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Abstract

Introduction: To date, there is much controversy in the literature on the impacts of social media use on young women’s health and wellbeing. Alongside the massive popularity of platforms like Instagram and TikTok, the social media culture has become a key mediator of social discourses on health, femininities, bodies, and identities. In contemporary Western societies, the individual pursuit of health is highly valued, related to contemporary forms of governance that emphasize self-regulation, individual responsibility, and individual choice. Furthermore, postfeminist discourses strongly encourage women to engage in constant work on their body, health, and identity. In this context, it is imperative to understand how the contemporary social media culture relates to young women’s health, body, and sense of self. Aims: The overall aim of this study is to understand the role of a new social media culture on narrative constructions of a sense of self among young women in late adolescence, aged 18–20 years old, and, particularly the ways in which such narrative identities relate to experiences and practices involving health and wellbeing. Methods: In this 3-year research we adopt a social constructionist approach in critical health psychology focused on socio-culturally situated practices and meanings involved in the construction of human experience. We adopt a qualitative research approach - consisting of in-depth interviews, focus groups and photo elicitation techniques - with people self-identifying as women. Data analysis will employ both narrative and reflexive thematic analysis. Ethics and dissemination: The study protocol was approved by the Ethics Committee of the University of Lausanne. Findings will be published in scientific journals, presented at meetings, and will serve for public health and educational purposes. Content in form of flyers and posts will be designed to communicate findings to participants via current social media platforms.

Keywords

critical health psychology young women social media narrative identities social practices postfeminism

Introduction

Social media platforms have become an integrative part of young people’s lives, alongside the massive expansion of smartphone devices, which allow them to be connected to the Internet and potentially available 24/7. Instagram, WhatsApp and Snapchat have become the most popular social media platforms among young people (Bernath et al., 2020; Berrios, 2020), and are used by 99% of those aged 14 to 19 in Switzerland (Latzer et al., 2019). This phenomenon has been accentuated in the context of the sanitary crisis related to COVID-19, as social media meant a way to remain connected with others, especially with peers (Widnall et al., 2020).

Having become the new norm, social media use is deeply transforming the process of identity formation (Twenge, 2017), a major purpose in the transition to adulthood, as young people develop an independence of self (Van Petegem et al., 2012). The dynamics involved in identity formation are defined by a complex dialectic between the self (agency) and the sociocultural realm (peers, family, community, and society), and are strongly connected to the relationship to the body (Erikson, 1968; Kling et al., 2018). As a developmental task, identity formation provides the foundation for a general sense of well-being (Erikson, 1968).

The contemporary social media culture contributes to the dissemination of ideals of health, wellbeing, body and identity, and thus plays an important role in shaping young women’s experiences and practices in those domains (Prichard et al., 2018). Having grown into important channels of postfeminist sensibilities (Gill, 2007), lifestyle-related content in social media tends to encourage young women to engage in specific practices of constant ‘work’ upon themselves and their body, alongside the promise to ‘improve’, ‘develop’, even ‘transform’ their identity, health, and body (Bishop, 2018; Riley et al., 2018; Strübel et al., 2016). In that sense, postfeminist discourses implicitly infer that women are not ‘good enough’ just the way they are, and are likely to trigger guilt and bodily dissatisfaction among female social media users who fail to meet the standards promoted by these channels (Riley et al., 2018; Strübel et al., 2016). Regarding health-related content, professional YouTubers disseminate discourses and practices about eating, exercising, and resting, all aiming to achieve health and happiness (del Rio Carral et al., 2021), contributing to reinforce postfeminism ideas, as well as the societal logics of healthism (Crawford, 1980).

Although the role of social media use in identity formation constitutes a major topic in the literature, to date, scarce research analyses how this social media culture relates to identity formation in terms of meanings attached to social media and health-related practices among young women. Furthermore, there is little literature on the role of narrative identities in relation to an unprecedented social media culture which heightens postfeminist discourses on female identity, body, and health. While existing studies on identity formation and narratives do not reflect on potential implications for health and wellbeing among young women (Marôpo et al., 2020; Pérez-Torres et al., 2018), those that investigate health risks and benefits do not integrate a narrative approach.

