Running head: SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 1

Social Media and Positive Youth Development: Navigating Social Media and Its Effect on

Health

Laura G. Stewart

Old Dominion University

SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 2

Social Media and Positive Youth Development: Navigating Social Media and Its Effect on

Health

For the past three decades, the Office of Disease Prevention and Health Promotion has

been developing goals for the improvement of the health of Americans. They recently released

their health goals for the year 2020 (healthypeople.gov, 2018). Only now, new in the 2020 goals,

has the importance of adolescent health been a goal of priority. While this population, from ages

10-17, experiences the most tumultuous path to independence and sense of self, they are just now

coming into focus as a population in crisis and in need of attention. The initiative outlines the

frequency of adolescents that have a supportive adult in their lives. The target goal is 83.2%,

while the current baseline falls at 75.6%. A contributing factor to an increased sensitivity to

social interactions stems from the lack of supervision of a supportive adult, and increased

internet use is associated with this dynamic (Mills, 2016). Additionally, even when parents

express concern over internet safety and health effects, they show little motivation and lack the

information needed to properly monitor use, and generally felt that their children were savvy

enough to avoid related negative outcomes (Erickson et al., 2015). While the new 2020 goals for

adolescent health strive to create an environment of support for success, there is little thoughtful

inclusion on the prevalence and effect that social media and internet access has on the health,

development and wellness in this group. Parents must go beyond simply limiting time spent

online and adopt a pointed scrutiny on where and who-with internet interactions are taking place

(Khurana, Bleakley, Jordan, & Romer, 2014). A lack of supervision can leave America’s

adolescents to navigate the pros and cons of social media and the internet unaided, resulting in

unhealthy habits that can lead to cognitive, emotional, and physical deficits. The self-regulating

capacity of an individual has a significant protective impact on these effects (Mills, 2016).
SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 3

Assessment

Aggregate

The Department of Health and Human Services (hhs.gov, 2018) houses the Office of

Adolescent Health. It is reported that 13% of the population in the United States is between the

ages of 10 and 19. In 2016, the City of Chesapeake had a population of 237,940. Between 1999

and 2006, there were 26,869 Chesapeake residents born, placing them in the target age group

(vdh.virginia.gov, 2018). An excellent access point to this population on a local level is through

a church organizations’ youth group. This is a non-threatening environment, with a fairly large

gathering of regularly attending teenagers in the target age group. Being a member of a large

church in Chesapeake, Virginia, with a sizeable youth group, and serving as a leader for middle

and high school students affords the benefit of having an already-established rapport with the

target group and unrestricted access to the building. There are also multiple time-frames and

venues available to conduct the education to help this age group navigate the pros and cons of

internet and social media use, and to bring awareness to the possible effects on health and

wellness that can occur.

Aggregate Characteristics

The World Health Organization (who.int, 2018) maintains the main health issues for

adolescents globally include early pregnancy, human immunodeficiency virus (HIV), violence,

alcohol, drug, and tobacco use, injuries, malnutrition and obesity, exercise and nutrition, and

mental health. In the United States, the Office of Adolescent Health (hhs.gov, 2018) reports that

the obesity risk for this group is 21% (1 in 5) nationally, and as high as 30% in Virginia. The rise

in obesity in adolescents may be related to environmental factors, including declined physical

activity, sedentary lifestyle and widespread dietary changes. Studies have shown that there is a
SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 4

correlation between obesity and increased internet use in children aged 8-17 (Bozkurt, Ozer,

Sahin & Sonmezgoz, 2017). Thirty percent (3 in 10) experience depression nationally, and

Virginia falls at 27% compared to this national statistic (hhs.gov, 2018). Youth internet

harassment that is deliberate, repeated and meant to cause psychological distress is reported by

up to 40% of teens aged 10-17 (Bottino, Bottino, Regina, Correia & Ribeiro, 2015). This type of

online behavior is linked to adolescent reports of headache, abdominal pain, sleep problems,

increased perception of difficulties, emotional problems, peer and social difficulties, not feeling

safe, not feeling “looked after” by teachers, and decreased social behavior. The Office of

Adolescent Health (2018) research indicates that 94% of American teens go online with a mobile

device each day, and 70% use a social networking site daily. As many as 20 hours per week are

spent on media communications, not including time spent checking e-mail and watching videos.

This qualifies as a significant source of influence for our youth.

Aggregate Comparisons and Contrasts

After extensive research to locate adolescent statistics regarding internet use and health

specific to the areas surrounding Chesapeake, only the most basic data could be found for those

areas. This further highlights the lack of focus we have as a society on the health and well-being

of this age group. Population data for the target age group for the surrounding areas of Hampton,

Norfolk, Portsmouth and Virginia Beach were found, but are rather irrelevant demographically to

the health needs outlined here. The Center for Disease Control (cdc.gov, 2018) provides state

data for adolescents age 13-17 through the Youth Risk Behavior Surveillance System (YRBSS).

