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Address correspondence to Jaimie L. Freeman, BSc, BA, MPhil, Oxford Internet Institute, University of Oxford, 1 St Giles’, Oxford OX1 3JS, United Kingdom
Specialty of Child and Adolescent Health, The University of Sydney (PHY Caldwell and KM Scott), Sydney, AustraliaThe Children's Hospital at Westmead Clincial School (PHY Caldwell and KM Scott), Westmead, NSW, Australia
Specialty of Child and Adolescent Health, The University of Sydney (PHY Caldwell and KM Scott), Sydney, AustraliaThe Children's Hospital at Westmead Clincial School (PHY Caldwell and KM Scott), Westmead, NSW, Australia
Given the potential for social media to spread health misinformation, it is important to understand how trusts impact adolescents’ engagement with health content on social media.
Objective
To explore the concept of trust when adolescents (13–18 years) engage with health information on social media. Five relevant databases (MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL) were systematically searched alongside Google Scholar and reference lists of included papers. Studies were included if they examined adolescents’ trust when engaging with health information on social media.
Study Appraisal and Synthesis Methods
Thematic analysis was used to synthesize the findings from this review.
Results
Thirty-four papers were included. Three key domains were explored: trust in the social media platform/service (general distrust of social media for health information; safety and privacy); trust in other users (mistrust of unknown users; fear of bullying or judgment; trust in friends or peers; celebrities and popularity; trust in others’ experience and the importance of social support); trust in content (tone and appearance of health information; expertise and verification; advertising, pushed, and suggested content).
Limitations
Narrow geographic representation of papers and limited quantitative studies.
Conclusions and Implications of Key Findings
Adolescents’ trust in health information on social media involves a complex interplay between trust in: social media platforms, other users, and health content. Central to many of the findings is the social and identity work done by adolescents on and through social media.
To our knowledge, this is the first systematic review to explore how adolescents trust health information specifically on social media
•
Friends and networks are important for adolescents’ trust in this space
•
The interface between adolescents’ trust and identity is central
How to Use This Systematic Review
•
Clinicians caring for adolescents should understand how adolescents’ evaluations of trust on social media influence adolescents’ health-related knowledge
•
Health care organizations and academic pediatricians designing health resources on social media should consider aspects of trust to ensure evidence-based information reaches adolescents
Social media is a space that allows adolescents to create and nurture social relationships and explore their interests.
A 2018 survey in the United States found that 97% of adolescents (aged 13–17 years) use social media platforms, such as Facebook, Instagram, and Snapchat.
Never has it been more apparent than during the COVID-19 pandemic that social media can widely and rapidly spread health information and mis-information.
; however, it is important that adolescents are armed with the expertise and resources necessary to safely navigate health information on social media.
In this review, trust is understood as a belief in the reliability, accuracy, or credibility of something (eg, a social media post containing sexual health information). Additionally, trust is confidence that actors, objects, or processes will operate in a certain way. For example, confidence that social media platforms will maintain anonymity, or that other users will not respond negatively to health information posted on one's profile.
In previous reviews conducted by our research team, we have explored how adolescents search for and appraise health information online, and the role of trust when adolescents access this information.
These previous reviews focus on health information on websites; however, given the importance of social media as a space for adolescents to encounter health information,
there is a gap in understanding the role of trust in social media. To address this, the current review aimed to explore how adolescents trust health information on social media.
Methods
We conducted a systematic review to answer the research question: What are adolescents’ considerations of trust regarding health information on social media in terms of use of social media platforms and services, other social media users, content, and other related issues? We conducted this review in line with the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) statement
to ensure explicit and comprehensive synthesis of the qualitative studies included.
Search Strategy and Selection Criteria
Five databases (MEDLINE, EMBASE, PsycINFO, ERIC, and CINAHL) were systematically searched, from inception to 7th September 2022, for literature relevant to adolescents’ trust in health information on social media. Reference lists of included papers and Google Scholar were searched for additional relevant papers. Papers were managed using EndNote 20 (Clarivate, 2022).
The search strategy was created with guidance from a health libraries research expert. The strategy was first prepared for MEDLINE (Table 1) and then applied to the other databases. Groups of terms, including Medical Subject Headings (MeSH) and “free terms,” relating to 4 domains (social media, trust, health information, adolescents) were developed. The terms for “trust,” “health information,” and “social media” built on terms in previous related reviews.
