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Seminar on
Use of social media among adolescents: Current Situation,
Challenges and Ways Forward
Under cordial guidance of
Hari Prasad Kaphle
Associate Professor (Public Health)
FHS, SHAS
Presented By
Janaki Kumari Timilsina
Faculty of Health Sciences
School of health and allied Sciences
Pokhara University, Dhungepatan, Nepal
2019
9/26/2019 1
Outline
• Introduction
• Benefits of Social Media on Adolescent Health
• Risks of Social Media
• Challenges and opportunities in adolescent health and social media
• Ways Forwards
• References
9/26/2019 2
Introduction
• Social media simply defined as a “label for digital technologies that
allow people to connect, interact, produce and share content.
• Broadly defined social media as “any interactive communication
channel that allows for two-way interaction and feedback.”
• Internet-based, disentrained, and persistent channels of masspersonal
communication facilitating perceptions of interactions among users,
deriving value primarily from user-generated content.(Carr & Hayes,
2015)
9/26/2019 3
Contemporary Examples Derived from Carr and Hayes’
Definition of Social Media
Social Media
 Social network sites (e.g., Facebook,, Google, YouTube)
 Professional network sites (e.g., LinkedIn)
 Chatboards & discussion fora
 Social/Casual games (e.g., Farmville)
 Wiki “Talk” pages
 Tinder
 Instagram
9/26/2019
Carr, C. T., & Hayes, R. A. (2015). Social media: Defining, developing, and divining. Atlantic Journal of Communication, 23(1), 46-65.
4
• The lives of adolescents today have become increasingly intertwined
with social media.
• A common type of social media use is through a social networking
site (SNS) profile, examples include Facebook, Twitter, and Instagram.
• The majority of adolescent's report ownership of at least one SNS
profile
• The majority of adolescents now have access to social media.
• These profiles are accessed frequently; most adolescents report that
they check their social media multiple times per day.
9/26/2019 5
• According to a national survey, almost 92% teens report going online
daily, of these 24% go online “almost constantly” and 56% go online
several times a day.
• Internet has provided a new avenue to enhance personal growth
through academic widespread enrichment, creative expression and
social interaction.
9/26/2019
Sadhir, M., Stockburger, S. J., & Omar, H. A. (2016). Challenges of internet and social media use in adolescents. Dynamics of Human
Health, 3(1).
6
How we use social media
9/26/2019 7
What Adolescents Do Online: Protective Aspects
ACTIVITY % OF ADOLESCENTS
Join an online community or a “group” on
Facebook in support of a cause
Post creative writing or artwork that you’ve done
share videos or music that you’ve created
Organize or invite people to an event using a
social networking site like Facebook
Volunteer for a campaign, nonprofit organization,
or charity
Participate in online study groups
54
53
50
45
34
26
9/26/2019
SOURCE: Carroll, J., & Kirkpatrick, R. (2011). Impact of social media on adolescent behavioral health. Oakland, CA: California Adolescent Health Collaborative.
8
Benefits of Social Media on Adolescent Health
• Social media use is highly associated with many benefits for
adolescent health and development.
• Adolescents use online searches to gain answers to many of their
health concerns with 31% of online adolescents getting health, dieting,
or physical fitness information from the internet.
• 17 % of adolescents who use the internet report they use it to gather
information about health topics that are hard to discuss with others,
such as drug use and sexual health (Lenhart, 2010).
9/26/2019 9
• Most adolescents use online networks to extend the friendships they
already have from other areas of their life, such as school, religious
organizations, sports and other local activities (Ito, 2008).
• Social networking sites provide a way for adolescents to experience
connectedness and opportunities to learn from each other (Ito, 2008).
9/26/2019 10
• Adolescents look to social networks as a key source of information
and advice in a critical developmental period with 57% of adolescent
social networkers saying they look to their online social network for
advice (Nielsen, 2009).
• Social networking sites can allow adolescents to find support online
that they may lack in traditional relationships, especially for
adolescents who are often marginalized, such as lesbian, gay, bi and
transgendered (LGBT), those who are living with an illness or
disability, or those who may feel physically unattractive or socially
reticent.
9/26/2019 11
• Social media can provide a supportive environment to explore
romance, friendship, and social status, while also providing adolescent
an opportunity to share and discuss their taste in music, ideas of drama
and flims, online games, and other aspects of civilization (Ito, 2008).
• The use of social media as a powerful health communication tool and
it is also one important area of current research interest.
