I was delivering an influenza vaccination to a seventeen-year-old patient when I noticed her talking to someone on her phone. As I injected her, she looked into her phone with a studied enthusiasm and exclaimed, “Hey guys! I’m getting my flu shot! My awesome doctor convinced me to get it, and believe me, it’s not so bad! Watch this!” This was my first introduction to yet another social media application—TikTok. As the mild irritation of having my photo unwittingly shared across the internet subsided, I realized the positive implications that new media applications can have on promoting healthy behaviors, such as improving influenza vaccination uptake in one of the most difficult populations to reach.
In his article “Social Media: Anticipatory Guidance,” Dr. David Hill describes the risks and benefits of social media for children and adolescents and how parents and patients can be counseled to understand and utilize these media constructively. He warns that most parents of young children are not cognizant of the comprehensive American Academy of Pediatrics’ media use guidelines published in 2016 and that, according to adolescents, parents are generally unaware of the information that they (adolescents) are sharing on social media.
Today, passive digital media use can begin as early as 2 years of age, with parents sharing information about their children online. This early and unfiltered exposure can lead to a “permanent digital footprint” that may come back to harm the children in later years. Dr. Hill’s paper describes that almost all 2- to 8-year-old children are exposed to electronic devices, but by virtue of their age they are naïve to traditional social media sites. During pre-teen years the use of electronic media increases dramatically from less than 1 hour to about 6 hours per day, most of the time being spent on passive programs like television shows and video games. Dr. Hill elaborates on how, as they enter their teenage years, social media use creeps in, with more than half of 13-year-olds using it for more than 2 hours per day, to “all day” use by older teens. The article discusses that, while the majority of teens feel that social media has no effect on their lives, about 25% say that social media use impacts them negatively, taking away from friendships and promoting bullying. Thirty percent of teenagers express the positive effect that social media use has on their lives by preventing isolation, maintaining connections with friends and family, and keeping them aware of what is going on in the world. The paper details how use of social media sites may help improve self-esteem, reduce isolation, build relationships, and may serve as a source of healthy and reliable information. Conversely, social media use can also have detrimental effects, including cyberbullying, on-line sexual solicitation, and association with mood disorders in young people.
The author recommends that anticipatory guidance for parents of young children should address parents’ own media use and its effects on parent-child interactions and social emotional development. Parents should be also be aware of the negative consequences of screen media on young children, including the effects on weight and sleep. In older children, Dr. Hill states that increased parental awareness and monitoring of social media utilization has been shown to have a direct effect on health outcomes and reduction of risky behaviors. Parents should have rules about type of media use—when and where it can be used—and should be vigilant about internet safety. They should also understand the positive effects that social media can have on adolescent development, healthy behaviors, and community engagement. Familiarity with the sites that promote digital literacy like Common Sense Media is recommended.
Tick tock tick tock… who knows what application is around the corner?