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Candidates for high office in the United States play an important role in determining the political agenda and shaping public and mass media understanding of which issues should receive attention. Critics contend politicians rarely address mental health, despite the importance of the federal government in ensuring Americans access to quality care. Two studies sought to understand how candidates for the presidency communicated about mental health using formal (mental, depress, anxiety) and informal (crazy, insane) terminology in social media posts and debates. Two coders examined 1,807 tweets from 41 politicians who competed in the 2016 and 2020 races, plus transcripts from 47 debates during the primaries and General Elections. Politicians often stigmatized mental illness, using mental health-related slang to insult opponents. They afforded less attention to policy and calls for action. The authors offer recommendations for mental health professionals and advocates to encourage politicians to address mental health policy while avoiding stigmatizing language.

It is important to evaluate the media's health coverage of Indigenous communities both because these communities have been hit very hard by health inequities, and because misinformation can negatively affect the future health of Indian Country. This study takes the unique angle of examining both Indigenous and non-Indigenous ("mainstream") news publications to evaluate information gaps in health, health policy, and health efficacy coverage. The Indigenous media examined, which covered 14 times more health stories than mainstream media, highlighted health issues in Indian Country through the lens of resilience by using framing to emphasize unequal power, while at the same time providing depth and specificity. Instead of putting Indigenous health stories into historical and cultural context, mainstream media focused on the lack of resources and the chronic struggle of Indigenous communities. Mainstream media often only covered the topic once per outlet; however, those outlets with connections to Indigenous communities did provide more balanced coverage. Instead of promoting change, most mainstream media stories blamed Indigenous people for their situation and offered a doom trajectory for tribes hit hardest by health disparities. This study reveals how embedded framing and mediatization direct non-Native readers' attention away from the systemic deprivation of support to U.S. Indigenous tribes that was guaranteed to them by the U.S. government in tribal agreements. The implications for journalism and policy are discussed.

COVID-19 created a substantial set of challenges for health communication practitioners in the process of planning, implementing, and evaluating entertainment-education (EE) campaigns. EE is a theory and evidence-based communication strategy that employs entertainment media for educational messaging. Here, we briefly review EE campaigns in response to previous health emergencies and present three cases of EE responses to the COVID-19 pandemic from leading global organizations (PCI Media, BBC Media Action, and Sesame Workshop). Responses ranged from adaptation and re-distribution of existing content to creating new content under social-distancing restrictions and utilizing transmedia. These cases demonstrate that EE initiatives responding to future pandemics may be well served by starting with existing infrastructure to quickly build capacity, support, and trust; working with partners to tailor programs to the local context; and continuing to focus on good storytelling while simultaneously considering evolving media formats and theory.

This study highlights the role of local communities in creating culturally rooted health information resources based on comparative effectiveness research (CER), depicting the role of culture in creating entry points for building community-grounded communication structures for evidence-based health knowledge. We report the results from running a year-long culture-centered campaign that was carried out among African American communities in two counties, Lake and Marion County, in Indiana addressing basic evidence-based knowledge on four areas of cardiovascular disease (CVD). Campaign effectiveness was tested through an experimental design with post-test knowledge of CER among African Americans in these counties compared to CER knowledge among African Americans in a comparable control county (Allen). Our campaign, based on the principles of the culture-centered approach (CCA), increased community CER knowledge in the experimental communities relative to a community that did not receive the culturally centered health information campaign. The CCA-based campaign developed by community members and distributed through the mass media, community wide channels such as health fairs and church meetings, postcards, and face-to-face interventions explaining the postcards improved CER knowledge in specific areas (ACE-I/ARBs, atrial fibrillation, and renal artery stenosis) in the CCA communities as compared to the control community.

