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Abstract

Introduction/Objectives:

Adolescents frequently encounter online health information (OHI). We aimed to synthesize clinician recommendations for engaging adolescents about OHI during clinical encounters.

Methods:

United States clinicians with expertise in adolescent sexual and reproductive health (SRH) participated in virtual semi-structured interviews. Transcripts were analyzed using rapid qualitative methods to generate descriptive themes.

Results:

Twenty-four clinicians from all U.S. regions participated. Participants emphasized the importance of addressing OHI given its accessibility, ubiquity, broad topical relevance (eg, SRH, nutrition, vaccines), and variable health impacts (ie, positive and negative). Clinicians described 4 entry points for discussion: patient initiation, screening, topic-specific conversations, and resource provision. They suggested strategies to build digital literacy (eg, assessing content creator motivations) and health literacy (eg, contextualizing population risks without dismissing personal anecdotes). Communication approaches included acknowledging partial truths before providing medical context and avoiding blanket dismissal of online content. Clinicians advised against directly labeling patients’ claims as “misinformation,” recommending instead more neutral, patient-friendly language.

Conclusions:

As clinicians increasingly navigate OHI in practice, these expert recommendations can help support digital and health literacy while fostering trust and improving adolescent–clinician communication.

Keywords

social media misinformation adolescents communication online health information

Introduction

Adolescents often access health information online. Over 80% of United States (U.S.) adolescents have looked online for health information (OHI),¹ often on social media.^2,3 In addition to active seeking, many also encounter OHI passively.^2,4 Engagement in active search may depend on factors such as health status, marginalized identity, or sensitivity of topics like sexual and reproductive health (SRH).^5-7 Despite concerns about misinformation (“unintentionally inaccurate information”),⁸ disinformation (“intentionally inaccurate information”),⁸ and other negative influences such as online safety risks,⁹ OHI has benefits such as improving knowledge about sensitive information (eg, SRH content not taught in schools)^10,11 and promoting emerging autonomy.¹² For the purposes of this study, we use the broader term OHI to encompass the range of online health content adolescents encounter, including both accurate and inaccurate information.

Navigating OHI poses challenges for adolescents, particularly assessing accuracy and relevance.^5,12,13-15 Clinicians remain trusted sources, and patient-sourced OHI increasingly influences clinical care.^16,17 Discussing OHI can strengthen trust and collaboration, but may also cause tension if clinicians dismiss patients’ beliefs about OHI.^18,19 Currently, no synthesized guidance exists on how clinicians can best approach these conversations with adolescents. While some studies have focused on clinician-patient communication about OHI in the context of adult populations with life-threatening conditions,^20,21 to our knowledge no studies have examined clinician communication strategies for discussing OHI with adolescents during routine care.

SRH represents a particularly salient context for OHI given the wide-ranging accuracy of content online^22,23 and adolescents’ reliance on digital sources for information not readily available elsewhere.^10,11,24,25 Communication strategies developed for value-sensitive topics are generalizable to other areas of health, especially since effective discussions about sensitive topics have positive global effects on adolescent-clinician relationships.²⁶ Thus our objective was to qualitatively summarize recommendations from adolescent SRH clinical experts on how clinicians can effectively discuss OHI with adolescents.

Methods

Study Design

We conducted a descriptive qualitative analysis²⁷ of semi-structured interview data following SQRQ reporting guidelines (Supplemental Appendix A).²⁸

Participants and Recruitment

Eligible clinicians (MD/DO, NP, PA) had self-identified expertise in adolescent SRH, treated patients in the U.S., and for physicians, had completed residency. A convenience sample was recruited via national listservs focused on adolescent care and SRH, an approach selected for its feasibility. Participants were compensated with a $50 gift card for their time.

Interview Guide

The guide was adapted from a prior clinician interview study on communication strategies²⁰ (Supplemental Appendix B). It consisted of fifteen questions and accompanying probes; domains included beliefs, practices, counseling recommendations, challenges, and considerations beyond the clinical encounter. The guide was reviewed by experts, refined through mock interviews, and iteratively adjusted. Though initially SRH-focused, the guide was iteratively broadened to encompass other health topics raised by participants.

Data Collection and Processing

Interviews were conducted virtually over Zoom by CS. Before interviews, participants completed a demographics survey that confirmed expertise in adolescent SRH clinical care and assessed self-reported skills in pediatric digital wellness and communication about OHI. Interviews averaged 47 min (range: 31-63 min). Recordings were transcribed, cleaned, and lightly edited for grammar. Transcripts were analyzed shortly after collection, continuing until saturation, defined as no new themes after 3 interviews.

Qualitative Analysis

Rapid qualitative analysis, an approach appropriate applied topics²⁹ that has been shown to generate findings comparable to traditional thematic analysis while being less resource-intensive,³⁰ was used to identify themes. CS, a researcher with over 10 years of qualitative experience, led analysis using the matrix method.^31,32 An Excel spreadsheet displayed major domains on separate tabs (eg, beliefs, recommendations), with columns for specific categories (eg, “concerns about OHI”). Transcript data were sorted into the most fitting column, with notations for emergent cross-column themes. Column summaries were updated after each transcript and were used to document emergent themes and subthemes. SR reviewed all recordings and verified data sorting; discrepancies were resolved by discussion. The core team (CS, SR, LF, BAA) iteratively reviewed final matrices, themes, subthemes, and illustrative quotations to support interpretation, prompting resorting of data until results were finalized. Extensive quotation tables with additional data are provided in the supplement for transparency (Appendices C-E). Participants were given the option to provide written feedback on preliminary results as a form of member-checking.³³

Reflexivity

The research team consisted of physicians, researchers, and physicians-in-training who believe that OHI offers opportunities and challenges for patient care.

Ethics Approval

The University of North Carolina at Chapel Hill IRB designated this study as Exempt (#24-2060). All participants provided written informed consent through an electronic survey.

Results

Participant Characteristics

Characteristics for 24 participants are shown in Table 1. Most were physicians (83%) trained in pediatrics (71%). Among family medicine or pediatric physicians (n = 16), 94% had adolescent medicine fellowship training. Most identified as cisgender women (79%), white (75%), and worked in academic settings (83%). Participants represented all U.S. regions. Over 70% used social media at least daily.

Table 1.

Participant Characteristics.

