{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:06:33Z","timestamp":1791939993784,"version":"4.3.4"},"reference-count":72,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Historically, pharmaceutical companies have struggled with trust and brand reputation among key stakeholders and have adopted innovative marketing strategies to reach patients directly and rebuild those relationships. Social media influencers are a popular strategy to influence younger demographics, including Generation Z and millennials. It is common for social media influencers to work in paid partnerships with brands; this is a multibillion-dollar industry. Long have patients been active in online health communities and social media platforms such as Twitter and Instagram, but in recent years, pharmaceutical marketers have noticed the power of patient persuasion and begun to leverage \u201cpatient influencers\u201d in brand campaigns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to explore how patient influencers communicate health literacy on pharmaceutical medications on social media to their communities of followers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 26 in-depth interviews were conducted with patient influencers using a snowball sampling technique. This study is part of a larger project using an interview guide that included a range of topics such as social media practices, logistics of being an influencer, considerations for brand partnerships, and views on the ethical nature of patient influencers. The constructs of the Health Belief Model were used in this study\u2019s data analysis: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. This study was approved by the institutional review board of the University of Colorado and adhered to ethical standards in interview practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>As patient influencers are a new phenomenon, it was our goal to identify how health literacy on prescription medications and pharmaceuticals is being communicated on social media. Using the constructs of the Health Belief Model to guide the analysis, 3 themes were identified: understanding disease through experience, staying informed on the science or field, and suggesting that physicians know best.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients are actively exchanging health information on social media channels and connecting with other patients who share similar diagnoses. Patient influencers share their knowledge and experience in efforts to help other patients learn about disease self-management and improve their quality of life. Similar to traditional direct-to-consumer advertising, the phenomenon of patient influencers raises ethical questions that need more investigation. In a way, patient influencers are health education agents who may also share prescription medication or pharmaceutical information. They can break down complex health information based on expertise and experience and mitigate the loneliness and isolation that other patients may feel without the support of a community.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/41867","type":"journal-article","created":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T14:57:15Z","timestamp":1675177035000},"page":"e41867","source":"Crossref","is-referenced-by-count":52,"title":["Communicating Health Literacy on Prescription Medications on Social Media: In-depth Interviews With \u201cPatient Influencers\u201d"],"prefix":"10.2196","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1582-0867","authenticated-orcid":false,"given":"Erin","family":"Willis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1360-0107","authenticated-orcid":false,"given":"Kate","family":"Friedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0139-9001","authenticated-orcid":false,"given":"Mark","family":"Heisten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6948-255X","authenticated-orcid":false,"given":"Melissa","family":"Pickett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4089-7508","authenticated-orcid":false,"given":"Amrita","family":"Bhowmick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/ijcs.12647"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1080\/15252019.2020.1763873"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1080\/15252019.2020.1802955"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1080\/10548408.2018.1468851"},{"key":"ref5","unstructured":"WilliamsAMove over, millennials, here comes Generation ZThe New York Times201509202022-08-01https:\/\/www.nytimes.com\/2015\/09\/20\/fashion\/move-over-millennials-here-comes-generation-z.html"},{"key":"ref6","unstructured":"US influencer spending to surpass $3 billion in 2021Insider Intelligence20212022-08-08http:\/\/www.emarketer.com\/content\/us-influencer-spending-surpass-3-billion-2021"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.2196\/29422"},{"key":"ref8","unstructured":"Health UnionHealthunion.com2022-08-08http:\/\/www.HealthUnion.com"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcps.2011.09.006"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2016.08.007"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2196\/10649"},{"key":"ref12","unstructured":"WalkerMMatsaKNews consumption across social media in 2021Pew Research Center20212022-08-08http:\/\/www.pewresearch.org\/journalism\/2021\/09\/20\/news-consumption-across-social-media-in-2021\/"},{"key":"ref13","first-page":"10","author":"Persily, N","year":"2020","journal-title":"Social Media and Democracy The State of the Field, Prospects for