Popular contraception videos on TikTok: An assessment of content topics

#GenderAffirmingHormoneTherapy and Health Information on TikTok: Thematic Content Analysis

Background

Transgender and gender diverse people often turn to online platforms for information and support regarding gender-affirming hormone therapy (GAHT); however, analysis of this social media content remains scarce.

Objective

We characterized GAHT-related videos on TikTok to highlight the implications relevant to GAHT prescribers.

Methods

We used a web scraper to identify TikTok videos posted under the hashtags #genderaffirminghormonetherapy and #genderaffirminghormones as of November 2023. We identified recurrent themes via qualitative content analysis and assessed health education videos with the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) scale and a modified Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) test.

Results

Out of 69 videos extracted, 71% (49/69) were created by GAHT users, 24.6% (17/69) were created by health care workers, and 21.7% (15/69) were created to provide health education. Themes included physical changes on testosterone, GAHT access, and combating misinformation and stigma surrounding GAHT. Health education videos scored highly on PEMAT-A/V items assessing understandability (mean 88.3%, SD 11.3%) and lower on actionability (mean 60.0%, SD 45.8%). On the CRAAP test, videos scored highly on the relevance, authority, and purpose domains but lower on the currency and accuracy domains.

Conclusions

Discussions of GAHT on TikTok build community among transgender and gender diverse users, provide a platform for digital activism and resistance against legislation that limits GAHT access, and foster patient-provider dialogue. Educational videos are highly understandable and are created by reliable sources, but they vary in terms of currency and quality of supporting evidence, and they lack in actionability.

Revitalizing the ICPD Programme of Action on the International Development Agenda: Toward a Path Forward for Reproductive Health and Rights in Troubled Times

Since the 1994 International Conference on Population and Development (ICPD), there have been notable improvements in reproductive health and rights. However, these overall gains obscure deep inequalities, and recent setbacks during and after the COVID-19 pandemic highlight the fragility of this progress. The reproductive health agenda is extensive yet remains underfunded and underperforming. Careful thought is needed on how to retain reproductive health and rights as a priority in the global development framework that will replace the Sustainable Development Goals in 2030. This paper examines the evolution of reproductive health, drawing lessons and recommendations for revitalizing and future-proofing its agenda and enhancing progress. Key recommendations include encouraging bolder thinking in research engaging with the field's multiple challenges, including nontechnical aspects; improving dissemination and utilization of policy-relevant research; presenting a stronger business case to influence policymakers; and employing broader, inclusive rights-based arguments that emphasize social justice and equity. Additionally, reevaluating the global reproductive health architecture is necessary, particularly the influential yet inconsistent role of the USA. Relevant lessons from maternal and child health and HIV efforts are distilled to further assist in this process of developing a more effective path forward, ensuring the ICPD's vision is achieved beyond 2030.

Insights on the Side Effects of Female Contraceptive Products From Online Drug Reviews: Natural Language Processing-Based Content Analysis

BACKGROUND

Most online and social media discussions about birth control methods for women center on side effects, highlighting a demand for shared experiences with these products. Online user reviews and ratings of birth control products offer a largely untapped supplementary resource that could assist women and their partners in making informed contraception choices.

OBJECTIVE

This study sought to analyze women's online ratings and reviews of various birth control methods, focusing on side effects linked to low product ratings.

METHODS

Using natural language processing (NLP) for topic modeling and descriptive statistics, this study analyzes 19,506 unique reviews of female contraceptive products posted on the website Drugs.com.

RESULTS

Ratings vary widely across contraception types. Hormonal contraceptives with high systemic absorption, such as progestin-only pills and extended-cycle pills, received more unfavorable reviews than other methods and women frequently described menstrual irregularities, continuous bleeding, and weight gain associated with their administration. Intrauterine devices were generally rated more positively, although about 1 in 10 users reported severe cramps and pain, which were linked to very poor ratings.