Characteristic	n/%^a
Characteristic	N = 24
Gender
Cisgender man	5 (21%)
Cisgender woman	19 (79%)
Age
Mean (SD)	41.5 (8.9)
Missing	2
Race and ethnicity^b
Asian	1 (4%)
Black/African American	2 (8%)
Hispanic/Latine	4 (17%)
White	18 (75%)
Other identities not listed	2 (8%)
Sexual orientation
LGBQ+	5 (21%)
Heterosexual or straight	19 (79%)
Clinical role
Nurse Practitioner (NP) or Midwife (MSN)	4 (17%)
Physician (MD/DO)	20 (83%)
Specialty
Family medicine	3 (13%)
OB/Gyn^c	4 (17%)
Pediatrics or med-peds	17 (71%)
Adolescent medicine fellowship (MD/DO only, excluding OB/Gyns, n=17)	16 (94%)
Years of practice since completing residency
Mean (SD)	10.5 (9.3)
Median [min, max]	3, 37
Region
Midwest	7 (29%)
Northeast	8 (33%)
South or Southeast	4 (17%)
West	5 (21%)
Practice type
Academic medical center	20 (83%)
Community setting^d	5 (21%)
Other	1 (4%)
Hours/week of clinical care
Less than 10 h	6 (25%)
10-20 h	6 (25%)
21-30 h	5 (21%)
More than 30 h	7 (29%)
Number of teen patients seen a week
Fewer than 5	4 (17%)
6-10	4 (17%)
11-15	2 (8%)
More than 16	14 (58%)
Personal social media use
Multiple times a day	9 (38%)
Daily	8 (33%)
Multiple times a week	3 (13%)
Weekly	2 (8%)
Never	2 (8%)
Self-categorized expertise
Adolescent sexual and reproductive health	24 (100%)
Patient-centered communication about online health information	8 (33%)
Pediatric digital wellness	7 (29%)

Percentages may not add to 100 due to rounding or because of multiple-selection answers.

Participants were asked in a single question to select the racial and ethnic identities with which they identify.

Sub-specialties included pediatric and adolescent gynecology and complex family planning.

Includes school-based health centers.

All participants identified as experts in adolescent SRH. One-third also reported expertise in communication about OHI, and 29% in pediatric digital wellness. While all were highly comfortable discussing SRH with teens, they were slightly less comfortable discussing online SRH content, with a few outliers at both extremes. Comfort was shaped by personal social media use, parenting teens, familiarity with common OHI, and knowledge of trustworthy alternative health resources.

No participants had formal training in discussing OHI with patients. However, many cited related experience, including media training, health literacy research, academic talks, or instruction in screen time and digital mental health. A few had training in digital content creation. Several—mostly senior fellows or recent graduates—had led didactic sessions on adolescent-relevant social media content.

Why It Is Important to Discuss OHI With Adolescents

Participants discussed the importance of OHI, its unique nature, concerns and benefits, and the consequences of not addressing it (Figure 1). They widely viewed understanding adolescent OHI exposure as essential to modern care.

Figure 1.

Common clinician beliefs about online health information.^a This figure demonstrates common clinician beliefs related to the importance of online information, its unique characteristics relative to other forms of health information, its broad topical relevance, concerns and benefits, and the consequences of not discussing it in clinical encounters. Additional context for each category of beliefs and illustrative quotes are also included in the figure.

They also reflected on how digital media is reshaping the world in medicine and in their personal lives. All recognized the internet as distinct from traditional information sources, citing its accessibility, low posting barriers, lack of verification, rapid dissemination, algorithmic amplification of extreme content, mixed creator motivations, constant and often passive exposure, and vast individualized content. Participant 3 explained:

Phones are really just becoming an extension of who we are, and even more so with AI . . . Opinions are being stated as facts quite regularly . . . I think [that] is something that even adults struggle with, to discern that objective truth. An adolescent is . . . ripe to see misinformation and to consider it to be truthful, and I think it’s up to us as healthcare providers to be one step ahead.

Although clinicians expressed concerns about misinformation, some noted this is not exclusive to the internet and emphasized that OHI can be accurate. They also raised concerns about lack of context (eg, other sources of medical knowledge) and exposure to explicit or harmful material.

Potential benefits included convenience, privacy, engaging formats, and availability of sensitive health information, which increased equity for adolescents without easy access to clinicians. Participants highlighted opportunities for youth to find representation, community, and empowerment, such as Participant 10:

It may give them the confidence or the vocabulary to come and have a discussion . . . [and] help them understand what other people are experiencing around them . . . I mean, there was no place to go except . . . the public library when I was growing up . . . And now it’s much more accessible.

The main SRH topics that clinicians believed were influenced by OHI included contraception, human papillomavirus vaccination, polycystic ovary syndrome, relationship/sexual safety, sexually transmitted infections, and vaginal/vulvar health. Other frequently mentioned topics included nutrition, gender-affirming care, body image, eating disorders, dermatologic concerns, mental health, substance use, and vaccines. Participant 11 explained:

This has the ability to impact every patient encounter I have . . . it comes up with substance use, and it comes up with mental health, and it comes up with everything that a teenager is going through.

Not asking about OHI was often seen as a “missed opportunity.” Participants noted potential harm to the patient-clinician relationship due to not recognizing the power of the digital world on adolescents, missed chances to correct misinformation or offer alternative credible sources, and risks of negative clinical outcomes if teens felt uncomfortable disclosing influential online content, as described by Participant 8:

If we’re not discussing it, we’re missing a huge elephant in the room of what’s shaping behaviors and decisions. By asking about it, you’re normalizing it. You’re inviting the teen into the conversation, and they might otherwise feel like you might judge them for something that they heard on TikTok.

Recommendations for When to Integrate Discussion During a Visit

Clinicians recommended multiple ways to integrate discussions about OHI into clinical encounters. One noted it could happen “a little bit everywhere” (Figure 2; Supplemental Appendix C), with other clinicians recommending integration during (1) patient-initiated conversations, (2) routine screening, (3) responses to specific concerns, and/or (4) provision of outside health resources.

Figure 2.

Recommendations for when to integrate discussion of online health information into clinical encounters.^a

While some participants supported screening for OHI exposure, others considered asking about this as a “next-level question” (Participant 22) that may not be feasible in routine visits, expanded upon by Participant 21:

Thinking of the busy pediatrician . . . screening for depression and anxiety, and then eating disorders and substance use and sexual activity . . . and sleep hygiene. They’re probably talking about social media, not specifically how it relates to information . . . There’s so many things we need to screen for but there’s not enough time.