What prevails in the literature is a strong polarization, defined by extensive yet fragmented evidence (Best et al., 2014), in which two main perspectives can be identified (Allen et al., 2014). According to the first perspective, social media use enhances a feeling of belonging and interconnectedness during identity formation. These platforms enabled an unprecedented participation culture among users (Burgess et al., 2016; Potts et al., 2008). In fact, many young people use social media to participate in political movements (Kahne et al., 2014) and may find online community support at anytime and anyplace (Meng et al., 2016). Further, social media use can help develop a sense of self by enabling spaces for self-expression and creativity (Boyd, 2014). On the other hand, a second perspective emphasizes that social media use may have a negative impact on identity formation. Highly popular social media practices among youth involve different forms of self-presentation, for example through the taking and sharing of selfies (Mills et al., 2018), which has been shown to increase anxiety and enhance feelings of physical unattractiveness among young women (Tiggemann et al., 2020). Also, social media consumption can fuel a tendency to compare oneself socially when exposed to celebrity and peer images, alongside an increased body dissatisfaction and negative mood (Brown & Tiggemann, 2016; Tiggemann & Zaccardo, 2015; Tiggemann & Slater, 2013). Consuming images of female influencers may also reinforce the intention to engage in specific health behaviors, such as dieting, associated to a personal negative body image (Jin et al., 2018). According to Rodgers et al. (2015), the internalization of media ideals through images consumed in social media platforms is responsible for enhancing body dissatisfaction among certain young women. Moreover, young women tend to over-evaluate the weight and shape of their body when comparing themselves to social media ideals (McLean et al., 2015). This mechanism increases vulnerability with regard to risk behaviors engaging the body, such as dietary restraints and eating disorders (McLean et al., 2015). Interestingly, displaying disclaimer labels on idealized images posted in social media may be ineffective at reducing body dissatisfaction among female populations (Fardouly & Holland, 2018).

While these two dominant perspectives converge in showing that social media practices have major health and wellbeing consequences for identity formation, both positive and negative, this polarization in the literature reveals a scarcity of studies that explore how young women make sense of their practices and identities within broader social discourses enhanced by social media culture. Among the few exceptions, Dobson (2014, 2016) explores digital representations of the self among girls and young women drawing on social media practices with a focus on gender. In her work, she presents these populations as active producers of the postfeminist logics. In such productions, their body and self are displayed according to sexualized and ‘shameless’ femininities. Such versions of the female self and body oppose to traditionally passive and ‘humble’ femininities. In this context, young women actively reinterpret their position as subjects rather than ‘objects’ of other people’s gaze, by means of freedom of choice (Dobson, 2016). Conversely, young women can also resist to such postfeminist logics through different forms of agency that counter these ideals of ‘over-sexualized’ bodies and selves (Retallack et al., 2016). Both forms of female agency are in constant tension; however, in both cases, women are encouraged to commit to different versions of self-improvement (Gill, 2016).

To date, there are scarce studies in Switzerland that focus on gender and social media use in late adolescence. A recent survey points out that the main motivations underpinning young people’s use of the Internet include staying in touch with others, looking for school-related information, and as a hobby (Heeg & Steiner, 2019). Another one highlights the popularity of Instagram, TikTok, and Snapchat among younger generations in general (16–25 years old) (Heeg & Steiner, 2019; Suter et al., 2018). However, to our knowledge, there is a lack of information on young women’s social media practices in particular.

Understanding social media as strongly ambivalent channels (Allen et al., 2014), we agree with Boyd (2014) on the need to overcome polarized approaches frequently found in studies on this subject, by adopting a more nuanced and context-aware approach. To do so and building on our previous research (del Rio Carral et al., 2021; del Río Carral et al., 2022) we designed a research project entitled “Navigating through a postfeminist social media culture: Young women’s experiences of health and wellbeing – MeStories Study”. This study aims to understand the role of a new social media culture on narrative constructions of a sense of self among young women in late adolescence (Meeus, 2018), aged 18 to 20, and, particularly, the ways in which such narrative identities relate to experiences and practices involving the self, the body, and health.