(web 2* or user generated content or online community or online communities or virtual community or virtual communities or social media or social medium or Social network* or blog* or weblog* or microblog* or micro-blog* or Twitter or tweet* or mobile apps or mobile app or mobile applications or mobile application or online forum or online forums or bulletin board* or message board* or Skype or instant messag* or text messag* or texting or Patientslikeme or Patients Like Me or YouTube or Flickr or Facebook or LinkedIn or MySpace or SecondLife or Second Life or Listserv or listserve or mailing list* or podcast* or webcast* or wiki* or Snapchat or Instagram).tw.
6
1 or 2 or 3 or 4 or 5
7
Trust/
8
(Trust* or faith* or credibl* or confiden* or plausib* or belie* or rely or relied or reliance* or reliabil* or integrity or accept* or accuracy or accurate or quality or truth* or authentic* or depend or dependabil* or honest* or credence* or certain* or assur*).tw.
9
7 or 8
10
exp Health Education/
11
exp Health/
12
Health*.tw.
13
((health* or wellness) adj2 (information or info or advice or messag* or news or notification* or fact* or material* or clue*)).tw.
14
10 or 11 or 12 or 13
15
6 and 9 and 14
16
Adolescent/
17
(teen* or young people or young person* or youth* or adolescen* or high school*).tw.
All papers reporting primary data, including quantitative, qualitative, and mixed methods, studies, were included if they met the following criteria: participants were adolescents aged 13 to 18 years; papers explored health information on social media and examined adolescents’ trust when engaging with this. The definition of social media for this review was restricted to websites and applications that enable social networking (eg, YouTube, Instagram, Facebook) as this is where existing research has focused to date. Any systematic reviews on the topic were searched for relevant primary studies. There was no exclusion by language. The definition of adolescence varies in the literature. Studies that included a broader age bracket were included if they covered a portion of the 13 to 18 age range and did not extend either below the age of 10 or above 28. Papers on trust in information on social media not related to health or reporting the results of interventions were excluded.
Study Selection
The titles and abstracts of all retrieved articles were screened by 2 authors: J.F. reviewed every title and abstract; K.S. and P.C. each reviewed half. The full text of prospective eligible studies were retrieved and assessed if the information in the abstract was insufficient to make an informed decision about relevance. Any discrepancies between the researchers were discussed until consensus was reached.
Critical Appraisal of Included Studies
All included studies reporting primary research were appraised for methodological quality using the Mixed Methods Appraisal Tool (MMAT).
This framework included items relevant to areas including the clarity of research questions, adequacy of data collection methods, relevance of sampling strategy, and rationale of approach.
Data Collection
Data were extracted from all papers that met the inclusion criteria. The authors developed a data extraction table to record information regarding study design, year, location, setting, participants, recruitment, and potential risks of bias. In accordance with the research question, the authors used line-by-line coding to extract data in the form of descriptions and quotations, following Thomas and Harden.
thematic synthesis methodology was used to analyze and synthesize the information from the included papers to develop analytical interpretations beyond the original papers’ findings.
Concepts were identified to capture the meaning of each sentence, using NVivo 12 (QSR International Pty Ltd, 2019) software for data management. Similar concepts were compounded to form preliminary, descriptive themes. Quantitative data were included under the relevant theme. J.F. recorded the descriptive themes in an analytical framework with accompanying descriptions and quotations. This was reviewed by all authors and redeveloped as a higher-level theoretical framework with 11 analytical themes.
Results
Study Selection
As illustrated in the PRISMA flow diagram (Fig. 1), the database search produced 8644 papers and a further 6 were identified through cited references, such as papers included in reviews that met our inclusion criteria, and Google Scholar. If relevance was unclear from the abstract alone and no full-text article was available, the authors were contacted to seek more information. One author responded and forwarded the full text, which was later excluded. The other author of 2 abstracts did not respond, so the abstracts were excluded as they did not contain relevant data for our review. In total, 351 full-text papers were assessed for eligibility, of which 317 were excluded, resulting in the inclusion of 34 titles. Full-text papers were excluded for the following reasons: not about adolescents or no relevant adolescent subgroup analysis (n = 61); not about online health information (n = 42); not about social media (n = 38); not about trust (n = 114); intervention (n = 54); review paper (n = 8). The 34 included titles described 31 studies. In 2 cases, 2 texts provided alternative yet complementary analyses of the same study. As these offered unique insights, they were individually included as separate papers. There was one PhD thesis and one published paper from this thesis. In this case, we have quoted the most comprehensive of these in the findings but included both titles in our table of included studies.
