Health-Related Opinion Leadership In Social Media: Attractive Health-Focused Contents For Instagram Users


Health-consciousness is always an important cosumption pattern for consumers and mostly associated with healthy nutrition. With the increasing popularity of social media, the focus of “health” is also carried into social media platforms. The owners of social media accounts have begun to create health-related contents and the followers of them interact with these accounts based on this focus. In the present study, it is aimed to highlight that interaction between health-related accounts and health-conscious users in the example of Instagram and exploring the causes of that interaction. Data gathered from Instagram accounts which were selected with the association method were analyzed through the social aspects analysis (number of likes and number of comments) and content analysis. The interaction between accounts and individual users was highlighted and attractive topics were explored to be food groups-minerals, healthy recipes, instructiveness, motivation, negative information, raw materials, serving size control, the importance of exercise, visuality, weight control, and well-being. Limitations, academic and managerial implications were given.

Keywords: Health-consciousnesshealthy consumption behavioropinion leaderscontent analysissocial media marketing


Healthiness is an important factor for people and generally associated with nutrition and nutritional behaviors (Magnusson, Arvola, Hursti, Åberg, & Sjödén, 2003). That means people consider living and being healthy as a consequence of eating healthy. In Turkey, people also have the similar understanding (Gfk, 2017). According to the report of Gfk (2017), people associate the concept of “healthiness” with drinking enough water (84%) and consuming healthy/nutritious foods (80%). Most of people try to eat three meals in a day and some of them extra two snacks. Increasing demand to organic foods in Turkey is an another indicator of living healthier (Ministry of Food, Agriculture and Livestock, 2016). In the report of Ministry of Food, Agriculture and Livestock (2016), it is highlighted that the number of organic food categories reached 213 and revenues generated from exportation of the products in these categories reached $ 79 million as of 2014. That shows the development of the sector in Turkey on both production and consumption sides.

Another focus of the study, social media, is also very popular in Turkey for the companies and the individual users (“We Are Social and Hootsuite”, 2017). 60% of the population use Internet and they are also active social media users who mostly access their accounts via mobile. People spend an average of seven hours with their computers, three hours with their phones, and three hours in social media platforms in a day. That constitutes a strong tool for companies. According to the report (“We Are Social and Hootsuite”, 2017), 52 % of the population search online products or services in a month, 52 % of the population visit an online retail store, 43 % purchase a product or service online. When it comes to the devices used for online purchases, 32 % of the population use a laptop or desktop computer and 31 % of the population use a mobile device. For all these e-commerce and other daily activities like searching news etc., Instagram is one of the most active social media platforms, together with YouTube and Facebook. The Instagram Report of DMR Instagram Report (2017) explains the popularity of this platform with the number and the activeness rate of users. Globally, there are 400 million active Instagram users monthly and 75 million people use Instagram actively every day. Turkey, on the other hand, with 22 million active users is in the fourth place (Instagram Usage Statistics, 2016).

In parallel with the focuses of the study, a health-related research in the context of social media was conducted in this study. The aim of this research is to analyse the role of opinion leaders with their health messages in social media in creating an interaction and to explore the most attractive health-focused Instagram messages. In this regard, the theoretical background and the related literature was given firstly. After that, the information about conceptual research model and the used research method to test the model and explore the related relationships. Lastly, before conclusion and discussion, research findings were explained.

Literature Review and Theoretical Framework

Health Consciousness

The term of “health consciousness” is defined as “a measure of an individual’s readiness to take health actions” (Lee et al., 2014, p.31). Health consciousness arises from the interaction between people and environment (Newman, 1999). In the theory of health as expanding consciousness, consciousness refers to informational capacity of human being. People interact with the environment and this process includes the cognitive and affective awareness, physiochemical maintenance and growth processes (Newman, 1999). Health consciousness necessitates taking healthy actions and people who have this focus behave more careful about his/her own health (Becker et al., 1977; Schifferstein & Ophuis, 1998). Besides, they want to improve their health, well-being and life quality (Newsom, Rook, Nishishiba, Sorkin, & Mahan 2005). Nowadays, as consumers begin to give more importance to being and living healthy, they also care about that in the process of food purchasing especially, as a quality parameter (Magnusson et al., 2003; Bower et al., 2003; Chan et al., 2016; Tan et al., 2017). From a general perspective, “health” is found as the most important motive for purchasing behaviors of consumers by itself in all product or service categories (Magnusson et al., 2003; Ureña et al. 2008). On the other hand, motives and attitudes of consumers which are already very important in consumer behavior (Solomon et al., 2012) have also an effect on health consciousness, especially in organic food consumption (Götze, 2002).

