A mixed methods study examining the role of professional YouTubers in young people's health behaviours in the UK : implications for health interventions

YouTubers are popular among young people and produce plentiful health content. Research suggests YouTube health content varies in quality and social media health interventions remain scarce. However, popular media and public health organisations are increasingly recognising YouTubers' potential influence as a source of health information for young people. Little research has considered the nature of YouTuber content, young people's engagement or YouTubers' motives for producing it. This programme of research sought to examine the role professional YouTubers play in young people's health behaviours in the UK. The research adopted a four-stage mixed methods sequential design. A questionnaire with 13-18 year olds (n=931) provided a sampling frame for three qualitative studies. These were a netnographic analysis of health-related videos (n=133) from 7 UK YouTubers, 8 focus groups with 13-18 year olds (n=85) and semi-structured interviews with UK YouTubers (n=3). Participating young people were from one county in North West England. The findings confirm YouTubers are a recognised source of health information for young people. YouTubers produce content on a range of topics with numerous perceived benefits. A successful trait is YouTubers' ability to foster a sense of community; this familiarity and trust allows them to endorse health-related products or behaviours. YouTubers were thus viewed as role models by young viewers. Several complexities of YouTuber health content production were also highlighted. Young people and YouTubers were concerned giving advice beyond their expertise could lead to misdiagnosis, triggering or worsening of health conditions. There was an inherent tension between self-promotion and health promotion with YouTubers reluctant to expose themselves to criticism, compromise their brand and authenticity or engage in self-regulatory practices. The distinction between commercial, NHS or charity sponsored, and unsponsored content and sponsor intentions (health promotion or commercial) were not always clear. The impact of YouTuber health content is therefore dependent on young people's critical literacy skills, which increased with age. Overall, the research confirms YouTubers' considerable potential to contribute to young people's health improvement interventions, but successful interventions must consider factors that affect young people's engagement and YouTubers' production of health content.