9/26/2019 12
Risks of Social Media
Social media use has become an integral part of adolescent lives.
But with its use, adolescents are currently facing problems of;
• Social Media and Adolescent Mental Health
• Cyberbullying
• Adolescent Relationship Abuse and Social Media
• Texting/Sexting
• Online Sexual Solicitation and Predation
• Internet Addiction
• Pornography
9/26/2019 13
Social Media and Adolescent Mental Health
• Adolescents who are the heaviest social media users report being less
content and are more likely to report that they get into problem a lot,
are often sad or unhappy, and are often bored or stressed.
9/26/2019 14
Cyberbullying
• Cyberbullying is aggressive and repetitive acts meant to hurt someone
and involves an imbalance of power inflicted through electronic
media.
• According to study, 20–40% of adolescents report having been
victims of cyberbullying.
• Cyberbullying are highly associated with increased anxiety,
depression, and low self-esteem in adolescents
9/26/2019
Source :Carroll, J., & Kirkpatrick, R. (2011). Impact of social media on adolescent behavioral health. Oakland, CA: California Adolescent Health Collaborative.
15
Texting and Sexting
• In social media texting can also be used to bully or humiliate people.
• An embarrassing or upsetting image or video can quickly be transmitted
or uploaded to an online video sharing site like YouTube via cell phones
or the internet.
• Sexting is a form of texting where ones send or receive sexually
suggestive nude or nearly nude images or messages.
• As many as 20% of adolescents reported they have sent nude or semi-
nude pictures due to pressure from boys to send sexts.
9/26/2019 16
Adolescent Relationship Abuse and Social Media
• Adolescents in relationships may also receive nude pictures or be
pressured to send nude pictures of themselves to a partner.
• Relationship abuse can also include sending nonstop text messages or
posting cruel comments on a boyfriend’s or girlfriend’s Facebook.
• Cell phones, instant messaging, and social networking websites are all
increasingly being used to monitor, threaten, and harass relationship
partners.
9/26/2019 17
Online Sexual Solicitation and Predation
• online sexual solicitation is term as “the act of encouraging someone
to talk about sex, to do something sexual, or to share personal sexual
information even when that individual does not want to do”.
• Online sexual predation happens when an adults makes contact with a
minor with intent to involve in sexual activities that may result in
statutory rape.
9/26/2019 18
Internet Addiction
• Internet addiction has been associated with depression, anxiety, stress,
self-injurious behaviors, sleep disturbances, increased alcohol and
tobacco use, and obesity.
• Additionally, studies have found microstructural changes in the brains
of adolescents with Internet addiction, including a decrease in gray
matter volume and alterations in neurotransmitters
9/26/2019 19
Pornography
• Exposure to pornographic material on the Internet is common.
• 70% of adolescents aged 15–17 years reporting the accidental
exposure while 72% of college students reporting exposure before age
18 years.
• Exposure to violent pornographic material has been related to sexually
aggressive behaviors in adolescents.
• Also pornography has been shown to have a negative influence on
attitudes and ideas towards the women sexuality and healthy
relationships.
9/26/2019
Springate J, Omar HA. The impact of the internet on the sexual health of adolescents. In: Tsitsika A, Janikian M, Greydanus DE, Omar HA, Merrick J, editors. Internet
addiction: a public health concern in adolescence. Hauppauge (NY): Nova Science Publishers; 2013. p. 133–8.
20
Challenges and opportunities in adolescent health and social
media
• The rise of social media presents challenges and opportunities in
adolescent health.
• A major area of concern is the influence of social media on adolescent
health behaviors.
9/26/2019 21
Social media combines the influence of two traditional areas of
influence on adolescent health:
• Peer influence and media influence.
Adolescents are thus uniquely vulnerable to the effects and influence of
social media: they are early adopters, nearly ubiquitous users, and highly
susceptible to peer influences.
9/26/2019 22
Area Challenges Oppurtunities
Eating disorders • Media often promotes “thin
ideal” body shape
• Quality and quantity of social
media engagement have been
linked to body dissatisfaction and
drive for thinness
• Future research should aim to
explore ways in which social
media may provide support to
patients in recovery from
eating disorders
• The potential impact of body
positive social campaigns on
adolescent body image
Sexual health Adolescents commonly use
technology to access information
about sex; this information may
be inaccurate or inappropriate
• Social media can be used to raise
awareness and acceptance of
sexual health prevention such as
HIV testing
• Future research should explore
ways to use social media to
deliver accurate health
information and result in safer
sexual health behaviors
9/26/2019
Moreno, M. A., Standiford, M., & Cody, P. (2018). Social media and adolescent health. Current Pediatrics Reports, 6(2), 132-138.
