TikTok Rx: Youth turn to social media for health advice

Young people have lots of questions about diet, exercise, and sexual health. TikTok is one of their most trusted venues for finding out information.

“They’ll go to TikTok and ask questions,” says Nicole O’Donnell, assistant professor at Washington State University’s Edward R. Murrow College of Communication. “They’re learning about health mostly through other people’s stories rather than some of the traditional health information you might get online.”

But are they getting good health advice? In a recent study, O’Donnell analyzed health content on TikTok. Influencers with motivational stories were prevalent, while content from credentialed health providers was lacking.

In this episode, she talks with Washington State Magazine science writer Becky Kramer about the potential pitfalls of teens relying on influencers for health information—particularly if the influencers are selling products.

O’Donnell also has advice for public health officials working on teen outreach. Short TikTok videos are effective at reaching young people. And personal stories count, she says.  

Transcript

Episode 28 Viewscapes - TikTok Rx

January 30, 2024

SPEAKERS

Becky Kramer, Larry Clark, Nicole O'Donnell

Nicole O'Donnell  00:00

People are watching content and seeking out content, especially if they have questions. So they'll go to TikTok and ask questions so they can see a video response instead of having to read through a Google response. And in doing so, they're learning about health mostly through hearing other people's stories.

[music]

Larry Clark  00:17

Young people have lots of questions about diet, exercise and sexual health. They often go to TikTok videos as trusted venues for finding out information says Nicole O’Donnell. O'Donnell is an assistant professor at Washington State University's Edward R. Murrow College of Communication, where she researches social media and health communication. Welcome to Viewscapes, the podcast of Washington State Magazine at WSU. I'm Larry Clark, the editor of the magazine. O’Donnell talked with magazine science writer Becky Kramer about TikTok influencers, the power of personal stories, and ideas to get more scientific and effective public health information on TikTok.

Becky Kramer  00:57

Well, Nicole, thank you so much for being on Viewscapes today. You mentioned that your research is in the area of media psychology. Tell me a little bit about what that is. 

Nicole O'Donnell  01:11

Well, thank you so much for having me. So media psychology explores media, like television, music, social media, and how it can influence our attitudes and our behaviors. I'm especially interested in people's positive experiences with media. So you're listening to your favorite song, how does that affect your mood or watching your favorite movie? We know that media can have positive effects and be inspiring and entertaining. And so I am also interested in how it can be educational and improve our health and well-being.

Becky Kramer  01:47

Some of your recent research is about TikTok and health related messaging. How are teens and young adults using TikTok?

Nicole O'Donnell  01:57

Well, I mean, it's always evolving, but we know that young people spend a lot of time on social media. I think some of the recent Pew Research said that young people are almost constantly online. At least 50% of youth state that, so it's no longer the hours per day. It's almost constantly and Tik Tok is definitely a favorite platform.

Becky Kramer  02:20

Almost constantly. That is something to think about. What kinds of health-related topics are kids and young adults most interested in?

Nicole O'Donnell  02:30

Yeah, so our research on TikTok and health shows that young people are using TikTok to seek out health information. So if we think about being on social media almost constantly, it's not just our traditional forms of social media of connecting with friends or family. One trend that we've seen in research is that TikTok is now almost like an entertainment source like television, and people are watching content and seeking out content, especially if they have questions. So they'll go to TikTok and ask questions so they can see a video response instead of having to read through a Google response. And in doing so, they're learning about health mostly through hearing other people's stories, rather than some of the traditional health information you might get online.

Becky Kramer  03:16

So yeah, so that's interesting too. So instead of Googling something, they might go to Tik Tok and do a search.

Nicole O'Donnell  03:25

We often think especially of younger generations as being constantly on social media, but they're not constantly creating content. So especially with TikTok, we find that people are mostly passive consumers. And what makes it more of a social media is sharing videos with your friends and family that stick out to you. Or liking content or commenting on it. But you might create one video a week or not create content at all, but you're consuming a lot more content than you're creating. And so I think that there are a lot of avenues for health information to be shared. So the last study that I conducted here at the Murrow College with two PhD students, Sultana Jerin and Di Mu, we looked at 500 posts on TikTok that had health educational content, and we were really interested to see the types of messages people are receiving.