State statistic comparisons to Virginia (VA) were found for the bordering states of North Carolina

(NC) and Maryland (MD) for relevant topics. In 2017, mental health concerns included those

reporting being cyberbullied at 12.6% (VA), 13.9% (NC) and 12.6% (MD). Those reporting
 SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 5

feeling sad or hopeless were 29.5% (VA), 29.4% (NC) and 29.9% (MD). Issues related to diet

and exercise included those drinking at least 1 soda once a day at 16.4% (VA), 22.3% (NC), and

14% (MD). Reports of those not engaging in physical activity for at least one hour, for at least

one day in the 7 days previous to the survey resulted in 17% (VA), 19.8% (NC), and 17% (MD).

In VA, 28.8% were reported as overweight or obese, compared to 30.2% (NC) and 27% (MD).

Of those reporting being overweight or obese, 58.4% reported no attempts to lose weight in VA,

56.4% in NC, and 56.4% in MD. Media use at 3 or more hours per day was reported by 42.9%

of VA adolescents, compared to 41.6% in NC and 38% in MD.

Literature Review

Author, Year, Name Type of Participant/Sample Purpose Protocol Findings/Main

of Study Study/Method Size Outcomes
1. Bottino, Meta-analysis Search produced To Search of 68.5% of
Bottino, 377 articles, 13 met review/evaluate PubMed, adolescents
Regina, inclusion criteria the associations Virtual experienced
Correia, & between Health negative
Ribeiro, 2015. cyberbullying Library, emotions as a
Cyberbullying and adolescent MEDLINE, result of
and adolescent mental health Cochrane cyberbullying
mental health: problems Library and
systematic SciELO
review
2. Bozkurt, Ozer Obese students 437 adolescents age To explore the Internet 24.6% of obese
Sahin & referred by the 8-17, 268 with prevalence and Addiction adolescents
Sonmezgoz, Department of obesity, 169 non- patterns of Scale form were
2017. Internet Pediatrics of a obese as a control internet use in considered to
use patterns Medical adolescents with have excessive
and internet faculty obesity internet use
addiction in hospital. Non-
children and obese controls
adolescents were selected
with obesity from local
public schools
3. Davids, Cross- 457 Ninth graders To establish the Self-reporting Adolescents
Roman, & sectional, relationship questionnaire, had a slightly
Kerchhoff, random between goals and the higher
2017. selection and aspirations, Aspirations aspiration for
Adolescent mental health Index intrinsic goals,
 SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 6

goals and behavior and particularly

aspirations in psychological involving a
search of well-being sense of
psychological community
well-being:
from the
perspective of
self-
determination
theory
4. Erickson, Qualitative 12 Parent-teen pairs To examine the Semi- Parents felt that
Wisniewski, study solicited randomly challenge structured their teens
Xu, Carroll, from two local between parental questionnaire were generally
Rosson, & service concern for regarding savvy enough
Perkins, 2015. organizations, youth online internet to avoid online
The boundaries adolescents ranging safety and the behaviors and risky behavior.
between: from 13-17 years youths desire to parent Most
Parental regulate their supervision boundaries set
involvement in own online as perceived by parents
a teen’s online experiences by parent and were vague and
world youth, negotiable, and
analyzed by unmonitored
structured
interpretive
thematic
analysis
5. Jelenchick, Mixed method, 714 students To develop and Developed an The PRIUSS
Eickhoff, in four phases between ages 18 refine a item pool demonstrated
Christakis, and 25 theoretically using concept promising
Brown, Zhang, grounded and mapping and validity and
Benson, & psychometrically a review of excellent
Moreno, 2014. validated literature reliability
The PRIUSS assessment
for adolescents instrument for
and young PIU tailored to
adults: Scale adolescents and
development young adults
and refinement
6. Khurana, Random 629 adults with To better Online Internet
Bleakley, selection from children age 12-17 understand the survey restriction by
Jordan, & an online roles of parent questionnaire parents was
Romer, 2015. probability monitoring and linked to less
The protective panel internet use of social
effects of restrictions as media,
parental potential therefore
monitoring and strategies to decreasing the
 SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 7

internet decrease the effects of

restriction on effects of online online
adolescents’ harassment harassment
risk of online (but not
harassment decreasing the
occurrence of
online
harassment)
7. Mills, 2016. Literature 249 articles To discuss how Utilized Cognitive
Possible effects review online behaviors cross- changes are
of internet use might affect the sectional and likely, but not
on cognitive cognitive longitudinal necessarily
development in development of studies from impeding IF
adolescence adolescents the U.S., healthy
Canada, adaptation to
U.K., internet use
Belgium and occurs
Europe

