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Effect of Health Influencer Literacy Education on Evaluation of Social Media Health Advice among University Students in Nigeria

Abstract

Social media has become an increasingly important source of health information for university students, with health influencers using platforms such as Instagram, TikTok, YouTube, Facebook, and other digital media to share information about nutrition, fitness, mental health, medications, skincare, reproductive health, and disease prevention. Although health influencers may contribute to health awareness, some social media health advice may be inaccurate, exaggerated, commercially motivated, unsupported by scientific evidence, or inappropriate for individual health conditions. University students who frequently encounter health content online may therefore be exposed to unreliable advice, particularly when they have limited skills for evaluating the credibility of health influencers and their claims. Health influencer literacy education provides an opportunity to improve students' ability to critically assess social media health advice before accepting or acting upon it. Against this background, this study investigates the effect of health influencer literacy education on evaluation of social media health advice among university students in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Theory, and Social Cognitive Theory. The Health Belief Model explains how students' perceptions of susceptibility to health misinformation, perceived severity of potential consequences, perceived benefits of evaluating health advice, perceived barriers, and cues to action may influence their information-evaluation practices. Health Literacy Theory emphasizes the ability to obtain, understand, critically evaluate, and appropriately use health information when making health-related decisions. Social Cognitive Theory emphasizes observational learning, behavioural modelling, self-efficacy, reinforcement, and the influence of social and digital environments on students' health-information behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how health influencer literacy education may influence students' evaluation of social media health advice in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise undergraduate students enrolled in selected public and private universities in Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties, departments, academic levels, and eligible students. Health influencer literacy education will be assessed using indicators such as exposure to influencer-literacy education sessions, frequency and duration of education, knowledge of health influencers and sponsored content, awareness of commercial interests and conflicts of interest, knowledge of credible health-information sources, ability to assess influencer qualifications, understanding of evidence-based health claims, awareness of misleading testimonials, knowledge of advertising and promotional tactics, ability to identify unsupported claims, and understanding of when professional medical advice should be sought. Evaluation of social media health advice will be assessed using indicators such as checking the qualifications and credentials of health influencers, examining the evidence supporting health claims, comparing information with credible health sources, identifying sponsored or promotional content, recognizing exaggerated or sensational claims, assessing references and sources, distinguishing personal experience from scientific evidence, identifying potentially harmful recommendations, and seeking professional advice before acting on questionable health information. Data will be collected using structured questionnaires, health-information literacy assessment tools, scenario-based evaluation tests, social media health-advice evaluation instruments, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, social media use, preferred platforms, sources of health information, exposure to health influencers, and health-advice evaluation practices. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of health influencer literacy education on evaluation of social media health advice. Where a quasi-experimental design is adopted, evaluation scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that health influencer literacy education has a significant positive effect on evaluation of social media health advice among university students in Nigeria. Students exposed to structured and practical health influencer literacy education are expected to demonstrate greater ability to critically evaluate online health advice than students without comparable exposure. Education may improve students' ability to assess influencer qualifications, identify sponsored content, recognize exaggerated health claims, distinguish personal opinions from evidence-based information, verify claims using credible sources, and identify health advice that requires professional confirmation. Practical exercises involving realistic social media posts and health-influencer content may strengthen students' ability to recognize misleading information and reduce reliance on popularity, follower counts, testimonials, or persuasive presentation as indicators of credibility. However, the rapid spread of social media content, sophisticated advertising techniques, algorithm-driven exposure, peer influence, confirmation bias, and the difficulty of distinguishing genuine expertise from online popularity may reduce the effectiveness of education alone. The study therefore expects continuous, practical, accessible, and culturally appropriate health influencer literacy education, supported by improved access to credible health-information sources, to contribute significantly to improved evaluation of social media health advice among university students in Nigeria. The study is expected to contribute to the literature on health misinformation, social media health communication, health influencer literacy, digital health literacy, health-information evaluation, university student health, health education, health promotion, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, universities, student health services, public health practitioners, health communication specialists, digital health organizations, healthcare professionals, social media platforms, development partners, and policymakers regarding strategies for improving the quality of health information accessed by young adults. The study will also provide evidence-based recommendations for integrating health influencer literacy into university health-promotion programmes, strengthening students' digital health-information evaluation skills, promoting responsible health communication by social media influencers, improving awareness of credible health-information sources, and developing sustainable interventions for reducing the impact of unreliable social media health advice among university students across Nigeria.

Keywords: Health influencer literacy education, social media health advice, health-information evaluation, university students, health misinformation, digital health literacy, social media, health communication, health education, Nigeria, public health.