The growing visibility of social media influencers has increased interest in their role in shaping health beliefs and behaviors. While prior research has largely focused on message characteristics or direct behavioral outcomes, less attention has been given to the conditions under which influencer-based health messages are interpreted and translated into action. This study conceptualizes influencer-based health communication not as a direct persuasive force, but as a conditional communication process. Drawing on Uses and Gratifications Theory and the Health Belief Model as interpretive frameworks, it examines how individuals engage with health-related influencer content, how such engagement relates to health perceptions, and how digital health literacy shapes message interpretation.Survey data from social media users were analyzed using Firth's penalized logistic regression to address the rarity of influencer-driven health behavior. Findings indicate that, despite high levels of exposure to influencer-based health content, the translation of such exposure into health-related action remains limited. Exposure to health content significantly increases the likelihood of influencer-driven behavior, whereas higher digital health literacy reduces this likelihood, suggesting a protective effect. Additionally, perceived commercial intent decreases the probability that influencer recommendations lead to action.By distinguishing between engagement and behavioral change, this study reframes influencer effects as conditional outcomes shaped by motivations, perceptions, and interpretive competencies. It contributes to health communication literature by moving beyond linear persuasion models and highlighting the critical role of digital health literacy. The findings also offer practical implications for strengthening individuals' ability to critically evaluate health information in digital environments.
Bozkurt et al. (Wed,) studied this question.