Methods

Theoretical Framework

Adopting a critical perspective in health psychology, this study embraces social media practices as complex, new hybrid forms of activity which are gendered, and linked to other health behaviors in everyday life.

Our framework is underpinned by a social constructionist perspective (Burr, 2015), according to which narratives are a major psychological instrument that enables individuals to make sense of the world, others, and themselves (Murray, 2017; Vygotski, 1997). These narratives are deeply socio-culturally embedded (del Rio Carral & Lyons, 2020; Lyons & Chamberlain, 2006). According to our perspective, health is defined as a state of well-being that includes the satisfaction of physical, cultural, psychosocial, economic and spiritual needs (Marks et al., 2018). Therefore, health and wellbeing are deeply intertwined with identity (Riley et al., 2018).

We will mobilize three main theoretical concepts. The first one is that of social practices, according to which our behaviors are embedded in concrete spaces and places, being shared and understood within a given community. Social practices are embodied by individuals in everyday life, guided by socio-culturally constructed meanings that orient their behavior (Kelly & Barker, 2016; Shove & Warde, 2002). Although partly predetermined, social practices are also dynamic, non-reflexive, and not completely rational (Giddens, 1984). Given its twofold understanding, the concept of social practices allow us to think about health and wellbeing in contextualized ways (Kelly & Barker, 2016). For instance, practices in which young women may engage in can be seen as ‘unhealthy’ from a scientific point of view (e.g., binge drinking). However, from a social practice theory standpoint, we can analyze such practices in terms of their personal meaning (e.g., releasing the body and emotions when drinking, belonging to a particular group culture). Thus, this framework allows us to consider feelings and how they are intertwined with subjective interpretations that affect why, where, with whom, and how people act (Kelly & Barker, 2016).

The second concept is narrative identity, understood as a lifelong changing process through which people make sense of themselves, their lives, and others (Habermas & Bluck, 2000). According to McAdams (2011), human beings create their own selective life story or autobiography to address the issue of identity. The engagement to construct an overarching meaning to life starts during late adolescence (McLean & Syed, 2015). Narrative identity constitutes a fundamental pillar to health and wellbeing (McAdams & McLean, 2013; Murray, 2017). As storytellers, individuals are able to position themselves as agents by constructing meanings regarding their life (Murray, 2017). This process may be healing to individuals when facing adversity and suffering, by helping them to develop new stories that can frame differently the links that connect their experience to new possibilities of being, feeling, and acting (McAdams & McLean, 2013).

Finally, the concept of postfeminism refers to recent sociocultural trends or ‘sensibilities’ specific to advanced capitalist societies (Winch, 2015). Postfeminism is organized by expectations and values on female identities and female bodies that emphasize individual choice and individual work upon the self and the body following a logic of self-improvement (Gill, 2007). Thus, it highly values self-surveillance among women (Elias & Gill, 2018). These sensibilities have been associated with the highly valued pursuit of health and wellbeing in our Western societies (Riley et al., 2018). Combined with ‘healthism’ (Crawford, 1980), postfeminism reinforces ideals on women’s bodies, health and identities and encourages women to engage in behaviors aimed at improving their self, health, and body (Riley et al., 2018). With the expansion of a social media culture involving interactive platforms and real-time marketing affordances, postfeminist discourses seem enhanced. This is partly due to the rise of influencers (Bishop, 2018), who seem to have become producers of postfeminist discourses by providing young women advice on how to become better persons through specific identities and body work.

Study Design

This study will take place in Switzerland and neighboring France¹ between September 2021 and September 2024.

