated content is processed differently. This project aligns with the current RFA as utilizes multi-level assessments of health and development, including real-time measures of TDM exposure.