Vivat Academia (2025).

ISSN: 1575-2844

Received: 12/11/2024 Accepted: 06/04/2025 Published: 06/18/2025

EVALUATION OF THE PERFORMANCE OF HEALTH INFLUENCER PROFILES AND THEIR PERCEPTION AND IMPACT ON YOUNG PEOPLE

Azucena García García[1]:

University of Valladolid. Spain.

mariaazucena.garcia@uva.es

Lorena Azcona Villoria:

University of Valladolid. Spain.

lorenaazcona@gmail.com

Noemí Martín García:

University of Valladolid

noemicarmen.martin@uva.es

How to cite the article:

García García, Azucena, Azcona Villoria, Lorena & Martín García, Noemí (2025). Evaluation of the performance of health influencers' profiles and their perception and impact on young people. Vivat Academia, 158, 1-21. https://doi.org/10.15178/va.2025.158.e1590

ABSTRACT

Introduction: The consumption of social media and content created by influencers is increasing, and the time spent on these new media continues to grow. Influencers use these platforms to share content and motivate their followers, influencing their purchasing decisions and transforming marketing. The objective of this work is to understand the performance (reach and engagement) of health influencers profiles and the impact and perception of their communications among young people. Methodology: A dual quantitative methodology was used and developed in two phases. The first phase was based on secondary data provided by the web analysis tool Fanpagekarma, and the second phase was conducted with surveys of 154 young students from the Degree in Advertising and Public Relations. Results: The study shows that health influencers on Instagram, such as @marianrojasestape and @marioalonsopuig, have a large number of followers and generate high engagement. Profiles that post more frequently, such as @farmaceuticofernandez, tend to have more interactions. Surveys reveal that 89% of young people follow these influencers, valuing their content as useful and trustworthy. Additionally, 88.3% have followed some recommendations from these influencers, mainly in areas such as mental health and physical exercise. Discussion: The results highlight the importance of consistency and quality of content to maintain engagement. The positive correlation between perceived usefulness and trust in the profiles underscores the need to maintain high standards of accuracy and relevance. However, the risks of spreading unverified information must be considered, emphasizing the importance of ethics and responsibility in health communication. Conclusions: Health influencers play a significant role in health education and the promotion of healthy habits among young people. Their ability to generate engagement and trust makes them key allies in public health communication. It is essential that both content creators and consumers maintain a critical and responsible approach to using these platforms.

Keywords: influencers; health; impact; reach; engagement; young people.

1. INTRODUCTION

The Royal Spanish Academy defines social networks as an

Information society service that offers users an internet-based communication platform so they can generate a profile with their personal data, facilitating the creation of communities based on common criteria and enabling communication between its users, so they can interact through messages, share information, images or videos, allowing these publications to be immediately accessible to all users in their group (n.d.).

This definition already suggests that these platforms provide a service to society through their content. Furthermore, they all enable multidirectional interaction between users and their virtual environment, defined by We Are Both (2022) as “the ability to hold conversations and exchange opinions among a large number of members on one or more topics” (para. 4). The concept of “social network” predates the internet, dating back a century and referring to relationships within a group or social system. Barnes (1954) used the term to analyze social classes in Norway, describing networks as constructed by territory, the occupational system, and personal relationships. Lozares (1996) and Requena Santos (1996) also provided definitions, highlighting networks as sets of actors linked by social relationships.

The increased use of social media has significantly boosted the growth of the influencer phenomenon, defining it as follows:

A person who has credibility on a specific topic can influence the decisions of other people, based on their authority, knowledge and position, and has a significant number of admirers who follow them and who are motivated thanks to the relationship they have been able to build with them over time (Montas, 2023, p. 3).

Influencers, in turn, leverage social media connectivity to share relevant and engaging content, creating large communities of followers. According to the IAB Spain (2024) Social Media Study, 45% of users say they search for information on social media before making a purchase, while Campines Barría (2024) states that 38.6% are influenced by influencer comments in these purchasing decisions. Influencers' ability to generate authentic and engaging content has transformed marketing strategies, allowing brands to reach their target audiences more effectively and in a personalized way. Proof of this is that Unilever, one of the world's leading advertisers, has focused its communication on these influencers in 2024, according to Ezequiel Jones, Digital Marketing Media and Commerce Leader in Latin America, because, in his words, “they generate the most engagement” (Kantar Media, 2024).