We adopt a qualitative methodology in critical health psychology (Lyons & Chamberlain, 2006; Marks et al., 2018), which allows the analysis of changing, uncertain phenomena (Willig & Stainton-Rogers, 2008), and is well-suited to develop interventions from the recipient’s perspective to move towards sustainable practices in the fields of public health and health promotion (Chamberlain & Lyons, 2020; Lyons & Chamberlain, 2017). Employing a qualitative research approach will also allow us to study experiences crafted through narratives on social media practices, the body, and the self.

We are also guided by the scientific recommendations from Levitt et al. (2017) on methodological integrity in qualitative research in psychology, namely the need to ensure fidelity and utility of the methodological procedures to the phenomenon under investigation

Study Population

We will target a population of young women living in Switzerland, aged from 18 to 20 years-old, an age range that is of particular interest in relation to the construction of narrative identities (McAdams, 2011).

Inclusion criteria are being 18–20 years old; identifying as a woman; living in Switzerland or neighboring France; speaking French or English; and being a regular social media user (at least 1 hour per day, various days a week).

The recruitment is conducted through an array of means, aiming to constitute a sample that takes into consideration different life situations that will allow for a heterogeneous sample in terms of socioeconomic background, ethnicity, and region (rural vs. urban). Recruitment techniques include intervention in high-school classes as well as undergraduate courses; distribution of information flyers in rural and urban public spaces (e.g., coffee shops, train stations, public libraries, etc.); and posts on social media channels (e.g., Instagram).

Data Collection

Data is currently ongoing and is planned to be finished by April 2023.

Considering that a total of 12–20 interviews is deemed to be sufficient to meet saturation and diversification criteria in qualitative research (Guest et al., 2006), a total of 40 individual interviews and three focus groups will be used to collect data, divided according to the study’s specific aims, as presented in Table 1.

Table 1.

The MeStories Study Specific Aims and Data Collection Techniques.

Specific Aim	Rationale	Data Collection Technique	Data Collection Approach
1. To analyze social media and health-related practices in everyday life contexts.	This will enable us to investigate social media and health practices as contextualized and embodied entities (del Rio Carral & Lyons, 2020), taking into account the socially-shared patterns of behavior (del Rio Carral & Lyons, 2020).	In-person in-depth interviews (n = 20)	Data collection will map detailed information about everyday life practices (del Rio Carral, 2014; del Rio Carral & Lyons, 2020), by translating the ‘know how’, and taken for granted, dimension of activity into discursive data or ‘say how’ (del Rio Carral, 2014). The interviews will cover detailed accounts on contextualized everyday behaviors produced by each participant, as well as meanings and feelings attached to them. The interview guide will be structured in two parts: 1. Following the chronological order of a concrete already performed day; and 2. Employing a reflexive approach to social media practices in everyday life.
2. To investigate how narrative identities are constructed with regard to social media practices and how these stories may orient meanings and behavior concerning the body, health and wellbeing (McAdams, 2011).	This will allow us to explore the meaning-making in relation to identity formation by encouraging reflexivity on social media experiences and practices.	In-person narrative interviews combined with photo eliciting (n = 20)	Narrative interviews enable participants to engage in a process of narrative construction upon the self (Murray, 2017) and stimulate reflexivity with regard to particular life events. Complementarily, photo eliciting is a methodological technique used to favor self-expression and collaborative dialogue between researchers and participants (Gube, 2022). Participants will be invited to reflect on how social media practices of ‘production’ and ‘consumption’ are constructed regarding their own sense of identity, health, and wellbeing. The interview will take place in three parts, during the same session: a) Creating a life line (Brott, 2004) that includes life turning points and markers for when the participant started using social media platforms; b) A social media tour (Breen et al., 2021) exploring content that the participant shares and consumes on social media and relating online experience to life events from the past, present and future; c) A reflexive approach to investigate how participants relate their social media use to their health, body and sense of self
3. To explore social discourses underpinning the contemporary social media culture through a collective analysis of dominant social discourses promoted by influencers (e.g., postfeminism, healthism).	Based on results from the two previous aims, this specific aim will contribute to capturing how postfeminist discourses on female health, bodies, and identities may structure beliefs and attitudes among young women.	3 focus groups (5–7 participants each), combined with photo eliciting	Focus groups are useful to explore culturally dominant values (Kitzinger, 1995) and shared or unshared beliefs and attitudes regarding a common subject (Seal et al., 1999). Based on the in-depth interviews, we will select images (videos and/or photos) that were most meaningful and typical of participants accounts. These images will be discussed collectively in focus groups, using a post-feminist lens. Each focus group will take place in two parts during the same interview session, divided as follows: a) Presenting to participants videos/images with postfeminist content published by influencers and inviting them to discuss what these impressions make them think about and how do they make them feel; and b) Introducing theory bits on postfeminism - with concepts such as self-surveillance, choice, individualism, or self-sexualisation (Riley et al., 2018; Gill, 2017) - and inviting participants to discuss each video/image within this framework (Thorburn et al., 2021).