23
Area Challenges Oppurtunity
Substance use • Exposure to alcohol and substance
use on social media may promote
earlier initiation of these behaviors
• Social media messages about
health consequences of smoking
changed attitudes
• Social media may present new
opportunities to identify youth at
risk who post about alcohol or
substance use behaviors
Prevention • Adolescents may misinterpret
online relationships or share
personal or health information
using these non-secure
communication channels.
• Providers can leverage
interactive sites such as help to
understand teen perspectives on
their clinic or practice
• Social media may provide new
opportunities to connect teens to
their providers or clinic and
receive updates or reminders
9/26/2019
Moreno, M. A., Standiford, M., & Cody, P. (2018). Social media and adolescent health. Current Pediatrics Reports, 6(2), 132-138.
24
Area Challenges Oppurtunity
Suicide • Social media posts
expressing suicidal ideation
may normalize this content
• Youth can feel powerless
when viewing suicidal
content on social media
• Content posted related to
suicide may offer
opportunities to prevent
suicide before it happens
• Future research should aim
to explore posted social
media content to more fully
understand predictors of
suicide
9/26/2019
Moreno, M. A., Standiford, M., & Cody, P. (2018). Social media and adolescent health. Current Pediatrics Reports, 6(2), 132-138.
25
Ways Forwards
New Tools to Promote Safe Social Media Use
One new tool to engage patients and families is the Family Media Use Plan.
Developed by the American Academy of Pediatrics as part of the 2016
revised Media Policies. The tool is online and is designed to be done as an
activity involving a parent and a adolescents.
CDC Social Media Toolkit
It Provides the ideas about using social media for health promotion,
including planning and implementing educational campaigns. This source
includes a chart to help choose appropriate types of social media format and
resources hence helps the adolecents.
9/26/2019
Source:http://www.cdc.gov/healthcommunication/ToolsTemplates/Soc ialMediaToolkit
26
TUNE
• It is a unique and interactive health and wellness program that helps adolescents
make positive choices and live healthier lives through music.
• TUNE uses many ways to promote its music and messages including the TUNE
website, Twitter, Facebook and YouTube which feature over 300 artist recordings.
Itgetsbetter.org
It is a website where gay, lesbian, bisexual and transgendered adolescents can find
videos of other youth and individuals with encouraging messages about making it
through the difficult adolescents years especially when faced with harassment and
bullying.
9/26/2019 27
Technological solutions
Internet providers need to continue to work with parents and policy
makers to create awareness and opportunities for privacy protection of
youth and to develop technologies that can assist adolescents in staying
safe.
Health providers
Medical and mental health providers/ health care professionals need to
include routine screenings to assess risk for depression that consider an
adolescent's social media use.
9/26/2019 28
References
• Carr, C. T., & Hayes, R. A. (2015). Social media: Defining, developing, and divining. Atlantic
Journal of Communication, 23(1), 46-65.
• Carroll, J., & Kirkpatrick, R. (2011). Impact of social media on adolescent behavioral health.
Oakland, CA: California Adolescent Health Collaborative.
• Sadhir, M., Stockburger, S. J., & Omar, H. A. (2016). Challenges of internet and social media use
in adolescents. Dynamics of Human Health, 3(1).
• Collins, R.L., Martino, S.C., & Shaw, R. (2011). Influence of New Media on Adolescent Sexual
Health: Evidence and Opportunities, Working Paper WR-761.
• The Nielsen Company. (2009). How Teens Use Media: A Nielsen report on the myths and realities
of teen media trends.
• Moreno, M. A., Standiford, M., & Cody, P. (2018). Social media and adolescent health. Current
Pediatrics Reports, 6(2), 132-138.
• Lenhart A, Purcell K, Smith A., & Zickuhr K. (2010). Social media & mobile internet use among
teens and young adults
9/26/2019 29
• Ito M., Horst, H., Bittani, M., boyd, d., Herr-Stephenson, B., Lange, P.G., . . .Tripp, L. (2008)
Living and Learning With New Media: Summary of Findings From the Digital Youth Project.
• Springate J, Omar HA. The impact of the internet on the sexual health of adolescents. In: Tsitsika
A, Janikian M, Greydanus DE, Omar HA, Merrick J, editors. Internet addiction: a public health
concern in adolescence. Hauppauge (NY): Nova Science Publishers; 2013. p. 133–8.