These articles provided a foundation of knowledge regarding healthy and unhealthy

internet use, and the impacts on adolescent health. An important teaching point emerged

regarding self-regulation and setting of self-boundaries, placing less responsibility on a parent

who is not sufficiently monitoring their child’s online activity. The Interagency Working Group

on Youth Programs (which is comprised of 20 federal agencies that support programs and

services for youth) admits that origins of adolescent health that once focused on prevention need

now focus on the role of resiliency and self-protective factors of the young person’s environment

(youth.gov, 2018).

Nursing Theory and Diagnoses

Application of Nursing Theory

When considering the aspects of positive youth development, the goal is to promote

improved quality of life, encourage healthy development, and healthy behaviors across all life

stages (healthypeople.gov, 2018). These goals place at the forefront the establishment of a
SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 8

strong sense of self in our youth, which will result in the development of strong self-esteem and

aspirations for the future. According to The Interagency Working Group on Youth Programs

(youth.gov, 2018), this can be accomplished through making adolescent support an intentional

process, preventing and addressing negative behaviors, and empowering our youth to have

competence for positive growth and development. Utilizing the self-determination theory as a

guide will assist with increasing adolescent awareness of the role they play in their own health.

This theory is perfectly in tune with the adolescents’ need to establish autonomy and

independence. The basis of this theory maintains that individuals are able to self-motivate to

realize their full potential and develop a solid sense of self (Davids, Roman & Kerchhoff, 2017).

Extrinsic forces threaten this sense of well-being and can have a negative impact on aspects of

life purpose, and autonomy. The negative impact of social media and internet use on health can

easily be categorized as an impactful extrinsic factor, and successful education will require a

focus on this.

Nursing Diagnoses

Imbalanced Nutrition. Social media and internet sites bombard consumers with the

promotion of unhealthy products such as sugar-filled and highly caffeinated drinks. Constant

exposure to these subtle messages can lead adolescents to make poor choices. The WHO also

maintains that this marketing can lead to the poor eating and exercise choices that perpetuate

premature illness and poor adult health (who.int, 2018).

Anxiety. Internet use and social media can perpetuate a negative self-image. In the

pursuit to present a particular “self,” much time and energy can be utilized obsessing over what,

how and when to post. As adolescents strive to present themselves in a certain way, there is a

lapse in the realization that others are also attempting to convey a certain personna. Social media
SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 9

gives us the feeling that we are privvy to a “backstage” pass, a real-life snapshot into another’s

life, when in reality the presentation is staged, deliberate and deceptive. This constant struggle to

keep up the façade can be anxiety producing and exhausting.

Knowledge Deficit. The stream of information that flows freely through internet and

social media sites. Most young people are not mature or knowledgeable enough to make the

critical distinction between “recognizing public media as a space where public opinion is shaped,

developed and debated and mistakenly concluding that social media content is a valid reflection

of where public opinion stands” (Treem, Dailey, Pierce, & Biffl, 2016, p. 773, para 2).

Proportionally, it is a minuscule representation of the general population of internet consumers

that routinely post, where most can be found simply browsing but not actually posting, and the

perception can be that an adolescents’ “bubble” is much larger than it actually is.

Disturbed Thought Process. Excessive social media and internet use has been

associated with many notable cognitive changes (Mills, 2016). With the need to constantly stay

connected, social interactions via smart phones can result in poor performance with multi-

tasking, especially during homework times. Thoughts can be bombarded with the stresses of the

perception that one is being constantly evaluated by peers. Social adjustment can be affected

when this is the venue of choice for forming new relationships. The ability to interpret social

cues can be affected, as internet communications cannot convey body language, tone or

intonations.

Priority Nursing Diagnosis

The diagnosis of “knowledge deficit” serves as an all-encompassing umbrella that

addresses many of the identified issues with adolescent health and internet use. A deficit to

knowledge relating to poor diet and sedentary lifestyle is a result of a lack of awareness of
SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 10

targeted media. Goals include claiming ownership for current eating patterns and identifying

behaviors under their control in relation to physical activity. Interventions include encouraging

water intake instead of sugar sweetened drinks, education on self-monitoring techniques such as

sitting at the table to eat, and avoiding boredom eating. A knowledge deficit related to anxiety

stems from an unawareness of how relationships and interactions can impact self-concept. Goals

include the ability to show self-reassurance and explain their own anxiety and coping patterns.

