Influencers are conventionally known for motivating followers to buy clothes, gadgets or to buy into a lifestyle. But during the COVID-19 pandemic, Portugal’s Directorate-General of Health has been using influencers for an entirely new kind of work: guiding people across the nation through pandemic public health measures.
The Directorate-General of Health has identified trusted members of communities, from firefighters, scout leaders and representatives of university societies to municipality leaders and teachers, to inform and motivate people to comply with the changing COVID-19 protection measures. Since May 2020, over 5000 micro-influencers have been trained.
By establishing a network of influencers across the nation, it was hoped that accurate and up-to-date COVID-19 information could reach everyone, leaving no one behind. The WHO/Europe Behavioural and Cultural Insights (BCI) unit, a new flagship initiative, is currently supporting the Directorate-General of Health to evaluate the project.
A human early-warning system
The project was initially targeted at vulnerable groups, such as elderly people in Portugal’s interior, who traditionally have access to fewer resources. However, after significant uptake by interested national associations and other parties, the project has now expanded to cover the whole country.
This network of influencers acts as a human early warning system, able to disseminate guidance rapidly and in a highly devolved way. The Directorate-General of Health organized train-the-trainer workshops to establish relationships with these influential community figureheads. They were also provided with skills to tailor materials such as flyers and workshop content to meet the needs of the target groups they were supporting.
The micro-influencers shared a range of information with their audiences, for example describing COVID-19 symptoms, highlighting health measures and directing people where to go to find out more. One of the great benefits of enlisting their help was their nonpartisan nature, and the information they conveyed was followed, at least in part, because it came from a familiar and trusted voice in the community.
Community “sentinels”
The flow of communication has also been multidirectional, with influencers acting as listening posts or “sentinels” in the community. They have, in turn, provided feedback to the Directorate-General of Health on a range of COVID-related issues, such as the uptake of health measures in local communities and any local concerns about clarity of information. Resources have then been duly dispersed by the Directorate-General of Health according to need, allowing a dynamic and reflexive response to the COVID-19 pandemic at all levels of public health.
As part of a growing portfolio of behavioural and cultural interventions implemented during the pandemic, the BCI unit is working with health authorities in Portugal to evaluate the project and understand where it could be improved, with an eye to providing recommended solutions to Member States on similar schemes for other diseases and illnesses in the future.
A central question is whether the intervention also plays a role in increasing health equity, trust and well-being, particularly for marginalized groups. Although the full impact of the micro-influencer project is yet to be seen, it represents an inspirational and pioneering effort to educate and protect people against COVID-19 using the power of community.