If not initiated by the patient, most participants found it easiest to discuss OHI in response to specific health topics. Once a topic was identified, some asked broadly about knowledge and information sources without probing about OHI, whereas others recommended directly asking. Participant 9 shared a strategy to normalize the topic:

Instead of asking, “Do you use social media . . . to get information?” I just say, “What are the social media people or websites that you get information from?” . . . It makes them feel it’s pretty normal to do that, and they can feel open about sharing what it is that they’re seeing.

Responding to patient hesitation was another common prompt. For example, if a patient hesitated about a treatment and the clinician was aware of popular online content (eg, concerns about medroxyprogesterone acetate and meningiomas), they would ask how that OHI influenced their thinking and decision-making.

Clinicians used resource provision to facilitate discussion about OHI quality, and some described pulling up materials to review together. Resource provision was used by almost all clinicians, even if they did not have time to address digital and media literacy more broadly, as explained by Participant 19:

I don’t always talk about sources and the quality. I try to refer like, “These are really good sources . . .” But I don’t know that I spend a ton of time explaining, “Here’s how you know that this is evidence-based.”

Barriers included time constraints, potential discomfort with social media, gaps in knowledge of OHI, and lack of engaging, teen-friendly alternatives. Participants shared that discussing their role as a parent or social media user helped facilitate this conversation, as represented by Participant 12:

I sometimes . . . use my kids as like a way to bring it up like, “Hey, my son showed me this. Have you seen this video?” . . . Or “Did you know about this fad or this concern or things that are being talked about on TikTok?”

Recommendations for How to Communicate About OHI With Adolescents

Educational Strategies: “Drama Is What Spreads”

Participants shared recommended educational strategies for either anticipatory guidance or responding to specific OHI (Table 2). Many emphasized digital media literacy, which included (1) Encouraging scrutiny about content creators’ motives or qualifications, (2) Describing characteristics of content most likely to spread online (eg, “drama is what spreads;” Participant 5), (3) Educating about lack of fact checking, and (4) Highlighting additional medical context not shared online. Several recommended asking patients about trust in the information before providing education, noting that some adolescents are already skeptical, as described by Participant 18:

Table 2.

Overview of Clinician-recommended Educational Strategies for Discussing Online Health Information With Adolescents.