Organic food market is handled as a significant channel of consumers to live healthier in most studies (Alvensleben, 1998; Schifferstein & Ophuis, 1998; Padel & Foster, 2005; Michaelidou & Hassan, 2008; Chen, 2009; Kriwy & Mecking, 2012; Pino et al., 2012; Irianto, 2015). Increasing demand for organic foods is found as a consequence of health consciousness in some studies and health consciousness is found to be positively related to consumers' attitude toward organic/healthy foods and the purchasing decision (Michaelidou & Hassan, 2008; Chen, 2009; Kriwy & Mecking, 2012). Moreover, consumers’ healthy lifestyle mediates the relationship between health consciousness and attitude toward organic foods (Chen, 2009). The main reason behind this is that although consumers have “health” focus; their lives may hinder taking healthy actions. With all these relationships, explaining the concept of “health-consciousness” and highlighting the importance of it are aimed with the example of a popular nutrition group, organic foods.

Social Media

Social media is defined as “a group of Internet-based applications that are built on the ideological and technological foundations of Web 2.0 (a platform in which content and software are produced by different companies collaboratively rather than individually) and that allows the creation and exchange of user-generated content (created contents by users in various ways like texts, videos etc.)” (Kaplan & Haenlein, 2010, p. 61). There are hundreds of various social media platforms including social networking sites, shared photos, podcasts, streaming videos, wikis, blogs, and discussion groups (Harris & Rea, 2009). On the other hand, the commercial appearance of Internet has been growing rapidly since its emergence (Howe, 2008).

Internet users can publish, maintain, upload, comment, rate, save, share, connect, unite, and read content through social media (Bernoff & Li, 2008). This group of people, “social media users”, consists of not only young people; they are a huge group involving and representing all of the population (Priest, 2010). Moreover, people in this representative group spend the great majority of their daily lives in social media (Lang, 2010). The popularity of social media and the research gaps about social media for points arising from being a rather new channel in the market as a communication tool enable researchers to study on the field based on both health-focused (Neiger et al., 2013; Antheunis et al., 2013; Korda and Itani, 2013; Moorhead et al., 2013; Avcı & Avşar, 2015; Pazarcı et al., 2015; Jonassaint et al., 2016; 2016; Sesma-Vazquez, Russell-Mayhew, & Williams, 2017) and with some other focuses like brand management (Hollebeek et al., 2014), consumer behavior (Parlak, 2015; Keskin & Baş, 2016; Soleimani et al., 2017), tourism management (Eröz & Doğdubay, 2013; Leung et al., 2013) etc.

In the marketing field, social media plays an important role for both companies and individual users (Kaplan & Haenlein, 2010). Advertising, for instance, is a field in which companies use social media for their communication campaigns (Tuten, 2008; Chu, 2011; Köksal & Özdemir, 2013; West, 2013). Social media includes different types of consumers and provides these different segments to companies, so that companies find their potential consumers through social media directly and more easily (Wellman & Gulia, 1999; Kaplan & Haenlein, 2010). In consumer behavior, on the other hand, social media is also an important tool in the process of information gathering particularly, enabling a mutual interaction between consumers and others (Mangold & Faulds, 2009; Hanna et al., 2011).

Social media providers like Facebook, Instagram, Twitter etc. can be interpreted as a consequence of the commercial side of Internet and as a commercial entity (Alexa, 2010). Instagram, one of these social media providers, is a rather new mobile photo and video capturing/sharing platform by which people capture and share their moments with their followers (friends, families etc.) (Hu et al., 2014). Since its launch, for seven years, it hasn’t lost its popularity both for its users as a communication tool and researchers as a research area (Sheldon and Bryant, 2016; Pittman and Reich, 2016; Chu et al., 2017; Holland & Tiggemann, 2017). Instagram provides a deeper and worthier content including social, cultural and environmental issues from lives of people compared to other text-based social media platforms like Twitter (Hu et al., 2014).

Opinion Leadership

The literature of “opinion leadership” dates back to 1940s (Lazarsfeld, Berelson, & Gaudet, 1944) and is described with that approach: “there are certain people who are most concerned about the issues as well as most articulate about it. We call them the opinion leaders”. It also refers a characteristic of some people who have an effect on the opinions, attitudes, beliefs, motivations, and behaviors of others in general and explained with diffusion of innovation theory mostly (Valente & Pumpuang, 2007). Opinion leaders often adapt to the innovations earlier than the majority and thus lead them about these innovations. That is also in question for new ideas. Moreover, opinion leaders have three main characteristics: they have fewer deflection on their ideas than their group members (followers), there is a differentiation among different opinion leaders who share different opinions and ideas, they have different characteristics from their followers, like about innovations, and so on (Rogers & Cartano, 1962).

