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Enfermería: Cuidados Humanizados

versión impresa ISSN 1688-8375versión On-line ISSN 2393-6606

Enfermería (Montevideo) vol.12 no.1 Montevideo  2023  Epub 01-Jun-2023 

Original Articles

Social and health behaviors of adolescence represented in TikTok

Jacqueline Leiva Castillo1

Mariela Rabanal Carrasco2

Daira Cabrera Palma3

Javiera Canales Abarca4

Marielle Gormaz Aguirre5

Javiera Meza Espinoza6

Valeria Morandé Morales7

1 Universidad de Chile, Chile,

2 Universidad de Chile, Chile

3 Universidad de Chile, Chile

4 Universidad de Chile, Chile

5 Universidad de Chile, Chile

6 Universidad de Chile, Chile

7 Universidad de Chile, Chile



To understand the social and health behaviors associated with adolescents between 13 and 19 years old through the TikTok social network in Chile in 2021.


It is located in the positivist paradigm and focuses on grounded theory. 50 public videos were selected from the social platform and documentary analysis was carried out under open coding.


Adolescents place great importance on their body image, with the use of filters being highlighted in all of them, while clothing showed a trend according to gender. On the other hand, the expressions manifested are mostly positive; the sound resources used for the videos are varied, with music being the most used; the main type of content viewed is dance, followed by humor; the most frequent opinions were positive and health behaviors tended to be non-promoting.


The social representations constructed by adolescents on TikTok are strongly marked by beauty stereotypes, the need for acceptance among peers, and the pursuit of popularity on social networks. Promoting health behaviors on this social network is scarce.

Keywords: adolescent; nursing care; health-related behaviors; nursing; social network



Comprender las conductas sociales y de salud asociadas en adolescentes entre 13 y 19 años a través de la red social TikTok, en Chile en el año 2021.


Se ubica en el paradigma positivista y se enfoca mediane teoría fundamentada. Se seleccionaron 50 videos de carácter público en la plataforma social y se realizó análisis documental bajo codificación abierta.


Los y las adolescentes le dan gran importancia a su imagen corporal, destacándose el uso de filtros en todos ellos, mientras que la vestimenta presentó una tendencia según el género. Por otro lado, las expresiones manifestadas son en su mayoría positivas; los recursos sonoros utilizados para los videos son variados, siendo el más utilizado la música; el principal tipo de contenido visualizado es baile, seguido de humor; las opiniones más frecuentes fueron positivas y las conductas en salud tendieron a ser no promotoras.


Las representaciones sociales construidas por adolescentes en TikTok están fuertemente marcadas por los estereotipos de belleza, la necesidad de la aceptación entre pares y la búsqueda de la popularidad en redes sociales. Las conductas promotoras de salud en esta red social son escasas.

Palabras clave: adolescente; atención de enfermería; conductas relacionadas con la salud; enfermería; red social



Compreender os comportamentos sociais e de saúde associados aos adolescentes entre 13 e 19 anos através da rede social TikTok, no Chile, no ano 2021.


Se situa no paradigma positivista e se enfoca mediante a teoria fundamentada. Foram selecionados 50 vídeos de caráter público na plataforma social e foi realizada uma análise documental sob codificação aberta.


Os e as adolescentes dão grande importância à imagem corporal, destacando-se o uso de filtros em todos eles, enquanto a vestimenta apresentou uma tendência de acordo com o gênero. Por outro lado, as expressões manifestadas são em sua maioria positivas; os recursos sonoros utilizados para os vídeos são variados, sendo a música a mais utilizada; o principal tipo de conteúdo visualizado é a dança, seguida pelo humor; as opiniões mais frequentes foram positivas e os comportamentos de saúde tenderam a ser não promotores.


As representações sociais construídas pelos adolescentes no TikTok são fortemente marcadas por estereótipos de beleza, pela necessidade de aceitação dos pares e pela busca de popularidade nas redes sociais. Os comportamentos de promoção da saúde nessa rede social são escassos.

