The mobile application TikTok has become a popular social media platform for individuals of all ages to receive and engage with health information presented by their algorithms. Due in part to the app’s popularity and scope, young women have emerged as a notable user demographic who commonly utilize the application to obtain information related to sexual and reproductive health. Seeing this, public health campaigns have become interested in TikTok as an opportunity to share health information and promote health literacy. However, existing literature shows that there is a need to generate a more comprehensive and targeted recommendation for public health offices intending to develop sexual and reproductive health campaigns for young women on TikTok. Through the analysis of existing literature, a recommendation is provided that addresses important gaps in sexual and reproductive health knowledge of young women, and what popular formats and themes of TikTok videos are likely to allow public health campaigns to provide the most successful and engaging content.
The popular Chinese-owned phone application TikTok emerged in 2018 as an unprecedented pioneer in the social media space through its popularization and amplification of short-form content. With over 500 million users on the application daily, TikTok has solidified its position as the fourth most popular social media platform globally. With the consistent influx of videos posted on the application daily and the widespread reach of viral content to various audiences, TikTok has become a new frontier for social media marketing and is emerging as a platform for organizations to run far-reaching and engaging public health campaigns that promote health literacy and advocate for women’s health.
The interest of public health organizations in TikTok stems from a niche of content on the application: health information. People in younger generations, especially women, have reported a consistent presence of videos containing health information on their TikTok feeds, with a notable focus on sexual and reproductive health. Health-based videos can range from users sharing their experiences with various health topics to self-proclaimed medical personnel explaining health materials from an accessible perspective.
However, due to the relative newness of TikTok, little research has been conducted on understanding how and why young women engage with health-based content on the app, especially in sexual and reproductive health information. By analyzing the influence of sexual health education and social media’s role in filling knowledge gaps young women have regarding their sexual and reproductive health, public health offices can obtain relevant insights and create reliable campaigns to disseminate valuable sexual and reproductive health education. Moreover, through an in-depth review of existing TikTok content regarding sexual and reproductive health, public health offices can garner a more comprehensive understanding of what is effective and engaging in the structure of short-form content. Much of the existing literature surrounding health-based TikTok use concludes with suggestions for public health campaigns on how to distribute reliable health information to young women. With this in mind, the paper compiles these suggestions and evidence and concludes with a twofold structured recommendation to public health offices on how to generate effective and engaging sexual and reproductive health campaigns aimed at young women.
Sexual education has been identified as a critical way to increase and foster empowerment in health while reducing the risk of unsafe sex-related behaviors (Najamabadi & Sharifi, 2019). However, only 30 states and the District of Columbia require public schools to teach sex education, and fewer require that sex and/or HIV education must be medically, factually, or technically accurate (NSL). Even with the teaching of sexual education, schools falter in delivering effective teaching for their students, with some programs focusing entirely on abstinence despite overwhelming evidence of their ineffectiveness. From 2015 to 2019, more adolescent females reported that they have received instruction about waiting until marriage (67%) than where to obtain birth control (48%) (Guttmacher). Consistent evidence points to a need for comprehensive, evidence-based, and accessible sexual education for young women to build a safe and positive view of sexuality and make informed, safe, and positive choices regarding their sexual and reproductive health (AAP).
Without the effective teaching of sex education, young adults reach out to friends and engage with social media posts to obtain information. Late adolescents (ages 18 to 24) have been identified as a group very vulnerable to social media norms toward personal attitudes and sexual health behaviors (Weaver, 2024). A 2024 study conducted on mostly female individuals aged 18 to 25 has shown that young people want to learn about sexual health information at a younger age and from health classes, with 80% of participants agreeing that schools should discuss sex and contraceptives more often. Almost 50% of participants see educational/informational sexual-health-related content in their social media feeds, and 59% of participants claim that social media influencers improve their ability to speak confidently about human sexuality (Weaver, 2024). This evidence reiterates the necessity for well-rounded sexual health classes since young people would prefer to learn in schools rather than through social media, regardless of the continual prevalence of health content on their social media. However, due to the lack of federal requirements for sexual health courses in high school education, social media needs to become a more reliable and trustworthy method for dispersing medical knowledge. Social media platforms, most notably TikTok, offer a unique method for public health campaigns to disseminate important and useful sexual and reproductive health knowledge.
TikTok has become a relevant contemporary source of health information, with a considerable amount of the app’s content surrounding sexual and reproductive health. Due to this, young women consistently engage with the application to answer questions regarding sexual and reproductive health that were not addressed in past educational curricula. A recent study on women aged 18 to 29 years shows that most young women in the United States who consistently use TikTok have obtained health information, either intentionally (65.5%) or unintentionally (92.4%) (Kirkpatrick & Lawrie, 2024). Most of the study’s participants reported they obtained health information from health professionals on the application, and were likely to trust and act on that information. The most common reasons listed by the survey participants for using TikTok were that they could obtain advice from other patients with the same disease or health conditions as them, and receive social support. Instead of other sources of guidance such as health-based websites, physicians, or printed reference material, evidence shows that young women consistently engage with and trust health advice posted by self-identifying health professionals on TikTok to address their concerns.
Another factor that influences TikTok’s popularity as a source of health content is the robust accessibility of information on the application. Hashtags such as #pregnancyscare and #birthcontrolproblems allow for videos encompassing a specific niche of reproductive/sexual health to be grouped and easily searchable. In a content analysis of 100 TikTok videos under the hashtags #sexeducation and #healthclass, certain topics emerged as more commonly searched and engaged with (Fowler et al., 2021). These included female anatomy (84%), sexual well-being (23%), and contraception (13%). The topic of sex education was also addressed in the content analysis, with 18% of videos discussing sexual health curricula in a satirical or critical manner. Identifying popular and unpopular search topics can illuminate what knowledge gaps exist in sexual and reproductive health. Moreover, analyzing the complaints young women have regarding existing sexual health curricula is crucial for knowing what to improve in information distribution. Public health campaigns can build a foundational understanding of the type of content needed for the young female population by examining the scope of usage and popular search topics outlined in this section.
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.
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.
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.
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.
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.
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.
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.
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.
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.
