How to navigate health promotion in the digital age—Social media and harm reduction among young adults

Social media has become the primary way that young adults communicate and share information. However, few strategies for engaging young adults aged 18–29 years have been described, especially in Canada, where mental health and addiction challenges are prevalent among this demographic. To address this need, we developed a systematic how-to guide to assist health care providers in leveraging platforms like Instagram and X to engage young adults. Key components of our guide include establishing credibility, fostering audience connection, and using diverse formats for information delivery. Implemented as a case study within the Evaluating Microdosing in the Emergency Department study, our strategy aims to disseminate information on opioid use, promote harm reduction, and involve young adults in research. By providing a blueprint for social media presence and engagement, we seek to inform future initiatives and assist health care professionals in effectively communicating health information in various settings, contributing to broader public health efforts.


A systematic how-to guide to assist health care providers in leveraging social media to engage young adults.


Social media has emerged as a pivotal tool for disseminating health promotion interventions aimed at supporting young adults. Despite social media’s widespread use for health communication, many campaigns have demonstrated limited effectiveness in gaining acceptance and uptake of their health promotion strategies among their intended audience.[1] While young adults aged 18–29 are the most active users of social media and 81% of them primarily source scientific information on the Internet, there is a significant gap in the literature regarding effective strategies for engaging young adults on these platforms.[2,3] We present a detailed methodological framework in the form of a how-to guide that provides strategies for health care providers and researchers to master health promotion and social media engagement among young adults.

In the midst of Canada’s ongoing opioid epidemic, a growing number of affected young adults face significant barriers to accessing opioid agonist therapies compared with adults, outlining a pressing need to promote awareness and engagement in life-saving interventions.[4,5] To address this public health emergency, we implemented our social media strategy as a case study within the context of the Evaluating Microdosing in the Emergency Department (EMED) study.[6] The EMED study assesses the effectiveness of buprenorphine/naloxone (Suboxone) microdosing versus standard dosing take-home induction packages in emergency departments.[6] The implementation of our social media strategy within substance use research serves as an important example of how Instagram and X (formerly Twitter) were effectively used to distribute information on opioid use, provide harm reduction resources, and engage young adults in research.

A comprehensive how-to guide for reaching young adults in your practice

Building your social media profile

To effectively engage young adults aged 18–29 on social media, begin by establishing a strong presence across multiple platforms, such as Instagram, Facebook, TikTok, and X, which are used most commonly by this demographic.[1] Choose uniform account names and user names across all platforms that represent your research study or medical practice to maintain consistency and signify your organizational identity. Establish a cohesive color scheme, logo, and profile aesthetic that you will use to reinforce the objectives of your platform, whether it is participant recruitment for a study, accepting patients, raising awareness, or promoting a treatment. Set up your profiles as business/professional accounts to access valuable user analytics and engagement metrics, including demographic information about your audience. Professional accounts also allow you to categorize your account to accurately represent the type of organization you belong to and reach your target audiences (e.g., family medicine practice). To establish credibility and foster trust among young adult populations, showcase the qualifications and credentials of your principal investigator or lead health care provider(s) on the biography and initial posts on your accounts. Factors including the type of language used (professionalism, objectivity, and factual accuracy), perceived expertise, and the number of likes, followers, and reposts all contribute to the credibility of health information on social media.[7] Keep your accounts’ biography or description short and simple, and include the name, location, and contact information for your practice or research site. To add legitimacy to your accounts, consider using a platform like Linktree, a link management tool that enables you to share your organization’s official links, previous publications, community resources, and support services.

For the EMED study accounts [Figure 1], we feature the study principal investigator, Dr Jessica Moe, as the face of our study to disseminate research findings and clinical information through her personal and professional lens. An X study on public perceptions of opioids found that health care professionals received the highest number of reposts and engagements, suggesting a preference for their credibility as sources for opioid-related information.[8] Our primary objective for these accounts is to promote harm reduction interventions and increase awareness of opioid-related issues, with a long-term vision for these profiles to serve as a platform beyond the EMED study.

FIGURE 1. Instagram and X profile snapshots for the Evaluating Microdosing in the Emergency Department study, featuring Dr Jessica Moe, as of 15 April 2024.

FIGURE 1. Instagram and X profile snapshots for the Evaluating Microdosing in the Emergency Department study, featuring Dr Jessica Moe, as of 15 April 2024.