Palavras-chave: adolescente; cuidados de enfermagem; comportamentos relacionados à saúde; enfermagem; rede social


Adolescence is a critical period in life with great opportunities to build and maintain a healthy lifestyle into adulthood, hence the importance of focusing multidimensional efforts to invest in it. From a positive health perspective, adolescence is a time of great changes and discoveries, and it is possible to strengthen protective health factors to maximize their potential for growth and development. 1 In Chile, according to data from the 2017 Census, the population of adolescents is 2,392,112 people, which corresponds to 13.6 % of the total inhabitants of the country. Of these, 1,221,919 are men, while 1,170,192 are women. 2 This stage is characterized by a series of rapid and diverse changes, biological, psychological and social, which are necessary to reach maturity, highlighting as an important element the exploration and formation of their own identity. In this search, the peer group acquires great importance, becoming the most significant relationship, as they share their doubts, fears and future projects with them, seeking greater support and approval, and it is in this sense that adolescents give great importance to the opinions of others, and are often pressured to assume high-risk behaviors for their health, such as drug and/or alcohol consumption, poor diet, among others. 3

The current massification of social network platforms has allowed the establishment of new ways of interacting and communicating with other people, especially in the adolescent population, who have had the opportunity to explore in them different aspects during their identity construction process, in order to achieve a greater sense of belonging and social approval, especially from their peers. 4 In this way, these platforms have an impact on the construction of imaginaries and social representations, which constitute a useful tool that allows recognizing the social thinking of a group, their way of seeing reality and especially reveal health behaviors associated mainly in this age group. 5) Among the various existing social networks, TikTok, an application whose mission is to “enhance creativity and make people enjoy themselves”, stands out. This social network allows its users to actively participate in the different “trends”, uploading short videos with songs and filters, many of which can become viral, capturing the attention of adolescents and generating an impact or trend among their peers by imposing a form of dress, beauty stereotypes and a common language, both corporal and verbal. 4 Given the above, this social network has quickly positioned itself as one of the most downloaded, so that today this app can be categorized as a social phenomenon. 6) If we visualize these expressions from the health area, it allows us to identify adolescent health-promoting or non-health-promoting behaviors and how these could influence their health.

In Chile, great importance has been given to adolescent health by implementing health policies framed in programs and technical standards in order to advance in closing gaps in health care for this age group towards greater coverage and thus respond to adolescent health problems. 7) Thus, in 2016, after updating the Healthy Youth Checkup, a Technical Standard for Comprehensive Adolescent Health Checkup was created in 2021,2 guiding health strategies with the aim of improving its quality and looking at the adolescent as a whole person and from a rights-based approach. For Nola Pender, nursing should help to understand health-related human behaviors, and in turn guide the generation of healthy behaviors. In this logic, its actions should be aimed at prevention and/or screening and early treatment of diseases or risk factors associated with chronic non-communicable diseases, consistent with a comprehensive approach to care, which allows considering all factors that may affect the health of people. 8) For the process of acquiring health-promoting behaviors to be effective, there are elements that should be considered by the nursing professional; firstly, perceived self-efficacy, which according to Nola Pender’s model influences the level of commitment of the person to the action plan and has an effect inversely proportional to the perception of barrier. That is to say, the more self-efficient an individual considers him/herself to be in adopting these behaviors, the fewer barriers he/she will perceive and vice versa. 8 Another important element is that if a reference in the person's life, be it a social model, a family member, a friend, etc., shows changes in his or her behaviors and supports this person in achieving the same, the adoption of healthy behaviors will be easier. A final important element to consider is that for the behavior to be maintained in the long term, it will depend on the intentionality of the individual. In this process, the nursing professional should motivate the person to recognize his or her own risk factors and non-health-promoting behaviors, reinforced by education as a strategy. (8

It is important to note that, although there are various publications on adolescence and social networks, there is currently no research that integrates these topics.9 In addition, most of these studies have been conducted mainly by disciplines, but not from the disciplinary field of nursing. It is considered essential that these know the dynamics that comprise these social platforms to better understand this population, in order to provide more comprehensive care and attention focused on their needs.