Likewise, the topic of health education associated with the use of ICTs has become a relevant issue given that information overcomes traditional communication barriers "in order to extend its impact on the population and with this the benefits of promotion and prevention" (Hernández-Sarmiento et al., 2020, p. 501). Particularly in the young population that makes intensive use of the internet and social networks (Unicef España, Universidad de Santiago de Compostela y Consejo General de Colegios Profesionales de Ingeniería en Informática [2], 2021). Taking into consideration the data from a report by the World Health Organization (WHO) which states that in 2021, 1.5 million young people between 10 and 24 years of age died (4,500 per day), most of these due to injuries, trauma, interpersonal violence, self-harm behaviors and ailments related to motherhood. Furthermore, according to this same report, “half of mental disorders in adulthood have already begun by age 18” (WHO, 2024, para. 4).

Therefore, this study has a two-fold objective. First, it seeks to evaluate the reach and level of engagement of communications issued by influencers in the health sector. Second, it aims to analyze the perception and impact of such content on young followers.

The results of this work will allow the design of effective communication strategies for brands and maximize the impact of health messages in an environment where health is one of the main elements that contribute to the happiness of the population (Centro de Investigaciones Sociológicas [3] [CIS], 2024a) and one of its main concerns (CIS, 2024b).

2. THEORETICAL FRAMEWORK

Modern social media was born to satisfy the human need to socialize. Its origin dates back to ARPAnet , created in 1947 for the US Department of Defense. In 1971, the first email was sent, and in 1991, the World Wide Web was opened to the public (Martín-García, 2017). Messenger, SixDegrees , Friendster, MySpace, and LinkedIn were some of the first platforms. Facebook, created by Mark Zuckerberg in 2004, and YouTube, launched in 2005, revolutionized communication and entertainment. Twitter, WhatsApp, Instagram, Pinterest, Twitch, TikTok, and BeReal are other social networks with the most users that have emerged since then.

Social media offers connectivity and social support, access to information and resources, an outlet for personal expression, and an opportunity to develop digital skills (Ellison et al., 2007). These advantages are crucial in today's globalised society. According to the 2024 IAB Spain Social Media Study, Spanish users spend an average of 1 hour and 8 minutes on these channels, with 1 in 3 following some type of influencer. The most common classification of social media is based on content. Thus, there is vertical social media (specific topics) and horizontal social media (general topics) (Navarro, 2015). The main characteristics of social media are connectivity, interaction, personalisation, real-time functionality and virality (Correduría Inteligente, 2019). While social media has transformed communication, social mobilization and global connection, it has also brought challenges such as polarization and misinformation (González Basto, 2023).

Brands began to have a presence on social media around 2006-2007 with Facebook Pages, allowing companies and individuals to manage their own advertising campaigns on social media (Kaplan & Haenlein, 2010). These platforms allow companies to reach a global audience quickly and effectively by allowing them to measure the impact of commercial messages with tools such as Facebook Insights and Twitter Analytics. In addition, social media offers advanced segmentation tools, allowing brands to target their messages to specific audiences based on interests, behaviors, and demographics. This not only improves the effectiveness of advertising campaigns but also optimizes return on investment. Direct interaction with consumers through comments, messages, and reactions facilitates two-way communication, fostering closer and more personalized relationships (Tuten & Solomon, 2017). This interaction also provides valuable insights into customer tastes and realities, allowing brands to adjust their strategies and the content of their marketing messages in real time. It also facilitates the ability to measure and analyze the performance of social media campaigns with tools such as Facebook's Band Lift , which allow measuring the impact of advertising campaigns on brand perception (Meta Business Help Center, 2023).

In this context, influencers play a crucial role for brands thanks to their ability to reach specific audiences and generate trust (Martínez-Sanz et al., 2023). Brands capitalize on the credibility and authenticity that these individuals have cultivated among their followers, a phenomenon analyzed in depth in the documentary Anuncios hasta en la sopa[4] (Harper, 2016). Influencers not only amplify the reach of brand messages, but also make them more persuasive and connect in a more emotional way (Sánchez-Fernández & Jiménez-Castillo, 2021). Furthermore, influencers can provide direct and valuable feedback on products and services, helping brands improve and adapt their offerings. In the current context, there are different types of influencers depending on, for example, their number of followers: celebrities (public figures), influencers (more than 50,000 followers), and microinfluencers (fewer than 50,000 followers) (Carbellido, 2024). According to the influencer agency Hello Monday, engagement is a key parameter to measure the effectiveness of an influencer (Belén, 2024). This concept refers to the level of active participation of users and it is measured through likes, shares or comments (Ballesteros Herencia, 2019). Relationship marketing strategies include identifying customers, advertising products, collecting data after the sale, offering after-sales service, developing customer potential and creating a community (Miranda Barragán et al., 2022). Therefore, influencers represent a vital extension of social media marketing strategies, helping brands connect more effectively and meaningfully with their audiences in an environment where it is increasingly difficult to reach certain targets.

