BackgroundApproximately one-half of American adults exhibit low health literacy and thus struggle to find and use health information. Low health literacy is associated with negative outcomes including overall poorer health. Health information technology (HIT) makes health information available directly to patients through electronic tools including patient portals, wearable technology, and mobile apps. The direct availability of this information to patients, however, may be complicated by misunderstanding of HIT privacy and information sharing.ObjectiveThe purpose of this study was to determine whether health literacy is associated with patients’ use of four types of HIT tools: fitness and nutrition apps, activity trackers, and patient portals. Additionally, we sought to explore whether health literacy is associated with patients’ perceived ease of use and usefulness of these HIT tools, as well as patients’ perceptions of privacy offered by HIT tools and trust in government, media, technology companies, and health care. This study is the first wide-scale investigation of these interrelated concepts.MethodsParticipants were 4974 American adults (n=2102, 42.26% male, n=3146, 63.25% white, average age 43.5, SD 16.7 years). Participants completed the Newest Vital Sign measure of health literacy and indicated their actual use of HIT tools, as well as the perceived ease of use and usefulness of these applications. Participants also answered questions regarding information privacy and institutional trust, as well as demographic items.ResultsCross-tabulation analysis indicated that adequate versus less than adequate health literacy was significantly associated with use of fitness apps (P=.02), nutrition apps (P<.001), activity trackers (P<.001), and patient portals (P<.001). Additionally, greater health literacy was significantly associated with greater perceived ease of use and perceived usefulness across all HIT tools after controlling for demographics. Regarding privacy perceptions of HIT and institutional trust, patients with greater health literacy often demonstrated decreased privacy perceptions for HIT tools including fitness apps (P<.001) and nutrition apps (P<.001). Health literacy was negatively associated with trust in government (P<.001), media (P<.001), and technology companies (P<.001). Interestingly, health literacy score was positively associated with trust in health care (P=.03).ConclusionsPatients with low health literacy were less likely to use HIT tools or perceive them as easy or useful, but they perceived information on HIT as private. Given the fast-paced evolution of technology, there is a pressing need to further the understanding of how health literacy is related to HIT app adoption and usage. This will ensure that all users receive the full health benefits from these technological advances, in a manner that protects health information privacy, and that users engage with organizations and providers they trust.

Purpose Social media platforms are changing the way consumers and celebrities engage. This research aims to better understand how and why consumers use social media to engage with celebrities, and identify the potential antecedents and outcomes, which may result from these online connections. Design/methodology/approach Both qualitative (two focus groups) and quantitative (survey) methods were used to explore consumer engagement with celebrities on social media. A structural model from the survey data was developed and analyzed. Findings Textual analysis of the focus groups revealed that consumers follow celebrities on social media to obtain career and personal information about the celebrity. Further, authenticity and emotional attachment were identified as favorable aspects of following celebrities on social media. An empirical study confirmed that the constructs of authenticity and emotional attachment positively influence the outcomes of word-of-mouth and purchase likelihood. Research limitations/implications The study was limited by the self-identification of a favorite celebrity and social media site. Future research should include empirical testing of specific celebrities featured on a specific social media site and the development of the constructs identified in the focus groups. Practical implications This research sheds light on the antecedents and outcomes associated with consumer–celebrity engagement on social media. The implications for marketers and advertisers include a better understanding of how celebrities transform themselves and engage with consumers on social media. Originality/value This paper fulfills an identified need to study authenticity and emotional attachment as they relate to celebrities and consumers’ engagements on social media.

Purpose Social media enables consumers to regularly express themselves in a variety of ways. Selfie-postings are the new tool for self-presentation, particularly among millennials. The purpose of this paper is to identify the motivations associated with selfie-postings among female millennials. Design/methodology/approach The exploratory study consisted of 15 in-depth interviews with women who were 19-30 years of age. The analysis of data was facilitated by an iterative constant comparison method between data, emerging concepts and extant literature. Findings Textual analysis reveals impression management to be pivotal in understanding the consumer selfie-posting process. Other sub-themes include happiness and physical appearance. In addition, self-esteem was revealed as a motivator and an outcome. Research limitations/implications The study was limited to females who were 19-30 years of age. Future research should include males and a wider age group and focus on empirical testing of the identified themes. Practical implications This research sheds light on the motivation and outcomes associated with selfie-postings. Implications for marketers and advertisers include a better understanding of how to engage consumers to post content in the form of selfies with brands and products. Originality/value This paper fulfils an identified need to explore the growing trend of selfie-postings and contributes to academic literature in consumer behavior by identifying the motivations of selfie-postings.

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