9/26/2019 30
9/26/2019 31

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Use of Social Media among Adolescents

  • 1. Seminar on Use of social media among adolescents: Current Situation, Challenges and Ways Forward Under cordial guidance of Hari Prasad Kaphle Associate Professor (Public Health) FHS, SHAS Presented By Janaki Kumari Timilsina Faculty of Health Sciences School of health and allied Sciences Pokhara University, Dhungepatan, Nepal 2019 9/26/2019 1
  • 2. Outline • Introduction • Benefits of Social Media on Adolescent Health • Risks of Social Media • Challenges and opportunities in adolescent health and social media • Ways Forwards • References 9/26/2019 2
  • 3. Introduction • Social media simply defined as a “label for digital technologies that allow people to connect, interact, produce and share content. • Broadly defined social media as “any interactive communication channel that allows for two-way interaction and feedback.” • Internet-based, disentrained, and persistent channels of masspersonal communication facilitating perceptions of interactions among users, deriving value primarily from user-generated content.(Carr & Hayes, 2015) 9/26/2019 3
  • 4. Contemporary Examples Derived from Carr and Hayes’ Definition of Social Media Social Media  Social network sites (e.g., Facebook,, Google, YouTube)  Professional network sites (e.g., LinkedIn)  Chatboards & discussion fora  Social/Casual games (e.g., Farmville)  Wiki “Talk” pages  Tinder  Instagram 9/26/2019 Carr, C. T., & Hayes, R. A. (2015). Social media: Defining, developing, and divining. Atlantic Journal of Communication, 23(1), 46-65. 4
  • 5. • The lives of adolescents today have become increasingly intertwined with social media. • A common type of social media use is through a social networking site (SNS) profile, examples include Facebook, Twitter, and Instagram. • The majority of adolescent's report ownership of at least one SNS profile • The majority of adolescents now have access to social media. • These profiles are accessed frequently; most adolescents report that they check their social media multiple times per day. 9/26/2019 5
  • 6. • According to a national survey, almost 92% teens report going online daily, of these 24% go online “almost constantly” and 56% go online several times a day. • Internet has provided a new avenue to enhance personal growth through academic widespread enrichment, creative expression and social interaction. 9/26/2019 Sadhir, M., Stockburger, S. J., & Omar, H. A. (2016). Challenges of internet and social media use in adolescents. Dynamics of Human Health, 3(1). 6
  • 7. How we use social media 9/26/2019 7
  • 8. What Adolescents Do Online: Protective Aspects ACTIVITY % OF ADOLESCENTS Join an online community or a “group” on Facebook in support of a cause Post creative writing or artwork that you’ve done share videos or music that you’ve created Organize or invite people to an event using a social networking site like Facebook Volunteer for a campaign, nonprofit organization, or charity Participate in online study groups 54 53 50 45 34 26 9/26/2019 SOURCE: Carroll, J., & Kirkpatrick, R. (2011). Impact of social media on adolescent behavioral health. Oakland, CA: California Adolescent Health Collaborative. 8
  • 9. Benefits of Social Media on Adolescent Health • Social media use is highly associated with many benefits for adolescent health and development. • Adolescents use online searches to gain answers to many of their health concerns with 31% of online adolescents getting health, dieting, or physical fitness information from the internet. • 17 % of adolescents who use the internet report they use it to gather information about health topics that are hard to discuss with others, such as drug use and sexual health (Lenhart, 2010). 9/26/2019 9
  • 10. • Most adolescents use online networks to extend the friendships they already have from other areas of their life, such as school, religious organizations, sports and other local activities (Ito, 2008). • Social networking sites provide a way for adolescents to experience connectedness and opportunities to learn from each other (Ito, 2008). 9/26/2019 10
  • 11. • Adolescents look to social networks as a key source of information and advice in a critical developmental period with 57% of adolescent social networkers saying they look to their online social network for advice (Nielsen, 2009). • Social networking sites can allow adolescents to find support online that they may lack in traditional relationships, especially for adolescents who are often marginalized, such as lesbian, gay, bi and transgendered (LGBT), those who are living with an illness or disability, or those who may feel physically unattractive or socially reticent. 9/26/2019 11
  • 12. • Social media can provide a supportive environment to explore romance, friendship, and social status, while also providing adolescent an opportunity to share and discuss their taste in music, ideas of drama and flims, online games, and other aspects of civilization (Ito, 2008). • The use of social media as a powerful health communication tool and it is also one important area of current research interest. 9/26/2019 12