Specifically, health influencers are individuals who communicate health-related topics through social networks. They are typically professionals who speak from their experience and background, though they may also be patients sharing their personal experiences. The role of influencers has been the subject of much debate, as the distinction between advertising and opinion can be unclear, potentially causing confusion among followers (Infosalus, 2022). Some authors, such as García-Rivero et al. (2021), have highlighted the dangers of non-professional influencers, stating that 'influencers who disseminate commercial information among their content can achieve high user penetration based on content with low science-based evidence' (p. 38). Others, such as Espinosa-Portilla and Mazuelos-Cardona (2020), have emphasised the need for collaborative, multi-agency and interdisciplinary work to address health misinformation (p. 3).

The topic of health influencers has been addressed in various academic works such as the one developed by Pérez-Ordóñez and Castro-Martínez (2023), who analyze how health micro- influencers on Instagram become opinion leaders, studying profiles with less than 100,000 followers. Martínez-Sanz et al., (2023), meanwhile, investigate health communication on TikTok, focusing on pharmaceutical influencers and their interaction strategies. Castro-Higueras et al. (2021) focus on the visual resources used by healthcare profiles on Instagram during the Covid-19 pandemic, and Jiménez-Marín et al. (2021) focus on analyzing the risks of drug advertising on Instagram, using the case of Paula Gonu, an influencer who recommended an acne treatment. However, none of these studies address the impact of the most followed health profiles in Spain or their influence on young audiences.

3. OBJECTIVES

The first objective was to establish the relevance and importance of influencers in the new digital environment, particularly within the healthcare sector. This study was structured around two general objectives. The first objective was to analyse communications made by influencers, while the second objective was to evaluate how young audiences respond to such information.

General Objective 1. To determine the reach and engagement (performance) of communications generated by healthcare influencers. These parameters will be measured using a series of metrics defined by five specific objectives:

SO1. To determine the number of followers of the main health sector accounts.

SO2. To check out the growth in followers (in %).

SO3. To know the number of posts they make per day.

SO4. To analyze the interaction rate of the posts they make.

SO5. To find out the number of Reactions, Comments, and Shares generated by these posts.

General Objective 2. To analyze the perception and impact of health influencers' content on younger followers. To answer this question, two specific objectives were developed:

SO6. To evaluate the consumption of this content and young people's motivations for following these influencers.

SO7. To recognize the impact that influencers' recommendations have on young people.

Young people were selected for this study because they represent a new form of information consumption due to their use of digital technologies. They prefer the internet to TV because of its immediacy, ease of access and constant updates (Costera Meijer, 2007). According to a study by Jaume I University, only 28.8% of young people read newspapers, opting instead to use social media for information (Yuste, 2015). Social media enables the rapid and superficial consumption of information, adapting to multitasking and the need for digital validation (Toledo Vita, 2020). Therefore, understanding this phenomenon among young people will enable insight into the changes that will develop in the media and society in the coming years. Furthermore, the Pan American Health Organization (PAHO), which is affiliated with the WHO, states that promoting health among young people enables them to enter adulthood with greater skills. This allows them to contribute productively to their communities and fosters economic growth (PAHO, n.d.).

4. METHODOLOGY

To address the objectives of this research, a dual methodology developed in two phases was used, both with a quantitative methodology.

The first phase will address the first of the general objectives and, therefore, will address the reach and engagement of the communications made by influencers of the health sector through the metrics developed in the specific objectives. To achieve this, this study will use the Fanpagekarma data source, which is an online tool offering detailed metrics for personalised reports by monitoring social media profiles in real time. This tool has previously been used in social media research by Jayasingh and Venkatesh (2015), Huertas and Marine-Roig (2016), Martínez-Fernández et al. (2015), Gutiérrez Montolla et al. (2018) and Brandariz Portela et al. (2022), to name a few.

This study measures the evolution between September 10, 2024, and October 10, 2024. The sample consists of 12 Spanish healthcare professionals who create content related to health. They include pediatricians, nurses and psychologists, among others. These creators typically use their social media platforms to answer questions in their community, make all kinds of recommendations, promote events, and collaborate with brands. The list published in an article by COM Salud (2022), the communications and marketing agency specializing in health, on the 15 healthcare influencers you should know on Instagram, was used to select the sample. This list is considered to be relevant because it includes trusted healthcare influencers active on Instagram, a platform with high levels of engagement among young people, and is also endorsed by the COM Salud agency, which specializes in healthcare marketing (COM Salud, n.d.) and, therefore, it has an in-depth understanding of what it means to be an influencer specialising in this field.