CONCLUSIONS

While exploratory, this study highlights the potential of NLP in analyzing extensive online reviews to reveal insights into women's experiences with contraceptives and the impact of side effects on their overall well-being. In addition to results from clinical studies, NLP-derived insights from online reviews can provide complementary information for women and health care providers, despite possible biases in online reviews. The findings suggest a need for further research to validate links between specific side effects, contraceptive methods, and women's overall well-being.

Online Misleading Information About Women's Reproductive Health: A Narrative Review

Misinformation about reproductive health threatens to harm health outcomes, compromise medical trust, and enable misinformed policy restrictions. In recent years, reproductive health misinformation has proliferated online due to ideological campaigns and limited content moderation for reproductive health topics. Developing evidence-based practices to counter reproductive health misinformation requires an understanding of the content that women are exposed to online, which is currently lacking. This review sought to identify common claims and narratives about reproductive health on social media and the internet that could easily mislead. We performed a narrative review of articles about online reproductive health misinformation, from which we extracted misleading claims and narratives. We conducted a qualitative content analysis to describe the ways in which the claims and narratives could be misleading. We found that potentially misleading claims and narratives about reproductive topics relating to contraception and abortion, fertility, chronic disease, breast cancer, maternal health, and vaccines abound across social media platforms and websites, with 112 identified in total. One-third of this content could mislead by claiming that evidence-based interventions were associated with unattributed risks. Twenty-three percent made medical recommendations that do not align with professional guidelines. Fourteen percent promoted alternative medicine. Smaller numbers of claims and narratives exaggerated risks of medical interventions, discouraged evidence-based interventions, directly undermined medical trust, and proposed inaccurate biological mechanisms. Healthcare professionals can proactively promote evidence-based medical decision-making by increasing their awareness of prominent misleading claims and narratives.

"Stop Gaslighting Your Patients": A Quantitative and Qualitative Analysis of User Experiences of IUDs on TikTok

STUDY OBJECTIVE

TikTok is a social media platform where patients can access and share information about intrauterine devices (IUDs). The primary objective of this study was to identify prominent themes of creators' experiences with IUDs on TikTok.

METHODS

We conducted a quantitative and qualitative assessment of eligible videos that appeared when searching for "IUD" on the TikTok platform between July 2019 and August 2022. Eligible videos contained content relevant to IUDs and were spoken and/or written in English.

RESULTS

Of the 354 videos that met inclusion criteria, the majority were created by users without healthcare expertise (77%) and mentioned personal experiences with IUDs (68%). However, videos that were educational (27%) or created by users with healthcare expertise (23%) averaged more likes and views than other video types. Common content areas included IUD insertion (45%), side effects (31%), and removal (25%). Perceived gaps in knowledge about the insertion procedure and feeling that providers did not adequately prepare patients for the procedure contributed to dissatisfaction with IUD insertion and motivated creators to share their experiences on TikTok. Video creators often relied on information that they found on TikTok to educate themselves about the IUD insertion process and expressed frustration at unacceptable levels of pain during insertion.

CONCLUSION

Healthcare providers should be aware that adolescent patients who use TikTok have likely seen videos depicting negative experiences with IUDs and be prepared to address patients' concerns, particularly regarding IUD insertion. Additionally, healthcare providers may use TikTok to educate users about IUDs.

Common myths and misconceptions surrounding hormonal contraception

Numerous community and professional myths and misconceptions around hormonal contraception exist, many promulgated through social media. As a result of these and other factors, people are moving away from hormonal methods and potentially exposing themselves to increased risk of unintended pregnancy. A number of key myths and misconceptions have been identified in a range of papers and here we summarise the evidence around the basis for these misunderstandings. The themes we explore are the physical side effects, the mental health effects, the impact on sexuality, the concerns about infertility, the concept of "unnaturalness", concerns about menstruation, concerns about safety and destigmatisation of side effects. For many of these themes, there is some evidence justifying the concern, but overall for most people, we argue that the benefits of hormonal contraception outweigh the disadvantages.