Public health officials (PHOs) are responsible for providing trustworthy information during a public health crisis; however, there is little research on how the public behaves when their expectations for such information are violated. Drawing on media dependency theory and source credibility research as our primary theoretical framework, we tested how credibility of information from PHOs is associated with people's reliance on a particular communication channel in the context of the 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea. Using nationally representative data (

Suicide prevention media campaigns are gaining traction as a means of combatting suicide. The current review set out to synthesize information about the effectiveness of these campaigns. We searched four electronic databases for studies that provided evidence on the effectiveness of media campaigns. We focused on studies that described an evaluation of the effectiveness of an entire campaign or a public service announcement explicitly aimed at suicide prevention. We identified 20 studies of varying quality. Studies that looked at whether campaign exposure leads to improved knowledge and awareness of suicide found support for this. Most studies that considered whether campaign materials can achieve improvements in attitudes toward suicide also found this to be the case, although there were some exceptions. Some studies found that media campaigns could boost help-seeking, whereas others suggested that they made no difference or only had an impact when particular sources of help or particular types of help-seeking were considered. Relatively few studies had sufficient statistical power to examine whether media campaigns had an impact on the ultimate behavioral outcome of suicides, but those that did demonstrated significant reductions. Our review indicates that media campaigns should be considered in the suite of interventions that might be used to prevent suicide. Evidence for their effectiveness is still amassing, but there are strong suggestions that they can achieve positive results in terms of certain suicide-related outcomes. Care should be taken to ensure that campaign developers get the messaging of campaigns right, and further work is needed to determine which messages work and which ones do not, and how effective messages should be disseminated. There is an onus on those developing and delivering campaigns to evaluate them carefully and to share the findings with others. There is a need for evaluations that employ rigorous designs assessing the most pertinent outcomes. These evaluations should explore the nature of given campaigns in detail - in particular the messaging contained within them - in order to tease out which messages work well and which do not. They should also take into account the reach of the campaign, in order to determine whether it would be reasonable to expect that they might have their desired effect.

With the development of new financing methods in the networked society, and due to the underdeveloped social security system in China, more and more patients and their families have to choose crowdfunding as an important way to raise treatment funds. Using thematic narrative analysis, this paper studied 100 texts of medical crowdfunding on Easy Fundraising from February 27, 2018 to May 1. It is found that the requests used a series of strategies including: constructing the identity of the patient in order to build a disadvantaged image worthy of help; using tragic narration based on the traditional Chinese cultural elements such as "family concept" and "filial piety" and contrast of the patients' experience before and after the illness to mobilize the sympathy of potential donors; and downplaying the needs itself in order to maintain patients' self-esteem.

The Food and Drug Administration, which now has regulatory authority over all tobacco products meeting the statutory definition, is tasked with communicating the risks of these products to the public through health warnings and public education. However, there have been no attempts to summarize what is known about non-cigarette tobacco product (NCTP) health messaging. We conducted a systematic review to examine the existing literature on health communication for NCTPs and identify key research gaps. A total of 45 unique studies were retrieved and coded, with the majority focused on messaging for smokeless tobacco (SLT, k = 32, 71.1%), followed by waterpipe tobacco (WT, k = 9, 20%), electronic nicotine delivery systems (ENDS, k = 2, 4.4%), cigars (k = 2, 4.4%), and a potentially reduced exposure product (k = 1, 2.2%). Studies most commonly examined tobacco product warnings (k = 26, 57.8%) and public education (k = 19, 42.2%), which included mass media campaigns. Most studies examined knowledge, attitudes, and beliefs as outcomes (k = 27, 60%), while behavior was an outcome in the minority of studies (k = 8, 17.8%). Pictorial warnings and public education about NCTPs demonstrated positive impact in some studies, although the literature is nascent. Given the increasing use of NCTPs such as ENDS, WT, and cigars, particularly among adolescents and young adults, more research is needed on effective ways to communicate product risk to those audiences most at risk.