Only the 12 profiles with a community of followers of 500,000 or more have been selected for this list and are considered to be macro-influencers. Therefore, the profiles of @armandobastidaep, @enfermerasaturada, and @davidcallejo10 were eliminated due to having a community of followers below this number. The profiles analyzed were:

Table 1.

Phase 1 sample. Instagram profiles analyzed.

Profile	Typology of contents
@boticariagarcia	Pharmacy and nutrition
@soyalvarobilbao	Neuropsychologist focused on children
@enfermerojorgeangel	Nursing
@luciamipediatra	Pediatrics
@maria_esclapez	Psychology
@marianrojasestape	Psychology
@marioalonsopuig	Surgery
@ neusmoya.podologist	Pediatric podiatry
@patri_psicologa	Psychology
@mireciennacido	Nursing focused on children
@silviacongost	Psychology
@farmaceuticofernandez	Pharmacy

Source: Elaborated by the authors, based on Fanpagekarma data (2024).

The second phase of the study focuses on addressing the second of the general objectives and the two specific objectives. It therefore seeks to understand the perception and impact of health influencers' content on younger followers. To this end, a quantitative methodology based on surveys was used, as this allows a large amount of information to be collected at a low cost and in a very short period of time (Soberón Miranda and Acosta, 2009). The study involved a trusted sample of 154 individuals aged 18 to 23, students of the Advertising and Public Relations Degree. Out of these, 22% (n=34) were men and 78% were women (n=120). The groups were aged 18 years ( 3%), 19 years (14%), 20 years (15%), 21 years (37%), 22 years (16%), and 23 years (16%). The questionnaire consisted of seven closed questions, five of which were single-choice questions and two of which, specifically the first and last, were multiple-choice questions. The first four focused on answering SO6, while the fifth, sixth, and seventh questions focused on SO7. The questions were as follows:

Q1. What is the main reason you consume health content on social media?

Q2. How often do you consume content from health educators on social media?

Q3. How useful do you consider the information published by health communicators?

Q4. How reliable do you think the health information shared by these content creators is?

Q5. To what extent do health educators' publications influence your perceptions of health issues?

Q6. Have you followed any recommendations from a health educator?

Q7. If you answered “yes” to the previous question, what kind of recommendation have you implemented?

The answers to this questionnaire Q1. a) To obtain reliable information on health topics, b) To improve my lifestyle habits, c) To follow wellness and health trends, d) General curiosity about the topic, e) I do not consume its content. The answers to Q2, Q3 and Q4 were based on a 5-point Likert-type scale (Q2. a) Every day, b) Several times a week, c) Once a week, d) Rarely, e) Never; Q3. a) Very useful, b) Somewhat useful, c) Neither useful nor useless, d) Slightly useful, e) Not useful at all; Q4. a) Very reliable, b) Somewhat reliable, c) Neutral, d) Not very reliable, e) Not at all reliable. The response to Q5. was based on a 4-point Likert-type scale a) A lot, b) Quite a bit, c) A little, d) Not at all, while in Q6. the respondent was also given four response options a) Yes, several times, b) Yes, sometimes, c) Only once, d) Never. Finally, Q7. was only focused on those respondents who consumed content from health influencers and had to select several of these contents that they had put into practice a) Change in my diet, b) Implementation of an exercise routine, c) Improvements in my mental health (meditation, rest habits, etc.), d) Visits to doctors or regular check-ups, e) It helps me debunk myths. The surveys were conducted in October 2024 and were provided online through the Google tool forms.

5. RESULTS

The results of the first part of the study reflect how these profiles have an average of 1,295,684.8 followers (Table 2). Within these profiles, the psychiatrist @marianrojasestape is one of the most followed accounts on Instagram, with more than three and a half million followers, in second place is the surgeon @marioalonsopuig, followed by the neuropsychologist @soyalvarobilbao. The nurse @enfermerojorgeangel, the pediatrician @luciamipediatra, and the pharmacist @farmaceuticofernandez, are in fourth, fifth, and sixth place in terms of most followed profiles on this social network and have communities of more than one million followers.

Table 2.

Reach of social media profiles.