Strategy	Illustrative quotes
Digital media literacy
Encouraging scrutiny about content creators’ motives or qualifications (after assessing for preexisting skepticism)	[I ask] “How do you know that [online content creators are] not trying to make you do something that they want you to do instead of something that you want? How well do they know your values, and what’s important to you, and what your goals and dreams are?” . . . No one wants to feel like they’re being manipulated into doing something for somebody else’s benefit. Participant 18
	[I try to ask] how do they decide if somebody is trustworthy, or how do they decide if a source is worth believing or not believing? And trying to build off what they say and also push them gently. [I say] “Oh, tell me more about why you believe that person, because they have a lot of followers?” Not as a way to be like, “You shouldn’t believe them,” because I think that doesn’t usually work. [Instead] a gentle nudge to think more critically about it. Participant 22
Describing characteristics of content most likely to spread online	[I explain that] the stories of extreme are always the ones that are told and not the everyday normal stories. There’s not going to be a lot of likes on a story like, “Hey, I tried a type of birth control, and I really liked it. Nothing happened. And it really worked well for me.” That’s just not sensational, and that’s not dramatic, and that’s not going to be something that gets traction online. Participant 4
	I always say whenever I’m doing the Nexplanon, “Tell me about what you’ve been watching.” “Oh, I’ve been watching removal videos,” and I’m like, “It’s the worst one, right? Why do you think that someone is going to video and show the smoothest Nexplanon removal? Is that going to be shared? No. Of course it’s going to be the worst thing ever with blood everywhere that took an hour to do. But the 98% of them that come out smoothly—there was no video, or they did do a video and they kept it from themselves. They’re not going to share it because no one’s going to share it, because drama is what spreads.” Participant 5
Educating about lack of fact checking	I often give them the example of, “You know, you and I could go make a website right now, and we could write that the sky is raining cats and dogs right now. And we could put that up on the Internet, and that would be there for people to see, right?” And most of them kind of laugh and I think get it. Participant 1
Educating about lack of fact checking	[A mom who used a TikTok remedy thought] everything on the Internet had to be checked. She said that “I thought advertisements had to be checked,” and I was like, “No, they don’t. You just need to have money. And once you’ve watched a video, it will catch the topic, and then they’ll keep sending you advertisements of those products.” Participant 4
Highlighting additional medical context not shared online	I always say, “Cousin Tina and Auntie Such and Such will tell you, ‘Don’t get that Depo because this this happened to me,’ and that’s fine. But you don’t know about the thousands of other people who were who were just fine. And so you have to consider the source and consider the ramifications of what happened with that person and whoever is telling you their complications. They’re not telling you what other medical problems they may have. They’re not telling you how their periods were before they got it. They’re not telling you the whole story. You have to consider the whole story.” Participant 5
Highlighting additional medical context not shared online	And so just trying to have to remind people that, “You don’t know anything about that person’s experience. I don’t know anything about their sort of unique situation . . . there’s just so much you don’t know from just watching a video.” Participant 20
Health literacy
Explaining broad risks versus anecdotes	[I will also say], “Sometimes exceedingly rare events can seem more common because your algorithm is presenting them to you more frequently. So the migrating IUD or implant can seem more common than it actually is in observational studies because you’re seeing it more often.” So I try to do a mini epidemiology lesson where I talk about kind of population-based risk versus anecdote or case-based experiences that might present on social media. Participant 8
Explaining broad risks versus anecdotes	Whether it’s online or in someone’s life . . . I try and put it in context, like, “Oh, absolutely. Some people do really gain weight when they’re on birth control. Often it’s not the result of the birth control. And in studies when you compare people on birth control to [people] not on birth control, they gain about the same amount of weight. I don’t dispute this person had that experience, but the science shows something a little different. . .” Really, you don’t really want to dispute. If it’s someone’s experience you may provide a counterpoint of like, “That’s real, what happened to that person. And [also] here’s what the science shows,” and then let the person put it together like using their values, or ask more questions. Participant 13
Emphasizing individual variability	A lot of times I’ll emphasize, “This conversation we’re having right now is nuanced, and it takes a lot of time because it’s very specific to you. If anyone is making blanket statements that are supposed to apply to a lot of people, I’d encourage you to be a little bit cautious of that. Because that’s an easy way out. That is not the way the real world works. And my goal is to have an individualized approach that’s best for you, not something that I would stand on a platform and tell a thousand people to just go and do . . .” Participant 3
Emphasizing individual variability	[I try to] have an understanding; rather than saying, “Well, that’s completely wrong, what I’m telling you is the end all be all,” but rather, “What are the areas that maybe don’t align with my scientific understanding? And let’s talk about maybe why they don’t align. Maybe they don’t align because you read about some specific case or situation that maybe isn’t applicable to you right now. . .” Participant 9
Describing how scientific evidence is generated	[I say] “Anybody can make a claim, and that might be their opinion.” I try and help them separate opinion from intentional lying, when the data is clear or is thought to be clear. We both know medicine is an evolving science, and as we learn new information [we adapt], but “the best data we have at this time is clear.” And so that’s sort of how I try to help them understand . . . “There are multiple times in history where snake oil has been sold, and you are just literally peeing out money because that product is just filtered by your kidneys and goes out. And it’s not doing a darn thing for you.” Participant 20
Clarifying health concepts	I think one of the things that I try to do is when I see patients in general and with parents is to give a mini biology lesson on how a normal cycle works. So knowing that the medicine that’s in birth control are the 2 hormones or the one hormone that your body naturally produces. “And this is what a regular cycle is, and birth control is kind of mimicking what a normal, typical cycle would do . . .” And it’s funny, because the teens are on their phone, or they’re kind of like “Whatever.” But parents are so intensely looking at this because they don’t know this stuff either. There [is] a lot of information, online or otherwise, [that is] perpetrated by what they’ve heard their entire lives. Participant 25
Guidelines for future information search
“Pre-bunking” future information searches	I’ll add, “There’s a lot of information out there on TikTok. Some of it might be true, but some of it is not. And there are influencers trying to sell you things that aren’t FDA-approved or scientifically backed.” I want them to be cautious as they go looking for more information. Participant 1
“Pre-bunking” future information searches	I think one of the things that providers could also do is to get ahead of misinformation. Once that information is out there, once it’s already in somebody’s brain, especially if they’re looking for it, then I think it’s impossible to backtrack. But I think if we’re having conversations earlier, like when kids first come in talking about contraception or whatever, and being like, “Hey, these are things that you may see on social media that are going around right now, and this is why this is incorrect or correct in part,” before it becomes . . . this is already in [their] brain when they come see me and talk about it. [By then] they’ve probably seen like a hundred of these websites, and they’re not really listening to me anymore. Participant 25
Offering verification resources	But I always say, “Okay, so we went over this paper. I’m going to send it with you, so that when you have this question, you have it right here. And so if you go to TikTok, and if you see them talking about this, then you can compare this with what’s on here. And then you know that this is a good source, or this may not be a good source. You don’t have to just rely on this piece of paper or whatnot, but you want to just not use TikTok as your source of everything. Participant 5
Offering verification resources	[I say] “Try and use this website to see if it matches and just kind of validate that information.” Again, it’s just like teaching them, “It may not necessarily be wrong what you’re hearing. It could be totally right, but just double check it right? And like these are the tools you can use to double check that information, or you can come to us.” Participant 21
Sharing general media literacy tips	That’s where I talk about websites that end in “edu” or “org” tend to be websites that are from institutions that are more trustworthy. If you’re looking up a birth control method and you end up on the Cleveland Clinic website, it’s probably like a legit place because it is a healthcare entity. I think what’s hard is that there are people [providing inaccurate information] that are using those .org [and .gov] websites too. And one of the other things you can think about is the “About Us” page and figure out who they are. Participant 4
Sharing general media literacy tips	[To determine more legitimate social media content], I go look at the caption . . . usually someone who I feel very confident about will actually put like citations in their captions. In the comments section I also see their interaction is with people who are commenting, or if they disabled comments, or anything like that. So that’s also something that I’m like, “Okay, is this going to be a safe space and also is this someone who would create a safe environment for someone who’s underage? I take a look at that stuff before I share that information with my patients. Participant 15

I’ve found it’s really helpful to ask . . . how valid they think the information is. Sometimes they’ll watch stuff on TikTok, and you’ll ask, “What do you think of that?” And they’re like, “Oh . . . I think it’s fake. I don’t believe it.” Then you have other people who are like “Oh, my God! All these people are having a terrible experience . . .I would never want that. . .” So finding out, “How valid do you think it is? How reliable do you think it is?”

Clinicians also recommended health literacy approaches, including (1) Explaining broad risks versus anecdotes, (2) Emphasizing individual variability (eg, “the right option for you”), (3) Describing how scientific evidence is generated, and (4) Clarifying health concepts.

Finally, they also provided several forms of guidance for future information searches, including (1) “Pre-bunking” (ie, preemptive warnings about variable quality), (2) Offering verification resources, and (3) Sharing general media literacy tips. Some noted challenges with these tips due to increasing mistrust in traditional sources, like Participant 4:

I talk about how websites that end in “edu” or “org” tend to be from institutions that are more trustworthy . . . What’s hard is that there are people [providing inaccurate information] that are using those .org [and .gov] websites too.

Participants also noted that some parents have low health or media literacy, and these strategies could help improve parental discernment as well.

General Recommendations for Adolescent-Friendly Communication

Participants described effective and ineffective ways of communicating with adolescents—and occasionally parents—especially during disagreement about OHI (Table 3). Approaches often varied based on the level of concern, with more serious claims prompting more directive responses.

Table 3.

Clinician Recommendations for Effective Communication About Online Health Information, Especially When Disagreeing With Claims.

