Executive Summary

• Evidence provided in this written submission comes from research undertaken with 1691 young people (age 13-18) on their engagement with social media, apps and wearable devices, and the impacts they report on their health and wellbeing behaviours

Key Findings

• Social media use impacted on young people’s physical and mental health behaviours: nearly half of young people in the sample reported they had changed their physical activity, body image or diet/nutrition behaviours as a direct result of content accessed from social media
• Different types of social media content had different impacts on young people: peer content (e.g., selfies); reputable accounts (e.g. celebrities, government); recommended content (e.g. YouTube); commercial content; and ‘likes’ all engaged and influenced young people in different ways but all of these did influence their health-related knowledge and behaviours
• Young people were critical users of social media: most young people in the studies could evaluate the types of content that were relevant to their needs, and swiped past content that had the potential to lead to harm
• Vulnerable young people can become even more vulnerable on social media: social media is a very powerful medium. If young people are vulnerable, for whatever reason, there was evidence that social media engagement can magnify those vulnerabilities thereby posing additional physical and mental health risks

Key Guidelines/Actions 

• Social media is a powerful educational resource that should be harnessed in schools and in the home to support young people’s education about health
• Action is required by adults who have a responsibility for young people’s health and wellbeing, including teachers, parents/guardians, and policy makers, to ensure they are digitally literate so they can support young people manage their social media use. 
• Technology and app designers and social media sites have a responsibility to act ethically in order to limit the range of inappropriate material that reaches young people.

Introduction

Dr Goodyear is a pedagogical researcher in the field of physical activity and health in the School of Sport, Exercise and Rehabilitation Sciences at the University of Birmingham, UK. Professor Armour is Pro-Vice Chancellor (Education) at the University of Birmingham, UK and has an extensive track record of pedagogical research into young people’s health and wellbeing.

This written submission provides evidence from three separate projects led by Dr Goodyear and Professor Armour that were all focused on young people’s engagement with health-related social media, apps and wearable devices. The projects took place between 2016-2017 and were funded by the Wellcome Trust, Society for Educational Studies and Richard Benjamin Trust. The projects involved a total of 1691 young people (age 13-18) and aimed to understand the health and wellbeing impacts from young people’s perspectives. This written submission brings together new evidence from young people together with evidence-based resources and guidelines that were created with key stakeholders (including NHS, mental health services and Youth Sport Trust) and advisory groups of young people. The aim was to support parents, practitioners and policy makers to better support young people. 

Main Body of Written Evidence

What does the current evidence tell us and where are the gaps?

1. Nearly half of the young people in our sample (46%) reported that they had changed their physical activity, diet/nutrition or body image behaviours as a direct result of content accessed from social media (Goodyear et al., 2018a).

2. Most young people in the study demonstrated considerable skill in evaluating the types of content that they felt were relevant to their needs, swiping past content that had the potential to lead to harm (Goodyear et al., 2018a). Many young people were able to recognise harmful, fake or untrue information (Goodyear et al., 2018b).

3. Social media is a very dynamic environment where young people’s physical, social and emotional needs can change rapidly, and negative impacts can escalate quickly as a result of the power of the medium and its content (Goodyear et al., 2018a).

4. Positive Effects: For many young people, social media and health-related apps were a valuable learning resource, particularly when they were curious and keen to learn about their bodies and their health (Goodyear & Armour, 2018; Goodyear et al., 2018a). 53% of the young people in our sample reported that they use social media to access health information on food intake, sleep, exercise and body image, and from SnapChat, Instagram and YouTube (Goodyear et al., 2018b). 63% of the young people in our sample reported that social media was a good source of health information (Goodyear et al., 2018b). In some cases, health-related content accessed from social media had increased young people’s motivation for and levels of physical activity (Goodyear & Armour, in press).

