Youth Social Media Use and Health Outcomes: #diggingdeeper

Abstract

See Related Article on p. 158Social media use has become an integral part of life for the vast majority of U.S. adolescents and young adults [1Smith A. Anderson M. Social media use in 2018. Pew Research Center, Washington, DC2018Google Scholar, 2Anderson M. Jiang J. Teens, social media & technology 2018. Pew Research Center, Washington, DC2018Google Scholar]. In recent years, youth social media use has evolved and become more sophisticated, as users report frequent use within and across multiple social media platforms (e.g., Facebook, Instagram, Snapchat) [1Smith A. Anderson M. Social media use in 2018. Pew Research Center, Washington, DC2018Google Scholar, 2Anderson M. Jiang J. Teens, social media & technology 2018. Pew Research Center, Washington, DC2018Google Scholar]. Public discourse surrounding social media use often emphasizes the negative repercussions to young people's health and well-being. The research in this domain, however, paints a more complex picture of the relationship between social media use and health outcomes. See Related Article on p. 158 Indeed, exposure to pro-substance use content via social media has been associated with a greater likelihood of substance use. A recent meta-analysis demonstrated positive associations between alcohol-related social media engagement and self-reported drinking and alcohol problems among adolescents and young adults [[3]Curtis B.L. Lookatch S.J. Ramo D.E. et al.Meta-analysis of the association of alcohol-related social media use with alcohol consumption and alcohol-related problems in adolescents and young adults.Alcohol Clin Exp Res. 2018; 42: 978-986Crossref PubMed Scopus (88) Google Scholar]. Celebrity endorsement of e-cigarette brands has been shown to significantly increase positive attitudes toward e-cigarettes and smoking intentions [[4]Phua J. Jin S.V. Hahm J.M. Celebrity-endorsed e-cigarette brand Instagram advertisements: Effects on young adults' attitudes towards e-cigarettes and smoking intentions.J Health Psychol. 2018; 23: 550-560Crossref PubMed Scopus (41) Google Scholar], and social media e-cigarette exposure was associated with current e-cigarette use and positive outcome expectancies [[5]Pokhrel P. Fagan P. Herzog T.A. et al.Social media e-cigarette exposure and e-cigarette expectancies and use among young adults.Addict Behav. 2018; 78: 51-58Crossref PubMed Scopus (89) Google Scholar]. Furthermore, pro-smoking information scanning (exposure to pro-smoking information through routine media use) during social media use significantly predicted subsequent smoking behavior among young adults. [[6]Zhu Y. Pro-smoking information scanning using social media predicts young adults' smoking behavior.Comput Hum Behav. 2017; 77: 19-24Crossref Scopus (14) Google Scholar]. Conversely, there is evidence that social media platforms can be leveraged as behavior change agents. Social media–based behavioral interventions have been linked with improvements in nutrition behaviors, such as increased fruit and vegetable intake or decreased sugar-sweetened beverage consumption [[7]Hsu M.S. Rouf A. Allman-Farinelli M. Effectiveness and behavioral mechanisms of social media interventions for positive nutrition behaviors in adolescents: A systematic review.J Adolesc Health. 2018; 63: 531-545Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar], and intermediate smoking reduction and cessation outcomes [8Ramo D.E. Thrul J. Chavez K. et al.Feasibility and quit rates of the tobacco status project: A Facebook smoking cessation intervention for young adults.J Med Internet Res. 2015; 17: e291Crossref PubMed Scopus (75) Google Scholar, 9Ramo D.E. Thrul J. Delucchi K.L. et al.A randomized controlled evaluation of the tobacco status project, a Facebook intervention for young adults.Addiction. 2018; https://doi.org/10.1111/add.14245Crossref PubMed Scopus (42) Google Scholar]. In a study of social media use and sexual risk behaviors among minority youth, individuals who were exposed to sexual health messages on social media were more likely to have used contraception or a condom at last intercourse [[10]Stevens R. Gilliard-Matthews S. Dunaev J. et al.Social media use and sexual risk reduction behavior among minority youth: Seeking safe sex information.Nurs Res. 2017; 66: 368-377Crossref PubMed Scopus (48) Google Scholar]. Notably, traditional media as an information source was not significantly associated with sexual risk behavior outcomes, suggesting that social media platforms may offer special avenues for influencing sexual health behaviors (and potentially other health outcomes) not afforded by traditional media sources. Other research suggests that the effects of social media use on adolescents' and young adults' health and well-being may depend on the specific way in which youth engage with the medium. In a study of social networking use among sexual minority and heterosexual youth, findings indicated that using sites for general identity expression or exploration was linked with negative mental health outcomes, whereas using sites specifically for sexual identity development predicted positive mental health outcomes [[11]Ceglarek P.J. Ward L.M. A tool for help or harm? How associations between social networking use, social support, and mental health differ for sexual minority and heterosexual youth.Comput Hum Behav. 2016; 65: 201-209Crossref Scopus (48) Google Scholar]. In a separate study, young adults' general social media use was not associated with impaired mental health functioning; however, posting unclear but alarming sounding posts to get attention (“vaguebooking”) was linked to suicidal ideation [[12]Berryman C. Ferguson C.J. Negy C. Social media use and mental health among young adults.Psychiatr Q. 2018; 89: 307-314Crossref PubMed Scopus (161) Google Scholar]. Interviews with a sample of adolescents with depression revealed that they use different social media sites for different purposes; anonymous sites offer a place to provide and receive positive social feedback with similar peers, whereas public sites may be used to display a different facet of their identity [[13]Radovic A. Blackwood A.N. Miller E. “It's your Twitter, so you can just say how you feel”: How adolescents with depression and their parents use social media.J Adolesc Health. 