Descriptive analysis of TikTok content on vaccination in Arabic

The extensive impact of social media on communication of public health information is a growing concern. This is particularly worrying in the context of vaccination. Thus, we investigated the quality of TikTok videos regarding vaccination in Arabic, with examination of the association of video source and content type with the information quality and video engagement metrics. The final sample comprised a total of 129 TikTok videos in Arabic posted between January 2021 and July 2024. Videos were categorized based on the source [healthcare professional (HCPs), lay individuals, media], and content type (COVID-19 vaccination, childhood vaccination, general vaccination, others). We utilized a miniaturized version of the DISCERN instrument (mini-DISCERN) scale to evaluate information quality by two independent raters and assessed video engagement metrics (Likes, Comments, Shares, and Saves). The results indicated a statistically significant discrepancy in information quality, with videos from HCPs and media outlets scoring higher on the mini-DISCERN scale compared to those from lay individuals [mean: (4.818 ± 0.726) vs. (4.053 ± 1.441) vs. (2.003 ± 1.640), P < 0.001]. The highest information quality was found for videos on childhood vaccination, whereas content on COVID-19 vaccination was rated significantly lower on mini-DISCERN [mean: (4.510 ± 1.269) vs. (2.542 ± 1.827), P < 0.001]. Videos with higher engagement metrics, particularly those from lay individuals, were negatively correlated with information quality. Linear regression analysis confirmed the significant influence of the creator background (β = -0.618, P < 0.001) and video topic (β = 0.179, P = 0.009) on information quality. This study highlights the critical role of content creator background and topic on the quality of vaccination-related information on TikTok in Arabic. We emphasize the need for stringent verification of TikTok content, especially from lay individuals, as videos with higher engagement metrics often contained lower-quality information regarding vaccination. We recommend enhanced support for content from HCPs and targeted digital literacy programs to combat vaccine misinformation on TikTok effectively.

Disseminating Premenstrual Dysphoric Disorder Information on TikTok: A Content Analysis

Premenstrual dysphoric disorder (PMDD) is characterized as an extreme form of premenstrual syndrome (PMS) in which a combination of severe mood, somatic, and cognitive symptoms present one to two weeks prior to the onset of menstruation. As people increasingly turn to social media, specifically TikTok, to gain information about health-related topics and information, discourse about this taboo chronic condition has increased. Sensitized by concepts from the theory of communicative disenfranchisement (TCD), our two-pronged methodological approach includes a content analysis of TikTok videos (N = 97) that discuss PMDD symptomology, treatment, and a thematic analysis of disenfranchising talk associated with PMDD. We identify TikTok as a meaningful communicative mechanism for health information-exchange, particularly for communication about contested illness. Practical and theoretical implications for applying TCD in mediated contexts, as well as engaging with social media as a means for health communication are discussed.

Social media as health educator: An assessment of the understandability and accuracy of tiktok content about contraception

BACKGROUND

Contraception knowledge and attitudes are largely formed from conversations within one's social network. More recently, this network has expanded to include social media. As the fastest growing social media platform, we aimed to assess popular contraception videos on TikTok for content understandability, actionability and accuracy.

METHODS

This is a secondary analysis of the most viewed, contraception-specific TikTok videos that were previously coded as containing educational messaging in a content-analysis study. We assessed videos for understandability (ability to explain a key message) and actionability (identify what they can do to act on that message) using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) instrument and for Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP) using a modified instrument within the health information education literature.

RESULTS

The 174 videos with educational content scored as understandable but not actionable in PEMAT-A/V assessment, with videos created by healthcare providers (HCPs) performing better than those by non-HCPs in six of eleven domains of understandability. Videos overall scored well in relevance and purpose within the CRAAP assessment. Videos created by HCP's (n = 99) scored higher than those by non-HCPs (n = 75) in relevance (score = 3.9 versus 3.3), authority (score = 4.8 versus 1.7), accuracy (score = 6.0 versus 3.5), and purpose (score = 7.1 versus 5.7) [all p < 0.001]. Regarding video engagement, the median number of views among the videos in the cohort was 604,450. Of all video views, 79.2% were of HCP-created videos and 20.8% were of non-HCP videos.

