Engagement With Influencers as Sources of Health Information and Product Promotions: A Cross-Sectional Survey of Austrian Youth Aged 15-25 Years

PURPOSE: Social media influencers have become a key source of health information for young people, despite often lacking medical expertise and being driven by commercial interests. This study examines influencers' role in shaping youth health behaviors, focusing on (1) their exposure to and trust in health-related content from influencers; (2) their engagement with influencer marketing of health products; and (3) how demographic characteristics, social media use patterns, digital health literacy, and parasocial relationships influence exposure, trust, and engagement.

METHODS: We conducted a cross-sectional study (January-March 2024) with a stratified sample of 1,003 Austrian youths (15-25 years).

RESULTS: Among the participants, 75.4% follow influencers, and 37.2% indicate following those sharing health-related content. Overall, 82.9% encounter health content from influencers, and 77.6% trust influencers they follow for health information. Furthermore, 52.8% have purchased products based on influencer recommendations, including food and drinks (45.4%), beauty products (42.6%), sports products (32.0%), and dietary supplements (31.2%). Lastly, parasocial relationships strongly predict following, trust, and purchases, while digital health literacy offers protection against influencer advertising.

DISCUSSION: Influencers play a prominent role in shaping young people's attitudes and health behaviors. Targeted educational efforts are crucial to help youth critically evaluate influencers' health content. The findings also underscore the urgent need for policies to protect young people from harmful marketing practices, such as promoting ultraprocessed foods and untested supplements, and point to the importance of addressing individual differences, such as gender and parasocial dynamics, which may shape how influencer content is perceived and acted upon.