Hashtag Healthcare: An Assessment of Current Educational Quality and Patient Perceptions of Scoliosis on TikTok

Abstract

Background: Significant racial disparities exist in healthcare, including in the diagnosis and treatment of scoliosis. The social media platform TikTok is estimated to reach over 1.7 billion monthly users in 2023. It is one of the most popular social media platforms for teenagers and young adults. This study aimed to explore TikTok content metrics related to scoliosis and determine demographic differences across videos. Methods: This cross-sectional study included TikTok posts searched using Exolyt analytics software for the top hashtags related to scoliosis from Sept 2020–Aug 2022. Data were collected for race and role of the creator and underlying themes. A staged approach was used to analyze content through familiarization, identifying thematic framework, indexing, summarizing, and interpreting data. The educational quality of videos was determined using the DISCERN scale by two independent reviewers (very poor: <26, poor: 27–38, fair: 39–50, good: 51–62, very good: 63–75). Results: The top five viewed hashtags #scoliosis, #scoliosisawareness, #scoliosischeck, #scoliosissurgery, #scoliosisgang yielded 220 unique, eligible posts for inclusion. Videos were grouped by the race of individuals seen in the video:176 (80%) white, 25 (11%) black, indigenous, and persons of color (BIPOC), and 19 (9%) unknown/not applicable (UK/NA). Posts by creators where race was UK/NA had significantly more views compared to other groups (P = .046). There was no difference in positive/negative tone (P ​= ​.900) between groups. BIPOC creators had a higher percentage of posts on body image (P = .023), embarrassment (P = .031), and relationships (P = .047), while white creators had more videos addressing pain (P = .012). There were no differences in the DISCERN score between racial groups (P ​= ​.711). Conclusions: In this analysis of the most popular scoliosis-related posts on TikTok, we identified important thematic content and video analytic differences by race. Only 8% of posts involved healthcare providers, and based on the DISCERN scale, the educational quality of the videos was very poor. This study highlights that racial differences in scoliosis extend to social media, and an opportunity exists for healthcare providers and professional organizations to create more diverse, educational content. Key Concepts: (1) TikTok is the most commonly used social media platform within the adolescent population. (2) Content related to scoliosis presented on TikTok is of low to no educational quality. (3) While black, indigenous, and people of color (BIPOC) represent the majority of users, they are underrepresented as content creators. (4) TikTok can be utilized as an educational platform if presented by a diverse patient population and supported by healthcare providers. (5) Continued monitoring of patient presented themes can help inform caregivers what matters most to their patient population and adjust educational content to help support these concerns. Level of evidence: Level II

Keywords

• Scoliosis
• Social media
• Adolescents