Online harassment of Japanese celebrities and influencers

Famous people, such as celebrities and influencers, are harassed online on a daily basis. Online harassment mentally disturbs them and negatively affects society. However, limited studies have been conducted on the online harassment victimization of famous people, and its effects remain unclear. We surveyed Japanese famous people (N = 213), who were influential people who appeared on television and other traditional media and on social media, regarding online harassment victimization, emotional injury, and action against offenders and revealed that various forms of online harassment are prevalent. Some victims used the anti-harassment functions provided by weblogs and social media systems (e.g., blocking/muting/reporting offender accounts and closing comment forms), talked about their victimization to close people, and contacted relevant authorities to take legal action (talent agencies, legal consultants, and police). By contrast, some victims felt compelled to accept harassment and did not initiate action for offenses. We propose several approaches to support victims, inhibit online harassment, and educate people. Our findings help that platforms establish support systems against online harassment.

Social Network Analysis of e-Cigarette-Related Social Media Influencers on Twitter/X: Observational Study

BACKGROUND

An e-cigarette uses a battery to heat a liquid that generates an aerosol for consumers to inhale. e-Cigarette use (vaping) has been associated with respiratory disease, cardiovascular disease, and cognitive functions. Recently, vaping has become increasingly popular, especially among youth and young adults.

OBJECTIVE

The aim of this study was to understand the social networks of Twitter (now rebranded as X) influencers related to e-cigarettes through social network analysis.

METHODS

Through the Twitter streaming application programming interface, we identified 3,617,766 unique Twitter accounts posting e-cigarette-related tweets from May 3, 2021, to June 10, 2022. Among these, we identified 33 e-cigarette influencers. The followers of these influencers were grouped according to whether or not they post about e-cigarettes themselves; specifically, the former group was defined as having posted at least five e-cigarette-related tweets in the past year, whereas the latter group was defined as followers that had not posted any e-cigarette-related tweets in the past 3 years. We randomly sampled 100 user accounts among each group of e-cigarette influencer followers and created corresponding social networks for each e-cigarette influencer. We compared various network measures (eg, clustering coefficient) between the networks of the two follower groups.

RESULTS

Major topics from e-cigarette-related tweets posted by the 33 e-cigarette influencers included advocating against vaping policy (48.0%), vaping as a method to quit smoking (28.0%), and vaping product promotion (24.0%). The follower networks of these 33 influencers showed more connections for those who also post about e-cigarettes than for followers who do not post about e-cigarettes, with significantly higher clustering coefficients for the former group (0.398 vs 0.098; P=.005). Further, networks of followers who post about e-cigarettes exhibited substantially more incoming and outgoing connections than those of followers who do not post about e-cigarettes, with significantly higher in-degree (0.273 vs 0.084; P=.02), closeness (0.452 vs 0.137; P=.04), betweenness (0.036 vs 0.008; P=.001), and out-of-degree (0.097 vs 0.014; P=.02) centrality values. The followers who post about e-cigarettes also had a significantly (P<.001) higher number of followers (n=322) than that of followers who do not post about e-cigarettes (n=201). The number of tweets in the networks of followers who post about e-cigarettes was significantly higher than that in the networks of followers who do not post about e-cigarettes (93 vs 43; P<.001). Two major topics discussed in the networks of followers who post about e-cigarettes included promoting e-cigarette products or vaping activity (55.7%) and vaping being a help for smoking cessation and harm reduction (44.3%).

CONCLUSIONS

Followers of e-cigarette influencers who also post about e-cigarettes have more closely connected networks than those of followers who do not themselves post about e-cigarettes. These findings provide a potentially practical intervention approach for future antivaping campaigns.

#OtoTwitter: The Top 75 Twitter Influencers in Otolaryngology and Association With Academic Impact

OBJECTIVES

Social media has enabled discussion of relevant topics within otolaryngology. With increasing academic discourse occurring on virtual platforms, it is important to examine who is influencing these discussions. This study thus aims to: (1) identify the top Twitter influencers in otolaryngology and (2) assess the relationship between Twitter influence and academic impact.

STUDY DESIGN

Cross-sectional analysis.

SETTING

Twitter.