The 34 included papers reporting primary research underwent critical appraisal using the MMAT (Table 2). The MMAT analysis did not raise any significant concerns about the quality of the included papers and none were excluded on this basis.
Table 2Results From MMAT Analysis of Included Papers
Screening Questions
Appraisal by Study Type
Score (%)
First author
Year
S1. Are There Clear Research Questions?
S2. Do the Collected Data Allow to Address the Research Questions?
Qualitative Studies
1.1. Is the Qualitative Approach Appropriate to Answer the Research Question?
1.2. Are the Qualitative Data Collection Methods Adequate to Address the Research question?
1.3. Are the Findings Adequately Derived From the Data?
1.4. Is the Interpretation of Results Sufficiently Substantiated by Data?
1.5. Is There Coherence Between Qualitative Data Sources, Collection, Analysis, and Interpretation?
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
Moving beyond text: How teens evaluate video-based high stakes health information via social media. Springer International Publishing,
Cham2019: 516-525
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
Exploration of health concerns and the role of social media information among rural and urban adolescents: a preliminary study. Journal articles reports - research.
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Adolescents' sex education using new digital media: the personal motivations and interactive experiences of young people online at Reddit.com. Conference Abstract.
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. Research Support, Non-U.S. Gov't.
Young people's attitudes and motivations toward social media and mobile apps for weight control: mixed methods study. Research support, non-U.S. Gov't.
The characteristics of the included studies are in Table 3. All were published in English, mostly during or after 2017 (n = 23). Primary studies were undertaken in a range of countries, including: the United States (n = 10), the United Kingdom (n = 10), Canada (n = 2), and Kenya (n = 1). Two studies reported cross-national data. Qualitative methods were used by most papers, although 6 reported some quantitative data analysis. Common methods included: surveys and demographic questionnaires (n = 11), as well as focus groups (n = 20) and interviews (n = 11), from which descriptions and quotations were extracted for analysis. A few papers included adolescents in clinical settings (n = 6). Health topics included general (n = 12), sexual health (n = 7), and physical activity, nutrition, and weight (n = 7).
United Kingdom Nonclinical sample from 7 secondary schools in Northern Ireland
527
100% male
14–15
Quantitative
Survey
Statistical analyses (including chi-square tests for independence, t-tests, analyses of variance and standard linear regression for correlational analyses)
The impact of online help-seeking behaviors on the mental wellbeing of adolescent males
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
United States Nonclinical sample from 2 charter schools and 2 Parent-Teacher Associations (PTA)
30
76.7% female; 23.3% male
13–18
Qualitative
Semistructured interviews and practical task (participants accessed known fitness content on social media)
Thematic analysis
Strategies young people use to assess fitness information online and intersecting identity characteristics that relate to how young people make these decisions
Moving beyond text: How teens evaluate video-based high stakes health information via social media. Springer International Publishing,
Cham2019: 516-525
Australia Nonclinical sample from urban and regional communities
22
50% female; 50% male
16–22
Qualitative
Literature review and focus group
Thematic analysis
How formal “expertise” is leveraged through the subjugation of young people's knowledge, and how this is problematic for sexual health promotion; seeking to engage with young people through social media
A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. Research Support, Non-U.S. Gov't.
United Kingdom Nonclinical sample of adolescents from a range of socioeconomic areas in Scotland
34
70.5% female; 29.5% male
14–18
Qualitative
Focus groups and practical task (participants looked for examples of health-related content on social media)
Thematic analysis
Young people's perceptions and experiences of engaging with health content online, particularly through social media, and their strategies for negotiating reliability online
“Young people and their engagement with health-related social media: new perspectives” United Kingdom Nonclinical sample from 10 schools in the West Midlands and the South of England
1296
Phase 1: 40% female; 60% male Phase 2: 57.2% female; 23.8% male Phase 3: 67.1% female; 23.9% male
13–18
Mixed methods
Phase 1: piloting and coconstructing participatory class activities Phase 2: participatory class activities and interviews Phase 3: survey
Descriptive statistics and thematic analysis
The ways in which young people engage with health-related social media and the influences they report on their health in the specific areas of physical activity, diet/nutrition and body image
“Health information-seeking behavior in adolescence: The place of the Internet.” United Kingdom and United States Nonclinical sample from UK high schools and US middle schools and high schools
157
NS
11–19
Qualitative
Focus groups
Thematic analysis
UK and US adolescents’ perceptions and experiences of online health information seeking
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
Exploration of health concerns and the role of social media information among rural and urban adolescents: a preliminary study. Journal articles reports - research.
