Pathological Processes Among Content Creators on Social Media: Scoping Review

Background: Content creators (CCs), like any other worker, are exposed to various occupational hazards that can affect their physical, mental, and social well-being, with psychosocial and ergonomic risks being particularly relevant. The combination of prolonged work hours, sedentary lifestyles, excessive public scrutiny, and often job insecurity and unpredictability (manifested as continuous connectivity and anticipation of sporadic tasks) presents a significant risk for the development of health issues. Objective: This study reviews the scientific literature to identify the potential pathological processes affecting CCs on social media. Methods: The scoping review method was used. Data were obtained from the following bibliographic databases: MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, and Virtual Health Library. The terms used as descriptors and in the title and abstract fields were "Content Creator" and "Pathologic Processes." The search was conducted in May 2024. Agreement between authors for paper selection was measured using the Cohen κ coefficient. The documentary quality of the papers was assessed using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) questionnaire, and the level of evidence and recommendation grade were determined according to the Scottish Intercollegiate Guidelines Network recommendations. Bias was evaluated using the Risk of Bias in Non-randomized Studies of Exposures (ROBINS-E) tool. Results: Of the 1522 references retrieved, 6 papers were selected based on the inclusion and exclusion criteria. Of the 6 studies reviewed, 3 were exclusively focused on a single gender. The agreement on the relevance of the selected studies, calculated using the κ index, was 84.9% (P<.01). The study population ranged from a minimum of 6 to a maximum of 1544 participants. The STROBE scores ranged from 81.3% to 96.8%, with a median of 14.9% (IQR 2.1). According to the Scottish Intercollegiate Guidelines Network criteria, this review provided evidence level 2++ with a recommendation grade of B. ROBINS-E highlighted a higher number of biases in Domains 5, 6, and 7. All interventions were based on interviews, either conducted online or via email. Participant activities, as documented in the respective studies, comprised influencer roles (n=2), blogging (n=2), YouTube content creation (n=1), and live streaming (n=1). The design of the reviewed works comprised 4 qualitative studies and 2 mixed methods (qualitative and quantitative) studies. The reported health impacts were diverse, comprising burnout (n=2), anxiety (n=1), co-occurring anxiety and depression (n=1), eating disorder (n=1), chronic pain (n=1), and unspecified mental health issues (n=1). All studies highlighted the necessity for further investigation into potential pathological processes among CCs engaged in social media activities. Conclusions: It was found that the most affected area was mental health, as observed in nearly all the reviewed studies. Despite the extensive documentation of mental health impact, it is necessary to identify the risk factors associated with the pathological processes of CCs to prevent the signs and symptoms identified in this literature review.

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