5. Negative Effects: A significant amount of unsolicited and unregulated health information on social media reached young people. Nearly all the young people in our sample reported seeing inappropriate content related to diet/nutrition, exercise and body image; e.g., water diets, FitTea, adult weight loss and/or bodybuilder transformations (Goodyear et al., 2018a). Some young people reported that they had developed obsessive/addictive monitoring behaviours, engaged with extreme diets and/or exercises, and experienced heightened levels of body dissatisfaction as a direct result of accessing material from social media (Goodyear et al., 2018b).

6. Different types of social media content have different impacts on young people. For example:

Goodyear et al. 2018, p.19

7. There are clear gaps in our understanding about how different populations of young people use and experience the positive and negative impacts of social media (Goodyear et al., 2018a). There are also few understandings about the social, contextual and educational factors that support young people to be critical and resilient users of social media (Goodyear & Armour, 2018b).

The areas that should be the focus of future research, and why

8. There is an urgent need to strengthen the evidence-base on the opportunities and risk-related impacts of social media on young people’s health and wellbeing. In particular, further evidence should be drawn from large samples of young people in different contexts and cultures, and with wide range of learning needs (Goodyear et al., 2018b).

9. New evidence is required on the types of educational mechanisms (e.g. campaigns, curriculum or pastoral) that engage young people with health-related knowledge and understanding through social media, and that impact positively on their health-related behaviours (Goodyear & Armour, 2018). This type of evidence would ensure that the support young people receive is relevant, effective and will lead to impacts.

10. Dr Goodyear and Prof Armour have created evidence-based educational workshops and school-based lessons for young people and teachers on social media and apps, and have piloted these with over 100 young people from 17 schools, and in collaboration with Youth Sport Trust and a Google Educator. These pilot activities have demonstrated that there can be positive impacts on young people’s health-related learning and behaviours, and the development of teacher knowledge and understanding about social media. Further research is required to evaluate the outcomes and impacts of these educational activities. 

11. New insights from young people’s perspectives is required to determine the risks and opportunities that are experienced (Goodyear & Armour, 2018). Most evidence has been limited to education and/or health interventions and has been limited in its capacity to identify the types of digital health and wellbeing technologies and social media sites young people engage with outside of the view of adults (Goodyear et al., 2018a).

12. Further evidence is required on the positive role that social media and digital health and wellbeing technologies play in young people’s lives. There has been an overwhelming tendency to report on the negative power of apps and health-related devices (Goodyear & Armour, 2018). Our understanding about the opportunities of social media to promote positive health and wellbeing behaviours is very limited.

The well-being benefits from social media usage, including for example any apps that provide mental-health benefits to users;

13. Health and wellbeing apps are not engaged with and/or used by all young people, and are not a solution to reach all young people. Only 35% of young people in our sample reported currently using an app or wearable health device (Goodyear & Armour, 2018). Of the young people that currently used health-related apps, Fitbit, Apple Health, and Clue were the most popular (Goodyear & Armour, 2018).

14. The young people reported three important features of content that can influence their uses of health related apps and devices:

Goodyear & Armour, 2018 p. 7

The physical/mental harms from social media use and screen-use, including: safety online risks, the extent of any addictive behaviour, and aspects of social media/apps which magnify such addictive behaviour;

15. Key risk-related impacts resulting from young people’s access to social media material are: mental wellbeing, including factors such as stress and anxiety; obsessive, addictive and/or disordered behaviours in areas of diet/nutrition and physical activity; and body dissatisfaction resulting from negative body comparisons (Goodyear et al., 2018b).

16. Personal, social, and cultural factors can contribute to and intensify a young person’s vulnerability and/or resilience to social media material (Goodyear et al., 2018b). Schools, PE lessons and sport, and family members’ and peers’ uses of social media and digital health and wellbeing apps, are powerful influencers on the ways in which young people engage with health-related material from digital technologies (Goodyear & Armour, 2018).

The extent of awareness of any risks, and how awareness could be increased for particular groups — children, schools, social media companies, Government, etc.

