Young Adults’ Interactions With Food and Nutrition Content on Social Media and Implications for Intervention Design: Semistructured Interview Study (Preprint)

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Abstract
BACKGROUND Young adults increasingly rely on social media for nutrition information. However, little is known about (1) which types of eating-related content they actively engage with and why, and (2) how they interpret, evaluate, and incorporate this content into their everyday food choices and health behaviors. OBJECTIVE This qualitative study explored how UK young adults (aged 18-25 years) interact with food and nutrition content across social media platforms to inform the design of future social media interventions. METHODS Semistructured online interviews, guided by the Capability, Opportunity, Motivation–Behavior (COM-B) model, were conducted with 25 active social media users (18/25, 72% women, mean age 22.2, SD 1.9 years, ethnically diverse) in the United Kingdom between August and October 2024. The study design was informed by patient and public involvement to ensure relevance and acceptability. Data were analyzed using reflexive thematic analysis. To guide intervention development, key findings (coded as barriers and facilitators) were systematically mapped to the Theoretical Domains Framework, and the COM-B. Ethics approval was obtained from the University of Cambridge (24.368). RESULTS Five key themes were identified: (1) evolving engagement patterns (passive scrolling to active interaction and mixed feelings on algorithmic control), (2) conflicted information seeking (frustration with contradictory advice, varied strategies to assess credibility), (3) multifaceted behavioral impact (simultaneous positive impacts such as cooking inspiration and negative impacts such as restrictive eating triggers), (4) shifting goals (a movement from appearance-focused to health-centered goals; yet, vulnerability to body-image issues), and (5) intervention preferences (demand for credible professionals, customizable content, and privacy protection). Participants demonstrated a reactive learning process, developing “digital nutrition literacy” often after negative experiences. Social influences were identified as the most frequently cited domain (mapped to TDF [theoretical domains framework]/COM-B) shaping interactions with social media content. CONCLUSIONS This study challenges assumptions of passive social media consumption, showing that young adults actively develop protective strategies yet remain vulnerable to misinformation. Digital interventions should leverage user agency and address diverse perceptions through customizable, credible content delivered with privacy and emotionally safe messaging. The COM-B and TDF mapping provide specific, evidence-based behavioral targets, particularly within the domain of Social Opportunity and Reflective Motivation, to guide the development of effective eHealth interventions. CLINICALTRIAL INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2023-083465
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