Can influencers play a real role in helping patients follow their treatment?
In this article, Loick Menvielle (EDHEC) and his co-authors analyse the conditions under which ‘health’ influencers on social media can promote adherence to treatment.
In recent research (1), Loick Menvielle (EDHEC Business School), Léna Griset (Toronto Metropolitan University) and Rupanwita Dash (EDC Paris Business School) examine how social media influencers can promote treatment adherence, that is, the practice of correctly following a prescribed course of treatment. Based on a survey of 475 participants conducted on Instagram, they identify three factors that contribute to better adherence: the influencers’ perceived social appeal, authenticity and expertise. An in-depth look.
In France, six out of ten patients do not follow their prescribed treatments correctly (2). This lack of treatment adherence - that is, failing to take medication at the correct dose, at the prescribed time or for the intended duration - is one of the main obstacles to effective care.
This non-adherence can lead to a deterioration in health, increase the number of hospital admissions or additional prescriptions, slow down recovery or even exacerbate certain chronic conditions. There is also a collective cost: increased pressure on the healthcare system and an estimated cost of 9.3 billion euros per year (3).
In the face of this challenge, social media offers an unexpected avenue (4). The ability of influencers to convey persuasive messages could indeed provide an innovative way of supporting public health initiatives. But through what mechanisms, and under what conditions, can this influence translate into health-promoting behaviours?
This is precisely what we sought to understand in our latest research (1). We investigated the links between influencers’ perceived social appeal, authenticity and expertise, and adherence to treatment, as well as the role of the type of message: depending on whether it is rational or emotional, it may or may not reinforce these links.
From medical advice to long-term patient engagement
In the doctor-patient relationship, the doctor’s clinical authority and the clarity of the information they provide play an important role in treatment adherence. However, this communication, which is often one-way and top-down, is not always sufficient to sustain the patient’s commitment in the long term.
This is particularly true in the case of chronic conditions (5), where following long-term treatment requires maintaining motivation over time and being able to manage one’s condition independently on a day-to-day basis.
Social media influencers draw on other means of persuasion, through regular interactions with their followers, accounts of personal experiences, and accessible, spontaneous and engaging content. In this way, they can foster identification and emotional engagement, whilst also helping to normalise certain health behaviours and encourage their adoption through imitation (6).
From appeal to credibility: the drivers of persuasion
An individual’s ability to persuade, and that of their messages, rests on three key factors: their social appeal, their credibility and the nature of the message. Influencers are no exception and can be analysed using this framework.
Social appeal. The persuasive power of a message depends, in particular, on how we perceive the person conveying it, and especially on their social appeal – that is, their ability to elicit our sympathy and interest (7). On social media, this appeal can encourage identification and the development of a parasocial relationship. This is a one-way emotional bond with a media personality, based on a sense of closeness and trust (8). These mechanisms could encourage the adoption of certain health behaviours promoted by influencers (9).
Credibility. The credibility attributed to the person conveying a message rests on two dimensions (10): on the one hand, expertise, that is, the knowledge and skills attributed to them; on the other hand, reliability, linked to the perception that they act sincerely and in the best interests of their audience. Reliability is fuelled in particular by perceived authenticity: the more sincere an influencer’s motivations appear, the more their message inspires trust. This is why we have chosen authenticity as an indicator of reliability. Expertise and reliability thus help to establish the relational trust necessary for persuasion.
The type of message. Influencers can share two main types of message: rational messages, based on facts, statistics or logical arguments, which highlight the benefits or risks associated with a particular behaviour; and emotional messages, which rely more on personal experience and feelings, and can make the message more memorable and easier to relate to.
How can influencers help to improve adherence to treatment?
We focused our research on Instagram, a highly visual and interactive platform that encourages storytelling, repeated interactions and the development of parasocial relationships.
Our survey was conducted amongst 475 users aged between 18 and 66. 64 per cent were women and 36 per cent were men; 13 per cent reported having been diagnosed with a chronic illness.
We measured the social appeal of influencers, their perceived authenticity and expertise, as well as self-reported treatment adherence – that is, as reported by the participants themselves. We also compared the relationships observed depending on whether the messages were rational or emotional.
Three key findings emerge from our results:
- a direct positive relationship between influencers’ social appeal and treatment adherence;
- the more an influencer is perceived as socially appealing, the more they tend to be regarded as authentic and expert;
- these two dimensions – authenticity and expertise – are in turn positively associated with treatment adherence.
In other words, social appeal is linked to adherence both directly and indirectly, by reinforcing the authenticity and expertise attributed to the influencer.
The tone of the message also makes a difference: when perceived expertise and authenticity are accompanied by messages with strong emotional resonance, self-reported adherence to the recommended treatment is higher.
Neither substitutes nor competitors for healthcare professionals: support staff who need supervision
Our findings suggest that influencers may be a promising tool for promoting treatment adherence. Influencer marketing could therefore play an increasingly important role in public health communication strategies, particularly by boosting engagement and encouraging certain behavioural changes.
However, realising this potential requires ensuring the credibility of the messages and those who convey them, as the growing influence of influencers in the health sector also increases the risks associated with medical misinformation.
We therefore propose distinguishing ‘qualified’ influencers from others by verifying their expertise and developing certification schemes or official labels, or by encouraging the creation of content developed in collaboration with healthcare professionals. The aim is not to replace healthcare professionals, but to provide them with additional channels capable of reaching patients where they are: on their news feeds. And in this way, to build public health strategies that are more engaging, credible and responsible.
References
(1) https://shs.cairn.info/journal-gestion-et-management-public-2024-5-page-1b
(2) https://www.lissa.fr/rep/articles/20684400
(4) https://journals.sagepub.com/doi/abs/10.1177/15248399241258442
(5) https://pubmed.ncbi.nlm.nih.gov/12435261/
(6) https://www.sciencedirect.com/science/article/pii/S0277953623008298
(7) McGuire, 1985 ; McCroskey & McCain, 1974
(8) Perse & Rubin, 1989 - https://psycnet.apa.org/record/1989-36445-001
(9) Belanche et al., 2021 ; Kim et al., 2024
(10) Hovland et al., 1953 - https://www.scirp.org/reference/referencespapers?referenceid=445194
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