Table 1.

Fourteen mechanisms explaining celebrity influence

Discipline	Mechanism	Description
Economics	1) Signals	Celebrity endorsements act as markers that differentiate endorsed items from competitors.
	2) Herd behavior	Celebrities activate people’s natural tendency to make decisions based on how others have acted in similar situations.
Marketing	3) Meaning transfer	People consume items to acquire the endorsing celebrities’ traits, which have become associated with the product.
	4) Source credibility	Celebrities share personal experiences and success stories associated with the endorsed item to be perceived as credible sources of health information.
	5) Halo effect	The specific success of celebrities is generalized to all their traits, biasing people to view them as credible medical advisors.
Neuroscience	6) Neural mechanisms of meaning transfer	Celebrity advertisements activate a brain region involved in forming positive associations, indicating the transfer of positive memories associated with the celebrity to the endorsed item.
	7) Neuropsychology of credibility	Endorsements from celebrities activate brain regions associated with trustful behavior and memory formation, thereby improving attitudes toward and recognition of the endorsed item.
Psychology	8) Classical conditioning	The positive responses people have toward celebrities come to be independently generated by endorsed items.
	9) Self-conception	People follow advice from celebrities who match how they perceive (or want to perceive) themselves.
	10) Cognitive dissonance	People unconsciously rationalize following celebrity medical advice to reduce the psychological discomfort that may otherwise result from holding incompatible views.
	11) Attachment	People, especially those with low self-esteem, form attachments to celebrities who make them feel independent in their actions, supported by others, and competent in their activities.
Sociology	12) Social networks	Celebrity advice reaches large masses by spreading through systems of people linked through personal connections.
	13) Commodification and social capital	People follow celebrity medical advice to gain social status and shape their social identities.
	14) Social constructivism	Celebrity medical advice may alter how people perceive health information and how it is produced in the first place.

Reproduced from Hoffman SJ, Tan C. Biological, psychological and social processes that explain celebrities’ influence on patients’ health-related behaviors. Archives of Public Health. 2015:73(3). doi:10.1186/2049-3258-73-3