  • 13. Risks of Social Media Social media use has become an integral part of adolescent lives. But with its use, adolescents are currently facing problems of; • Social Media and Adolescent Mental Health • Cyberbullying • Adolescent Relationship Abuse and Social Media • Texting/Sexting • Online Sexual Solicitation and Predation • Internet Addiction • Pornography 9/26/2019 13
  • 14. Social Media and Adolescent Mental Health • Adolescents who are the heaviest social media users report being less content and are more likely to report that they get into problem a lot, are often sad or unhappy, and are often bored or stressed. 9/26/2019 14
  • 15. Cyberbullying • Cyberbullying is aggressive and repetitive acts meant to hurt someone and involves an imbalance of power inflicted through electronic media. • According to study, 20–40% of adolescents report having been victims of cyberbullying. • Cyberbullying are highly associated with increased anxiety, depression, and low self-esteem in adolescents 9/26/2019 Source :Carroll, J., & Kirkpatrick, R. (2011). Impact of social media on adolescent behavioral health. Oakland, CA: California Adolescent Health Collaborative. 15
  • 16. Texting and Sexting • In social media texting can also be used to bully or humiliate people. • An embarrassing or upsetting image or video can quickly be transmitted or uploaded to an online video sharing site like YouTube via cell phones or the internet. • Sexting is a form of texting where ones send or receive sexually suggestive nude or nearly nude images or messages. • As many as 20% of adolescents reported they have sent nude or semi- nude pictures due to pressure from boys to send sexts. 9/26/2019 16
  • 17. Adolescent Relationship Abuse and Social Media • Adolescents in relationships may also receive nude pictures or be pressured to send nude pictures of themselves to a partner. • Relationship abuse can also include sending nonstop text messages or posting cruel comments on a boyfriend’s or girlfriend’s Facebook. • Cell phones, instant messaging, and social networking websites are all increasingly being used to monitor, threaten, and harass relationship partners. 9/26/2019 17
  • 18. Online Sexual Solicitation and Predation • online sexual solicitation is term as “the act of encouraging someone to talk about sex, to do something sexual, or to share personal sexual information even when that individual does not want to do”. • Online sexual predation happens when an adults makes contact with a minor with intent to involve in sexual activities that may result in statutory rape. 9/26/2019 18
  • 19. Internet Addiction • Internet addiction has been associated with depression, anxiety, stress, self-injurious behaviors, sleep disturbances, increased alcohol and tobacco use, and obesity. • Additionally, studies have found microstructural changes in the brains of adolescents with Internet addiction, including a decrease in gray matter volume and alterations in neurotransmitters 9/26/2019 19
  • 20. Pornography • Exposure to pornographic material on the Internet is common. • 70% of adolescents aged 15–17 years reporting the accidental exposure while 72% of college students reporting exposure before age 18 years. • Exposure to violent pornographic material has been related to sexually aggressive behaviors in adolescents. • Also pornography has been shown to have a negative influence on attitudes and ideas towards the women sexuality and healthy relationships. 9/26/2019 Springate J, Omar HA. The impact of the internet on the sexual health of adolescents. In: Tsitsika A, Janikian M, Greydanus DE, Omar HA, Merrick J, editors. Internet addiction: a public health concern in adolescence. Hauppauge (NY): Nova Science Publishers; 2013. p. 133–8. 20
  • 21. Challenges and opportunities in adolescent health and social media • The rise of social media presents challenges and opportunities in adolescent health. • A major area of concern is the influence of social media on adolescent health behaviors. 9/26/2019 21
  • 22. Social media combines the influence of two traditional areas of influence on adolescent health: • Peer influence and media influence. Adolescents are thus uniquely vulnerable to the effects and influence of social media: they are early adopters, nearly ubiquitous users, and highly susceptible to peer influences. 9/26/2019 22
  • 23. Area Challenges Oppurtunities Eating disorders • Media often promotes “thin ideal” body shape • Quality and quantity of social media engagement have been linked to body dissatisfaction and drive for thinness • Future research should aim to explore ways in which social media may provide support to patients in recovery from eating disorders • The potential impact of body positive social campaigns on adolescent body image Sexual health Adolescents commonly use technology to access information about sex; this information may be inaccurate or inappropriate • Social media can be used to raise awareness and acceptance of sexual health prevention such as HIV testing • Future research should explore ways to use social media to deliver accurate health information and result in safer sexual health behaviors 9/26/2019 Moreno, M. A., Standiford, M., & Cody, P. (2018). Social media and adolescent health. Current Pediatrics Reports, 6(2), 132-138. 23