Posting strategies

Using a variety of content formats, such as posts (images or videos), stories, live videos, reels, TikToks, polls, quiz/question stickers, and highlighted stories, can effectively engage diverse users and cater to user preferences. Posts, including tweets and status updates (X and Facebook, respectively), typically consist of images, videos, infographics, or written messages and serve as the main form of content for sharing information and visuals. They remain on your profile and are suitable for all social media platforms. Stories usually feature images, text, short videos, polls, or quiz/question stickers that expire after 24 hours and are beneficial for sharing real-time updates or quick snippets of information. These stories can be featured on your profile as story highlights after they expire, can be organized into custom categories, and act as an archive of content that users can explore on your page. There has also been a recent shift in young adults’ preferences toward short-video content (up to 90 seconds) on platforms like TikTok, as well as on Instagram and Facebook, where this content is called reels, often accompanied by audio, music, and text.[1,9] By incorporating this multimodal approach with various content formats, we can accommodate diverse preferences and increase engagement. Maintaining a consistent posting frequency is essential to sustain an online presence and engage with your audience effectively; however, avoid posting excessively, as this can lead to decreased engagement overall.[10]

Awareness posts

To convey the significance of your health-related cause, use concise yet informative infographics or TikToks/reels featuring current statistics, symptoms, signs, and available resources. These posts should be visually appealing, minimize text, avoid technical jargon, and use accessible language. For the EMED study, we created infographics that illustrated the severity of the opioid crisis, including statistics on opioid-related overdoses, deaths, and hospitalizations. Additionally, we shared resources for community support, such as nearby addiction clinics offering opioid-agonist therapies, other addiction services, and supervised consumption and overdose prevention sites [Figure 2].

FIGURE 2. An example of an Evaluating Microdosing in the Emergency Department study awareness infographic highlighting key statistics of the opioid epidemic.

FIGURE 2. An example of an Evaluating Microdosing in the Emergency Department study awareness infographic highlighting key statistics of the opioid epidemic.[11]

Educational posts

Create infographics or TikToks/reels to outline key information pertaining to your research or practice, such as the etiology of diseases, preventive measures, treatment options, recent publication findings, and study criteria. For instance, for the EMED study, we posted infographics on Suboxone [Figure 3], dosing regimens of Suboxone, available opioid-agonist therapy options, and the scientific mechanisms for opioid dependence.

FIGURE 3. An educational post example from the Evaluating Microdosing in the Emergency Department study introducing Suboxone.

FIGURE 3. An educational post example from the Evaluating Microdosing in the Emergency Department study introducing Suboxone.

Engagement posts

To encourage young adults to meaningfully engage with your content, tailor it to their interests and preferences. Simply raising awareness and providing educational content may not be effective. Young adults prefer to engage with and trust health information they perceive as real, often relying on personal experiences or stories as evidence of its authenticity.[1] To incorporate this form of authenticity, establish genuine connections and rapport with young adult audiences by having researchers or practitioners present information or showcase their work through TikToks, reels, or videos as stories.[1] Video-based platforms like TikTok allow a human touch through their versatile features, facilitating creative ways to incorporate visuals, text, and humor to share information.[9]

Similarly, Rath and colleagues discovered in a mass media intervention on opioid-use education that featuring people with lived experience sharing their personal stories through brief videos or written testimonials can also increase engagement among young adults.[12] We can increase user interactions using story features such as polls, quiz stickers, and question stickers. Polls can be used to gauge the audience’s interests and preferences for our content. A quiz sticker enables you to pose multiple-choice questions to assess the audience’s knowledge and offer information afterward. The question sticker provides users with a space to respond to prompts and ask questions anonymously.

For the EMED study, we shared patient testimonials, created reels interviewing research assistants and hospital staff about their involvement in opioid use care, and created day-in-the-life videos spotlighting Dr Moe as she navigated her roles as an emergency physician and researcher [Figure 4].

FIGURE 4. An engagement post example from the Evaluating Microdosing in the Emergency Department study.

FIGURE 4. An engagement post example from the Evaluating Microdosing in the Emergency Department study.

Increasing visibility and retaining engagement

Take advantage of hashtags in your captions, using short, one- to two-word phrases that categorize your content into topic areas relevant to your practice. For example, for the EMED study, we used variations of opioid epidemic terminology like #OpioidOverdose and #FentanylCrisis, as they help reach a broader audience and allow content to be discoverable by people specifically searching for opioid use–related topics. Additionally, build relationships with organizations and clinics that are raising awareness or providing services for similar causes on social media, especially those primarily serving adolescent and young adult populations. Collaborate with community organizations by reposting each other’s content to reach their audiences and target your desired demographic. Sharing their posts can also diversify your account and increase its depth and usefulness to patients.