Sub-theme	Illustrative quotations with bolded patient-facing language
Recommended steps for effective communication
Create a welcoming space
Thank patient for sharing	I think the first thing is always to appreciate their sharing it with you. Participant 3 I say, “Thank you for sharing that with me.” Participant 18
Applaud information search	I also try to use positive reinforcement: “It’s great you’re learning about your health and trying to take charge, especially as an adolescent transitioning to more independence.” Participant 1
Applaud information search	I think one of the things that is more challenging is wanting to continue to empower young people to seek out information and be proactive about learning . . . [while also being concerned about] not medically accurate misinformation or disinformation in a way that feels supportive and not blaming, but also helps correct the information that they have that gets them to a more complete and correct understanding of their question. Participant 24
Explore trust in information and foundational concerns
Assess preexisting skepticism, including asking about how valid or applicable they think the information is to their circumstances	I try not to come at it like, “Oh my God, that’s wrong! Don’t listen to it!” It’s sort of like, That’s interesting. That’s not what I’ve heard. You tell me more about that. And what do you think about that? Where does that come from?” You know, trying to get them again to think about it. And “Well, here are the sources I’ve seen, and this is what they’re saying, and you know I’m not sure why there’s a disconnect in that.” Participant 19 [also relevant to digital literacy strategies in Table 2 ]
Try to understand the concern or fear driving patient belief	I typically will dig deep into it and be like “Oh, you know, that’s something that I haven’t heard before. Can you tell me a little bit more about it, where you heard it or about . . . why that resonated with you?” . . . Sometimes they say, “Well, because I don’t want a brain tumor, I don’t want to bleed forever. I want to have fertility. Participant 3
	And I might say, “That’s that does sound really worrisome, that sounds really scary. And I’m glad you’re bringing it up now, because we can talk about that. I wouldn’t just label it, “that’s misinformation.” I would just say it sounds maybe they read something somewhere, too, that was related to that specific concern about having about fertility being able to have children later. Participant 9
Validate and empathize
Validate personal experiences, even if not broadly applicable	Usually when it’s brought up, it’s someone they know, someone they clearly look to as a source of information whether that be a family member or friend. So I don’t discredit their belief. I try to not say it’s not true. But I rather just reframe it and say the likelihood of that experience is compared to the typical. Participant 16
	I’m like, “Well, I can’t argue with your personal experience, nor would I try to. It’s just different than what I’ve learned, read, etc. But you know everybody’s different.” Where do we go from here with that? I don’t argue with people. Participant 18
Align yourself with shared goals	[After understanding patient concerns], I say “Great, I want all those things as well. Let’s talk about the safest ways to get those things to happen.” Participant 3
Align yourself with shared goals	But what I am going to say is that “You know I’m here to protect you and take care of you, and if you want me to take care of you, you got to take care of yourself. So we’re in this together.” It’s the way that I word things and so that that’ll kind of change the perspective. Participant 5
Consider self-disclosure to build empathy (may be more applicable with parents)	I actually find it very effective [to share own parenting experiences with patients] . . . I will tell them "When [the HPV vaccine] first came out, when my sons were babies, I wasn’t so sure I was going to... I mean, they don’t get it as a baby, but I wasn’t so sure I was going to give it to my sons, and now that my sons were ages that they’re at, I’ve given it to my older one, and my younger one’s going to get it at his next physical.” So they find that very helpful. Parents actually find that helpful that I kind of grappled with it, having the medical knowledge I have. Participant 12
Give and receive information
Ask for permission to share perspective	“Is it okay if I share with you my thoughts about what you showed me?” And as long as they say yes, which they usually do, I tell them what I think about it. Participant 18 I definitely try to use principles of motivational interviewing and say things like, “Are you okay if I tell you more about that?” . . . Asking for permission is good. Lecturing? Not good. Participant 1
Acknowledge what may be partially truthful about the claim	And I think sometimes there are truths to some of the things that are brought up. But unfortunately, just with the Internet, right? It’s a giant game of telephone and things can be understandably distorted. Participant 3 I think a lot of times what parents or adolescents are questioning has truth in it. I just don’t think it’s the full truth . . . I try to validate the truth of what they’re saying, and then be like, “This is why it’s not the full truth,” kind of thing. Participant 25
Provide additional information based on scientific evidence and clinical judgment:	A lot of times, I’ll say, “In the big studies that have been done, that’s not a side effect that’s reported typically. But I can’t say [whether that’s true] for your friend, or whoever they may have experienced . . .. But you know, in your case, I think the risk of that happening for you is really low.” Participant 23 I always tell them, “My job is to tell you what the facts are about these different things, to educate you on these things, answer your questions and let you know if there’s any risks, benefits, any contraindications.” Participant 5 Ideally, I say, “Tell me what you heard. Tell me your concerns.” And then I’ll share what I know, like, “Here’s what the CDC recommends, and here’s why.” I try to give them evidence without sounding like I’m just saying, “I know better.” Participant 1
Be open to learning	I usually just say, “This is my understanding, based on what we’ve learned and seen, but to make you feel comfortable . . . I’m happy to look more into it and get more information.” Or, “How about you bring your information next time, and I’ll bring my information next time, and we can kind of go through these things together?” It doesn’t always work . . . But we try and make it more of a collaborative approach, if possible. Participant 21 My responses is, “That’s really interesting. I have never heard about that before. Do you mind if I look this up, and then I might be able to provide you with a response?” . . . versus being like, “Yeah, no, that’s garbage.” They don’t even listen. Maybe they have some good idea, or I might be able to say, “There’s no literature on this. It doesn’t look like it’s going to hurt you. It may or may not help you, but it doesn’t look like it’s going to hurt you. So that’s your choice.” Participant 20
Provide options while avoiding absolutes
Provide management options, including making changes as desired	[I say] “What happens for one person might not necessarily happen for another person. What I know about the side effects are XYZ. This is what we would do if you experience them, or this is how we might manage them or prevent whatever concern they’re bringing from what they’ve heard online, you know, prevent XYZ from happening.” Participant 24 Usually I’ll just provide a lot of reassurance like, “If this happens for you and you don’t want this anymore, we take it out. It’s not a problem.” Participant 23 Opening that door of, “If it’s not working out or you learn something new, and you want to talk about it, [I am here].” Participant 8
Avoid absolutes	There are no absolutes in medicine. So I think that, like if someone says, like my cousin got an implant, and it caused them to grow a 3rd ear, or something like something that just like feels like so impossible, there’s no possibility, I would just say, “I’ve never encountered that and none of the research on this topic has ever shown that to be a risk, so I think that that would be an exceedingly rare outcome.” Participant 8 [I say] “I don’t have a crystal ball, and I can’t say exactly what your experience will be going forward.” . . . I think it’s really important to both cover yourself as a clinician, and to be relatable and human. We can never say with 100% certainty that something can’t happen. Participant 8
Reassure and empower
Emphasize that patient has final say	But I tell them that “This is your decision,” and that it is their body, and I’m not going to give them something without their consent at that time, whether their mama tells them or not. Participant 5 “It’s your body. You decide what we do to this. I want you to know what’s out there but also want you to have realistic expectations for things.” Participant 17 If someone says, “No, yeah, I don’t want to hear your thoughts about it,” I usually say, “Okay, you’re the best judge. . .” It’s the autonomy statement: “You’re the best judge of what is useful to you.” Participant 18
Reassure of continued care or availability as an information source	“It doesn’t sound like my input on this is helpful to you at this time. I’m always available to provide my own perspective on it whenever it could be useful.” Participant 18 “Ultimately this is your decision as a parent. And I want you to know that I support your decision as a parent, and if you ever change your mind, I’m here,” because they often expect aggression from us. And when we kind of pull down some of those, fighting postures, I hope that there’s more trust built. I see a lot of patients that are like ready to vaccinate their kids like at 4 or 5, because they’re like, “Okay, well, they don’t have autism now.” But they’ll never like trust us if they’ve been told, “You can’t come back to our practice.” Participant 4
