The role of social influencers for effective public health communication

Health-Related Communication of Social Media Influencers: A Scoping Review

Social media influencers (SMIs) are an essential part of today's digital media landscape and have the ability to significantly impact the health-related attitudes and behavior of their audiences. Despite an increasing number of studies, research has produced mixed results, and a comprehensive overview of the main findings is lacking. Therefore, the goal of this scoping review was to comprehensively map the literature focusing on SMIs and their health-related communication. Specifically, we analyzed the most frequently studied health topics and social media platforms, the methodological characteristics of the studies, as well as the communication techniques employed by SMIs, and the potential positive and negative effects of their communication on their audience. Additionally, we examined the major research gaps in this area. Altogether, we analyzed n = 116 empirical papers. The results reveal a wide range of different outcomes influenced by SMIs, including both positive and negative changes in health-related attitudes and behavioral intentions among their followers. Furthermore, our findings highlight the need for future research to prioritize experimental and longitudinal studies, investigate actual behavioral outcomes resulting from influencer content exposure, and closely examine the potential negative effects of SMIs' health-related communication. More attention needs to be paid to health-related misinformation disseminated by SMIs. Lastly, this study identified several highly relevant health topics and social media platforms that should be the focus of future research.

Exposure to user-generated e-cigarette content on social media associated with greater vulnerability to e-cigarette use among youth non-users

INTRODUCTION

Social media are important venues for youth's exposure to e-cigarette content. This study examined how exposure to user-generated e-cigarette content (i.e., content created and shared by individual social media users) is associated with vulnerabilities to e-cigarette use among youth non-users.

METHODS

We pooled data from the 2021 and 2022 National Youth Tobacco Survey. Youth who have never used e-cigarettes were included. Weighted linear and logistic regressions were conducted to examine how exposure to user-generated e-cigarette content (from real-life friends, online-only friends, and celebrities/influencers) on social media was associated with e-cigarette use vulnerabilities measured by perceived norms, perceived risk, and susceptibility of use, controlling for demographics, advertising exposure, and mental health conditions. Multiple imputations were performed to account for missing data.

RESULTS

Exposure to e-cigarette content on social media posted by real-life friends, online-only friends, and celebrities/influencers were associated with more positive descriptive norm (βs = 1.56, 0.37, and 0.35, respectively, all ps < .001), more positive injunctive norm (βs = 0.46, 0.19, and 0.10, respectively, all ps < .001), and higher odds of e-cigarette use susceptibility (ORs = 1.48, 1.50. 1.29, respectively, all ps < .001). Exposure to content posted by real-life and online-only friends were associated with reduced risk perception of e-cigarette use (β = -0.04, p < 0.05 and β = -0.07, p < 0.001).

CONCLUSIONS

Our study highlighted that friends and celebrities/influencers are important sources on social media that can influence youth non-users' vulnerabilities to e-cigarette use. Interventional messages communicated through friends and influencers on social media may in turn help reduce e-cigarette vulnerability among youth non-users.

The Emerging Landscape of Social Media Influencers in Public Health Collaborations: A Scoping Review

Social media content creators or "influencers" are an increasingly influential voice in the public discourse generally, including global perceptions and practices related to health. In response, public health entities are increasingly embracing social media influencers (SMIs) as potential health promotion collaborators. Despite burgeoning interest in the potential of these partnerships, research evaluating this strategy remains limited. To address this gap, we conducted a scoping review to characterize and describe the current landscape of health promotion collaborations with SMIs with a focus on current practices. A search of six electronic databases (PubMed, SCOPUS, Communication & Mass Media Complete, CINAHL Plus, Web of Science, and APA PsycINFO) revealed wide-ranging and inconsistent approaches to these partnerships, including their optimal practices, data reported, and their evaluation criteria. Among the 658 articles initially identified, 15 publications met our inclusion criteria, spanning 7 countries, 8 social media platforms, 11 distinct health topics, and 21 different outcome measures. Basic information necessary for comparing across interventions was often lacking. We noted a lack of consensus on what constitutes an SMI with 53% of included studies lacking any definition or criteria. Although SMIs offer substantial promise as an emerging opportunity for health promotion, particularly for populations that may be otherwise difficult to identify or reach, this review highlights how the current lack of standardized methodologies and metrics prevents meaningful comparisons between collaborations and evaluations of their effectiveness. Based on these findings, we propose four key criteria to aid practitioners in the implementation and evaluation of SMI collaborations.

Factors influencing women to accept diet and exercise messages on social media during COVID-19 lockdowns: A qualitative application of the health belief model

This study investigates how engagement with social media leads women to adopt diet and exercise practices. We base our analysis on qualitative research, including surveys and in-depth interviews, with thirty (30) Australian women aged 18-35 years between April and August 2021. Our findings reveal how healthism discourse on social media, namely Facebook, Instagram and TikTok, underpin the adoption of diet and exercise practices by enhancing experiences of digital intimacy, repeat messages and personal testimonials from other women, and supporting new routines during COVID-19 lockdowns. This article contributes to health marketing literature by providing critical knowledge about women's experiences that prompt and shape complex ideologies of health that are often masked through diet and exercise practices on social media.

TikTok and Attention-Deficit/Hyperactivity Disorder: A Cross-Sectional Study of Social Media Content Quality

OBJECTIVES

Social media platforms are increasingly being used to disseminate mental health information online. User-generated content about attention-deficit/hyperactivity disorder (ADHD) is one of the most popular health topics on the video-sharing social media platform TikTok. We sought to investigate the quality of TikTok videos about ADHD.

METHOD

The top 100 most popular videos about ADHD uploaded by TikTok video creators were classified as misleading, useful, or personal experience. Descriptive and quantitative characteristics of the videos were obtained. The Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) and Journal of American Medical Association (JAMA) benchmark criteria were used to assess the overall quality, understandability, and actionability of the videos.

RESULTS

Of the 100 videos meeting inclusion criteria, 52% (n = 52) were classified as misleading, 27% (n = 27) as personal experience, and 21% (n = 21) as useful. Classification agreement between clinician ratings was 86% (kappa statistic of 0.7766). Videos on the platform were highly understandable by viewers but had low actionability. Non-healthcare providers uploaded the majority of misleading videos. Healthcare providers uploaded higher quality and more useful videos, compared to non-healthcare providers.

CONCLUSIONS

Approximately half of the analyzed TikTok videos about ADHD were misleading. Clinicians should be aware of the widespread dissemination of health misinformation on social media platforms and its potential impact on clinical care.

Evaluating the elevation of authoritative health content online during the COVID-19 pandemic

Purpose

To respond to the COVID-19 “infodemic” and combat fraud and misinformation about the virus, social media platforms coordinated with government healthcare agencies around the world to elevate authoritative content about the novel coronavirus. These public health authorities included national and global public health organisations, such as the Centers for Disease Control and Prevention (CDC) and the World Health Organisation (WHO). In this article, the authors evaluate the effectiveness of this strategy by asking two key questions: (1) Did people engage with authoritative health content on social media? (2) Was this content trusted?

Design/methodology/approach

The authors explore these issues by drawing on data from a global online questionnaire on “Public Trust in Experts” (n = 429) conducted during the initial phase of the pandemic in May 2020, a crucial period when reliable information was urgently required to influence behaviour and minimise harm.

Findings

The authors found that while the majority of those surveyed noticed authoritative health content online, there remained significant issues in terms of Internet users trusting the information shared by government healthcare agencies and public health authorities online.

Originality/value

In what follows, the authors examine the role of trust in implementing this novel public health strategy and assess the capacity for such policies to reduce individual and social harm.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-12-2021-0655