Profile	Followers	Follower growth (in %)	Posts per day
@boticariagarcia	674,759	1.49%	0.9
@soyalvarobilbao	2,187,813	0.96%	0.8
@enfermerojorgeangel	1,030,060	3.08%	2.0
@luciamipediatra	1,097,285	0.69%	1.2
@mariaesclapez	518.012	0.68%	0.4
@marianrojasestape	3,544,799	2.86%	0.5
@marioalonsopuig	2,736,413	2.64%	0.7
@ neusmoya.podologist	597,509	1.36%	0.5
@patripsicologa	678,927	0.91%	1.8
@mireciennacido	709.404	4.39%	0.5
@silviacongost	506,732	1.31%	0.7
@farmaceuticofernandez	1,066,404	2.01%	2.9
Mean (Standard Deviation)	1,295,684.8 (1,023,958.4)	1.9% (1.2%)	1.1 (0.8)

Source: Elaborated by the authors based on data obtained from Fanpagekarma.

The percentage of profile growth between September 10, 2024, and October 10, 2024, is around 1.9%. The nurse and baby care educator, Pedro Camacho, or @mireciennacido, as known by his followers, has increased his audience by 4.4% in one month, followed by @enfermerojorgeangel, which also exceeded 3%. On the other hand, @mariaesclapez, @luciamipediatra, @patripsicologa, and @soyalvarobilbao are the profiles with the lowest increase in followers. Finally, regarding the number of posts they make per day (Table 2), the educator who publishes the most is the pharmacist @farmaceuticofernandez, publishing an average of three pieces of content per day, followed by @enfermerojorgeangel with two posts, and the psychologist @patripsicologa with an average of 1.8 posts per day. In contrast, the profiles @maria_esclapez, @marianrojasestape, @neusmoya.podologa and @mireciennacido do not post daily, but rather every other day. On average, these profiles publish one piece of content per day.

The engagement data for the posts (Table 3), based on the number of reactions, comments, and shares, shows that the profiles @farmaceuticofernandez and @enfermerojorgeangel have the highest number of reactions, with both accounts receiving over a million comments during the month analyzed. On the other hand, the profile @silviacongost, despite having half a million followers, received fewer than 40,000 reactions to its posts. The most followed health profiles in Spain generate an average of 421,282 reactions, comments, and shares per month. In terms of the interaction rate of their posts, psychologist and writer @maria_esclapez achieved the highest interaction rate during the month under analysis, followed by @enfermerojorgeangel with 1.82% interaction on posts and @neusmoya.podologa in third place. On the other hand, those who achieve the least interaction with their posts are psychologists @silviacongost and @patripsicologa, whose posts do not reach 0.5% interaction. The average interaction rate stands at 1.2%.

Table 3.

Profile Engagement. Reactions, Comments and Shares.

Profile	Number of Reactions, Comments and Shares	Post engagement rate
@boticariagarcia	144,720	0.75%
@soyalvarobilbao	477,090	0.84%
@enfermerojorgeangel	1,120,806	1.82%
@luciamipediatra	280,755	0.68%
@mariaesclapez	156,913	2.54%
@marianrojasestape	499.148	1.02%
@marioalonsopuig	693,459	1.17%
@ neusmoya.podologist	131,099	1.58%
@patripsicologa	174,345	0.47%
@mireciennacido	115,998	1.21%
@silviacongost	39.196	0.37%
@farmaceuticofernandez	1,221,855	1.29%
Mean (Standard Deviation)	421,282 (400,455)	1.2% (0.6%)

Source: Elaborated by the authors based on data obtained from Fanpagekarma.

In the second part of the research, which focused on the perception and impact of these influencers' content on younger followers, the survey results show that 89% of young people being surveyed consume this type of content, with general curiosity about the topic being the most valued (31.8%), followed by an attempt to improve their lifestyle habits, selected by 31.2% of respondents as the main reason for their use. In third and fourth place, with the same scores, are obtaining reliable information on health topics and following wellness and health trends, both marked by 13% of users (Figure 1). Notably, only 11% of respondents stated they do not consume this type of content.

Figure 1.

Reasons for using content from health influencers.

Source: Elaborated by the authors (2024)

Regarding the frequency with which they consume this content (Table 4), on average, respondents stated that they consume it more than once a week (3.18%). 37.7% stated that they do so several times a week, 29.9% said they seldom do so, and another 22.1% did so once a week. In contrast, 7.8% consume this content daily, and 2.6% never opt for this type of profile.

Table 4.

Frequency of consumption

Never (1)

Seldom

(2)

Once a week

(3)

Several times a week

(4)

Every day

(5)

Mean (Standard Deviation)

Frequency of consumption

2.6%

29.9%

22.1%

37.7%

7.8%

3.18 (1.032)