A systematic review of social media use among rural US adolescents and associated health outcomes

BACKGROUND: Understanding social media use among rural adolescents is important because they are a geographically and socially isolated population which may impact how they use social media and affect the impacts of use. The goal of this study was to systematically review and evaluate the literature on rural US adolescent social media use. Specifically, what is known about their social media use, amount and type of use, and the associations between social media use and health outcomes. METHODS: A systematic search was conducted on seven databases: PubMed, CINAHL, SCOPUS, PsycINFO (ProQuest), Web of Science, Embase, and Google Scholar. Studies were eligible for inclusion if they sampled rural US populations, sampled adolescents (ages 10–19), and had at least one of the following as an outcome: how much adolescents use social media, how adolescents are using social media including content, and/or whether social media use was associated with a health outcome. RESULTS: A total of 34 articles matched the inclusion criteria and were included in analysis (N = 22,315). Results suggest that rural US adolescents use social media to the same extent as non-rural adolescents. Rural adolescents with marginalized identities rely on social media to form connections with those with shared identities outside of their geographic area. Social media also fostered an environment for harmful connections, as numerous studies reported cyberbullying. In respect to mental health, using social media was found to be an avenue for coping with anxiety during the COVID-19 pandemic; however, increased time spent on social media did not reduce existing feelings of nervousness, anxiety, depression, or stress in the pandemic. Interventional studies indicated that social media was successfully used as a tool to disseminate health information and provide support to marginalized groups amongst the already hard-to-reach population of rural adolescents. CONCLUSIONS: This systematic review highlights the lack of research dedicated to social media use amongst rural US adolescents, despite high prevalence of use. More research on the specific popularity of platforms and content consumed is needed to understand the nuanced effects of social media and to further investigate social media usage as a potential intervention target for this geographically and socially isolated population.