METHODS

The Right Relevance program was used to identify and rank the top 75 Twitter influencers, excluding organizations, according to the search terms "otolaryngology," "head and neck surgery," "ear nose throat," "rhinology," "head and neck," "laryngology," "facial plastics," and "otology." Demographic data and h-index were collected for each influencer. Correlational analyzes were performed to assess the relationships between Twitter rank and geographic location, sex, subspecialty, and h-index.

RESULTS

The majority of the top 75 influencers were otolaryngologists (87%), female (68%), and located in the United States (61%). General otolaryngology (n = 20, 31%) was more well-represented than any individual subspecialty including facial plastics (n = 10, 15%), rhinology (n = 10, 15%), and neurotology (n = 9, 14%). There was a significant relationship between Twitter rank and h-index (Spearman ρ value of -0.32; 95% confidence interval: -0.51 to -0.01; P = .006). Twitter rank was not significantly correlated with subspecialty, sex, or geographic location (P > .05).

CONCLUSION

The majority of Twitter influencers within otolaryngology were otolaryngologists, female, and located in the United States. Social media influence is positively associated with academic impact among otolaryngologists.

Self-Perception of Extroversion Increases with Social Media Use: A Social Media Induction Task

Previous studies have examined the relationship between social media and extroversion, often relying on correlational designs. This study introduced a social media induction procedure to examine the relationship between social media and extroversion with an experimental design. In a procedure adapted from the personality research literature, participants used a written prompt to imagine themselves as a social media influencer and were then asked to use social media with this mindset. Participants' extroversion was measured before and after this activity using the Big Five Inventory. The results show that this social media induction procedure resulted in increased reports of extroversion after the task, and this post-task change was not predicted by other related social media factors (such as hours of social media use per day). These results complicate the assertion that differences in social media use between extroverts and introverts are due to its stronger appeal to extroverts.

Social media influencers' impact during pregnancy and parenting: A qualitative descriptive study

Pregnant people and parents engage with social media networking sites seeking support and information that is shared in a relatable way. Engaging with social media influencers (SMIs) and their followers, however, may have both affirming and harmful effects. SMIs can facilitate information-sharing, discussion, and supportive behaviors, but engaging with SMIs can lead to negative experiences and exposure to misinformation. To date, little is known about the impacts of following influencers during pregnancy and early parenthood. The aim of this study was to explore how engaging with SMIs impacts pregnant people and parents of children aged 5 or under in Australia. A qualitative descriptive approach was taken. Qualitative data from 85 anonymously completed online written surveys were thematically analyzed using Braun & Clarke's six-step process. Five overarching themes and two subthemes were identified. The first theme, "Comparisons of self," held two subthemes: "Unfavorable comparisons of self to SMIs" and "Favorable comparisons of self to SMIs." Additional themes were "A virtual community of inspiration and togetherness," "Sharing of information, opinions & experiences," "Gatekeeping self-efficacy," and "Credibility." The findings of the study indicated that discordance between influencer-mediated expectations of parenthood and a person's actual experience may affect well-being and perceptions of parental self-efficacy. Information sought from influencers may substitute for face-to-face education by clinicians. Health professionals who are also influencers may possess the ability to provide evidence-based information. This content, however, is not without risk for bias or incompleteness.

A qualitative analysis of adolescents' perspectives on peer and influencer alcohol-related posts on social media

INTRODUCTION

Adolescent exposure to alcohol-related content on social media is common and associated with alcohol use and perceived norms; however, little is known about how exposure differs by the source of the content (e.g., peer or 'influencer'). The purpose of this study was to utilise qualitative methods to compare adolescent perspectives on peer- versus influencer-generated alcohol content on social media.

METHODS

Nine virtual semi-structured focus groups were conducted with adolescents (aged 15-19 years), following a general script aimed at ascertaining adolescent comparative perspectives on peer and influencer alcohol-related media content and the contexts in which it occurs.

RESULTS

Five main themes emerged: (i) although both influencers and peers post predominantly positively-valenced alcohol content online, adolescents perceived some differences between these posts; (ii) adolescents perceived their peers to be more cautious and strategic when posting about alcohol than influencers are; (iii) the decision to engage with peer or influencer alcohol-related posts is influenced by a number of factors; (iv) both peer and influencer posts were perceived to send the message that drinking is acceptable, normal or cool; and (v) adolescents believed they are more likely to be influenced by peers' alcohol posts than influencers' alcohol posts, with some exceptions.