17. Young people report that schools/teachers and parents/guardians fail to understand young people’s uses of social media (Goodyear et al., 2018b). The young people stated that schools focus primarily on cyberbullying, but a bigger problem is peer-pressure on social media and its relationship to enhanced body dissatisfaction (Goodyear et al., 2018b). Young people believe that the media/news makes fun of their uses of social media and exaggerates or inadequately represents the real risks (Goodyear et al., 2018b).

18. In order to provide support to young people that will be effective, adults’ digital literacy should be a key focus. Digital literacy support for adults should aim to help adults to critically evaluate the relevance of health-related information for their own and young people’s lives, as well as developing digital skills to navigate social media sites so they can understand and offer appropriate support to young people (Goodyear et al., 2018b).

What monitoring is needed, and by whom

19. Young people need to be protected from the development of harmful views and/or behaviours that are linked to their engagement with social media (Goodyear et al., 2018b). This is an important action/responsibility for schools/teachers and parents/guardians.

20. Schools/teachers and parents/guardians should engage in on-going conversations with young people to ensure that these adults act in ways that respect young people’s digital rights and meet their expectations (Goodyear & Armour, 2018). Schools/teachers and parents/guardians are more likely to be effective if they support young people’s agency in digital/online contexts (Goodyear & Armour, 2018).

What measures, controls or regulation are needed;

21. Young people should be supported by schools/teachers and parents/guardians to act prudently and carefully, and to become thoughtful users of social media and digital technologies. They need to be empowered to engage in critical, safe, and ethical behaviours.

Where responsibility and accountability should lie for such measures;

22. There was evidence in our data that social media sites tailor what young people based on the images they follow, post or like, previous videos watched, commercial adverts, cookies, and/or topics the site/device considers that young people will enjoy (Goodyear et al., 2018b).

23. Young people suggested that the liability/accountability lies with the social media sites and app developers, and feel that mechanisms should be in place to protect young people against inappropriate content that reaches them (e.g., fake news) and restrictions should be placed on apps to prevent excessive usage and the development of addictive behaviours (Goodyear et al., 2018b; Goodyear et al., in press).

24. The young people reported that schools, teachers and family members were individuals who could offer them the support they need to navigate social media and digital health and wellbeing apps (Goodyear & Armour, 2018). Yet, the data showed that adults need to be more understanding of young people’s uses of digital health technologies and become sufficiently digitally literate to offer support to young people at times of risk/vulnerability and to ensure positive health outcomes are realised (Goodyear & Armour, 2018; Goodyear et al., 2018b).

25. National and international governments should take greater responsibility for the ways in which commercial social media can permeate young people’s lives by supporting schools/teachers and parents/guardians to become better informed, and by requiring technology and app designers and social media sites to act ethically (Goodyear & Armour, in press).

26. The third sector should proactively provide continuous professional development resources for schools/teachers and appropriate educational support for parents/guardians.

April 2018             

References and Supporting Material

• Goodyear, V.A., & Armour, K.M. (2018). “There’s an app for that!”: An Exploratory Study into Digital Technologies and Health/Wellbeing Education in Schools. Report submitted to the Society for Educational Studies.
• Goodyear, V.A., & Armour, K.M. (In Press). Young People, Social Media, Physical Activity and Health. London: Routledge.
• Goodyear, V.A., Armour, K.M., & Wood, H. (2018a). Young people and their engagement with health-related social media: new perspectives. Sport, Education and Society, I First. Available at: https://www.tandfonline.com/doi/full/10.1080/13573322.2017.1423464
• Goodyear, V.A., Armour, K.M., & Wood, H. (2018b). The impact of social media on young people’s health and wellbeing: Evidence, guidelines and actions. University of Birmingham: University of Birmingham, UK. Available at: http://epapers.bham.ac.uk/3070/1/The_Impact_of_Social_Media_on_Young_People’s_Health_and_Wellbeing_(FINAL_15TH_JAN).pdf
• Evidence-Based Digital Resources can be accessed from: http://opencpd.net/Digital%20Case%20Studies%20.html