Reform"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/widm.1385"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/16.2.207"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2010.499985"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1080\/07359683.2011.595639"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7332.278"},{"issue":"10","key":"ref19","first-page":"669","volume":"36","author":"Ventola, CL","year":"2011","journal-title":"P T"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1001\/virtualmentor.2013.15.11.pfor1-1311"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1108\/ijphm-02-2017-0007"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.12720\/joams.3.4.319-322"},{"issue":"1","key":"ref23","first-page":"35","volume":"2","author":"Wolin, B","year":"2014","journal-title":"J Digit Soc Media Mark"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1080\/00913367.2021.1977737"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijinfomgt.2020.102246"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbusres.2020.11.014"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1080\/00913367.2021.1880345"},{"key":"ref28","unstructured":"GeyserWWhat is an influencer? \u2013 social media influencers definedInfluencer Marketing Hub2022-08-07https:\/\/influencermarketinghub.com\/what-is-an-influencer\/"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbusres.2020.02.020"},{"key":"ref30","unstructured":"Chronic Diseases in AmericaCenters for Disease Control and Prevention20222022-08-08https:\/\/www.cdc.gov\/chronicdisease\/resources\/infographic\/chronic-diseases.htm"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1093\/her\/16.6.671"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1111\/j.1083-6101.2005.tb00268.x"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-2466.2000.tb02855.x"},{"key":"ref34","author":"Bandura, A","year":"1997","journal-title":"Self-Efficacy The Exercise of Control"},{"key":"ref35","author":"Glanz, K","year":"2008","journal-title":"Health Behavior and Health Education Theory, Research, and Practice"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1207\/s15324796abm2601_01"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2015.12.019"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2018.1511658"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.24.5.1290"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2014.950019"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1177\/1359105313496446"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1080\/02650487.2020.1824751"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7387-8"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.012809.103604"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.4103\/2277-9531.127580"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1016\/0738-3991(88)90045-6"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2018.1523260"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1177\/109019818401100101"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.52.1.1"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1177\/109019817400200403"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02628.x"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.3109\/16066359.2012.727505"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2013.802623"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneb.2017.09.010"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2010.521906"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1108\/yc-07-2016-00622"},{"key":"ref57","unstructured":"AuxierBAndersonMSocial media use in 2021Pew Research Center2023-02-23https:\/\/www.pewresearch.org\/internet\/2021\/04\/07\/social-media-use-in-2021\/"},{"key":"ref58","unstructured":"FoxSPurcellKHealth informationPew Research Center2023-02-23https:\/\/www.pewresearch.org\/internet\/2010\/03\/24\/health-information\/"},{"key":"ref59","unstructured":"For industry: using social mediaU.S. Food and Drug Administration2022-08-08https:\/\/www.fda.gov\/about-fda\/center-drug-evaluation-and-research-cder\/industry-using-social-media"},{"key":"ref60","unstructured":"Pharma DTC ad spend in the U.S. 2012-2021Statista2022-08-08https:\/\/www.statista.com\/statistics\/686906\/pharma-ad-spend-usa\/"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.6.552"},{"key":"ref62","first-page":"A","year":"2004","journal-title":"Health Literacy A Prescription to End Confusion"},{"key":"ref63","unstructured":"Health literacy: accurate, accessible and actionable health information for allCenters for Disease Control and Prevention2022-08-08https:\/\/www.cdc.gov\/healthliteracy\/index.html"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1080\/00913367.2015.1019249"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-008-9149-z"},{"key":"ref66","author":"Gubrium, J","year":"2002","journal-title":"Handbook of Interview Research Context and Method"},{"key":"ref67","author":"Parker, C","year":"2019","journal-title":"Snowball Sampling"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1177\/1049732316665344"},{"key":"ref69","author":"Miles, M","year":"1994","journal-title":"Qualitative Data Analysis An Expanded Sourcebook"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.3233\/efi-2004-22201"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.1023\/b:busi.0000005783.58142.6e"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.1111\/ablj.12019"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2023\/1\/e41867","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:42:05Z","timestamp":1782841325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2023\/1\/e41867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,13]]},"references-count":72,"URL":"https:\/\/doi.org\/10.2196\/41867","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.41867","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,13]]}}}