Date of Award

January 2023

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Nicola Hawley


Purpose: This exploratory study investigated the social and cultural factors that shape social media use among adolescents in

American Samoa. Methods: This project was a secondary qualitative analysis. Methodological considerations included an

interpretivist approach to epistemology and alignment with the Fa’afaletui Pacific framework. Phenomenology methods were

used to “bracket” researcher biases. A 21st-century flexible coding approach proposed by Deterding et al. 2021 was applied

to the dataset [31]. Transcript excerpts were re-sorted by the index code: social media/technology as a predictor of mental

illness. An abductive thematic analysis, stemming from inductive and deductive reasoning, was used to analyze the codebook

and construct themes. Results: The final indexed sample consisted of 18 key informants (>18 years) and 20 adolescents (13-

18 years). Among the 18 KIs, stakeholder perspectives varied with 8 from the ‘top of the mountain’ (44%), 6 from the ‘top of

the tree’ (33%), and 4 from the ‘person in the canoe fishing’ (22%). Among the 20 adolescents, 11 were female (55%) and 9

were male (45%). Thematic analysis synthesized three themes: (1) messages communicated on social media, (2) influences

of Americanization and Fa’asamoa, and (3) social media fostering connectedness. Conclusion: Both KIs and Samoan

adolescents described social media as a “double-edged sword” that could cause both positive and negative effects on

adolescent mental health. Regulation and cultural sensitivity can potentially leverage social media as a tool in future health

delivery. Findings from this study may be disseminated to inform school-based mental health policies.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/10/2025