Exploring Adult Providers' Perceptions of Youth Sexual and Reproductive Health Promotion Using Social Media in New Zealand
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Nnabugwu, Adetoun
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Conn, Cath
Cammock, Radilaite
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Auckland University of Technology
Abstract
Youth sexual and reproductive health (YSRH) is a significant public health concern in New Zealand, with the outcomes revealing persistent health inequities among young people, especially marginalised youth population groups who experience disproportionately high rates of sexually transmitted infections (STIs), unintended pregnancies, and related mental health challenges. These disparities are driven in part by structural barriers such as inadequate access to quality, culturally responsive sexual and reproductive health (SRH) services and persistent stigma associated with STIs and adolescent sexuality, predisposing them to risky behaviours and delayed care-seeking. Further, SRH providers working within traditional health promotion frameworks face significant challenges in engaging young people, who, as digital natives, are often difficult to reach through conventional health service delivery models.
The rise of digital technologies has introduced new and emerging possibilities for YSRH promotion. Social media platforms have emerged as a powerful tool for disseminating health information and connecting with young people who naturally thrive within digital environments as producers and consumers; that is, as prosumers of content. This research therefore explored the perspectives of SRH providers in New Zealand on their use of social media to promote SRH among youth, examining the opportunities, barriers, and systemic and structural factors that shape digital health promotion practices in the New Zealand context.
The study is grounded in a constructionist epistemology and uses critical theory as its theoretical framework to centre youth-adult power dynamics. As a practice-based qualitative research project, the study used semi-structured interviews and focus group discussions to explore provider perspectives on using social media as a YSRH promotion tool. Data collection was conducted in two phases between August 2022 and August 2023. Phase one involved recruiting and collecting initial data from 13 SRH providers across 10 local organisations participating in the research. This resulted in eight one-on-one interviews and two group discussions (split as two- and three-group participants, respectively). Phase two involved the presentation of preliminary findings to the participants, providing them with the opportunity to validate the results and contribute to the final research artefact. Braun and Clarke’s reflexive thematic analysis approach was applied for data analysis and employed a critical youth lens to illuminate youth-adult tensions in digital health promotion practices and highlight possibilities for change. Three themes were developed, each corresponding to one of the three research questions and collectively informing the development of the artefact (an output is a requirement of the doctoral pathway chosen), a ‘Youth-Adult co-design model for digital YSRH promotion’. This practical framework facilitates equitable partnerships between SRH providers and young people.
The findings revealed three key dimensions of the power relations between SRH providers
and young people in digital YSRH promotion. First, SRH providers, constrained by institutional ressures and professional norms, prioritise control through existing adult-led practice frameworks, with some expressing scepticism that social media-based SRH promotion can produce lasting behavioural change in youth. Second, the non-fluency in youth language and digital realities among adult providers creates critical barriers to authentic youth-adult relationships, affecting trust and community building. Providers demonstrated aversion to new technological possibilities due to privacy and confidentiality concerns, ethical standards, risks of misinformation, fragmented or dissenting feedback on posts and digital incompetence, all of which contrast with youth’s lived realities and agency. Additionally, cultural and religious factors fuel stigma and discrimination within SRH practices, challenging inclusivity and diversity for marginalised groups such as men who have sex with men and lesbian, gay, bisexual, transgender, queer and intersex people. Third, the findings highlight promising prospects for institutionalising meaningful and authentic youth-adult partnerships as a pathway to navigate the barriers and complexities of digital disconnect and mistrust between adult providers and young people.
This study aimed to place youth at the heart of SRH promotion, establishing young people as equal partners and co-creators of change rather than passive beneficiaries. It highlights the urgent need for a policy and regulatory framework that safeguards YSRH and rights while supporting partnerships between youth and SRH providers to better navigate social media spaces, free from epistemic exclusions and autonomy restrictions. Equally important is establishing coherent communication strategies to guide how SRH messaging is conceptualised, designed, and disseminated, ensuring resonance with the diverse realities of young people. Beyond message creation, this study calls for a genuine co-creation approach that goes beyond tokenistic consultation, positioning young people as experts and collaborators throughout the full design and evaluation cycle of interventions. Finally, it reflects on the importance of flexibility and adaptability, essential qualities for reimagining youth–adult partnerships and developing inclusive, future-ready digital health promotion ecosystems.
This exegesis is complemented by a creative artefact, a ‘Youth-Adult co-design model for digital YSRH promotion’, which translates the research findings into a practical framework for adult providers and young people to engage collaboratively and build authentic connections. Located in Chapter 7, the artefact offers a five-step, iterative strategy (Reach, Engage, Referral, Uptake, Transformation) designed to foster a crucial mindset shift, leading to enhanced practices across social media and digital platforms that enable youth agency, particularly in New Zealand and, by extension, across international contexts.
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Keywords
youth-adult co-design, youth SRH promotion, social media, critical youth theory, digital SRH promotion