Selected Papers of #AoIR2023: The 24th Annual Conference of the Association of Internet Researchers Philadelphia, PA, USA / 18-21 Oct 2023 Suggested Citation (APA): Gliniecka, M. (2023, October). Discussing health without adults – youth voices in peer-led discussions on teenagers’ subreddits. Paper presented at AoIR2023: The 24th Annual Conference of the Association of Internet Researchers. Philadelphia, PA, USA: AoIR. Retrieved from http://spir.aoir.org. DISCUSSING HEALTH WITHOUT ADULTS – YOUTH VOICES IN PEER- LED DISCUSSIONS ON TEENAGERS’ SUBREDDITS Martyna Gliniecka Western Sydney University In many Western democracies, young people have become a key target group of formal digital health services, interventions and policies delivered by the state, institutions and organisations (Clarke et al., 2015; Lattie et al., 2022). The implementation of digital health initiatives has been amplified even more during the COVID-19 pandemic (Archard et al., 2021; Davenport et al., 2020; Evans et al., 2020). More and more initiatives actively involve young people in health research, policymaking and service design (Brady, 2020; Jacquez et al., 2013). Giving voice to young people aims for them to express and have their views taken into account in matters that affect their lives (Saldanha & Nybell, 2017). However, it is not always standard practice, and the execution of participatory principles can be weak (Dadich, 2015; Fox, 2013; Pincham et al., 2020). ‘Youth voice’ can be a metaphor for using young people’s presence as an illusion of participation (Bragg & Buckingham, 2014). Conditions for hearing voices are structured and incentivised, not spontaneous, and the voice is often expected to be exercised in an appropriate or acceptable manner (Bragg & Buckingham, 2014). There is an assumption about the unified representation of children’s culture and one ‘youth voice’ (Alldred, 2011). Therefore, many digital health initiatives are still rooted in adult- led top-down approaches and are not often developed with young people or based on their preferred digital practices (Patterson et al., 2019; Shaw et al., 2015). At the same time, in online spaces, young people are active shapers of participatory and user-led culture (Goodyear & Armour, 2019). One of the forms of youth digital participation is engaging with health content (Goodyear & Armour, 2018). Young people enact some digital practices with peers without adults’ governance. Informal peer-led discussions are user-driven and bottom-up naturalistic voluntary communication in self- formed online communities (Naslund et al., 2016). The Internet offers ways for spontaneous engagement with peers, which makes young people feel empowered (Regan & Steeves, 2010). Young people feel they can make their own terms by choosing the degree of participation, avoiding judgement, and staying anonymous and safe among people with similar problems (Betton & Woollard, 2019; Kang et al., 2018; Lupton, 2020; Seemiller & Grace, 2019). Some young people consider general platforms, not specifically health-oriented, like YouTube, Tumblr and Instagram, better than specifically designed digital health apps and interventions (Lupton, 2021). Another platform that young people use for health is Reddit (Sit et al., 2022). In this paper, I analyse peer-led discussions on teenagers’ peer communities: r/teenagers, r/AskTeenGirls and r/AskTeenBoys. Reddit is a highly anonymised, multi- topical platform, with communities of interest created by the users and peer moderation (Murphy, 2019). Reddit attracts many young people, as most Redditors are young, geeky and tech-savvy (Massanari, 2015). This paper responds to the question of how youths’ voices about health matters are represented in peer-led discussions. I also ask how the Reddit platform supports plural youth health voices. My final research question is how the dialogical account of voice can offer alternative thinking about the voices of young people to include and consult with for research, policy and practice. Bakhtinian theory of voice emphasises plurality and diversity of voices coexisting together (Bakhtin, 1984). Voices mobilise new meanings as they emerge from dialogical interactions (Linell, 2009). Voice is always set in the context – placed within relations with human and non-human entities (Mazzei & Jackson, 2017). I use key ideas from Bakhtin’s theory of voice – heteroglossia, double-voicedness, centripetal and centrifugal forces, and polyphony – to unpack the messiness and complexities of discussions on teenagers’ subreddits as contributing to youth health discourse. This study employs unobtrusive digital ethnography by incorporating online lurking: passive observation of existing online communities without announcing the researcher’s presence (Costello et al., 2017). Unobtrusive digital ethnography has been utilised in several studies conducted on Reddit (Foeken & Roberts, 2019; Lavis & Winter, 2020; Robards, 2018; Robitaille, 2018). Creating an artificial conversation wouldn’t meet the expectations of investigating naturalistic phenomena. Moreover, the candidness of interactions could have been disrupted when announcing the researcher’s presence in the community. The sample included 50 health-related threads from teenagers’ subreddits. Data collection utilised third-party data scraping software. The analysis method is qualitative thematic analysis (Braun & Clarke, 2012). Ethics-wise, posts were anonymised during data collection and paraphrased for publication to avoid tracing them with a search engine. The situated ethics approach has been consulted with Reddit users and the youth advisory board and received a formal exemption from human ethics review. This paper focuses on two elements of youth-led youth health discourse: voices about young people’s conceptualisation of health and narratives about actors like parents, teachers, healthcare professionals and technologies involved in health experiences. Analysis shows that the ‘youth voice’ around health on Reddit is not unified but represents a variety of voices and understandings of health matters. The heteroglossic environment of Reddit supports the diversity of meanings of what health means. Redditors talk about health with physical, mental, and social aspects. Redditors seem to not prioritise any dominant ideas about health but maintain an open discussion and diverse points of view. The second part of the paper focuses on Redditors’ voices about human and non-human actors engaged in youth digital health. For example, Redditors often criticise parents for dismissing their health concerns, influencing decisions about their health, and having high expectations. Redditors also vent about their experiences with school: health class curriculum, school psychologists and uncomfortable health topics. Redditors also describe their positive and negative experiences with health services and discuss healthcare systems' political and social implications. Finally, Redditors discuss health monitoring with wearable technologies, self-assessment of health symptoms using search engines, and the role of Reddit in their digital health experiences in both critical and optimistic ways. Young people have many actors influencing their health. Because of that, the autonomy of peer-led discussions can play an even more important role in youth-led youth health. In a peer-led environment, young people choose which topics or health matters they find meaningful, how to use platforms to facilitate their needs and expectations, and how and with whom they want to form connections. Therefore, sites such as Reddit are important sites for the study of youth health. Young people harness opportunities from peer-led platforms to form a youth-led discourse, often contrary to the real-life underprivileged positions. Although I emphasise the beneficial side of peer-led discussions, there are also some dangerous practices such as misinformation, aggression, or harmful advice. Nevertheless, voices on Reddit pertain to the plurality of dialogism. In dialogism, multiple voices can peacefully coexist in one space, painting a non-unified picture of a phenomenon of youth health. Dialogical youth health means multiple and diverse concepts, experiences, practices, and opinions. There is a space on teenagers’ subreddits for each of these young people’s voices. 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