Strategize your captions by providing a brief description up front and using the space below for extended information, context, or additional hashtags. This dual approach ensures users are not overwhelmed by text while also providing opportunities for deeper engagement and exploration.

Limitations

We acknowledge the key limitations inherent in our approach, notably socioeconomic disparities that hinder access to social media and technology, particularly among marginalized groups. Furthermore, there is a lack of control over platform algorithms that determine which demographic groups are exposed to our content.

Conclusions

We hope this comprehensive guide provides a framework for health care professionals and researchers to navigate social media effectively in promoting public health initiatives among young adults. Our strategy has the potential to create a meaningful impact by improving health literacy, reducing stigma, and enhancing access to support services. Future research should evaluate the effectiveness of our approach and alternative methods, exploring qualitative or quantitative approaches to gauge user engagement and perceptions, assess the impact of this guide, and identify areas for improvement.

Competing interests

None declared.


This article has been peer reviewed.

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References

1.    Lim MSC, Molenaar A, Brennan L, et.al. Young adults’ use of different social media platforms for health information: Insights from web-based conversations. J Med Internet Res 2022;24:e23656.

2.    Hausmann JS, Touloumtzis C, White MT, et al. Adolescent and young adult use of social media for health and its implications. J Adolesc Health 2017;60:714-719.

3.    Hargittai E, Füchslin T, Schäfer MS. How do young adults engage with science and research on social media? Some preliminary findings and an agenda for future research. Soc Media Soc 2018;4:1-10.

4.    Pilarinos A, Fast D, Nosova E, et al. Initiation of opioid agonist treatment and subsequent substance use and other patterns among adolescents and young adults in Vancouver, Canada. Drug Alcohol Depend 2022;235:109441.

5.    Belzak L, Halverson J. Evidence synthesis—The opioid crisis in Canada: A national perspective. Health Promot Chronic Dis Prev Can 2018;38:224-233.

6.    Moe J. Evaluating buprenorphine/naloxone microdosing vs. standard dosing in emergency departments. Last updated 29 February 2024. Accessed 3 March 2024. https://clinicaltrials.gov/study/NCT04893525.

7.    Jenkins EL, Ilicic J, Barklamb AM, McCaffrey TA. Assessing the credibility and authenticity of social media content for applications in health communication: Scoping review. J Med Internet Res 2020;22:e17296.

8.    Carabot F, Fraile-Martínez O, Donat-Vargas C, et al. Understanding public perceptions and discussions on opioids through Twitter: Cross-sectional infodemiology study. J Med Internet Res 2023;25:e50013.

9.    McCashin D, Murphy CM. Using TikTok for public and youth mental health—A systematic review and content analysis. Clin Child Psychol Psychiatry 2023;28:279-306.

10.    Peruta A, Shields AB. Marketing your university on social media: A content analysis of Facebook post types and formats. J Mark High Educ 2018;28:175-191.

11.    Federal, provincial, and territorial Special Advisory Committee on the Epidemic of Opioid Overdoses. Opioid- and stimulant-related harms in Canada; March 2024. Accessed 15 April 2024. https://health-infobase.canada.ca/en/substance-related-harms/opioids-stimulants/.

12.    Rath JM, Perks SN, Vallone DM, et al. Educating young adults about opioid misuse: Evidence from a mass media intervention. Int J Environ Res Public Health 2022;19:22.


Ms Dabla has a bachelor of science degree and 2 years’ experience in the field of addictions and substance use, along with 2 years of clinical and research experience in respiratory health. Ms Newby has a bachelor of arts degree in kinesiology and 5 years’ experience as clinical support staff, along with 2 years of research experience in the field of substance use. Ms Kang is a medical student who has worked in addictions and mental health research for 4 years, focusing on youth mental health, harm reduction, and social determinants of health. Dr Jessica Moe is an assistant professor in the Department of Emergency Medicine at the University of British Columbia, a clinician scientist at the BC Centre for Disease Control, and scientific director of the Emergency Opioid Innovation Program within Emergency Care BC, and practises as an emergency physician at Vancouver General Hospital and BC Children’s Hospital.

Corresponding author: Dr Jessica Moe, jessica.moe@ubc.ca.

Khushi Dabla, BSc, Madison Newby, BA, Munsa Gill Kang, Jessica Moe, MD, FRCPC, DABEM, MA, MSc. How to navigate health promotion in the digital age—Social media and harm reduction among young adults. BCMJ, Vol. 66, No. 8, October, 2024, Page(s) - Premise.



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