DISCUSSION AND CONCLUSIONS

Future studies should aim to further understand the unique attributes and circumstances in which exposure to peer and influencer alcohol-related posts impact adolescent alcohol-related cognitions and behaviours. This knowledge will inform prevention and intervention efforts, such as media literacy training and media-specific parenting practices.

A Deep Dive Into Instagram's Top Skinfluencers

We characterized skinfluencers from various training backgrounds and compared their posts on Instagram featuring skin care products.

Using Social Influence Strategies to Improve Rates of Online Mental Health Survey Participation: Results from Two Experiments

Online surveys are routinely used in mental health screening and treatment follow-up assessment, though they can yield low response rates. We tested the effects of social psychology-informed influence strategies for increasing rates of participation in an online mental health screening survey (Experiment 1) and a treatment follow-up survey (Experiment 2). In Experiment 1 (N = 45,569), embedding one or any combination of three motivational appeals (personal gain, community gain, and inclusivity) in screening survey invitation and reminder emails unexpectedly led to lower rates of survey participation compared to when the appeals were not included (overall participation rate = 12.02%, ORs = 0.75 to 0.97, ps < .001). In Experiment 2 (N = 873), a video of a TikTok influencer encouraging survey participation embedded in treatment follow-up survey invitation and reminder emails did not significantly affect survey completion compared to a humorous gif unrelated to survey participation (overall participation rate = 47.88%, OR = 1.18, p = .200). Moderator analyses revealed that the video led to higher rates of participation than the gif among White participants (OR = 1.39, p = .031) and non-Hispanic participants (OR = 1.35, p = .029) only, whereas the video led to lower rates of participation than the gif among students who did not disclose their race (OR = 0.31, p = .010). Results suggested that efforts to improve online survey participation should be balanced with possible downsides (e.g., added email length) and should be evaluated for differential performance among population subgroups prior to widespread implementation.

The Influence of Social Media on the Decision of Rhinoplasty Among Adults in the Western and Southern Regions of Saudi Arabia: A Comparative Cross-Sectional Study

Introduction Rhinoplasty, a cosmetic surgical procedure aimed at altering the appearance of the nose, has gained immense popularity worldwide. Patients undergo this procedure for various reasons, ranging from aesthetic concerns to functional impairments. Social media, being a ubiquitous platform for sharing and consuming visual content, has emerged as a potential influencer for individuals contemplating rhinoplasty. This study aims to investigate the impact of social media on the prevalence of rhinoplasty among individuals residing in the southern and western regions of Saudi Arabia. Methods A cross-sectional study was conducted through an online self-administered questionnaire, targeting male and female adults aged 18 years or older, residing in the western and southern regions of Saudi Arabia. The questionnaire comprised 17 questions, categorized into two sections. The first section sought demographic information, including age, gender, education, and other relevant characteristics. The second section focused on the influence of social media on the decision-making process related to rhinoplasty. Results A total of 1645 participants responded to the survey, with 96.80% being Saudi citizens. The majority of respondents were females (69.11%); 58.52% of the respondents were from the western region of Saudi Arabia, while 41.48% lived in the southern region. Most participants (64.27%) were aged between 18 and 30 years. The study revealed that Snapchat (Snap Inc., Santa Monica, California, United States) was the most influential social media platform, with 43.41% of respondents reporting it as the key influencer for their decision to undergo rhinoplasty. Twitter (Twitter, Inc., San Francisco, California, United States) and Instagram (Meta Platforms, Inc., Menlo Park, California, United States) followed at 22.97% and 12.09%, respectively. Interestingly, 28.42% of respondents acknowledged that social media played a significant role in their decision to undergo rhinoplasty, particularly when promoted by celebrities or trusted figures. Comparing responses from the western and southern regions, the study showed that individuals from the southern region were relatively more influenced by social media, with 27.8% and 29.3% of respondents reporting the influence from the two regions, respectively. Out of the total respondents, only 38.75% reported dissatisfaction with their nose's appearance and condition, while 23.60% expressed a tendency towards undergoing rhinoplasty. Conclusion The study's findings underscore the critical role of social media in influencing patients' decisions to undergo rhinoplasty, particularly in the southern region of Saudi Arabia. Snapchat emerged as the most influential social media platform, with celebrities' pictures before and after the procedure being the leading factor in motivating patients to undergo rhinoplasty. The study highlights the need for further research to explore the potential risks and benefits associated with the influence of social media on patients' decision-making regarding rhinoplasty.

