Identifying and profiling authoritative cardiology-related key opinion leaders on Xiaohongshu: a social media-based...

To identify and characterize distinct types of authoritative cardiology-related key opinion leaders (ACKOLs) on Xiaohongshu and examine their communication characteristics and engagement patterns.

A social media profiling study was conducted on Xiaohongshu. Eligible ACKOLs were identified through manual searches and screened using predefined criteria. We applied a theory-informed 14-indicator profiling framework covering communicator credibility, social network visibility, message production, message expression and communication style, and audience engagement. K-means clustering was performed to classify ACKOLs, and word clouds were generated to visualize thematic characteristics.

A total of 150 ACKOL accounts comprising 46,616 posts were included. Four distinct types were identified: Public Health Educators, Clinical Narrators, Academic Interactors, and Authoritative Experts. Public Health Educators focused on accessible prevention-related science popularization content. Clinical Narrators emphasized clinical case sharing and psychosocial support. Academic Interactors showed the highest engagement and the strongest academic dissemination profile. Authoritative Experts had the largest follower base and strongest professional authority but relatively lower engagement. Together, these ACKOL types demonstrated complementary roles in information dissemination, emotional support, and audience engagement.

ACKOLs on Xiaohongshu exhibit substantial heterogeneity in communication strategies and audience engagement. Different ACKOL types jointly form a complementary digital health communication ecosystem that may support cardiovascular disease management and patient-centered health communication.