Approaches to use with caution or discernment, depending on the specific patient or situation
Humor
Consider preexisting rapport	When I’m not at my best, I might be more blunt. Sometimes, if I’ve built good rapport with a patient, I’ll just say, “Ha! That’s not true,” kind of playfully, I try to keep the calm, collaborative energy, but yes there are definitely times when I’ve been dismissive [with that approach]. Participant 1
	Actually, I can think of a specific example that wasn’t my best, but it kind of worked because of the rapport I had with the patient. We were talking about vaginal health and she said, “I buy these things off Amazon,” or, “I saw them on TikTok.” I immediately said, “Stop doing that.” I was like, “Show me what you’re buying.” She was about to show me, or maybe she already had, and I just said, “Don’t buy that anymore.” She kind of laughed, and it fit with the vibe of what we were doing. Participant 1Sometimes they’ll say something like, “Oh, I know you’re going to be mad at me [about my health behaviors],” I said, “No, what I’m gonna be mad at you for, I don’t have sex with you,” like I’ll make a joke, and they’ll be like, oh, that’s right. Participant 5
Immediate/direct debunking
Use additional effective communication steps before correcting claim	I think early on I was probably being a little bit too like, “Well, that’s not correct—let’s talk about what is.” And I would use more of that approach to things, because it was really out of concern that our patients are hearing things that aren’t true, and I really want them to have the best information. So the intent is still the same, but I think with adolescents—they’re just such a special group or population—and so I think just the way in which you frame it, I think I’ve changed. Participant 2I say, “Oh, that’s actually not correct.” I say, “That is incorrect or that’s wrong. What we know about birth control is that only depo is related to weight gain. And that’s in patients who are already overweight.” Usually they’re like, “Oh, okay.” They’ll take it and they’ll believe me. So I usually just like call it call spade a spade and say, “That is wrong.” Participant 14
Assess degree of patient belief in the health claim/receptiveness to correction	It depends on how much they’ve leaned in. I was a resident during Covid, and I got pretty good at being able to tell like when I talked about the Covid vaccine, of people who were on the edge like, “Oh, we could go either way. I just need a little more information,” to people who are firmly like, “I will never get that vaccine.” I usually just read the room, and if they are firmly in the, “I believe what I believe, I’m not going to listen to anything you say,” I just say, “Hey, that’s incorrect. I would love to talk to you more about that if you’re willing to hear it.” They usually say no. And if they’re on the fence I’ll go a little bit more of like, “Hey, that’s not correct. Can we talk about what is correct, what the science shows?” And they may say, “Sure, tell me that.” Participant 14
Using the term “misinformation” [Supplemental Table 3]
Use the term educationally, not directly calling a patient’s claim “misinformation”	I don’t know how people would receive . . . it seems loaded. I think also it’s hard enough to differentiate when you’re actually watching something if it’s misinformation or someone’s opinion, or someone’s personal experience or actually excellent information; it’s hard enough watching it, but to secondhand categorize it, it seems like there’s a risk of dismissing an information source. It seems also like it might just be jargon that might not translate. But I think I would like if a patient were bringing up like I saw these videos, I would probably feel comfortable saying, “Yeah, there’s a lot of good information and also biased information and also actual lies on the Internet. And sometimes it’s hard to tell. What did you think of what you saw?” “I think I would feel comfortable saying “There’s a real variation of what’s out there.” Participant 13I use it a lot, just to say that the Internet is full of a lot of misinformation . . . and even I find it hard to figure out what is real and what’s not real. Participant 4
Reflect the language the patient or caregiver uses	No, I don’t use that term with patients .... unless, maybe if a caregiver . . . said, “I’m concerned, there’s misinformation about what they’re accessing,” I may reflect that language back and say, “There is a lot of misinformation,” and then I’ll phrase it differently. I might say “There’s information out there that maybe isn’t fully true or is based on not a lot of evidence or not a lot of information or data” . . .. If what I’m hearing is that the teen is getting information that is not accurate, I wouldn’t just call it misinformation. Participant 9
Consider neutral alternatives	No, I don’t think I would use [“mis/disinformation”]. Those feel shaming and stigmatizing in terms of like, “Don’t you know better? Or like you don’t know that that’s false?” . . . My online ecosystem looks very different than my patients’. And so I really just I talk about more neutral words, like content or just information like, I don’t have to label it. Like “what kind of things have you heard?” So I think I keep it very not labeled. I might like document in my note and if they see that in my note, I think that that’s okay. But I think I would be in general like cautious about using anything a that I think, could come off as condescending or shaming, or overly jargony and technical. Participant 8I feel like I say, “You can find anything online. There’s all sorts of stuff out there.” I feel like I say, “Not all of it is true, not all of it is real. Also, there are so many individual people, someone’s specific experience might not be the same as you. Let’s talk about what’s going on with you,” and then we’ll kind of talk through like their own individual thing. I don’t feel like I use misinformation. But I just kind of say, “You can find anything online.” And usually people are like, “Yeah, you can, you can find anything online.” Participant 23
Ineffective approaches
Telling patients not to use social media or insisting all online information is low-quality
Recognize that telling adolescents to stay off social media is often unrealistic	You can’t just say, “Hey, don’t look at that, stay off TikTok.” Yeah, okay, you tell a 15-year-old to stay off TikTok. And then not understanding that there is accurate information on there. . . . The data is actually mixed on the benefits and harms of social media use. Adults tend to emphasize the harms and adolescents tend to emphasize the benefits. Where do we meet in the middle and understanding that there is benefit to being online, but there are also harms? And how do we talk about both? So yeah, it’s the blanket, “Well, the Internet’s bad” [that is not effective]. Participant 14
	I think if we just label all online information as bad and social media is the worst thing in the world and “Don’t do anything on social media,” I don’t think that’s helpful, because let’s be realistic: social media, the Internet is here. We got to deal with it. Let’s try to give our patients the tools so that they can distinguish what is good and what is not, what is going to be beneficial for them, what is not going to be beneficial with them. Participant 15
Understand that there is accurate information available online, including on social media	Assuming that there’s no good information on social media [is ineffective]. Telling someone, “Just spend less time on your phone,” is not really going to do anything productive. Participant 3I think I think shutting it down is never a good idea. “Don’t believe you anything you hear on TikTok” is silly, and nobody should say that because there is good information out there and you’re immediately shutting off that connection . . . “There’s good information out there, there’s bad information out there.” Participant 11
Dismissing patient concerns or invalidating personal experiences (even if unlikely)
Recognize that invalidating claims may backfires and damages relationships	Yeah, I mean, I think that one of the things that I’ve learned is that dismissing people’s claims, it’s like the worst possible thing that you could do so. Participant 4I don’t ever want to dismiss someone’s thoughts. If the patient is coming to you with this, or thinking like, “Hey, I’m curious about this,” I don’t want to be like “No, no. Why are you even thinking that?” Participant 15It’s shutting people down before they have a chance to explain themselves or be heard. I don’t think it’s received well. Even if you’ve heard that complaint a million times, and you know all the literature says it’s not true, I do think it’s good to listen, and I think that’s the only way somebody will listen back to you. And then I think dismissing people’s concerns that they’ve heard on social media or the Internet and not addressing them. I think is a way for people not to buy into treatment recommendations or to really give things a try. Participant 17
Lecturing or talking down to patients
Talk to patients respectfully and avoid condescension	Talking down to young people talking from like a, “You’re wrong” perspective, telling them what they should do. That’ll never resonate with the young person. Well, it doesn’t resonate with anybody. I don’t want to be talked down to. I want to be respected. I want to be given information and allowed choices and time to think through what I think is appropriate for me. That’s very paternalistic. “I know what’s best for you cause I’m a grown up, and I’m smarter than you,” or whatever: don’t do that. Participant 19You just need to be aware of what is out there [on the internet] so that you can actually talk about it in a way that doesn’t come off as condescending because that’s going to turn them off. And they’ll be like, “My doctor didn’t even listen to me. They don’t want to consider this.” Participant 20Oh—teenagers hate lectures. That’s a guarantee. Participant 1