Brain Activities Show There Is Nothing Like a Real Friend in Contrast to Influencers and Other Celebrities

Especially for young people, influencers and other celebrities followed on social media evoke affective closeness that in their young minds seems real even though it is fake. Such fake friendships are potentially problematic because of their felt reality on the consumer side while lacking any inversely felt true closeness. The question arises if the unilateral friendship of a social media user is equal or at least similar to real reciprocal friendship. Instead of asking social media users for explicit responses (conscious deliberation), the present exploratory study aimed to answer this question with the help of brain imaging technology. Thirty young participants were first invited to provide individual lists including (i) twenty names of their most followed and loved influencers or other celebrities (fake friend names), (ii) twenty names of loved real friends and relatives (real friend names) as well as (iii) twenty names they do not feel any closeness to (no friend names). They then came to the Freud CanBeLab (Cognitive and Affective Neuroscience and Behavior Lab) where they were shown their selected names in a random sequence (two rounds), while their brain activities were recorded via electroencephalography (EEG) and later calculated into event-related potentials (ERPs). We found short (ca. 100 ms) left frontal brain activity starting at around 250 ms post-stimulus to process real friend and no friend names similarly, while both ERPs differed from those elicited by fake friend names. This is followed by a longer effect (ca. 400 ms), where left and right frontal and temporoparietal ERPs also differed between fake and real friend names, but at this later processing stage, no friend names elicited similar brain activities to fake friend names in those regions. In general, real friend names elicited the most negative going brain potentials (interpreted as highest brain activation levels). These exploratory findings represent objective empirical evidence that the human brain clearly distinguishes between influencers or other celebrities and close people out of real life even though subjective feelings of closeness and trust can be similar. In summary, brain imaging shows there is nothing like a real friend. The findings of this study might be seen as a starting point for future studies using ERPs to investigate social media impact and topics such as fake friendship.

Dermatology through the lens of social media: A qualitative study among adolescents

Social media (SM) use has accelerated at an unprecedented pace and dermatology literature evaluating SM use is primarily centered on the quality and quantity of dermatologic content, with minimal research on how adolescent patients experience such content. We recruited 15 patients between the ages of 13-18 years from the Atrium Health Wake Forest Baptist Department of Dermatology to interview regarding their experience with dermatologic content on SM. Despite most participants' insightful comments on SM use and the relative lack of dermatologic content validation on SM, many participants adopted skin care advice from SM. Adolescents are particularly vulnerable to social influence and it is important dermatologists understand how pervasive skin-related content is on these platforms.

Description of the Exposure of the Most-Followed Spanish Instamoms' Children to Social Media

There is evidence of the risk of overexposure of children on social networks by parents working as influencers. A cross-sectional study of the profiles of the sixteen most-followed Instamoms in Spain was carried out. An analysis of these profiles was performed over a full month (April 2022), three times a week, to describe the representation of influencers' children in the posts shared by them, as well as their role in the Instamoms' marketing. A total of 192 evaluations of the profiles were performed in the study period. The average number of children exposed by an Instamom was three, generally preschoolers and schoolchildren. The children appear in a context of the family home and accompanied by their mother. The type of advertising that accompanies the appearance of underage children is usually women or children's clothing, but also food products, leisure, etc. Appearance of children in the posts had a statistically significant influence on followers measured by the number of likes. Results provided the identification of two Instamom clusters with differentiated behaviors in relation to appearance of children in posts. It is important to involve Social Pediatrics in the protection of the privacy and interests of children given the increase in sharenting. The authors believe that there are concerns about their explicit consent to public exposure from early childhood and about the medium and long-term effect that this may have on their future well-being.

