199 - Escaping the Doomscroll: Analyzing User Receptivity to Health-Messaging Videos on TikTok

Publication Number: 4196.199

Joseph Mekhail, Northwell Health, New York, NY, United States; Caroline Howard, Northwell Health, New York, NY, United States; Lillian M. Ravikoff, Northwell Health, Bronx, NY, United States; Neel Sharma, Northwell Health, New York, NY, United States; Jack P. Brenner, Northwell Health, Lake Success, NY, United States; Melanie Malkasyan, Northwell Health, Fair Lawn, NJ, United States; Samuel James. Kraus, Northwell Health, New Hyde Park, NY, United States; Hannah Likier, Northwell Health, Flemington, NJ, United States; Anna Goldman, Northwell Health, Great Neck, NY, United States; Saia Kalash, Northwell Health, Lake Success, NY, United States; Ruth Milanaik, Northwell Health, Great Neck, NY, United States

Background: 63% of U.S. teens report using TikTok, and 16% describe their use as "almost constant." Excessive platform engagement during a single session, or doomscrolling, has been associated with increased anxiety and depression. To address these health concerns, TikTok launched the official TikTok Tips account in partnership with HeadSpace, a platform to support mental wellness. When users have been scrolling excessively, TikTok Tips will display one of a number of videos employing various strategies to promote sleep, nutrition, breathing exercises, and socialization. These videos reach a vast audience: the six most-viewed videos have amassed ~9 billion views and 70 million likes. However, it is unclear which health messaging strategies lead to the highest user receptivity.

Objective: To identify which health-messaging strategies and messenger characteristics are associated with higher user receptivity.

Design/Methods: For each of the six videos, Apify was used to randomly sample 1000 comments (n=6000). Twelve independent raters evaluated each comment as positive, negative, or neutral. Chi-squared tests assessed associations between user receptivity and messenger interface (animation vs human), messenger sex, messenger race, and health-messaging strategy characteristics (empathetic vs direct; breathing exercise included vs not). Stimulus set: two human-empathetic videos (female Black; male White), two human-direct videos (female White; male Black), and two animated videos with breathing exercises (purple ball; orange ball) (Figure 1).

Results: User receptivity varied by messenger interface, with animation receiving more positive comments (46%) than human messengers (15%)(p <.001). Among human messengers, Black messengers received more positive comments (25%) than White messengers (6%)(p <.001), while messenger sex did not affect receptivity (Figure 2). Positive receptivity was higher when breathing exercises were included (39%) compared to when breathing exercises were omitted (11%)(p <.001). Empathetic strategies elicited higher receptivity (19%) compared to direct, prescriptive strategies (11%)(p <.001) (Figure 3). In the animated condition, the color of the cartoon was not associated with receptivity.

Conclusion(s): Empathetic language, breathing exercises, and cartoon interfaces elicited the strongest positive engagement. These findings support prioritizing animated, skills-focused, empathetic content to mitigate the adverse health effects of doomscrolling and maximize the impact of in-app well-being messages. This user receptivity data may be applied to other health-messaging initiatives to reach a younger audience.

Figure 1. The Six Most-Viewed TikTok Tips Videos
Video characteristics including: messenger interface (animation vs human), messenger sex, messenger race, and health-messaging strategy characteristics (empathetic vs direct; breathing exercise included vs not).

Figure 2. User Receptivity by Messenger Interface and Human Messenger Race
User receptivity varied by messenger interface, with animation receiving more positive comments (46%) than human messengers (15%) (p <.001). Messenger sex did not affect receptivity.

Figure 3. User Receptivity by Inclusion of Breathing Exercises and Tone of Human Messenger
Positive receptivity was higher when breathing exercises were included (39%) compared to when breathing exercises were omitted (11%) (p <.001). Empathetic strategies elicited higher receptivity (19%) compared to direct, prescriptive strategies (11%) (p <.001).