The present research aimed to understand the social and health behaviors associated with adolescents between 13 and 19 years of age through the social network TikTok, in Chile in the year 2021, with the purpose of getting closer to their reality and being able to provide them with care more focused on their own needs, thus contributing to the development of the Nursing discipline.


This research seeks to understand the social representations of adolescence from the perspective of these people, which implies a subjective construct. It is included in the post-positivist paradigm. According to Kolakowski, this aims to study a complex subjective reality from an objective analysis that is irreducible to a single dimension and whose meanings depend on the context shown by the adolescents in the videos in order to understand the reality of the study phenomenon in an integrative manner. Furthermore, this paradigm brings together various theoretical approaches, methods, disciplines and research praxis whose basic purpose is to understand the phenomena and facts from the perspective of the subjects. 10 The rigor criteria considered for this research were those described by Guba & Lincoln: credibility, transferability, dependability, confirmability. 11

Transferability refers to the ability to extend the findings of the study to other situations and contexts, 11 in such a way that the data obtained in this research were worked under a strict description so that they could be used in other contexts of work or research with adolescents. Credibility refers to the in-depth and broad understanding of the information obtained from the unit of analysis and being able to transmit it reliably in the study. 12 In the present research, an attempt is made to include this criterion by avoiding researcher bias by describing in detail the information collected and quoting TikTok content creators verbatim whenever and wherever possible, as well as implementing self-awareness to recognize how researchers might influence during the study and thus avoid subjectivity in data analysis. For this research, the criterion of dependence was guaranteed through the triangulation of the results, since these were contrasted from the point of view of each of the researchers. For the fulfillment of confirmability, an exhaustive record of the decisions, data, bibliography, strategies, especially those related to the record of the analysis of each video, was made, thus allowing neutrality and objectivity in the process.12

As a methodological approach, grounded theory was used. This is based on symbolic interactionism, a psychosocial theory developed by Blumer in 1938, and seeks to understand a phenomenon from the perspective of the individuals involved in that reality.13

The data collection technique was the observation of public videos shared through the TikTok platform. This research focuses on the documentary analysis of videos whose participants post on the social network TikTok, during the months of September to November 2021. The videos were selected using the following inclusion criteria: adolescent participants in videos published on said social network, of any gender who are between 13 and 19 years old, residents of Chile and who have public profiles on the TikTok application. These videos were compared and analyzed together by all the researchers, all women; two academics and five students, in order to identify the themes or concepts present in each of them. In order to be consistent with the stated objectives, the analysis went as far as open coding as proposed by Strauss and Corbin, with which codes were obtained and then grouped into categories by inductive means, and the data were analyzed using the constant comparison method. The number of videos selected was 50, thus reaching data saturation, taking into account Morse’s approach. 14

Regarding the ethical aspects of this research, the Ezekiel Emanuel ethical criteria were met, 15 highlighting that this research is based on the analysis of public and freely accessible videos of adolescents on the TikTok social network. This research has social and scientific value given that its results contribute to disciplinary knowledge on the social representations that adolescents manifest in health-promoting or non-health-promoting behaviors and, from there, focus care on these needs. In relation to scientific validity, there is methodological coherence for the study conducted. Since the sample were videos from a social platform, the equitable selection of subjects, respect for the subjects, condition of authentic dialogue and informed consent do not apply.

Results and analysis

The following are the results and analysis of the videos, which corresponded to 36 videos of female gender, 13 of male gender and 1 non-binary. The central categories resulting from the analysis of the research were body image; expressions; sound resources; type of content; sound resources and opinions. T1

Table 1: Results summary 

Source:Own elaboration (2022)

Body image

From the discipline of psychology, body image refers to the mental representation of the size, shape and form of our body (in general and its parts); that is, how the person visualizes him/herself and how he/she believes others see him/her. In addition, body image involves the feelings towards the body (dissatisfaction, concern, satisfaction, etc.) and how one acts with respect to it (exhibition, avoidance, etc.). 16 This body image is part of the physical self-concept, which corresponds to one of the most important dimensions in creating the adolescent's self-concept and is subject to sociocultural events, such as advertising, information, family environment and friendships. 16 For this category, the following codes were analyzed: use of filters, clothing, body adornment and hair.

