Teens frequently mention risky behaviors on social networking sites

About half of teens reference sex, substance use or other risky behaviors on their publicly available online profiles, according to a report in the January issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. However, a second article reports that a brief e-mail from a physician shows promise in reducing mentions of sex on social networking Web sites.

More than 90 percent of adolescents have Internet access and about half use social networking sites, according to background information in the articles. "MySpace, the most popular social networking site, regularly ranks among the world's 10 most popular Web sites and includes more than 200 million Web profile accounts, of which 25 percent belong to minors," the authors write. "Members of a social networking site create a personal Web profile that may contain images, text and audio. The social networking sites play an important role in adolescents' social lives as a place for identity exploration and peer group interaction."

Despite these potential benefits, risks may be associated with the display of information related to sex, substance use, violence and other health risk behaviors in a public venue. For instance, displaying such information may attract unwanted attention from sexual predators or jeopardize future employment prospects. To determine the prevalence of risky references, Megan A. Moreno, M.D., M.S.Ed., M.P.H., then of the University of Washington and Seattle Children's Hospital Research Institute, Seattle, and now of the University of Wisconsin–Madison, and colleagues analyzed the content of 500 publicly available profiles between July and September 2007. All of the profile owners reported being 18 years old and living in the United States.

A total of 270 (54 percent) of the profiles contained references to risky behaviors, including 120 (24 percent) that mentioned sexual behaviors, 205 (41 percent) referencing substance use, 37 percent mentioning alcohol use and 72 (14.4 percent) referring to violence. Women were less likely than men to display references to violence; reporting a sexual orientation other than "straight" was associated with more references to sexual behavior. Teens whose profiles mentioned church or religious involvement, or indicated active participation in a sport or hobby, were less likely to display any type of risky information.

The findings suggest social networking sites may provide a new way to detect teens at risk for engaging in unhealthy behaviors, the authors note. "Given the popularity of social networking sites among teens and the high prevalence of risk behaviors displayed there, social networking sites can be explored as an innovative venue to identify, screen and ultimately intervene with adolescents who display risk behavior information," they write.

In a second report, Dr. Moreno and colleagues assessed a potential online intervention by creating a MySpace profile with the user name "Dr. Meg," containing information about professional credentials and research interests. They then identified 190 MySpace profiles of 18- to 20-year-olds that contained three or more references to sexual behaviors or substance use, including at least one reference each to alcohol and tobacco use. Half of the profile owners were randomly selected to receive a single e-mail from the Dr. Meg profile, warning them that their profile contained risky information. The e-mail also provided clinical resources, including a link to a Web site with information about sexually transmitted diseases.

Before the e-mail was sent, 54.2 percent of the profiles referred to sex and 85.3 percent mentioned substance use. Three months after the e-mail intervention, 42.1 percent of the profile owners who received an e-mail and 29.5 percent of those who did not made protective changes to their profile. Specifically, references to sex decreased to zero on 13.7 percent of profiles in the group that received the e-mail and 5.3 percent in those that did not, and references to substance use disappeared on 26 percent of the intervention profiles vs. 22 percent of the controls. A total of 10.5 percent of intervention profiles and 7.4 percent of control profiles were set to "private" at the three-month follow-up.

"Our study illustrates that developing online interventions to reduce online risk behaviors is feasible, low-intensity and low-cost," the authors conclude. "Our findings suggest that some teenagers may be open to feedback regarding their Web profiles and subsequently alter online behaviors. Given the hazards associated with displaying risk behavior information, parents and health care providers should recognize the importance of social networking sites in adolescents' social lives, discuss social networking site disclosures with both younger and older adolescents and provide Internet safety resources."

(Arch Pediatr Adolesc Med. 2009;163[1]:27-34, 35-41. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Health Professionals Must Seek to Balance Benefits, Risks of Sites

"As with any new media technology, there are potential benefits and drawbacks to social networking sites," write Kimberly J. Mitchell, Ph.D., and Michele Ybarra, M.P.H., Ph.D., of the Crimes Against Children Research Center, University of New Hampshire, Durham, in an accompanying editorial.

The sites "provide educational benefits to youth; they foster learning and the development of critical thinking skills that complement those taught in classrooms," they continue. "They also provide psychosocial benefits that facilitate identity development, enhance cognitive skills related to perspective taking, allow autonomy and serve as a form of social support, which may prove critical to youth who feel isolated, lonely or ostracized for any number of reasons."

"On the other hand, content on social networking site profiles may increase one's likelihood of being harassed or targeted with unwanted sexual solicitation; it may negatively affect one's future professional opportunities; and its images may portray risky health behaviors as normative. It is our job as professionals to understand these risks and benefits and to identify strategies that help youth reduce the former and increase the latter."

(Arch Pediatr Adolesc Med. 2009;163[1]:87-89. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.