Interventions include helping teens identify factors that precipitate anxiety, encourage positive

self-talk, and use empathy to encourage normal anxiety responses (nurselabs.com, 2018).

Alternative interventions to conduct a more comprehensive educational plan relate to the

lack of interest in learning and a decreased motivation to learn that is often associated with this

age group. Goals include the ability to consider information and apply it appropriately to

specific situations to maintain healthy behaviors. Interventions include providing an atmosphere

of respect and trust, and discussion of how to integrate new information into everyday life

(nurselabs.com, 2018). The spiritual nature of this community setting allows for a relevant use

of scripture to re-enforce these diagnoses. Scripture is utilized to connect a difficulty with the

support of God through His word. Such scripture would include 1 Peter 5:7 (New International

Version [NIV]) which addresses anxiety, stating “Cast all your anxiety on Him because He cares

for you.” When battling the falsehoods and false-selves that others portray, Romans 1:29-32

warns against those that set out to spread wickedness and arrogance and boastfulness, calling on

us to recognize this and evaluate ourselves that we do not participate in similar behavior. When

seeking knowledge, Solomon states in Proverbs 24:14, “Know that wisdom is such to your soul;

if you find it, there will be a future, and your hope will not be cut off.”
SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 11

There is also an abundance of internet use measurement tools available, and many

inconclusive studies regarding the appropriateness and accuracy of results. One particular tool

seems appropriate to an adolescent group, and could be utilized to help bring concrete awareness

to internet use. It is referred to as the Problematic and Risky Internet Use Screening Scale

(PRIUSS) (appendix). This tool was designed to evaluate for internet use ‘‘that is risky,

excessive or impulsive in nature leading to adverse life consequences, specifically physical,

emotional, social or functional impairment” (Jelenchick et al., 2014, p. 172, section 1.1).

Conclusion

Bridging the gap between what adolescents know, and what they think they know, could

create an environment of change and reduction of the knowledge deficit involved with the impact

of internet use and social media on health and wellness. With the connection linking internet use

with increased obesity and mental health issues in adolescents, there is a need to empower our

youth with the information and tools they need to take their health into their own hands. As

fewer youth have a supportive adult that supervises their internet use and healthy/unhealthy

activities, it is crucial that this target group be armed with the instruments needed to self-regulate

their behavior, and re-gain a sense of independence and self-esteem.

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Appendix
SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 13

References

Bottino, S.M., Bottino, C.M., Regina, C.G., Correia, A.V.L., & Ribeiro, W.S. (2015).

Cyberbullying and adolescent mental health: Systematic review. Cedernos de Saude

Publica, 31(3), pp 463-475. DOI: 10.1590/0102-311X00036114

Bozkurt, H., Ozer, S., Sahin, S., & Sonmezgoz, E. (2018). Internet use patterns and internet

addiction in children and adolescents with obesity. Pediatric Obesity, 13(5), pp 301-

306. DOI: 10.1111/ijpo.12216

Davids, E.L., Roman, N.V., & Kerchhoff, L.J. (2017). Adolescent goals and aspirations in

search of psychological well-being: From the perspective of self-determination theory.

South African Journal of Psychology, 47(1), pp 121-132.

DOI: 10.1177/0081246316653744

Erickson, L.B., Wisniewski, P., Heng, X., Carroll, J.M., Rosson, M.B., & Perkins, D.F. (2016).

The boundaries between: Parental involvement in a teen’s online world. Journal of the

Association for Information Science and Technology, 67(6), pp 1384-1403.

DOI: 10.1002/asi.23450

Jelenchick, L.A., Eickhoff, J., Cristakis, D.A., Brown, R.L., Zhang, C., Benson, M., & Moreno,

M.A. (2014). The problematic and risky internet use screening scale (PRUISS) for

adolescents and young adults: Scale development and refinement. Computers in Human

Behavior, 35, pp 171-178. DOI: 10.1016/j.chb.2014.01.035

Khurana, A., Bleakley, A., Jordan, A., & Romer, D. (2015). The protective effects of parental

monitoring and internet restriction on adolescents’ risk of online harassment. Journal of

Youth and Adolescence, 44(5), pp 1039-1047. DOI: 10.1007/s10964-014-0242-4

SOCIAL MEDIA AND POSITIVE YOUTH DEVELOPMENT 14

Mills, K. (2016). Possible effects of internet use on cognitive development in adolescence.

Media and Communication 4(3), pp 4-12. DOI: 10.17645/mac.v4i3.516

Treem, J.W., Dailey, S.L., Pierce, C.S., & Biffl, D. (2016). What are we talking about when we

talk about social media: A framework for study. Sociology Compass, 10(9), pp 768-784.

DOI: 10.1111/soc4.12404