After many years, today, with the spread of online social media, traditional information and news sharing processes have been changed (Zhang et al., 2016). People have been exposed to a wide variety of information and news via social media, and they are able to interact with these new information and news (Kwak et al., 2010; Lerman & Ghosh, 2010, Lee & Ma, 2012, Fatma, 2014; Scott, 2015). That has been done through interactive tools of social media like retweets, replies, comments, mentions (e.g. in Twitter) (Crane & Sornette, 2008).

Opinion leaders can be found in various ways in the literature and one of them is about sharing healthy information, health messages and healthy consumption patterns. A study reviewed the literature on the transmission of health messages (Valente & Pumpuang, 2007). In this context, celebrities, self-selection, self-identification, staff selected, positional approach, Judge’s ratings, expert identification, snowball method, sample sociometric, and sociometric are found as methods of the use of opinion leaders in the transmission of health messages. When it comes to a new version of opinion leadership, opinion leadership in social media, the subject is handled with some different perspectives to disclose entreated relationships about online influence, media trust, information seeking, emotions, word of mouth, branding (Huffaker, 2010; Stieglitz & Dang-Xuan, 2013; Turcotte et al., 2015; Weeks et al., 2015; Bao & Chang, 2016; Kelley & Alden, 2016; De Veirman et al., 2017).

Research Framework

In the scope of the present study, opinion leadership in social media in the focus of health-conscious consumption is examined. Figure 1 represents the conceptual research model of the study (Richins & Root-Shaffer, 1988). As can be seen in the model, it is aimed to analyse the role of opinion leaders with their health messages in a social media platform, Instagram, in creating an interaction between users and themselves and between users (consumers) each other through word of mouth. In the literature of opinion leadership, it is argued that involvement should be occur to arise opinion leadership and opinion leadership create an interaction among people (Richins & Root-Shaffer, 1988). Such an interaction represents word of mouth which refers “a very dynamic form of interpersonal communication” in social media age (Shardanand & Maes, 1995; Hennig-Thurau et al., 2004; Litvin et al., 2008). With this approach, the research problem, ambiguous content of social media in the focus of “health consciousness” can be solved by exploring the attractive health-related topics in the sample of Instagram.

Figure 1: Conceptual Research Model
Conceptual Research Model
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Research Design

In order to analyse opinion leadership in social media, Instagram was chosen as the social media platform. Because, Instagram is an active platform with over 150 million users monthly who upload nearly 55 million photos and generate 1.2 billion likes daily (Bakhshi, Shamma, & Gilbert, 2014; Hu et al., 2014). According to Bakhshi et al. (2014), there are two social aspects creating interaction such as number of likes and number of comments. In this regard, these two social aspects helped us to see interaction between opinion leaders and Instagram users and also among Instagram users between each other in order to achieve the aim of this research, analysing the role of opinion leaders with their health messages in social media in creating an interaction between Instagram users. To analyse these two social aspects in accounts of opinion leaders, association method was used firstly. 20 people were asked with the question “Which Instagram accounts do you know in which health related contents are created/shared? Please say the first ten accounts that come into your mind”. Then, most common answers were put in order. After that, the accounts which have over 100K followers and share at least a post almost every day were selected as the sample of the study. Conclusive accounts are shown below in Table 01 :

Table 1 -
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Selected accounts were analyzed through number of likes and number of comments which refer to two social aspects to create interaction in social media (Bakhshi et al., 2014). One-month period (01.09.2017-1.10.2017) was chosen in the process of analysis to see interaction among health-conscious opinion leaders and health-conscious Instagram followers of them. After that, comments of health-related contents (posts) which have the maximum number on each selected account were gathered and analyzed through NVivo 11, a qualitative data analysis program, in order to have a deeper insight about the interaction between health-focused opinion leaders in social media and health-focused followers of them.


The accounts were analysed through number of likes and number of comments between 01.09.2017-1.10.2017. Findings were presented in the Table 2 in order to visualize the conducted complex data including so many numbers.

Table 2 -
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As it can be seen in the Table 2 , selected accounts include health-related contents via photos and videos. Moreover, the number of likes of these contents range from 2847 to 22904 and the number of comments range from 101 to 290. These remarkable numbers are accepted as the indicators of high interaction on the selected accounts representing health-focused opinion leaders.

In order to explore the source of the interaction between opinion leaders and individual users in social media in “health” context, 1746 comments which are sum of the highest number of comments for health-related contents on selected accounts were analysed based on most frequently mentioned topics through NVivo 11. In the process of data analysis, data (comments) was retrieved from Instagram firstly and then the similarities between comments were revealed through “nodes” and “cases” systems on the program (Each account represented a case and each concept represented a node). It was utilized from the nature of this type of content analysis, to reach concepts and relationship in order to explain the situation through data (Yıldırım & Şimşek, 2008). Explored relationships are presented in the Figure 2 .