Becky Kramer  04:20

So you talked a little bit about personal stories and the power of personal stories in terms of health related content. Tell me a little bit about the role of influencers on TikTok. 

Nicole O'Donnell  04:33

Most of the content that we looked at for health educational videos, had influencers present and was really inspiring content. The topics that were most frequently discussed were diet, exercise and sexual health. Those were highly present in our sample and really engaged with, and to me, that makes sense. When we think of a younger audience, they're not going to be looking up cardiovascular disease as they are some other health topics that might be important, looking up diet and exercise. But that message is mostly coming from influencers and people sharing their personal stories, rather than medical professionals. And it's important for people to have the opportunity to share their stories and hear from others, but we need to make sure to have some type of balance as well and be critical consumers of the information we're receiving.

Becky Kramer  05:25

Are there potential pitfalls then of having this information come from people sharing a personal story versus something that's been vetted by the scientific community?

Nicole O'Donnell  05:36

One of the biggest pitfalls that we have seen with our influencer content is they're sharing their personal stories, but they're also sharing an aspirational version of health. So they're sharing their diet tips. But you know, they're making these incredibly expensive smoothies with, you know, raw vegetables and exercising on the beach. And in health communication, we see that as kind of sharing and unattainable lifestyle. And we know that's generally how influencers present themselves: in this really beautiful, ideal way. But beauty doesn't equate health. And, you know, I think especially young people who are looking for health information, need to be critical of that and need to understand that, you know, you don't have to be incredibly wealthy to be healthy, despite some of like the aspirational images they promote. 

Becky Kramer  06:28

You looked at diversity in this work as well. Are people seeing messages from diverse content creators?

Nicole O'Donnell  06:35

So there's a ton of opportunity. So we know that regardless of race, class, young people have access to phones. 95% of youth in the United States have access to phones. But the people who are promoting content primarily and whose voices are being amplified, are generally not diverse at all. Especially we see kind of the young, white, beautiful female influencer. And that's the content that is being amplified that people are engaging with. So there's a lot of opportunity for more diverse content creators across kind of the health education spectrum. Because we know all young people are using the platform. Are they seeing themselves?

Becky Kramer  07:14

So one of the examples you gave from and influencer, and I think you actually call them “med influencer,” was the hashtag “that girl” content. So essentially, you mentioned young, white, beautiful. Tell me a little bit about what you saw with the “that girl” content?

Nicole O'Donnell  07:39

Yeah, so “that girl” content mostly focuses around the aspirational lifestyle. And it was a trend that showed that you can look to be the best version of yourself and to be that girl, the girl that people aspired to be. There was usually a formula to the posts that we saw with these hashtags. So someone who woke up early, made their bed, made an organic fruit smoothie, did some exercise and some journaling, and usually really, within an incredibly privileged setting. But it was not only tagged as “that girl,” it was also tagged as this educational health content through the hashtag “EduTok” that we explored. So they were saying that this was educational content as well, which I found interesting. So we know that this content is out there promoting these types of lifestyles, but how frequently it was equated with health education was interesting.

Becky Kramer  08:35

Do you have other examples?

Nicole O'Donnell  08:38

Yeah, so the reason we studied EduTok specifically was because TikTok saw an opportunity for their platform to be educational. And so they created the hashtag EduTok campaign in 2019 and partnered with health influencers, so health professionals can create formal content. And it was a really unique opportunity, and one that now anyone can contribute to. So if you are a doctor, you can have your content be promoted under this EduTok hashtag. But also, if you're just an everyday person wanting to share your story, you can use the same hashtag. So again, there's a lot of voices present and a lot of opportunity within this realm of EduTok.

Becky Kramer  09:23

So if you're a consumer and you're interested in health, what are some things you might be aware of to be a more savvy consumer of health information on a platform like TikTok? 

