Social Media Screening: Racial Disparities in Pap Smear Content on TikTok

Pap smear rates have been declining in recent years, highlighting the need for effective public health messaging to encourage regular screenings. This study examines how Pap smears and cervical cancer screenings are discussed on TikTok, a key focus of public health messaging efforts. Using the Extended Parallel Process Model (EPPM), we analyzed threat and efficacy messages in 155 TikTok videos tagged with #PapSmear and #FirstPapSmear. Our sample included content from health care professionals and non-health care creators, with diverse racial and ethnic representation. Findings reveal a low prevalence of threat messaging, with only 3.2% of videos addressing the susceptibility to or severity of cervical cancer. In contrast, efficacy messaging was more common: 12.3% of videos provided strategies to make Pap smears more comfortable, and 18.1% discussed the diagnostic benefits of Pap smears. Black creators were more likely to share negative experiences and promote Pap smear importance compared to all other creators, whereas White creators emphasized the diagnostic value of the Pap smear. Hispanic creators most frequently mentioned preparatory strategies, and messages from Asian creators did not include self-efficacy messages. Health sources were more likely than non-health sources to offer preparation tips for Pap smears and emphasize their diagnostic value. Engagement data analyses showed that videos highlighting diagnostic benefits received more likes, while those offering Pap smear preparation tips garnered more likes, comments, and saves. Addressing racial and ethnic differences in the creation of Pap smear content may improve public health education.