Conceptualizing and Measuring Social Media Use in Health and Wellbeing Studies: A Systematic Review (Preprint)

BACKGROUND Given the increasing use of social media and the effects of such use on health and well-being, researchers have called for a public health research agenda to guide the design of social media platforms as well as the public’s use of these platforms in ways that improve health and well-being. However, despite an increasing number of studies revealing both the benefits and harms of social media use, there is heterogeneity and lack of consensus in how social media use is conceptualized, defined and measured. Additionally, little is known whether existing literature focuses on negative well-being outcomes or positive wellbeing outcomes, and whether studies use theories. OBJECTIVE The main objective of this study was to systematically review the literature on the association of social media use with health and wellbeing and examine (1) how social media use has been conceptualized and measured, (2) what health and well-being outcomes have been focused on, and (3) whether studies used theories. METHODS Relevant studies were located through a comprehensive search strategy involving four steps. First, key word searches were conducted on six major databases: PubMed, Web of Science, PsycINFO, EMBASE, ProQuest and Annual Reviews. Second, a search was conducted on Google Scholar using the same sets of search terms and the first 100 results were examined. Third, the reference sections of reviews identified in the first two rounds of searches were examined, and finally, the reference lists of the final set of articles included in the review were searched. Through a multi-stage screening, articles that met our inclusion criteria were included for analysis. RESULTS The review included a total of 233 articles published between 2007 and 2020 in 51 different countries. The findings indicated that while 28% of the studies investigated the effects of the problematic use or addiction of social media on health and well-being, 72% studied the effects of social media use as a “normal” behavior. Most of the studies used measures assessing the time users spend using social media. The majority of the studies that examined the effects of problematic social media use or addiction used addiction scales. Most studies studied the association of social media use with mental illnesses such as depression, anxiety, self-esteem, and loneliness. While there is a considerable number of studies investigating physical health outcomes such as self-rated health, sleep, and sitting time or lack of physical activity, relatively a small number of studies studied social, psychological and emotional wellbeing. Most of the studies (79%) did not use any theory. CONCLUSIONS Most studies conceptualized social media use as a “normal” behavior and mostly used time-spent measures, whereas a considerable number of studies conceptualized social media use as an addiction and used various addiction measures. The studies disproportionately focused on investigating the effects of social media use with negative health and well-being outcomes. The findings suggest the need for going beyond time-spent to more sophisticated measurement approaches that take into account the multiplicity of activities that users perform on social media platforms, and the need for more theory-based studies on the association of social media use with not only negative well-being or “ill-being” but also with positive health and well-being outcomes.