2015; 56: S23Abstract Full Text Full Text PDF Google Scholar]. These findings are reflected in surveys and interviews with adolescents, who report mixed views on whether social media has a positive, negative, or both a positive and negative influence on their lives [2Anderson M. Jiang J. Teens, social media & technology 2018. Pew Research Center, Washington, DC2018Google Scholar, 14Rideout V. Fox S. Digital health practices, social media use, and mental well-being among teens and young adults in the U.S. Hopelab and Well Being Trust, 2018https://www.hopelab.org/reports/pdf/a-national-survey-by-hopelab-and-well-being-trust-2018.pdfDate accessed: November 6, 2018Google Scholar, 15Vaterlaus J.M. Patten E.V. Roche C. Young J.A. #Gettinghealthy: The perceived influence of social media on young adult health behaviors.Comput Hum Behav. 2015; 45: 151-157Crossref Scopus (156) Google Scholar]. Taken together, these findings highlight the complex relationship between social media use and health outcomes among youth and young adults, calling for research that uses novel approaches to examine the multifaceted nature of this relationship. In this issue of the Journal of Adolescent Health, Ilakkuvan et al. [[16]Ilakkuvan V. Johnson A. Villanti A.C. et al.Patterns of social media use and their relationship to health risks among young adults.J Adolesc Health. 2019; 64: 158-164Abstract Full Text Full Text PDF PubMed Scopus (38) Google Scholar] address a gap in this field by developing nuanced profiles of young adults' (aged 18–24 years) social media use. The authors constructed latent profile models based on participants' use/co-use and frequency of use across 10 sites. They subsequently examined the association between latent profile membership and alcohol, tobacco, and other drug use, and symptoms of depression and anxiety. The authors found that young adults can be classified by distinct social media use patterns, determined by frequency of use of particular sites, and that these patterns are associated with differences in health-related risk factors and behaviors. The approach taken by Ilakkuvan et al. is consistent with recent efforts to understand the effects of social media use on youth in ways that extend beyond a one-size-fits-all paradigm. The various uses and features of the different sites afford youth the opportunity to shape their social media experience in ways that satisfy both their social and developmental needs. Many young people report “connectivity and connection” as central to their social media experience and that the interaction they experience through social media with others is a positive force in their lives [2Anderson M. Jiang J. Teens, social media & technology 2018. Pew Research Center, Washington, DC2018Google Scholar, 14Rideout V. Fox S. Digital health practices, social media use, and mental well-being among teens and young adults in the U.S. Hopelab and Well Being Trust, 2018https://www.hopelab.org/reports/pdf/a-national-survey-by-hopelab-and-well-being-trust-2018.pdfDate accessed: November 6, 2018Google Scholar]. Developmental considerations, including the desire to form social bonds and become more autonomous from parents [[17]Arnett J.J. Adolescence and emerging adulthood: A cultural approach. Prentice Hall, Upper Saddle River, NJ2004Google Scholar], might in part explain the near-ubiquitous use of social media to communicate with peers, network, explore, and share. By digging deeper into who uses what sites, and why, there is the potential to learn about the pathways that connect social media to health and risk behaviors. As the authors note, one important implication of this work is that it has the potential to facilitate the dissemination of persuasive health communications and health-promoting content designed specifically for audiences likely to be receptive to the message. Conceptual and methodological approaches like the ones used here also help parents and medical professionals identify youth who may be more vulnerable to the effects of social media. This is especially important for adolescents, and research is needed to determine if there are similar classes of users among adolescents. For example, it is likely that adolescents have different social media profiles compared with the emerging adults in the study's sample; “professional users” is an example of a class that may not apply to younger users. In addition, findings from the study by Ilakkuven et al. suggest that creative users, for example, have 10 times the odds of using other drugs compared with high users. Knowing that the use of some sites may be associated with a greater likelihood of performing risk behaviors may serve as an entrée into discussions between parents and their adolescents about social media use and engaging in risky health behaviors. Although the perils of social media are reason for caution, it has the potential to be a powerful tool for advancing health communication efforts. By providing insight into how youth make decisions concerning risk and health behaviors, social media may offer important information to advance positive health outcomes in adolescent and young adult populations. Patterns of Social Media Use and Their Relationship to Health Risks Among Young AdultsJournal of Adolescent HealthVol. 64Issue 2PreviewSocial media use is pervasive among young adults, and different sites have different purposes, features, and audiences. This study identified classes of young adults based on what combination of sites they use and how frequently, and compared their health risk factors and behaviors. Full-Text PDF