Nicole O'Donnell  09:35

Yeah, that's a great question. And I think about this as a media researcher, but also as a parent, right? I have a daughter and a son so I'm always interested in, you know, the messages that young people are getting from media and to be a critical consumer or a savvy consumer. The first thing that I tell young people is to check their emotions. If they feel pressured, anxious or inadequate when viewing content, it's usually a sign that the content is more detrimental or harmful than beneficial. So if you're feeling inadequate and feeling really anxious looking at this content, you know, check in with your emotions. Also ask yourself if the person is a role model. So I'm really interested in the people that we see as healthy role models. And just because you're an influencer, and potentially, you know, really beautiful and have a lot of followers, does that make you a role model or a health role model? And even asking that question, I think makes us a little bit more critical of the content we're viewing. And then, of course, kind of the tried-and-true advice is to balance your online time with your offline time. So as a media scholar, we're often asked, you know, how do we help young people manage their online use? And the solution isn't to not have social media at all. If all of your friends have social media, part of that growing up experience is doing things that your friends are doing. But to balance your online time with your offline time, because I think a lot of the negative media effects research we see is when media starts to replace other activities you should be doing that are important to your development. So the number one is sleep. If you are scrolling your phone late at night, you can't turn off TikTok, and you're trying to sleep and then you can't turn off your brain. That's a sign to put your phone on the counter downstairs or have your parents create a rule to put your phone on the counter downstairs. If you are not taking part in physical activity, or sports, or socializing with friends offline, maybe you should start to schedule more of that time as well. It doesn't mean that you need to be off these platforms, because a lot of your friends are on the platforms, you want to be on them too. But that balance is critical. 

Becky Kramer  11:51

Boy, even as an adult, I think about that. We previously talked about something I found really interesting. And that was people sharing social media posts, even when they're not sure it's accurate. Tell me a little bit more about that. Why would someone share a post, in this case, you know, health information, if they're not sure if it's accurate?

Nicole O'Donnell  12:19

One of the positive gratifications we get from media is learning can be really fun. And sometimes we'll read information and feel like we've just learned something new, that's worthy to be shared with others. When we do share information, whether or not we know it's credible, it's often because we think that information will help other people. So we see this within the line of fake news research. People aren't trying to trick their friends and family by sharing information that might be false. Instead, they're trying to share information that they think could be helpful to their friends and family, especially when it comes to health. And so I think that a lot of motivation is there and trying to help other people and being excited that you've learned something new that you didn't know before.

Becky Kramer  13:07

So you talked earlier about opportunities, and TikTok and health information that can be a platform that reaches young audiences, and that, in particular, people are interested in consuming health information in a short video. What are some opportunities here in terms of public health messaging?

Nicole O'Donnell  13:29

One thing that we found in our research was that we need more public health professionals sharing credible information on TikTok. Public health professionals can absolutely utilize these platforms, but they need to do so in a way that resonates with their audience. And one way that they can do that is by sharing real people's stories. So in our work, we found that people sought out people's real life experiences more so than kind of the list of medical advice. If those stories are told in tandem with public health departments, I think that can be a really useful tool.

Becky Kramer  14:05

Do you have any parting thoughts? 

Nicole O'Donnell  14:09

Questioning the motives of content if it's trying to sell you something. And within our study, we saw that often medical advice was paired with trying to sell you a product. And it might be a physical product or it might be trying to sell even the content creator as an influencer. So like, “follow and share for more tips” instead of giving you actual tips about how to improve your health. So as people are making credibility, judgments, that's one thing to ask yourself, what am I being sold here?

Becky Kramer  14:42

Thank you, Nicole. It was great to have you as a guest today.

Nicole O'Donnell  14:46

And I really appreciate the invitation in sharing our work at the Murrow College.

[music]

Larry Clark  14:52

Thanks for listening. If you liked the Washington State Magazine podcast, please share on social media and like us on podcast directories. We’d love to hear your ideas for episodes too. Go to magazine.wsu.edu. Our music was by WSU emeritus professor and composer Greg Yasinitsky.