  • 24. Area Challenges Oppurtunity Substance use • Exposure to alcohol and substance use on social media may promote earlier initiation of these behaviors • Social media messages about health consequences of smoking changed attitudes • Social media may present new opportunities to identify youth at risk who post about alcohol or substance use behaviors Prevention • Adolescents may misinterpret online relationships or share personal or health information using these non-secure communication channels. • Providers can leverage interactive sites such as help to understand teen perspectives on their clinic or practice • Social media may provide new opportunities to connect teens to their providers or clinic and receive updates or reminders 9/26/2019 Moreno, M. A., Standiford, M., & Cody, P. (2018). Social media and adolescent health. Current Pediatrics Reports, 6(2), 132-138. 24
  • 25. Area Challenges Oppurtunity Suicide • Social media posts expressing suicidal ideation may normalize this content • Youth can feel powerless when viewing suicidal content on social media • Content posted related to suicide may offer opportunities to prevent suicide before it happens • Future research should aim to explore posted social media content to more fully understand predictors of suicide 9/26/2019 Moreno, M. A., Standiford, M., & Cody, P. (2018). Social media and adolescent health. Current Pediatrics Reports, 6(2), 132-138. 25
  • 26. Ways Forwards New Tools to Promote Safe Social Media Use One new tool to engage patients and families is the Family Media Use Plan. Developed by the American Academy of Pediatrics as part of the 2016 revised Media Policies. The tool is online and is designed to be done as an activity involving a parent and a adolescents. CDC Social Media Toolkit It Provides the ideas about using social media for health promotion, including planning and implementing educational campaigns. This source includes a chart to help choose appropriate types of social media format and resources hence helps the adolecents. 9/26/2019 Source:http://www.cdc.gov/healthcommunication/ToolsTemplates/Soc ialMediaToolkit 26
  • 27. TUNE • It is a unique and interactive health and wellness program that helps adolescents make positive choices and live healthier lives through music. • TUNE uses many ways to promote its music and messages including the TUNE website, Twitter, Facebook and YouTube which feature over 300 artist recordings. Itgetsbetter.org It is a website where gay, lesbian, bisexual and transgendered adolescents can find videos of other youth and individuals with encouraging messages about making it through the difficult adolescents years especially when faced with harassment and bullying. 9/26/2019 27
  • 28. Technological solutions Internet providers need to continue to work with parents and policy makers to create awareness and opportunities for privacy protection of youth and to develop technologies that can assist adolescents in staying safe. Health providers Medical and mental health providers/ health care professionals need to include routine screenings to assess risk for depression that consider an adolescent's social media use. 9/26/2019 28
  • 29. References • Carr, C. T., & Hayes, R. A. (2015). Social media: Defining, developing, and divining. Atlantic Journal of Communication, 23(1), 46-65. • Carroll, J., & Kirkpatrick, R. (2011). Impact of social media on adolescent behavioral health. Oakland, CA: California Adolescent Health Collaborative. • Sadhir, M., Stockburger, S. J., & Omar, H. A. (2016). Challenges of internet and social media use in adolescents. Dynamics of Human Health, 3(1). • Collins, R.L., Martino, S.C., & Shaw, R. (2011). Influence of New Media on Adolescent Sexual Health: Evidence and Opportunities, Working Paper WR-761. • The Nielsen Company. (2009). How Teens Use Media: A Nielsen report on the myths and realities of teen media trends. • Moreno, M. A., Standiford, M., & Cody, P. (2018). Social media and adolescent health. Current Pediatrics Reports, 6(2), 132-138. • Lenhart A, Purcell K, Smith A., & Zickuhr K. (2010). Social media & mobile internet use among teens and young adults 9/26/2019 29
  • 30. • Ito M., Horst, H., Bittani, M., boyd, d., Herr-Stephenson, B., Lange, P.G., . . .Tripp, L. (2008) Living and Learning With New Media: Summary of Findings From the Digital Youth Project. • Springate J, Omar HA. The impact of the internet on the sexual health of adolescents. In: Tsitsika A, Janikian M, Greydanus DE, Omar HA, Merrick J, editors. Internet addiction: a public health concern in adolescence. Hauppauge (NY): Nova Science Publishers; 2013. p. 133–8. 9/26/2019 30