Many teens discuss health risk behaviors on social networking websites

Jan 5 2009

In a pair of related studies released by Seattle Children's Research Institute and published in the January 2009 issue of Archives of Pediatric & Adolescent Medicine, researchers found that 54 percent of adolescents frequently discuss high-risk activities including sexual behavior, substance abuse or violence using MySpace, the popular social networking Web site (SNS).

The studies, Adolescent Display of Health Risk Behaviors on MySpace, and Reducing At-Risk Adolescents' Display of Risk Behavior on a Social Networking Web Site, were led by research fellow Megan A. Moreno, MD, MPH, MSEd, and Dimitri Christakis, MD, MPH, of the Center for Child Health, Behavior and Development at Seattle Children's Research Institute, and the University of Washington.

With the rise in SNSs' popularity and use, parents and those who work with teens have concerns that these sites might expose teens to ill-intentioned online predators, cyberbullies and increased peer pressure. There are also fears that university enrollment and future hiring decisions may be compromised by what adolescents post online in personal profiles. SNSs like Facebook.com and MySpace.com are increasingly popular; MySpace, the most commonly used SNS, has more than 200 million profiles, with 25 percent belonging to youth under 18, according to multiple studies.1, 2

"As with television, movies, games and all media, social networking sites are neither inherently good nor bad," said Christakis, Director of the Center for Child Health, Behavior and Development at Children's. "Their upside needs to be acknowledged even as we remain concerned about their downside. We need to devise ways to teach teens and their parents to use the internet responsibly. In the 90's we talked about a digital divide that separated rich from poor. That divide is quickly narrowing, but a new one is emerging rapidly: the 21st century digital divide separates too many clueless parents from their Internet-savvy children."

In their study Adolescent Display of Health Risk Behaviors on MySpace, the research team collected information directly from readily available public MySpace profiles. A total of 500 randomly chosen Web profiles of self-reported 18-year-old males and females from the United States provided the data. Researchers examined the extent to which high-risk behaviors were reported in the profiles, as well as any correlations that suggested that certain behaviors may be influenced by other items, interests or activities. They found that 54 percent of the MySpace profiles contained high-risk behavior information, with 41 percent referencing substance abuse, 24 percent referencing sexual behavior and 14 percent referencing violence. In the study, females were less likely to display violent information than males, and teens who reported a sexual orientation other than "straight" showed increased displays of references to sexual behaviors. Profiles that demonstrated church or religious involvement were associated with decreased displays of risky behaviors, as were profiles that indicated engagement in sports or hobbies.

"Online displays of risky behaviors may actually just be displays," said Moreno, formerly a research fellow at Children's and now Assistant Professor of Adolescent Medicine at the University of Wisconsin School of Medicine and Public Health. "Some teens may be grandstanding, or may be indicating intention or considered behavior. If that's the case, then there's a silver lining because this presents opportunities for education and prevention before risky behavior takes place." Moreno adds, "When online displays of dangerous behavior discuss actual behaviors, the good news is that teens may be amenable to participating in online interventions. Our related study looked at this, and we were happy to see that even a brief email intervention may be feasible and showed promise for influencing online behavior."

The researchers' pilot study Reducing At-Risk Adolescents' Display of Risk Behavior on a Social Networking Web Site examined whether a physician's online communication to teens about references to sex and substance abuse found in their MySpace profile would have a positive impact on reducing online display of such behaviors in the SNS. Looking at 190 self-described 18 to 20-year olds with public MySpace profiles that met study criteria for being at-risk, the profiles received a single intervention email from "Dr. Meg," the physician online profile of Moreno, who became a MySpace member. Her profile displayed information about her professional credentials and research interests. The email was sent from within the MySpace system to the subjects' profiles, and no personal emails were used. The intervention provided basic information about the risky nature of online personal disclosures and also provided a resource link to a Web site containing information about testing for sexually transmitted infections.

Three months after the MySpace email intervention, the same online profiles were evaluated again for references to sex and substance use, as well as any changes in profile security settings (switching from a "public" to a "private" profile). At the beginning of this study, 54 percent of subjects referenced sex and 85 percent referenced substance use. After the email intervention, 13 percent of the profiles decreased references to sex behaviors, and 26 percent decreased their substance use references. Ten percent of the profiles changed their security listings from "public" to "private," and a total of 42 percent of the profiles implemented any of these three protective measures. Of those who received the email intervention females were most likely to eliminate sexual references.

Using results from both studies, the researchers conclude that SNS are readily available tools to identify displayed health information and also to communicate with teens about these displays, and they are another way parents and physicians can learn about how adolescents make health-related choices. They add that adolescence is a period of identity exploration which now includes online identity, and adolescents may be open to communicating with health professionals about their online displays. The researchers provide tips for parents and healthcare providers: http://www.seattlechildrens.org/home/press_room/teens_and_myspace.asp.