A Longitudinal and Comparative Content Analysis of Instagram Fitness Posts

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.

'I've learned a lot about myself this year': Young student women's perceptions of their cumulative use of digital fitness technologies across the Covid-19 pandemic

Many young women turned to digital fitness technologies (DFT) to support their health and wellbeing during the covid-19 pandemic. The present study explores young student women's retrospective perceptions of their cumulative engagement with DFT, across periods of restriction and easing (March 2020-2021). Seventeen UK-based women (Age M = 20.29, SD = 1.72); Ethnicity White = 94.12% participated in one-on-one interviews using an adapted scroll-back technique. Data was analysed using narrative-informed reflexive thematic analysis. Three themes were developed: My lockdown #fitnesstransformation: DFT as information and inspiration, My unrealistic expectations: DFT as a source of comparison and concern and My new body positive and resilient self: DFT as a catalyst to self-development. Themes highlight how perceptions of DFT changed over time as a consequence of repeat engagement, sociocultural context and psychological meaning-making. Crucially, findings underscore the importance of examining the collective and cumulative effects of DFT engagement on health and wellbeing, both positive and negative.

Issues Related to the Use of Visual Social Networks and Perceived Usefulness of Social Media Literacy During the Recovery Phase: Qualitative Research Among Girls With Eating Disorders

BACKGROUND

The patient-centered approach is essential for quality health care and patient safety. Understanding the service user's perspective on the factors maintaining the health problem is crucial for successful treatment, especially for patients who do not recognize their condition as clinically relevant or concerning. Despite the association between intensive use of visual social media and body dissatisfaction and eating disorders, little is known about the meanings users assign to posting or searching for edited photos and the strategies they use to protect themselves from digital risks.

OBJECTIVE

This study aims to examine how young women recovering from eating disorders in Northern Italy perceive the health risks and potential benefits associated with visual social networks (ie, Instagram and Snapchat). The literature has found these platforms to be detrimental to online body comparisons. It also explores the perceived usefulness, willingness, and personal interest in coconstructing social media literacy programs with girls recovering from eating disorders.

METHODS

A total of 30 semistructured interviews were conducted with adolescent girls aged 14-17 years at the end of their treatment for eating disorders. The following areas of research were addressed: (1) the meanings associated with the use of Instagram and Snapchat; (2) the investment in the photographic dimension and feedback; (3) the impact of visual social networks on body experiences; (4) the potential and risks perceived in their use; (5) the importance of supporting girls undergoing treatment for eating disorders in using social networks; and (6) the usefulness and willingness to co-design social network literacy programs. Content analysis was applied.

RESULTS

A total of 7 main contents emerged: active or passive role in using social networks, the impact of online interactions on body image, investment in the photographic dimension, effects on self-representation, perceived risks, self-protective strategies, and potential benefits. The findings highlight a strong awareness of the processes that trigger body comparisons in the virtual context, creating insecurity and worsening the relationship with oneself. The self-protective behaviors identified are the development of critical thinking, the avoidance of sensitive content, increased control over social networking site use, and a certain skepticism toward developing antagonistic ideologies. All these topics were considered fundamental.

CONCLUSIONS

The findings provide important insights for health professionals working with youth in preparing media literacy programs. These programs aim to reduce potential risks and amplify the positive effects of online resources. They underscore the importance of addressing this issue during hospitalization to develop skills and critical thinking aimed at changing small habits that perpetuate the problem in everyday life. The inherent limitations in current service practices, which may not adequately address individual needs or impact posttreatment life, must also be considered.

An Exploratory Content Analysis of the Use of Health Communication Strategies and Presence of Objectification in Fitness Influencer Social Media Posts

Health and fitness content intended to inspire people to live healthy lives (e.g. "fitspiration") has been linked to negative body image among girls and young women. Fitness influencers purport wanting to motivate healthy behaviors. This study seeks to examine the presence of strategies known to positively influence health behaviors (e.g. attitudes, self-efficacy) as well as of content known to have a negative influence (e.g. objectification) among fitness influencers. We conducted a content analysis (N = 441) of a random sample of one year of posts from four Instagram fitness influencers popular with girls and young women in the United States. The main analysis consisted of codes related to objectification, health promotion strategies, health-related content, and social engagement (i.e., likes). We found that fitness influencers included content that conveyed constructs previously found to positively influence health behaviors (e.g., attitudes and self-efficacy), but objectification was frequently present, in more than half of the posts. Additionally, we found that the presence of objectification in posts was negatively associated with likes, a form of social endorsement. We suggest health communicators aim to work in tandem with fitness influencers to include content that may motivate positive health behaviors and improve media literacy and that influencers aim to reduce the amount of objectifying content included in their posts. Our findings shed light on content being conveyed and possible insights into the negative effects associated with viewing such content.

