Following celebrities’ medical advice: meta-narrative analysisBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7151 (Published 17 December 2013) Cite this as: BMJ 2013;347:f7151
- 1Department of Clinical Epidemiology & Biostatistics and McMaster Health Forum, McMaster University, 1280 Main Street West, MML-417, Hamilton, Ontario, Canada L8S 4L6
- 2Department of Global Health & Population, Harvard School of Public Health, Boston, MA, USA
- 3Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Correspondence to: S J Hoffman
- Accepted 10 November 2013
Objective To synthesise what is known about how celebrities influence people’s decisions on health.
Design Meta-narrative analysis of economics, marketing, psychology, and sociology literatures.
Data sources Systematic searches of electronic databases: BusinessSource Complete (1886-), Communication & Mass Media Complete (1915-), Humanities Abstracts (1984-), ProQuest Political Science (1985-), PsycINFO (1806-), PubMed (1966-), and Sociology Abstracts (1952-).
Inclusion criteria Studies discussing mechanisms of celebrities’ influence on people in any context.
Results Economics literature shows that celebrity endorsements act as signals of credibility that differentiate products or ideas from competitors and can catalyse herd behaviour. Marketing studies show that celebrities transfer their desirable attributes to products and use their success to boost their perceived credibility. Psychology shows that people are classically conditioned to react positively to the advice of celebrities, experience cognitive dissonance if they do not, and are influenced by congruencies with their self conceptions. Sociology helps explain the spread of celebrity medical advice as a contagion that diffuses through social networks and people’s desire to acquire celebrities’ social capital.
Conclusions The influence of celebrity status is a deeply rooted process that can be harnessed for good or abused for harm. A better understanding of celebrity can empower health professionals to take this phenomenon seriously and use patient encounters to educate the public about sources of health information and their trustworthiness. Public health authorities can use these insights to implement regulations and restrictions on celebrity endorsements and design counter marketing initiatives—perhaps even partnering with celebrities—to discredit bogus medical advice while promoting evidence based practices.
We thank Julia Belluz, Timothy Caulfield, Jennifer Edge, Farrah Mateen, Ray Moynihan, Daniel Rosenfield, and Anna Song for feedback on earlier drafts of this manuscript.
Contributors: SJH conceived the study, led its methodological design, and cowrote the manuscript. CT led implementation of the literature searches, assessed the studies for inclusion or exclusion, and cowrote the manuscript. Both authors approved the final version of the manuscript and take responsibility for the integrity of the findings. SJH is the guarantor.
Funding: SJH is supported by the Canadian Institutes of Health Research and the Trudeau Foundation. Both authors were independent from sources of funding in designing, researching, writing, and submitting this report.
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Ethical approval: Not required.
Data sharing: No additional data available.
Transparency: The guarantor affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.
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