United Kingdom Online ethnography and nonclinical sample for interviews recruited on social media
10
100% female
10–24 for online ethnography
Ethnography
Online ethnography (Instagram, Twitter, and Reddit) [plus semistructured interviews with those over 18 years, outside the scope of this review]
Thematic analysis
The harms and benefits of young people's engagements with self-harm content on social media, including why and how young people engage in online self-harm discussions and what they post
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Kenya Nonclinical sample from Kibra, a suburb in the city of Nairobi
133
54% female; 46% male
15–19
Qualitative
Focus groups
Thematic analysis
Adolescents’ current sexual and reproductive health information sources, existing information gaps, and the role of technology in accessing this information
United States Clinical sample of adolescents with Type 1 Diabetes from Seattle Children's Hospital Diabetes Clinics
45
42% female; 58% male
13–19 (M = 15.9, SD = 1.7)
Qualitative
Focus groups and demographic questionnaire
Descriptive statistics and thematic analysis
The experiences and perspectives of adolescents with type 1 diabetes on the feasibility of social media use as a tool to collaboratively manage their diabetes with their diabetes care team
Young people's attitudes and motivations toward social media and mobile apps for weight control: mixed methods study. Research support, non-U.S. Gov't.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Adolescents' sex education using new digital media: the personal motivations and interactive experiences of young people online at Reddit.com. Conference Abstract.
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
Belgium Nonclinical sample of first graders from 3 secondary vocational schools in Flanders
41
49% female; 51% male
12–14
Mixed methods
Focus groups and demographic questionnaire
Descriptive statistics and thematic analysis
Opinions of adolescents toward the use of different behavior change techniques and toward Facebook/text messaging as a delivery mode for physical activity interventions
United States Nonclinical sample of African-American youth from urban areas in Midwestern United States
75
71% female; 29% male
14–24 (M = 18.3)
Qualitative
Focus groups
Content analysis
The user requirements of African-American youth inform the design of a culturally appropriate, network-based informatics intervention for the prevention of HIV and other sexually transmitted infections
Vietnam Nonclinical sample initially recruited from high schools and universities
1080
58.06% female; 41.94% male
15–25
Quantitative
Online survey
Statistical analyses (including chi-square, t-test, analysis of variance, and multivariate logistic Regressions)
Use of Facebook and youths’ perception of the reliability and usefulness of health-related information that they previously encountered while using Facebook
Themes were drawn out with findings relevant to each of our 3 key areas (trust in social media platforms/services; trust in other users; trust in content). We identified the concept of “identity formation and performance” within many of these; no other related issues were identified.
On trust in social media platforms/services, 2 themes were identified: i) general distrust of social media for health information; ii) safety and privacy.
With respect to trust in other users, 6 themes were identified: i) mistrust of unknown users; ii) fear of bullying or judgment; iii) trust in friends or peers; iv) celebrities and popularity; v) trust in others’ experience; vi) the importance of social support.
Three themes were established under trust in content: i) tone and appearance of health information; ii) expertise and verification; iii) advertising and pushed or suggested content.
Quotations from adolescents illustrating each theme are in Table 4 and highlighted below. The authors have separated these into 3 key areas to provide structure in this review; in practice, these themes are inextricably linked and feed into and out of one another. This emphasizes the complexity of adolescents’ trust in health information on social media and its role in adolescents’ identity formation and performance.
Table 4Illustrative Quotations From Included Studies
Theme
Quotations
References Where Theme Is Mentioned
Trust in the social media platform/service
General distrust of social media for health information
“Bea: [You] can't always trust the information that you find. Alison: And if you do trust it, [. . .] you could do more harm than good. Cara: Yeah.”
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Exploration of health concerns and the role of social media information among rural and urban adolescents: a preliminary study. Journal articles reports - research.
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. Research Support, Non-U.S. Gov't.
“I came out online first and then to friends in school including teachers. But I felt... I felt like I could. It's… it's really contradictory online because it's so impersonal yet personal at the same time. But it felt like I was seen on as a male online, and if I can do that here then I can do that in school and in my home and in other places where that impacts my life.”
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. Research Support, Non-U.S. Gov't.
Young people's attitudes and motivations toward social media and mobile apps for weight control: mixed methods study. Research support, non-U.S. Gov't.
Adolescents' sex education using new digital media: the personal motivations and interactive experiences of young people online at Reddit.com. Conference Abstract.