Physical attributes of workout instructors and appearance-related messaging in a sample of home workout videos on YouTube: A content analysis

Given the popularity of home workouts and effects of exposure to media messaging regarding appearance ideals, the purpose of this analysis was to examine the content of YouTube home workout videos. A sample of 298 YouTube home workout videos was coded for demographic factors and body shape of instructors and the presence of body positivity messaging, appearance-related messaging, and other relevant themes. All videos in the sample included detailed instructions and demonstrations of the exercises by instructors. The majority of the videos depicted young White women with low body fat and thin/athletic bodies with visible muscles. Instructors often focused on burning fat/calories but also emphasized body functionality, exercising for fun/enjoyment, and the importance of taking care of one's body. Overall, findings demonstrate that workout instructors on YouTube conformed to unrealistic, narrowly defined appearance ideals present in Western culture, but the messaging in the videos contained many positive and affirming qualities.

Social media influencers and adolescents' health: A scoping review of the research field

Social media influencers (SMIs) have become an important source of health information for adolescents. However, the lack of expertise and commercial interests of SMIs pose challenges for adolescent health. To gain a better understanding of these challenges, this scoping review aimed to synthesize existing research on the role of SMIs in adolescent health. Using the PRISMA-ScR approach, we conducted a comprehensive search of eight databases and screened articles based on predefined criteria. The final sample included 51 articles published between 2012 and 2022. Results revealed inconsistent definitions and classifications of SMIs. The most common topics included appearance, nutrition, and substance use, while mental and sexual health topics were underrepresented. The ability of SMIs to establish trustworthy relationships with their followers was highlighted in the reviewed studies, shedding light on potential benefits and challenges for adolescent health. However, most studies focused on the negative roles of SMIs, such as the promotion of unrealistic body images, unhealthy diets, substance use, and inaccurate diagnosis and treatment advice. In addition, inappropriate advertising of unhealthy products (e.g., junk food, tobacco products and alcohol) was identified as a major challenge. The reviewed studies identified stricter regulation and improved social media and health literacy as important avenues for policy action. Less attention was given to the potential positive impact of SMIs and how to effectively include them in health promotion campaigns. In addition, the majority of studies were conducted in the Global North and relied on quantitative approaches, resulting in a lack of representation of minority populations and male adolescents.

Hashtag fitspiration: credibility screening and content analysis of Instagram fitness accounts

BACKGROUND

Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects.

METHODS

This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, "thinspiration", or negative messages.

RESULTS

Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger's coefficient κ_q) was high (Stage 1: 92% agreement [95% CI 87, 97], κ_q 0.84 [95% CI 0.73, 0.95]; Stage 2: 93% agreement [95% CI 83, 100], κ_q 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25-34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy; 54%). Most included accounts included an exercise video (93%) and example workout (76%).

CONCLUSION

While many popular Instagram fitspiration accounts offered credible content such as example workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.

Social media and body dissatisfaction in young adults: An experimental investigation of the effects of different image content and influencing constructs

Research shows negative correlations between media exposure of body images in the context of hegemonic beauty ideals and body satisfaction. The present study deals with the underlying mechanisms and the effects of different exposure contents. In the online experimental study, a sample consisting of 226 individuals (82.3% female, 17.7% male) received a three-minute exposure to Instagram images of women and men in the context of either hegemonic beauty ideals in the experimental group or body diversity in the control group. A conducted Mixed ANOVA with repeated measures showed significant group differences, including an increase in body dissatisfaction in the experimental group and a reduction in the control group after exposure. Statistically significant detrimental effects of exposure to images in the experimental group on women's state mood as well as descriptive similar tendencies on men's state mood were found. Moderating effects of the tendency to make upward social comparisons and the internalization of the gender-specific beauty ideal on the relationship between exposure content and the change scores of body dissatisfaction were found. Furthermore, a mediation model was calculated to investigate the effect of exposure content on post-measurement of body dissatisfaction, using the constructs "comparison processes regarding sexual attractiveness" and "assessment of one's own sexual attractiveness" as mediators. The model did not yield significant mediation, although significant relationships were found between the model components. Exploratory analyses were conducted on the influence of the assessment of one's own sexual attractiveness on related social comparisons and the intensity of engagement with Instagram content as a predictor of body dissatisfaction. The results highlight the relevance for psychoeducational purposes of addressing a critical engagement with depicted beauty ideals in social media. Moreover, the study proposes body diversity as an alternative content that can have a positive impact on body satisfaction, which can be actively sought during the individual Instagram user experience.