UMMS Affiliation

Department of Population and Quantitative Health Sciences; School of Medicine

Publication Date


Document Type



Allergy and Immunology | Health Communication | Immune System Diseases | Medical Immunology | Respiratory Tract Diseases | Social Media


BACKGROUND: Increasingly, social media is a source for information about health and disease self-management. We conducted a content analysis of promotional asthma-related posts on Instagram to understand whether promoted products and services are consistent with the recommendations found in the Global Initiative for Asthma (GINA) 2019 guidelines.

METHODS: We collected every Instagram post incorporating a common, asthma-related hashtag between September 29, 2019 and October 5, 2019. Of these 2936 collected posts, we analyzed a random sample of 266, of which, 211 met our inclusion criteria. Using an inductive, qualitative approach, we categorized the promotional posts and compared each post's content with the recommendations contained in the 2019 GINA guidelines. Posts were categorized as "consistent with GINA" if the content was supported by the GINA guidelines. Posts that promoted content that was not recommended by or was unrelated to the guidelines were categorized as "not supported by GINA".

RESULTS: Of 211 posts, 89 (42.2%) were promotional in nature. Of these, a total of 29 (32.6%) were categorized as being consistent with GINA guidelines. The majority of posts were not supported by the guidelines. Forty-one (46.1%) posts promoted content that was not recommended by the current guidelines. Nineteen (21.3%) posts promoted content that was unrelated to the guidelines. The majority of unsupported content promoted non-pharmacological therapies (n = 39, 65%) to manage asthma, such as black seed oil, salt-room therapy, or cupping.

CONCLUSIONS: The majority of Instagram posts in our sample promoted products or services that were not supported by GINA guidelines. These findings suggest a need for providers to discuss online health information with patients and highlight an opportunity for providers and social media companies to promote evidence-based asthma treatments and self-management advice online.


Asthma, Clinical guidelines, Internet, Misinformation, Qualitative methods, Social media

Rights and Permissions

© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

DOI of Published Version



Heineman B, Jewell M, Moran M, Bradley K, Spitzer KA, Lindenauer PK. Content analysis of promotional material for asthma-related products and therapies on Instagram. Allergy Asthma Clin Immunol. 2021 Mar 8;17(1):26. doi: 10.1186/s13223-021-00528-3. PMID: 33685515; PMCID: PMC7938386. Link to article on publisher's site

Journal/Book/Conference Title

Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

Related Resources

Link to Article in PubMed

PubMed ID


Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.