O3248: Risky Social Media Challenges: A scoping review, 2000-2024

Background: With increased popularity of social media (SM), reports of social media challenges (SMC) emerged including those that cause injury. SMC are activities in which individuals share, or replicate content seen on SM taking the “challenge” to participate. While SMC are frequently reported in the media, peer-reviewed literature on these challenges is limited and varied. Our objective was to conduct a scoping review of social media challenges to map the research area and identify gaps in existing literature.

Methods: The study protocol utilized an established framework for scoping reviews. We conducted a comprehensive search of Medline and PsychInfo from 2000 through 2024. Inclusion criteria were articles or studies related to risky SMC defined as activities disseminated via SM that have a reasonable likelihood of causing injury or disciplinary ramifications, published in English, and full text available. We excluded challenges that involved intentional injury with an associated mental health crisis (such as, cutting). Identified articles were reviewed by two authors for inclusion with a third to resolve discrepancies. We utilized a standard data extraction form to describe all included articles. Two authors conducted article extraction, with 12% of articles completed by both reviewers to assess reviewer agreement. Descriptive statistics summarized article characteristics.

Results: A total of 1651 articles were identified via our search criteria. After screening, 55 met inclusion criteria and underwent data extraction. All included articles were observational studies, with the majority categorized as case reports (25.5%) and reviews (21.8%). The number of articles on SCM has increased annually since 2010, with a significant jump from 5 articles in 2023 to 12 in 2024. The most common social media platforms discussed were YouTube (50.9%) followed by TikTok (30.9%), both video-based platforms. The top referenced risky SMC were the Cinnamon Challenge (33%) followed by the Fire Challenge (24%). Injuries or fatalities were mentioned in 87% of the articles including burns (46.8%), poisoning (31.9%), aspiration or lung injury (21.3%), and strangulation (19.1%). Of the specific injury cases mentioned, 67% required emergent medical evaluation, and 25% required prolonged medical follow-up. The majority (67.3%) of articles did propose or discuss possible interventions including parent, school or medical provider education (74.5%), platform changes (24.3%), and legislation (18.9%). However, there were no descriptions of employed interventions.

Conclusion: This scoping review describes the growing body of literature on SMC, including the types of challenges, associated injuries and fatalities and the platforms involved. Articles on SMC are increasing, whether from increased engagement in challenges or increased awareness of the phenomenon. As popularity of various SM platforms evolves, there is a need for intervention to mitigate the harmful effects of SMCs on children and adolescents.