DISCUSSION

Much of the contraceptive educational messaging on TikTok is understandable, relevant, and accurate. HCP-created videos overall scored better as compared to other creators, though even HCP-created videos score fail to provide actionable recommendations. The videos created by HCP also had greater metrics of engagement. Given this, we encourage HCPs to use social media to better inform its users.

An analysis of oral contraceptive related videos on TikTok

Background

TikTok has increasingly become a source of information about reproductive health. Patients seeking health information about oral contraception on TikTok may be influenced by videos containing misinformation or biased information.

Objective

This social media infodemiological study aims to provide a descriptive content analysis of the quality and reliability of oral contraceptive health information on TikTok.

Study Design

Researchers screened 1,000 TikTok videos from December 2022 to March 2023 retrieved under various search terms related to oral contraceptives. Data, including engagement metrics such as views, likes, comments, saves, and shares, were recorded. Video content including contraceptive methods discussed, efficacy, tolerability, and side effects were recorded. Two reviewers independently used a modified DISCERN criteria and Global Quality Scale (GQS) to assess the quality and reliability of information for each video.

Results

Five hundred seventy-four videos were analyzed after applying exclusion criteria. Videos had a median length of 27 seconds (Q1=13sec, Q3=57sec) and received a median of 35,000 total views (Q1=4856 views, Q3=411,400 views) and 166 views per day (Q1=28 views per day, Q3=2021 views per day). Video creators were 83.3% female and 58.7% white. The mean modified DISCERN score was 1.63 (SD=1.06) and the mean GQS score was 2.28 (SD=1.37). Video creators were 83.3% female and 58.7% white. The mean modified DISCERN score was 1.63 (SD=1.06) and the mean GQS score was 2.28 (SD=1.37). The most common topic discussed in the videos was the effects of contraception. Healthcare professionals had significantly higher DISCERN and GQS scores (p<.001) than non-healthcare professionals. However, they received fewer views, likes, and comments on their videos (p<.001). Healthcare professionals were 86 times more likely than non-healthcare professionals to post educational videos (p<.001). However, non-educational content received significantly more views, likes, and comments than educational content (p<.001).

Conclusion

TikTok videos related to oral contraceptive health had low quality and reliability of information. The majority of videos were made by non-healthcare providers, and the most common topic discussed was the effects of contraception. Videos made by healthcare professionals contained more reliable contraceptive information, but received less engagement than videos made by non-healthcare professionals. Healthcare providers should consider the prevalence of poor-quality information about oral contraceptives on social media when counseling and educating patients about reproductive health.

Evaluating the Quality and Impact of TikTok Videos on Autologous Breast Reconstruction with Deep Inferior Epigastric Perforator Artery Flaps

Background

With the rising influence of social media on healthcare perceptions, this study investigates TikTok's role in educating the public about autologous breast reconstruction, specifically focusing on deep inferior epigastric perforator flaps.

Methods

We conducted a systematic analysis of 152 TikTok videos related to deep inferior epigastric perforator flap procedures, evaluating the accuracy of the content, viewer engagement metrics, and the influence of content creator characteristics on viewer interactions.

Results

Our analysis identified a wide variance in the quality of information, with many videos lacking in-depth educational content, thereby posing a risk of misinformation. Despite the presence of high-quality educational videos, there was a discrepancy between the educational value provided and viewer engagement levels. Thematic analysis highlighted common concerns among patients, providing insights for healthcare professionals to better tailor their social media content.

Conclusions

The study underscores the significant impact of platforms like TikTok on patient education and emphasizes the need for healthcare professionals to guide the narrative on social media and ensure the dissemination of accurate and helpful information, ultimately aiding patients in making informed decisions about their healthcare.