TikTok has acquired more than one billion monthly users in just five years, but the influential video-sharing app remains one of the least studied social media platforms around.
Researchers at UBC’s faculty of medicine want to change that.
In a commentary published this week in BMJ Global Health, assistant professor Dr. Skye Barbic of the department of occupational science and occupational therapy joins research associate Marco Zenone and postdoctoral fellow Nikki Ow in calling for a global research agenda into TikTok’s impact on public health.
They argue that health researchers need to better understand the implications of TikTok’s immense reach and the opportunities it presents. We spoke with Dr. Barbic and Zenone about their motivations.
Why do you consider it urgent that researchers turn their attention toward TikTok?
SB: Over a billion people are using TikTok an average of 17 hours a month. According to TikTok, 80 per cent of them are under 30. Given TikTok’s influence on discourse about important public health topics, I think it’s paramount that we understand what’s happening on the platform, how people are using it and how we can improve experiences from a safety perspective—especially for young people. It’s very rare that you see something so widely used that has so little research about it.
Did researchers wait too long to investigate the public health implications of earlier social media platforms such as Facebook and Instagram?
MZ: In my view, the research community at the outset focused too much on the public health opportunities of social media—creating accounts for health organizations, conducting outreach campaigns through ads and online community building—versus the potential negative implications, such as the spread of misinformation or disinformation, surveillance capitalism and the portrayal and promotion of health-harming products. For example, a recent study found that 98 of the top 100 TikTok videos with the hashtag #alcohol portrayed alcohol in a positive way. That’s concerning to us as public health researchers.
We also know that there is high engagement on health-related content but we don’t know the quality of the health information amplified on the platform. People may be using TikTok to learn about specific mental health conditions, but we don’t know if they’re getting accurate information or advice. Content creators providing that information could have conflicts of interest: Are they selling a product? Do they have proper credentials? This can have implications for how information is received and incorporated into lives or treatment plans.
With other platforms we’ve always had to play catchup and take action only after a significant harm has occurred, such as COVID-19 misinformation or the rapid spread of JUUL vaping products via Instagram.
Does TikTok do anything to weed out bad health information?
MZ: TikTok does some checks. For example, if you search “vaccine” or anything related to the COVID-19 pandemic, you’ll get a link to evidence-based information, which is a good thing. But we need that for cancer treatment misinformation or content promoting unproven medical interventions. TikTok can be used for good but it can also be used for nefarious purposes. A bad actor who doesn’t have the best intentions can easily reach many people. And this isn’t specific to TikTok—it’s an issue with social media and the business model of maximizing content engagement to show ads.
How can researchers get a handle on a platform that’s so young and still evolving?
SB: Research is often slower than technological innovations so we need to be much quicker and more agile in our response. We need to work alongside the end users of these platforms to understand what’s happening so we can respond accurately in public health, and in health services more generally. That may require us to be a little more non-traditional in our research methods, to be in new spaces and to listen and learn. We have so much work to do as a research community to engage users and understand their perspectives.