Health Promotion on Instagram: Descriptive-Correlational Study and Predictive Factors of Influencers' Content

The pandemic has accentuated the power that influencers have to influence their followers. Various scientific approaches highlight the lack of moral and ethical responsibility of these creators when disseminating content under highly sensitive tags such as health. This article presents a correlational statistical study of 443 Instagram accounts with more than one million followers belonging to health-related categories. This study aims to describe the content of these profiles and their authors and to determine whether they promote health as accounts that disseminate health-related content, identifying predictive factors of their content topics. In addition, it aims to portray their followers and establish correlations between the gender of the self-described health influencers, the characteristics of their audience and the messages that these prescribers share. Health promotion is not the predominant narrative among these influencers, who tend to promote beauty and normative bodies over health matters. A correlation is observed between posting health content, the gender of the influencers and the average age of their audiences. The study concludes with a discussion on the role of public media education and the improvement of ethical protocols on social networks to limit the impact of misleading and false content on sensitive topics, increasing the influence of real health prescribers.

Patterns of Promotional Content by Dermatology Influencers on TikTok

Collapse

Examining the Influence on Perceptions of Endometriosis via Analysis of Social Media Posts: Cross-sectional Study

Background

Social media platforms, such as Facebook and Instagram, are increasingly being used to share health-related information by “influencers,” regular users, and institutions alike. While patients may benefit in various ways from these interactions, little is known about the types of endometriosis-related information published on social media. As digital opinion leaders influence the perceptions of their followers, physicians need to be aware about ideas and beliefs that are available online, in order to address possible misconceptions and provide optimal patient care.

Objective

The aim of this study was to identify and analyze frequent endometriosis-related discussion topics on social media in order to offer caregivers insight into commonly discussed subject matter and aspects.

Methods

We performed a systematic search using predefined parameters. Using the term “endometriosis” in Facebook’s search function and a social media search engine, a list of Facebook pages was generated. A list of Instagram accounts was generated using the terms “endometriosis” and “endo” in Instagram’s search function. Pages and accounts in English with 5000 or more followers or likes were included. Nonpublic, unrelated, or inactive pages and accounts were excluded. For each account, the most recent 10 posts were identified and categorized by two independent examiners using qualitative content analysis. User engagement was calculated using the numbers of interactions (ie, shares, likes, and comments) for each post, stratified by the number of followers.

Results

A total of 39 Facebook pages and 43 Instagram accounts with approximately 1.4 million followers were identified. Hospitals and medical centers made up 15% (6/39) of the Facebook pages and 5% (2/43) of the Instagram accounts. Top accounts had up to 111,600 (Facebook) and 41,400 (Instagram) followers. A total of 820 posts were analyzed. On Facebook, most posts were categorized as “awareness” (101/390, 25.9% of posts), “education and research” (71/390, 18.2%), and “promotion” (64/390, 16.4%). On Instagram, the top categories were “inspiration and support” (120/430, 27.9% of posts), “awareness” (72/430, 16.7%), and “personal story” (72/430, 16.7%). The frequency of most categories differed significantly between platforms. User engagement was higher on Instagram than on Facebook (3.20% vs 0.97% of followers per post). On Instagram, the highest percentage of users engaged with posts categorized as “humor” (mean 4.19%, SD 4.53%), “personal story” (mean 3.02%, SD 4.95%), and “inspiration and support” (mean 2.83%, SD 3.08%). On Facebook, posts in the categories “awareness” (mean 2.05%, SD 15.56%), “humor” (mean 0.91%, SD 1.07%), and “inspiration and support” (mean 0.56%, SD 1.37%) induced the most user engagement. Posts made by hospitals and medical centers generated higher user engagement than posts by regular accounts on Facebook (mean 1.44%, SD 1.11% vs mean 0.88%, SD 2.71% of followers per post) and Instagram (mean 3.33%, SD 1.21% vs mean 3.19%, SD 2.52% of followers per post).

Conclusions

Facebook and Instagram are widely used to share endometriosis-related information among a large number of users. Most posts offer inspiration or support, spread awareness about the disease, or cover personal issues. Followers mostly engage with posts with a humoristic, supportive, and awareness-generating nature. Health care providers should be aware about the topics discussed online, as this may lead to an increased understanding of the needs and demands of digitally proficient patients with endometriosis.