For the code use of filters, it is important to mention before, that the base platform contains programming that allows “beautifying” the faces through a filter of the same name, which is predetermined when starting an account in TikTok, so that all videos contain a filter that allows “perfecting the features”. In the videos analyzed, it can be highlighted that in 46 of the 50 videos, the most used filter is the “basal filter”, which distorts the body image of adolescents, adjusting to the canons of beauty chosen by the network, which is in line with current trends in order to achieve the standard of beauty they use, where mostly the resulting image is far from who they really are.

The clothing code shows a trend of what is “acceptable” or “fashionable” for adolescents, 17) since there is a marked dress preference throughout the review of the videos and a notable difference between the different genders when dressing. Although the majority of the videos, in 36 of the 50 videos analyzed, are created by females, there is still a large gap that allows distinguishing preferences by gender. Within the feminine, we can observe an inclination to a style of clothing that highlights the silhouette and body shape, either in the use of skin-tight dresses, crop tops or tight clothes, from which we can conclude that they seek to achieve the prototype imposed by society for the female gender. On the other hand, in all the videos of the male gender 13, he prefers to use a trend of loose sportswear, with dark tones, highlighting the use of recognized brands visibly stamped on the clothes or sneakers, so that it is noticeable where his clothes come from. In this way, it is interpreted that the male gender does not give more importance to highlight their physique than the females, by using a more relaxed, sober and loose clothing style, but they are more concerned about the monetary value, recognition and popularity of the garment to be used, implying that part of their body image and status is given by this. On the other hand, the only person identified with the non-binary gender, combines garments with influences of both genders, such as the use of skirt and pants, tight and black clothes, so it can be inferred that they also give importance to their body image.

The third code is use of body adornment, present in all the videos, which involves any accessory, object, or invasive aesthetic procedure (piercings, tattoos, others) or non-invasive (hair coloring, hairstyles, etc.). These adornments allow adolescents to feel comfortable with their own body and the way they look, which also allows them to fit in with fashion trends, and even to represent or have a significant object or souvenir, which they are not afraid to show or make visible to onlookers.

The fourth and last code in this category is hair, which, although it is a natural feature, is also an important part of the construction of the body image, to which different styles of cuts, colors, shapes and accessories are added, representing a particular style and form of expression for each person. Throughout the analysis, it was observed that the extension of hair is different for different genders, because society has imposed customs for each one, affecting the expression and own decision of how to use or have hair. In conclusion, 30 of the 36 women used long, loose, and natural colored hair. Although some colored hair was observed, these were found in a smaller proportion, only in 6 videos, being mainly colors similar to the natural ones and a smaller number of artificial colors (only 2), as well as men. In relation to the person of non-binary gender, the length of her hair was up to her shoulders, she had colored hair in artificial tones, it was straightened and did not present any special hairstyle.


The category expressions is understood as a form of communication through body language that uses gestures, postures and movements and face, transmitting information about the emotions and thoughts of the sender. It is usually performed at an unconscious level and is usually a very clear indicator of the emotional state of the person. 18 Within this category, two codes could be identified, positive expressions and negative expressions.

The positive expressions code incorporates emotions and attitudes such as joy, tranquility, empowerment, sensuality and coquetry.

On the other hand, the code negative expressions involves diverse emotions such as anger, sadness, worry, among others. When comparing both codes, it is observed that the former is repeated to a greater extent than the latter, which may be associated with the fact that most of the videos analyzed were dances or humorous videos, which clearly tend to express positive emotions in this social network.

The expression most frequently observed within the positive code is joy, present in 44 of the 50 videos, where adolescents use dance or humorous videos or other means to express this emotion and/or transmit it to the viewers. The expressions that also had a strong presence are sensuality and coquetry, (considering the latter with a more innocent connotation than the former), these expressions were observed only in videos of females, who mainly used dances to mark their fluid and sensual movements or videos where they sang a song according to the expression indicated and showed gestures or body movements of this type.