Clinicians recommended foundational principles, which included: (1) Centering trust and respect, (2) Remaining humble, and (3) Being curious and asking questions (Supplemental Appendix D). Many stressed that correcting misinformation was secondary to building trust, noting that negative encounters could have lasting effects on adolescents’ willingness to seek care as emphasized by Participant 13:

We as clinicians . . . are a stand-in for the healthcare system . . . For many young people, this may be their first time seeing a clinician on their own . . . Setting a tone of being patronizing or dismissive risks that person’s long-term trust in the healthcare system and willingness to seek care. The risks are so immense to me that I would much rather someone leave believing that hormones cause cancer than believing that doctors will never listen to them.

Specific recommended steps for effective conversations included (1) Create a welcoming space, (2) Explore trust in information and foundational concerns, (3) Validate and empathize, (4) Give and receive information, (5) Provide options while avoiding absolutes, and (6) Reassure and empower (Table 3). Understanding the patient’s core concern was often seen as critical to effective conversations, as illustrated by Participant 3:

I typically will dig deep, like “Oh, you know, that’s something that I haven’t heard before. Can you tell me more about it, where you heard it or . . . why that resonated with you?” . . . Sometimes they say, “Well, because I don’t want a brain tumor, I don’t want to bleed forever. I want to have fertility.” I say, “Great, I want all those things as well. Let’s talk about the safest ways to get those things to happen.”

In contrast, participants strongly recommended against telling adolescents to avoid social media and/or to dismiss all OHI. They described this not only as ineffective, but also potentially inaccurate, as described by Participant 14:

The Internet is not going anywhere, so people just need to know that [teens are] going to be on it. You can’t tell them to just stay off it. You need to understand that there are both positive and harmful effects of being online.

They also recommended against dismissing personal experiences (even if highly unlikely) and lecturing or talking down to patients.

Some strategies—like humor, direct debunking, or labeling claims “misinformation”—were seen as needing more discernment, especially related to preexisting rapport (Supplemental Appendix E). Views on the term “misinformation” varied: some found it educational, while others felt it was stigmatizing or confusing. Those who used it emphasized applying it broadly, not targeting the patient, as explained by Participant 21:

I don’t think I have any strong opposition to the word. [My concern would be] pointing it at them versus keeping it broad like, “It’s not your fault. It’s the world’s fault, and we’re helping you navigate it.”

Discussion

We synthesized recommendations from 24 adolescent SRH experts for effective communication about OHI. Participants described integration points in clinical encounters, shared strategies to improve digital and health literacy, and offered guidance for navigating disagreements with patient-identified information. They also discussed patient-friendly language, including how to approach the term “misinformation.”

Although developed from the perspective of adolescent SRH experts, many recommendations—including the use of relational counseling strategies, trust-building approaches, leveraging preexisting skepticism, and providing tailored resources—are likely applicable to general pediatric and primary care settings. SRH-specific recommendations may be less immediately relevant to general practitioners given well-documented gaps in SRH counseling in primary care^34,35; however, efforts to increase clinician confidence in SRH content and promote confidential time with adolescents could improve SRH counseling rates^36,37 and open additional avenues for discussing OHI given adolescents’ hesitancy to share some forms of online information-seeking with parents.^38,39

Participating clinicians frequently recommended relational counseling strategies (eg, aligning with shared goals). Prior research shows many clinicians rely on informational approaches when counseling about patient-identified information, but only some combine these with relational techniques.²⁰ A recent randomized trial with cancer patients found that combining both approaches resulted in positive patient-reported outcomes, while informational-only approaches were perceived just as negatively as outright dismissal.²¹ These findings underscore the importance of combining relational and informational approaches.