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
“On Facebook, simply ‘Liking’ sexual health content was deemed sufficient to attract judgement,” as Josie and Kyle explained: Kyle: Like you've liked it an’ then everybody's like “Oh, why?” Josie: Like, “What's he dae'in (doing) that for?!” Kyle: Yeah, “What are you dae'in that for, you dirty (a promiscuous person)?! (laughing)”
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
“[Cyberbullying] occurs more on social media these days, [more] than it occurs in person. There are [like] new bullies. [Fights] start on social media — [someone writes something] on Instagram or whatever, and then it's a problem in the [whole] school because of what [one] person wrote.”
“…if you could find other reasons that people should watch the videos without that direct link to the diseases that you are talking about – because that's a lot of where the stigma comes from.”
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
“It would be nice to create a Facebook page from our class on Facebook, to share activities Moderator: Can other people be allowed to join your group? No, only people I know!”
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
“Female: ‘Yeah. With health information, I think it's better if it's anonymous because I don't think everyone's really comfortable about talking about that kind of stuff with random [people]... It's something they want to keep to themselves.’ Female: ‘Close friends, yeah, but not like everyone I have on Facebook.’”
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. Research Support, Non-U.S. Gov't.
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
“well, I feel, I get jealous sort of… that's how I feel… I am happy for their sake, but still, I can feel like no, it will never work and stuff like that… and that is not so nice”
“Interviewer: What's a good amount of likes? Female 1: 500 Female 2: 100, or like 110…. Interviewer: So if a picture of something—an exercise someone was doing—had 100 odd likes, does that show it's good?… Female 1: It doesn't appeal to us as much, because it's only 100 likes—so it shows that if other people are not interested, why should we.”
“Darnell (18) explained that if a video has over 100,000 views, that means it has a good audience. When searching for videos, Jasmine (17) selects the video in her search results that has the most views.”
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
“on Facebook [. . .], reliability could be determined by how many people ‘like’ the page, cos that would mean that it's been around for a while and [. ..] it's a popularity sort of thing”
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
“You can form really strong bonds over the internet and I think if you have something as big as diabetes in common then like you could probably bond really fast. I mean I trust you guys and I've only met you today”
“Sometimes it feels good to just let it out and then people comment and they're like yeah this happened to me too or they say something positive about that experience and how it is handled. It makes you feel good.”
"Peter: Social media is most likely to have personal opinions I think and the more informative like official sites they would have dry facts about the illness or any other problem you might have, so you kind of should look at both, to have the facts and then see how other people react to that, I think that's a great combination. Anya: It's true."
“If you were talking to someone [on social media] that had a certain way they handled their diabetes, that you liked...you could exchange tips and tricks for treating diabetes.”
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
Adolescents' sex education using new digital media: the personal motivations and interactive experiences of young people online at Reddit.com. Conference Abstract.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
“If they really wanna put the websites, put stuff that we can relate to. Not just ‘if you do this, [then you'll be] more like this.’ [We] need, ‘I tried this, and this is what happened,’ be specific and maybe we would understand more. I think girls wouldn't be so insecure.”
“Male: ‘You have also got to be aware that when you put something on the internet, there are a lot of clever people out there that can manipulate things really easily and in really funny ways and just turn things into huge jokes.’ Female: ‘Whereas if you are already making the jokes about it, people aren't going to take it and make jokes about it because it is already funny...’”
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
Young people's attitudes and motivations toward social media and mobile apps for weight control: mixed methods study. Research support, non-U.S. Gov't.
Adolescents' sex education using new digital media: the personal motivations and interactive experiences of young people online at Reddit.com. Conference Abstract.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
“If there is a place where only doctors or medical professionals could post information and then if teenagers or other kids wanted to post information it would have to go through someone that would check all the information to make sure it was valid I guess. So that you knew it was reliable and like good information.”
“Normally, if there is a verified tick or someone like known that's more trustworthy in that area, in health. So, it's like, if there is someone new with barely any followers...then it makes it less likely for you to follow that person.”
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
“it is like advertisements sort of … and if it is shown often then it gets stuck … and then you start to drink these [points at an Instagram depicting energy drinks] and that is not good for me”
“When they advertise other websites or other things at the beginning of their videos, I don't usually trust those, because, I mean, I just don't know. I just don't trust those ads…Yeah, they're advertising something, like: ‘Oh you should get this’ or ‘Oh, you should try out this,’ then I usually don't trust it… It seems more of just a way to get publicity for something else that they need, rather than trying to help other people in that subject.”
