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Tuesday Jan 03, 2017

Can Increased Awareness Trump Cyberbullies?

"The world would be a better place without you."

Those were some of the last words 13-year-old Megan Meier read online before she hung herself on Oct. 16, 2006.

The cruel messages came from a trio of online tormentors(www.nbclosangeles.com) who created a fake Internet persona "to mess with Megan." Since then, Megan's mother, Tina, has started the Megan Meier Foundation(www.meganmeierfoundation.org) in her crusade against cyberbullying.

The grieving mom may gain an unlikely ally on Jan. 20: Melania Trump. In a speech delivered before her husband's victory in the presidential election, Melania Trump pledged to combat cyberbullying as first lady.

Although the U.S. Constitution does not give presidents' spouses any official responsibilities, they have historically picked signature issues to champion using their enormous social influence. These issues have ranged from improving housing conditions (Ellen Wilson) to beautifying the country ("Lady Bird" Johnson) to helping orphans (Dolley Madison).

For the past few decades, first lady platforms have shifted from noncontroversial issues with almost universal support to more complex issues -- interestingly, often related to health.

Betty Ford tackled drug and alcohol addiction while supporting abortion rights and raising awareness for breast cancer. Rosalynn Carter was a leader in mental health reform. Nancy Reagan supported drug use prevention and later was an advocate for stem cell research and patients with Alzheimer's disease. Hillary Clinton famously championed health care reform as first lady. More recently, Michelle Obama led efforts to curb childhood obesity.

Mrs. Trump's declaration against cyberbullying falls in line with the trend of first ladies supporting social and health care causes.

Cyberbullying (www.cyberbullying.org) has been described as "willful and repeated harm inflicted through the use of computers, cell phones and other electronic devices."  It disproportionately affects children who are disabled; those who identify as lesbian, gay, bisexual or transgender; and those who are obese(www8.nationalacademies.org). The CDC estimates that 15.5 percent of high-school students are cyberbullied(www.cdc.gov). The psychological and social impact of school bullying has been well studied. More than 160,000 students a day miss school to avoid bullying(www.theatlantic.com). Emerging research shows that school bullying is closely linked to cyberbullying, and both can have an impact on children's health. Cyberbullying victims report increased depression, anxiety and somatic symptoms(www.ncbi.nlm.nih.gov), such as abdominal pain or headaches. And victims of cyberbullying are almost twice as likely to have attempted suicide(www.ncbi.nlm.nih.gov) compared with their peers.

So what can Mrs. Trump do to help victims?

Like many other public health issues, there isn't a magic bullet solution because of the diversity of the demographic groups that are impacted and the complexity of the issue. However, bringing awareness to cyberbullying is a good start.

Mrs. Trump should also support the efforts of StopBullying.gov(www.stopbullying.gov) -- a partnership of HHS, the Department of Education and the Department of Justice. There are many anti-bullying programs and community efforts; we just need more evidence-based research(www.cdc.gov) regarding which programs are most effective.

Mrs. Trump could visit schools and communities that have successfully combated cyberbullying. She could also encourage funding of these efforts.

From a policy standpoint, she could lobby to include cyberbullying in existing anti-harassment statutes.

And she should remember that children who are bullies need help, too. These children often come from violent homes.

As family physicians, we can play a role in screening for and preventing cyberbullying  -- although there is limited evidence on this topic. I ask my adolescent patients about school and bullying as part of a routine physical. Additionally, I ask about electronic usage patterns.

Family physicians can initiate dialogue between patients and their parents regarding bullying. Parental involvement is a key factor in mitigating bullying.

The intersection of health and technology is lauded for its potential to improve countless lives. But there is a dark corner of technology that can prove detrimental, especially to teens.

Melania Trump has the ability to change our culture, which -- in her words -- "has gotten too mean." But most importantly, she has the ability to help children like Megan.

Natasha Bhuyan, M.D., is a board-certified family physician in Phoenix. You can follow her on Twitter @NatashaBhuyan(twitter.com).

Posted at 04:32PM Jan 03, 2017 by Natasha Bhuyan, M.D.

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