Clinicians advised against dismissing all OHI and/or telling adolescents to completely avoid social media. Such approaches were seen as unrealistic and potentially damaging to trust, especially given the central role of digital media in teens’ lives. Consistent with existing literature, respect, empathy, and honesty were emphasized.^16,40 Dismissing patients’ views may increase reliance on non-clinical sources, potentially leading to harm.^41,42 Thus, grounding conversations in trust and respect while acknowledging the complexity of OHI—even if beliefs remain unchanged—is important for strong therapeutic relationships.

Participants recommended leveraging adolescents’ preexisting skepticism of OHI, a strategy incorporated into digital media initiatives such as Common Sense’s Digital Citizenship Curriculum.⁴³ Recent data demonstrate low trust in OHI among 18 to 25 year olds (no data were collected for minors), with TikTok and YouTube being most trusted (47%-54%) and Reddit, Instagram, Facebook, and X/Twitter less so (<42%).⁴⁴ Adolescent trust is shaped not only by platforms but also by other users (eg, friends vs influencers) and the health content itself.¹³

While many of these findings are relevant to individual clinicians, efforts at the educational and policy levels are also needed to promote these skillsets across the pediatric workforce. The American Academy of Pediatrics (AAP) has been focused on promoting social media wellness for patients and families, and their 5 Cs framework for discussing social media includes: Child (how the child interacts with social media), Content (how the content makes the child feel/act), Calm (whether devices are being used for managing emotions or impacting sleep), Crowding out (whether media interfere with other daily activities), and Communication (continuous conversation about media within the family).⁴² While all domains are important, our findings align most with Content, offering new strategies for clinicians to support adolescents and families in navigating OHI.⁴² As more evidence is generated related to effective communication about OHI, AAP, and other bodies such as the Society for Adolescent Health and Medicine (SAHM) can create guidelines and disseminate continuing medical education content, while medical schools also work to incorporate effective OHI communication skillsets into training.⁴⁵

Finally, clinicians emphasized the importance of having trusted alternative resources to provide to patients. In a separate publication, we describe these 24 clinicians’ perspectives on specific commonly used SRH online resources, including key considerations for adolescent populations and recommended improvements to future resources (in press).⁴⁶

Limitations and Strengths

This small qualitative study is not fully generalizable, especially as it was a convenience sample. Participants were adolescent SRH experts, so recommendations may be most applicable to SRH. However, the sensitive nature of SRH is also a strength. Most clinicians were sub-specialists, indicating generalists may need to adapt the strategies; still, the “mix and match” format offers flexibility for busy workflows. Finally, while clinicians endorsed these strategies, whether they use them in practice and their actual efficacy was not assessed.

Future Research

Future research should include direct observation of clinician communication and adolescent perceptions of recommended approaches. Trials of interventions aimed at improving clinician communication are also needed to determine the best ways of integrating these skills into medical training and continuing education curricula, ideally assessed with adolescent trust- and health-related outcomes.

Conclusions

As OHI increasingly shapes adolescent health beliefs and decision-making, clinicians need evidence-informed, trust-centered strategies to engage meaningfully with patient-identified information. These strategies are likely adaptable to broader pediatric and primary care settings, though clinicians in non-SRH settings may need to tailor approaches to their specific patient populations. Beyond individual practice, these findings highlight the need to integrate OHI communication skills into medical training and continuing education curricula. AAP and SAHM should consider developing formal guidance to support clinicians in navigating patient-identified OHI. Future efforts should evaluate whether these strategies improve adolescent trust and health outcomes.

Supplemental Material

sj-docx-1-jpc-10.1177_21501319261437319 – Supplemental material for Clinician Recommendations for Discussing Online Health Information With Adolescents: A Qualitative Study

Supplemental material, sj-docx-1-jpc-10.1177_21501319261437319 for Clinician Recommendations for Discussing Online Health Information With Adolescents: A Qualitative Study by Cambray Smith, Sarah Rebbeor, Melissa B. Gilkey, Betsy Sleath, Christopher M. Shea, Leah Frerichs and Bianca A. Allison in Journal of Primary Care & Community Health

Footnotes

Acknowledgements

We thank our participants for their insight shared during these interviews.

Abbreviations

AI: artificial intelligence

OHI: online health information

SRH: sexual and reproductive health

ORCID iDs

Cambray Smith

Sarah Rebbeor

Betsy Sleath

Leah Frerichs

Ethical Considerations

The University of North Carolina at Chapel Hill IRB designated this study as Exempt (#24-2060).

Consent to Participate

All participants provided written informed consent through an electronic survey.

Author Contributions

Dr. Cambray Smith conceptualized and designed the study; curated the data; led the investigation, formal analyses, visualization, and validation processes; oversaw resources, software, supervision, and administration; secured funding; and drafted the initial manuscript and critically revised in response to coauthor feedback. Sarah Rebbeor contributed to investigation, formal analysis, validation, visualization, and provided critical review of the manuscript for important intellectual content. Drs. Melissa B. Gilkey, Betsy Sleath, and Christopher M. Shea contributed to conceptualization, methodology, validation, and critical review of the manuscript for important intellectual content. Drs. Leah Frerich and Bianca A. Allison contributed to conceptualization, formal analysis, funding acquisition, methodology, supervision, validation, visualization, and critical review of the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development under Award Number F30HD11645 (CS) and the National Center for Advancing Translational Science Award Number 1K12TR004416 (BAA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. CS is a recipient of the Gertrude B. Elion Mentored Medical Student Research Award of Triangle Community Foundation which provided support for this project. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders or the authors’ institutions. The funders had no role in the design or conduct of this project nor in decisions about reporting or publication.

Declaration of Conflicting Interests

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

Data Availability Statement

Deidentified transcripts will be made available upon reasonable request after our final set of analyses (in development) is published. Requests should be submitted to cambray_smith@med.unc.edu. CS had full access to the dataset and takes responsibility for the integrity of the work as a whole.

Related Publications

A research letter about perspectives toward online SRH resources for adolescents shared by these 24 participants is in press with by JMIR Pediatrics and Parenting titled: Clinician Perspectives on Commonly Used Online Sexual and Reproductive Health Resources for Adolescents: A Qualitative Analysis.

During the preparation of this work the authors used Microsoft CoPilot based on GPT-4 architecture to decrease the word count after the full manuscript had been drafted and reviewed by multiple coauthors. After using this tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

Supplemental Material

Supplemental material for this article is available online.

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