Figure 2: Health-related topics to create interaction in social medi
Health-related topics to create interaction in social medi
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As it can be seen in the Figure 2 , people interact with health-conscious account owners who were interpreted as opinion leaders in social media based on some significant topics such as food groups-minerals, healthy recipes, instructiveness, motivation, negative information, raw materials, serving size control, the importance of exercise, visuality, weight control, well-being. All these topics are either direct health messages of account owners or fields about which people seek information and ask questions to owners. First of all, people wonder about food groups like protein, carbohydrate etc. or minerals like calcium, potassium etc. and find answers to their questions about these issues on such accounts. They also ask for healthy recipes from account owners. Another and the most important topic is instructiveness. People mostly highlight their improvements and teachings occurred by way of such accounts. Motivation is often mentioned in these accounts and followers are tried to be motivated by photos/videos or strong affirmations. Followers, on the other hand, mention that they see these accounts as a motivator. Besides, people want to check health-related negative information and ask the owners questions like “…... is/are very unhealthy. Is it correct?” Moreover, people want to learn the raw materials and healthiness rates of some foods like which type of flour is healthier to make home-made bread. Serving size is another topic people wonder which foods they can eat (healthy) in what portion. Both account owners and followers highlight the importance of exercise in living healthy as a supplementary contribution to healthy nutrition and talk about that. People give importance to visuality, too. They talk about healthy contents that seem nice to them. Additionally, weight control is often asked to account owners. Health-conscious account owners also give detailed information about that topic. Lastly, physical and mental well-being play an important role on the lives of both the account owners and followers of them. To increase physical and mental well-being, both sides support each other.

Conclusion and Discussions

In this study, opinion leadership in social media was analyzed in the “health-consciousness” context. Research findings provide evidence that social media is interpreted as a very dynamic form of interpersonal communication (Shardanand & Maes, 1995; Hennig-Thurau et al., 2004; Litvin et al., 2008). The number of likes and the number of comments on selected health-conscious accounts show the interaction between account owners and followers in light of two social aspects of social media, namely Instagram (Bakhshi et al., 2014).

To have a better insight and understanding why individual users interact with health-related accounts, the content analysis was conducted with the data retrieved from comments for health-related contents on selected accounts. Food groups-minerals, healthy recipes, instructiveness, motivation, negative information, raw materials, serving size control, the importance of exercise, visuality, weight control, well-being were attractive topics, generated from that content analysis by way of exploring similar mentioned topics on comments on selected accounts and revealing the relationships between these comments, for health-conscious Instagram users (Yıldırım & Şimşek, 2008). All these explored topics show that people are really interested health-related contents in especially food purchasing and consuming (Magnusson et al., 2003; Bower et al., 2003; Chan et al., 2016; Tan et al., 2017). Moreover, it was proved that there is a new form of opinion leadership, opinion leadership in social media (Huffaker, 2010; Stieglitz & Dang-Xuan, 2013; Turcotte et al., 2015; Weeks et al., 2015; Bao & Chang, 2016; Kelley & Alden, 2016; De Veirman et al., 2017), and people interact with the owners of these opinion leaders’ Instagram accounts with the perspective of involvement and word of mouth (Bao & Chang, 2016). People are really gathering information and following the news in a rather new way, in social media, for example in the opinion leaders’ Instagram accounts (Kwak et al., 2010; Lerman & Ghosh, 2010, Lee & Ma, 2012, Fatma, 2014; Scott, 2015).

In addition to useful findings of this research, there are also some limitations and issues that can be improved by further researchers. Sample size, for instance, is a limitation of the research. That size can be increased and it can be studied on a bigger data. Moreover, the present study is conducted with a holistic view to explore the important topics and have a general insight by selecting only a field, health-consciousness. Further research can also categorize opinion leaders based on similar features like professionals, specialists, bloggers, celebrities (without a profession), friends, families etc. With such a categorization, the strength of categories and effectiveness of them can be seen. Further research can also be conducted on another social media platform like Facebook, Twitter etc., and even a comparative study based on selected platforms can be carried out. Finally, companies can be aware of opinion leaders in social media. They can utilize their strength in social media platforms by including these opinion leaders on companies’ communication campaigns and reach their potential customers. For example, each opinion leader in social media can have a different characteristic and different strength contents such as giving healthy recipes, having a successful YouTube channel, creating contents that motives for psychological well-being etc. Companies pay attention these strong characteristics of these opinion leaders and use them as an attractive advertising channel for their promotion.


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