The Power of Strategic Social Media Influencer Communication to Improve Black Women's Knowledge and Awareness of Environmental Endocrine-Disrupting Chemicals: Surveys of Instagram Users.

Background: Black women are disproportionately affected by hormone-related health conditions, which may result from higher exposures to endocrine-disrupting chemicals (EDCs) in consumer products. EDCs are chemicals that interfere with the body's natural hormones. Objective: The Product Options in Women-Engaged Research project was developed to educate Black women about EDCs. We assessed the impact of strategic social media influencer (SMI) communication on knowledge and awareness of EDCs and intentions to change product-use behaviors. Methods: We recruited 7 SMIs to engage with their audiences about EDC-related information on Instagram. The SMIs attended a workshop to learn about EDCs in consumer products and then created Instagram content to share with their audiences. We surveyed SMIs at baseline and 1 month after they shared EDC-related content. SMI audiences were surveyed cross-sectionally before and after the SMIs posted EDC-related social media content. We evaluated social media engagement and analyzed the impact of these communications on SMIs and their audience. Results: The social media posts reached over 16,000 accounts and elicited over 28,000 engagements (eg, views, likes, and shares). SMIs' EDC knowledge and awareness increased after attending the workshop and sharing newly created content, and the SMIs had greater intentions to avoid EDCs at follow-up than at baseline. Engagement with the social media content about EDCs also led to positive outcomes among SMI audiences and particularly impacted intentions to engage in exposure reduction behaviors. In total, 80% of follow-up survey respondents reported that, in the future, they will always consider a company's chemical policy (n=68) and product ingredients when shopping (n=73) compared to 26.8% (n=63) and 46.9% (n=115), respectively, of baseline survey respondents who already reported doing so (P<.001). More follow-up respondents than baseline respondents self-reported an intention to avoid parabens (n=33, 32.7% vs n=39, 15.3%; P<.001), bisphenol A (n=25, 24.8% vs n=38, 14.9%; P=.03), per- and polyfluoroalkyl substances (n=17, 16.8% vs n=9, 3.5%; P<.001), and fragrance (n=6, 5.9% vs n=5, 2.0%; P=.08). Conclusions: Our findings demonstrate that strategic SMI partnerships incorporating a culturally tailored training program can be used to reach large audiences of Black women, improve knowledge about EDCs, and promote intentions to change behaviors to reduce exposures to EDCs.