Study examines TikTok’s influence on youth sexual health decisions

^{“I have a passion for empowering women, and more generally people, to make informed decisions about their bodies,” says Clinical Associate Professor Stephanie Delkoski.}

On one of the hottest days of the summer, Clinical Associate Professor Stephanie Delkoski, DNP, APRN, WHNP-BC, and her team set up shop at the Minnesota State Fair to conduct research in the Driven to Discover Research Facility with other researchers from the University.

The questions they were seeking to ask fairgoers — specifically youth — focused on how they use the social media platform TikTok in sexual and reproductive health decision-making.

Delkoski’s team, which included Clinical Associate Professor Maria Ruud, DNP, APRN, WHNP-BC, and Assistant Professor Camille Brown, PhD, RN, PHN, sought to describe the prevalence of youth using social media platforms as a source of sexual and reproductive health education and how they evaluate the accuracy of the information they gather. They also examined the differences in experiences by sexual orientation and gender identity.

The research team included practicing nurses who have anecdotally encountered increasing adolescent and young adult patient reports of TikTok as a source of sexual health knowledge gathering and have shared that their sexual and reproductive health choices were guided by it.

“Sometimes the information that patients shared was accurate, and other times it was pretty clear that it was one person’s experience and not necessarily reflective of common experiences based on available literature or evidence,” says Delkoski, who maintains a clinical practice at M Health Fairview Women’s Clinic in Minneapolis.

Prior research has shown that adolescents and young adults are increasingly turning to social media for sexual health information due to factors such as convenience, accessibility and anonymity. But there is little known on the prevalence of TikTok as a source of sexual health education among this demographic and how they evaluate the validity of the content they encounter. 

“Understanding the prevalence of TikTok as a source of sexual health education and how young people determine the validity of the content can inform public health interventions aimed at promoting accurate and reliable sexual health information among adolescents and young adults,” says Delkoski.

The study, Byte-sized Choices: Youth, TikTok, and Sexual Health, involved collecting quantitative data through surveys with questions about the use of social media, focused on TikTok specifically, for the gathering of sexual health related information, as well as how they judge the accuracy and credibility of the sexual health content they view. Qualitative data was collected from a subset of participants in brief, one-on-one interviews. The interviews focused on what attracted them to use TikTok as a source of sexual health education, the types of sexual health education they gathered, how they evaluated the accuracy of the information and how that education may influence sexual health decision making. 

In total, 244 surveys were received and 52 interviews were conducted. The participants reported spending 3-4 hours on social media daily, and about half of them said they seek sexual and reproductive health information from TikTok. They liked using TikTok because it was easy to gather digestible, quick, tailored, free, and inclusive information. The majority of the participants consider the accuracy and validity of the information they are viewing from TikTok in some way.

Of those surveyed, 42% reported using social media to help them to make a sexual or reproductive health decision. Of these people, at least 50% said their decisions informed by TikTok were in the areas of relationships, contraception, menstrual cycles, sexual and reproductive rights, and body positivity.

“Many of the youth and young adults who engaged in our research were really passionate about the topic and eager to share what attracts them to TikTok and use of other social media platforms for sexual health information gathering. It was really fun because the participants were really excited to talk with us,” says Delkoski. “Overall the atmosphere in the D2D building had energy and enthusiasm for supporting research broadly. There was a general desire to expand knowledge and understanding of diverse topics and ultimately drive innovation and improve health outcomes.”

She says the results from this study can help identify gaps and misconceptions in existing sexual health education programs, allowing for more targeted and effective interventions. For instance, in interviews TikTok was identified as filling in participant knowledge gaps around sex among LGBTQ+ people. This is notable as 30% of participants in the study identified themselves as LGBTQ+.

“I have a passion for empowering women and, more generally people, to make informed decisions about their bodies. In order to make an informed decision, they have to have accurate information. The results of this study help me think about, as a clinician, how to provide accurate information in a fast, digestible way. More broadly, we can take the knowledge we gained from this project to think about how we can educate youth and young adults about how they can consider the accuracy of the information when they’re viewing it.”