Promoting Cardiovascular Health in Hispanics through Social Media Influencers

Objective: Trustworthy influencers may promote health content on social media. As no definition of such influencers exists, we aimed to identify their attributes to pilot and evaluate a Hispanic/Latino-centered cardiovascular health Instagram campaign led by a model case and an American Heart Association (AHA) ambassador, compared to other health organizations. Methods: A priori frameworks, Walker and Avant’s concept analysis, and literature reviews identified attributes of Trustworthy Social Media Health Influencers , guiding selection of a model case (@dr.mauriciogonzalez). The social media-adapted hierarchy of effects model and Spanish transcripts on the AHA’s Life’s Essential 8™ guided the Instagram campaign. Three pairs of reels (Control Cholesterol; Eat Better/Manage Weight; Be More Active) were posted concurrently on the AHA’s (@american_heart; Chief Medical Officer for Prevention as ambassador) and model case’s accounts (October 8–12, 2024). A collaborative reel on all Life’s Essential 8™ (October 14) linked both accounts (model case as ambassador). Engagement (likes, comments, shares, and saves) and watch time were tracked for 4 weeks, with Instagram polls assessing user willingness to change behaviors. We assessed Instagram engagement, [likes + comments / followers] × 100, and influencer/Spanish content in the past 3 months for 4 other health organizations. Results: The identified attributes of a Trustworthy Social Media Health Influencer were: 1) evidence-based content, 2) professional credentials, 3) authentic content aligned with credentials, 4) avoidance of commercial conflicts of interest, and 5) ≥1,000 followers. The collaborative reel outperformed AHA’s individual reels and the model case’s Control Cholesterol reel, with 186 and 1.5 times more engagement and 243 and 1.6 times more watch time, respectively. Its poll responses (618) were ≤206 times higher than for AHA’s reels, with 100% of responders indicating willingness to change behaviors. AHA’s content had higher engagement (59.5%) than the American Diabetes Association, Endocrine Society, Obesity Society, and National Lipid Association (2.2–15.8%); none of the latter posted Spanish content. Conclusion: Cardiovascular health promotion for Hispanics/Latinos may benefit from underutilized collaborations between Trustworthy Social Media Health Influencers and stakeholder organizations. Consensus on these influencers’ attributes and controlled replication of our strategy are warranted.