The complete interview and focus group guides are presented as supplemental material.

All interviews and focus groups will be audio recorded and the content will be transcribed verbatim.

Data Analysis

Specific data analysis procedures will be applied to respond to each of the specific aims.

For specific aim 1, focused on social media and health-related practices, we will conduct a reflexive thematic analysis on verbatim transcriptions of the interviews (Braun & Clarke, 2006, 2019; Clarke & Braun, 2013). Main themes characterizing how participants talked about their own social media practices will be coded. Key analytical stages are becoming familiar with the data, defining initial codes, looking for themes, revising themes, defining themes, and producing the final outputs.

For specific aim 2, focused on narrative identities, a narrative-based analysis will be conducted upon the verbatim transcriptions of the individual interviews. This analysis will integrate how participants talked about the visual posts, videos or images they chose to describe their experience of social media production and consumption. Each life episode will be analyzed as a ‘story’ (Murray, 2017) as follows: first, we will identify three main sections, a beginning, a middle and an end (Murray, 2017). Second, the content (main themes) of each section will be described, following a thematic content analysis (Clarke & Braun, 2013). The analysis will then consider three discursive dimensions, following Murray (2017): a) a personal dimension relating to the tone of the narrative (e.g. pessimistic, satire, etc.); b) an interpersonal dimension that take into account the interview context (narrator telling a story to the researcher, throughout different positionalities) (e.g. self-responsible, empowered, etc.), and c) a socio-cultural dimension embracing broader social discourses (ex. postfeminism). These discursive dimensions will be articulated.

Finally, for specific aim 3, focused on postfeminist discourses, we will conduct a reflexive thematic analysis on verbatim transcriptions of the three focus groups (Braun & Clarke, 2006; Braun & Clark, 2019; Clarke & Braun, 2013). We will identify main themes characterizing socially shared perceptions of participants about the presented videos/images, how they refer it to their own social media experiences, as well as norms, attitudes and experiences that are commonly shared or discordant between participants. The same key steps listed for objective one will be followed.

Disagreements on the analytical procedures or interpretation of findings will be discussed within the research team to reach a consensus. With respect to the thematic analysis, these adjustments may imply the modification of certain themes or subthemes to ultimately build a common thematic structure. Regarding the narrative analysis, we will adapt potential differences regarding the interpretation and classification of narrative plots, logics, tones, and dimensions.

Ethics and Dissemination

The study protocol was approved by the Institutional Review Board of the University of Lausanne, under the number C_SSP_112,021_00,011.

Before the interview or the focus group takes place, each participant will be informed about the aims of the study and their rights. The researcher will read an informed consent form with the participants, answer their questions, and then invite them to sign the consent form. In line with ethical principles and best practices in qualitative research in psychology, participants can refuse to answer any questions that they are not comfortable with, as well as to leave the study at any time. They will also be informed about this possibility in the information sheet prior to the project engagement. No consequences of any sort will result from study withdrawal.

In addition, the study is followed by scientific committee formed by experts in youth and adolescence studies, critical health psychology, and postfeminism. These experts were consulted during the development of the study protocol and continue to advise the study team in key aspects, such as the definition of recruitment strategies and development of interview guides. They will also be invited to participate in data analysis and publications.

