User Engagement
Though a video on TikTok can have a considerable amount of reach in terms of views, another aspect goes into measuring overall engagement: interactions. A combination of views and interactions measures the success of the video in engaging the audience. In a content analysis of 400 TikTok videos that mentioned the words “EduTok” and “health”, there were certain constructs and topics that received greater engagement and are worth discussing in the context of sexual and reproductive health (O’Donnell et al., 2023). Videos that had role model constructs, aimed to inspire, or had personal testimonials earned greater reach and engagement than those that did not. Videos had a higher reach when they discussed prevention, severity, and cues to action compared to videos that discussed barriers, self-efficacy, or susceptibility. Posts that were framed as debunking misinformation were also popular, earning more interactions than those that did not. These findings present an opportunity for public health organizations to understand which types of video constructs perform better on TikTok, and earn more engagement from the population of young women who use the app for health information.
Common Video Themes
In the study discussed in the previous section, the content analysis also identified common themes that were consistent across popular TikTok posts. These themes had both positives and drawbacks, both of which can be of note to public health organizations when creating videos regarding sexual and reproductive health.
Idealized Frames
The first theme involved the use of idealized frames for promoting health; in other words, the video provided steps that a viewer should take to achieve an idealized version of health. These videos involved role model constructs, providing a visual model for healthy behavior. However, some of them contained commentary that supported holistic health approaches, and almost all featured young, wealthy, white women with a limited representation of other demographics. Campaigns can focus on this drawback, ensuring their posts have diversity and inclusivity, as well as circulating legitimate and accurate health information.
Anecdotes
Videos that contained individuals who shared their personal health experiences were common; the users intended to demonstrate their informal expertise, aided by an open and honest delivery. These videos commonly
contained a virtual rather than tangible call to action, promoting their page to expand their follower base or promote products. These stories were commonly linked to health coaching services or advertising natural health products. Utilizing this information, campaigns can create videos with someone discussing personal experiences in an enlightening, compassionate manner, and link the videos to their public health campaign rather than unethical services or untrustworthy products.
“Research”
The last theme pertained to the use of the word “research” mentioned in health-based videos as a means of boosting credibility. Research is mentioned without credible research or sources, and claims made in the many videos lacked evidence or contained unfounded fear appeals. Posts that emphasized severity and leveraged shock value earned higher engagement, as is seen commonly across social media platforms. For public health organizations, this theme is not a place of inspiration, since its success is rooted in the dissemination of inflaming or unsupported health-related content. Campaigns can note, however, that the mention of research or evidence can help the video’s engagement, rather than harm it.
Discussion
The analysis of existing literature on health-based TikTok usage by young women conducted in this paper was completed to generate a well-structured and comprehensive recommendation for public health organizations on how to conduct an effective TikTok campaign aimed at young women, specifically in the context of sexual and reproductive health. This recommendation is structured in a two-fold approach: 1) Public health organizations must identify gaps in curriculum and knowledge in sexual/reproductive health in young women and 2) Public health organizations must identify themes, and formatting of effective health-based TikTok videos.
Bridging Knowledge Gaps
The first part of the recommendation explains how public health campaigns can bridge existing gaps in knowledge/curricula regarding sexual and reproductive health for young women. As mentioned previously, only 30 states require the teaching of sex education at public schools, with many curricula being non-comprehensive and abstinence-focused. It is known that late adolescents frequently engage with social media to answer health questions due to inefficient sexual education. Videos that contain anecdotal health stories and a social context that aligns with late adolescence can be effective. Also, posted videos could include a health professional offering advice and information; young women are likely to trust content posted by these types of users. However, campaigns must provide clarity on the health professional’s qualifications, since misinformation and skepticism surrounding falsely identifying health professionals is heightened on TikTok. Lastly, popular topics such as female anatomy, sexual well-being, and contraception are likely to align with topics that were not taught in sexual health courses in high school and should be a subject of focus and priority.
Popular Constructs, Themes, and Formatting of TikTok Videos
The second part of the recommendation focuses on the popular constructs, themes, and formatting present in successful and engaging health-based TikTok videos to provide public health campaigns with initial ideas on video structure. The most effective constructs for health-based TikToks were role model constructs, inspiring content, or personal testimonials. Popular videos discussed prevention, severity, and cues to action. Role model constructs were the most effective; users who post acting as a role model for a specific topic, disease, or health concern had the greatest engagement. Videos that debunked misinformation were also popular. Public health campaigns should focus on generating content that contains an honest, open, captivating role model figure who confidently explains sexual and reproductive health topics and answers questions well. If the campaign already has a topic in mind, then understanding what structures of health-based videos perform best for young women will be useful.
Again, through content analysis, the role model construct of videos that contained idealized frames and anecdotal conversations performed the best. Public health campaigns should focus on posting models for healthy behavior/activity/knowledge rooted in legitimate health information and include diverse demographics of spokespeople. These “role models” should deliver insight openly and honestly to connect better with the audience. Campaigns need to focus on choosing individuals that resonate with the audience of young women, and due to the sensitive and occasionally stigmatized nature of the subject matter, ensure they are relatable and compassionate. Analysis of visual content showed that content creators who wear casual clothing, film in a personal residence, or are shown as general content creators reach more TikTok users about reproductive health (Nair et al., 2023). Using phrases that simplify the content into groups, such as #birthcontrol or #MyBodyMyChoice, allows for improved searchability of content by a specific topic, and creators can connect their content to other TikTok creators and viewers with similar stories and opinions (Nair et al., 2023). Campaigns should implement extensive and relevant hashtags for their campaign topic to have the most reach and engagement.
Conclusion
Instead of other sources of information such as health-based websites, physicians, or printed reference material, young women consistently turn to TikTok to answer questions about their health not given through high school sexual health curriculum or other sources in adolescence. Public health organizations focused on communicating sexual or reproductive health information can benefit from the structured recommendation discussed within this paper and address the surge of health misinformation on TikTok. By bridging knowledge gaps and emulating proven engaging health content, public health campaigns can disperse relevant health-based content for young women to cultivate a more comprehensive and confident understanding of their health and well-being.