How can I Be as attractive as a Fitness YouTuber in the era of COVID-19? The impact of digital attributes on flow experience, satisfaction, and behavioral intention

In the past decade, the social media platform has dramatically changed individuals’ daily activities in real life and on the Internet, including shopping, socialization, entertainment, study, and even health and fitness. In the era of COVID-19, particularly, consumers tend to rely more on digital attributes of social media platforms for their decision-making process by reducing the physical touchpoint. Responding to this ongoing trend, this study investigates how fitness YouTube channel attributes and fitness YouTuber attributes influence flow experience, satisfaction, and behavioral intention of YouTubers who work out at home via a fitness YouTube channel during the COVID-19 pandemic. Based on the social media literature and the cognitive appraisal theory, this research formulates a research model that specifies the influence of three dimensions of fitness YouTube channel attributes (i.e., social interaction, information quality, and visual content) and three dimensions of fitness YouTuber attributes (i.e., social attractiveness, physical attractiveness, and attitude homophily) on flow experience, YouTube channel satisfaction, and behavioral intention in the context of YouTube. This study recruited participants in the United States who currently work out via a fitness YouTube channel through three waves of data collection during the COVID-19 era. The empirical results revealed that flow experience was significantly affected by information quality, visual content, and physical attractiveness. Also, YouTube channel satisfaction was significantly affected by social interaction, information quality, and visual content. Lastly, behavioral intention was significantly affected by flow experience and YouTube channel satisfaction. Based on the findings, this study proposes meaningful implications for the extant literature and social media industry during the COVID-19 pandemic.

Sexual Health Influencer Distribution of HIV/Syphilis Self-Tests Among Men Who Have Sex With Men in China: Secondary Analysis to Inform Community-Based Interventions

Background

Social network–based strategies can expand HIV/syphilis self-tests among men who have sex with men (MSM). Sexual health influencers are individuals who are particularly capable of spreading information about HIV and other sexually transmitted infections (STIs) within their social networks. However, it remains unknown whether a sexual health influencer can encourage their peers to self-test for HIV/syphilis.

Objective

The aims of this study were to examine the impact of MSM sexual health influencers on improving HIV/syphilis self-test uptake within their social networks compared to that of nonsexual health influencers.

Methods

In Zhuhai, China, men 16 years or older, born biologically male, who reported ever having had sex with a man, and applying for HIV/syphilis self-tests were enrolled online as indexes and encouraged to distribute self-tests to individuals (alters) in their social network. Indexes scoring >3 on a sexual health influencer scale were considered to be sexual health influencers (Cronbach α=.87). The primary outcome was the mean number of alters encouraged to test per index for sexual health influencers compared with the number encouraged by noninfluencers.

Results

Participants included 371 indexes and 278 alters. Among indexes, 77 (20.8%) were sexual health influencers and 294 (79.2%) were noninfluencers. On average, each sexual health influencer successfully encouraged 1.66 alters to self-test compared to 0.51 alters encouraged by each noninfluencer (adjusted rate ratio 2.07, 95% CI 1.59-2.69). More sexual health influencers disclosed their sexual orientation (80.5% vs 67.3%, P=.02) and were community-based organization volunteers (18.2% vs 2.7%, P<.001) than noninfluencers. More alters of sexual health influencers came from a rural area (45.5% vs 23.8%, P<.001), had below-college education (57.7% vs 37.1%, P<.001), and had multiple casual male sexual partners in the past 6 months (25.2% vs 11.9%, P<.001).

Conclusions

Being a sexual health influencer was associated with encouraging more alters with less testing access to self-test for HIV/syphilis. Sexual health influencers can be engaged as seeds to expand HIV/syphilis testing coverage.