This study employed qualitative methods, conducting 44 in-depth interviews with biological mothers of newborns to understand women's perceptions and use of new media, mass media, and interpersonal communication channels in relation to health issues. Findings contribute to theoretical and practical understandings of the role of communication channels in diffusion of innovations theory. In particular, this study provides a foundation for the use of qualitative research to advance applications of diffusion of innovations theory. Results suggest that participants resisted mass media portrayals of women's health. When faced with a health question, participants uniformly started with the Internet to "Google it up." Findings suggest new media comprise a new communication channel with new rules, serving the functions of both personal and impersonal influence. In particular, pregnancy and the postpartum period emerged as a time when campaign planners can access women in new ways online. As a result, campaign planners could benefit from introducing new ideas online and capitalizing on the strength of weak ties favored in new media. Results expand the innovativeness/needs paradox in diffusion of innovations theory by elaborating on the role of new media to reach underserved populations. These findings provide an opportunity to better understand patient information seeking through the lens of diffusion of innovations theory.

Despite numerous health benefits for babies and mothers, many women do not either initiate or continue breastfeeding for the recommended duration, and increasing breastfeeding is a national priority. It is important to understand media messages on the topic, given that breastfeeding is influenced by many environmental factors and that perceived norms, social support, and perceptions of difficulties predict breastfeeding. The current study analyzes how media covers (1) breastfeeding in general, (2) public breastfeeding, and (3) extended breastfeeding (past 1 year). Guided by the theory of planned behavior, this study analyzes 318 news articles sampled from 10 of the most commonly read mainstream newspapers from 2008-2013. This sample covers a wide range of topics related to breastfeeding, including health benefits, societal reform efforts, social/human interest stories, parenting choices, and stories about pumped breast milk and formula. The results indicate approving social norms by public health officials and medical professionals about breastfeeding in general. A significantly larger number of articles discussed positive behavioral beliefs associated with breastfeeding rather than negative behavioral beliefs. However, articles more often presented barriers, rather than factors that facilitate breastfeeding. Theoretical and practical implications are discussed.

The United States spends more on health care than any other country in the world, but often experiences poorer health outcomes and lower patient satisfaction than other developed countries. One possible explanation for this paradox is overtreatment, the use of medical tests and treatment for which harms outweigh benefits. Because journalists play a key role in informing people about the health care system, including issues such as overtreatment, it is important to understand how they define the issue and its importance. This qualitative study of health news journalists offers an analysis of journalists' perspectives on overtreatment coverage. The interviews produced four major themes in regard to journalists' beliefs about overtreatment and its coverage: journalists' roles and responsibilities, the medical context, causes of overtreatment, and economics/costs. Journalists view overtreatment as an important but complex issue driven by Americans' faith in medicine and cultural norms that make uncertainty unacceptable. The medical contexts most associated with overtreatment are cancer testing and treatment and overprescribing. Journalists see themselves as providing information to help consumers make personal treatment decisions, rather than helping audiences understand health policy. For decades, the American public has expressed dissatisfaction with the U.S. health system; in one recent assessment, two-thirds of Americans graded the overall quality of health care in the country at a "C" or worse (Blendon, Benson, SteelFisher, & Weldon, 2011; Blendon, Brodie, Benson, Altman, & Buhr, 2006). A study of patient satisfaction in 11 Western countries showed greater dissatisfaction with the U.S. system than with those in any of the comparison countries, with more than one-quarter of Americans saying the U.S. health system needs to be completely rebuilt (Papanicolas, Cylus, & Smith, 2013).

The mass media provide an important channel for delivering crisis and emergency risk information to the public. We conducted a content analysis of 369 newspaper and television broadcast stories covering natural disaster and foodborne outbreak events and coded for seven best practices in crisis and emergency risk messaging. On average, slightly less than two (1.86) of the seven best practices were included in each story. The proportion of stories including individual best practices ranged from 4.6% for "expressing empathy" to 83.7% for "explaining what is known" about the event's impact to human health. Each of the other five best practices appeared in less than 25% of stories. These results suggest much of the risk messaging the public receives via mass media does not follow best practices for effective crisis and emergency communication, potentially compromising public understanding and actions in response to events.