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
“M7: I was watching this video about like weight loss and stuff and then half way through they mention this diet pill that you can take and I was like ah no, I'll just get off it do you know what I mean. You can't trust any of it.”
Exploration of health concerns and the role of social media information among rural and urban adolescents: a preliminary study. Journal articles reports - research.
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
Exploration of health concerns and the role of social media information among rural and urban adolescents: a preliminary study. Journal articles reports - research.
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Exploration of health concerns and the role of social media information among rural and urban adolescents: a preliminary study. Journal articles reports - research.
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
Perceptions of health information on social media were mediated by factors including gender and educational level of the user, and interpersonal influences from Facebook (eg, talking to new people on social media).
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Exploration of health concerns and the role of social media information among rural and urban adolescents: a preliminary study. Journal articles reports - research.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
however, these sources were still popular as they are convenient while using social media for other purposes, easily accessible, highly familiar, and relevant.
Exploration of health concerns and the role of social media information among rural and urban adolescents: a preliminary study. Journal articles reports - research.
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. Research Support, Non-U.S. Gov't.
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. Research Support, Non-U.S. Gov't.
Young people's attitudes and motivations toward social media and mobile apps for weight control: mixed methods study. Research support, non-U.S. Gov't.
Adolescents had to balance the tension between anonymity, which affords users the opportunity to be more open, with concerns about privacy if others found out that information was associated with them.
A survey on adolescent health information seeking behavior related to high-risk behaviors in a selected educational district in Isfahan. Research Support, Non-U.S. Gov't.
For some, anonymity and privacy controls made social media advantageous for accessing and sharing health information, particularly for sensitive health concerns
Adolescents' sex education using new digital media: the personal motivations and interactive experiences of young people online at Reddit.com. Conference Abstract.
: “I think it's more comfortable to have anonymous postings, because if they don't know who you are then you're a little bit more comfortable saying something.”
Anonymity provided adolescents with an opportunity to ask questions that they felt uncomfortable asking in other settings (eg, offline), while simultaneously offering a personal and social environment in which to express themselves.
Adolescents stressed the importance of password protection for preserving privacy, and distinguished between information for sharing publicly and for certain people.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Young people's attitudes and motivations toward social media and mobile apps for weight control: mixed methods study. Research support, non-U.S. Gov't.
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
Adolescents differentiated access given to close friends compared with unknown users or acquaintances (ie, “friends” on Facebook), allowing them to perform different identities for different audiences.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Due to these concerns, some adolescents adopted different personas in different online spaces. For example, some used irony or humor in public spaces on social media, while reserving more literal or explicit health information for private spaces.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
Adolescents expressed a hesitance to share and be identified with health information online for fear of bullying, stigma, or judgment; they did not trust others’ responses to their shared health information.
An exploratory study of current sources of adolescent sexual and reproductive health information in Kenya and their limitations: are mobile phone technologies the answer?.
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
This fear was exacerbated by the public, anonymous nature of social media, which could enable cyberbullies to send abusive or hurtful responses to others
It was not only anonymous or unknown others that adolescents were concerned about. In sharing health information, adolescents sometimes lacked trust in friends’, peers’, or family's responses
Booth KM. Youth and information quality: An intersectional exploration of how teens assess fitness information on social media. [PhD Thesis]. Pennsylvania, PA: The Pennsylvania State University; 2018.
What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study. Research Support, Non-U.S. Gov't.
and this could impact on their conceptions of their own identity. For example, adolescents discussed fearing others’ responses to images of themselves or their bodies on social media and highlighted its negative psychological effects
Distrust in others’ responses was also seen in adolescents’ concerns about the stigma surrounding health information, particularly for sensitive information including mental or sexual health concerns
: “with the stigma of, if you found something about a sexual health infection, then you don't really want to be like, hey it's made me think of you. It just has that connotation.”
Due to distrust in others’ online responses, some stressed the importance of social media moderation, “blocking,” and holding users and “trolls” accountable for online behaviors.
Opinions towards physical activity interventions using Facebook or text messaging: focus group interviews with vocational school-aged adolescents. Research support, non-U.S. Gov't.
Assessing feasibility and strategies for clinicians to communicate via social media with adolescent patients about HPV vaccination. Conference Abstract.
Osteoporosis knowledge translation for young adults: new directions for prevention programs.
Health Promot Chronic Dis Prev Can.2017; 37 (L'application des connaissances sur l'osteoporose chez les jeunes adultes: nouvelles orientations pour les programmes de prevention): 229-237https://doi.org/10.24095/hpcdp.37.8.01
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