On the other hand, in 5 videos, the most repeated negative expression in the videos is annoyance, both towards parental figures and socially incorrect situations, where they expose some experiences or points of view on a specific topic and explicitly or implicitly invite the viewers to give their opinion about it.

In addition, it is important to mention that in the data collection a video was analyzed in which a teenager exposed her suicidal ideation in a comical or ironic way, seriously minimizing this worrying situation, which is in line with the trends and normalization of these issues of current generations, which speak openly about serious mental health problems such as depression or suicidal ideation, but in a romanticized and even humorous way. It is inferred that this social network and probably other similar ones, are a source of venting for adolescents, whether they are experiencing positive or negative feelings, they seek to channel these through the application and express them by sharing them with their audience, and mainly seek validation, understanding or admiration from their peers.

Sound resources

For the category sound resources, we understand those resources used in the videos that constitute the corpus and are characterized by being different sounds used as forms of expression. These sonorities carry diverse symbolic connotations, which, in turn, can express moods, identities and sense of belonging. In other words, they become a means for each adolescent to find his or her own form of self-representation. 19 In accordance with the above and because of the analysis of the videos, different codes were found, such as music, dialogues of scenes from movies or series, melodies and own voice. Within this set, the code that is most used is music, in which different genres can be appreciated.

As for the music code, it can be understood as a means used by adolescents to externalize their own emotions, sensations and feelings in an indirect way, and also to construct their identity. (19 These characteristics are key to this age group. Their musical preferences are mainly concentrated in the reggaeton genre and its subgenre, trap. These are accompanied by explicitly sexual lyrics, together with a predominant associated dance called perreo.2 In accordance, in the videos analyzed that used reggaeton or trap music as background music, the adolescents perform gestures, dances, sensual, flirtatious, and obscene movements, and their clothing tends to be short and tight, casual or sporty.

Therefore, this social network is a platform that adolescents use for personal expression, so it is possible to infer that the use of this type of content and resources (trap and reggaeton) is related to their current interests and experiences. This is interesting in health areas related to risky sexual behavior, teenage motherhood and fatherhood, and substance use. A significant increase in these aspects can be observed during the adolescent period, where a link can be established between these types of songs, which are to their liking and represent them. The normalization and popularity of this type of behavior is harmful for these people, as it can predispose them to teenage pregnancy and substance abuse. The latter behavior generates significant neurological damage since their nervous system is still developing.20 In addition, these musical tendencies promote risky behaviors, such as accidents, overdoses, violent behaviors, among others. On the other hand, it is also possible to identify an important influence on depressive, anxious and suicidal states. 21

As a sound resource, dialogues from movie scenes and series were also used, showing that the means for their representations are not limited to only one, but rather it is the massive and representative use of a sound resource that will determine whether it will be preferred or not for these contents. Unfortunately, as there were only 2 videos that presented this characteristic, it is not possible to conclude another trend for its uses.

As for the own voice, it also takes different forms, but it is generalized in its own voices. This instrument is vital for the communication between the one who emits and the one who watches. By means of mechanisms of tonality and intensity of the voice, effects of accentuation and intonation are created, which can transmit different emotions or interpreting different characters in the video, even without the support of spoken language. As the psychological activity of sender and receiver is implied, the above devices serve to mention the meaning and emotional intention of speech.

Among the different videos selected, the ones that use own voice the most are the humorous ones, 29 out of the 50 videos. This is because adolescents often use their own resources to give greater emphasis to what they want to convey through their content. Moreover, they are also closely related to those of the personal information code, where they use different intonations and costumes to represent the characters of the fictitious or real situations that they stage.

Content type

The category of type of content as the common theme or category in which a video can be classified, according to its characteristics and mainly the purpose of the central message transmitted or content, i.e., if the objective of the video is to amuse the public, its code corresponds to humor, whereas if the motive is to promote the product to be marketed, the type of content will be advertising. (19 Within the video there can be both verbal and non-verbal messages and these, in turn, can be sound or visual, this set of elements reflects what is sought to convey to the receiver, which in this case are the users of the platform and according to what they seek to express. In this context, the following codes were analyzed: dance, humor, transmission of personal information and advertising.