Addressing Military Sexual Violence by Proposing a Social Media Influencer Model

Military sexual violence (MSV) is a prevalent issue that uniquely affects mission readiness. Although research on MSV and social media is growing, examinations of possible interventions like those employing social media in this population are scant. Given the growing interest in targeting MSV, the present systematic review was conducted. The PRISMA framework was used to conduct a systematic review of MSV and social media (N = 71). Queries were limited to articles published between 2010 and 2020. SAGE Journals, PubMed, and JSTOR were utilized. Terms and potential combinations were entered into the databases in varying Boolean combinations. Additional recorders were identified for inclusion via the reference sections of relevant records. After removing duplicates from the query results, we selected records of suspected relevance by title and screened abstracts. Finally, articles with relevant abstracts were reviewed thoroughly to determine whether they met inclusion criteria for the review. The employments of military leaders in a social media intervention puts into practice the military's central values and development of its leadership core. This intervention promotes group solidarity while maximizing conversations around meaningful messages. Findings in this review suggest military leaders could feasibly employ a cost-effective global intervention using social media, as a tool to help actively address MSV.

Sponsorship Disclosures and Perceptions of E-cigarette Instagram Posts

OBJECTIVES

Instagram influencers have many followers and are often paid to promote products, including e-cigarettes. This experimental study assessed effects of sponsorship disclosures on perceptions of e-cigarette Instagram influencer posts.

METHODS

Young adult e-cigarette users (age 18-29; N = 917) were randomly assigned to 3 experimental conditions varying the clarity of sponsorship disclosure on simulated Instagram influencer posts: clear (eg, "#sponsored") ambiguous (eg, "#sp"), or no disclosure (ie, vaping-related hashtags only). After viewing each of 4 Instagram posts featuring a fictitious e-cigarette brand, participants reported hashtag recognition, ad recognition, ad trust, influencer credibility, and post engagement intentions. After viewing all posts, participants reported brand attitudes, brand use intentions, and vaping intentions.

RESULTS

With greater recognition of clear (but not ambiguous) disclosure hashtags, ad recognition increased (p = .001), perceptions of influencer credibility decreased (p = .022), and intentions to engage with posts decreased (p = .008). Ad trust was lower with greater hashtag recognition regardless of disclosures (p < .001). Sponsorship disclosures did not significantly affect brand attitudes, brand use intentions, or vaping intentions.

CONCLUSIONS

Recognizing clear sponsorship disclosures may influence young adults' perceptions of and engagement with e-cigarette Instagram posts but may not affect perceptions or use of products.

Exploring the Characteristics and Behaviors of Nurses Who Have Attained Microcelebrity Status on Instagram: Content Analysis

Background

Instagram is a social media platform that enables users to share images and videos worldwide. Some nurses have used Instagram to document their experiences as a nurse and have subsequently gained microcelebrity status—that is, a user who purposefully seeks to amass a substantive Web-based following and has become recognized as a niche area of interest.

Objective

This study aimed to identify the characteristics and behaviors of microcelebrity nurses who act as influencers on Instagram and use their nursing profile to gain attention and presence on the Web.

Methods

A qualitative, exploratory, nonparticipatory content analysis of media and text generated by a purposeful sample of 10 registered nurses who use Instagram and sustain a definable microcelebrity status was conducted. In this study, manifest and latent data were examined to gain an understanding of the characteristics and behaviors of nurses who have attained microcelebrity status on Instagram.

Results

Data analysis revealed 5 themes of Instagram posts: (1) engaging Instagram users, (2) educational opportunities and insights, (3) nursing-related humor, (4) emotions experienced by nurses, and (5) media and narratives including patient details or work context. Messages were primarily positive in nature; however, multiple potential privacy, ethical, and professional issues were noted throughout the posted content.

Conclusions

The findings of this study help to expand the current knowledge related to the use of social media platforms such as Instagram, especially in regard to the emergence of nurses who use this form of technology to achieve or maintain a microcelebrity status. This study calls for additional research on nurses’ attainment of microcelebrity status on social media as well as further policy development to adequately prepare nurses to navigate social media.

What Do Adolescents See on Social Media? A Diary Study of Food Marketing Images on Social Media