The dissemination of results will be assured by the presentation in international conferences (such as those organized by the European Society for Health Psychology - EPHS, and the International Society for Critical Health Psychology - ISCHP) and scientific journals. At least five publications will be submitted to peer reviewed journals, including open access ones.

Aiming to communicate the results to a broader audience, we will discuss with participants and the scientific board strategies for scientific vulgarization, including the creation of flyers and posts to be shared online. Moreover, we will offer to present the study’s outcomes to key institutions and non-public associations that work towards the protection, health, and wellbeing of young people in Switzerland, such as the Plateforme National Jeunes et Medias, Office Fédéral des Assurances Sociales (OFAS), ciao.ch, Action Innocence, and La Brigade des Mineurs. Dissemination of recommendations in schools and higher education institutions will be facilitated by members of our scientific committee.

Discussion

This study will contribute to a deeper understanding of a key contemporary issue, that is the role played by social media culture in identity formation among young women and the major challenges raised by this issue in relation to health and wellbeing.

From a scientific point of view, it will fill in gaps in the literature. First, this research will provide knowledge on contextualized ways in which young women engage in social media and on meanings that craft their health behaviors regarding social media use. Second, it will provide knowledge on the role upon female narrative identities of an unprecedented social media culture in our Western societies that seems to reinforce postfeminist definitions of the female body, health, and identity. Third, this study will consider young women as agents through their ability to construct life stories that may be participating to the transformation of this new social culture through alternative narratives and practices on the self, body, and health. Such counternarratives will be important to further develop knowledge on health promotion among this population. Last, this project will provide crucial information on the role played by influencers’ productions as key agents of a new social media culture, among young women. This knowledge will be important to further define potential benefits and risks to young women’s health and wellbeing based on the articulation of findings from our three studies.

At a broader, societal level, our research will provide nuanced and contextualized guidelines for social media practices among young women within a Swiss context. The study’s outcomes may contribute to raise awareness among young women generations of specific risks of social media use, but also benefits for their health and wellbeing. They can also be a key reference for policy makers, as well as for stakeholders as it will consider, for the first time, the part of postfeminist discourses in the new social media culture and its relations with young women’s social media practices in Switzerland. Institutional actors can be therefore able to rely on the insights of this study when designing and planning public health and education programs and policies.

Supplemental Material

Supplemental Material - Young Women’s Experiences of Health and Well-Being in a Postfeminist Social Media Culture: The MeStories Study Protocol

Supplemental Material for Young Women’s Experiences of Health and Well-Being in a Postfeminist Social Media Culture: The MeStories Study Protocol by Dulce Ferraz, Rabel, E. J, Franzoni, A, Del Rio Carral. M in International Journal of Qualitative Methods

Footnotes

Acknowledgments

We would like to thank all colleagues who have collaborated to the development of this study proposal, in particular the members of the MeStories scientific committee: Prof. Dr Grégoire Zimmermann, associate professor of child and youth psychology, University of Lausanne, Switzerland; Prof. Dr Antonia Lyons, Professor of health psychology, Victoria University of Wellington, New Zealand, Prof. Dr Heidi Gautschi, Professor/trainer in digital & media literacy, High School of Education (HEP) Vaud, Switzerland; Prof. Carlo Fabian, Head of the Institute Social Work and Health, FHNW School of Social Work, Switzerland. We thank also the Fond National Suisse (FNS) for funding the study.

Authors’ Contributions

DF wrote the first draft of this manuscript, based on the project originally written by MRC. EJR and AF contributed to the writing of specific topics and, along with MRC, revised the entire manuscript.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is supported by the Fond National Suisse (FNS) (Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung), grant number 10001F_201142/1.

ORCID iDs

Dulce Ferraz

Eileen J. Rabel

Maria Del Rio Carral

Supplemental Material

Supplemental material for this article is available online.

Note

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