title: Social media in adolescent health literacy education: a pilot study.
abstract: BACKGROUND
  While health literacy has gained notice on a global stage, the initial focus on seeking associations with medical conditions may have overlooked its impact across generations. Adolescent health literacy, specifically in dentistry, is an underexplored area despite the significance of this formative stage on an individual's approach to healthy lifestyles and behaviors.
  
  
  OBJECTIVE
  The aim is to conduct a pilot study to evaluate the efficacy of three major social media outlets - Twitter, Facebook, and YouTube - in supporting adolescents' oral health literacy (OHL) education.
  
  
  METHODS
  A random sample of 22 adolescents (aged 14-16 years) from an English-medium international school in Hong Kong provided informed consent. Sociodemographic information, including English language background, social media usage, and dental experience were collected via a questionnaire. A pre- and post-test of OHL (REALD-30) was administered by two trained, calibrated examiners. Following pre-test, participants were randomly assigned to one of three social media outlets: Twitter, Facebook, or YouTube. Participants received alerts posted daily for 5 consecutive days requiring online accessing of modified and original OHL education materials. One-way ANOVA ( analysis of variance) was used to compare the mean difference between the pre- and the post-test results among the three social media.
  
  
  RESULTS
  No associations were found between the social media allocated and participants' sociodemographics, including English language background, social media usage, and dental experience. Of the three social media, significant differences in literacy assessment scores were evident for participants who received oral health education messages via Facebook (P=.02) and YouTube (P=.005).
  
  
  CONCLUSIONS
  Based on the results of the pilot study, Facebook and YouTube may be more efficient media outlets for OHL promotion and education among adolescent school children when compared to Twitter. Further analyses with a larger study group is warranted.
authors.affiliation: The University of Hong Kong, Hong Kong, China (Hong Kong).
authors.forename: Carrie Kw
authors.identifier: http://orcid.org/0000-0002-9137-2082
authors.initials: CK
authors.lastname: Tse
authors.forename: Susan M
authors.identifier: http://orcid.org/0000-0001-8325-8397
authors.initials: SM
authors.lastname: Bridges
authors.forename: Divya Parthasarathy
authors.identifier: http://orcid.org/0000-0003-4275-5009
authors.initials: DP
authors.lastname: Srinivasan
authors.forename: Brenda Ss
authors.identifier: http://orcid.org/0000-0002-7112-0734
authors.initials: BS
authors.lastname: Cheng
keywords: adolescents; dentistry; health informatics; health literacy; oral health; oral health literacy; social media