Regarding the dance code, it can be observed that this type of videos was essentially made by females, highlighting the cheerful, feminine, flirtatious and sensual body movements, but at the same time steps of popular choreographies performed mostly by influencers that are repeated according to the trends. It follows that adolescents seek to achieve greater recognition and popularity through the creation of trending content such as dances with pre-established choreographies and the projection of a body image that meets current standards of beauty, in order to feel admired and/or loved by others.

As for the humor code, it can be observed that there is no great difference according to gender in terms of the users who make this type of videos, and these correspond to representations of everyday situations, highlighting those in which the adolescent also plays an adult female character, usually a mother or grandmother, using a towel or handkerchief to represent the change of characters. This makes it possible to visualize the perception that adolescents have of adults, specifically their relatives, considering that they react in an exaggerated manner and that they have a worldview of the world different from theirs. 22

On the other hand, it is important to mention that adolescents, through these humorous videos, tend to normalize or underestimate some important health situations, such as risky sexual behaviors and teenage motherhood/parenthood or suicide. This can lead them to acquire risky behaviors for their health, since they do not contemplate the real and potential consequences that these types of situations can have.

In relation to the third code transmission of personal information, it was observed in all the videos, except two of the female gender, in terms of users who make this type of videos. Within these, a very popular trend on the platform stands out, which consists of delivering personal information and characteristics of all kinds. From this it can be inferred that adolescent girls adopt a perspective of self-objectification, considering themselves as a body that is constantly observed and evaluated, and that can become someone else's possession, such as a partner.23 This can impact in various ways on their health, normalizing and perpetuating situations of violence.

Regarding the code advertising, we observed a young person who promotes his products through the platform, indicating where they can make inquiries or orders, and asking other users to help him spread the information. This could lead us to infer that adolescents seek small instances of work, such as the sale of handicrafts, to earn some money, either out of economic necessity or as a means of saving. 24) This is relevant, given the illegality of child labor in Latin America, as determined by the Declaration of the Rights of the Child, which establishes that they should not be allowed to perform any type of work, much less those that may harm their health, education and development. 25 However, this contradicts the economic reality of many countries and the needs that these adolescents may have. Notwithstanding the above, it is important to point out the term progressive autonomy, which is also considered in this Declaration. This term establishes that adolescents also progressively acquire autonomy as they grow older, and in this sense, the search for income through volunteer work could be understood as part of their personal growth. (25


The category opinions is understood as “subjective expressions, constructed on the basis of values, principles and feelings of a particular individual”. 26 Opinions can be expressed through different media. In the case of the social network TikTok, these can be expressed through written comments or video responses, provided that the person posting allows it. In this context, written comments will be analyzed, which can be categorized in the codes positive comments or negative comments.

In the positive comments code, comments with references to support, identification, admiration, interest, praise and advice were considered. For example, when a situation experienced by the adolescent was shown through a video, and those who viewed it usually offered encouragement to overcome the situation (in the case of a tragic situation). Or, in the case of an everyday situation that attracted the attention of this age group, many of their peers felt identified and showed their support in the comments. Another type of comment observed was praise for the physical appearance of the content creators. This could be observed in both male and female videos, but to a greater extent in the latter.

The comments had different approaches, for example, when talking about physical aspects, people asked about exercise routines, while in relation to clothing, they asked about the store where these clothes were purchased. This highlights one of the central axes of the functioning of this social network, which could be characterized as the idealization of a physical appearance considered unattainable.

Within the negative comments, there were comments of criticism, questioning, uncertainty, sexualization of minors, bullying, advice and non-validated therapies, among others. Although these are a type of interaction allowed by the platform and users, since they are part of the right to freedom of expression of individuals, they often exceed the limits of respect and dignity of human beings (such as comments on weight and body image, manipulation of negative behaviors, mockery and denigration, among others) who, in turn, are exposed to this type of transgressions. Those who provoke such transgressions take refuge behind a screen, making it easier for this type of interaction to affect the self-esteem of those who create the content, thus becoming a health risk for adolescents.