Food marketing influences eating preferences and choices, especially among adolescents, contributing to the rise of overweight, obesity, and other chronic health disorders. Recent social media advancements have provided food marketers with platforms to reach out to many in more personal and authentic ways as compared to classical media advertising. Such personalized and borderless social media platforms allow marketers to easily use owned, paid, and earned (word-of –mouth) marketing strategies, including paid and non-paid influencers to reach younger target audiences. This study therefore aims to explore food messages adolescents (12–18 years old) encounter on social media, and assess these messages for their sources, the presence of core and non-core food, and the marketing strategies employed. To attain an in-depth understanding of the food messages that adolescents are continuously exposed to, we carried out a diary study with 21 Flemish adolescents who took screenshots of food images they encountered on their social media platforms for the duration of one week. A quantitative and qualitative content analysis of 611 images revealed that adolescents are mostly exposed to messages of non-core (67% of images) and branded (49% of images) food, often (49% of images) presented in association with a social context such as hanging around with friends, eating at restaurants and celebrating with food. Adolescents often encounter branded food images through peers and social media influencers, the majority of which are part of earned (49% of branded images) or paid (40% of branded images) media food marketing. This research provides an in-depth understanding of the social media messages that adolescents encounter on a daily basis and sheds light on food norms typically communicated on social media by marketers, peers, and influencers. Study findings highlight prominent social media food messages that should be tested for their persuasiveness, providing insights for future research that aims to assess the effects of social media food marketing on adolescents. Based on the study findings, we call for relevant policy actions that address current social media marketing strategies targeted at adolescents.

The effect of influencer marketing of food and a "protective" advertising disclosure on children's food intake

BACKGROUND

Children are active on social media and consequently are exposed to new and subtle forms of food marketing.

OBJECTIVES

To examine whether exposure to a YouTube video featuring influencer marketing of an unhealthy snack affects children's ad libitum snack intake and whether inclusion of an advertising disclosure moderates this effect.

METHODS

In a randomized between-subjects design, 151 children (aged 9-11 y; mean, 10.32 y ± 0.6) were exposed to influencer marketing of a non-food product (n = 51), or an unhealthy snack with (n = 50) or without (n = 50) an advertising disclosure. Participants' ad libitum intake of the marketed snack and an alternative brand of the same snack was measured.

RESULTS

Children exposed to food marketing with (P < .001, d = 1.40) and without (P < .001, d = 1.07) a disclosure consumed more (kcals) of the marketed snack relative to the alternative; the control did not differ (.186, d = 0.45). Consumption of the alterative brand did not differ across conditions (.287, η_p² = .02). Children who viewed food marketing with a disclosure (and not those without) consumed 41% more of the marketed snack (.004, η_p² = .06), compared with control.

CONCLUSIONS

Influencer marketing increases children's immediate intake of the promoted snack relative to an alternative brand. Advertising disclosures may enhance the effect.

Food and Beverage Cues Featured in YouTube Videos of Social Media Influencers Popular With Children: An Exploratory Study

Food and beverage cues (visual displays of food or beverage products/brands) featured in traditional broadcast and digital marketing are predominantly for products high in fat, sugar and/or salt (HFSS). YouTube is hugely popular with children, and cues featured in content uploaded by YouTube video bloggers (influencers) has been shown to affect children’s eating behavior. However, little is known about the prevalence of such cues, the contexts in which they appear, and the frequency with which they are featured as part of explicit marketing campaigns. The objective of this study was to explore the extent and nature of food and beverage cues featured in YouTube videos of influencers popular with children. All videos uploaded by two influencers (one female, one male) over a year (2017) were analyzed. Based on previous content analyses of broadcast marketing, cues were categorized by product type and classified as “healthy” or “less healthy” according to the UK Nutrient Profiling Model. Cues were also coded for branding status, and other factors related to their display (e.g., description). In total, the sample comprised 380 YouTube videos (119.5 h) and, of these, only 27 videos (7.4%) did not feature any food or beverage cues. Cakes (9.4%) and fast foods (8.9%) were the most frequently featured product types, less frequent were healthier products such as fruits (6.5%) and vegetables (5.8%). Overall, cues were more frequently classified as less healthy (49.4%) than healthy (34.5%) and were presented in different contexts according to nutritional profile. Less healthy foods (compared with healthy foods) were more often; branded, presented in the context of eating out, described positively, not consumed, and featured as part of an explicit marketing campaign. These data provide the first empirical assessment of the extent and nature of food and beverage cue presentation in YouTube videos by influencers popular with children. Given the emerging evidence of the effects of influencer marketing of food and beverages on children’s eating behavior, this exploratory study offers a novel methodological platform for digital food marketing assessment and delivers important contextual information that could inform policy deliberations in this area.