It is important to point out that there are still no legal remedies to protect adolescents on social networks, let alone international agreements that can hold responsible and incriminate anyone who harasses or assaults a minor virtually.

Although in the analysis carried out, most of the comments were positive, this could have been manipulated by the creator of the video, who can delete comments that are not to his/her liking and even block other users. However, on the TikTok platform there is great exposure to cruel and denigrating comments, sexual harassment, dissemination of erroneous information, among others, which can have repercussions in different spheres of the health and lives of adolescents. 27

Health behaviors

For the category health behaviors, the codes health-promoting behaviors and non-health-promoting behaviors can be recognized. It should be noted that, due to the short duration of the videos, these behaviors could not be identified in all the audiovisual creations analyzed.

In the videos where health behaviors can be recognized, they were mainly found to be non-health promoting, visualizing risky actions such as the incorrect use of masks on public roads (in the context of a pandemic), unhealthy eating and the minimization of the seriousness of mental health disorders, among others. The latter could be related to the low-risk perception of adolescents. This phenomenon is associated with multiple factors, but among them, we could highlight the social pressure exerted by their peers and the image that adolescents have of their referents regarding health behaviors.

On the contrary, as health-promoting behaviors, it was only observed in one video, where an adolescent recounts how she had a good adherence to her psychological therapy despite the scarce family support she received, which reaffirms the progressive stigmatization of diseases associated with mental health and their treatments. 28


This study showed how adolescents construct their identity based on interactions in social networks, modifying their behavior in order to obtain recognition, popularity and the admiration of their peer group, which coincides with Rodado. 29 Continuing along these lines and as stated by Del Prete and Redón, it was observed that adolescents still yield to social standards, which have been modified and made more flexible in recent times, making stigmatized topics, such as mental health or suicide, much more visible. 9) However, it is worrying to see how, together with the greater visualization of such topics, their normalization and underestimation has increased, referring to them even with irony.

On the other hand, there is a limitation in social networks in not being able to clearly identify what they mean, this is due to the loss of valuable information such as facial expression and body language. However, the social network TikTok has transformed the way of communicating with other people, favoring immediate expressions through videos and leaving aside written messages, generating a more effective communication. 27 Additionally, the interaction given on this platform can only be partially controlled, since public profiles are open to any user, allowing them to decide who to interact with, but not who can interact with their videos, despite the possibility of deleting comments. This can also be related to what was mentioned above about popularity, since, by being able to access a large and varied audience, whoever creates the video will have more chances of going viral, giving popularity and recognition to the user.

Mazón, 30 in conjunction with what has been studied by Lara, 31 state that social networks have a direct impact on everyday real life, as they blur the boundary between what is considered the virtual world and the real world. This can affect the health of adolescents, mainly in their self-concept and self-image due to the overexploitation of beauty stereotypes and opinions about the way of being or one's own body. Although this was described by the authors mentioned above (Castells; 32 Del Prete & Redón; 9 Mazón;30 Lara 31) it is believed that this impact is currently accentuated due to the high number of hours that young people use these virtual platforms, so it is necessary to emphasize that beauty standards, especially female, are very present in TikTok. This constantly exposes and pressures this group to achieve an unrealistic image, as expressed by Salinas 33 in his study on other social networks. Thus, it can be corroborated that with the high frequency that young people use filters to alter their faces, how important it is for them to comply with body image standards.

On the other hand, the way of representing gender has been transformed over time, breaking with the stereotype of gender binarism and the social roles assigned to each one, distancing from what Gavilanes. 34 Although this has not yet occurred on a massive scale, many adolescents can now freely show their gender expression. Moreover, although there is still resistance and discrimination by their peers and society, today these hate speeches no longer go unpunished, but are strongly rejected by the majority, resulting in strong clashes of opinion on these platforms. 34


It should be mentioned some important milestones occurred in the collection of data, and the operation of the TikTok social network. Initially, in the search for videos that qualified for this research project, those audiovisuals that had all the inclusion criteria proposed in the theoretical framework were selected, so the description of age and nationality for each author of the content was sought in the TikTok profile. However, these data are the decision of the adolescents themselves to describe them or make them public, so it was difficult to find videos that met the proposed criteria, which is why the inclusion criterion of residence in Chile had to be eliminated.

During the analysis, we noticed the dynamism of the social networks, which allowed us to eliminate videos or classify them as private. This made it difficult to collect all the data in each unit of analysis, so that some only have a description of what was seen before being deleted. The same happens with the comments, within the functioning of the social network, users can decide to delete the publication of opinions, even in some videos there was never the option to express external ideas. In the same line, it is important to mention that some comments were in other languages, since TikTok uses algorithms that allow a video to be viewed anywhere in the world, however, the application does not have the possibility of translation, so only comments in Spanish or English were analyzed.

Another difficulty in the development of the analysis was the correct interpretation of the data, since the adolescents who use this network have language codes specific to their generation. Some of these are easier to understand, such as changing letters for numbers to describe obscene words so that the application does not delete the content. While, in others, there were situations or words that had a different meaning specific to this group and could not be interpreted without delving into the information they share generationally.

In short, thousands of teenagers enter social networks daily, exposing feelings, opinions, representations, and even their own identity. In this context we can find those who exhibit their private lives openly on such platforms, without elucidating the dangers this can have. An example of this are the videos of high sexual, sensual and flirtatious connotation, being the public videos what carry a greater risk of exposure of minors. It is important to mention that in these videos there is a high percentage of harassment by people who are twice or three times the age of the adolescents, which is illegal and can lead to both legal penalties for older people and psychological problems for minors. (35

On the other hand, adolescents are strongly influenced by peer acceptance in different social networks. This, together with the need to create an image based on these standards, has an impact on the health behaviors they acquire, i.e., adolescents often give in to social pressure and engage in risky health behaviors. 27 On the contrary, according to the Health Promotion Model, the probability that a person acquires a health-promoting behavior is greater when people who are important to him/her provide support and accompaniment during this process.36

In summary, social representations are fundamental to understand reality, which is consistent with what is expressed by Dittus. 37 The author understands how important it is to conduct studies in this area, which aligns with the objectives of the present research. His results highlight how adolescents, through certain behaviors, construct a representation of themselves on social networking platforms and, more specifically, on TikTok. In turn, it was important to pay attention to this dimension, given that from its analysis, it was possible to sustain conclusions that show the different states of health of these subjects. (37 In addition, this study made it possible to contemplate the variety of factors that shape and impact the health of young people. Based on this, it is possible to understand how these dynamics work, giving more tools to be able to manage more effectively comprehensive care, and to carry out updated techniques of counseling, accompaniment, education, among others. In the same way, it can provide a basis or be a complement to other research, as it could also be important in decision making on Public Policies, where this type of research considers their points of view, avoiding adult-centric resolutions.

Finally, we emphasize that this research is not only useful for the nursing profession but can also contribute to the foundations of other health sciences and social sciences.


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Authors’ participation: a) Conception and design of the work; b) Data acquisition; c) Analysis and interpretation of data; d) Writing of the manuscript; e) Critical review of the manuscript. J. L. C. has contributed in a, b, c, d, e; M. R. C. in d, e; D. C. P. in a, b, c, d, e; J. C. A. in a, b, c, d, e; M. G. A. in a, b, c, d, e; J. M. E. in a, b, c, d, e; V. M. M. in a, b, c, d, e.

How to cite:Leiva Castillo J, Rabanal Carrasco M, Cabrera Palma D, Canales Abarca J, Gormaz Aguirre M, Meza Espinoza J, et al. Social and health behaviors of adolescence represented in TikTok. Enfermería: Cuidados Humanizados. 2023;12(1):e3078. doi: 10.22235/ech.v12i1.3078

Scientific editor in charge:Dr. Natalie Figueredo

Received: October 12, 2022; Accepted: April 21, 2023

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